I’m scheduled for knee replacement but read so many negatives ?

@genie15 This is such excellent advice! Like you, I had a TKR six years ago and had a terrible recovery! I could not tolerate the pain meds and they had me only using Tylenol, which did not help at all. I swore that I would never have the left knee done! Well…….I have to eat my words because I am having the left knee done on Oct 1st……….different surgeon and different Boston hospital! This surgeon, who is one of the top drs at this hospital, has done many knee and hip surgeries. Through a friend, I know that most of the nurses go to him. He will do “minimally invasive surgery” on my knee, which hopefully will make my recovery a little easier. Also, he told me to start preparing my quads and glutes with exercises that will strengthen them before the surgery. I was never told that with my first TKR. Betweeen now and then, I am exercising every day to build up strength! I had a wonderful PT for the first surgery but she is no longer at the PT practice, so I will have to find someone new. Here in the Boston area, there is a “wait” to get to see a PT because so many “baby boomers” are having knees and hips replaced. I do think that initially, PT will come into my home but I will have to make sure that I get on a “list” for outside PT as soon as I can. I do dread the recovery process (and the length of it!), but I know that arthritis is not going to go away, and possibly continue to progress. I am 76 and generally in good health (although I also have this same arthritis in my left hip!) but for now, the knee is more painful, so I will get that done first. My poor husband was my “caregiver” with the first knee, and it was hard on him, although he did everything that he could possibly do for me!!! I was just a patient in terrible pain for quite a while!!! Hoping that this other knee will be a different and more positive experience for me! Thanks so much for your extremely helpful post!!!

@SusanEllen66 Great answer—my Total Knee Replacement has not been a success. If a person has some pain but their level of pain and have reasonable function, they may want to weigh their options. Would losing weight help, for example?

@steveinarizona and @genie15

Couldn’t have agreed more. Having left TKR done in 2024 and now 4 months after right TKR, my only comment is to have realistic expectations of TKR. Recovery will not be easy and implants cannot really replace our natural knees. My left knee is about 80-90% of the healthy knee and it still feels artificial at times but it sure beats the pain, limited motion and instability before the surgery.

I’m at 9 days post op for left TKR and agree with all the aboves. My experience has been: a flareup of Menieres vertigo and nausea at +48 hrs post op left me dehydrated and missed doses of meds, in the ER til 2 am. 3 days later, in the ER again with bowel blockage, ony took 4 hrs to get that washed out and moving again. So I would emphasize, also strengthen your non-op leg cuz its going to have to do double work for a while getting on and off the pot. Toilet handles/safety rails a must. Riser seat, helpful at the very first but I don’t need it now. Stay on top of fluid and fiber intake, and daily Miralax has been helpful too.
As far as the knee, its doing well with expected swelling and all, no other issues; can tootle around with the walker at will, just cane if balance is ok, no support for one or two steps so full weight bearing.
I did the whole series of PT, steroids, gel injections (both knees) and finally decided its better to do the TKR and get moving again while I’m relatively young (65), rather than wait another 5-10 years and accumulate more damage from sedentary life.
Good luck with your decision!

I am 11 months post op TKR. Choosing the right surgeon is essential for not only the surgery but for after care visits. Choose your best physical therapist and rely on their help and guidance throughout your recovery. At home, ice will be your friend and should be applied multiple times daily. I found an ice machine from Amazon worked the best for me. A slanted pillow was helpful to let leg rest while relaxing. Once cleared for exercise, the recumbent bike is a great machine to help back you back up physically and emotionally. Listen to the professionals you surround yourself with. I am no longer in pain and will celebrate at my 12 months mark.

@genie15 Great post! I agree with you.

Here were my criteria for a knee surgeon:
(1) Does it minimally invasively (i.e.,. subvastus or mid vastus). Traditional surgery cuts the muscle and tendon to get access to the knee while this approach avoids that. My surgeon did mid vastus.
(2) Does not use a tourniquet. Recent research suggests that it is not necessary and could even be counter productive. My surgeon did not use a tourniquet and used tranexamic acid instead.
(3) Does Partial knee replacements, total knee replacements and revisions. My surgeon does all three. One can plan on a partial but not know until the surgeon gets inside the knee area, Partials are actually more complex surgery and revisions are usually the most complex so a surgeon that does all three is more likely to be a skilled one,
(4) There are three types of implants: bicruciate retaining (BCR), cruciate retaining (CR) and posterior stabilized (PS). BCRs are very rare and I know of only three surgeons in the country who regularly do them but I wanted one and got it. My surgeon has been doing BCRs for a decade. It means that I kept all my ligaments instead of losing the ACL and possibly the PCL.
(5) An important part of a TKR is alignment. Our knees/legs have to be properly aligned if we are to walk or run properly. For years the gold standard was mechanical alignment (draw a line straight down the leg), More recently surgeons have been trying to emulate the patient's natural alignment and there are three new forms: kinematic; inverse kinematic and Functional. I had functional.
(6) The surgeon must have extensive experience doing the exact procedure he would do for me. For example, if the surgeon usually uses a tourniquet, I would not want to ask him to do my procedure without it. he is not extensively experienced AT THAT. I would like at least a hundred such procedures, preferably hundreds or even thousands.
(7) The surgeon must have great hands.
(8) The surgeon must have a great mind.

My surgeon did all of this, I had zero post surgery pain and when I started PT in the third week my ROM was 122 and my extension was essentially flat. Four years ago the same surgeon replaced my left hip and I had no post surgery pain then either.

I had my six month checkup recently. My surgeon told me I had no limitations. I am an 81 YO male. I asked him if that meant I could go on trampolines with my grandkids; he said yes. I asked if that meant I could run; he said if I wanted to.

There is no guarantee of a pain free recovery. But doing what @genie15 says is a great way of maximizing ones chance of such a recovery.

In reply to andoman:
I had one TKR and swore I would never do it again. Two years later that knee is reliable and pain free while other joints suffer more and more from arthritis. Arthritis is a progressive disease and there is no cure, no matter what you hear or read. That's the bottom line for dealing with the decision about having knee surgery. The bad leg will only get worse, and so will the other joints. It's your choice how to plan ahead. Another bottom line is one my physical therapist repeatedly told me: "It's all connected." It's an obvious statement, but there are real implications for patients in it. If you are a senior, have not been physically active throughout your life, or have other diseased joints or chronic illnesses, you are in for a really rough road through TKR. I was like that and my experience was horrible. In hindsight I understand that there were critically important things to know and do ahead of time, and they would have improved the experience by 200%. So here's a preparation list based on my own experience and doing lots of reading since then. I hope it will help you:
LOSE THE WEIGHT. Weight is half of your pain. It's making your diseased joint worse every time you stand on that bum leg. My doctor told me every extra pound puts about 7 pounds of stress on that knee. Lose the weight first and maybe you can put off the surgery. If you can't, read the rest of the list.
READ ABOUT THE DIFFERENT TYPES OF KNEE REPLACEMENT SURGERY. It's technical, but it's your future, so you need to know before you choose a surgeon. You get one shot at a new joint and you want it to go well. The worst patient experiences seem to come from problems in surgery and the fixes are rarely successful. Once you know about your choices, make a list of questions about them for the surgeon. Any surgeon who can't or won't answer those questions is a surgeon you should avoid!
FIND THE BEST SURGEON FOR YOU. Do NOT just accept someone else's referral. You can find out about surgeons on line. Experience is the single biggest qualifier. TKR is tricky. They really need to be on top of their game. If you can find one with great patient reviews through patient portals or the hospital website, that's helpful. If the surgeon is distinguished among his/her peers by doing research or inventing a surgical technique, that's a point in their favor. Decide how far you could travel to get surgery from a great surgeon. It could improve your recovery 1000%.
FIND A QUALIFIED PHYSICAL THERAPIST. Look for one with a Ph. D. In physical therapy or one with special certification for knee replacement recovery. You will spend far more time with the therapist than anybody else after surgery. I got one that injured me and set my recovery back months. You need the best you can find. The surgeon will fo little or nothing after the surgery, so having a good therapist is critical. Also be ready to call on your primary physician for advice and meds during recovery.
ICE IS YOUR BEST FRIEND. Recovery depends on sleep. Sleep does not come if you're in pain all night. ICE IS YOUR BEST FRIEND. GET AN ICE MACHINE AND BUY A LARGE SIZED ICE PACK FROM THE PHYSICAL THERAPIST.
GET YOUR BODY READY FOR SURGERY. How? Exercise the muscles around the bad joint. The stronger they are, the more they will support that leg, and the sooner you can get back to living. Also, have someone like a physical therapist evaluate your posture and gait. I learned months too late that standing, sitting and walking with bad posture puts undue stress on the knees. Just learning some posture exercises and how to walk better can reduce pain and swelling significantly, and give you a far better future life.
TRUST YOUR BODY. It will give you feedback all the way through. When it's in pain you can learn to distinguish what kind of pain and what may be causing it. Read as much as you can about how, and how long, the surgical leg heals. If you understand it you will be better able to know when you're given bad advice. Therapists are just people. Some make mistakes. Learn to make your own decisions about what your body can tolerate at each stage of recovery. It's not the same experience for everyone. Listen to your own body. There are no deadlines. Some folks get well in weeks, some months, some years. Don't try to be like anyone but yourself.
SUPER IMPORTANT: FIND A RELIABLE, POSITIVE AND PATIENT COACH. TKR is not a journey you make alone. The coach supervises your meds, food, transportation, exercise and safety when you go back home, for many weeks. Pick someone kind and reliable. Anxiety and depression are part of the journey. The coach can really help emotionally.

Best wishes to you. I hope you have a fast recovery!

No doubt , it’s a big decision . The recovery process is one you’ll never forget. However, it’s worth it. Get ready:
Mentally and physically. Start by doing the exercises you will need to do post surgery. It will encourage you to do the work post surgery. It’s important to have someone to help and encourage you the first couple of weeks. An elevated toilet seat and bars for the toilet were so helpful getting up and down. Eat nutritiously and drink lots of water.
I had tkr in ‘24 and ‘25. Best decision , I do have some occasional soreness and buckling. My surgeon reminded me that it’s not my original knee. It’s worth it . My quality of life has gotten so much better. I can live with the occasional minor issues. Be brave ! Best wishes.

You will know when and if you need a knee replacement. I walk with a broken partial knee replacement for 6-7 years. One day I decided enough is enough and I had to have it done. Weigh the cost of where you are know and where you may be after. Not all replacements are bad. Wish you the best

@momma2lucy
Me too! My husband is VERY active. And,we cruise ( alot- like 5 in the last 14 mos). I am unable to do much. Due to the looong boardingcwalk, I currently have them help via w/ c. And, when I need to get from stem to stern...I use a cane. Out and about, I use nordic walking poles.