Knee #2- am I ready?

Posted by amytro @amytro, Mar 9, 2019

I just hit my 4-week mark post first TKR. My "good" knee took the brunt of compensating for the operative knee and is now really sore (even with the narcotic pain meds). I am seeing my surgeon next week to schedule knee #2. Any advice about how many weeks post-surgery is ideal before getting the other done? I met people in the hospital who were having their second knee done 5 weeks after their first. I was thinking 8-10 weeks would help me to be solid. Any thoughts or recommendations? I know we're all different but am interested to hear how YOU did it! Thank you.

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@contentandwell

@amytro I am in southern NH so go to Boston for most of my medical care, and my TKRs were done down there. As I said, I had a very sudden recovery after my second TKR and had to go to NYC for my daughter's wedding. We went a couple of days early and I walked all over the place! I was amazed. A couple of weeks previous to that I never thought I would be able to do much while there.
Good luck with this, let us know what your doctor says. Is he/she in the Boston area?
JK

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Wow- that's an encouraging story-- your sudden recovery, that it. I'd love one of those for knee #2. I am in in Western Massachusetts- equally close to Hartford, CT, Albany, NY and Boston.

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@mikec

I scheduled my knee replacements 12 weeks apart, the left knee in April and the right knee in July. I started flat trail bike riding 8 weeks after the first knee. My thoughts were that the second knee does take some abuse while you are rehabing the first knee. I wanted to make sure that the muscles around the second knee were back in shape prior to the TKR. The bike riding was low impact excerise that helped with both knees between TKR's. I kept a timeline of my process so that I could track my progress. My first surgery was on April 14th, 2017 and the second knee was done on July 10th, 2017. I have a note that I was walking between 3000 and 4000 steps a day on August 28th, 2017. A couple of other tips that helped me are: Try not to do too much too soon. When you think you have iced enough, ice it more. Be dedicated to doing your therapy routine when the therapist is not with you. It has been 23 months since I started this process and I still do my knee exercise routine everyday. Everyone is different and my timeline is an just an example. Pay attention to your own body/knees and adjust your schedule. Good Luck!

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Please tell me you're not doing knee slides 2 years PO! 🙂

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@contentandwell

@amytro Lots of good advice, but I would wait a bit longer. As has been said, every TKR is different. I would want to be pretty much totally better before embarking on doing it all over again. Bottom line though, I would talk to my surgeon about it. If you are confident of him/her you should take the advice given to you. They want their patients to succeed so they do have your best interest at heart. Your doctor may be fine with doing it soon but may want to delay it longer. Around here none of the top surgeons will do two knees at the same time, but some do and some patients are very happy with the outcome, so doing it soon may work out great for you.
JK

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@amytro @contentandwell Just my two cents but this is the best reply I've heard. Every TKR is different even when done on the same person, by the same surgeon, and at the same hospital. Another thing to consider is that you want enough time to go by to ensure that you did, indeed, pick the right surgeon. You don't want to find out that he used the wrong size implant on both knees! I had a friend who didn't find out until around 5 months PO since she and her PT team thought her progression ( or in her case, lack of) was mostly due to swelling and such. She was glad she waited and had the revision and other knee done by a better surgeon. But if you can by on a Cortisone shot or some other way to help you relieve pain, I would TRY to heal well on the first knee, condition the other, and go from there. Everyone says that the stronger you are the better the recovery but for me, that wasn't true really. Before my RTKR, I did an hour on the Elliptical 5 days a week, upper body weights 4x per week, and did a lot of walking. I was strong and healthy but this Thursday will be 7 weeks PO and my ROM is only 0/106 no assist and bend is around 113 with assistance from myself. (pulling while doing my knee slides) I was hoping to at least be 115 by now but no banana. So, my other knee will have to wait until next year. The verdict is still out on the surgeon as far as I"m concerned. So along with you insurance (make sure you have enough PT days left) there are a few things to consider before getting your other knee done.

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@debbraw

@harley105 - I think you (and I) are both going to see a real difference even another month from now and certainly when we are 6 months out. You are doing all the right things! Does your chiro do any special treatment? I'm doing acupuncture twice a week and that is helpful for me in managing the pain. Best of luck!

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Hi - yes, my chiro was recommended by a friend who had 2 knees before 50. She told me how good he was mixing PT and Chiro techniques. I follow recommendations from people who know where I am because they were there, you know? So he has helped a lot with the sciatica...I'm just going one time a week now. Acupuncture is something I have used for various pain things over the years, but the IT band exercises are starting to make a difference now .. 8.5 weeks out. Good luck!

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@dkapustin

@amytro @contentandwell Just my two cents but this is the best reply I've heard. Every TKR is different even when done on the same person, by the same surgeon, and at the same hospital. Another thing to consider is that you want enough time to go by to ensure that you did, indeed, pick the right surgeon. You don't want to find out that he used the wrong size implant on both knees! I had a friend who didn't find out until around 5 months PO since she and her PT team thought her progression ( or in her case, lack of) was mostly due to swelling and such. She was glad she waited and had the revision and other knee done by a better surgeon. But if you can by on a Cortisone shot or some other way to help you relieve pain, I would TRY to heal well on the first knee, condition the other, and go from there. Everyone says that the stronger you are the better the recovery but for me, that wasn't true really. Before my RTKR, I did an hour on the Elliptical 5 days a week, upper body weights 4x per week, and did a lot of walking. I was strong and healthy but this Thursday will be 7 weeks PO and my ROM is only 0/106 no assist and bend is around 113 with assistance from myself. (pulling while doing my knee slides) I was hoping to at least be 115 by now but no banana. So, my other knee will have to wait until next year. The verdict is still out on the surgeon as far as I"m concerned. So along with you insurance (make sure you have enough PT days left) there are a few things to consider before getting your other knee done.

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@dkapustin definitely the right surgeon is very important. I was very careful about choosing my surgeon, and also the knee. I have not regretted that at all. He has been great, and was extremely responsive when I was in pain for longer than seemed to be typical. He was as happy as I was when the pain lifted so suddenly.
JK

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@amytro I know every person and every surgery is different, but I thought I would share my experience with you. In my opinion I would wait several months if you are able. I had my TKR in May 2017 and like you my old knee took a beating because it was the stabilizing leg. I too was going to have the other knee replaced as soon as I recovered. However, in August, I fell and landed on my new knee and my shoulder. My new knee was fine, but in September, I realized that something was wrong with my shoulder. I went to see a shoulder specialist and found out that I had torn 3 tendons and my bicep muscle. I was scheduled for surgery in October and was released from the knee surgeon even though I was still in PT. I had surgery on my shoulder and they had to repair a good bit of damage due to the fall and arthritis. The span between the 2 surgeries was 5 months. I had a much harder time recovering from my shoulder surgery. Major surgery is a trauma to the body and in my case, I feel needed more recovery time. I was exhausted all the time and after some testing, I recently found out that I was anemic and my B12 levels were very low. I have to wonder if having the 2 surgeries so close together was a factor. I just started taking B12 injections and a high dose of iron. I will be retested in 6 months. I will be cleared from my shoulder surgeon soon and now have gone back to the knee surgeon. I am going to try and schedule my knee surgery in August. This will give me 10 months to recovery from my shoulder surgery and will give my body a chance to raise the iron and B12 levels. I wish I could have waited a few months in between the knee and shoulder surgery, but I had to have the shoulder surgery or I would have risked losing range of motion in my arm. Discuss it with your doctor. Everyone is different. My body just needed a little more time to heal. Good luck to you. Let us know what you decide. I am also interested to see how your second operation goes, since I am about to schedule mine next week.

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@ssbionicknee

@amytro I know every person and every surgery is different, but I thought I would share my experience with you. In my opinion I would wait several months if you are able. I had my TKR in May 2017 and like you my old knee took a beating because it was the stabilizing leg. I too was going to have the other knee replaced as soon as I recovered. However, in August, I fell and landed on my new knee and my shoulder. My new knee was fine, but in September, I realized that something was wrong with my shoulder. I went to see a shoulder specialist and found out that I had torn 3 tendons and my bicep muscle. I was scheduled for surgery in October and was released from the knee surgeon even though I was still in PT. I had surgery on my shoulder and they had to repair a good bit of damage due to the fall and arthritis. The span between the 2 surgeries was 5 months. I had a much harder time recovering from my shoulder surgery. Major surgery is a trauma to the body and in my case, I feel needed more recovery time. I was exhausted all the time and after some testing, I recently found out that I was anemic and my B12 levels were very low. I have to wonder if having the 2 surgeries so close together was a factor. I just started taking B12 injections and a high dose of iron. I will be retested in 6 months. I will be cleared from my shoulder surgeon soon and now have gone back to the knee surgeon. I am going to try and schedule my knee surgery in August. This will give me 10 months to recovery from my shoulder surgery and will give my body a chance to raise the iron and B12 levels. I wish I could have waited a few months in between the knee and shoulder surgery, but I had to have the shoulder surgery or I would have risked losing range of motion in my arm. Discuss it with your doctor. Everyone is different. My body just needed a little more time to heal. Good luck to you. Let us know what you decide. I am also interested to see how your second operation goes, since I am about to schedule mine next week.

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I just want to say that I am 7 weeks PO from a RTKR and there is no way in Hades I would even consider getting the other done until next year if it's possible. I am struggling with this one and will get cortisone shots, etc on my other one until this knee surgery is a distant memory. As you might have guessed, I'm not one of those who breezed through it and was shoveling snow 5 weeks PO.

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@dkapustin

I just want to say that I am 7 weeks PO from a RTKR and there is no way in Hades I would even consider getting the other done until next year if it's possible. I am struggling with this one and will get cortisone shots, etc on my other one until this knee surgery is a distant memory. As you might have guessed, I'm not one of those who breezed through it and was shoveling snow 5 weeks PO.

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Thanks for your reply! I wish cortisone still worked for me but after 5 years of shots, it doesn't. I do think I will chicken out if I don't get it done soon. I'm not shoveling snow but I am recovering well with flexion at 120 after 5 weeks and I'm driving to essential places like PT, the doctor and the pharmacy. I meet with the surgeon to discuss in a week so I'll surely take his opinion into consideration as well! Thank you.

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@amytro

Thanks for your reply! I wish cortisone still worked for me but after 5 years of shots, it doesn't. I do think I will chicken out if I don't get it done soon. I'm not shoveling snow but I am recovering well with flexion at 120 after 5 weeks and I'm driving to essential places like PT, the doctor and the pharmacy. I meet with the surgeon to discuss in a week so I'll surely take his opinion into consideration as well! Thank you.

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@amytro. When cortisone stopped working for me, I got synvisc shots, and they did help a lot. I could have had the knee done six months after my liver transplant but I simply couldn’t face another surgery and recovery so I waited until a year after my transplant. At that point I was definitely more up to doing the exercises to ensure that the TKR was a success.
If you decide to try synvisc, you can have one shot, or a series of three, one a week. I chose the latter.
JK

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@contentandwell

@amytro. When cortisone stopped working for me, I got synvisc shots, and they did help a lot. I could have had the knee done six months after my liver transplant but I simply couldn’t face another surgery and recovery so I waited until a year after my transplant. At that point I was definitely more up to doing the exercises to ensure that the TKR was a success.
If you decide to try synvisc, you can have one shot, or a series of three, one a week. I chose the latter.
JK

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@contentandwell I see that you were able to get the synvisc shots. I tried to do that for both knees ( not at the same time) and my insurance refused to pay for them. I found that to be very frustrating. I will be scheduling my left knee this week.

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