Mako TKR in one month; had stem cell, PRP

Posted by saeternes @saeternes, Oct 26, 2019

I have my left knee replacement scheduled at the end of November. I have had knee issues for years, finally got stem cell treatment in 2017, along with PRP. It worked very well, and my knee had only mild pain, could do anything. Then, walking fast in the dark, I smashed down over a jut in the sidewalk right onto my knees. That was last March. Since then, nothing but problems. On a work trip to Hong Kong my knee swelled up and hurt so much that I had to be put in a wheel chair at the airport. Really awful. It calmed down and I made it through two more trips with the help of compression hose and additional PRP. Then with only one trip left, I had another acute incident, but it cleared and I made it through my final trip. Just recently had another incident, but it has resolved as well. This usually happens when I am lying in bed and suddenly something catches in my knee. Very painful, can't move at all. Anyway, long story short, I had hoped the stem cell treatment would come back to life, but given that it is not an easy treatment itself (much better than TRK, of course), and one must self-pay, I decided not to try again. My Mako surgery is coming up (I am doing this outside my city because although we have a good ortho center, they do not do Mako) and I have read everyone's stories with great interest, especially that of Debbra who had a tradtiional TKR in 2017 and Mako in 2019. I watched a video of Dr. Kae's surgery (search for "Dr. Kay's story, social media diary" on YouTube) and was impressed by his rapid recovery. Of course not everyone can do that. I am working out hard when I can on weights and bike. So, if others have experience with Mako TKR (not partial) and are willing to discuss their experience in detail--hospital, pain, walking, devices (canes, etc), therapy, sleeping, feel of knee), I would be very grateful. Thank you.

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@saeternes

Thanks Debbra. If you could write a bit more detail about your immediate post surgery recovery, how long you used cane or other devices, when you cold walk on your own, sleeping and anything you can think of I would love to hear it.

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@saeternes - Sure, I'm happy to share my recovery story! In 2017, I hurt my knee and long story short, my ortho surgeon had me in physical therapy for a couple of months before my first knee replacement. That was a huge help. My knee was replaced on 4/18/17 and when I was released from the hospital, my ROM extension/flexion was 3/105. I started in-home PT on 4/21. By one week, I started using the stationary bike and my ROM was 5/120 (I'd lost a little on the extension, but gained a lot on flexion). I just used the walker for a week and transitioned to a cane. By 2 weeks, I could walk in the house w/o a walker or a cane, but I used the cane outside. At three weeks, my ROM was 0/120 and I started to drive. At that point, I went from in-home PT to outpatient. My last PT visit was 9 weeks. I used oxycodone for 9 weeks, but at the end it was just one at night to sleep.

On my second robot assisted TKR, I asked my ortho-surgeon for a prescription for "pre-hab" so I could prepare for the surgery. I had the surgery on 1/29/19 and when I was released from the hospital my ROM was 5/110. I started in home PT on 2/1/2019. I only used the walker a couple of times when I got up at night to go to the bathroom. Before the first week was out I was using the stationery bike and I had transitioned completely to a cane. At one week, I could do 20 minutes on the bike and walk outside with the cane. At two weeks, my ROM was 0/128. Two weeks also marked the point where I could drive so I ended in-home PT and went to outpatient. At three weeks, I walked a full mile. My last PT visit was 8 weeks but I didn't really need that much - the prescription was written for 8 weeks so I used it all. I used oxycodone for 5 weeks, but at the end it was just 1 to sleep and maybe one before PT.

Second time was much easier all the way around. Let me know if I skipped anything that interests you. Will you keep us posted on your prep and recovery? I'm pulling for you.

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@debbraw

@saeternes - Sure, I'm happy to share my recovery story! In 2017, I hurt my knee and long story short, my ortho surgeon had me in physical therapy for a couple of months before my first knee replacement. That was a huge help. My knee was replaced on 4/18/17 and when I was released from the hospital, my ROM extension/flexion was 3/105. I started in-home PT on 4/21. By one week, I started using the stationary bike and my ROM was 5/120 (I'd lost a little on the extension, but gained a lot on flexion). I just used the walker for a week and transitioned to a cane. By 2 weeks, I could walk in the house w/o a walker or a cane, but I used the cane outside. At three weeks, my ROM was 0/120 and I started to drive. At that point, I went from in-home PT to outpatient. My last PT visit was 9 weeks. I used oxycodone for 9 weeks, but at the end it was just one at night to sleep.

On my second robot assisted TKR, I asked my ortho-surgeon for a prescription for "pre-hab" so I could prepare for the surgery. I had the surgery on 1/29/19 and when I was released from the hospital my ROM was 5/110. I started in home PT on 2/1/2019. I only used the walker a couple of times when I got up at night to go to the bathroom. Before the first week was out I was using the stationery bike and I had transitioned completely to a cane. At one week, I could do 20 minutes on the bike and walk outside with the cane. At two weeks, my ROM was 0/128. Two weeks also marked the point where I could drive so I ended in-home PT and went to outpatient. At three weeks, I walked a full mile. My last PT visit was 8 weeks but I didn't really need that much - the prescription was written for 8 weeks so I used it all. I used oxycodone for 5 weeks, but at the end it was just 1 to sleep and maybe one before PT.

Second time was much easier all the way around. Let me know if I skipped anything that interests you. Will you keep us posted on your prep and recovery? I'm pulling for you.

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@debbraw Debbra. you could be the post person for Mako! What a fabulous recovery you had. What is your flex now? The woman I know at my water aerobics classes says she had 145 at a few weeks but I have a hard time imagining that. I didn't think 145 was even something that most doctors expect for anyone.
JK

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@contentandwell

@debbraw Debbra. you could be the post person for Mako! What a fabulous recovery you had. What is your flex now? The woman I know at my water aerobics classes says she had 145 at a few weeks but I have a hard time imagining that. I didn't think 145 was even something that most doctors expect for anyone.
JK

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Hi @contentandwell - JK, they quit measuring when I got to 130 and of course, it's been months now since I've been at PT and that's the only way I've ever gotten an accurate ROM measurement. Yes... I think my doctor was very pleased with the recovery and interested in seeing the differences since the two knees were done within 2 years of each other.

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I hope I can do half as well! Thanks for all the details. I see my a note to my surgeon asking about Conformist but I suspect I will stick with Mako. Your story is so encouraging, Debra. Two more questions: how much pain did you experience, and when? And did you have nerve ablation? I will certainly post with updates after the surgery. Take a look at Dr. Kay's 2 mim video on his recovery from Mako, I mentioned it in my first post.

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@saeternes

I hope I can do half as well! Thanks for all the details. I see my a note to my surgeon asking about Conformist but I suspect I will stick with Mako. Your story is so encouraging, Debra. Two more questions: how much pain did you experience, and when? And did you have nerve ablation? I will certainly post with updates after the surgery. Take a look at Dr. Kay's 2 mim video on his recovery from Mako, I mentioned it in my first post.

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@saeternes From everything I have read and heard it sounds as if Mako will give you just as good results as Conformis. They are just two different, more advanced ways, of solving the problem of TKRs having a high incidence of patient dissatisfaction. There are probably more sites that are not partial to something as the site I found, sites that will extol the virtues of Mako vs Conformis.
JK

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JK I would be interested in some detailed info about your surgery with Conformis - how the recovery and pain went. Debbra, if you could discuss your pain level a bit more and how it changed that would be great. Thanks so much.

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@saeternes I live in southern NH so Boston is only about 55 miles away and I go there for most of my medical care. The surgeon who was the developer of the Conformis knee is in Boston (Brigham and Women's Hospital) so I went to him because I knew I wanted the Conformis knee. I had heard that recovery and results are generally better.
Initially I had a lot of pain, which really puzzled the doctor. He was seeing me frequently to check up on it. Then, almost overnight, the pain went away! It lasted about six weeks, maybe a bit less. I had the surgery in mid-October (2017) and on the first weekend of December I was in NYC for the celebration of my daughter's marriage and I walked all over the place, pain-free. Two weeks prior to that I was worried I wouldn't be able to get around in the city, but then the pain vanished so I have no idea why that happened, nor did the doctor.
My ROM is about 0 - 120. The flex part of that varies a bit depending on who measures it and the day. It has been up to 123 and down to about 117. Based on my results I would recommend the Conformis knee. I love walking and never feel knee pain when I walk. I particularly love walking in cities. We were on vacation last October and I was walking many miles each day. My husband had to go back to our hotel room because he couldn't walk any more. I felt like the Energizer bunny!
If you go to the Conformis site you can find what doctors in your area do that knee.
JK

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@contentandwell

@saeternes I live in southern NH so Boston is only about 55 miles away and I go there for most of my medical care. The surgeon who was the developer of the Conformis knee is in Boston (Brigham and Women's Hospital) so I went to him because I knew I wanted the Conformis knee. I had heard that recovery and results are generally better.
Initially I had a lot of pain, which really puzzled the doctor. He was seeing me frequently to check up on it. Then, almost overnight, the pain went away! It lasted about six weeks, maybe a bit less. I had the surgery in mid-October (2017) and on the first weekend of December I was in NYC for the celebration of my daughter's marriage and I walked all over the place, pain-free. Two weeks prior to that I was worried I wouldn't be able to get around in the city, but then the pain vanished so I have no idea why that happened, nor did the doctor.
My ROM is about 0 - 120. The flex part of that varies a bit depending on who measures it and the day. It has been up to 123 and down to about 117. Based on my results I would recommend the Conformis knee. I love walking and never feel knee pain when I walk. I particularly love walking in cities. We were on vacation last October and I was walking many miles each day. My husband had to go back to our hotel room because he couldn't walk any more. I felt like the Energizer bunny!
If you go to the Conformis site you can find what doctors in your area do that knee.
JK

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Thanks JK. Great that you had such good results, although 6 weeks of pain is a little frightening. At least it went away. I'm going ahead with Mako, not sure anyone in our area does Conformis - I just read yesterday that Stryker (which makes Mako) has struck a deal with Conformis to develop a custom knee that can be used with its robotic arm. The best of all worlds! But it will take a few years for FDA review and approval so I'm not waiting. Thanks again!

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@saeternes

Thanks JK. Great that you had such good results, although 6 weeks of pain is a little frightening. At least it went away. I'm going ahead with Mako, not sure anyone in our area does Conformis - I just read yesterday that Stryker (which makes Mako) has struck a deal with Conformis to develop a custom knee that can be used with its robotic arm. The best of all worlds! But it will take a few years for FDA review and approval so I'm not waiting. Thanks again!

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@saeternes I have a follow-up appointment with my surgeon next month, I’ll try to remember to ask him about that.
I am sure you will be happy with the results of the MAKOplasty too.
JK

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