Alternatives to knee replacements

@rorygrabowsky : Just adding a few comments.... Had knee pain due to some arthritis, and partially torn Meniscus, and some cartilage floaters in knee. Cortisone injection did not help, so had knee “clean-out” surgery in 2019. Did not really help matters, even after another cortisone shot, and a series of hyaluronic acid injections. Caved, and had knee replacement surgery September of 2018 at age 69. Quite a bit of pain, as is to be expected from a major surgery. Ditched walker within 4 days of surgery, and was walking short distances on neighborhood streets within a week. Rehab is a bitch, but having been in good shape generally, and being able to join a facility with a heated indoor pool helped matters a lot. However, I did not know about PRP or stem cell treatment before my 1st surgery, or the replacement decision, otherwise I might have tried those first.

can you tell me bout the replacement, how long was the rehab, what was the pain level after the surgery and when were you able to walk without assistance. Just tell me what you can and remind me why you didn't do injections of any materials.

@rorygrabowsky : Just adding a few comments.... Had knee pain due to some arthritis, and partially torn Meniscus, and some cartilage floaters in knee. Cortisone injection did not help, so had knee “clean-out” surgery in 2019. Did not really help matters, even after another cortisone shot, and a series of hyaluronic acid injections. Caved, and had knee replacement surgery September of 2018 at age 69. Quite a bit of pain, as is to be expected from a major surgery. Ditched walker within 4 days of surgery, and was walking short distances on neighborhood streets within a week. Rehab is a bitch, but having been in good shape generally, and being able to join a facility with a heated indoor pool helped matters a lot. However, I did not know about PRP or stem cell treatment before my 1st surgery, or the replacement decision, otherwise I might have tried those first.

@rorygrabowsky, My reason for not having any more injections was that they would not have helped me. I had bone on bone pain before the replacement and was told an injection would no longer help. I had one about six months prior to the knee replacement and it helped for about a week and then I did some more damage to it by working on my knees on concrete and the pain was back like it was prior to the cortisone shot. That's when I decided I needed to do the knee replacement. I think you have to wait for 3 months after a cortisone injection before you can have a knee replacement.

When I met with the surgeon he gave me some pre-surgery exercises to do while waiting for the replacement surgery which was scheduled a month later. I actually think the exercises are good for all of us elderly types to maintain mobility and flexibility. Here's some cheat sheets that explain the different exercises.

Before surgery knee exercises: https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/preparing-for-surgery/before-surgery-knee-exercises
Post Op knee exercises: https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/after-surgery/knee-exercises

I also have an exercise bike at home which helped a lot during the home rehab. I had my TKR on the 1st of April, 2019 and the weather was not great in Minnesota so it put a crimp in outdoor walking for the most part although I was able to get out and walk in my driveway using a walker the first and second week after my surgery. I then used a cane for about a month until I was able to walk OK without it. I think I felt I was almost back to normal about 2 months after my TKR. I still take stairs gingerly but I think that's more due to my degenerative arthritis and my age (not wanting to fall or trip!).

The goal of the surgeon and care team is to get you out of the hospital the day after your surgery so the the physical therapist at the hospital gets you up the morning after the surgery and starts you on the post op exercises and makes sure you can walk OK and shows you how to go up and down a small staircase they use for post op. The most important lesson I learned from my post op rehab was icing and elevating the leg. This helps control the swelling and reduces the pain. I wasn't having much trouble with the pain but the swelling was there and my follow up with the surgeon about a month after the surgery, well lets just say he gave me the what for because I was not elevating and icing the knee enough. So anytime I wasn't exercising or doing something, I iced and elevated my leg. I did it when I was watching TV, reading, working on the computer or just napping on the sofa.

Questions you might want to ask your surgeon or care team before the surgery...
- 8 Questions to Ask Before Knee Surgery: https://www.arthritis-health.com/blog/8-questions-ask-knee-surgery
My personal thoughts for questions...
- What type of hardware do you recommend/use for the knee replacement?
- Will I get an allergy test for the bone cement, metals, etc. used in the replacement components?
- Can you explain the risks - possible nerve damage, etc.. ?

Other members may be able to provide other questions, but I would make a list and take it with you when you talk to the surgeon.

Best of luck whatever you decide!

Rory. I would strongly recommend not doing anything until Covid is under control. My husband
had TKR Oct 27. Then had a revision due to suspected infection(extreme pain)
He contracted Covid in hosp or rehab center, and it has been a nightmare Hospitalized 5 times. He is just starting to feel a little better. Lost 30 lbs. No appetite. Does not sleep well. Huge setback on knee PT. Kidney damage due to antibiotics (high creatinine level) which I had to administer by PICC line. He is 78.
Wait till corona is not a risk.
I think one is able to change from Medicare and a supplement to an Advantage plan at any time. Not just during open enrollment.
Joan Flynn

@ellerbracke cortisone shots are always a gamble. If the doctor doesn't get the exact right spot they do no good. I finally did find a doctor who hit it every time and it did provide quite a bit of relief. I also had Synvisc when the cortisone was no longer helping, and that was a huge help for a while. I have discovered since then that the best doctors to go to for these shots are the physiatrists - doctors of physical medicine. They use guided imagery so they can hit the spot consistently. Eventually, I did need TKRs on both knees.

The second TKR had to be delayed due to a low platelet count. During the wait, I exercised a lot and the improvement in my supporting muscles made a huge difference. I was waiting for 3 years. I highly recommend exercising but anyone who is waiting for a TKR should check with their orthopedist to know exactly what exercises that doctor advocates. Mine loves the recumbent bike and water jogging.
JK

This was very helpful and hope that you are doing well, however, can you tell me how long after the surgery were you clear of pain and what kind of activity were you able to do. A very Happy and HEALTHY New Year to you and your great family.

My pain was not too bad after my TKR. The worst for me was getting into the next day after the surgery since we had smaller SUV and the front seat didn't go far enough back where I could easily get my foot inside without overbending the knee. That gave me about 3 days of pain that wasn't normal. I think my pain was around 3 to 4 on a scale of 10 for a week or so. They prescribed Tramadol but I never took any. I took high dose Tylenol when I was having some pain. My daily rehab for the first week was mostly walking around the house and in the driveway with a walker and also riding a recumbent exercise bike. I didn't use high resistance because I just wanted to work on the flexibility. I also did the post op exercises several times daily given to me by the surgeon's care team.

Since it was my right knee I was not supposed to drive for 6 weeks but I felt I was OK by the end of 5 weeks so I started driving again. I did carry a cane with me for the first 5 weeks but didn't use it all the time. I still take stairways carefully but I think that's more my age and degenerative arthritis than the knee. A very Happy and Healthy New Year to you and your family also!!

My pain was not too bad after my TKR. The worst for me was getting into the next day after the surgery since we had smaller SUV and the front seat didn't go far enough back where I could easily get my foot inside without overbending the knee. That gave me about 3 days of pain that wasn't normal. I think my pain was around 3 to 4 on a scale of 10 for a week or so. They prescribed Tramadol but I never took any. I took high dose Tylenol when I was having some pain. My daily rehab for the first week was mostly walking around the house and in the driveway with a walker and also riding a recumbent exercise bike. I didn't use high resistance because I just wanted to work on the flexibility. I also did the post op exercises several times daily given to me by the surgeon's care team.

Since it was my right knee I was not supposed to drive for 6 weeks but I felt I was OK by the end of 5 weeks so I started driving again. I did carry a cane with me for the first 5 weeks but didn't use it all the time. I still take stairways carefully but I think that's more my age and degenerative arthritis than the knee. A very Happy and Healthy New Year to you and your family also!!

What is TKR??