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TKR #2..... Lessons I am learning
Yesterday, I had a Total Knee Replacement on my right knee, 10 years after having a successful TKR on my left knee. 28 hours later I realize I have learned a lot with more hints, suggestions, mysteries, and solutions to be discovered along the way. I want to list these items for your review. Please let me know if you agree with my assessment and anything else you want to share that will help others making the same trip. What else should we be mindful about?
When was your TKR or when are you planning it? Thank you for sharing your creative and helpful ideas Here are my 24-hour learnings.
1. To be well prepared, do the pre-op exercises. I know it is 300 unique exercises held from 1-2, or 1-5 seconds in 2 sessions every day. And then there is that 5-10 minute one at the end. You will be so happy that your surgery leg is strong and sturdy.
2. Take the medications as prescribed or with approved substitutes if needed because of allergies. If you have any doubt about dosages or synergistic medications, please ask. Just because the pharmacy sheet or the internet describes a medication one way, know that there are good reasons for choosing the ones on your list. One antihistamine was kind of funky.....it just didn't fit. Then I found out that while it was listed for treatment of itchiness, it also dissipated my major pain medication, Dilaudid more quickly. Know that you must wait for anesthesia-related medications to disappear before you can move on to after-surgery dosages.
3. To prevent swelling, make sure your knee is kept above your heart. I sure didn't remember that one and it is so good to know. Use ice as directed. Just refrain from wrapping an ice pack too tightly around the surgery knee. I made that mistake .......oweee.
What assists will be most helpful? Do you need a walker....yes you do. And the worst thing that can happen is a fall. Walkers prevent falls. A raised toilet seat is a must to prevent strain and injury.
Be careful though.......we have only 21 inches in our commode room. Have you seen the stools for showers and the movable grab bars? Remember the goal is to prevent falling. As my surgeon said, "don't fall, I can't fix you."
And finally. Take time to heal......You cannot expect to be back on the volleyball court or in the swimming pool right away. Gold and tennis will have to wait. And you will be better off finding new and less rigorous activities to replace those that are no longer part of your activity itinerary.
What bothers you the most? What do you still not understand?
May you be free, protected and safe from inner and outer harm.
Chris
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Hi Chris many prayers for a speedy recovery….. as always even as you going through another tkr yourself you are finding ways to help others…I think that will also aid in your recovery as well …..you are a stronger woman than I …:I would never go through again …….god bless you Chris
All great tips here. But I need additional info, having learned I’m going to have to have a root canal. It’s only 12 weeks since I had my very successful right knee replacement. (2 years ago I also had my left knee done).
The recent surgery went very well, not much pain and I’m back walking and biking. But now with no pain whatsoever. I’m grateful beyond words but concerned about having to have a root canal, because of possible infection going to the knee. My surgeon said if I can hold off they advise waiting 3 months after a knee replacement to have dental procedures because an infection might settle in the knee. Naturally, I’m hesitant to proceed and will try and hold off unless the tooth really goes haywire. I’d love to hear if anyone has successfully proceeded with a tooth extraction or root canal after TKR. Thanks to all. I’m finding this forum very helpful.
I needed a crown after reverse total shoulder Surgeon
Had me wait 6 mos post op to get done. Also had to take 2000 ng amoxicillin for 2 years prior to any procedure. same for my recent TKR. However if it’s a total necessity check with your surgeon because you don’t want to get abscess in your tooth either,
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1 ReactionThe question is not that clear-cut. See this article from 2012.
Evidence Insufficient to Recommend Routine Antibiotics for Joint Replacement Patients Who Undergo Dental Procedures
December 18, 2012
New, collaborative evidence-based guideline proposes
The American Academy of Orthopaedic Surgeons (AAOS), and the American Dental Association (ADA) found that there is insufficient evidence to recommend the routine use of antibiotics for patients with orthopaedic implants to prevent infections prior to having dental procedures because there is no direct evidence that routine dental procedures cause prosthetic joint infections.
The AAOS and ADA’s recommendations are based on a collaborative evidence-based clinical practice guideline that focuses on the possible linkage between orthopaedic implant infection and patients undergoing dental procedures.
I’m going to try and hold out as long as I can. The surgeon and dentist said if it starts to hurt to take 750 mg of amoxicillin twice daily. I have an even greater fear of a knee infection because one caused my dad’s demise after his TKR. Thanks for your input.
How many years ago was your shoulder surgery? Im just wondering if perhaps that necessitated 6 months, where now the recommended wait time is 3 months? Thanks again.
Thanks for passing along the article. I’ve seen some too that don’t necessitate the need for antibiotics before dental procedures. I’d err on the safe side, however. As I stated in my earlier response, our family history is a bit bleak in regard to knee infections after TKR. One led to my father’s being confined to a wheelchair for the remainder of his life. Fingers crossed I can hold out as long as possible without getting a root canal. Thanks again for the article.
I agree with you @cstucky about erring on the side of caution. I am especially concerned because my cousin has lived for years without a hip after chronic MRSA set in.
My very respected orthopedic surgeon explained it this way: We know the risk is low for joint infection, but it is not zero. We know the mouth can be a vector for many infections, especially if you have periodontal disease or an abcess. We know the antibiotics are quite safe as a preventive measure. We also know joint infection, if you get it, can be devastating. So I recommend prophylactic antibiotics permanently.
My dentist happens to agree. I see them like other health practices, like hand washing, masking & vaccination - giving me the best chance to remain healthy.
Sue
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4 ReactionsThanks, Sue. Very helpful. I’ll delay as long as I can. Thankfully, I have a very cautious and caring surgeon and dentist. When the surgeon urged me to hold on for three months, I sat up and took notice. Doing the countdown now. Ten days until three months is up, but if the tooth doesn’t flare too much I’ll wait longer. The lesson here is awareness. No one told me going into either knee replacement to avoid dental work afterwards for a time. Hopefully these posts will raise others’ awareness.
Thanks for your thoughtful response.
I had to have 2 teeth removed after TKR: 1 at 8 weeks and another at 12. Emphasis on “had to”. One due to pain and risk of infection the other due to pain and probable infection.
No problems w knee infection. Both times took 2G amoxicillin prior per ortho surgeon followed by a week of lower dose amoxicillin prescribed by dentist. There appears to be various interpretations within the surgical and dental community regarding when dental procedures become “safe” after TKR and the need for Amoxicillin. I consider the antibiotic to be in the “better safe than sorry” category and was very happy to use.
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2 ReactionsAlmost 3 years since my shoulder surgery now but I had my TKR in May so it’s probably my surgeon who now is only 37 years old maybe 6 months is his preference