I need a TKR: Do I do it, or go as long as I can?

Posted by happyat76 @happyat76, Oct 30, 2019

I was told in January of this year that I need a TKR as there is bone rubbing on bone, no cartilage in my left knee. I was seen by an Orthopaedic surgeon in a hospital and I saw the x-ray myself. My question is this. I can still walk, although my knee gives out sometimes, I have a throbbing pain constantly and I do have some troubling walking. I can’t walk far. What should I do? Should I book the operation? Should ?I let it go for a while longer? What will be the outcome if wait? I am 78 now and really don’t want to go through with this, but am worried that I may end up in a wheelchair not being able to walk. I am also about 50 lbs. overweight. I have a bad back also. I would appreciate any suggestions.

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@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

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@carolasc : Carol: I already posted some experiences with my TKR, but to be specific;
Yes, you can go up and down stairs, with or without carrying stuff. Initially holding onto railing, later without.
Absolutely. You can get off the floor the day of surgery. Just flip onto your stomach, and go from there. Later on you can do it most anyway you want.
I don’t do yoga, but I go for 2 mile walks 5 days/week. I do sometimes bike stationary ones, but there’s no reaon not to ride actual ones. Hikes: you’re supposed not to do steep downhills. Uphills - no limitations.
Travel - yup. As mentioned before, 4 months after TKR, full size suitcase, by myself, in Austria, snowy conditions, in and out of trains.
Yard: oh yes. After 7 days I was inspecting my veggie bed, and have been roaming up and down my backyard over sticks and stones and bumps and dips almost every day.
Limitiations: as per surgeons’s instruction.
Oh: I forgot: to kneel - yes, you can. Won’t feel good, but with some padding ok. Except not “useful” kneeling, as I would put it - as in pulling weeds where your weight is centered over and in front of your knee. That won’t work, I’m afraid.

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@ellerbracke

@carolasc : Carol: I already posted some experiences with my TKR, but to be specific;
Yes, you can go up and down stairs, with or without carrying stuff. Initially holding onto railing, later without.
Absolutely. You can get off the floor the day of surgery. Just flip onto your stomach, and go from there. Later on you can do it most anyway you want.
I don’t do yoga, but I go for 2 mile walks 5 days/week. I do sometimes bike stationary ones, but there’s no reaon not to ride actual ones. Hikes: you’re supposed not to do steep downhills. Uphills - no limitations.
Travel - yup. As mentioned before, 4 months after TKR, full size suitcase, by myself, in Austria, snowy conditions, in and out of trains.
Yard: oh yes. After 7 days I was inspecting my veggie bed, and have been roaming up and down my backyard over sticks and stones and bumps and dips almost every day.
Limitiations: as per surgeons’s instruction.
Oh: I forgot: to kneel - yes, you can. Won’t feel good, but with some padding ok. Except not “useful” kneeling, as I would put it - as in pulling weeds where your weight is centered over and in front of your knee. That won’t work, I’m afraid.

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@carolasc : re. yoga - while I do not do yoga, I use the child’s pose to relieve back stress between sets of planks. And I am about 95% able to get the TKR knee to comply. With a little bigger behind, I could totally do that pose……. all the way.

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I could have written this…same age, same problem—knee and back and overweight. My surgeon said, “when the pain gets too bad, you will be back.”

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@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

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Carol
Yes you can do 1 through 6 not right away but if you have a good surgeon and good physical therapist and you do the work it can all be accomplished! It takes a lot of hard work on our part! Doesn’t happen overnight! My new knee is awesome! I even have done close to 4 miles walking and continue to bike! My therapist taught me how to get up and down from floor! I would however recommend 6-8 weeks of physical therapy prior to strengthen (which I did)and I was in physical therapy office one day post op! Took about 4 months and have 2 flights stairs in house! Awesome no pain. I still continue with daily exercise regimen one year and four months later. It was so much easier than my reverse total shoulder replacement that I waited way too long to get done after a failed shoulder surgery. Best of luck!

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Hi Carol,
I had TKR on my right knee two years ago at a Boston hospital. I am so glad to read so many success stories responding to your questions. I didn’t have a good experience, but it was because I was allergic to the several pain killers that were prescribed for me. One made me nauseous and with another one, I broke out in a rash. As a result, I could only take Extra Strength Tylenol, which did not begin to touch the pain! That affected my home PT because I could barely do the exercises. I lost my appetite and felt very “down” because I felt that I was not making any progress. When I was finally able to go to outside PT, I had a wonderful therapist who took all of this into consideration. I started out very slowly with PT and ended up staying with it for about six months…….the reason being that I had made very little progress with home PT. My both knees were bone on bone. My doctor told me that it takes a full two years for total healing. However, I think that many people recover quicker than that. It took me a lot longer. I have to be honest and say that I do not want to go back to get my other knee done. I do go for cortisone shots every 3-4 months and I exercise on the bike a lot, as well as doing quad strengthening exercises frequently. I will do all I can for my non-surgical knee to keep the muscles strong rather than face another surgery. I can get down on the floor to exercise but I have a hard time getting back up with the surgical knee. I can kneel, as long as I use a small pillow. I used to do yoga but there are poses that I just cannot do any longer, so I do the ones that I can. I was always a “walker” and I can still walk about 2-3 miles. After two years, my surgical knee is feeling much better and due to the hard work of my wonderful PT, I have a great bend now in that knee. I guess that my advice would be to not rush into the surgery until the cortisone shots no longer work or the knee pain really interferes with your life and it is absolutely necessary. Many, many people have terrific results. My difficulty was because of pain meds. Also, I would advise you to have allergy testing for different types of metals and the bone cement that is used. My doctor insisted on that testing and my results came out very high with nickel. Many of these knee replacements have nickel in them, so my surgeon used a replacement from a company called “Smith and Nephew”, which had no nickel. Didn’t mean to be a “Debbie Downer” at all……..If I could have taken the pain meds, I am sure that I would have had a totally different experience. All of my best wishes to you for a successful surgery and recuperation! MaryAnn in MA

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@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

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Greetings @carolasc, welcome to our "sharing group". I am so pleased to have been able to read what other members have written in their replies to you. As mentioned, we often receive posts from members who have not had such positive results. And yet we know that this type of surgery is performed very frequently with greatly satisfactory results.

What I have noticed is that folks are having their TKR surgeries at an earlier age so that they can get back on the golf course or tend to their animals on the farm among other activities. From those comments, I would also assume that some of us are wearing out our knees sooner than folks used to because we are more active.

I am 80 and had my first TKR at 70 and my second one last year. The first one took longer to heal....almost a year. This last one had me back on the walking trail and in my Yoga class within a month or so. Here are the differences that I have noticed.

1. The surgical technology with things like Mako Robotic assist has jumped ahead of what it was 10 years ago. That means today the actual surgery is minimally invasive and more accurate.
2. Our medical professionals know more about what pre and post-surgery exercises ensure a more successful outcome.....(especially the pre-surgery).
3. Traveling is easier today for everyone not just those with TKRs.
4. Yoga classes are now available online and on Zoom so they are easier to find. And there are special stretch Yoga classes for those of us who need to ease into full use of our knees.
5. Because of the advanced construction of the replacement, they fit better and are made of plastics and other materials which seem to be more lenient on the tissues around our knee.
6. Yes there are limitations and the most important one is to try not to fall and to remember that walking downhill is still hard on any knee. My first surgeon told me that my TKR might last 15 years if I only walked uphill. However, walking downhill could wear it out in 5 years. I read recently that we can now expect today's replacements and the new surgical technologies to assure an even longer life.
7. I am enclosing a photo of me on my knees in a chapel. And another of both TKRs. Can you tell which one is the newest?
8. And my personal philosophy focuses on taking care of "Quality of Life" issues as soon as possible so that you don't wait until normal aging makes recovery much more difficult.

May you be safe, free and protected from inner and outer harm.
Chris

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I'm 63 and had both of my knees undergo TKR this year -- the first three months ago, and the second two months ago. My knees weren't as painful before my surgeries as it seems your knees are now, but three orthopedic surgeons told me before my surgeries that my knees were bone-on-bone as well, without any cartilage left.

My recoveries from my two surgeries have been much more painful, difficult, and long lasting than I ever imagined they would be, and I wonder everyday whether I ultimately made a good decision to have my knees replaced. My physical therapists have been telling me to be patient and that in a few months from now, as my healing progresses, I will come to see that I was wise to go forth with surgery. I'm not so sure.

I went into surgery not knowing as much as I should have about modern TKRs, but here is what I would now strongly suggest for you. Research surgeons that perform MAKO robotic surgery and that preserve ALL knee ligaments. Conventional TKRs don't use and benefit from the high-tech accuracy of computerized robotics, and they necessarily sacrifice (permanently remove) at least one or more knee-stabilizing ligament, including the anterior cruciate ligament (ACL). I very much regret that my ACLs are gone forever. In my view the more accurate and less invasive/traumatic the surgery, the better.

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@oceanspruce

I'm 63 and had both of my knees undergo TKR this year -- the first three months ago, and the second two months ago. My knees weren't as painful before my surgeries as it seems your knees are now, but three orthopedic surgeons told me before my surgeries that my knees were bone-on-bone as well, without any cartilage left.

My recoveries from my two surgeries have been much more painful, difficult, and long lasting than I ever imagined they would be, and I wonder everyday whether I ultimately made a good decision to have my knees replaced. My physical therapists have been telling me to be patient and that in a few months from now, as my healing progresses, I will come to see that I was wise to go forth with surgery. I'm not so sure.

I went into surgery not knowing as much as I should have about modern TKRs, but here is what I would now strongly suggest for you. Research surgeons that perform MAKO robotic surgery and that preserve ALL knee ligaments. Conventional TKRs don't use and benefit from the high-tech accuracy of computerized robotics, and they necessarily sacrifice (permanently remove) at least one or more knee-stabilizing ligament, including the anterior cruciate ligament (ACL). I very much regret that my ACLs are gone forever. In my view the more accurate and less invasive/traumatic the surgery, the better.

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I'm sorry about your surgery results. I'm 68 y/o and had both knees replaced this year. The surgeon used the Mako assistant and recovery went well for both knees. I highly recommend it. To your point, it's almost impossible for the surgeon to knick or cut either the lateral or medial ligaments.

I did have both my ACL and PCL removed. I think they can be saved, but it complicates the surgery, and I don't notice they're gone. Running and impact sports should not be done after a TKR anyway, and that's when the ACL and PCL would be needed.

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@heyjoe415

I'm sorry about your surgery results. I'm 68 y/o and had both knees replaced this year. The surgeon used the Mako assistant and recovery went well for both knees. I highly recommend it. To your point, it's almost impossible for the surgeon to knick or cut either the lateral or medial ligaments.

I did have both my ACL and PCL removed. I think they can be saved, but it complicates the surgery, and I don't notice they're gone. Running and impact sports should not be done after a TKR anyway, and that's when the ACL and PCL would be needed.

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