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

Here's the "Conclusion"from the study I've just included, which has posted on the National Institute of Health website:

"A significant number of patients needing a TKA still have an intact ACL. The goal of TKA is to approximate the function of a normal knee. The retention of the ACL allows for better knee, kinematics, improved proprioception, increased maximum flexion and an overall improvement in the knee function. The low constraint that is possible with the presence of both cruciates may decrease implant stresses and improve the longevity of these implants.

"The distribution of OA shows that the medial and patello-femoral compartments of the joint are primarily affected. This could also allow for a more conservative and patient-tailored prosthetic design."

Don’t do it til you are using a cane, walker or wheelchair cuz pain is so bad. I had bone on bone too but could bend to 150 degrees. Had TKR & can only bend to 105 now. Regret TKR.

Hi @ivy7656, Welcome to Connect. I'm sorry you had such a bad experience with your TKR. I couldn't live with the daily pain and now I don't have any pain but I'm limited in not being able to get on my knees for any kind of task around the house or yard.

Do you mind sharing what brought you to Connect? Were you trying to find an answer to a question?

I say do it before you have so much damage to muscles and ligaments that your recovery is adversely affected. I had -22 extension on on right knee and I am still working on full extension 5 months out of surgery. Almost there, but it has been a daily challenge. Extension is actually more important than flexion for being able to walk normally. Talk to a PT. My Pre-surgery PT was very helpful, but it did not mitigate my need to get it done. No doubt the post surgery pain is something to deal with and I understand prolonged recovery because i still have undiagnosed pain from my left knee two years out. I think i waited too long for intervention. It is a very personal choice and a lot to consider. Best of luck!

I agree it is personal decision …. Only we know our pain and how much we want to deal with on daily basis before surgery…..but after surgery there are no guarantees on how much flexion or extension you will get back…. So for me I had tkr and revision within year… my other knee is bone on bone but not much pain so I am making an appointment to see how I can better protect and increase longevity….. I do not want to have tkr again if I can help it…. Even though my revision was very successful thank God …..best luck to you whatever you decide to do … this support group on mayo is very helpful and supportive….

Am in agreement with Rennie - the longer you wait, the more damage can occur to the knee, and the more difficult rehab will be. For me, I think I waited a little too long, and am having difficulty getting full extension and better flexion. They are making progress, but it's slow. Also, as a retired nurse, the additional consideration is your overall state of health. The longer you wait, the older you get, and the greater the chance that health problems could make the surgery more risky and the rehab more difficult. Good luck whatever you decide to do.

I say, go ahead and have the TKR surgery. Waiting only increases the risk of more damage to the knee, which will make recovery harder. My knee bothered me for about four months before I went to the doctor for an examination.
When he said I had bone-on-bone arthritis, I was stunned. I got a second opinion, but it was the same as the first doctor. Both recommended TKR as the only remedy. My knee had deteriorated to the point it had turned inward and I was knock kneed. So much for waiting until the condition of my knee got worse. The knee was as worse as it could get! I realize by having the surgery you give up being able to run and kneel for the rest of your life. I get it. But I asked myself, what am I really giving up? I already can't run or kneel NOW. Was I scared to have TKR surgery done? Yes! Do I regret doing TKR surgery? No! My pain is gone. Is recovery hard? Yes, it is. Although each person has a different experience with recovery, the one constant is--you have to commit yourself to do the PT, all of it, in order to have a successful rehab. I am 6+ months out from the surgery and can do pretty much what I want. The muscles around my knee are still a little stiff, but each week I have improvement. Yes, go ahead and do it! One last word of advice: You want your surgeon be someone who has tons of experience. So use an orthopedist who does so many TKRs he could do the surgery in his sleep!

I say go for the surgery, the longer you wait, the more damage to your knee and more difficult rehab. It is not an easy surgery or recovery. I am 6 months post TKA and am glad I had the surgery. I will need another TKA in my other knee. I don't look forward to it but it has improved my quality of life and activity levels. I'm a retired nurse, pick an experienced surgeon and train for the surgery by doing exercises to strengthen your legs. Educate yourself about the surgery and prepare your home. It is a good idea to attend a class on the procedure if your hospital offers it. I would also recommend staying 1 night in the hospital after the procedure. Expect to have pain after the procedure and during rehab. Ice really helps and you must do your PT! Good luck!

I’m 72, overweight and have mobility limitations similar to yours. I can still walk and exercise but I’m pretty sure I waited too long. The bad knee is impacting the ankle and hip. My surgery is a week from now. I think I should have done it 1-2 years ago. Just my thoughts. And, no, I don’t want to go through it either, but will.

Good point rennie - it is possible to wait too long for joint replacement, making recovery all the more difficult.

I could still function well enough to strengthen my legs in the gym (with a trainer) before my TKRs. Both were done last year and I worked very hard post-op on the exercises. Best thing I ever did. FWIW I'm 68, 180 lbs and a former marathoner (hence the need for TKR.....). One suggestion is to lose excess weight first. In fact the surgeon may insist on a certain weight depending on the individual.