Consultation prior to total knee replacement

Keep up the strengthening work on your knees. It's amazing how long you can put off replacement if you keep the muscles strong. It sounds a bit odd that you new knee would not be your stronger knee unless the muscles are just not "there"? Also, having had a TKR for five years I can tell you it will never feel like a natural knee (because it isn't) but you get used to it. Have your doctors mentioned that long term cortisone shots can be harmful to the cartilage of your other knee? I'd be a little skeptical about any doctor that would continue to give shots for more than a year. Has anyone mentioned trying viscosupplementation as an alternative to surgery?

Hello. I am in Northern California and had TKR at Enloe Hospital in Chico 20 days ago. I took an opioid for 10 days along with Advil and Tylenol. The pain was tolerable, but I got depressed. So, I quit on the spot. Now I enterchange the Tylenol and Advil. I am doing everything right per my surgeon. I can't sleep very well because if low level pain and I know how important sleep us to healing. I wake up frequently, try to put ice man on for a while, maybe take Tylenol without food, but sleep is interrupted a lot. I was expecting this kind of thing, but I am sharing. I think I am pretty lucky. So, keep your chin up and expect the best results. I realize by reading from Mayo Connect anything is possible and report anything strange to your surgeon quickly.

Same here.

Sounds like a Patient Bill of Rights and such a document is absolutely necessary. I wish I had one before I agreed to a TKR. In addition to what's been mentioned, discuss the Saphenous Nerve and the term "tuck the saphenous nerve". I am not an md, but I believe this means the surgeon locates and moves the nerve out of the way which avoids relentless, shocking nerve pain that radiates down the leg after surgery. Second, discuss whether the tendons above and below the patellar are cut or moved out of the way. In my humble, non doctor opinion, never cut a tendon but these ideas increase the time each procedure requires. Third, did the prospective patient try cortisone, Hyaluronic Acid, PRP and stem cell? Fourth, was the prospective patient counseled on the benefit of weight loss + diet modification & no surgery? Fifth, how does a prospective patient know if the PT people are competent? Sixth, powerful pain meds are frequently prescribed and the subject of addiction needs to be thorougly discussed. It's unlikely any surgeon is going to take the time (hours) to discuss all of this so a video produced by a competent facility makes a lot of sense.

I am almost 12 months since TKR on the right knee. I still can't bend it properly, it's swollen and deformed, it gets inflamed easily and remains inflamed for days, and I'm still going for more procedures and surgery. Fortunately, I didn't do the left knee. Severe arthritis in my left knee is more easily managed than "the cure" on my right knee.

Some medical providers must be better than others at giving out information. I agree there should be some minimum national standards on basic surgical info provided. I consider our local clinic/hospital good. For my first TKR, at the time of scheduling the appointment for surgery (to be 3 months later), I went home with a knee DVD and a half inch thick book with info on joint replacements arranged by chapter, including pre and post surgical exercises I could start doing at home. We also were required to attend a 1-2 hour group session presentation offered at the hospital, in which the speakers were members of the surgical team, anesthetist, physical and occupational rehab nurse etc. We were encouraged to ask questions at any time during the sessions in which both the surgery and recovery/rehab were covered in detail.

But still, people have different tolerances for listening to medical jargon, and some will tune out and just want the whole thing done and over with and not care about the hows and whys. In the end, it's your body at stake, so no one should be shy about asking explanations from your doctor.

For others considering TKR, it's very unlikely that scar tissue will form if you 1) strengthen the quad and hamstring muscles ahead of surgery, if possible AND MOST IMPORTANT, 2) do all the recommended exercises post-op, everyday until you reach what the Dr and PT conciser desired flexion and extension, usually 120 degrees and zero degrees, minimum.

I keep reading on here about people getting a build up of scar tissue post TKR. Please remember, a successful recovery from a TKR is 10% due to the skill of the surgeon and OR team and 90% due to the work the individual puts in pre and post op.

Surgery is the easy part folks. A surgeon should not perform this procedure on someone who can't perform the post-op exercises, something that very, very rarely happens. So get busy!

When my surgeon asked if I had any question’s regarding the surgery for THR I told him that the ONLY reason I was having the surgery was because of the trust I was putting in him. I researched many other surgeons and no one came close! Chicken little had nothing on me. I always do a tremendous amount of research and this time I did almost none because I was afraid that if I knew too much I wouldn’t go through with it. Believe me I had no choice as I would have eventually ended up in a wheelchair. I don’t care how many videos or classes you participate in, if your surgeon is not excellent at what he does, none of it matters. Even though I am sure that even the best surgeons can make a mistake. Many years ago I had a massive dvt in my leg. The just out of med school doctor didn’t believe that I had a dvt. The tech who did the ultrasound missed it. I knew I had a dvt. The tech asked a much more experienced tech to do another ultrasound and of course he found it. It went from my ankle to my groin. Since that time no one goes near me unless they have credentials off the charts.

My surgeon, and the literature I was given to prepare for the surgery, did not mention anything about scar tissue and how debilitating it can be. Now I've learned that my prior knee surgery 53 years earlier would make me susceptible to scar tissue formation. Sure enough.

Good points. No one should just blindly trust what a Dr or surgeon says. And if you're having a major surgery like THR and TKR, do some research! Dr's don't have time to educate you on everything. The more you know, the more questions you can ask. Good surgical results are due to a great surgeon and the work you put in.

Ay!nyone have ROBOTIC TKR! Glad sounded it or wish you would have TKR the old wa