Am I a good candidate for TKR surgery now or should I wait?

Oh, my dear @skmsf, you are living my life all over again. I m 81 and had my first TKR when I was 71. Like you, I was active and healthy at that time except for my knees. They were beginning to interfere with my activities, my business, and especially with the time I wanted to spend with my grandchildren.

When I met with the surgeon about my knees, he asked which one was the most painful and I said...."the left one". Nevertheless, he had all of the tests and imaging done on both knees. When we met for the diagnosis, he showed me the images and explained the reasons that would lead him to choose "the right one". It was much more damaged than "the left one". However, "the left one" had a Baker's cyst which came back quickly after the fluid was removed.

The surgery was scheduled for the "left one". Why......he wanted to relieve me from the pain. For me, that was a thoughtful and caring decision.

Now I am 81 and recently had a TKR on the "right one". More difficult....... but then we now have Robotic TKRs that are more accurate and thorough. The pre-surgery exercises were amazingly helpful to make sure my leg was strong. The post-surgery exercises had me driving and climbing stairs promptly.

So, @skmfs there are reasons to go either way........now or later.

Before I say goodnight, I do want to let you know that your concerns about the worrisome posts on Connect are a result of the fact that few of the thousands with successful TKRs are going to post in this particular discussion.

May you have happiness and the causes of happiness.

Chris

I'm 7 months out of a TKR and 3 months out of a MUA and my knee feels very tight especially after walking.the feeling in my leg also feels like it weighs a ton laying down and walking.
A second opinion is probably needed at this point.

My knee history was very similar to yours. Bone on bone, cortisone shots, avid walker, pain many years. Last fall, age 66, living alone, I had both knees replaced (5 weeks apart) and I am thrilled that I did.

Following PT and home care instructions, I am now pain free. Yes, there is still some stiffness but walking daily and water fitness classes (NOT water aerobics) are really minimizing even that.

Everyone's road is different. Staying positive, connected to my surgeon's office and activity made a difference. Blessings to you on the road you choose.

Thank you so much for sharing your story and for your encouragement. It’s been a difficult decision for me and wonderful to hear of a really positive outcome!

Thank you Chris. It is really encouraging to hear from someone with such a similar story. And, you’re right, few that have had a successful surgery would be likely to seek out this forum. Thanks again for being a mentor on this forum.

I was 61 when I finally decided to do the surgery ….. my knee was very swollen had hard time walking and no shots worked anymore …. If they had i would not have done I would have waited …. To me this is last resort …. I did my homework on surgeons so I thought but ended with bad outcome long story short had same knee replaced within the year ….. better outcome second time around but I still have pain and stiffness it does not stop me from doing most things …… my other knee is bone on bone I will not be getting it done …. I am going to try non surgical alternatives….right now you are doing the right thing getting your information in order to make informative decision….. I thought I was going to be back to work 6 weeks after surgery it has been long 2 years …… be prepared for any outcome hope it goes text book for you….. good luck

Thank you for sharing your experience ezas123. I am sorry for your bad outcome and the pain and disruptions to your life the surgeries have caused. To look at the surgery as a “last resort” seems an excellent way of thinking about it and something no medical professional has ever said to me. I’m glad you said it because it seems accurate.

Very thoughtful post Sherry. A few comments:

1. This isn't scientific, but my opinion is that most people who post here have had problems, some inevitable and unfortunately, others avoidable if only the patient took their part in recovery seriously. Once a decision is made to have a TKR, find a trainer or pt and do as much pre surgery rehab as possible to make the muscles around the knee strong. Post surgery do ALL the recommended exercises, usually 3x day and usually immediately after surgery.

2. If you aren't having significant and constant pain, wait. I started pre hab exercises and my knee got better. I put off surgery until the day I jammed the lateral side of my knee and swelling commenced and the pain would not go away. And the pain kept me up at night. That's when I decided to have surgery.

3. Putting this all together, you want to eventually come out of surgery feeling better, Ala, no pain or much less pain. If there is no pain at the moment, hold off. My surgeon recommended this, saying he doesn't want people coming back feeling worse than before the surgery.

4. Chances are very good that with bone on bone, you need a TKR. That said, only do it when the pain is constant. Cortisone will make it feel better, but it's a band aid. And you can't have surgery within 3 months of a cortisone shot.

5. Finally, and I've posted this often, do exercises pre surgery to strengthen the quads and hamstring muscles. And literally attack the post-op rehab (well, don't over do it, but you get my meaning). They will have you take a short walk while you are still in the recovery room. Activity is your friend now. Do all the ankle pulls and leg lifts and what not, probably 3x day, and see a pt asap after surgery. The results should be good with a bit of patience. No one feels great after a surgery like this, but each day gets a little better.

I had both knees replaced in 2022. I'm a 68 y/o male and former runner. Now I'm in the gym 6 or 7 days a week, work with a trainer 2x week, and have never felt better. Now I practiced what I preached and never gave scar tissue a chance!

As for surgeons, find someone in their mid 30s to mid/late 40s, with a solid pedigree (university or residency or both) and who use a robotic assistant, like the Stryker Mako.

Scar tissue is the biggest threat to a recovery. I've seen too many people post here who neglected the post op rehab or thought they could do it later or at their leisure. First thought wrong! Keep that knee moving as much and as far as it will allow. Get obsessed with your recovery!

All the best to you!

Terrific reply Chris!

I waited as long as I could to replace “bone on bone” knees, as I had minimal pain. Did right knee 4/23 with excellent surgeon, but have continued pain & stiffness & cannot stand more than a minute or so without significant pain. I was in great shape before surgery, biked 15 miles every day, now I cannot do much of anything despite having achieved good ROM. I expected it to go smoothly but it’s been a disaster. Most patients do well, but my surgeon said 10% do not, & I guess I’m in that 10%. No one knows until after surgery how they’ll do. If you don’t have pain, & can do all activities you want, I’d wait as long as possible to do surgery.