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Am I a good candidate for TKR surgery now or should I wait?
I was diagnosed with bone on bone osteoarthritis in both knees 4 years ago after a painful episode of swelling and stiffness in my left knee. After a cortisone shot and waiting a few weeks for an appointment with an orthopedic surgeon I felt ok and chose not to have the knee replaced. The surgeon advised me that I would know when it was time to have the surgery by the amount of pain I was in. Fast forward 4 years and I’ve had a similar incident, another cortisone shot and another referral to the orthopedic surgeon next month. I feel better again, not in pain, no swelling or stiffness. I’m not athletic but walk quite a bit and have stairs in my house I’m able to navigate without a problem. I’m 71 and in good health and wonder if I should go ahead with the surgery now instead of waiting until I’m older and perhaps in poorer health.
By the way, reading about the various problems people have had recovering on this website are a little scary for me especially the pain and length of recovery time. I’m interested in knowing how those who’ve had the surgery came to the decision to have it done and if you are you glad you did it. Thanks.
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Shelly, as long as you are in some doubt as to whether to do your knee, you probably don't need to do it yet. I was surprised to hear I was a candidate for knee replacement after my first set of x-rays. I had twisted my right knee by stepping in a hole walking downhill through a forest, and after three or four months, it still was not back to normal, so I went to an orthopedist to find out why. I had a hard time believing my cartilage was that bad, because prior to the twist, I had no pain in the knee. I was treated first with cortisone a few times which improved it a lot, and then with Synvisc injections when the cortisone quit working. Then the Synvisc quit working too and my knee got more painful, but I could still get around and do most things. My kitchen is a full flight of stairs up from the main entrance, so I always had a lot of steps to climb every day, and going downstairs putting weight on the knee was very troublesome. I made the decision for surgery the day I was walking down our rather steep grassy hill, my knee suddenly gave out in an explosion of pain and I went rolling down the hill. It remained very painful for the next few days, but it was still summer and I had to hobble around doing harvesting garden chores. I decided then and there that I was ready for surgery because I did not want to go through another unexpected fall, with that amount of pain. If I had fallen while on our stairs and landed on the basement cement, I'm sure I would have had other injuries, lucky for me the grass was soft. I had a very successful surgery, my pain afterwards was limited to just a dull aching sensation, no sharp or debilitating pain like I expected. Elevation and icing many times a day, get up and walk around for 5 minutes every hour. PT beginning immediately after surgery, (overnight stay in the hospital) 3 x week, tapering down to 2 x week after 4 weeks, then 1 x week for a couple more. It's tedious to do the assigned home exercises, but having to report back to a PT person makes you more likely to not skip. I was pretty much back to a new normal in about 3 months.
My left knee was not quite as painful as the right had been when I decided to do the surgery on it about 1 year later. But again, I had pain stepping down on each stair step, which I had to use many times a day, and I was so pleased with my first outcome, that I had no qualms about going to my same ortho surgeon to do my other knee. Same good outcome.
For me, the first three days at home were the most uncomfortable and awkward to get around. I soon quit using the walker around the house after a couple of days and relied on walls and furniture to get where I was going. I quit using the tramadol and oxycodone sent home with me after the first day, because they made me nauseous and tired and I didn't need them for pain. With the first surgery, I learned that YES, you do need to take the laxatives they prescribe, even if you normally don't ever need any! At least for a few days until the surgery anesthesia and hospital opioids leave your body.
Any surgery is a risk, there are thousands of successful TKR's done every year, which is no consolation if you are one of the unlucky ones with problems.
HeyJoe415:
Excellent post. One caveat-I did everything you wrote about, continued to do PT & exercise, but still have pain & stiffness in TKR (robotic surgery with surgeon with excellent credentials) almost 5 months post-op.
I’m active, normal weight, etc., but have not had a good outcome. Simply bad luck apparently, or unknown factors neither my surgeon nor I can explain. Majority of patients do well, some do not, despite all best efforts…
Thank you @heyjoe415 I find your post very useful, informative and encouraging. I have been especially concerned about scar tissue since so many posts relate to that and have a friend who underwent a very painful procedure to break it up. It was awful for her. But, I did not understand the relationship between exercise and the development of scar tissue.
So well thought out clearly. I decided against reverse shoulder surgery. I had this injury 11 years ago and decided to see a specialist. Based on what I read in this forum plus doing my own research, I decided to hold off. However, I work out quite often, daily exercise , no chronic pain, feeling good overall. I am glad I did. Continue to take of yourself . Best wishes.