TB frank, my knee surgeon's PA said it was NOT doable but I haven't asked anyone else. Also (didn't mention this previously, perhaps making the whole knee question moot), but I 'm looking into spinal revision surgery to (hopefully) allow me to walk and even stand without support. Apart from avoiding intolerable pain, that's a longstanding dream (at least, since I've had to eliminate all of my other enjoyable exercise: running, biking, gymnastics...

My spinal surgeon's never admitted errors, left me "toeing out" on the left, making walking unsteady and acts on the entire leg up to and including the hip. It throws off my center of gravity (can really only ambulate with supermarket carts!) . Apart from my "drunken sailor" gait, this also causes twisting of that knee with every foot-strike. (Undoubtedly aggravates the preexisting arthritic-based knee problems.)

(A bitter complaint, that surgeon denies having ANY connection to that and other problems even though they only appeared as soon as I came to. ) Note, he was head of spinal services at the Hospital for Special Surgery, supposed to be the best orthopedic hospital in the nation. So much for choosing a doc on the basis of fame and charisma - and after eight consults!

If approved, I'd work this time with ' a surgeon at Duke uni, one who specializes in extreme spinal surgery, board certified in orthopedic and neurosurgery. It would mean several lengthy trips (to and from PA to NC), with uncertainty about how I'd manage the lengthy recuperation even if nothing serious goes wrong - far from knowable.

I apologize for getting carried away with my lengthy description of issues which basically make it impossible to be encouraging about how I might manage the TKJR with a fused spine. I guess I've talked my way out of anyone's ability to be positive (only sympathetic). Maybe, that reduces this outreach primarily to venting. You are so kind to have written back to my initial query, and I'm sorry your analysis resulted largely in this negative presentation of obstacles . Even if so, though, merely your reading this (if you have! No blame if not) , has been a comfort.

I'm interested in your complex knee brace (though I have difficulty picturing my attaching it, again owing to the spinal limitations). Your going to the trouble of such descriptions plus presenting issues I need to examine in decision-making, is much appreciated! (Maybe, I'd basically need to choose between a TKJR and a spinal revision, to start - to be minimally realistic about my options).

At least, my overall health (organ function, including heart) is pretty good for my age - 77. Apart from paroxysmal AFIB, my problems are mostly in the nuisance category, rather than life-threatening (attributable mostly perhaps to regular gym work-outs . Reminding me of another quandary - how would needing to majorly restrict gym exercise during the protracted recovery period from either operation, affect me? (I''m forgetting just what the requirements were for the spinal rehab. Daily walking of at least a mile? If so, back to the supermarkets, I guess, especially in Winter. )

If all this were a decade or two ago, perhaps daring combo surgical approaches would be more realistic, but chances are, I'm stuck now. Nevertheless, it would be very helpful to hear from others here who've dealt with questions of how and if to combine a spinal fusion with TKJR. I'd love to learn of their decisions and/or outcomes. (Think I'll divide this entry into at least two parts to make it less off-putting!)

Thank you again for your kindness!