Consultation prior to total knee replacement

The degree of pain after surgery seems to vary widely by person. After reading about all the patients here with extreme pain for a long time, I feel lucky that I had very little of what I would call real pain after surgery. Instead I had just a dull ache sensation in the area for a few weeks until the swelling went down. I quit taking pain pills the day after I got home, all they did was make me nauseous and woozy and constipated. I had both knees done, one year apart, and then a shoulder replacement, all by the same surgeon. I was surprised each time about the lack of sharp pain. I am a very sensitive wimp and normally even a small cut bothers me, so it's not like I have any special ability to rise above it. I'm not allergic, but sometimes have sensitivity to various types of drugs upsetting my system. I wonder if my nervous system is super susceptible to the effects of the pain blockers used during and after surgery, and they stayed active longer than normal in my tissues. I don't know enough about the various choices of pain blockers, or how they are used by surgeons, but I wonder if there is an art to deciding what, where and how much to use and it might be that some doctors are better at it. I would think that along with all medical research, there should be new potions being constantly developed for the important field of pain management.

The hip knee orthopedic surgeons at mass gen are excellent. Did you use one of them? Most of them teach at Harvard medical school.

Good point. I had both knees replaced last year with amazing results. That said, I had a great surgeon, and I prepped for one year with a trainer twice a week, and worked out four other days/week with one day off. This made the recovery much more doable, and that by itself is important. There is no waiting after surgery. The exercises 3 day are absolutely required.

But even with that, the right knee recovered slightly more slowly as far as swelling. Take what you read here but don't assume it will apply to you. Do the hard work and you should have a great recovery.

Thank you! I have also read that the second TKR for some people is easier, but honestly, after that first one, I am not willing to take that chance ever again unless it is absolutely necessary!!!

Thank you! For now, I am going to just stay with a cortisone shot every three months to my left knee. The right knee is replaced, but it doesn’t feel like my natural knee any longer. Kneeling down or getting up from trying to exercise is a major ordeal!!! I depend on the strength of my “non-surgical knee” to get me to a standing position! Not being able to take pain meds after the surgery was the deal breaker for me. The pain was excruciating and I couldn’t do the at home PT very well because of that. Prior to the surgery, I did work at strengthening my quads faithfully, but I guess it wasn’t enough. If I had the other knee done, I would run into that same situation with the pain meds. If it was *absolutely necessary* for the second knee replacement, and there were no other alternatives, I guess that I would have to consent to it, but for now, I’m just leaving this other knee alone!!!

Thank you! I have heard all good things about the hip and knee surgeons at Mass General. My primary care is there, so I am affiliated as a patient with MGH. However, a nurse friend of mine highly recommended The New England Baptist. She had had her hip surgery there. It is known for knees, hips, backs, necks etc. My doctor was James Bono, MD who is renowned in his field of knees and hips. He is “a doctor’s doctor”. My problem was not being able to tolerate the pain meds after the surgery. They tried four different types of medication and I was allergic to each one. So……all that I could do was Extra Strength Tylenol, which did not even begin to “touch” the pain that I was having! It would be the same situation if I had to have the second knee done, so for now, I will just continue with the cortisone shots every three months and hope that they continue to help me.

A second opinion and new x-rays might be a good idea at MGH. I had my hip done at MGH. It was a complex hip replacement. Four months in and I am finally feeling ok. My surgeon said that I exceeded expectations when I saw him two weeks ago. I was also told to go to New England baptist but my 92 year old neighbor had her surgery done ant MGH about 5 years ago and after doing extensive research I decided to go with her surgeon. So glad I did. Although not allergic to pain meds I can only take Tylenol for pain because I am on blood thinners for life due to the 3 dvts I’ve had in the past 22 years. I had no problem taking 25 mgs of Tramadol but it really wasn’t all that helpful.

Thank you so much for that information! Unfortunately, my primary care is leaving MGH and my husband and I are waiting for an assignment to a new primary care. As soon as we receive one, I will ask about their knee replacement surgery.

I just looked up the rankings for orthopedics and MGH is #9, New England Baptist is #16. Not sure how much it matters but I was surprised as I was told that NEB was the place to go for hip/knee surgery. Anyway good luck. It can’t hurt to get a second opinion as I do think that even though you are allergic to pain meds at some point the pain ought to be going away.

Thank you *so much* for letting me know that! I had no clue!!! It is so good to know that MGH has a higher rating! For now, I will continue with the cortisone shots in my left knee until they become ineffective but when that happens, I will definitely look into MGH!!! Like you, I was told by a close friend, who is a nurse, to go to NEB. I have heard excellent ratings on MGH so when I am assigned my new primary care (my PCP is leaving (: ) I will definitely get an opinion on my left knee. Thanks a million for sharing that information with me!