Delaying TKR

Posted by dna41 @dna41, Aug 11 12:52pm

I have two bad knees and am scheduled for TKR on one of them in September. I have read so many posts about how difficult this surgery is and how painful. I am terrified of doing it. I previously had shots in my knee but stopped because the actual shot itself (to me) was excruciating painful. I can't do that again without more or different anesthetic to my knee. Does anyone know if there is an alternate pain eliminating way to have a gel shot? I'm thinking if there is, maybe I can just continue having the shots rather than the surgery. Any thoughts or suggestions on this?

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Profile picture for Lawanna Bean @lawanna85

Good suggestion. I have a friend who stayed for a month in an in-patient rehab and was very pleased. She had no help at home. But I would suggest you do your homework on in-patient rehab facilities. They are not all created equal. In the Dallas area, there are mostly rehab facilities for substance abuse. Others had low ratings. My Dr. does not recommend an in-patient rehab facility. Instead, he kept me in the hospital 4 days and 3 nights for a bilateral knee replacement. Once home I had an inpatient home therapist come in 3 times a week for 2 weeks. That was invaluable. Do the research and keep asking questions!

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Excellent plan and advise Lawanna. Thank you!

Joe

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Profile picture for dna41 @dna41

Yes, my doctor does robotic surgery using Zimmer Biomet ROSA knee technology.

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That's interesting. My knee surgeon used Stryker/Mako and my shoulder surgeon uses Zimmer Biomet.

I think the robotic assistant is most useful in knee replacements. There are three areas that need to be prepped for the implant, the bottom of the femur, the top of the tibia, and the back of the patella. The femur is tricky and requires a number of cuts. Accuracy is everything, and the robotic assistant makes sure the surgeon does very refined cuts, while virtually eliminating cuts that aren't needed.

It's fascinating to me. Better yet, it worked!

Joe

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Profile picture for dna41 @dna41

Thank you again. I believe I have a good surgeon. My concern now is after care. I think I need to go to rehab for a few days but you have to have the surgery in a hospital in order for that to happen (Medicare). My surgeon uses a surgical facility so the surgery is outpatient.

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Most TKRs are outpatient, But if you don't have support at home, take Sue's advice and find out what your insurance will cover as far as an extended hospital stay, admittance to a rehab facility, and/or getting assistance through a visiting nurse.

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Profile picture for heyjoe415 @heyjoe415

That's interesting. My knee surgeon used Stryker/Mako and my shoulder surgeon uses Zimmer Biomet.

I think the robotic assistant is most useful in knee replacements. There are three areas that need to be prepped for the implant, the bottom of the femur, the top of the tibia, and the back of the patella. The femur is tricky and requires a number of cuts. Accuracy is everything, and the robotic assistant makes sure the surgeon does very refined cuts, while virtually eliminating cuts that aren't needed.

It's fascinating to me. Better yet, it worked!

Joe

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Another thanks to you! You always have something of value to share.

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Profile picture for heyjoe415 @heyjoe415

You are very welcome Nina.

It's fine and normal to have some fear before any surgery, The fact that you are seeking advice ahead of your TKR tells me that you know how to lessen that fear, with information and knowledge.

And please know that the first week after surgery is the 'worst". It is a traumatic (to the body) surgery, so there will be some pain and stiffness as you start to rehab your new knee. I comforted myself by the fact that the pain was 1). less than I experienced before surgery and 2) the pain and stiffness lessened each day I did the rehab work (which was everyday!).

And if you change your point of view from "I have no choice" to "The surgery will work and it will make me feel much better in the near future", the journey will be a little easier.

Now at age 70, I've had both knees replaced (2022), my right hip replaced (March 2025) and on Aug 6th this year (yep, two weeks ago) I had my left shoulder replaced, I have faith and trust in the surgeons I work with, and the process of joint replacement has seen incredible advances over the last 30 years or so.

Again I wish you well. Reach out to me anytime before or after your surgery. I know you'll be feeling a lot better this Christmas!

Joe

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Your comment about shifting point of view is helpful to me to keep in mind as I prepare for upcoming knee surgery.
I have an excellent dr. Although he's skilled with robotic procedure, he won’t be using it in my case.

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I would not use an "outpatient" facility because I live alone. I used the hospital and got an extra day or two which made all the difference. I hired a stranger (a friend of a friend) who helped me for the first 2 - 3 weeks I was at home. I've had 5 major joint replacement surgeries. After she left, I had prescheduled some neighbors, extended cousins to come for the next month for some visits, meals and getting around. It made all the difference. By 6-8 weeks out I was ready to fully be on my own. it timed out with my driving clearances as well. Good luck!

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Profile picture for heyjoe415 @heyjoe415

Hi Lawanna,

Wow, a bilateral TKR at 85. You are a warrior! Good for you. You are an inspiration!

Joe

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Still doing great. Of course, I have days when the nerves are healing and there is discomfort. But that's normal. My flection is now 124 and 113 at 7 weeks so I am pleased. So glad I had this done.

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Profile picture for dna41 @dna41

Another thanks to you! You always have something of value to share.

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Thank you so much for your kind words. That means a lot to me.

I have a friend at the gym, now retired, who was a sales rep for Zimmer Biomet and he knew my shoulder surgeon.

In a comment he can make now that he's retired, he stated what I thought was obvious - almost all of these medical devices are good. Good surgical outcomes though are largely personal, that is, a good surgeon and a patient willing to do the required rehab will get good results.

My point being, do a lot of research before selecting a surgeon. And be prepared. The best ortho surgeons are booked out 3 to 6 months. So at the first sign of joint or back trouble, find a great Dr. It's our health after all and we deserve the best.

Joe

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Profile picture for loll @loll

Your comment about shifting point of view is helpful to me to keep in mind as I prepare for upcoming knee surgery.
I have an excellent dr. Although he's skilled with robotic procedure, he won’t be using it in my case.

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Thank you Loll.

Yeah robotic assistants are most valuable, imo, for knees. There is no need I know of to use one for the hip, and my surgeon didn't use a robotic assistant when I had my shoulder replaced on Aug 6th - yep, two weeks ago!

Point is, robotic assistants won't be used for all joint replacements by all ortho surgeons. I've had good experiences both ways. I trust my surgeons to do whatever it takes to have a successful surgery, because a good surgeon is still the most important variable.

Joe

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Profile picture for Lawanna Bean @lawanna85

Still doing great. Of course, I have days when the nerves are healing and there is discomfort. But that's normal. My flection is now 124 and 113 at 7 weeks so I am pleased. So glad I had this done.

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Flexion at 124!?! That is terrific. 120 is the goal when finishing PT so you are doing great!

As for nerves, I had a limited sense of feeing on and around both kneecaps. This wasn't a problem, and resolved around 6 months I think.

I'm glad you're happy with the results. You deserve them!

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