Having knee replacement: how to prepare and questions about PT

Posted by ronnie3716 @ronnie3716, May 1, 2016

I’m having knee replacement (L) on June 20th.
Any suggestions on how to get ready for it?
How soon does physical therapy start after one gets home?

@babette

@contentandwell I was going to post today and I'm glad you nudged me! I'm on day 13 and had a great surgery experience and hospital stay. It's completely different, in a good way, this time! I had a nerve block/spinal and woke up with my head clear as a bell, so I highly recommend that. I do have pain and the surgeon wants me to wean from the narcotics so I have some trepidation… We'll talk on November 6 when I see him to have my sutchers removed. I'm lucky to have the same PT coming to my house 3X per weekend; she really motivates me, which I need! And, assuming I can drive at 4 weeks, I'll transfer to an outpatient PT facility I really like. So things are going really well. Thanks for asking! 🙂

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Awesome
Is your range of motion quite different than the first time?

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At exactly 2 weeks out, my range of motion is much better than it was the first time around: 0 – 110.

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@babette

At exactly 2 weeks out, my range of motion is much better than it was the first time around: 0 – 110.

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@babette it really makes me happy to hear how much better things are for you now. What a tremendous relief for you.
JK

Liked by babette

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@kneeproblem

Has anyone out there had to get a revision if so place tell me how it went. I had a partial knee replacement which has come loose so they want to remove it a d put in a full knee replacement asap. Please let me know if anyone had this done and how you are doing

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I need a TKR revision surgeon who has done lots of revisions. Anyone have a recommendation

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Hi – I'm sorry you have to have a revision I had one about 10 weeks ago. I researched my options for a year and had the best possible surgeon and outcome after a year of living hell. Where do you live? Are you willing/able to travel?

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@juneelaine

I need a TKR revision surgeon who has done lots of revisions. Anyone have a recommendation

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If can travel,Mayo Clinic Rochester,Minnesota where the clinic was founded. Any of the doctors in ortho dept. are very capable. If u go into the Mayo website,than to Ortho dept. can see credentials of the doctors. My doctor is Dr, Pagnano.I have had two knee replacements and one hip.My wife has had two knee replacements and two hips! I do cardio dance 4 days a week and strength training three days a week. Rochester has accommodations from luxury to basic.All are very clean as you are serviced by people who have the Midwest work ethic.Getting around is a breeze, free shuttle service or if close to Clinic just grab a wheel chair, no checking out no return just leave at your destination. The last time I talked to Dr. Pagnano I asked him about my first knee, how long it would last. He said typically 1% fail a year.So if you are out 10 years there is a 90% chance of NO failure. As u know ortho.surgery it is very lucrative and in high demand with baby boomers and the obesity epidemic.Orthropedic surgeons are paid on commission,they are incentavized to do more operations! Mayo doctors are paid on salary! The Mayo philosophy is to do what’s best for the patient.I’ll give you an example of how it works. When my knee started acting up I went to three surgeons and they all told me the same thing,we need to operate ASAP. I went to Mayo and after extensive testing, exponentially better than other doctors,Dr. Pagnano said I need not do anything;I would know when I would need the surgery. This is important as the longer u can push the operation the greater probability you will die before it fails.Best to you and contact me if you have any other questions.

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I'm scheduled for a bilateral knee replacement. I'm also a caregiver & widowed. Hs anyone here done a bilateral replacement at the same time?

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@mom4twins4me

I'm scheduled for a bilateral knee replacement. I'm also a caregiver & widowed. Hs anyone here done a bilateral replacement at the same time?

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Yes in Jan 2019. Surgeon said I was an excellent candidate for bilateral. Young 61, great health, fitness and weight. I wished I would have done one at a time. Learned a lot since then especially from this discussion group.

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Has anyone with had a total knee replacement? Doctors have me worried about being put under. My knee is bone on bone.

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@riderwayne

Has anyone with had a total knee replacement? Doctors have me worried about being put under. My knee is bone on bone.

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Hello @riderwayne. I moved your discussion to the Joint Replacements (https://connect.mayoclinic.org/group/joint-replacements/) group and combined it with an existing discussion titled, "Having knee replacement: how to prepare and questions about PT." This discussion is filled with members asking questions about the time leading up to the actual surgery, how to best prepare and how to get the best results after the surgery takes place.

@riderwayne, you mentioned you are nervous about being put under anesthesia. Since you posted the original discussion in the HCM group, are you nervous about being put under because of heart issues?

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@riderwayne – I had a left TKR just about one year ago at the Mayo Clinic in Rochester. I too was nervous about the anesthesia. They set me up at my pre surgery meeting (one week prior) to meet with an anesthesiologist to go over my fears and my personal surgery drug plan. I felt really listened to and confident that I would have a successful experience.

While in pre op the anesthesia team came in to assure me that my concerns were addressed and that I would not be put under, but rather awake during the procedure. They also agreed to give me smaller doses (unless i needed more). I recall some diazepam type drug in an IV before they inject some anti pain drug into my leg guided via ultra sound. In the OR they gave me something that put me in an awake, yet not awake and not remembering state. When I got to post op the drug wore off quickly and I was alert and not in the least bit nauseated. I could not remember the procedure nor could I remember how I went in with one gown and came out with a different one. Yikes! I went to my room and a bit later someone came in and had me up and walking. I only took extra strength tylenol during my 24 hour hospital room stay and again never once felt groggy, confused or sick from the surgery.

Fair warning though…..they do inject some type of long lasting pain med right in to the knee area before you leave the OR. I thought I was a tough guy, but in about 48 hours it wears off so make sure you fill your pain med prescription. I ended up taking full doses of Tramodol for 2 days and 1/2 dose for 2 or 3 more and then just a 1/2 dose before bed for about a week with advil/tylanol during the day.

I strongly encourage you to be your own advocate and request to meet with the anethesia team.

Wishing you a life with out pain, Kajon

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@riderwayne

Has anyone with had a total knee replacement? Doctors have me worried about being put under. My knee is bone on bone.

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@riderwayne I too was apprehensive about having a general anesthesia since after my first TKR I was left in a very confused state. My orthopedic surgeon said that was not a problem. Whatever I had it put me to sleep but it did not bother me afterward at all.
As @kajon commented I would discuss either with the anesthesiologist or your orthopedic surgeon. He is really the one who determines what type of anesthesia is used I think unless there are unusual circumstances.
JK

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@contentandwell

@riderwayne I too was apprehensive about having a general anesthesia since after my first TKR I was left in a very confused state. My orthopedic surgeon said that was not a problem. Whatever I had it put me to sleep but it did not bother me afterward at all.
As @kajon commented I would discuss either with the anesthesiologist or your orthopedic surgeon. He is really the one who determines what type of anesthesia is used I think unless there are unusual circumstances.
JK

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I had a spinal, as I get sick under general. I did great and was up moving around the next morning and PT in the afternoon.

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I guess I should have mentioned on top of HypertrophicCardiomyopathy I also have pacemaker defibrillator.

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Physical Therapy starts with exercise immediately. The first two days of a total knee are not fun. It gets better after you are on your feet with a security belt and a physical therapist taking in a walker progressively. If you have done some general exercise before surgery, you will recover faster. They will give you pain medication . At home, you should have a Home Health Physical Therapist. When you complete home visits, go to out patient Physical therapist. Follow directions on pain medication. Do not increase yourself. Have instructions on how to get off hydrocordon to lesser pain medication. Avoid sleeping pills. Breathing techniques and eating early and exercising daily works the best. The most progress is 6 months. However, a full range and good fiunctional knee comes more at 1 year. I have two wonderful asymptomatic total knees. It is not a cake walk, but it is well worth it.

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