Mako TKR in one month; had stem cell, PRP

Posted by saeternes @saeternes, Oct 26, 2019

I have my left knee replacement scheduled at the end of November. I have had knee issues for years, finally got stem cell treatment in 2017, along with PRP. It worked very well, and my knee had only mild pain, could do anything. Then, walking fast in the dark, I smashed down over a jut in the sidewalk right onto my knees. That was last March. Since then, nothing but problems. On a work trip to Hong Kong my knee swelled up and hurt so much that I had to be put in a wheel chair at the airport. Really awful. It calmed down and I made it through two more trips with the help of compression hose and additional PRP. Then with only one trip left, I had another acute incident, but it cleared and I made it through my final trip. Just recently had another incident, but it has resolved as well. This usually happens when I am lying in bed and suddenly something catches in my knee. Very painful, can’t move at all. Anyway, long story short, I had hoped the stem cell treatment would come back to life, but given that it is not an easy treatment itself (much better than TRK, of course), and one must self-pay, I decided not to try again. My Mako surgery is coming up (I am doing this outside my city because although we have a good ortho center, they do not do Mako) and I have read everyone’s stories with great interest, especially that of Debbra who had a tradtiional TKR in 2017 and Mako in 2019. I watched a video of Dr. Kae’s surgery (search for “Dr. Kay’s story, social media diary” on YouTube) and was impressed by his rapid recovery. Of course not everyone can do that. I am working out hard when I can on weights and bike. So, if others have experience with Mako TKR (not partial) and are willing to discuss their experience in detail–hospital, pain, walking, devices (canes, etc), therapy, sleeping, feel of knee), I would be very grateful. Thank you.

Meaning TKR, of course.

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Hello, anyone there?

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@saeternes

Hello, anyone there?

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Hi, @saeternes Welcome to Connect.
I have had two TKRs, I know the first was not Mako, but in looking at the info about my second orthopedic surgeon I noticed that he seems to do Mako so I’m not sure if that one was or not. I think he would have told me if it was so I suspect it was not. My recovery was great, Mako or not.

As you mentioned, I believe that @debbraw had Mako on her TKR last winter so I have tagged her so she can contribute. I do know a woman who had it and she had an amazing recovery.

You have had a series of mishaps with your knee so I hope that your surgery will get you back on track and out of pain. When is your surgery scheduled? You must be looking forward to the relief it will provide. I hope you will keep us apprised of your progress, I look forward to hearing about it.
JK

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I have had one regular TKR, which resulted with a 24-26 ROM due to scar tissue build up. I just lived with it.Then I learned about Knee reconstruction and that was done 2 years ago this month. The ROM was about the same. The Therapist Doctor worked diligently to increase the ROM, but scar tissue kept increasing. My 2nd knee is now bone on bone and I do not know what to do. Any alternative I asked about was told it is too late. What are Mako and PRP?
Thank you for any suggestions. Connie

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@mclgracie

I have had one regular TKR, which resulted with a 24-26 ROM due to scar tissue build up. I just lived with it.Then I learned about Knee reconstruction and that was done 2 years ago this month. The ROM was about the same. The Therapist Doctor worked diligently to increase the ROM, but scar tissue kept increasing. My 2nd knee is now bone on bone and I do not know what to do. Any alternative I asked about was told it is too late. What are Mako and PRP?
Thank you for any suggestions. Connie

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Mako is robotic arm assisted surgery. It is supposed to result in fewer complications, faster recovery, better fit, and less pain.Gracie, PRP is Platelet Rich Plasma, they extract blood, spin it, and re-inject the plasma. Supposed to help with healing. My surgery is in a month. JK, I'm sure you would have known if it had been Mako, they make you first do a C-scan of your knee to produce a 3D model, and the robot bases its calculations on that. If the surgeon is as much as 2 mill. off, the robotic arm will not let him or her cut. Would love to hear from anyone who has gone through it. If you could post something about the person you know who had Mako surgery and how the recovery went, that would be great. Thanks for responding!

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@saeternes

Mako is robotic arm assisted surgery. It is supposed to result in fewer complications, faster recovery, better fit, and less pain.Gracie, PRP is Platelet Rich Plasma, they extract blood, spin it, and re-inject the plasma. Supposed to help with healing. My surgery is in a month. JK, I'm sure you would have known if it had been Mako, they make you first do a C-scan of your knee to produce a 3D model, and the robot bases its calculations on that. If the surgeon is as much as 2 mill. off, the robotic arm will not let him or her cut. Would love to hear from anyone who has gone through it. If you could post something about the person you know who had Mako surgery and how the recovery went, that would be great. Thanks for responding!

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@saeternes I did have a scan, but some googling has made me believe it was only because I had a Conformis knee replacement, and Conformis is made to mimic your natural knee in size, etc., not be an "off the shelf" knee. Because it is custom made the Conformis knee does give a better, quicker recovery and from what I have seen, greater satisfaction.
My googling also led to this site, a description of Conformis vs Makoplasty with descriptions of both. It is from an orthopedic group's but it describes the two different methods. I am sure it is biased because this group does the Conformis knee. I think either is a great improvement over traditional TKRs.
https://www.orthopedicsnh.com/blogs/conformis-vs-makoplasty-total-knee-replacement/
As I said above, I am very happy with my Conformis knee, and a woman I know from my water aerobics class had Mako and she had great results with that. I think one of the most important things is to get a very highly regarded orthopedic surgeon in whom you have confidence. A less than great surgeon can result in poor results even using Conformis or Mako.
JK

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Hi @saeternes – I learned something from you! I didn't know that the robot assisted TKRs were called Mako. Anyway, as you know, I was a regular old poster-child for before and after since my right knee was done in 2017 the old way and my left was done with the robot-assisted surgery. You've read my story and I won't repeat it here, but if there is anything specific you want to know, please shout out. I'm a big fan of this surgery and I think you are going to be pleased with the results. I'm glad you are working on the bike… That will pay off during your recovery. Is your right knee bad too? Or is it just your left?

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@contentandwell

@saeternes I did have a scan, but some googling has made me believe it was only because I had a Conformis knee replacement, and Conformis is made to mimic your natural knee in size, etc., not be an "off the shelf" knee. Because it is custom made the Conformis knee does give a better, quicker recovery and from what I have seen, greater satisfaction.
My googling also led to this site, a description of Conformis vs Makoplasty with descriptions of both. It is from an orthopedic group's but it describes the two different methods. I am sure it is biased because this group does the Conformis knee. I think either is a great improvement over traditional TKRs.
https://www.orthopedicsnh.com/blogs/conformis-vs-makoplasty-total-knee-replacement/
As I said above, I am very happy with my Conformis knee, and a woman I know from my water aerobics class had Mako and she had great results with that. I think one of the most important things is to get a very highly regarded orthopedic surgeon in whom you have confidence. A less than great surgeon can result in poor results even using Conformis or Mako.
JK

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Thanks JK I did not know about the confotmis knee bit it is interesting. I'll read more about it although I am locked in now and will go ahead with Stryker Mako. Let me know if you hear any more from others who have had it done.

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@debbraw

Hi @saeternes – I learned something from you! I didn't know that the robot assisted TKRs were called Mako. Anyway, as you know, I was a regular old poster-child for before and after since my right knee was done in 2017 the old way and my left was done with the robot-assisted surgery. You've read my story and I won't repeat it here, but if there is anything specific you want to know, please shout out. I'm a big fan of this surgery and I think you are going to be pleased with the results. I'm glad you are working on the bike… That will pay off during your recovery. Is your right knee bad too? Or is it just your left?

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Thanks Debbra. If you could write a bit more detail about your immediate post surgery recovery, how long you used cane or other devices, when you cold walk on your own, sleeping and anything you can think of I would love to hear it.

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@saeternes

Thanks JK I did not know about the confotmis knee bit it is interesting. I'll read more about it although I am locked in now and will go ahead with Stryker Mako. Let me know if you hear any more from others who have had it done.

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@saeternes from what I have heard and read I am sure that you will be just as happy with Mako as I am with Conformis, just different approaches. As I said that article was done by a practice that does Conformis so I am sure it is biased. No matter the approach, the talent of the surgeon is the most important factor I think.
JK

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@saeternes

Thanks Debbra. If you could write a bit more detail about your immediate post surgery recovery, how long you used cane or other devices, when you cold walk on your own, sleeping and anything you can think of I would love to hear it.

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@saeternes – Sure, I'm happy to share my recovery story! In 2017, I hurt my knee and long story short, my ortho surgeon had me in physical therapy for a couple of months before my first knee replacement. That was a huge help. My knee was replaced on 4/18/17 and when I was released from the hospital, my ROM extension/flexion was 3/105. I started in-home PT on 4/21. By one week, I started using the stationary bike and my ROM was 5/120 (I'd lost a little on the extension, but gained a lot on flexion). I just used the walker for a week and transitioned to a cane. By 2 weeks, I could walk in the house w/o a walker or a cane, but I used the cane outside. At three weeks, my ROM was 0/120 and I started to drive. At that point, I went from in-home PT to outpatient. My last PT visit was 9 weeks. I used oxycodone for 9 weeks, but at the end it was just one at night to sleep.

On my second robot assisted TKR, I asked my ortho-surgeon for a prescription for "pre-hab" so I could prepare for the surgery. I had the surgery on 1/29/19 and when I was released from the hospital my ROM was 5/110. I started in home PT on 2/1/2019. I only used the walker a couple of times when I got up at night to go to the bathroom. Before the first week was out I was using the stationery bike and I had transitioned completely to a cane. At one week, I could do 20 minutes on the bike and walk outside with the cane. At two weeks, my ROM was 0/128. Two weeks also marked the point where I could drive so I ended in-home PT and went to outpatient. At three weeks, I walked a full mile. My last PT visit was 8 weeks but I didn't really need that much – the prescription was written for 8 weeks so I used it all. I used oxycodone for 5 weeks, but at the end it was just 1 to sleep and maybe one before PT.

Second time was much easier all the way around. Let me know if I skipped anything that interests you. Will you keep us posted on your prep and recovery? I'm pulling for you.

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@debbraw

@saeternes – Sure, I'm happy to share my recovery story! In 2017, I hurt my knee and long story short, my ortho surgeon had me in physical therapy for a couple of months before my first knee replacement. That was a huge help. My knee was replaced on 4/18/17 and when I was released from the hospital, my ROM extension/flexion was 3/105. I started in-home PT on 4/21. By one week, I started using the stationary bike and my ROM was 5/120 (I'd lost a little on the extension, but gained a lot on flexion). I just used the walker for a week and transitioned to a cane. By 2 weeks, I could walk in the house w/o a walker or a cane, but I used the cane outside. At three weeks, my ROM was 0/120 and I started to drive. At that point, I went from in-home PT to outpatient. My last PT visit was 9 weeks. I used oxycodone for 9 weeks, but at the end it was just one at night to sleep.

On my second robot assisted TKR, I asked my ortho-surgeon for a prescription for "pre-hab" so I could prepare for the surgery. I had the surgery on 1/29/19 and when I was released from the hospital my ROM was 5/110. I started in home PT on 2/1/2019. I only used the walker a couple of times when I got up at night to go to the bathroom. Before the first week was out I was using the stationery bike and I had transitioned completely to a cane. At one week, I could do 20 minutes on the bike and walk outside with the cane. At two weeks, my ROM was 0/128. Two weeks also marked the point where I could drive so I ended in-home PT and went to outpatient. At three weeks, I walked a full mile. My last PT visit was 8 weeks but I didn't really need that much – the prescription was written for 8 weeks so I used it all. I used oxycodone for 5 weeks, but at the end it was just 1 to sleep and maybe one before PT.

Second time was much easier all the way around. Let me know if I skipped anything that interests you. Will you keep us posted on your prep and recovery? I'm pulling for you.

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@debbraw Debbra. you could be the post person for Mako! What a fabulous recovery you had. What is your flex now? The woman I know at my water aerobics classes says she had 145 at a few weeks but I have a hard time imagining that. I didn't think 145 was even something that most doctors expect for anyone.
JK

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@contentandwell

@debbraw Debbra. you could be the post person for Mako! What a fabulous recovery you had. What is your flex now? The woman I know at my water aerobics classes says she had 145 at a few weeks but I have a hard time imagining that. I didn't think 145 was even something that most doctors expect for anyone.
JK

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Hi @contentandwell – JK, they quit measuring when I got to 130 and of course, it's been months now since I've been at PT and that's the only way I've ever gotten an accurate ROM measurement. Yes… I think my doctor was very pleased with the recovery and interested in seeing the differences since the two knees were done within 2 years of each other.

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I hope I can do half as well! Thanks for all the details. I see my a note to my surgeon asking about Conformist but I suspect I will stick with Mako. Your story is so encouraging, Debra. Two more questions: how much pain did you experience, and when? And did you have nerve ablation? I will certainly post with updates after the surgery. Take a look at Dr. Kay's 2 mim video on his recovery from Mako, I mentioned it in my first post.

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@saeternes

I hope I can do half as well! Thanks for all the details. I see my a note to my surgeon asking about Conformist but I suspect I will stick with Mako. Your story is so encouraging, Debra. Two more questions: how much pain did you experience, and when? And did you have nerve ablation? I will certainly post with updates after the surgery. Take a look at Dr. Kay's 2 mim video on his recovery from Mako, I mentioned it in my first post.

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@saeternes From everything I have read and heard it sounds as if Mako will give you just as good results as Conformis. They are just two different, more advanced ways, of solving the problem of TKRs having a high incidence of patient dissatisfaction. There are probably more sites that are not partial to something as the site I found, sites that will extol the virtues of Mako vs Conformis.
JK

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