I need a TKR: Do I do it, or go as long as I can?

Posted by happyat76 @happyat76, Oct 30, 2019

I was told in January of this year that I need a TKR as there is bone rubbing on bone, no cartilage in my left knee. I was seen by an Orthopaedic surgeon in a hospital and I saw the x-ray myself. My question is this. I can still walk, although my knee gives out sometimes, I have a throbbing pain constantly and I do have some troubling walking. I can’t walk far. What should I do? Should I book the operation? Should ?I let it go for a while longer? What will be the outcome if wait? I am 78 now and really don’t want to go through with this, but am worried that I may end up in a wheelchair not being able to walk. I am also about 50 lbs. overweight. I have a bad back also. I would appreciate any suggestions.

You know the answer. Lose the weight / That will help. Try PRP which helps in the pain area. I am in the same boat, but working on weight loss, did PRP and stem cells. If your bone on bone stem cells will not work. I do a lot of biking as walking is uncomfortable. Good luck.

REPLY

@happyat76 : Just some general thoughts: the decision whether to have or not have a TKR depends mostly on your current lifestyle, and what you expect going forward. I know someone who had bone-on-bone knee joints for years, and she is still skiing competitively on a senior rec. team. Probably because her well-trained muscles take the pressure off the knee. I was in really good shape when my knee problems started, and after arthroscopic surgery that did not help I bit the bullet and had the TKR, even though it was not strictly necessary at that point, UNLESS I wanted to stay as active as I am used to being. There was no point in trying (more) PT, since 7+ months of exercises after the first surgery failed to help. Regretfully, I did not know anything about PRP or stem cells (no orthopedic surgeon will tell you, I think). Might have been a viable alternative, might not. I’ll never know. Definitely worth considering.
Summary: for me, and at the young age of 69 at the time of surgery, it was the right call. I am mostly pain free, and am back to most activities that keep me in shape and happy.

REPLY

@happyat76 Your symptoms sound like mine. I am slightly younger than you are, I had my second TKR at age 70 but I am so glad that I did. I couldn't walk long distances prior to it but I am almost unstoppable now. Not everyone gets such great results. I believe the most important thing is to get a really great surgeon. Also, there are two big improvements on TKRs, Makoplasty, and the Conformis knee. They both seem to have higher odds of being successful than the older ways. My TKR is a Conformis knee.
I have also read that the sooner you get it done the better off you are because the muscles are more equipped to help your recovery whereas if you wait a long time the muscles have weakened. I also think that carrying a lot of excess weight can make your recovery more difficult, although many people do have excess weight and have successful TKRs.
It is a tough decision, one only you can make. You really do have to weigh the pros and cons. A friend of mine who is a doctor (not orthopedic) really tried to discourage me from having it done because many people are not happy with the results but I think if you research carefully and choose the best possible surgeon, then that greatly increases the odds of it being very successful.
I will be very interested in hearing what you decide. Please keep us up to date on your progress.
JK

REPLY
@contentandwell

@happyat76 Your symptoms sound like mine. I am slightly younger than you are, I had my second TKR at age 70 but I am so glad that I did. I couldn't walk long distances prior to it but I am almost unstoppable now. Not everyone gets such great results. I believe the most important thing is to get a really great surgeon. Also, there are two big improvements on TKRs, Makoplasty, and the Conformis knee. They both seem to have higher odds of being successful than the older ways. My TKR is a Conformis knee.
I have also read that the sooner you get it done the better off you are because the muscles are more equipped to help your recovery whereas if you wait a long time the muscles have weakened. I also think that carrying a lot of excess weight can make your recovery more difficult, although many people do have excess weight and have successful TKRs.
It is a tough decision, one only you can make. You really do have to weigh the pros and cons. A friend of mine who is a doctor (not orthopedic) really tried to discourage me from having it done because many people are not happy with the results but I think if you research carefully and choose the best possible surgeon, then that greatly increases the odds of it being very successful.
I will be very interested in hearing what you decide. Please keep us up to date on your progress.
JK

Jump to this post

I still haven’t decided what to do. I will let you know. ?How do I know who is a great surgeon? Thanks for your input.

REPLY

@happyat76 choosing a good surgeon is probably the most important thing, so ask around and read on the web reviews of surgeons in your area. Also, take a look at the different companies that make knee components and read about them. I had Makoplasty (robotic arm, guided by surgeon), made by Stryker, and am happy with it although only 6 weeks out so time will tell. Others have had great results with the custom knees made by Conformis. I still think a good surgeon and good prehab is the best predictor of results, but the knees also are important. Good luck.

REPLY
@happyat76

I still haven’t decided what to do. I will let you know. ?How do I know who is a great surgeon? Thanks for your input.

Jump to this post

@happyat76 Finding a great surgeon or doctor can be difficult. I rely somewhat on recommendations from friends and relatives who I know are as picky as I am, I also look at the rating sites and if there are many reviews I tend to believe them, if there are few it is much less reliable. I also check their credentials and make sure they are certified in their speciality of course.
Most of the time this has worked out well for me. Right now I am ambivalent about two doctors in my arsenal of doctors. I am mostly happy with all of the rest. The two doctors I am ambivalent about were both highly recommended by other medical professionals so even that is not 100% reliable.
JK

REPLY
@saeternes

@happyat76 choosing a good surgeon is probably the most important thing, so ask around and read on the web reviews of surgeons in your area. Also, take a look at the different companies that make knee components and read about them. I had Makoplasty (robotic arm, guided by surgeon), made by Stryker, and am happy with it although only 6 weeks out so time will tell. Others have had great results with the custom knees made by Conformis. I still think a good surgeon and good prehab is the best predictor of results, but the knees also are important. Good luck.

Jump to this post

@saeternes I agree, the best possible surgeon is the most important thing to assure a successful TKR.
Does all Mako surgery use the Stryker knee?
JK

REPLY
@contentandwell

@happyat76 Finding a great surgeon or doctor can be difficult. I rely somewhat on recommendations from friends and relatives who I know are as picky as I am, I also look at the rating sites and if there are many reviews I tend to believe them, if there are few it is much less reliable. I also check their credentials and make sure they are certified in their speciality of course.
Most of the time this has worked out well for me. Right now I am ambivalent about two doctors in my arsenal of doctors. I am mostly happy with all of the rest. The two doctors I am ambivalent about were both highly recommended by other medical professionals so even that is not 100% reliable.
JK

Jump to this post

I would wait as long as you can. They don't tell you that you will not be able to do simple things like walk in your yard on even ground, kneel to pull weeds, walk in the snow, chase after that fun grandchild, carry that baby up and down stairs, enjoy long walks in nature. Those sites for recommendations are not always reliable, more like paid advertisements. Ask for personal experiences, and DO talk about the custom Conformis or how the size for you will be decided. Take as long as you need….Good Luck!

REPLY
@doodles418

I would wait as long as you can. They don't tell you that you will not be able to do simple things like walk in your yard on even ground, kneel to pull weeds, walk in the snow, chase after that fun grandchild, carry that baby up and down stairs, enjoy long walks in nature. Those sites for recommendations are not always reliable, more like paid advertisements. Ask for personal experiences, and DO talk about the custom Conformis or how the size for you will be decided. Take as long as you need….Good Luck!

Jump to this post

@doodles418 That was exactly what I thought, wait as long as possible, but the current thinking is that recovery is better if you don't wait!
If you definitely have a TKR in your future you should get it done as soon as possible, while you still have as much function as possible, or exercise a lot which I did, otherwise your muscles can atrophy somewhat making recovery more difficult.

I had to put my last TKR off for two years due to platelet issues. During that time I exercised A LOT. As a result my knee actually hurt less prior to when I finally had it done, because I had really strengthened those supporting muscles.
JK

REPLY
@contentandwell

@doodles418 That was exactly what I thought, wait as long as possible, but the current thinking is that recovery is better if you don't wait!
If you definitely have a TKR in your future you should get it done as soon as possible, while you still have as much function as possible, or exercise a lot which I did, otherwise your muscles can atrophy somewhat making recovery more difficult.

I had to put my last TKR off for two years due to platelet issues. During that time I exercised A LOT. As a result my knee actually hurt less prior to when I finally had it done, because I had really strengthened those supporting muscles.
JK

Jump to this post

@contentandwell I was told that at 61 I was an excellent candidate for knee replacement. I believed that going ahead with surgery while I was young, active (even with bone on bone), in the best shape physically (never was overweight), I was biking 20 miles a day, doing all the pre-hab exercises plus strength and weight training for 2 months prior to surgery that I would have great success. It's been a year post-op and my life is not better after surgery. All those theories about being young did not help. Surgery has risks that we all take when we go under the knife. I researched my surgeon, he was a 5 out of 5 stars on those websites. I asked about custom and was told they didn't offer that option ( that's where I should have canceled out). Now I am one of those suffering with daily pain and limitations due to a size issue. I'm still looking for a good surgeon who wants to take on someone else's surgery mistake. I wished I would have waited now that I know what I know now. Much has been learned on this discussion group since I started 3 months post-op last March. Wish I would have known about it before making a decision. I hope @happyat76 takes in all this information and can make a better decision for themselves .

REPLY
@doodles418

@contentandwell I was told that at 61 I was an excellent candidate for knee replacement. I believed that going ahead with surgery while I was young, active (even with bone on bone), in the best shape physically (never was overweight), I was biking 20 miles a day, doing all the pre-hab exercises plus strength and weight training for 2 months prior to surgery that I would have great success. It's been a year post-op and my life is not better after surgery. All those theories about being young did not help. Surgery has risks that we all take when we go under the knife. I researched my surgeon, he was a 5 out of 5 stars on those websites. I asked about custom and was told they didn't offer that option ( that's where I should have canceled out). Now I am one of those suffering with daily pain and limitations due to a size issue. I'm still looking for a good surgeon who wants to take on someone else's surgery mistake. I wished I would have waited now that I know what I know now. Much has been learned on this discussion group since I started 3 months post-op last March. Wish I would have known about it before making a decision. I hope @happyat76 takes in all this information and can make a better decision for themselves .

Jump to this post

@doodles418 that’s terrible that your TKR was not more successful than it was, particularly since you researched the doctor and were in good shape. What does the doctor say about it now? If you can’t get satisfaction from that doctor I hope you will find a different doctor who may be able to help you. When you do I hope you will let us know how it goes.
JK

REPLY

I had one TKR in my 60’s and the second one in my mid-70’s. Both are totally successful but the recovery was much faster with the first one. As a result I am active and weight isin control.

REPLY
Please login or register to post a reply.