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.

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@jenniferkn

Hi Carol,
I am 61 years old and have just had a TKR. I had bone on bone from years of activity after a tearing my left ACL at 18 and having it reconstructed when I was in my mid-30s. I am quite active and found that I couldn't hike anymore. Running was out of the question. So I decided to do it. Having said that I did get steroids for a few times, but after they became less effective I went to OrthoVisc and PRP (Platelet Rich Plasma). After two cycles of treatments I decided the tune ups were to difficult to manage 2x a year.
To answer your questions:
1. I am 9 weeks out of recovery and can go upstairs and downstairs carrying things (while holding the railing).
2. I can get up off the floor — I like to do core and yoga
3. I can kneel (but put a soft towel under my knee to relieve the pressure).
4. Yes, I attend yoga and core. I hike 5 miles easily now. I have been riding my bike (10+ miles) when I have time.
5. Travel – easy peasy.
6. I'm walking on uneven ground now. Haven't had snow yet. I live in VT so soon!
7. Limitations: I don't think I am allowed to run again, but I have let go of that. I have heard of people that play tennis though, so I'm looking forward to that in my future. Maybe next summer.

I would say it is best to do it when you are healthy and strong. I was worried that the longer I waited the less in shape I would be. And the recovery would be more challenging. I took spin classes up to the day I had my surgery to give me the best shot at recovery well.

Best of luck with your decision!
Jennifer

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Jennifer,

Well done and congratulations on a fine recovery. You did everything right and my answers would be the same. I did wait 3 months to kneel, with a cushion. And pre-op prep, spinning is especially good, and is crucial to a good recovery.

Finally, for anyone considering TKR, get right on the exercises post-op. They'll have you walk with a walker in the hospital. Movement is everything! Do exercises everyday, not just when you're in pt.

And thanks Jennifer. I hired a personal trainer to help me strengthen my knees (quads and hamstrings). That was tricky because I was bone on bone. But I got through it and had both knees replaced this year. My surgeon also used the Make robotic assistant.

Well done!

Joe

REPLY
@jenniferkn

Hi Carol,
I am 61 years old and have just had a TKR. I had bone on bone from years of activity after a tearing my left ACL at 18 and having it reconstructed when I was in my mid-30s. I am quite active and found that I couldn't hike anymore. Running was out of the question. So I decided to do it. Having said that I did get steroids for a few times, but after they became less effective I went to OrthoVisc and PRP (Platelet Rich Plasma). After two cycles of treatments I decided the tune ups were to difficult to manage 2x a year.
To answer your questions:
1. I am 9 weeks out of recovery and can go upstairs and downstairs carrying things (while holding the railing).
2. I can get up off the floor — I like to do core and yoga
3. I can kneel (but put a soft towel under my knee to relieve the pressure).
4. Yes, I attend yoga and core. I hike 5 miles easily now. I have been riding my bike (10+ miles) when I have time.
5. Travel – easy peasy.
6. I'm walking on uneven ground now. Haven't had snow yet. I live in VT so soon!
7. Limitations: I don't think I am allowed to run again, but I have let go of that. I have heard of people that play tennis though, so I'm looking forward to that in my future. Maybe next summer.

I would say it is best to do it when you are healthy and strong. I was worried that the longer I waited the less in shape I would be. And the recovery would be more challenging. I took spin classes up to the day I had my surgery to give me the best shot at recovery well.

Best of luck with your decision!
Jennifer

Jump to this post

Thank you for your answers to questions i have as well.
I don’t have everyday pain, but stairs and yoga are a the biggest challenges. I have adjusted my life. So I hesitate to get TKR at 72 because I don’t have constant pain most people talk about.
One of these days i will pull the trigger, till then i will stay active so i am in shape for surgery.

REPLY
@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

Jump to this post

Hi Carol,

My answers would be the same as Jennifer's, except I'm 68 y/o. I had both knees replaced this year. My surgeon used the Stryker Mako robotic assistant and the results were incredible.

It's easier to say what I can't do anymore. I can't run or do anything that creates impact on the knee. A knee replacement is close to the original knee anatomy, but it's not a perfect fit. My ACL and PCL were removed and the meniscus is replaced with irradiated polyethylene, a very durable plastic. I had bone on bone pain, and now that's gone.

If you do the surgery, look into the Mako assistant and a surgeon who uses it. Also, take time to strengthen your quads and hamstrings before surgery. Jennifer did spin classes, and that's a good idea because cycling doesn't stress the knee. I hired a personal trainer to help.

And above all, do the post-op exercises immediately and every day for as long as you're improving (range of motion – bent knee, and flexion – straight knee). Do these with a pt and every day you're not with the pt.

All the best!

Joe

REPLY
@carolasc

Thanks for your positivity – it is so good to hear such a good outcome as I feel more people wish they have never had tkr after doing it. I think one of the biggest fears I have is getting back into my home after surgery – I live in a split entry home, 7 steps from the garage into the house and 7 more up from the entry to the main level. Most people tell me it’s impossible to do the day of surgery or even the day after. I am so glad you are doing so well – thanks for your reply! It gives me hope.

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Carol, remember that most of the people who post here are looking to solve problems and only a few people post their success stories, so you are getting a very skewed view of success rates on this website. Besides myself having both knees done, I personally know three other people with TKR's very well, and all of us are happy with the results. If you are an active healthy person before surgery, have a good surgeon, do pre-op exercises and work hard at PT afterwards, there is every reason to believe that you will have a good recovery. I am now 75, had separate knees done at 72 and 73.
As far as stairs, I live in a stupid house where the kitchen and main living area as well as our bedroom is up a full flight of stairs from the entrance. I came home from the hospital the day after surgery and had to pull myself up 13 steps using the handrail – moaning and groaning all the way, but I got it done. I had to use the stairs nearly every day to clean the cat litter box or do laundry or use the chest freezer. I believe that being forced to use the stairs speeded up my regaining flexion and knee strength. You have to push your knee to its limits in order to work it back to a good range of motion, and this should start right after surgery. And of course lots of icing and elevation of the knee.

I have no problem getting off the floor, you just have to figure out a way to twist around so that you don't put all your weight on your knees for rising, so you do need good arm strength. You won't be able to do it right after surgery, so plan to do some of your recumbent exercises in bed to start with.

I do a lot of gardening, I have a boat safety cushion that I can kneel on with one knee, putting most of the pressure below the knee cap by having the knee itself off the cushion. Walking is no problem, I can do anything that normal daily life requires. I only do occasional light yoga, cushions under the knees are a must, and I can't flatten my knees very far when sitting cross legged. I believe you are supposed to avoid movements that may twist your knee sideways. I have not been kind to my knees, I had a fall earlier this year, coming down hard with both knees on a pile of hard dead branches, and then flipping a hammock and hitting one knee on the metal support bar underneath. In both cases, I was able to walk off the pain within an hour or so and assume my artificial knees were not damaged.

TKR's will never feel like my original bone knees, I'm aware that something "else" is in there, and I have clicking in both knees most of the time. But I no longer have the dull pain of arthritis or big jolts of pain coming down stairs. I would do it again.

REPLY
@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

Jump to this post

hello, Carol
I am 66, 7.5 weeks out of TKR on my right knee; 2.5 weeks out on my left. My knees were both bone on bone, I did not have robotic surgery, I feel fantastic. Just recently, I can get off the floor easily, have gone on 1.5 mile walks, walked in my yard and drive. I plan on taking water aerobics, see no problem doing yoga or travel and do not feel I have any travel or limitations.

I did strength and leg exercises prior to surgery and all PT. These helped immensely. I continue to stretch, PT (leg #2) daily and exercise. This surgery was more than a success for me, it altered how freely I function and opened my perspective to my taking on more hikes, aquatic exercise and other activities which I love. Best wishes for your good health.

REPLY
@loreleiks

hello, Carol
I am 66, 7.5 weeks out of TKR on my right knee; 2.5 weeks out on my left. My knees were both bone on bone, I did not have robotic surgery, I feel fantastic. Just recently, I can get off the floor easily, have gone on 1.5 mile walks, walked in my yard and drive. I plan on taking water aerobics, see no problem doing yoga or travel and do not feel I have any travel or limitations.

I did strength and leg exercises prior to surgery and all PT. These helped immensely. I continue to stretch, PT (leg #2) daily and exercise. This surgery was more than a success for me, it altered how freely I function and opened my perspective to my taking on more hikes, aquatic exercise and other activities which I love. Best wishes for your good health.

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Thank you for your positivity – I am so glad you are doing so well. Wow – 5 weeks between surgeries. That’s pretty amazing! Thanks again!

REPLY
@ddsack

Carol, remember that most of the people who post here are looking to solve problems and only a few people post their success stories, so you are getting a very skewed view of success rates on this website. Besides myself having both knees done, I personally know three other people with TKR's very well, and all of us are happy with the results. If you are an active healthy person before surgery, have a good surgeon, do pre-op exercises and work hard at PT afterwards, there is every reason to believe that you will have a good recovery. I am now 75, had separate knees done at 72 and 73.
As far as stairs, I live in a stupid house where the kitchen and main living area as well as our bedroom is up a full flight of stairs from the entrance. I came home from the hospital the day after surgery and had to pull myself up 13 steps using the handrail – moaning and groaning all the way, but I got it done. I had to use the stairs nearly every day to clean the cat litter box or do laundry or use the chest freezer. I believe that being forced to use the stairs speeded up my regaining flexion and knee strength. You have to push your knee to its limits in order to work it back to a good range of motion, and this should start right after surgery. And of course lots of icing and elevation of the knee.

I have no problem getting off the floor, you just have to figure out a way to twist around so that you don't put all your weight on your knees for rising, so you do need good arm strength. You won't be able to do it right after surgery, so plan to do some of your recumbent exercises in bed to start with.

I do a lot of gardening, I have a boat safety cushion that I can kneel on with one knee, putting most of the pressure below the knee cap by having the knee itself off the cushion. Walking is no problem, I can do anything that normal daily life requires. I only do occasional light yoga, cushions under the knees are a must, and I can't flatten my knees very far when sitting cross legged. I believe you are supposed to avoid movements that may twist your knee sideways. I have not been kind to my knees, I had a fall earlier this year, coming down hard with both knees on a pile of hard dead branches, and then flipping a hammock and hitting one knee on the metal support bar underneath. In both cases, I was able to walk off the pain within an hour or so and assume my artificial knees were not damaged.

TKR's will never feel like my original bone knees, I'm aware that something "else" is in there, and I have clicking in both knees most of the time. But I no longer have the dull pain of arthritis or big jolts of pain coming down stairs. I would do it again.

Jump to this post

Thanks for your honesty and positivity. Glad you are having success with your new knees. It gives me hope that things will go well for me too!

REPLY
@vgen

Thank you for your answers to questions i have as well.
I don’t have everyday pain, but stairs and yoga are a the biggest challenges. I have adjusted my life. So I hesitate to get TKR at 72 because I don’t have constant pain most people talk about.
One of these days i will pull the trigger, till then i will stay active so i am in shape for surgery.

Jump to this post

Hi vgen,

I'd suggest getting in shape as much as possible, given the current state of your knees. Hire a trainer, explain your condition and that you want to prepare for knee replacement, and the trainer will guide you to strengthening your quads and hamstrings.

72 is the right age for this, considering other health issues of course. I'm 68 and did pre-op work with a trainer, had both knees replaced this year, and followed post-op exercises RIGOROUSLY! And the results were incredible and life changing.

The first week after surgery is the hardest, but then everyday you get a little better and the pain lessens.

All the best!

Joe

REPLY
@loreleiks

hello, Carol
I am 66, 7.5 weeks out of TKR on my right knee; 2.5 weeks out on my left. My knees were both bone on bone, I did not have robotic surgery, I feel fantastic. Just recently, I can get off the floor easily, have gone on 1.5 mile walks, walked in my yard and drive. I plan on taking water aerobics, see no problem doing yoga or travel and do not feel I have any travel or limitations.

I did strength and leg exercises prior to surgery and all PT. These helped immensely. I continue to stretch, PT (leg #2) daily and exercise. This surgery was more than a success for me, it altered how freely I function and opened my perspective to my taking on more hikes, aquatic exercise and other activities which I love. Best wishes for your good health.

Jump to this post

Thanks for posting and congrats on your success. I experienced the same and the results were life changing and life affirming.

Joe

REPLY
@carolasc

I am also considering a TKR as I have bone-on-bone knees too. From those who have had TKR and PT and feel it was a success, I would like to ask these questions:
1. After having TKR can you go up and down stairs easily? Carry something up & down stairs?
2. Can you get up off the floor easily?
3. Can you get on your knees at all?
4. Could you attend a yoga class, a water aerobics class, go for a 1-2 mile walk, go hiking, ride a bike, etc?
5. Travel easily?
6. Walk in the yard, on snow, or uneven ground?
7. What are your new limitations?
Thanks for any insight!

Jump to this post

Hi @carolasc
I have had two TKRs.
Stairs are not a problem. I do like to hold onto the handrail so I try to only carry things that I can do with one hand. If I must use both hands I put the object (like my laundry basket) a few steps ahead of me, and then as I catch up to it move it further. That works for me.

Getting off the floor is different but very doable.

I can get on my knees but I do not have as much flex as I would have liked so I need to hold onto something or I will topple forward. Frankly, I blame myself for that. I really did not do the PT in between formal sessions as much as I should have. My ortho can do a small procedure to give me better flex but I have chosen to not do that.

I have gone to all of the classes you mention and walked a lot. The only one that gives me a problem is yoga due to my lack of flex plus my less-than-great balance which is not from the TKRs.

I have traveled a lot, not a problem, and I can easily walk on uneven ground.

My only limitation is that some things are not possible without better flex than I have, but most things that I cannot do are more apt to be caused by balance.

I agree with @jenniferkn, it's best to do it when you are still in good shape. That will make the recovery easier. I had my second TKR when I was 70.

The biggest piece of advice I can give you is to make sure you find the best possible orthopedic surgeon that you can. I was less aware of all of that before I had my first knee done and that knee is more apt to hurt after a lot of exercise. The second knee was done by an incredible surgeon and is the Conformis knee which is custom-made to mimic your original knee. That knee never bothers me.
JK

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