FWIW, I see PRP as an expensive and temporary fix, with results not guaranteed. If a patient's knee has degraded to this point, a TKR may be a better option.
Some people are concerned about TKR surgery. I think it has a long track record and has become even better with robotic assistance.
The patient has to do both pre-surgery and post-surgery rehab on the knee. It is time consuming and boring. Vigorous rehab goes a long way toward ensuring a good outcome. I'm 70 now, had both knees replaced in 2022 four months apart (Stryker/Mako robotic assistant used) and couldn't be happier about my knees. I spin 5x/week and can do anything in the gym EXCEPT impact exercises - so no running, BB, racquetball, jumprope. I was a marathon runner and miss that from time to time. But my running days were over long before the surgery.
Thank you for your post. I've been told that I'll eventually need TKR one both knees but the one that has less OA is the one with a degenerative medial meniscus tear. I'm 63. My Dad also had both of his knees replaced so although he was a quarterback in college with injuries then, I do believe its hereditary. Your post gives me hope because I love to spin but cannot do that right now. I'm postponing even thinking about TKR right now. Going for my second PRP injection hoping this helps.
Thank you for your post. I've been told that I'll eventually need TKR one both knees but the one that has less OA is the one with a degenerative medial meniscus tear. I'm 63. My Dad also had both of his knees replaced so although he was a quarterback in college with injuries then, I do believe its hereditary. Your post gives me hope because I love to spin but cannot do that right now. I'm postponing even thinking about TKR right now. Going for my second PRP injection hoping this helps.
Thank you for your post. I've been told that I'll eventually need TKR one both knees but the one that has less OA is the one with a degenerative medial meniscus tear. I'm 63. My Dad also had both of his knees replaced so although he was a quarterback in college with injuries then, I do believe its hereditary. Your post gives me hope because I love to spin but cannot do that right now. I'm postponing even thinking about TKR right now. Going for my second PRP injection hoping this helps.
Hi ThreeD! If you love to spin, you'll be happy to know that this is a great way to get cardio exercise after a TKR. In my case, I attribute the successful TKRs (both knees, four months apart) to:
1) having an outstanding surgeon - it pays to do a lot of homework here - I prefer surgeons in their late 30s to late 40s with a solid med school/residency pedigree (Mayo, Cleveland Clinic, for ex.) and having performed many surgeries - hundreds or thousands.
2) getting physically prepared ahead of surgery. I worked with a personal trainer at my gym for six months ahead of my TKRs. He is experienced in kinesiology and was a tremendous help.
3) Get obsessed with post-op rehab. You should see an actual PT about twice a week for 4 to 6 weeks. The most important part is being obsessed with doing the at-home physical therapy. It has to start immediately, ideally 3x/day. It helps if you have someone who can help and encourage you (my wife did an incredible job!).
4) When you are able to get on a bike in the gym, I suggest doing low-RPM spinning for maybe 4 or 5 months. You can certainly increase the intensity of the workout. Just remember that it can take up to one year before everything "settles down".
There is a little luck involved in a successful recovery from TKR, but really not much. The most important thing is to be diligent about rehab, and to not wait. They will take you on a walk in the hospital a few hours after surgery, and you really need to continue at-home and in-office PT until you achieve the recommended range of motion (ROM, the degree to which your knee bends). 120 degrees is considered a success (I think I get to 130). Extension, straightening the leg, should be zero degrees. In my opinion, ROM is the most important.
Finally, don't be discouraged by post-op pain. TKR is a major and traumatic surgery, so respect that and do the prescribed rehab work diligently. And remember, instead of getting worse, the pain will decrease day-to-day.
I spin 5x/week now and love it! So if you love to spin, a successful TKR certainly makes that possible (and I think the spinning/movement is good for the new knee).
As for when to get the TKR, listen to the pain. When your sleep is disturbed due to knee pain, you have a constant limp, and the knee is swollen - well that's about the right time to schedule the surgery. If you are getting good relief from PRP or cortisone shots, then certainly continue that if it makes you feel better.
I was 67 when I had my TKRs. The cause - inherited OA. I've had my big toes fused, both knees replaced, getting my right hip replaced next month, and will have to get my left shoulder replaced. The good news - joint replacement surgery has dramatically improved over the last 20 years or so. For the knee, my surgeon used the Stryker/Mako robotic assistant.
All the best to you and everyone considering a TKR!
PRP injections are not FDA approved at this time due to lack of success and lack of clinical trial data. It is expensive and not covered by insurance or Medicare. https://pmc.ncbi.nlm.nih.gov/articles/PMC10960087/
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Thank you for your post. I've been told that I'll eventually need TKR one both knees but the one that has less OA is the one with a degenerative medial meniscus tear. I'm 63. My Dad also had both of his knees replaced so although he was a quarterback in college with injuries then, I do believe its hereditary. Your post gives me hope because I love to spin but cannot do that right now. I'm postponing even thinking about TKR right now. Going for my second PRP injection hoping this helps.
I've been wondering about this. Please keep us posted.
Hi ThreeD! If you love to spin, you'll be happy to know that this is a great way to get cardio exercise after a TKR. In my case, I attribute the successful TKRs (both knees, four months apart) to:
1) having an outstanding surgeon - it pays to do a lot of homework here - I prefer surgeons in their late 30s to late 40s with a solid med school/residency pedigree (Mayo, Cleveland Clinic, for ex.) and having performed many surgeries - hundreds or thousands.
2) getting physically prepared ahead of surgery. I worked with a personal trainer at my gym for six months ahead of my TKRs. He is experienced in kinesiology and was a tremendous help.
3) Get obsessed with post-op rehab. You should see an actual PT about twice a week for 4 to 6 weeks. The most important part is being obsessed with doing the at-home physical therapy. It has to start immediately, ideally 3x/day. It helps if you have someone who can help and encourage you (my wife did an incredible job!).
4) When you are able to get on a bike in the gym, I suggest doing low-RPM spinning for maybe 4 or 5 months. You can certainly increase the intensity of the workout. Just remember that it can take up to one year before everything "settles down".
There is a little luck involved in a successful recovery from TKR, but really not much. The most important thing is to be diligent about rehab, and to not wait. They will take you on a walk in the hospital a few hours after surgery, and you really need to continue at-home and in-office PT until you achieve the recommended range of motion (ROM, the degree to which your knee bends). 120 degrees is considered a success (I think I get to 130). Extension, straightening the leg, should be zero degrees. In my opinion, ROM is the most important.
Finally, don't be discouraged by post-op pain. TKR is a major and traumatic surgery, so respect that and do the prescribed rehab work diligently. And remember, instead of getting worse, the pain will decrease day-to-day.
I spin 5x/week now and love it! So if you love to spin, a successful TKR certainly makes that possible (and I think the spinning/movement is good for the new knee).
As for when to get the TKR, listen to the pain. When your sleep is disturbed due to knee pain, you have a constant limp, and the knee is swollen - well that's about the right time to schedule the surgery. If you are getting good relief from PRP or cortisone shots, then certainly continue that if it makes you feel better.
I was 67 when I had my TKRs. The cause - inherited OA. I've had my big toes fused, both knees replaced, getting my right hip replaced next month, and will have to get my left shoulder replaced. The good news - joint replacement surgery has dramatically improved over the last 20 years or so. For the knee, my surgeon used the Stryker/Mako robotic assistant.
All the best to you and everyone considering a TKR!
Joe
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2 ReactionsPRP injections are not FDA approved at this time due to lack of success and lack of clinical trial data. It is expensive and not covered by insurance or Medicare.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10960087/