Knee replacement

[August_West]

My mom had both done. 9 months apart. Conscious decision not to do both together.

I think both decisions suck. You win and lose both ways.

She was able to come home instead of inpatient after doing one at a time which is a main reason she decided not to do both at once.

But man going back for the second one had to be torture after getting through the first.

 

[Waquoit]

Not sure why a PT would make such a blanket statement, any PT I know and work with would hedge every statement regarding a replacement as being a strictly case-by-case thing. Replacements happen for different reasons, with different interventions, for different people with different histories. I’ve seen plenty of hip patients that are the opposite of “easy”

Are you for real? For one, the quote you commented on was my quote not the PT. And of course, some hips end up a tougher rehab than knees. But that is the exception to to the rule. Ask anyone with any knowledge of the subject outside a medical consulation "What's a tougher rehab, hips or knees" The answer will be knees. Unless you run into a knob that says something like dooshy like, "Replacements happen for different reasons, with different interventions, for different people with different histories."

 

[Rocktheworld]

Are you for real? For one, the quote you commented on was my quote not the PT.

My bad, figured you meant that given you followed that “I hear this all the time” with talk of your PT (PTA or DPT?) girlfriend. I don’t think that was a stretch but okay. The point remains that I’ve never heard blanket statements like that made by the DPTs I’ve known and worked with for years in acute rehab and acute care.

And of course, some hips end up a tougher rehab than knees. But that is the exception to to the rule. Ask anyone with any knowledge of the subject outside a medical consulation "What's a tougher rehab, hips or knees" The answer will be knees.

Lol why would I ask anyone who isn’t involved in medical management of joints and their replacement?

Better yet, why do you (seem to) reject those people’s opinions?

Unless you run into a knob that says something like dooshy like, "Replacements happen for different reasons, with different interventions, for different people with different histories."

The only way you can perceive that statement as “douchey” is if it somehow threatened your sense of your own intelligence. People, their surgeries, their histories, their responses to therapy, are all so varied that blanket statements like “hips are easy” are pointless. You don’t say that to someone going in to surgery because you really don’t know how the surgery will go and how they will respond to therapy.

 

[Yardigan]

I had both done at the same time about 4 years ago. Best thing I've ever done that involved surgery. Dr. Paul Murray at Hartford Hospital did them. He's terrific, IMO, and probably does more knee and hip replacements than anyone in CT.

Minisectomy's are mostly a waste of time as far as I'm concerned, because removing cartilage, while it can offer temporary relief. only puts you that much closer to bone-on-bone.

A few things I learned:

If you need both (bi-lateral) and you are healthy, do them together. You are weight-bearing immediately.

Best Advice: Take your pain meds by the clock -- and you will be fine. Don't let the pain get ahead of you or it will be tougher to get it under control. My pain never exceeded a 2 out of 10.

Do the PT. Rehab is so important with joint replacement. Also, everyone focuses on degrees of flex, but extension is just as important, if not more so.

BoneSmart is a great online forum that will provide lots of info.

Good luck. You will wish you had done it sooner.

Very informative site, thanks! Also like hearing "you'll wish you had it done sooner"....

 

[Waquoit]

Lol why would I ask anyone who isn’t involved in medical management of joints and their replacement?
Better yet, why do you (seem to) reject those people’s opinions?

You mean like how the OP asked the world in his initial post? And I was at the gym a while back at the same time as an orthopedic surgeon whe a guy was peppering him with questions on this topic. He said hips are an easier rehab than knees. I guess didn't feel the need to add a bunch of qualifiers, that it was obvious that some rehabs are easier or tougher than others.

The only way you can perceive that statement as “douchey” is if it somehow threatened your sense of your own intelligence. People, their surgeries, their histories, their responses to therapy, are all so varied that blanket statements like that are pointless.

It was douchy. I consider BY discussions the same way I view discussions at the local watering hole. It's casual conversation, not a grad school dissertation. Every once in awhile you run across someone who has to parse every word into mind-numbing boredom. Like you.

 

[Rocktheworld]

You mean like how the OP asked the world in his initial post? And I was at the gym a while back at the same time as an orthopedic surgeon whe a guy was peppering him with questions on this topic. He said hips are an easier rehab than knees. I guess didn't feel the need to add a bunch of qualifiers, that it was obvious that some rehabs are easier or tougher than others.

It was douchy. I consider BY discussions the same way I view discussions at the local watering hole. It's casual conversation, not a grad school dissertation Every once in awhile you run across someone who has to parse every word into mind-numbing boredom. Like you.

Buddy if I really wanted to use drawn-out jargon you would know. That was already a pretty dumbed-down way to phrase what I said (and THAT’s a douchey statement, HTH) that I would say to any lay person like you. We in rehab just never make blanket statements like that (and surgeons shouldn’t either) because they’re worthless. I would never tell a 20-something who had a stroke “oh you and your cognition will be fine because you’re young and your brain is more capable of re-wiring itself than someone in their 80s” because, while at a theoretical level there are factors associated with different outcomes, you never know how recovery is going to go for each individual. I’ve met tons of people who were told things like that by their surgeons and things don’t pan out and people are disappointed and people look bad. It’s just not worth talking about surgery and recovery like that.

FWIW by DPT buddy who just opened a private practice with his DPT wife just said “hahahah no that’s ret@rded” to that statement, if that’s simple enough and watering-hole-appropriate for you.

 

[Spaceman213J]

My dad just had both knees done over three days in late October. He strengthened his quads and calves before the surgery. He had a lot of pain, but was glad he did them together. He turned 73 in May, and was pretty active before the surgeries. He golfed and loved working in his garden. The last month he 's been back gardening and is hoping to start golfing again soon, especially since it's free for him.

The surgeries went very well. He just had a reaction to the adhesive they used to hold the gauze and dressings in place. He ended up with blisters a few inches from the incisions. He also had a reaction to the first narcotic they put him on. My dad is a very mellow and laid back guy and I never heard him speak like he did to anyone, especially my mother the first few day he was home. They switched the med and his personality went back to normal.

I also know a few guys from my church and from the golf course I work at who have had their knees done and everyone who had them done separately told me they wish they could back and have had them done together.

 

[Da_Aisijimo_Gou]

I mean the designation of the degree to which you can bear weight on the limb(s) on which/were operated Talk to you doctor and you surgeron

Thanks for clarifying your comment @Rocktheworld. No real knee issues for me now, but given some time and past history ...

 

[Mokum]

I have had knee surgery but not replacement, just a few years ago. The result of an injury playing HS football. My only advice is make sure you have a doctor that really knows his stuff. Good luck, hope it works for you.

 

[Hankster]

My dad just had both knees done over three days in late October. He strengthened his quads and calves before the surgery. He had a lot of pain, but was glad he did them together. He turned 73 in May, and was pretty active before the surgeries. He golfed and loved working in his garden. The last month he 's been back gardening and is hoping to start golfing again soon, especially since it's free for him.

The surgeries went very well. He just had a reaction to the adhesive they used to hold the gauze and dressings in place. He ended up with blisters a few inches from the incisions. He also had a reaction to the first narcotic they put him on. My dad is a very mellow and laid back guy and I never heard him speak like he did to anyone, especially my mother the first few day he was home. They switched the med and his personality went back to normal.

I also know a few guys from my church and from the golf course I work at who have had their knees done and everyone who had them done separately told me they wish they could back and have had them done together.

Well Space I can relate to the "he also had a reaction to the narcotic..." I have had a number of surgeries. Never had a problem until............the VA. When she finished hooking me up, she said I am going to start your IV. She didn't turn the knob a 1/16 when I immediately sat up. Anybody see the movie The Rocker? In the beginning they told them he wasn't the drummer anymore? So he chased them down the street. He flew off the van and laid flat in the street. Then from the waist up he rose and looked at them? Well that was me. Only vomiting. I felt I was on fire. Seriously, on fire. The head doc of surgery ran out and yelled that I have Red Man Syndrome. Everyone rushed to take out all the needles, bottle went in the trash and re-hooked me. Terrible experience. What a coincidence. The ad at the bottom of my screen talks about "New Joint Relief Tip". Somebody holding their knee.

 

[HuskyBandDad]

That's EXACTLY what I'm thinking...They hurt now, but I "know" that hurt...and if I get one done...and it hurts worse than "this" does now... they might have to lasso me and drag me in to get the second one done...

Just reading this thread now as I am sitting on my butt recovering from right hip replacement on Wednesday. Had my left hip done 6 years ago. Same surgeon did both. Need a right knee soon and will have my same surgeon do it maybe next year.
I know a few people that have knee replacements. The few that had both done were approx 6 weeks apart.
I think doing both at the same time will depend a lot on the surgeon. Many do not like doing at the same time but many do. My surgeon does not like to do both at same time.
You will have pain. In my case they do a lot to monitor pain.
As others have said get in shape and do the re-hab.
The first few weeks after surgery will be in-home rehab then out patient. Many doctors avoid rehab facilities.
My goal is when I will be cleared to drive. Takes longer if it is your right leg.

 

[TheRealKBuks]

If its unicompartmental OA you could always try an unloading knee brace. I personally would explore this option before going under the knife. Braces There are tons of different styles of unloaders so one that's appropriate for you may be different that the ones in the link I provided. But its worth exploring

 

[Richmondhsky]

If its unicompartmental OA you could always try an unloading knee brace. I personally would explore this option before going under the knife. Braces There are tons of different styles of unloaders so one that's appropriate for you may be different that the ones in the link I provided. But its worth exploring

I tried the unloading brace and didn't find any relief. I also tried PRP to no avail, as many have already said don't wait! You'll def wish you had done it earlier.

 

[SallyH]

Good luck. Surgeons are very stingy with pain meds these days. My son-in-law had a knee replacement and was (and to a lesser extent, still is) pretty miserable - in S. Carolina.

 

[TheRealKBuks]

I tried the unloading brace and didn't find any relief. I also tried PRP to no avail, as many have already said don't wait! You'll def wish you had done it earlier.

I've just seen too many people go for a knee replacement and end up with foot drop. This is just me personally, I would avoid the knife at all cost.

 

[Yardigan]

Good luck. Surgeons are very stingy with pain meds these days. My son-in-law had a knee replacement and was (and to a lesser extent, still is) pretty miserable - in S. Carolina.

How long ago?

 

[SallyH]

How long ago?

Six to eight weeks. He roams around the house at night. It will get better. He also diligently prepared before the surgery.

 

[SWHuskyFan]

I had bilateral knee replacements about 5 years ago, best thing I ever did. I put it off way too long, within a month or so , the pain was less than I was in before the surgery. The decision to do both came down to not wanting to go back in to do the other leg after I just started feeling human again. I don't feel like rehabbing them both at the same time was all that much harder than it would have been. One negative is that I had to go to a rehab facility for a few days because I did both. I had to be ok to do stairs before they sent me home. Another negative was already mentioned above, it's a longer surgery and I had to get a transfusion. I feel like they gave me as much pain meds as I needed, within a few weeks the need was gone.


I don't even think about my knees anymore, they are just fine. I want to say it's been like that for about 3-4 years. It took a bit to get over all the soft tissue damage that had been done during the surgery and likely all the damage I'd done to it before the surgery.

I recommend this website, lots of informative articles and forums with people who've gone through it helping out. I used it a lot before and after my surgery.
BoneSmart

This is the surgeon I used, it's all he does and I feel like he did a great job.
Quality Orthopedic Care | Dr. Paul B. Murray

 

[Doctor Hoop]

Call this "The Good, The Bad, and The Ugly"

There are higher risks with getting both done at the same time, in all possible risk areas, the main being risk of blood transfusion and risk of infection. That said, some surgeons are still doing them.

The good:
My advice is as follows:
1. Get them done one at a time. Don't be afraid to get the second one done because of a week of pain with the first. Instead, think about how good your first one feels, and move to make the second feel that good.
2. Get them done by a joint replacement specialist. Someone who's doing this 6-10 times each week is likely to be more consistent in providing excellent results.
3. You'll probably have "joint replacement teaching" done at the hospital a week or two before surgery. Do it. You'll learn a lot about what to expect.
4. Don't worry as much about rehab and pain control. Modern TKA gets you out of bed on the same day, walking fully weight bearing on it. Within a week many people don't need more than a cane to get around. And current pain management is "multimodal," with more anti-inflammatories and injectable medications and less of the constipating and disorienting narcotics. And don't take any Oxycontin, for cryin' out loud.
5. Plan to go home with visiting therapists after surgery, if your home situation allows it. You'll probably do better, certainly no worse, than if you go to a rehab stay. Therapy is moving the knee, walking on it, using cold therapy, and some quad strength exercises. That's almost all you need.

The bad:
Plan to stay a day or two in the hospital at most, but many people are going home the same day now, especially under age 70. That first night, if you go home, is as tough as it gets. But see 4. and 5. above.

The ugly:
8-10 inch scar. People used to try to do "minimally invasive," with a much smaller incision. More component malposition, and higher complications. Let the doc see what he's doing. And don't dictate components. Some patients come in requesting a certain company's components because they saw an ad, or a friend had someone use "X" for them. Let the doctor pick the components he's comfortable with.

 

[Yardigan]

Call this "The Good, The Bad, and The Ugly"

There are higher risks with getting both done at the same time, in all possible risk areas, the main being risk of blood transfusion and risk of infection. That said, some surgeons are still doing them.

The good:
My advice is as follows:
1. Get them done one at a time. Don't be afraid to get the second one done because of a week of pain with the first. Instead, think about how good your first one feels, and move to make the second feel that good.
2. Get them done by a joint replacement specialist. Someone who's doing this 6-10 times each week is likely to be more consistent in providing excellent results.
3. You'll probably have "joint replacement teaching" done at the hospital a week or two before surgery. Do it. You'll learn a lot about what to expect.
4. Don't worry as much about rehab and pain control. Modern TKA gets you out of bed on the same day, walking fully weight bearing on it. Within a week many people don't need more than a cane to get around. And current pain management is "multimodal," with more anti-inflammatories and injectable medications and less of the constipating and disorienting narcotics. And don't take any Oxycontin, for cryin' out loud.
5. Plan to go home with visiting therapists after surgery, if your home situation allows it. You'll probably do better, certainly no worse, than if you go to a rehab stay. Therapy is moving the knee, walking on it, using cold therapy, and some quad strength exercises. That's almost all you need.

The bad:
Plan to stay a day or two in the hospital at most, but many people are going home the same day now, especially under age 70. That first night, if you go home, is as tough as it gets. But see 4. and 5. above.

The ugly:
8-10 inch scar. People used to try to do "minimally invasive," with a much smaller incision. More component malposition, and higher complications. Let the doc see what he's doing. And don't dictate components. Some patients come in requesting a certain company's components because they saw an ad, or a friend had someone use "X" for them. Let the doctor pick the components he's comfortable with.

Outside of transfusion and infection risks...any other reasons you can see for one at a time vs 2 for 1?
Also, are we really only talking about a "week of pain"?

Thanks, Doctor!

 

[superjohn]

Are you for real? For one, the quote you commented on was my quote not the PT. And of course, some hips end up a tougher rehab than knees. But that is the exception to to the rule. Ask anyone with any knowledge of the subject outside a medical consulation "What's a tougher rehab, hips or knees" The answer will be knees. Unless you run into a knob that says something like dooshy like, "Replacements happen for different reasons, with different interventions, for different people with different histories."

Knee replacements are a harder/longer recovery and more painful than hip replacements. As you point out, this is well known.

 

[superjohn]

I have had knee surgery but not replacement, just a few years ago. The result of an injury playing HS football. My only advice is make sure you have a doctor that really knows his stuff. Good luck, hope it works for you.

Doctor who knows his stuff and make sure you do all of the rehab properly, can't at all half arse it.

 

[UConnFranklin]

I had one done about nine years ago. My knee is terrific now. However, I developed a clot and was put on blood thinners. Apparently, clots happen frequently with this surgery. This meant that when my knee became swollen I couldn't take anything to help reduce the swelling. I was in tremendous pain and couldn't bend my knee more that 65 degrees. My knee stayed the size of a soccer ball for 6 months until they took me off the blood thinners and could start taking celebrex. This immediately reduced the swelling and the pain. Now I have near normal flex of the knee and absolutely no pain. It's very strong. If I had to do it again, I would, even with all of the pain. It was worth it.

 

[bturn]

I had knee / acl surgery last month for a tear

doctors and PT people will tell you to avoid stairs at all costs, they say it to me every time i see one of them, are you using stairs at all etc

a poster mentioned extension is more important than bending it and is 100% correct. bending it will come, not getting straight is a concern, mine isn't 100% straight and i am doing exercises 3x a day and PT 2x a week and focusing on getting it straight

different people have different tolerance to pain meds. i don't do well with pain meds, hurt my stomach
take colace with pain meds, your first bowel movement after surgery will hurt more than your knees if you don't. i did not take enough colace, heed this advice

i don;t know the recovery for a replacement but average for a tear like mine is full year to get back to 100%

again, not same as replacement, but hope it helps and good luck

 

[Yardigan]

Starting to get real...
Pre-op to the hospital this coming Monday. Did a lot of research on the doc and hospital and feeling pretty good about that. Doc is chief of ortho surgery, has done in the 1,000s, with several hundred two-fers.
Hospital is using an 'opioid sparing pathway' and they set out prior to surgery to try to reduce any inflammatory processes that occur by treating it before it actually happens.

Have a flexible schedule and work from home...surgery 9/11, hoping to be back to work at least half-time after two weeks.