Knee Replacements

M

Momtwo

Recycles dryer sheets
Joined
Sep 25, 2004
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I need to get 2 knee replacements. I have been suffering for years with arthritis and the pain has gotten unbearable.
Has anyone here had this done?

Thanks.

Momtwo
 
The only thing I've heard about Knee replacement is if you need both Knees done is to do them at the same time.

A friend of mine had it done last year and said it was painfull but worth it. He also said if your going to suffer only suffer one time.
 
I'm an RN and I taught patients about the pre and post-operative stuff involved in getting their hips and knees replaced--what to expect, how to prepare your home, etc. Many patients wished they had done it sooner. Their quality of life went way up! Talk to your doctor about getting both at once--the rehab is harder, and the risk of blood clots is higher. The doctors I worked with generally did one at a time, but sometimes people wanted them both done at once. They usually needed to go to a rehab facility after their hospitalizations.
HTH,

Leslie
 
My sister's boyfriend is a world class skier. He had two done at once at 79 and is back skiing again. The guy across the street from me had one and is happy as a clam. It sounds like it is no fun for a while - but once the healing is complete it is like a new lease on life.
 
One of our friends that we travel with had both of her knees replaced in the last year and half, and she said she wished she would have done it several years ago. She had one done at a time a few months apart. She's thoroughly satisfied!
 
My mom had both done at the same time about 7 years ago (67ish). Well worth it but I recall that recovery was not trivial. She said that if she had done one knee at a time she would have been even more miserable knowing that she would have had to repeat the process.
 
TargaDave said:
My mom had both done at the same time about 7 years ago (67ish). Well worth it but I recall that recovery was not trivial. She said that if she had done one knee at a time she would have been even more miserable knowing that she would have had to repeat the process.
Click to expand...

I think that if your ortho surgeon medically clears you for bilat total knee replacement, then it comes down to your personality/how you deal with pain. Bilateral knee surgery typically results in more pain, especially during the first few weeks of rehab (BTW, I work in rehab). However, those patients who choose it say they'd rather deal with more pain once than go through the surgery/rehab twice. (Yes, rehab is not trivial.) So I think you need to evaluate your pain tolerance. In terms of outcomes, there is quite a bit of individual variability...but overall it seems to me that bilat TKR's tend to recover their function well (sometimes even faster than single TKR's). I think it may because they really have no choice...gotta bend the knees to get from sit to stand, etc...can't avoid the motion by using the "good" leg. But again...that's part of why it is more painful than single TKR!

By the way...if you do pre-op rehab (get a PT consult for development of a home exercise program), your post-op rehab will go soooooo much better, in general. The stronger you are before rehab, the easier it is for you to recover strength afterwards.

Also, the majority of patients do indeed say the pain is worth the end result.

Discuss all options, risks/benefits thoroughly with your surgeon. Disclaimer (gotta do it) - the above and any other past/future posts from me should not be considered personal medical advice. Consult your physician.

Hope this helps.
 
No knees, but I have had three shoulder replacements because of complications. From my experience the post surgery rehab PT is the key to a good outcome. If knees are anything like shoulders then expect a significant amount of pain post surgery.

2soon
 
My DH had both knees replaced at one time, he was ~66. What made the difference is that he is lean for his age and he worked for several months before the surgery with a PT to increase his UPPER body strength. After surgery he had in-home, and when able, office PT services.

Our home is handicapped accessible which doubtless made a big difference, better accessibility than the hospital.

Most physicians won't consider a dual knee job unless there is an able-bodied caretaker at home 24/7 for the first couple weeks. After that you will both need a break!
 
My mom had both of hers done at the same time, about a year or so ago. After the surgery one of them was 'catching', she went through some cortisone shots but finally ended up going in to get that one 'teaked' a bit.

Now she is 100% satisfied with the whole thing. Says she used to have to plan around her knees, i.e. pre-take pain medications before walking, etc. Now she says she can 'walk forever' and that she doesn't have to think about her knees at all.

Recovery did look kinda nasty though, they had her up walking the day after the surgery, and a lot of the therapy was basically forcing the knee to bend until she just couldn't take the pain anymore.

If you asked her though, she'd say absolutely do the surgery, with no hesitation at all.

Best of luck to you!

- John
 
My advice: be sure your surgeon is Board Certified Orthopedics (don't know if there is a more specific certification or not) and if you can find out what the doc's & the hospital's post op infection rate is, that would be good info for decision making.

Just had a cousin who had unilateral Total Knee Replacement (TKR) replacement. No I didn't stutter there. His original surgery was in March '06. About a week & a half post op the dr had to go back in & evacuate the knee... raging infection. He ended up having a main line vein access & home iv antibiotics over the summer. Continued with major pain & dysfunction. Long story short.... went to another ortho at a specialty ortho hospital & in October had the TKR removed. Infection was still present & would have never healed. Underwent the 2nd TKR the first of this month & just last week had the staples removed. So far, so good.

Don't mean to scare you from having the surgery, but just be aware that while the risks may be small, complications can arise. And they ain't pretty. Do your homework.
 
Bram said:
Don't mean to scare you from having the surgery, but just be aware that while the risks may be small, complications can arise. And they ain't pretty. Do your homework.
Click to expand...
Listen to the doctor and do the therapy, too.

In the two situations where I've seen a hip replacement go bad, one woman was on her fourth prosthesis due to persistent staph infections & bone loss. The man absolutely refused to follow doctor's orders to rest and let his body recover. The "I'm too important to the Navy" syndrome resulted in him having both hip prostheses removed, at which point he commuted around work in a scooter. When he retired he was still hipless... hopefully he's been able to remedy the situation by now.

Yes, they're both still working for a living!
 
Absolutely vet the hospital infection rate and pick a surgeon who has done so many s/he can do the job blind folded.

Surgeons need to learn their craft on someone, but not on me thank you. Ask if there is any chance a resident or other learner will have their hands on the job. Teaching hospitals are great facilities but know what you are getting into.

In my DH's surgery there were two surgeons, one for each leg. Both had a lot of experience but the leg worked on by the senior of the two was actually the more difficult to heal.

Oh yes, the surgery was not the most painful part. They made both legs the same length. Muscles, tendons protested for quite a while.
 
Thanks so much! I appreciate everyones input on this.

My surgeon has been doing them for over 25 years and has never had an infection. I totally trust him.
We have decided to have one done in mid-Feb. and one beginning of April.

Momtwo
 
Just wanted to update you. I had the TKA of my left knee on February 12th. I am doing well and have 105 degree range in that knee. However the pain and post op problems have been enough to make me put off the TKA of my right knee. I will get it done but not until my body recovers from this surgery. The surgery itself has taken it's toll on my system. There is pain but also exhaustion to deal with. I think in the long run, it will all be worth it!

Momtwo
 
A friend of mine had one knee done a few months ago--he echo'ed al the coments here about the importance of wholehearted devotion to doing the PT regimen. He needs to get the other one done, but he's not in a hurry-- the discomfort from the first rehab is still a little too fresh on his mind.

Momtwo--congrats, and stay on those exercises!
 
Momtwo said:
Just wanted to update you. I had the TKA of my left knee on February 12th. I am doing well and have 105 degree range in that knee. However the pain and post op problems have been enough to make me put off the TKA of my right knee. I will get it done but not until my body recovers from this surgery. The surgery itself has taken it's toll on my system. There is pain but also exhaustion to deal with. I think in the long run, it will all be worth it!

Momtwo
Click to expand...

You're doing great, momtwo! Keep up the good work!
 
As someone who may have to finally give up and get the knee replacement surgery, I have another question. I actually need both knees and one hip to be done. Any experiences in getting both knees and a hip done at the same time. Not sure what the ultimate impact may be, given it's essentially both ends of the same bone, and didn't know if that would have more complications or not. I understand the pain bit, but if I can get through all of it in one (hopefully short) time, I can grin and bear it.
Any comments?
 
I think you would be nuts to do all three at the same time. You need all your rehab resources. Two knees at once is ok if you are in excellent physical shape and are committed to work on upper body strength before the surgery.

The critical issue is rehab. You loose the strength in your legs very quickly.
 
Brat said:
I think you would be nuts to do all three at the same time. You need all your rehab resources. Two knees at once is ok if you are in excellent physical shape and are committed to work on upper body strength before the surgery.

The critical issue is rehab. You loose the strength in your legs very quickly.
Click to expand...
Often called "nuts", so that is not new.
Upper body strength is pretty good anyway, but the leg joints are the problem. Thus the question.
would the rehab to restrenghten the muscles aid or subtract from each other when both knees and hip are involved? Now when I "launch" myself from a chair, both the hip and the knees twinge and hurt. Didn't know if the simultanous surgery would have the same effect, or if the thigh muscle having to repair itself, for one, would be stretched by both at the same time, and if that would make a difference.
That's why I'm asking
 
whitestick said:
Often called "nuts", so that is not new.
Upper body strength is pretty good anyway, but the leg joints are the problem. Thus the question.
would the rehab to restrenghten the muscles aid or subtract from each other when both knees and hip are involved? Now when I "launch" myself from a chair, both the hip and the knees twinge and hurt. Didn't know if the simultanous surgery would have the same effect, or if the thigh muscle having to repair itself, for one, would be stretched by both at the same time, and if that would make a difference.
That's why I'm asking
Click to expand...

OK, not sure if I understand your questions exactly, but I'll try to reply. When the knee is replaced, the quadricep muscle undergoes significant atrophy. With hip replacements, the hip abductor (gluteal region) muscle is significantly affected (assuming a posterior approach). All I can say is I surely wouldn't want to have to rehab TWO severely affected muscles in the same leg at the same time.

Now, even beyond the above, did you know that hip replacement patients have precautions - ie. can't bend their hip past 90 degrees, cross the leg past midline, or turn the leg inward? You have to learn to do all of your functional activities (in/out of bed, sit to stand, etc.) without breaking these hip precautions. This means you do these tasks in a different manner...and usually you are using the "good leg" to help you manage functionally. If it were me, having bilat knee replacements and a hip replacement at the same time would not be something I'd do. But that's just my opinion.

BTW, have you talked to a surgeon to see if it would even be considered? I'd be amazed if they agreed to it.
 
simple girl said:
BTW, have you talked to a surgeon to see if it would even be considered? I'd be amazed if they agreed to it.
Click to expand...
No, I try and get some understanding of what's going on before asking the doctors, so I have intelligent questions or at least myths to dispel. I wanted to collect some more thoughts before talking to the doctors.
I see your point about the different muscles. I had presumed that it was the same quadricep muscle, which is why I asked the question. I had heard some of that about the hip, but not all of that. Almost sounds like you wouldn't want to do it. Are all of the stories about people being glad that they did it, around knees and not hips?
Dratted hip hurts the worst though, and causes me more pain then the knees do, although they bring in their fare share as well. Darn bad genes anyway.
 
I hope you don't mind me asking, but what causes these knee problems? Is this genetic caused by arthritis? Or excessive running/sports? How can I reduce the risk of this problem from occuring? Reading this thread kind of scared me. I think I am just a few years younger than CFB. I run about 10 miles per week on sidewalks.

Do most private health insurances cover physical therapy? I have only scanned potential plans in my health insurance research and I don't recall this being broken out, but I guess I figure it is covered.

Kramer
 
Kramer.. I know what you mean..! Seems like 'everyone's doing it' these days. A male friend of ours who's not even 40 just got a hip replacement.

I don't remember growing up with that many immobilized elders.. maybe they just led more active lives? Or maybe they didn't run on pavement? Or both?

I think I did see something about increased instance of knee problems in women who have spent a lot of time wearing high heels. I stick to low-heeled shoes these days, dowdy tho' it may be...

I came across this, that might be useful to whitestick and others in researching the operation:
http://www.amazon.com/Total-Knee-Replacement-Rehabilitation-Owners/dp/0897934393

Momoftwo.. best wishes for a speedy recovery!
 
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