Chuckanuts Total Knee Replacement story

[Chuckanut]

Knee replacement surgery is a major surgery that has a long painful recovery for most people. Fortunately, it is also commonly done with a high degree of success at the end point. But, the end point is often one to two years into the future. Perhaps others can learn a bit from what I have and will soon go through.

Part 1 - How I got to where I am

Without going through the details, I will tell you that I injured my knee 40+ years ago, in my 20's. At that time the treatment was to remove the cartilage on that side of the knee. So I had that done.

Over the years I have followed two simple rules regarding my knee:

1. If I did something that makes it very sore, stop and don't do it again.
2. Treat mild soreness with a bit of rest, aspirin, ibuprofen, and sometimes ice packs. This worked well for nearly 40 years.

Almost two years ago, I noticed that my knee was no longer cooperating with my efforts to keep it happy. The soreness after a day of walking or hiking remained even after a good night's sleep and several doses of ibuprofen. Soon, I found that simply getting up from being seated for more than 30 minutes was a painful challenge. My knee did not want to support my body until I gave it a dozen warm-up steps while holding on to the back of the chair. Stairs that went down became Personal Enemy #1. The gradual downward slope of knee health had gone off a cliff in a period six months.

After a visit to the orthopedic doctor, I got my first shot of cortisone which was a revelation. For the first time in years I could walk and move my right leg without giving it a second thought. I had forgot how good it felt to have a healthy knee and not worry about where I stepped, how high I stepped or if I had to twist my foot a bit. Alas, the 2nd shot had a more limited benefit and the third shot was barely helpful at all. Lubricants injected into the knee did little good. Arthritis had developed to the point that medicines could no longer defy it. In retrospect I should have skipped the shots and had the surgery a year ago, but I figured to give it a try. Besides, according to the doctor, insurance companies demand these intermediate steps before they give the OK for the replacement.

So here I am about to start the Summer of Recovery. Despite a few health issues (Hey!, I am approaching 70.) I only take one prescription med - a statin to keep my cholesterol down. My weight is in the normal range, my BP and other stats are all normal. The only thing slowing me down is my right knee.

People who have had knee surgery often say "you will know when you need it". They are right. I know. There is no doubt.

 

[Unpaintedhuffhines]

I didn't make it as long as you. Had mine done 11 months ago @ 57. Rehab is a ton of work, so don't underestimate it. Someone asked me 6 weeks after the surgery "was it a good idea?" and I wasn't so sure. 3 months after I was convinced it was. Took me 6 months to realize "I didn't think about my knee yesterday."

I asked my doctor when I would know. She said "when you come to my office and say 'either you do the surgery, or I'm finding someone else.'"

Sure changed my quality of life that's for sure.

 

[aja8888]

I assume Part 2 is coming soon?

I had a hip replacement ten years ago at 65. I hung on for at least 5 years before getting it done. Both knees are still OK.

Good luck!

 

[W2R]

Knee replacement surgery is a major surgery that has a long painful recovery for most people. Fortunately, it is also commonly done with a high degree of success at the end point. But, the end point is often one to two years into the future. Perhaps others can learn a bit from what I have and will soon go through.

Part 1 - How I got to where I am

Without going through the details, I will tell you that I injured my knee 40+ years ago, in my 20's. At that time the treatment was to remove the cartilage on that side of the knee. So I had that done.

Over the years I have followed two simple rules regarding my knee:

1. If I did something that makes it very sore, stop and don't do it again.
2. Treat mild soreness with a bit of rest, aspirin, ibuprofen, and sometimes ice packs. This worked well for nearly 40 years.

Almost two years ago, I noticed that my knee was no longer cooperating with my efforts to keep it happy. The soreness after a day of walking or hiking remained even after a good night's sleep and several doses of ibuprofen. Soon, I found that simply getting up from being seated for more than 30 minutes was a painful challenge. My knee did not want to support my body until I gave it a dozen warm-up steps while holding on to the back of the chair. Stairs that went down became Personal Enemy #1. The gradual downward slope of knee health had gone off a cliff in a period six months.

After a visit to the orthopedic doctor, I got my first shot of cortisone which was a revelation. For the first time in years I could walk and move my right leg without giving it a second thought. I had forgot how good it felt to have a healthy knee and not worry about where I stepped, how high I stepped or if I had to twist my foot a bit. Alas, the 2nd shot had a more limited benefit and the third shot was barely helpful at all. Lubricants injected into the knee did little good. Arthritis had developed to the point that medicines could no longer defy it. In retrospect I should have skipped the shots and had the surgery a year ago, but I figured to give it a try. Besides, according to the doctor, insurance companies demand these intermediate steps before they give the OK for the replacement.

So here I am about to start the Summer of Recovery. Despite a few health issues (Hey!, I am approaching 70.) I only take one prescription med - a statin to keep my cholesterol down. My weight is in the normal range, my BP and other stats are all normal. The only thing slowing me down is my right knee.

People who have had knee surgery often say "you will know when you need it". They are right. I know. There is no doubt.

Thanks for your narrative and insights! I am a bit behind you in the process, but hoping to get total knee replacements done before long, maybe later this year.

 

[candrew]

I'm doing my best to hang in there at least until Medicare kicks-in for me in the fall of 2022. Both knees have been scoped to repair cartilage tears and clean out floaters. Most recent was a surgery in 2008. Surgeon told me that arthritis in the right knee was Grade 3. I immediately ceased running and cycle now to stay fit. Most days are good. Occasionally, there are those mornings after a previously long day on my feet that I really feel it.

 

[Chuckanut]

I didn't make it as long as you. Had mine done 11 months ago @ 57. Rehab is a ton of work, so don't underestimate it. Someone asked me 6 weeks after the surgery "was it a good idea?" and I wasn't so sure. 3 months after I was convinced it was. Took me 6 months to realize "I didn't think about my knee yesterday."

I asked my doctor when I would know. She said "when you come to my office and say 'either you do the surgery, or I'm finding someone else.'"

Sure changed my quality of life that's for sure.

My goal was to make it to 70 before the TKR on the theory that at that point, it should last the rest of my life unless I live for a very long time. I came close enough, IMHO. A second TKR is never as good as the first, so I am told. That said who knows what medical science will come up with in 20 years. FWIW, some of the older implants are lasting as much as 30 years, though there are people who get it redone in less than a decade also.

I love what your doctor said. She sounds like the voice of experience.

 

[Chuckanut]

I immediately ceased running and cycle now to stay fit. Most days are good. Occasionally, there are those mornings after a previously long day on my feet that I really feel it.

Cycling is one way I kept my knee going. Using a stationary bike or a real bike I cycle 3x a week if not more. It really loosens up the knee and keeps the soreness away. One way I knew the end was near is that cycling no longer helped very much. In fact, its just another source of knee pain these days, though still much less than walking. I still cycle under some load to keep the leg muscles fit. I walk a mile or two (if I can take the pain) every day for the same reason, keep those muscles as fit as possible to help recovery.

 

[Chuckanut]

[FONT=&quot]Part 2 – Getting Ready with the Medical Personnel[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]TKR is as brutal surgery. Successful recovery means lots of the right follow-up at the right time. For starters, I received my prescriptions two weeks early with instructions to fill them ASAP. Don't take chances your local pharmacy will be out of stock on the pain killer the day you get home.
[/FONT]
[FONT=&quot] [/FONT]
[FONT=&quot]Here are the meds I will be taking after the surgery. How long I take each depends on how well I heal, the pain level, and what, if any, side effects I have. [/FONT]

Aspirin 325mg - once daily
Tylenol 1000mg - 3 times daily
Oxycodone 5mh 1-2 tablets – 4 times daily (as needed)
Senna – 1-2 times daily (though the pharmacist says I should take one pill every time I take the Oxycodone)
Warfarin 2 mg - one tablet daily (dosage to be adjusted to meet INR target goal of 2-3)

In regards to the Oxycodone, which is a big hot-button drug at the moment, I am supposed to take it up to the limit if the Tylenol does not do a good enough job of easing the pain. While I would prefer to not take it, the reality is that almost everyone needs it to control the pain in the first week or two, especially when visiting the physical therapist. One thing I hear over and over again is don’t get behind the pain. Stay out in front of it. A lot of bone has been cut, shaped, drilled and had things pounded into it. Other tissues around the knee have been cut, stretched, poked, stitched, stapled and otherwise tormented in the process of getting the implant done right ( a very big goal of mine!). IOW, your knee area has been beat-up by the surgeon and it's going to hurt a lot.


Besides the meds, I have had an EKG done (all ok there) and various blood tests so the operating team knows how to treat me properly.

We have not yet decided on the anesthesia – fully out, or a nerve block with some sort of sleepy time aid.

I have also schedule the first two weeks of PT. And made an appointment for a blood test to check the warfarin dose, and find out if any adjustments need to be made.

 

[aja8888]

Reading Part 2 makes me think my "hip job" was a piece of cake in comparison. I sure hope my OE knees last another 20 years or so.

 

[W2R]

One thing I hear over and over again is don’t get behind the pain. Stay out in front of it. A lot of bone has been cut, shaped, drilled and had things pounded into it. Other tissues around the knee have been cut, stretched, poked, stitched, stapled and otherwise tormented in the process of getting the implant done right ( a very big goal of mine!). IOW, your knee area has been beat-up by the surgeon and it's going to hurt a lot.

Not to mention the fact that you knee was hurting tremendously already, before you ever went into surgery! It's like they are pounding on a wound, almost. Yow. Oh well, we were brave enough to get through a lot in life so far, and we can get through this.

Normally I try to minimize the pain killers; when I got my dental implants, the oral surgeon MADE me take one hydrocodone for when the Novacaine wore off, so I did that but didn't need or want any more after that. However, I have heard that a TKR is a whole new ballgame when it comes to pain.

We have not yet decided on the anesthesia – fully out, or a nerve block with some sort of sleepy time aid.

Oh this is great to hear! I didn't know the latter was ever used. I hope my surgeon decides on the nerve block with sleepy time aid for me, on the theory that the less anesthesia, the better (as long as it works). I had Versed for my cataract surgery, which was sort of a hypnotic sleepy time thing where I was conscious, but I didn't feel a thing. I thought it was terrific.

Love this thread!

 

[Bamaman]

My wife is the poster child for arthritis, as she has it virtually everywhere. She got the knee replacement a year ago, and the pain bothered her the first 4 months. Then click, the pain went away.

We just returned from Madrid, Barcelona and Paris, and she can now climb steps and navigate the metro systems with the best of them. The knee's great.

Last week, she had rotator cuff surgery, and her shoulder was about as bad as it could get. When it rains it pours. Here we go again with a very painful surgery and physical therapy.

 

[Souschef]

Chuckanut,
Have you looked into Nanoknee? It is a different approach that is less invasive and does not require the long rehab.

 

[Moemg]

Make sure you take a pain killer before rehab.Also have an ice system in place .

 

[JohnML]

I am 61 and have had both knees replaced. The first was 4 years ago and the second a year later. They were both very long and painful recoveries. It was about 4 weeks after the first surgery before I started feeling like maybe it was not a bad decision. I was working at the time and went back after about 6 weeks the first time which was too soon. The second time I took the full 8 weeks and it was a little better. It was almost a year on each before I could say I was mostly "recovered".

As for anesthesia I was completely out. Pretty sure I would not want to hear the hammering, drilling and sawing. I also had a spinal nerve block so I had almost no pain at all for about 24 hours or so. I came right out of anesthesia, no groggy incoherent time at all. Which was nice, but I experienced anxiety from the sensation of not having legs... I asked for something to help with that and I think they put a little Valium in the IV. For the second knee I told them in advance about the anxiety and they had it in the IV before I woke up. I stayed in the hospital over night both times. My doctor didn't want me in there any longer than necessary. He said hospitals are where the resistant bacteria live.

I am SO glad I had this done 3-4 years ago before the "opioid crisis" became such a thing. I can tell you I NEEDED lots of opioids the first 4-6 weeks. A couple of times I tried to wean myself off too soon and paid for it with hours of excruciating pain. After a few weeks, the pain started to subside it was no problem to gradually ease off the drugs. When I hear people talk about trying to manage this pain with Tylenol I feel panicky for them. Might as well take a Tic-Tac!

Today I can do quite a bit on the fake knees. I swim almost every day, ride my bike and do some limited (3 miles) walking. All pain free. I almost don't remember I have them now except when my wife's knees are hurting and she is trying to get down a lot of stairs. Or when I walk through metal detectors that are all over nowadays...

 

[Ronstar]

I had knee surgery in the 1970's to remove some loose bone fragments. Post op pain was the worst pain I've ever had. But the knee recovered and I've gone through 40 years of on and off running since. Slight knee discomfort and minor swelling pop up after long or hard runs, but eventually subside given enough rest.

After reading the many knee posts on this board, I've given up running for good. Thanks Op and others who are sharing their stories. I hope your replacements hold up fine and let you lead a normal life pain free.

 

[SumDay]

Thanks for sharing Chuckanut! I'm having my left knee replaced on July 11, and can certainly relate to Update #2. Did all that last week. The knee replacement class at the hospital was interesting and the free lunch wasn't bad.

One thing I wasn't aware of were the dental implications. I had to scramble to get a cleaning before the surgery, and apparently can't have any dental work done for three months afterwards. And, for at least a couple of years, I'll have to take antibiotics before each cleaning or procedure.

Infection is the enemy.

 

[Moemg]

My SO who is a giant medical chicken had his total knee with a spinal and sedation. The good thing about that is you can stay ahead of the pain since the spinal wears off gradually .

 

[Chuckanut]

Chuckanut,
Have you looked into Nanoknee? It is a different approach that is less invasive and does not require the long rehab.

Yes, I briefly looked into it, but I think my knee is to far gone for that. It seams like an adaption of the techniques many surgeons are already using to lesson the amount of cutting they have to do. My surgeon uses a robot guided 'scalpel' which is supposed to reduce bone cutting and the size of the initial incision. I am also suspicious of new techniques and devices. I know several people who had to have a second hip replacement after they found that their 'new' prosthetic leaked dangerous metallic ions into their blood stream. Another had to have a new 'mesh' removed that was installed to fix a hernia.

I want tried and true parts put into me. Though small there is enough risk involved already. Most people I know who have had the TKR are doing very well a few years out. They walk, hike, and live life with few thoughts to their repaired knee. One guy plays an awesome game of pickleball. The only limitations seem to be kneeling, pounding the legs (as in running or frequently carrying very heavy stuff) and torquing the knee with twisty movement(so no tennis, basket ball, etc.) I can live with that.

 

[Chuckanut]

Part 3 – How I prepared myself and my home.

Part 3 – How I prepared myself and my home.

Having lined up everything with the various medical professionals (I hope!), I next attacked getting myself and my home ready. First, I lined up a caregiver for the first two weeks, a relative who was a CNA in a previous life. Being a CNA is not necessary, but it is a plus. I have removed anything I might trip over, though the grandkids toys will require monitoring. A fall is never a good thing after a TKR a,nd especially bad while the knee is healing.

I have raised my favorite recliner by 3 inchers with a platform (something I now wish I had done years ago). I even put new foam rubber in my couch cushions which has restored them to actually supporting my body. I have crutches, a walker, a shower seat and a toilet seat riser available. I purchased a simple, gravity feed machine to ‘ice’ the knee using a cuff that holds ice water.

My home has a lot of stairs. I fear them, but I have been assured that with some help I should be able to go up and down a few times a day albeit slowly. I am told that after a week, going up and down the stairs gets somewhat easier. By week three I should be able to hobble up and down them adequately with a walking aid. If necessary I can stay on any level of my house and not use the stairs.

My doctor did not prescribe any pre-op exercises since he thinks I have good strength in my legs already. I have spent the last few months stationary biking 3-4 times a week, and walking 3-4 times a week, until the pain says stop, to keep up that strength. I have also been doing push-ups, planks and chair dips in order to increase my upper body strength. I will have to rely on my arms for some time to pull myself up and set myself down.

The thought of being ‘out of action’ for the rest of the Summer and well into the Fall is depressing so I made plans for my first hiking tip of the 2020 season with reservations at a National Park I have not visited in over a decade. It’s good to have something to look forward to doing, a prize for working through the long and somewhat painful process of recovery.


Oh, I am also enjoying a glass of good wine or a good craft beer with many meals. Alcohol is a NO-NO for a while after the surgery.

 

[Moemg]

I am really impressed . You covered all the bases .

 

[Chuckanut]

I am really impressed . You covered all the bases .

I've had a lot of help from those who have gone before me. I owe a lot to friends who have given me advice, and others who have written about their experience.

 

[W2R]

I am really impressed . You covered all the bases .

+1

Wow, I am really impressed! Thanks for posting and I can see that I still have a few bases to cover. So, I'd better get busy.

I am seeing the "knee guy" (board certified orthopedic surgeon specializing in knees) on Wednesday afternoon. He squeezed me in after all his other patients when the other orthopedic surgeon asked him to do that. I really hope the knee guy will schedule me for surgery very soon.

 

[SumDay]

Sounds like you're on top of this. A friend suggested a toilet riser, which DH is installing today. It also has arms to help you stand back up.

I too worry about my steps, but I don't HAVE to use them to be comfortable, but I will be using them as part of my therapy.

6 days to go for me...

 

[ExFlyBoy5]

I think it is wise you are doing this now. My Dad complained about his knee for years and years and when he was finally ready to have it done (he was then in his mid 80's) he could no longer have the surgery due to COPD and the high risk of the surgical procedure. So, the last 5 or six years of his life were made quite a bit more miserable because of it. He also had a couple of falls that he attributed to his knee giving way. Thankfully, the worst injury from those falls were bruised ribs.

 

[Walt34]

Thanks for sharing Chuckanut!

+1.

Chuckanut and everyone else who is sharing their experiences of events before and after their TKR. Although I am not going to have one in the immediate future, I did inherit my mother's bad knees and I'm 99% sure I will have one or more in my lifetime.

So while I may not comment much if at all, I follow these TKR threads with intense interest!