Total Knee Replacement Advice Needed

[Bamaman]

You've received such good advice on here. They just about covered every important subject. I've not got a pain of any kind, however my wife has been going thru surgery after surgery for recent years--including a knee replacement 2 years ago.

Pain is there for a reason, and it's a warning that something needs to be addressed. We often see "he men" with bone on bone issues but won't admit it's time to have surgery. We also see so many people wait until damage is done--and surgery just doesn't work as well. I'm just glad your husband is of normal weight. And I'm glad he's getting the surgery done.

You're fortunate to have access to a medical center as strong as Duke. They will have the latest equipment and facilities PLUS their quality of surgeons is top notch. With insurance, the very best orthopedic surgeon costs the same as a marginal surgeon. (My wife's doctor specializes in knee replacements, doing about 6 per week.)

You will want to find a great physical therapy office where you live. In the first couple of weeks, they are especially important in getting him on a good start.

My wife's been in pain management 20 years, and her biggest problem was with medications. Her pain doctor bows out when she has surgeries and turns it over to the orthopedic surgeon. The orthopedic doctor didn't properly address her pain medications, and the nerve block he gave her didn't work. Until I could get her home from 3 days in the hospital, she was absolutely miserable.

But my wife did overcome the knee surgery well, and hiked three major European cities two times last year (pre pandemic.) But then mid foot arthritis caught up with her and she had a mid foot fusion (plates & screws) 3 weeks ago. She cannot put one ounce of weight on the repaired foot and is essentially in bed for 2 months with a 1 year recuperation. The foot reconstruction is much worse surgery than the knee replacement. And then she'll have to get the other foot fused.

Good luck to your husband, as he'll come out of the replacement just fine.

 

[Dancer373]

This thread has come at just the right time. I tore my left meniscus and PCL a year and a half ago. Had surgery to repair those and they cleaned out the arthritis as well. I've had steroid shots for the last year and a half. Now I'm looking at replacement. Thanks for all the information.

 

[aaronc879]

The knee that was replaced took a lot of the workload off the remaining knee. So, it got better too. Of the two knees, the replaced one is better than the natural knee. But I no longer feel like I need to get the other one replaced. I'm not ruling it out for the future, but presently I no longer plan to have it done even if COVID vanished tomorrow.

(Now that's a nice daydream! I wish it would. )

Sorry I took so long to answer. I drifted off to sleep and napped for a while.

I'm happy to hear you may not need the other knee replacement.

No need to apologize. You are retired, you can nap ANYTIME you want.

 

[stedmakr]

I've had both my knees replaced and they were both life changing events. It one point I was limping heavily and could not walk a quarter of a mile without having to sit and rest. Nor could I stand unassisted for several minutes at a time. I can now walk several miles and I ride my bike and hour and a half every a day. The surgeries very literally changed my life and my future prospects for an engaging life as I age. I am currently 66.

Do exactly as your medical team advises. Not to much, not to little. I was told that recovery was essentially a full time job. Do your exercises every day or several times a day as directed. There were no shortcuts. Ice!!! Don't attempt to save money by skimping on physical therapy.

Create a nest at home. In my case it took me several weeks before I could get a good nights sleep. My wife slept in a different room which allowed me to watch Netflix during many sleepless nights.

The surgeon is just one part of a larger process that includes administrative support before surgery, nursing care and physical therapy. Each element is critical.



I

 

[harllee]

No info on TKR, but a big thumbs up for Duke's outpatient orthopedic surgery unit. Organized, well thought out, good communication. DW just had ankle surgery there one week ago! No pain.

Good to know about Duke Orthopedic. DH has researched and talked to many people and that is how he decided on Duke

 

[harllee]

I am so grateful for the all good advice and I will tell DH your stories to give him confidence. DH might go ahead and get an ice machine--he ices his knees everyday so the ice machine would be convenient. We already have the rails on the toilet. I will make sure all throw rugs etc are removed. We will get a shower chair that will fit into the tub/shower. I see one on Amazon that I think will work with our situation. We have a stationary bike that we both ride on days we cannot bike outside. We are fortunate to live in an area with great medical facilities (that is one reason we retired here) and we are told that the doctor DH is seeing in a couple of weeks is the "knee" guy to see at Duke.

 

[W2R]

We will get a shower chair that will fit into the tub/shower. I see one on Amazon that I think will work with our situation.

I have and like this shower stool because it can be adjusted up to 21" high. A high shower stool is easier to get up from with bad knees or later in recovery from knee surgery, IMO. It fits in a standard bathtub.

Sounds like you are making some great decisions and will be well prepared for your DH's surgery. If his orthopedic surgeon is the "Knee Guy" at Duke, that sounds like he knows what he is doing! Good.

Create a nest at home. In my case it took me several weeks before I could get a good nights sleep. My wife slept in a different room which allowed me to watch Netflix during many sleepless nights.

It took me a few weeks after surgery before I was able to get in and out of my bed safely and without excessive pain while doing so. Luckily I had my lift recliner which was easy to get out of, due to the lift function. I slept there until I felt ready to sleep in my bed once again. I had a "nest" all around it, with everything I might need for entertainment or snacks or whatever, and of course my cell phone to call Frank in case I needed help for some reason.

 

[MrsHaloFIRE]

I haven't read all of the comments but if you can't go to the appt have your DH call you and out you on speaker. Hang out until the Dr comes in. Listen and ask questions. Docs are very cool about this

 

[Telly]

Purchases - I forgot to mention that by far the most useful helper gizmo for DW was a Hurrycane. Folding one about $37 at Walmart. Read the instructions on how to use it properly with respect to gait. DW used the walker only the first couple days at home, then switched to the Hurrycane. The Hurrycane was easy to keep close by and goes everywhere a person can go. A walker has spacing considerations. The Hurrycane can stand by at hand on hard floors or rugs with low pile. Or handle hooked over a chair back or leaning against a wall, etc.

My DW was an outlier as far as how quickly she recovered from both TKRs, and I worried about her possibly getting herself into a damaging situation. She would abandon the walker somewhere in the house the second day home, and I was wheeling it to be near her when I found that out. The Hurrycane was an acceptable companion. I think my DW's internally wired programing is, "I will NOT be an Invalid!!!

 

[harllee]

I haven't read all of the comments but if you can't go to the appt have your DH call you and out you on speaker. Hang out until the Dr comes in. Listen and ask questions. Docs are very cool about this

Thanks --we have called the surgeon's office and I am allowed to come to the visits at his office so that is good.

 

[harllee]

Purchases - I forgot to mention that by far the most useful helper gizmo for DW was a Hurrycane. Folding one about $37 at Walmart. Read the instructions on how to use it properly with respect to gait. DW used the walker only the first couple days at home, then switched to the Hurrycane. The Hurrycane was easy to keep close by and goes everywhere a person can go. A walker has spacing considerations. The Hurrycane can stand by at hand on hard floors or rugs with low pile. Or handle hooked over a chair back or leaning against a wall, etc.

My DW was an outlier as far as how quickly she recovered from both TKRs, and I worried about her possibly getting herself into a damaging situation. She would abandon the walker somewhere in the house the second day home, and I was wheeling it to be near her when I found that out. The Hurrycane was an acceptable companion. I think my DW's internally wired programing is, "I will NOT be an Invalid!!!

Thanks for the suggestion. DH already has a cane and unfortunately is already using it pre-surgery but I will look into this one. I expect DH is going to need a walker after surgery for a while. Several of our friends have walkers and have offered to loan them.

 

[Bob_Walter]

I would also ask about PRP injections.

 

[harllee]

I would also ask about PRP injections.

PRP? Had to look that up --Platelet Rich Plasma injections. I read a few articles and it does look like there is some evidence that it helps some knee arthritis but the science seems to be unclear. Bob, have you had these injections and did they help? It does not look like Medicare would cover this. What is the cost? I saw an article that said several thousand dollars.

Anyone on this Forum that has had PRP for knee arthritis?

 

[timo2]

If you have access to a hot tub, that is a helpful item also. As soon as the doctor said I could get back in a hot tub, I did. It relieved various joint and muscle pains. Plus I was able to try to do squats and cross my legs with the aid of water support.

 

[harllee]

OP here--DH met with the knee surgeon at Duke this morning and they have an opening for TKR on April 13 so he signed up. The doctor said he was an excellent candidate for TKR--his left knee is "awful" and his right knee is not so bad so maybe he will have to only have one knee replaced. DH is also a good candidate because his BMI is 24 and other than psoriatic arthritis he has no health issues. The surgeon said he had done over 5000 TKRs (he does about 10-20 per week) and has only had 30 surgeries that had to be redone in his career. He has a whole wing at Duke Hospital just devoted to his patients. One thing I liked is that DH will not have to go under general anesthesia--they do a "block" which is similar to what you are given at a colonoscopy and he says patients recover from that much quicker than general anesthesia.

They gave DH a list of exercises to do to prepare for surgery but he is already doing most of them. They fitted him with "half crutches" and had him practice with those and they said to use those for walking in the house to get use to them. The surgeon says his patients do much better on the half crutches than walkers--he said people shuffle their feet too much with walkers and the half crutches promote much better walking and can be easily used on steps. Anyone else here used half crutches?

DH will be provided with an ice machine so we do not buy that.

Regarding recovery, DH will have PT at home and then at the PT's office but the doctor said he does not believe in painful PT. If the PT is causing a lot of pain then you are doing too much. He says getting rid of the swelling is the main thing he wants his patients to concentrate on by icing, etc and if you do too much PT early it causes too much swelling.

Overall DH was very impressed with the surgeon and is looking forward to getting his knee fixed. In the meantime I need to get the house ready--take up all throw rugs and trip hazards. I am also going to order some the items suggested in this thread from Amazon to help DH recover.

 

[Telly]

...........Overall DH was very impressed with the surgeon and is looking forward to getting his knee fixed. In the meantime I need to get the house ready--take up all throw rugs and trip hazards. I am also going to order some the items suggested in this thread from Amazon to help DH recover.

That's GREAT!

We'll be pulling for him.. or pushing for him, whichever is better

 

[W2R]

What terrific news, Harllee! That surgeon sounds like he really knows what he is talking about.

I don't know anything about half crutches, but the surgeon is right about the walkers - - although it was very stable, for me the metal hospital walker was also very awkward to use except with itty-bitty steps. During recovery your DH will want to re-learn to walk normally.

The surgeon was also absolutely right about PT. I probably talked about that in my thread somewhere.

In my case, my surgeon said my left knee had some of the worst degenerative arthritis he had ever seen. But after the surgery (on my right knee, which had other issues), the left knee also improved dramatically so I don't see any need to have surgery on that one, too. I am confident that your DH will only need surgery on that one knee, especially since the surgeon suggested that might be the case.

 

[harllee]

What terrific news, Harllee! That surgeon sounds like he really knows what he is talking about.

I don't know anything about half crutches, but the surgeon is right about the walkers - - although it was very stable, for me the metal hospital walker was also very awkward to use except with itty-bitty steps. During recovery your DH will want to re-learn to walk normally.

The surgeon was also absolutely right about PT. I probably talked about that in my thread somewhere.

In my case, my surgeon said my left knee had some of the worst degenerative arthritis he had ever seen. But after the surgery (on my right knee, which had other issues), the left knee also improved dramatically so I don't see any need to have surgery on that one, too. I am confident that your DH will only need surgery on that one knee, especially since the surgeon suggested that might be the case.

W2 Thanks! I looked at the X-rays--left knee totally bone on bone. Right knee has some spacing. Both knees hurt DH but the doc thought that maybe once the left is done this will take the pressure off the right, similar to your situation.

 

[harllee]

Based on the threads of W2R and Chuckanut I ordered a Lounge Doctor knee pillow (manufactured right here in NC) and DH is already using pre-surgery it and loving it. DH says he thinks the Lounge Doctor is helping the existing knee swelling that he has. One question--the information that the doctor gave us says not to use a knee pillow for at least 3 weeks after surgery because it will make it harder to straighten the knee. Was anyone else told this?

 

[harllee]

By the way--the Lounge Doctor is fairly expensive so I did what I do whenever I order anything pricey -- I googled "Lounge Doctor coupons " and I found a 25% off coupon I was able to use on the Lounge Doctor website. The price on the Lounge Doctor website and on Amazon was the same but I was able to use the 25% off coupon on the Lounge Doctor website so that is where I ordered it --free shipping and came in 3 days.

 

[W2R]

Based on the threads of W2R and Chuckanut I ordered a Lounge Doctor knee pillow (manufactured right here in NC) and DH is already using pre-surgery it and loving it. DH says he thinks the Lounge Doctor is helping the existing knee swelling that he has. One question--the information that the doctor gave us says not to use a knee pillow for at least 3 weeks after surgery because it will make it harder to straighten the knee. Was anyone else told this?

My surgeon didn't say anything one way or another about it, but then he didn't really do a lot of talking. If your DH's surgeon said that, then I am confident that he is right.

Actually I didn't use the Lounge Doctor as much as some people do, although I did buy it and it has a great reputation. Mostly I couldn't figure out how to use it easily in my recliner, and after my surgery that's where I slept until I could get in and out of my bed independently and safely. I guess that took a week or two maybe (it probably says in my thread somewhere). Until then I had to get help to lie down and use the Lounge Doctor, so I just didn't do it much.

As for straightening my knee, I didn't feel like I was doing well with that at all, until I quit PT and just let it rest, un-swell, and heal on its own. I know that is contrary to what people say to do, but it worked for me. It straightens just as easily as my other knee that didn't have surgery. Maybe I was lucky.

Good deal on the Lounge Doctor coupon!

P.S. - - I am SO happy for your DH that he is getting his knee fixed, in just four short days! It's a bit of an ordeal at first, but once that part of recovery was over, I found the improvements in my knee function and mobility are remarkable.

 

[nap470]

Based on the threads of W2R and Chuckanut I ordered a Lounge Doctor knee pillow (manufactured right here in NC) and DH is already using pre-surgery it and loving it. DH says he thinks the Lounge Doctor is helping the existing knee swelling that he has. One question--the information that the doctor gave us says not to use a knee pillow for at least 3 weeks after surgery because it will make it harder to straighten the knee. Was anyone else told this?

I was told by the surgeon and the PT not to sleep with a pillow under the knee. I don’t remember if they gave me a timeframe of how long.

 

[Chuckanut]

the information that the doctor gave us says not to use a knee pillow for at least 3 weeks after surgery because it will make it harder to straighten the knee. Was anyone else told this?

My doctor never gave me any such warning.

I have found that the surgeon's advice can vary greatly. For example, some people are told to take antibiotics before dental work for the rest of their lives, others for a year. My Dr told me to take them for two years.

Why the differences? I have no idea. All, I know is I have enough antibiotics left to get me to 2.5 years, so that is how long I will take them.

 

[harllee]

My doctor never gave me any such warning.

I have found that the surgeon's advice can vary greatly. For example, some people are told to take antibiotics before dental work for the rest of their lives, others for a year. My Dr told me to take them for two years.

Why the differences? I have no idea. All, I know is I have enough antibiotics left to get me to 2.5 years, so that is how long I will take them.

DH's surgeon said that the current thinking on dental procedures after TKR is that antibiotics are not necessary for routine cleanings but should be used for other dental procedures like filings and extractions for 5 years.

I think the general thinking about antibiotics before dental procedures have changed. I have a slight heart murmur. For many years I was told by my doctor and dentist to take antibiotics before any dental procedure. Then about 10 years ago I was told that the thinking had changed and that antibiotics were not necessary.

 

[Bamaman]

Congratulations on finding such a fine orthopedic surgeon as you have. And needless to say Duke's a top of the line hospital. It never hurts to go with a physician that specializes in a procedure and does them time and time again.

My wife had a knee replacement 2 1/2 years ago and did quite well with it. She had good quality PT and just did what she was told. They had her up and walking right away. In her case, the block didn't take, and she was miserable in the hospital without proper medications to relieve her pain.

Five weeks ago, the DW had mid foot fusion surgery and bunion surgery, and she's essentially in bed for two months. The knee replacement was relatively easy compared to having all the bones in the top of feet fused with plates and screws. And really good foot surgeons are hard to find. It's a surgery with a 90% chance of relieving serious pain but sometimes it takes a full year to recover. Then she's got to have the other foot fused.

In the meantime, I'm glad to remain by her side all day. I enjoy cooking very much, but laundry and keeping the house up to the DW's cleanliness standards is for the birds.