What was your knee replacement tipping point?

[Carpediem]

My DW (57), who used to enjoy running in her 40s and LOVES walking in her 50s, has been battling knee issues for a few years. She had arthroscopic knee surgery in early 2017. The doc said her knee was basically bone on bone on one side of her knee with a little cartilage left on the other side. The treatment plan was (1) exercise to strengthen the knee, which is no problem for my DW since she loves exercising, and (2) a series of knee injections. His hope was to delay a total knee replacement as long as possible.

After a year of following his plan, she still has good and bad days. But the worse thing is that she is still unable to walk more than 1-2 miles at a time. We used to walk 3-3.5 miles on a daily basis 2-3 years ago. She is very frustrated and discouraged about this and we know that walking will be one of the activities that will be important to us in retirement.

Last night we started talking about knee replacement and wondering if we had reached the point in which we pursue it. She wondered how others had come to the decision to do it (versus putting up with some pain everyday). We've both read good and bad stories about the surgery and she's not very high on having it done but realizes it might be the best/last option.

For those who have had knee replacement, what was the tipping point at which you said, "I've had enough" and had it done versus managing the pain on a daily basis?

[SumDay]

I have a relative and several friends who have had it done, and the only complaint I've heard is that they wish they'd done it sooner. The days immediately following were rough for some, but all in all, they had good experiences.


I have a knee issue, and found riding a three wheel trike far less painful and still allows me to get some distance, exercise and fresh air. TerraTrike


Good luck!

[Midpack]

DW faced exactly the same with her right ankle and hip, also let it go until the joints were bone to bone. She was very active into her 40's (including completing a marathon run, several bike century rides, etc.), but her mobility has gone downhill with the decades (she's 61 now) - much to her frustration. She tried other treatments but when she had pain every day and it reached the point it often kept her up at night just laying in bed, she had the ankle replaced over 4 yrs ago, and the hip almost 2 yrs ago. Her quality of life has improved dramatically and both surgeons told her she could expect 20 years or more before another replacement might be under consideration.

She would say the same as SumDay observed, wish she'd done it a year or two sooner. And as you probably know, recovery is the hard part, and if you're not committed to therapy/exercise - your recovery will take longer and the outcome won't be as good.

The two things I would add to nudge you along:

• She favored her left good ankle to protect her bad right ankle for a few years before having it replaced. As a result, her right hip suffered and probably hasten the detiorationed in her right hip, only to face a hip replacement too.
• Not only does delaying prolong the pain, recovery will probably be (much) more difficult the older the patient is, something to give serious thought. DW bounced back from the ankle faster than she did from the hip just two years later, and we were told ankle replacement is the hardest to bounce back from compared to hip or knee.
  

Best of luck...short term pain for long term gain hopefully.

[Moemg]

My SO has a huge pain tolerance so when He decided it was time I knew it was probably past time .The problem with waiting is your knees just get worse and you get older both of which make surgery harder . He aced the Total Knee and completed Physical therapy in record time .He is happy with his new knees and except for kneeling He has no restrictions or pain.

[gerntz]

I wouldn't tip the surgeon for a knee replacement operation. They get paid well enough.

[HadEnuff]

Quote:

Originally Posted by gerntz I wouldn't tip the surgeon for a knee replacement operation. They get paid well enough.

Well, that really depends upon whether you'll be back for the surgeon to do the other knee.

[HadEnuff]

I am so far, blessed with pretty good knees. Not even close to needing anything done. However, pertinent to the OP's question, I heard a great interview a few years ago, with Billy Jean King. She said she had terrible knees, and delayed and delayed the FKR, and eventually she just couldn't go on anymore, so she had them done. I don't remember if she had them both done at the same time or not, but she said her only regret was not having done it much sooner. She was back to playing tennis, not very well according to her, but....

I have, since Christmas, had two close pals have the procedure done. One was just about timely, the other should have been done 5 or 10 years ago (both guys are 65). Recovery was easier for the one who didn't wait so long, but I think they are both doing well, and report that they feel better now than they had for years.

[googily]

A friend of mine just had her knee replaced at 51. She had had it scoped two years earlier to try to stave off a replacement, but she's a New Yorker who walks a whole lot, and got to the point she just couldn't take it anymore. Was making her day-to-day life exhausting.

I had to start contemplating the notion of a hip replacement at 51 thanks to a torn labrum and borderline dysplasia, but I am blessed with virtually no arthritis. My PT prodded most strongly to avoid the replacement as long as possible, and I found a top-notch surgeon who agreed and did the fixing. I'm assuming the replacement is in my future, but I wanted to push it until I'm past 60, so hopefully this repair comes with an eight-year guarantee. [emoji16]

[Carpediem]

Thank you for the feedback. Very helpful.

For those of you who had knee replacement, how long did your PT last? And were you an active exerciser prior to your surgery? Do you think DW's recovery might be aided by the fact she currently exercises daily?

[Chuckanut]

Quote:

Originally Posted by googily A friend of mine just had her knee replaced at 51.

Was it total or partial?

From what I have read, at that age a partial is best since one will probably need another replacement in her lifetime. A TKR after a partial is supposed a lot more successful that two TKR's.

My goal is to have one TKR on the knee. Unless I really outlive my ancestors that should be enough.

[googily]

Quote:

Originally Posted by Chuckanut Was it total or partial? From what I have read, at that age a partial is best since one will probably need another replacement in her lifetime. A TKR after a partial is supposed a lot more successful that two TKR's. My goal is to have one TKR on the knee. Unless I really outlive my ancestors that should be enough.

Pretty sure it was a TKR, but I don't know for sure.

[Bamaman]

The deciding factor is pain. When you are miserable, don't be a He Man. Your body is telling you it is time for a change. And sometimes that means a knee, hip or shoulder replacement.

My wife is out of the hospital 2 weeks for the knee replacement, and the knee is doing great. She is going to physical therapy and is ahead of schedule. Xrays this week showed everything lining up perfectly. We drove an hour to get to an orthopedic surgeon that does nothing but knee replacements, and his clinic has a whole hospital floor in a wing for just their patients.

My wife has been under pain management for 15 years, and is one of their success stories. She takes the maximum amount of controlled meds she needs to take, but she is well balanced and lives life to the fullest. Going into the hospital upset her regular pain regime. The pain block given in surgery did not work, and her surgeon didn't properly address her medicinal needs. She was absolutely miserable the first 2 days--excruciating pain. Before she ever had any future procedures, we will be making concrete plans on what meds will be taken and when. She fell thru the cracks. Doctors and staff simply ignore people with special medicinal needs because they don't understand what pain management is.

[harllee]

I have good knees (thankfully) but DH (age 68) has bone on bone knees. So far he has been able to delay knee replacement by getting Euflexxa shots in both knees every 6 months. DH is reluctant to consider TKR because we have had 3 friends who had it done and it was not successful. It appeared that everything was done correctly in all 3 situations (good surgeon, physical therapy, etc) but in all 3 cases the knee replacement had to be redone and the reason give is that the glue gave out (3 different surgeons involved). Could that be correct? I researched this and there does seem to be some major class action lawsuits for glue failure in TKRs. All 3 of our friends have had the knee replacements redone and one of them have has had a second failure. The other 2 are waiting to see if theirs fail again. All 3 say they wish they had never had the replacement done. Is this unusual?

[aja8888]

Quote:

Originally Posted by harllee I have good knees (thankfully) but DH (age 68) has bone on bone knees. So far he has been able to delay knee replacement by getting Euflexxa shots in both knees every 6 months. DH is reluctant to consider TKR because we have had 3 friends who had it done and it was not successful. It appeared that everything was done correctly in all 3 situations (good surgeon, physical therapy, etc) but in all 3 cases the knee replacement had to be redone and the reason give is that the glue gave out (3 different surgeons involved). Could that be correct? I researched this and there does seem to be some major class action lawsuits for glue failure in TKRs. All 3 of our friends have had the knee replacements redone and one of them have has had a second failure. The other 2 are waiting to see if theirs fail again. All 3 say they wish they had never had the replacement done. Is this unusual?

Neighbor down the street (woman about 70) had the same thing happen. First one failed in 6 weeks, the second attempt was "better". That was 9 months ago and she wishes she never had the replacement done.

[stedmakr]

I'm 63 and had my right knee replaced at 61 followed by my left knee 2 months ago. Great success with the right knee. I was more aggressive with a recovery regime on the left knee and tore the LCL which is slowing recovery, even though the device is fine.

I waited too long on both knees. I did all the leg strengthening exercises and took the shots prior to making a the decision, but I also limped for about 3 years before the first operation. In retrospect my thought process was too deliberate.

As for a trigger, if you're in pain or have a mechanical problem like a limp and its not going to get better then listen to your doctor and fix the problem. An x-ray that shows bone on bone combined with pain, a mechanical problem, or just an inability to walk for distance should be enough to drive a decision.

The caveat is that TKR is a major operation. Not all outcomes are 100% positive. The patient will probably miss six or more weeks of work and require close to 24/7 care for the first week or so after the surgery.

To some up, if your knee is diminishing the quality of your life and less invasive alternatives aren't working a TKR is a viable tested solution.

[Dash man]

Quote:

Originally Posted by stedmakr The patient will probably miss six or more weeks of work and require close to 24/7 care for the first week or so after the surgery.

I have to disagree. DW had both knees replaced last year at age 61. They were done three months apart. In both cases she was up and walking with a walker the same day as her surgery. While she couldn’t drive for three weeks, she didn’t need my help using the restroom or climbing stairs. They taught her how to do all that in the hospital. We did install temporary handles on the toilet and in the shower, and she used a walker for about a week. I did monitor her stair climbing, but she never needed assistance except for carrying the walker upstairs. She was mostly self sufficient and never came close to needing 24/7 care.

[stedmakr]

Dash man, not wanting to get in a back and forth but since others are viewing, perhaps my 24/7 comment was imprecise so I'll try again. For the first week after surgery it is my experience that the patient is not self sufficient (to use your words). There is the possibility of a fall, the patient will need help with household chores like cooking and monitoring the drug regime. I don't believe any surgeon would suggest that a patient be alone for the first week after surgery. Not everyone who undergoes a TKR has a spouse.

[Dash man]

Stedmakr, I agree they shouldn’t be alone, and I did cook. But I was amazed at how well DW was able to get around and do things for herself...just herself. I did all the chores. I think we agree now.

[rayinpenn]

For the first knee I had just has an injection of that stuff that’s supposed to lube the knee. It didn’t work and I was just plain miserable. Over time the stiffness and pain had me pretty wore down. I hobbled into the orthopedic surgeons office and he said I guess your ready?

The second knee gave me spells where the first one was all the time. I wasn’t going to wait for it to be full time. When I was in pre-op a spell kicked in and I knew I had made the right choice.

The advice I always give is after the surgery get off the opioids asap. Two extra strength Tylenol’s 3 times a day does the trick.
Most don’t and I didn’t get excruciating pain.

[aaronc879]

Quote:

Originally Posted by rayinpenn The advice I always give is after the surgery get off the opioids asap. Two extra strength Tylenol’s 3 times a day does the trick. Most don’t and I didn’t get excruciating pain.

There is a wide range of results from joint replacement. Some people need opiods for a couple days, some for months. I am recovering from a THR which is supposedly less painful than a TKR. I am almost 3 weeks post-op and still have a 6 in pain most of the time without opiods, 4 with. I take 1300mg of Tylenol in an attempt to avoid Oxycodone but the Tylenol does next to nothing. I have nerve damage and the pain that goes with it so maybe that's why it worse but i'm just saying everyone is different. Do not suffer through the pain just to avoid opiods. That can lead to chronic pain. Opiods are not a bad thing if taken correctly. If you continue having significant pain then continue taking the opiods unless your surgeon says otherwise IMO.