Does it make sense to pospone surgery?

Posted , 7 users are following.

I've been diagnosed with OA on my right knee and my doctor is recommending a partial knee prosthesis. I'm not sure if to do it as soon as possible or to wait. Have any one of you tried out using an unloaded OA knee brace?

I know surgery is inevitable but is sooner better than latter?

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  • Posted

    Do you mind if I ask how old you are? If it was me, I would try every options first, ex: Synvics One injections (I have had 8), cortisone injections (I have had 1), PT, knee brace, icing. This is such a painful operation and long recovery, why do a partial when some day it will lead to a full TKR? I will be 11 weeks post TKR next week. (IMO) Good Luck!
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    • Posted

      Let the forum say amen! If you can, hold off as long as you can. I had tkr in July 2016, and it's been hell! I'm having a revision on January 31st. Now if the pain is excruciating and you just can't handle it, go ahead with the surgery. I wish those who had it before me would have told me the butt naked truth! I'm going to give it to you raw and uncut. Knee replacement surgery is no joke and it hurts....a lot! There's going to be sleepless nights, stiffness and depression might come to visit. It gets less painful as time goes on and in time you're going to get better. Most people that had the surgery say it was worth it in the long run. Be blessed.

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  • Posted

    Try anything you can to avoid it! It's a horrible painful procedure that will totally change you. Have you read the horror stories in this forum. Heartbreaking to say the least. Knee replacements are the surgeons bread and butter! That's how they make their living. They just move on to the next patient when they're finished with you and push you on to the PTs. Whose qualifications are questionable at best. The aftercare is awful. Perhaps a second opinion or just tell the surgeon you don't want it and want to try something else. Good luck whatever you decide. Keep us posted.

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  • Posted

    Hiya Normaluisa,

    Happy New Year.

    Well its like this - have it done now. It makes absolutely no sense to postpone the inevitable - just do the business.

    ?I was 71 when I had a partial knee replacement (medial compartment, right knee) done as an NHS patient in a private hospital on 6 Nov 2015. although I went into it with a great deal of reluctance I had got to the point where daily pain was so great I could hardly walk. And my consumption of pain killers was like eating sweets. I had been diagnosed with osteo arthritis too.

    ?As you are able to elect when you can have the surgery I would take steps to prepare your body for what is undeniably a hard road ahead. Prepare your body both physically and mentally. There are things you just will not be told - I spent some 6 weeks before surgery having a massage therapist working and advising me on strengthening my right leg muscles ... the idea being to get the leg as fit as possible so that your surgeon has the best strongest knee/leg muscles in the world. Then for about 6 weeks afterwards the same therapist will need to work on the incision scar and the muscles to prevent scar tissue forming. Scar tissue will inhibit your recovery like you wouldn't believe. You'll be given a set of exercises to do daily until told to stop. DO THEM WITHOUT FAIL. You could go onto Youtube and type in the search box   - exercises after partial knee replacement. There are shedloads of short videos on the sort of exercises you have to go through, this will prepare you mentally.

    ?OK, so, my timeline was ..... surgery on 6 Nov, discharged home on 9 Nov, dressing removed on 19 Nov, back driving my car on 29 Dec and back at work driving a bus on 26 January. My stitches were self disolving staples.

    ?The secret is you have to get the leg muscles strong before surgery so your leg is in best shape possible as it will be a big plus in aiding your recovery. Then afterwards, get that scar tissue worked on, you just must not let it form. My hospital would not let me home on day 3 until I could walk up and down stairs on crutches and until I could get a 90 degree bend in the knee before leaving hospital. If you can't get that 90 bend you are gonna have a bloody hard time afterwards.

    ?Hope this helps, get it done sooner rather than later. Any questions just ask me.

    John

     

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    • Posted

      I agree totally with the exercise before surgery to strengthen the leg/quad muscles and also the incision massage after surgery. My PT actually showed me how to do that and it helped so much! The best advice I could give to someone who is having this surgery is to prepare yourself mentally that if you push past the pain in therapy you will feel so much better. I was actually doing the exercises at home first thing when I got up because it hurt so badly until I did. No pain no gain!
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  • Posted

    I just had a MAKO assisted (robotic) partial left knee replacement in October. It is my understanding not many people even qualify for partial since most OA is not isolated to one compartment of the knee. I had heard so many accounts from different health professionals that most people who have partials end up with a total within a couple of years that I was skeptical to go through it. I am only 51 so I decided it would be of benefit to have more flexibility with my knee while I am still fairly young plus with the robotic surgery there is much less bone loss. But, I had been dealing with my knee problem since 2012. It got aggressively worse over the last 3 years. I said all that to say this: I was doing great at therapy until we started working it more and a problem became obvious. I had IT band syndrome. It is really painful and I had to stop my knee therapy to have that issue addressed. The IT band shortened over time while I was babying my bad knee and it now had to be stretched...which I might add is much less pleasant than knee therapy. If you choose to put your surgery off, Google some IT BAND stretching exercises and keep it in shape. My knee feels better now that we are back to therapy on it and I'm doing great. Just wish I had realized the back/hip issues and tendon/muscle related issues that could cause my knee recovery progress to be hampered. Best of luck with whatever you decide.

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    • Posted

      Hi,

      ?Yes, based on the attitude of my surgeon you are correct about those who qualify for a partial;. At my first meeting with the man who was gonna give me my life back he explained the two options - partial v total.

      ?I opted for partial. I quizzed him extensively but he just wouldn't be drawn on what to do. In the end he said - 'I will prepare my team for a partial, BUT, if when I get in I see the OA is more extensive than is showing on X-ray then I will go straight away and do a total and we can discuss it afterwards. I agreed, but, I just knew it was gonna be a partial.

      ?My knee damage originally occured  from a sporting injury years ago. Then in 2000 I was out walk and stumbled and tore my right knee cartilidge which using keyhole surgery was removed and cleaned up - during this process the surgeon found the onset of OA.

      ?Well, I got another 15 years out of the damaged knee ! From 2007 onwards though I began to develop lower back pain and right side Sacriliac joint (Si) pain. My Osteopath at the time frequently commented on my gait. In 2014 I had X-rays which were mis diagnosed and my knee pain increased and so did the swelling, eventually, a further year down the track I got to a top surgeon and  .... bingo ! job done.

      ?The bonus to the partial was that the surgeon was able to realign the leg, knee and hip/Si joint geometry and I'm now totally pain free, except if I sleep too long my lower back stiffens up, is a bit painful,

       until I get up and mobile, then all is OK. But then at 72 I can still work, drive a tourist shuttle bus handle heavy passenger baggage, walk along the Cornish South West Coastal path, up hill and down dale, over all sorts of rough terrain - no problems. And I can do all this knowing that at some point in the future I am still gonna be able - if necessary - to still have a total if need be.

      John

       

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    • Posted

      I should add that my surgeon is delighted with progress. I've just had my 1 year post op review and surgeon doesn't want to see me for another 4 years. He is giving me a life span on this partial of some 15 years or more. (Well, that'll probably see me out !!! ). He explained it is a stainless steel implant and is compacted onto the bone so that the bone will grow into and around it.

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    • Posted

      Hi Cementless,

      ?Yes it is. I specifically asked the surgeon how the implant was fixed, cemented, screwed or what. He said stainless steel - and impacted. The precise location is right leg, top inside of the Tibia. No sign of OA affecting any other part of Tibia or Femur. I do regard myself as fortunate as it seems the OA has come about from the original sporting injury decades ago as opposed to being genetic or inherited in some way. My sister has had a TKR after me to remedy a more inherited OA and she has had a battle in terms of recovery. I might add she had an epidural anesthetic and was aware of all the banging, drilling etc that went on. I had a general anesthetic and was aware of nothing. Different surgeons in different parts of the country. I don't know why the difference in anethesia - maybe because I have a heart condition (atrial fibrillation and am on Warfarin and a beta blocker ) and it was the anethesetists choice for me.

      John

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    • Posted

      John, mine is also cementless because I was tested for the bone cement monomer and it showed I was mildly allergic to the bone cement. Thank goodness my bones were still good without osteopenia ortherwise the ortho would have had to use some bone cement anyway. I too have AFIB and was AFIB free for 5 months until the pain medications and then wham....pulse 188 for a few hours. I take Eliquis bid and a beta blocker when I feel my pulse elevating. This has been rough on me. I am 69. almost 11 weeks post TKR and still need pain medication, muscle relaxants and my 3rd (last) month on Celebrex.
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    • Posted

      My SI joint issues plus nerve pain in my feet are the things that finally tipped the scales for me to go ahead with my surgery. Limping on a bad knee is just not good under any circumstances for a long period of time. It sound like uou have had amazingly great luck with your surgery. I'm happy for you and hope mine gets to that point soon.

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    • Posted

      Ising4him,

      You will get there, you will.

      ?Yes I have been very fortunate,but, in the first 4 weeks I went through all the emotional trauma that everyone else goes through, hating myself for having such barbaric surgery done, hating the PT people, hating being dependant on my partner to help me, pushing my exercises to the point of bawling my eyes out, wishing I could be as I was and not having the surgery. Yes all that and more. Hating that I couldn't measure my progress in post op recovery. Hating being on pain killer medication.

      ?You mention the Si joint issues - in retrospect - I think the Si joint pain was worse than the pain from the OA in the knee.

      ?In the end I developed my own personal mantra - kept receiting to myself - if you don't bloody well get this right you'll never walk properly again. Mindpower is a great resource we all have,  yet, it is a resource we seldom use. Through this mantra I did exercise a great deal of mind power and that was a massive positive support.

      I wish you (and others) all the good fortune I have had - remember - "Fortune favours the brave".

      John

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  • Posted

    Thank you all for your advise and comments. They are all very useful to me I know now that I need to prepare for this surgery, making sure that I have strong muscles and mentally that the recovery period will be much longer than I was told.

    I was considering doing the surgery in February in Quito Ecuador with the same surgeon who took out my meniscus eight or more years ago and who has treated me since then. As I am no longer a permanent resident there, I asked him how much time I needed to be there after the surgery for the PT and he told me three weeks maximum. I mistakenly understood that it meant that I would be healed and that I could get back to traveling and moving around as I do now. But who knows how my recovery will be. Maybe I need to take more time so I can't plan it when I have too many things on my plate.

    So, for the moment, I will focus on strengthening my leg. I want to obtain an unloader brace. Any experiences? Dsuggestions? And prepare mentally

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    • Posted

      Btw, I do not have too much pain, i feel some soreness under my knee cap and only once in a while I feel the need to take a pain killer. Nevertheless, it has limited my activities, I haven't been back on the tennis courts. I thought that having the surgery done would in about five to six months bring me back to the court. Now, I'm doubting that

      Norma

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    • Posted

      I know lots of people who have had knee replacement and most of them will tell you that it takes about a year for it to stop swelling and seem more normal. You have to gradually increase how long you are active on the knee each day to prevent alot of swelling. I think each individual case is different and depends on how determined you are with your therapy/exercise program both before and after surgery. One thing I know is the more physically fit you are going in the faster you will heal. That being said, there is really no way to know how fast you'll be back in the full swing of things since every case is unique. I believe you have an idea of what you can be prepared for though.

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