Having a Mako PKR in 3 weeks

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Hi Everyone! I'm Linda and I'm having an outpatient Mako PKR (robotic) on 7/26/17. I'm 61 and in good health and pretty active. (have a personal trainer and was walking a few miles/day before my knee pain). Has anyone had their PKR done using Mako? Would appreciate all tips, precautions, etc. Even if yours was not done robotically, I can use any guidance you care to share.

It seems most here have had TKR's, but my surgeon feels confident my arthritic damage is limited to the medial side. (although I do have intermittent pain on the lateral.) Makes me a bit nervous to go through just the partial and possibly have lateral pain after, but he feels in my case it's better to preserve as much of my own knee as possible as my lateral pain is not usually severe or constant.

It took me quite awhile to make the decision to have the surgery, but after almost 2 years of suffering through 2 rounds of Orthovist, arthroscopy for 2 torn menisci (with microfracture which btw my new surgeon would never do-horribly painful and didn't work!!), multiple weeks of PT and cortisone shots...and still can't walk to the end of the street without pain, I decided to go for it is definitely impacting my quality of life.

Thanks to all who have shared their knowledge so freely. I have been busily reading through as many discussions as I can. But to be honest, with surgery only 3 weeks away, I'm feeling somewhat overwhelmed. Making my detailed to-do lists, but not checking off a whole lot yet! I know I will have other questions...thanks in advance for your help.

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  • Posted

    Hi Linda

    I had PKR 14 months ago , right side latera

    Side. Recovery was good . Followed all advice on here as far as icing often , taking pain Med's , doing exercises . My Doc also said I only needed partial . Lately though I've been swelling on and off . Trying to figure it . Maybe over activity ,

    Overall very happy .

    You'll do great ! Lots of great help / support on this forum . It'll be over before you know it !

    Debbie

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    • Posted

      Hi Debbie, Thanks for your encouragement! This forum has a wealth of information which has been greatly helpful for planning. Good luck with your continued recovery and hope your swelling disappears! Linda
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  • Posted

    I had bilateral medial pkr Mako nov 16, 2017. Was great! 4hrs after surgery was walking hall. I would have had a perfect recovery but a few blood vessels ruptured-each leg,and i swelled up. Low blood pressure but didnt need transfusion. I was off walker(no cane) and drove at week 4. Had surgery Wednesday and the following Thursday cooked a full onThanksgiving dinner. If i had a desk job, i would have been able to rtn to wk at 2minths but i have a job that im on my feet 12+hrs so it took 4months at part time 6-8hr days.

    Equipment i needed:

    A long handled scrubber, a potty chair that fits over the toilet, shower chair,walker (i had a cane and a grabber but didnt have to use it). Lots of extra pillows and a few premade towel rolls for the exercises. Cleaned house, changed sheets day before. Made home made gel packs with 1/3 70%alcohol and 2/3water w a few drops blue dye.

    I had a spinal with conscious sedation. The incision is off to side and smaller.

    If your surgeon gets in there and sees more deterioration than mri showed, he'll end up doing a tkr.

    You'll do great! Adequate pain control, elevation, ice works for all of us!

    Hope this helps

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    • Posted

      AuntEG...thank you! I have been so nervous about everything and hearing how well you have done is really helping me to believe I can have a positive outcome as well. Thank you for all your suggestions too.

      I'm not sure yet if I'm having spinal with sedation or general. It's on my question list for the surgeon (which keeps growing) I have never had  a spinal but I do know I don't want to be aware of anything they are doing!

      I had my "mapping" CT-scan this morning for the Mako and the tech told me he takes images from the hip to the foot so if my lateral side shows damage, my surgeon will see it. Up till now, he seems quite sure I only need the partial but I'm going to make sure I talk to him about what the scan showed.

      Pain control is another concerning topic for me as I can't have anything with codeine. Hoping Nucynta (which worked ok for my arthroscopy but I only needed it for 2 days) will work along with Tramadol in between.

      Thanks again for your help!

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    • Posted

      Hi Aunt EG

      Thank you for posting your very positive outcome, it does help to hear of success stories, especially when having a bad day. So many people have had unfortunate experiences and when we are in pain or not achieving the goals we think we should achieve recovery seems a long way off.

      I think I too have had a perfect recovery so far, at almost three weeks post PKR I can straighten my knee and bend it  to 95 degrees, I am sleeping better only awakening once or twice in the night. Although my mobility is getting better daily I absolutely still need the pain killers to be able to exercise. I am not a tablet or pill taker so this actually worries me. I don't want to become addicted (Tramadol and paracetamol 4 X daily) I tried to lessen the dose and found I was too stiff and it was too painful to exercise.

      i would like to hear when you managed to do without.

      your pre op advice was marvellous .

      Tricia

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  • Posted

    Hi, pretty much agree with AuntEG and same recovery. I had the Mako PKR, general anesthesia as I'm chicken about seeing, hearing and needles in my spine. Stayed overnight and glad of it. One and half year later my other knee went bad had a tkr. This one has been much better, no swelling, good ROM whereas the PKR still has some swelling and feels unstable at times. Maybe it's my fault for not continuing to work out harder. But if I knew then what I do now, I may have pushed for the total. Recovery a little harder and longer. Since then-a year and half after tkr - that hip went bad and had replacement in Feb. Hip is easy peasy recovery with its own challenges. My knees did suffer as a result of the bad hip. But now life goes on and the left PKR is still fussy. I might have a discussion about the future of your knee and deterioration or not. And I might have a discussion with a PT about the results she has seen with her experience. 

    But bottom line: the Mako PKR went very well, pretty much same PT, less pain in the short term.

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    • Posted

      Hi Melinda...thanks so much for replying. I'm very happy to hear you also had good results with your PKR and that your surgery was with Mako. Wow, you have really been through a lot with having both knees plus your hip done. Good advice about talking to the surgeon about the future of my knee as well as having a chat with the PT. Thanks again and wishing you the best with your continued recovery!

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    • Posted

      Hi Melinda

      Was wondering when your knee is swelling ? Is it over activity or just all the time ? I am 14 months PO PKR and finding same thing . I do walk and work out as I can but seems it will swell if I do to much . Not sure can't pin point it just yet . Oh and I think if I sit too long it gets stiff and could swell .(wasn't doing that and is now )

      Anyway I am now trying to do specific exercise to better strengthen the knee. Frustrating for sure to feel like a step back at times . In my case only one side of the knee was bad so the partial made sense. Who knows. I did really well with recovery though , I didn't have 3 months to be off work . I only took 4 off with the partial .

      Anyway your first person I saw mention swelling at a later stage so just wanted to touch base with you !

      Debbie

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    • Posted

      Hi, Debbie, sounds the same as mine. At my annual checkup, the xray showed nothing unusual. I'm putting some on myself for not  working harder. But next doc visit, I think we'll have a serious discussion for the future...barring no more hips to mess up recoveries and progress. My neighbor down the street walks his, dog, runs and plays tennis on two tkrs. Don't know how old they are but he does still go to gym. Meow, meow, he'll probably wear them out. wink

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  • Posted

    Hi Linda

    I had a Biomet Signature PKR just over 2 weeks ago (20th June 2017) so it's still very fresh. The same as you medial side after failed  Anthroscopy. I am 62, not skinny 148lbs but prior to anthroscopy very active and quite fit. Swam 3 times a week and walked 5 to 7 miles three times a week.

    I wasn't quite as lucky as some in that I found the pain in the first three days almost unbearable. Much much worse than the anthroscopy for me. But everyone is different.  Even so I was up on the second day attempting exercise with the physiotherapist. Good pain killers are key to a good recovery. It took a while for me to get it right as lots didn't agree with me including morphine and codeine.

    I have been very conscientious  and done 3 lots of exercise every day with lots of icing and elevation. It isn't easy and for me is extremely painful but if you are dedicated and want your life back, as I do, then it can be a success. I have had my staples out at ten days and it is a neat 3 inch scar - the benefit of the PKR.

    todays physio session was a success in that I can get a straight leg and the bend to 95 degrees. I believe that is quite good for this early time but doable if you put the effort in and lots of icing and elevation. I had lots of swelling and bruising until 4 days ago, think elephant man to start with and now just a small swelling at the knee with a little bruising. I am still using 2 sticks but can potter around the kitchen unaided.

    every other need is the same as the anthroscopy.

    i am hoping that I will be better than normal within 2 months as I have a big holiday planned😊.

    its early days but if things continue as they are I will opt for the same on my left knee which is going the same way. Hope this says it all.

    good luck and I will be happy to answer any questions you may have.

    Tricia

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    • Posted

      Hi Tricia...thank you so much for your detailed and thoughtful reply. I am so happy to hear you are coming along in your recovery but am very sorry you had so much pain early on. I have always been pretty strong when it comes to pain, but to be honest reports of the extreme level of pain experienced by so many here early on really scare me. My arthroscopy was painful (I also had microfracture with it) but I was able to be off my heavy duty pain med after 2 days. However, I will be a "good soldier" and do everything recommended I can as like you, I REALLY want my life back!  

      So since I posted, I may actually now be having a TKR due to pain on the lateral side (although milder) in addition to the medial. So even more research has to be done as I was feeling pretty prepared for the partial.

      Good luck with your continued recovery and hope you have a wonderful holiday! I have a big family wedding in N.Y.(I'm in Florida) 6 weeks post-op and would love to go, but I think I need to be realistic.

      Please keep us posted with your progress! 

      Linda

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    • Posted

      Hi Linda ..... Thank you for your reply. I am sorry to hear that it might be a TKR now, however, there are two schools of thought anyway. Many surgeons feel that a PKR is only a stepping stone to ultimately a total replacement - just putting off the inevitable especially if arthritis is involved. I know this probably won't make it any easier for you when your mindset  is on a PKR. I'm in the UK and the NHS are very reluctant to spend their money on something that may have to be redone. So I paid for a partial. I had actually done all my research on stem cell therapy and was hopting for that,  but as I had bone on bone it wasn't possible. It was then too big a leap for me to go for a TKR. 

      You our can research forever and in the end I have found everyone is different. I knew of three people personally with not very good outcomes with TKR either from a less than perfect surgery or not enough recovery exercises. But reading this forum showed me all manner of recoveries. You sound a pretty determined and positive lady so I'm sure you will make it to your wedding although you might still need a cane! Just concentrate on the bend for the plane.

      Its the goal that keeps me going funnily I too am going to New York in September (it will be eleven weeks after my surgery) a long haul flight for me then on a cruise through New England up to Canada. So I need to be VERY fit!

      I will let you know how I progress as you must too.

      Tricia

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    • Posted

      Tricia, thank you soooooo much again for your thought provoking reply. You are so right when you say there are two schools of thought and the more I research, the more I realize there is no definitive right and wrong. Everyone's situation is so different. I also know people who feel their partials were unsucessful, but who knows how well they adhered to protocol? Outlook is so important too (for both TKR and PKR) as Chico and so many here have pointed out repeatedly.

      I'm really trying to go with my gut on this. Being completely truthful, my lateral pain is much milder than the medial. Arthritis does show on my CT scan and MRI's but is it enough to warrant a TKR? Noone knows. My surgeon said it's completely my decision (which it is). So my gut is telling me if the lateral progresses some number of years down the line, do I want to subject myself to another major surgery? The answer is NO. Also, I've read so often that pain can be severe with both operations, although my logical mind (if I have one left!) tells me, PKR patients "should" recover faster...but I see that's not always the case!

      I am VERY determined to succeed. I have gone through so much in my weight loss journey having kept off about 90 pounds despite medical challenges. I work out regularly with a trainer but am depressed I can't do the activities I used to do which are so essential for keeping the weight off. Plus, not being able to walk my 2-3 miles/day (I can't even walk to the end of the street without pain) is reducing my endurance as well as increasing my anxiety which is a huge issue for me. Being able to walk distances has actually helped me to get off of anti-anxiety meds...and I don't want to go back there. Also, my husband and I really enjoy our walking time together (whether at home or on vacation (we had to cancel 2 vacations this summer) and I miss it.

      Sorry for rambling! Your vacation sounds so exciting! For sure, you have a huge goal to work toward. You sound extremely motivated as well and I look forward to hearing about your continued progress. I will keep you poste dand thanks again! Linda

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    • Posted

      Hi Linda

      This has nothing to do with either of our current situation with our knees!

      I just had to say how remarkable your weight loss is. I had to laugh, we could be twins. I lost 60lbs in 2008 (I didn't want to be the fastest person at my sons wedding😏wink. I was very focused and it was hard work that's why I know I can do this. But 90lbs - how marvellous is that🍾. 

      I completely understand your your need to be able to walk distances. Prior to my anthroscopy in 2015 my husband and I loved to walk and often did 7 to 8 miles. I think that's how I kept the weight off along with swimming. Unfortunately since then the walking has diminished down to just one mile and that takes me 40 minutes and hurts a lot. Even swimming had to stop as I couldn't kick my leg out in breaststroke.

      So we have the same goal- get new knees, be able to walk distances and keep the hard fought weight off. Having read of your successes I am sure you will achieve your goals. As will I provided my left knee doesn't get any worse before my right knee gets better 😊 If that makes sense.

      Thats today's essay Linda (lol) I just wanted to recognise your achievements so far. You have to walk in the shoes to know how hard it is. Just like everyone's knee stories on this forum.

      Tricia

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    • Posted

      Dont be scared regarding pain, as that does not help...some people have pain management problems for a variety of reasoned but expect your pain to be well managed....medications when applied sucessfully are excellent! Consult your hospital immediately if your pain is not being sucessfully managed. There is some but it should not be unbearable, if it is then it can be addressed.
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    • Posted

      Hi Tricia...wow...congratulations on your amazing weight loss! And yes, we could definitely be twins! (I am 61!) It really helps me to know there is someone who really understands just how hard it was to reach this point in their weight loss journey only to encounter such a huge challenge as needing knee replacements...and in your situation, not one but TWO! I also lost about 60 pounds around the same time as you and s-l-o-w-l-y eeked my way to 90 with lots of struggling over the years. One thing I know is I will absolutely not let this surgery get in my way and will do everything possible to regain my physical fitness including keeping the scale from creeping up.

      I know you are stll early on, but do keep me posted with how you do with maintaining your weight. (although I expect getting on the scale now can't be easy...good reason to stay off of it LOL!) Although I understand many have appetite issues from the pain meds and aren't overeating anyway. I certainly expect fluctuations for the first few months, but hopefully nothing I can't correct down the road. Thank you again for your kind thoughts and wonderful support. Being only 2 weeks away, I have to say my nerves are getting to me a bit... 

      Linda

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    • Posted

      Thanks Jenny! I really do have a very supportive team so I'm not overly worried. My doctor, his physician's assistant and nurse are extremely responsive and I feel confident they will address any pain issues i'm having promptly. 

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    • Posted

      Thanks Jenny 

      I have read your blog. It is both entertaining and informative. Well done!

      its amazing how kind and comforting complete strangers have been on this site. Hope you are now well on the way to a full recovery.

      Tricia

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    • Posted

      Thank you. Its good. Walked for a hour at weekend, bit achy afterwards but whole leg feels bionic. Cannot get used to NOT taking a stick out with me...good problem to have!
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    • Posted

      Go Jenny!  I did take some time today to read sections of your blog...much more to go! Your progress is very encouraging to me and I really appreciate the time and effort it took to create such a comprehensive accounting of your TKR experience. A huge thank you from me!
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