TKR and realistic expectations

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hello all - a google search led me here. I am scheduled for a total knee (right) on Monday. A bit of background. i'm 60 y/o male, of average weight. long history of right knee issues. two scopes for torn medial meniscus -1st in '94, 2nd maybe 10 years ago or so. last 3 years knee starting 'locking'.  i'd take a step or two and it'd 'unlock'.  i had supartz on 3 occasions over the past 3 years.  first two series (a year apart) worked.  last series this past spring did not work. "locking" occurs more frequently and it doesn't "unlock" as readily.  that's when it's most painful.  not too much pain at rest, but walking, going down stairs is difficult.  i limp when walking.  saw two surgeons, both recommended knee replacement (one partial, the other total). i'm scheduled for the total.  here's the problem. i have a trip to spain and morocco scheduled for 8 weeks later.  a bit more background. this will be my 15 or 16th surgery - 5 back, 4 shoulder (2 & 2), 3 knee (one left). cervical fusion, broken finger and i've bounced back from all. for example, I had a microdisectomy in 2017 and was only missed 3 weeks of playing hockey.  My physiatrist and PT both said i'm the most resilient patient they've ever seen. i'm not bragging just providing context, but this has me shaken. i've been depressed and i think it is mostly because i haven't been able to convince myself that this is what i need to do. plus the trip looms over it all. with previous surgeries it was a day of two of "whoa is me" followed by "F this - let's get this going cause i got to get back to my life!"  I still play hockey 3x week - granted i'm not any good anymore, but i still get out there!   my surgeon says i will be fine for spain and that he finds the "magic" number is typically 6 weeks, that his patients turn the corner at that time.  anyway - i guess my question is - do you think it is possible for me to go on a two week holiday with a lot of walking daily, 8 weeks post TKR??  thank you all in advance for your help and sharing your experiences!!  

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  • Posted

    every one is different  but from my own you will have to take it easy with all that walking comming up==i went to exercises for my  2nd  knee and the first one then gave a lot of trouble with the load on it==my knees are very cold  all the time even after 2 and 4  yrs on
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  • Posted

    You need to read CHICO MARX post (he was also a hockey player).  I would say that most likely you will not be able to go on the trip....it takes most people 6 months to a year to completely heal.  Just traveling in the car for two hours about 6 weeks after my knee replacement, cause it to blow up like a ballon.   Having said that there are those that heal faster than normal but knee replacement is not like any of the other surgeries you have had...again read Chico Marx's post since he had tons of surgeries also....

    Also did they tell you shouldn't play hockey (or run) after the replacement?   

    For me, I knew I had to do the surgery when I stop planning trips because I knew I couldn't walk.  If you could manage the trips without the knee replacement, I would those trips and then have the replacement afterwards. 

     

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  • Posted

    If you want know about recovery after TKR read the posts on here, especially those by CHICO MARX. Recovery from TKR is not like recovery from any other surgery. I disagree with your surgeon saying the magic number is 6 weeks, more like 6 months+. 
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  • Posted

    I would not do this surgery prior to trip! I am a year on Friday still recovering nicely and although everyone is different this surgery is rather brutal and it's a marathon of a recovery not a Sprint. 8 weeks later seems like a huge amount of time but it isnt. Wishing you all the best 😘

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  • Posted

    Played hockey for 45 years.  Metal hip, metal knee, four spine ops with two fusions.  Neuro said my back was like a "junkyard".  Hip was replaced in '09.  Two weeks after the op, asked the ortho when I could get back on my skates again.  "What?"  "Yeah, I play hockey."  He replied: "Listen, you could go back to playing hockey but I'll see you again in three years instead of 25.  You'll destroy the hip."  Same with the knee.  Your hockey days are absolutely over.  The knee cannot be pounded (running, jogging, singles tennis, etc.) or twisted/torqued by any competitive sport.  You are done...

    Expectations?

    https://patient.info/forums/discuss/tkr-pre-op-expectations-622045

    Banish all expectations from your mind...they will be your worst enemy.  The knee will be healed when it's healed.  Unlike a hip or shoulder, a knee cannot be pushed in rehab.  This is a very slow process that takes a full year...back to work in 4-6 months depending on a lot of factors. But you may be one of the very few lucky ones.

    Click on my name and then "See All Discussions".  Got 30 out there on all sorts of topics that might be helpful.

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  • Posted

    thank you all for the quick replies and comments - Chico I will read that link.  btw can i just say i LOVE the marx bros - tho Harpo was always my favorite! smile 
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  • Posted

    I am a 58 year old, female and 9 weeks out from a LTKR. It was my 12th surgery. My recovery has gone very well. It exceeded both my and my doctors expectations. I got rid of the walker at 1 week. At two weeks I was only using the cane outdoors. It has gone so well in fact that I am scheduled for the right knee in 3 weeks. 

    With all that being said - I would NOT be able to take that kind of trip now. The walking would be way too much for me. I would not undertake it. I would fear that I could set my progress way back or even damage my new knee by pushing it too hard. My doctor cautioned me about aggressive PT because he has seen it, "Do more than just set people back." I would consider the walking you'd be doing - aggressive PT. If I were you - I would wait until after the trip to do the surgery or reschedule the trip. Sorry - I know it's not the answer you would like to hear. 

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  • Posted

    I am almost a year out. Had partial followed by total three years later. Like you, I have been through the spectrum with surgeries. Back and neck fused and multiple surgeries on both. Elbows, wrists, and way to many knee surgeries. I bounced right back every time. I ride horses and was told I would be riding again in 4 weeks. Bull s---!

    The knee replacement took so much out of me. Scar tissue formed faster than anticipated and hindered a lot of therapy. First, I couldnt straighten it enough. Then I couldnt bend it enough. The swelling was out of this world and no ampunt of icing it waa helping to reduce it. 6 weeks went by and I went to the barn with a major limp. Just to get a reminder of what I was working for.

    At 9 weeks, I got p****d off and climbed up in the saddle. I had to take my foot out of the stirrup and let my leg just hang down. I could noy handle the pain and I had walked around wit broken back for 11 months.

    Even that pain did not stop me, but the knee was worse. At 11 weeks, I had enough and forced the knee to bend, breaking up thr scar tissue and finally loosing the tight squeezing feeling that still remained. So, it got a tiny bit better. And I climbed in a saddle and rode. But it was still painful. Still is.

    They say this is the hardest orthopedic surgery to go thru and recover from. I believe it now. I only said something to you because I thought I would bpunce back like I always did, and was so wrong! I pray that is not the case for you, but with such a big trip planned, I would think twice about the surgery right now.

    I got a new brace for my other knee today. One with hinges on the sides and I did everything in it except ride a horse. I was amazed at how much it helped and how much my knee DOES NOT HURT tonight. Maybe that could help you until you return from your trip. They want to replace that knee too, but with the brace, I am making the decision to put it off. Indefinitely.

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  • Posted

    No sorry I don’t think it is given the walking element. You may well turn ‘a’ corner around 6 weeks in but it’s the first of many corners! See @chicomarx diagram of what to expect recovery to be like.  I think I’ve had a very good experience of my recent surgery ( 10 weeks ago) and I’m doing really well but still very much building up activity and I’m 100% sure a lot of walking would kick off lots of swelling and pain.  Morocco not being in EU so no EHIC and ? easy access to good medical care if you are maybe not in major towns is something to think about. Have you checked all this with your travel insurers as they may or may not cover tou for knee  surgery related issues on that timescale  or they may put up your premium and if I put don’t tell them in advance it will invalidate your policy! Sorry if you’ve realised that but it’s the kind of thing people maybe overlook.  

    So a trip might well be ok and cheer you up as not a long flight ( make sure you are in a seat where the operated leg is on aisle side) and think about how you will manage icing etc ( take some gel packs and make sure access to a freezer) . BUT the other big issue is - recovery is not that predictable - we are all different - you may get a fairly good ride like I have - or not. So be prepared to maybe have to postpone. 

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  • Posted

    thank you all again. I really appreciate everyone taking the time to post and share their experiences.  Special shout out to Chico - i can see why so many of you suggested i read your posts.   I'm meeting with my PT and physiatrist today and must make a decision on whether to go with it as scheduled or ppd till after the trip.  unfortunately i can't change the trip as we're visiting my daughter who is studying in Spain till December.

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    • Posted

      Gotta work with your doc but that trip is a crapshoot...  I would put off the op until after the trip.  Some docs don't want their patients on a plane soon after the op; some people do it and have lots of pain and swelling because of the cramped seating.  Icing is possible; elevating is not.  Plus walking around during the visit could be very painful depending on the timing.  Go have fun...get a cortisone shot if necessary to get you through it.

      I mentioned that expectations are useless because any statistics apply to the population of patients and never to any one individual...

      https://patient.info/forums/discuss/the-tkr-recovery-bell-curve--563756

      You never know where you'll fall inside the curve before or during recovery.  It only happens when you are fully recovered and can look back on your experience thereby pinpointing where you fell within the spectrum.  I'm approaching 5,000 posts read and I can count the number of people who beat this in three months on less than one hand.  Yeah...there might be more out there; this Forum is just a slice of the whole.  But here, we have seen the full range...from very lucky to very unlucky.  No one can tell in advance.

      However, there is some hope for you and I...  Can't play hockey anymore but I'm DYING to get back on my skates...just a leisurely glide.  As before, the knee CANNOT be allowed to twist or torque so I want to make sure that I am well protected against that.  Seems that Donjoy (the #1 brace company on the planet) has a model that does just that...the knee is locked so it can't twist.  It's called the Defiance...single hinge model.  I'm saving my pennies.  However...before you can even think of doing this, you need all your leg strength and balance back.  Then you might give it a thought.  For me...I'm definitely NOT telling my doc.

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    • Posted

      Chico -you (and everyone) are bang on. I just got back from speaking with my long time PT and physiatrist - both who know me and my body well. i've decided to put off the surgery. the devil you know... i just left a message for my surgeon. On another note, Chico - us hockey players are nuts to be sure - i completely identify, respect and understand your comments above!  

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  • Posted

    Hi Eddie it took me at least 8weeks to be comfortable with my knee. Walking didn't become easy until the 3month stage. However you're fit so go on your holiday But listen to your knee if it aches stop and rest. If you can manage to get some ice while away use it. Your knee may swell after walking so enjoy but listen to your knee

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