TKR Question

Posted , 12 users are following.

I am age 84 and am suffering a lot of pain from severe osteoarthritis in both knees (walking bone on bone) I have had two lots of cortisone injections which worked like magic. However, I saw a consultant who has recommended TKR on each knee. He also wouldn't OK another lot of injections before my op' as there is a risk of infection. I can see the point of that but he then told me that his waiting time was eight months and it was much the same for all of his colleagues. I am now scarcely able to walk, get very little sleep and am in pain for most of the time. I have tried Co-codamol but it makes me sick, as does Tramadol and I can't take NSAIDs owing to stomach problems so I take Paracetamol, which does practically nothing. The thought of being like this for probably eight months is unbearable and all I can hope for is that someone will cancel and I can get treated earlier. It makes me wonder if I will still be around when they send for me.

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  • Posted

    This is terrible. What area do you live in. I do know the Orthopaedic department is one of the busiest for waiting lists. One way our hospital gets the lists down is using the private hospital facilities. i would keep going back to your doctor. It's not fair you are suffering like this They told me once my quality of life has been affected then they would operate and gave me a 2 month wait. I really hope they can do your operation soon. x

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  • Posted

    You poor thing!!! I'm surprised he refused to give more cortisone injections if the wait is 8 months. Perhaps you should see another Dr and explain the situation and how bad your life is due to the pain? You might find one that is willing to give you cortisone injections. Keeping everything crossed for you! 🤞🤞🤞🤞

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  • Posted

    8 Months seems quite short to me. Mine was over a year (waiting list) and I know of people with longer. However I didn't have to wait that long and I agree they should prioritise you if you are struggling. Tell them you are available at any time at short notice and you are more likely to get a cancellation. I would add that although the initial recovery is tough for the first week or two there is a good chance you will be relatively pain free soon after and almost completely free of pain after a couple of months though full mobility might take a bit longer..

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  • Posted

    Hi Shaxta

    I agree with what Tricia advises.Go back to your GP, perhaps with a family member or good friend and really explain how difficult life is for you and how your quality of life is affected with loss of sleep and constant severe pain which is not relieved by medication .If you have low mood ,mention that as well.write it down before you go so that you can leave it for him to read when he writes on your behalf to the consultant.You may be considered for the NHS operation at one of the private hosptitals where your consultant works as Tricia mentioned as the lists are usually shorter.

    Keep your chin up and wishing you the best of luck Flic x

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  • Posted

    get your consultants secretary's number and lay it on thick. you should not be waiting that length of time

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  • Posted

    Have you trued Hylaronic Acid? It has been great for my non replacement knee while I am still waiting for my TKR to have less pain and stiffness.

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    • Posted

      Worked for me for many years with my bone-on-bone condition. The latest numbers show that it's a 50-50 proposition whether it will work on any specific individual. Trial and error. For my #2, I'm going COOLIEF before I do another TKR.

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    • Posted

      the HA has worked well for me and I am bone on bone. I talked to the doc that does the RFA for my back and he is not a big fan of COOLIEF. I will try that before another TKR as this long recovery is not to my liking.

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  • Posted

    Where in the country are you? Under the Choose and Book scheme 'In most cases, you have the legal right to choose the hospital or service you'd like to go to. This will include many private hospitals, as long as they provide services to the NHS.' Ask your GP which hospitals are available to you, although if there are any risk factors a private hospital may not be suitable.

    We're lucky that we have the Elective Orthopaedic Centre in Epsom which our local hospital use. It's a NHS facility, but because it deals only with elective surgery the waiting list is not very long. I waited 2 months for my surgery and there was a woman in my ward who had come from Manchester to have a hip replacement. The disadvantage of being so far away from home will nit suit everyone though.

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    • Posted

      it does vary an awful lot. I'm in the Southampton area and could've had mine done within weeks of first meeting my consultant if I hadn't had a holiday booked which delayed it. However, a friend of mine who works as a medical provider in the NHS has been waiting months just to finally get diagnosed correctly and was then told about 6months before she gets her hip replaced!!!!! It seems the same system sadly is not used throughout the country.

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  • Posted

    I don't know your overall health condition but a bilateral TKR at your age could be very, very challenging. I understand the concern about more cortisone and it's true that there's a limit to that modality. Before you consider the TKRs, there are two more "rungs" on the Ladder of Care that you might want to consider...

    1. Synvisc (hydraulic acid) - This is like "oiling" your knees. There are one- and three-shot regimens that your ortho could use. I had these many years ago and the three-shot routine worked on me for 11 months each time. (Then I moved to a warmer climate and never had them again.) The downside is that this procedure has no effect on some people so it's trial and error. Also, your ortho may deem you beyond the effective range of Synvisc due to your age or the condition of your knees. I know that my doc told me that neither cortisone nor Synvisc would work for me 3 1/2 years ago when I had my TKR. I would explore this possibility with your orthopedic surgeon.
    2. COOLIEF (Cooled Radiofrequency Ablation) - This is a quick 15-minute procedure done under sedation that temporarily deadens the nerves to the knee that transmit the pain signal to your brain. It is FDA-approved in the US and can last up to 2 years (although 12-15 months is more likely). It is specifically meant to alleviate joint pain (knee, hip, shoulder, elbow) caused by osteoarthritis. Again, this may or may not work on you...trial and error. For people it gives relief to, they love it. When the pain returns, they just do it again. If it keeps working, a TKR can be put off indefinitely.

    Personally, I am bone on bone with osteoarthritis in my second knee...but I have zero pain. If and when it acts up, I'm running...err...driving to the local doc who does the COOLIEF procedure. I do NOT want another TKR (I'm almost 72) and will do anything to avoid it. My ortho already told me that I am beyond the reach of cortisone and Synvisc so I'll be doing COOLIEF.

    Check out their website to find a certified doc near you. Hope this works for you.

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    • Posted

      I'm curious as to why you'd avoid another TKR at any cost? I had my left knee done in January this year and am having the second done January 2020. Like you I'm bone on bone with not too much in the way of pain and I could cope with what pain I do have, but the problem with both my knees was them either giving way or proving very difficult to straighten after being bent. I'm so pleased with how much better my left knee is, even though there are some soft tissue issues still, that I can't wait for the other one to be done. I'm approaching 71 so not much younger than you.

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    • Posted

      I guess my hesitation is that I didn't have a great first month experience post-op as I was still drooling on my pajamas at that point. For me it came down to:

      1. I had already fully rehabbed a hip replacement in six weeks, four knee scopes over weekends, two shoulder impingements in 1/3 the estimated time and spine fusions almost immediately. I expected the same with the knee. I even told my bandmates that I'd do a four hour gig that weekend. But the knee, unknowingly, had other, more sinister plans in store for me. Frankly, it's the most painful op I've ever had as well as the one with the longest rehab time. I put my mind to it and got past it but it took a hell of a lot of time, work and patience. My really "expectations" got in the way.
      2. My second knee is pain free, stable and strong while I can see your reasons for doing your #2. I see no need to put a jinx on it or fix something that ain't broken. If the time does come where it gets painful, I will absolutely do the COOLIEF to put off the TKR...for me, it's a no-brainer where you have legitimate concerns about the stability of your OEM knee. If it works, I'd certainly consider additional procedures over time. Lots of good reviews out there for COOLIEF.

      Yes, there's always the consideration of age where you don't want to be too old to have problems with the pain and rehab. I guess I'll cross that bridge when I come to it given my years and success/failure of the COOLIEF. Just gonna let it roll on down the road right now.

      Just a note: It seems that you had a very good experience with your first TKR. After 3 1/2 years on the Forum and reading well over 20,000 posts, that is definitely NOT typical. My experience with 4-6 weeks of very intense pain, 12 weeks to get my ROM back and full year-long recovery seems to be the standard everyone should use to set their expectations. If it's less painful and you're back to normal in six weeks or six months, then good for you. You will get a lot of support here for your success story.

      But one thing that has emerged from all the posts on the knee #2 experience is that the majority of people on the Forum report that #2 was unlike #1, in both directions. So, if you had a good experience the first time, you cannot expect that the second time around. It's really a coin flip as no one can predict in advance how any one knee will respond to the op. We all hope for it and will cheer you on but just be ready in case your #2 is more like the typical recovery reported here. That said, I wish you all the good luck in the world as you jump off the next cliff. Don't forget your parachute!!!

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    • Posted

      Thanks Chico, I agree there's no sense in heading down the surgery option if you don't have too and it's worth exploring all other options first. You've had more than your fair share of surgery so I can understand your reluctance. I've also had quite a lot, but this is the first joint replacement. With the instability I have I don't really have a lot of choice other than a brace, which I don't fancy as I think it doesn't help to maintain any strength in the joint or surrounding tissues, muscles etc. I should say that my knees have been a problem for 25 years at which time I was given physiotherapy and told that if I did the exercises regularly I should be able to delay surgery for 10 years, so I haven't exactly rushed into it!

      You're right that it is a very painful operation and for the first few days I was thinking 'never again' (rather like childbirth, which you won't have experienced - lol). I wouldn't want anyone to think it's been an easy or straightforward recovery and there have been a few setbacks along the way and times that I wondered if I'd done the right thing. I have some ongoing issues still with the IT band and pain where it goes across the femoral condyle , that my surgeon says will take 18 months to settle, but it is so much more stable. It was probably 6 months after the first that I really felt the benefit and whilst I realise no two recoveries are the same I feel it's time to go ahead. I've had terrible backache since being more mobile (have scoliosis of the lumbar spine) and am hoping that having two straight legs will help. I know there are no guarantees, but I think we all know when the time is right for us. I hope your other knee remains pain free for many years and you never have to go through it again. Thank you for your good wishes - my parachute is packed and ready to go!

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    • Posted

      I think your instability is the key factor here. Yeah, you could try COOLIEF for the pain and braces for the stability but that's just a "kludge" that can be permanently fixed by TKR. On the other hand, there's the recovery which is long and probably painful. Sounds like "a rock and a hard place" scenario. Bummer...but sometimes we have to deal with the crap head-on. Just like me, I've got another half-pound of metal going into my spine on January 22nd. No choice.

      The bright side is that medical technology has advanced to where these guys and gals can actually fix us and provide us with a better quality of life. A hundred years ago, we'd be consigned to wheelchairs to waste away. I'm grateful to be living right now.

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    • Posted

      A rock and a hard place sounds about right, but we're still here and breathing as you say. Good luck with the spinal surgery and recovery. Let's hope we're both in a better place after January!

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