When should I get TKR?

Posted , 6 users are following.

People keep asking me when I am going to get new knees? I did homework and found out TKR is tricky. Worse recovery than hip or heart surgery. My doctor says I am too young, that I will have to have it done again in ten years. He also say when you can't sleep or it is painful all the time that is when to get it done. I woke up 8 years ago not having full ROM in both knees and my quads hurt. I assume I pulled something. My job requires heavy lifting, pushing and standing. Never had a problem with my knees. Anyhow, first step was cortisone shots. That moved pain to medial part of the knee. I never noticed any swelling, ever. Although lab work say I do. I have tried many thing and no change. Abstaining weeks away from certain foods and eating only certain foods, acupuncture, Rhus Tox, ice, heat, rest, yoga, DMSO, WD40, dandelions, onions, fish oil, Vitman D3, TENS unit... I even got fire ants to sting me 60 plus times on one knee. NO CHANGE, ZERO! I hobble around and make do. Wear Breg Freestyle braces and sit whenever possible. I sort of adapted. At rest I have no pain. Lifting and pushing are way less painful than running or standing. Honestly I am not totally convinced it is OA causing the problem. Reason being, I was rear ended about 4 years ago and as a preventive measure I got neck x rays. Doctor said I had spurs, OA that is was a mess. My neck feels fine and always has. They say the same about my knees. I did get checked for RA since my father was diagnose with it in the 70s. Test were not absolute so i was tested for Sclera Derma and Marfans. Those were not thrown out but was not likely I had those. time line of ailment are as follows. Woke up 10 years ago with lower back issues. Hurts when I bend over in one area. Then followed by Plantar faciatis and sciatica (1 time for about a month). Knees followed by feeling of being in a cloud, fog 5 years later. This led to getting my crystals checked (didn't know people had such), MRI of head, chest and torso. I do have a leaky heart valve, slightly enlarged lower ascending aorta and a meandering pancreatic duct. No real concern there other than keeping an eye on it. I mention these thing just in case there might be a connection to my knee pain. My plan is to put surgery off until i can walk at all. Am I a fool for not just biting the bullet and have surgery. Any input would be grateful. Thanks.

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  • Posted

    Only you can decide when to go ahead with it. I suffered for 20 years with arthritic knees, but managed them until it got to the point I was able to do less of the things I enjoyed doing and one knee became very unstable. At that point 2 years ago I had a discussion with a surgeon, but still didn't feel ready. Over the past year I struggled and then decided enough was enough and to have it done whilst I was still reasonably fit, as I reasoned I would make a better recovery.

    When I attended the pre-op class at the hospital there was a chap who could barely walk on crutches and he admitted he'd left it too long, said he wished he'd had it done when he was at my stage,

    It is a tough, painful operation and like any other it has risks, but my quality of life was diminishing. The first 3 days had me thinking 'never again', but that wore off by the end of the first week. The first 6 weeks were pretty hard going at times, but since then there's been many little victories and at 10 weeks it's all looking good. There was talk of doing the other knee in May, but it's behaving at present so I can't see the point if rushing into it plus I'd rather this one was stronger before I embark on the second.

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  • Posted

    Been on here over three years. We have heard of people with very, very bad knees who had the TKR done in their 40's. Docs really don't want to do then in people under 50 because, with care, they'll last 20-25 years (not 10). That means a revision in their 70's but at least those are pain free years. Maybe your doc said 10 because of your job. And speaking of that, with a TKR you'll need a different one or wear out the knee in a few years.

    When I had my hip done, I asked the doc when I could get back on my skates and play hockey again (45 years in the sport). He told me any time but the hip would last 3 years instead of 25. Gave it up the next day. I think the same rule applies to you. There are a lot of no-no's with a new knee. No running, jogging, competitive sports and more. The knee cannot take any pounding or twisting. Beat it up carrying all that weight and you'll be in trouble.

    Your case is complex and we're Not-Docs. However:

    • Look into SynVisc shots. They worked for me for years and years. One shot lasts 6 months; the three shot protocol can provide relief for up to a year.
    • Climate... I had my hip done in NJ...lived there most of my life after 0.1-23 in NYC. The winter with the hip was horrid; the knees had the SynVisc protection. Job move in 2010 to the warmth of DFW in Texas and I didn't need the SynVisc for the next six years. Zero pain until a little twist made my left knee untenable any longer. Right one is bone on bone but no pain, no shots. Putting off #2 as long as possible.
    • There's a new FDA-approved procedure out called Coolief. Supposed to be excellent for knees and lower back and lasts up to 2 years. I have a doc appointment for a consult in 2 weeks. With hip, knee and two spine fusions all metal, I still have chronic lower back pain. Check it out.
    • You may have a brace not suited to your problem. I called DonJoy (the big guys) and actually got through to a specialist. Told him I wanted a brace that would absolutely not let my knee twist so I could do a light skate again (no hockey). Defiance Single Hinge was his response...and they've got tons of brace types and variations within those types. A quick call might point you to a more appropriate brace, if there is one.
    • Voltaren Gel (RX in the US, generic diclofenac elsewhere) is the best topical pain reliever on the market. Talk to your doc; check for interactions.
    • CBD oil is becoming HUGE and there are FULL SPECTRUM blends intended for joint pain. Do some research. CBD oil with no or minute quantities of THC are legal in all states and by mail.
    • In cannabis legal states (CA, CO, etc.), there are always pure cannabis products available. My son lives in Denver and has his special card to buy what he needs for his horrible Osgood-Schlatter knees. Helps him a lot. Latest study says that up to 50% of seniors in California with severe knee arthritis vape full strength cannabis oil (THC and CBD components) and have thrown away all their opioids. This is NOT just CBD oil but made from the whole plant...big difference. It's the 60's again at Hotel California where "you can check out any time you want, but you can never leave." Again, you have to be in a legal state and get the OK from a real doc before you can get the "magic card".

    Your doc is right about the pain of a TKR. Everyone is different and we have heard from some pretty lucky people who beat this in less than two months. For the rest of us, the whole recovery usually takes a year. Major pain and ROM work the first three months, rebuilding all the atrophied muscles over the following six to nine, pretty good by 12, some lingering stiffness to 18 months. Back to work is usually in the 4-6 month range depending on age, job, strength, general health, etc. Heavily demanding jobs are usually not candidates for early (3 month) returns and even people with desk jobs regret that decision. Lots of pain, swelling and sleeplessness. There is no true week to week timetable as the recovery is not linear. Advances, setbacks and plateaus are very common. No expectations, no demands...the knee controls the recovery. Push it and pay a heavy price. Time, work and patience are your tools. The knee was the toughest recovery of all my implant ops.

    Hope some of this helps...

    Oh... You may want to consider investing in a pure hydrotherapy tub. This is NOT a "party hot tub" but one specifically designed with 62 jets for two people only. I do it almost every night. It is soooooo great!!! Highly recommended...

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  • Posted

    Barry 33726 as lynda said perfectly, only you can make this decision. I am also young, first tkr at 46 second tkr on other knee 6 weeks ago at age 47. Yes the surgery is a rough recovery . I wondered why I did this surgery one week after each one but then it just keeps getting better week at a time. It is tough but can be so rewarding . You have to stay positive and think all the good things that can come from a tkr and this will get you through all of it. I am no Doctor but I think knee replacements can last way way longer than 10 years. My physical therapist tells me that they should last 20 to 30 years!

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    • Posted

      i too was told by my consultant that my new knee could last 20 years depending on how i treat it ie not gaining too much weight and don't go too hard on using it ie running or excessive walking.

      AGE : I was told that i was fairly young at almost 58 to have TKR but at my physio i met people in their early 40's as well as people in their 80s!

      2 years down the very long and painful road and mine aches sometimes and stiffens when i sit too long in one position.

      Fingers crossed mine lasts as i'm certainly not looking forward to having the same knee done twice as i'm still plucking up the courage to have my second knee done

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  • Posted

    Wow, great points you made. I must ad I did the Synvisc generic chicken comb lubricating injections, twice. No Change at all. Tylenol and ibuprofen do nothing at all for me. Swelling or pain. I am under weight if anything. I still can't help to wonder if lower back has something to do with knee problems. The more people I talk to had lower back issues prior to knee problems.

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    • Posted

      Forgot to ad , thanks so much for your reply and not sure how I missed putting this in the post but I had stem cell shots and booster shot every 3 months over the last year with no results.

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  • Posted

    Geeze, where's my head. I also spent as much as 15minutes to 8 hours in hot tub. No results to reduce pain or add functionality either. Hot or cold adds no factors to my pain either. I guess on the positive side it hasn't been getting worse. Anyhow I plan to seek another doctor for a second opinion in next few months to get some opinions. Thanks to all.

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