Waaaaay OT - Knees

[Don Jordan]

The fact is I have faith in your opinions. This is a most cool board. That said I have a question a little from the beaten path:

has anyone had a knee replaced? I'm looking for pros and cons. I have no cartilage left and it's bone on bone. I'm a perfect candidate but a little apprehensive.

any comments would be appreciated. Thanks.

[Captain Neon]

I guess the question you have to ask yourself is how long do you expect to be around and if the knee replacement will last you until then. Once you wear out a knee replacement, currently, you can't be another. Perhaps I'm wrong, and technology and procedures have improved. Other than that, it is a pretty routine procedure and you'll be laid-up for a few weeks with some PT to get going, but lots of people have them every day and they offer a marked improvement in lifestyle.

[PatS....]

I haven't, but my cousin has. He's 56, was hit on his motorcycle when he was 16 and badly mashed up both knees. He's had dozens of operations since and was in constant pain and could barely walk.

I think he had the first one done about 5 yrs ago and the second one done 1 1/2 yrs after.

He's a different person not being in pain and or on painkillers all the time. He says he sleep through the night, which he hasn't done since 16.

And he's wearing out his bicycle and has lost 60 pounds.

He has no regrets about the replacements at all.

[Don Coatney]

My wife Lisa is as bionac as possible having had two knee replacements. She can now out walk me as I am close to needing work on my knees. Go for it. Make sure they do the correct knee. On the last one Lisa used a sharpie and wrote YES with an arrow on her thigh pointing to her right knee. She wrote NO with an arrow pointing to her left knee. Then she wrote MAYBE on her inner thigh with an arrow pointing up:D

[RobertKB]

My dad is 89 and had knee replacements done in his early 80's. It was the first time in years I saw him walk without a limp. He says he wore them out jogging and playing squash for 50 years. He has always been an exercise freak since a teenager and still rides his bike when the weather permits. He just told me he has already ridden 500 kilometres this year.

My wife had bad arthritis in both knees and has had full replacements. She is now mobile whereas before she was not. She still has pain in the area but blames the fibromyalgia she has.

It is a painful operation but overall the results have been good in my family. Physiotherapy lasts about two or three months. They like you to leave the hospital with a 90 degree bend but it requires physiotherapy to get further. My wife has around 125 degrees in each knee. Knees can be done more than once also. Like all operations, there are dangers and during your pre-op preparations you should be told these.

Good luck!

[greg g]

Hve know several folks who have had knees and hips replaced. One guy said I should had it done earlier so he could kick himself in the butt for putting it off.

My doctor has told me I am probably looking at shoulder replacements in the near future.

Since they aren't load bearing, I can put it off for a while and work within the limits the situation imposes. Can;t work over my head, have lost a lot of upper arm strength and grip strength, but hey that what power tools are for.

When mobility and chronic pain are involved, my vote would be fix it. I know that they used to recommend putting it off but the materials have improved and lengthened their service life.

Besides you better get it dones as soon as possible, or the death panels will put you out to pasture if you wait much longer.........

[Joe Flanagan]

My Mom had it done. She had no cartiledge left either. They did both. It was a tough recovery for her but when she was healed, what a difference. No more pain. She told me that she'd go to take a step and brace herself for the pain and there wouldn't be any and she was just amazed. I'd do it. But that's easy for me to say, isn't it. Make sure they give you all sorts of good narcotics and you can lay in front of the TV all day.

Funny, I had the same experience with the Sharpie. They had to take some torn cartiledge out of one of my knees and they took the pen and wrote something like "THIS ONE" on my skin. They triple checked me too. Kept asking which knee it was. Like I was going to forget.

Good luck Don. Do it when you can't work on your car and you won't be missing anything.

[claybill]

the direct answer is YES, DO IT. but wait until you 'have to do it' they want you to be at least 60 years for regular circumstances. you can replace a knee only once. each knee lasts 12-15 years, do the math. there are 2 kinds ,

1-a straightforward one..and 2- one that swivels. i have one of each, .ask the doc to show you the unit (similar) and its performance characteristics.

it takes the doc 1 hour, 10 minutes to do it. you are out of the hospital in 3 days. you PT first day, oyu can stand on it in 3 days..in 6-8 weeks you can do most thngs.

do lots and lots of stretching forward AND backward,press hard, right away.

pick a doctor that does at least 2-3 a week.

vicadin will gt you thru it the first week.

they are making huge strides in knee surgery lately..sometimes non-invasive is enough....make sure you ahve good insurance, and be careful of post op infections..total cost is about 45,000 per knee!! some people do both at once..i prefer one at a time as i can drive right away.

been all thru it.....

call me if you want. bill. 815-77-0644.

[Don Jordan]

Thanks for the input - I've been putting it off for some time but the consensus is to it now. I called the insurance company and they cover 80%. Guess I'll do it now while I'm still working and still insured.

Again thank you I feel a little more confident about the procedure. I wonder how long it will be before I can push in the clutch.

[randroid]

Don,

About six months ago the six-year-old girl next door had a heart transplant

(Insert HUGE plug for the Ronald McDonald House here)

and as I am writing this I can hear her laughing and running and playing in their backyard with other kids while the grown-ups are making a barbecue dinner. What was your question?

-Randy

[MacGyver]

Hey Don, I agree with what Claybill said. But would like to add a few things.

I am a Registered Nurse on a surgical unit and work directly with patients from the moment they are out of surgery until they go home. We probably do 3-4 total knee arthroplasties a week and 90% are out in a few days. I've seen this be as quick as 2 days or as long as 2 weeks but there are many variables to that. My first thought would be: If you are overweight, PLEASE lose some weight first. You'll increase you chances of coming out of this on top exponentially. You said you're a perfect candidate so I imagine your weight isn't a problem. But if it is, shed some #s first.

2. Do your physical therapy! Once you are medically stable it will be your effort and performance in PT that gets you discharged. Outpatient PT is your new best friend. Only through effort will your knee work properly. If you don't move it and fight through some discomfort you'll never get your range of motion and stability back.

3. These things can be redone. You don't want that. It usually means there was an infection or some sort of failure. Every once in a while we do a revision beacuse the prosthesis just wore out. Revisions can be made and hardware replaced. Sometimes its better, sometimes its not as good as the first round. But it can be done.

4. Immediately post-op (first month) Alcohol use will increase the chance of infection. Smoking will delay the entire healing process. If you can help it, avoid these for a while...

Ok, I'm getting too long winded here. In short, GO FOR IT! I've got patients in there 30s all the way up to upper 80s. All shapes and sizes. The ones that keep moving and work hard, (and it is work at first) are the ones that are successful. The ones that don't move get contracutres and the knee will simply not bed. But it all cases, once the surgical/incisional pain subsides they realize that old nagging pain they had prior to the procedure is gone.

Mark

If you have any specific questions, I'd be happy to do my best to answer them. Otherwise, Go For It.

[claybill]

also...it is not recommended after your replacement..

to kneel.

walking down (stairs) is harder on your knee than walking up.

golfing, requires a twisting motion ..wears it out more quickly.

etc etc

i drove myself home from the hospital after 3-1/2 days..(automatic, of course)

bill

[power_hungry]

My dad had one of his knees replaced about 14 years ago, then had that one replaced last year. He was 85 for the revision, so he must of been around 70 for the first one. The second one has been better than the first, although the first wasn't a blazing sucess.

He's a farmer and been climbing up and down off tractors, working fields, wrestling with the irrigation systems etc. up until he retired this spring at 86.

[claybill]

I'm on year 11 for the right.....and year 3 on the left...hoping.!!!

bill

[Frank M.]

Hi Don. I had my right done 6 yrs ago. Made life easier. No pain at night now. Home in 4 days. Couldnt leave hospital till I could go up and down steps. Once home--therapist came for exercise instructions. She said 2 times a day--I did them 5. Pain will definitly let you know its there,but with pills its bearable. Early Dec. to April before feeling like normal again,but as bad as pain was the depression. Got stuff for that and was ok in a week and a half. Maybe it had something to do with being inside too long. Who knows? Theres not much choice about having it done. It would just get more miserable by the day. Im now 81 and glad I did it when I did. Tougher to get up and down from a creeper,but wouldnt have been able to by now, the way I was. Frank M.