Knee replacement questions

[scottmandue]

I retire next year and Dr is suggesting I will need a knee replacement soon (arthritis).
I think I can tough it out until after retirement.
so gathering facts.
First the gory part, do they actually cut out my entire knee joint and install a metallic one? (this freaks me out some... no, a lot).
Second logistics.
We live at the top of about 20 steps, I'm thinking all I have to get up those once then I can camp out in the house for a month or three. I have big construction worker neighbors who help out with all kinds of heavy lifting. I could sit in a wheelchair and they could carry me upstairs?

A lady at my wife's work had a knee replacement and she told her "no way he will be able to do the stairs"
Well duh... I wasn't planing on running up and down the stairs right after the operation

[KFC911]

As far as the last part...stairs. I personally would not rely on others, but imo, I don't see how a knee replacement would be any different than a full leg cast as far as getting around and up & down stairs without using the "bad" leg...btdt. I could haul azz on crutches, and though it's been a long time ago, I don't recall any issues with stairs, and I lived in a 3rd floor apt at the time. Maybe someone else can ease your concerns about the surgery....'cause I can't .

Best of luck Scott!

[scottmandue]

Originally Posted by KC911

As far as the last part...stairs. I personally would not rely on others, but imo, I don't see how a knee replacement would be any different than a full leg cast as far as getting around and up & down stairs without using the "bad" leg...btdt.
Best of luck Scott!

I survived a pretty bad motorcycle accident (tib/fib with four pins in my leg) and I got along fine... but that was 30 years ago... and not up 20 stairs.

When the Doc gave me the bad news I asked about recovery, he said "a couple days in the hospital... and maybe a little while in a convalescent hospital" I didn't say anything but I think he saw the NFW in my eyes... he looked me up and down and said "but you probably won't need that".

My wife is panicking/overreacting... perhaps if I show here I can get up/down the stairs hopping on one foot (two 1 1/2" pipe railings).

[island911]

How old are you? (rhet) but that's a Q. Over the years, Hip and knee replacements make tiny wear particles, which the body tries to 'eat' but cant, so the attachment area gets 'eaten' instead. Which will loosen many designs from the bone. And then they do a so-called 'revision' to fix that for maybe another 10-15 yrs. After that... 2nd revisions are harder to come by. -Hips wear less, as the knee joint has both rolling and sliding elements.

That's my (dated) 2cents worth.

[rwest]

When I broke my leg, I went up and down my circular staircase on my butt- doesn’t take that much time and frankly I didn’t have anything better to do with my time!

[pwd72s]

Another aspect to think about is cost. Insurance better if you're not retired?

[scottmandue]

Originally Posted by rwest

When I broke my leg, I went up and down my circular staircase on my butt- doesn’t take that much time and frankly I didn’t have anything better to do with my time!

That is brilliant!



I'm 61 and this is my first joint replacement.

[Tervuren]

There is likely a "what do and what not to do" from the place that will be doing it that will give better insight than we do.

If it is 20 flight of stairs without a turn I would think you could put a slide under the leg that had been done, then use your remaining three to bug it up backwards without much issue.

You will want to do it in a way everything in that leg stays relaxed, you could practice ahead of time.

[masraum]

paging Dr Tobra. Dr Tobra, please call...

I think I've heard about people that had a knee replacement done and were walking on it in a very short period of time (days? maybe a week?).

I think a lot depends upon you. Tobra is always talking about "if you smoke, stop now" as far as improving your recovery time. Are you American sized and out of shape? If so, I would think losing weight and trying to get into better shape before hand would help. I can only assume that if your leg muscles were stronger that would be a huge improvement.

But, I'm talking out of my butt. I know that there are several knee replacement threads and folks that'll come along with more personal and/or professional knowledge.

[Zeke]

As one facing shoulder replacement I can tell you that knee replacement is not a walk in the park but far easier to do and has a terrific success rate. You'll be off and (not) running in no time. Seriously, my friend who did both at different times (recommended) that the PT was painful but he is a lot older than you and is a big man, mostly a cigar smoker and bourbon drinker. I think he backed way down though but it might have been too late.

[Arizona_928]

my aunt had both done. not at the same time. she has maybe 4/5 stairs to get to the house, but she didn't go down the basement for a few months. Completely happy with the results, and even goes on wild vacations now.
bless her heart.

[id10t]

I've been thru knee replacement (and hip) hundreds of times - as a therapist aide in the hospital. Its been 20 years but a lot of what I saw/did still applies.

Part of your in hospital rehab will be doing "a few" stairs/steps - 3 or 4 of them. But, stairs are a PITA (well, K) and depending on what size they are (width and height) and your assistive devce (walker, crutches, cane) can complicate navigating them. From what most of the folks I worked with said that had stairs to deal with is they simply camped out on the ground floor, sleeping in a spare room or on a couch.

Some advice - if you know you are going to do it, ask teh doc for a PT consult so you can start the exercises they'll have you doing post-op NOW. Helps a lot - the folks that got out quick were healthy and in shape and had muscle done in the critical areas. The little old ladies who were 5 feet tall and 4 feet around had many more issues and typically went to assisted living for a while after leaving the hospital.

In the OR or recovery room they will put a machine on your leg that simply bends your knee and straightens it. Wear it. Use it. Don't slack off on it.

If you don't hate your physical therapist, either you are slacking off or they are slacking off. Get up and walk. Then walk some more.

Do your PT. Do not slack off. Do not slack off on bending the knee (per PT directions). You'll get out of it what you put in. One of the guys that I worked on said that what we put him through in those first few days post op was worse that what the Germans did when he was shot down in WW2. But he came back to have his other knee done with a smile on his face and ready to do it.

A coworker had her knee done last week of February. She was out of work for a month, then back full time. Already going to her regular gym, etc. From what she said current protocol is procedure early in the morning and you are up and out of bed and taking your first few steps at dinner time. Out of the hospital in 3-4 days depending on lack of fever, etc. Finding a good outpatient rehab place for a month or two of after care, etc. can be harder - my coworker went through two therapists and then changed facilities before finding one who would actually make her work.

[Noah930]

1. Yes, the knee joint is cut out with power saws. The bone at the distal end of the femur (with what's left the cartilage), and the bone on the proximal part of the tibia (with remaining cartilage) vets cut away. Then, using special jigs, you're drilled, sized, trial fitted, and then implanted with a metal and plastic knee prosthetic joint. If you're on this DIY board, you'd probably find it pretty fascinating, if it wasn't your own body part going through it all.

2. Stairs will be tough at first, but I'd imagine you could scootch yourself up and down at first, if needed. Like others have written, your recovery in large part depends on what you put into it. Eventually, stairs should not be a problem at all. But if you wanted to do things like skiing or surfing, you may have to give those activities up.

[scottmandue]

Originally Posted by pwd72s

Another aspect to think about is cost. Insurance better if you're not retired?

State employee, insurance stays the same.

Originally Posted by masraum

paging Dr Tobra. Dr Tobra, please call...
I know that there are several knee replacement threads and folks that'll come along with more personal and/or professional knowledge.

That is why I'm asking here, I now it has been kicked around here plus looking for input from the multiple Dr's we have here.

Originally Posted by Noah930

1. Yes, the knee joint is cut out with power saws. The bone at the distal end of the femur (with what's left the cartilage), and the bone on the proximal part of the tibia (with remaining cartilage) vets cut away. Then, using special jigs, you're drilled, sized, trial fitted, and then implanted with a metal and plastic knee prosthetic joint. If you're on this DIY board, you'd probably find it pretty fascinating, if it wasn't your own body part going through it all.

2. Stairs will be tough at first, but I'd imagine you could scootch yourself up and down at first, if needed. Like others have written, your recovery in large part depends on what you put into it. Eventually, stairs should not be a problem at all. But if you wanted to do things like skiing or surfing, you may have to give those activities up.

I actually kinda suspected that was the procedure but honestly I was squirming a bit reading that.

As far as skiing etc. that would be the old joke:
"Dr will I be able to play the violin after the operation?"
"Sure young man!"
"That is funny, I couldn't play violin before."

We live near a park and I do love to go walking/biking.

As far as retirement I'm thinking of getting back to drawing/painting and picking up the guitar again (none of which requires a good knee)

I'm 61, 190 lbs (want to get back to 185) don't smoke and only drink when I'm out with the boys.

Like I said the Ortho Dr looked me over and said "you should be okay."


I don't suppose they have a carbon fiber knee I could upgrade to?

[Bob Kontak]

Originally Posted by scottmandue

I actually kinda suspected that was the procedure but honestly I was squirming a bit reading that.

Dude, you get trial fitted after the bone gets cut away.

Why the drama?

[Bowling]

Yes they cut your bones away. Find a great Doctor and you wont regret it. Tremendous pain relief after the post op suffering...

[flyenby]

There is a recent procedure,where they cut on the side of the knee. I know someone who had it done 3 years ago. Much less invasive,less nerve damage. No nasty scar....you should really look into it

Scott,

I've had both done.

A total knee replacement is about 80% of the way to amputation--they remove a huge section of bone and joint and replace it with stainless steel, titanium, and polypropylene. The procedure is truly violent--I witnessed part of it when I came out of anesthesia during my second one. I was jarred awake by one of the docs pounding a titanium pin into my femur with a huge red plastic mallet. In my stoned state, I could feel the impacts, saw everything with surreal vividness, but felt no pain. Being of a mechanical bent myself, I was pretty interested in the proceedings, and must have grunted something out, because the anesthesiologist, eyes big as saucers above her mask, quickly reached over and adjusted something, and back off I went.

The right was done with a procedure called "minimally invasive," which means they come in from the side, and don't cut the quadriceps. It supposedly shortens recovery time because there is less to heal. I had only so-so luck with it, so I decided to go with the standard procedure for the left, which was done a year later. Now, five years out from my last one, they are both doing quite well, but neither has been a walk in the park, as you might say. Speaking of walking, they had me up the same day as the operation, hanging onto a walker in absolute agony, despite near-lethal doses of morphine. Rehab starts on day zero, and you have to commit to it--you get one chance to attain full articulation of the joint, and you don't want to screw it up.

Recovery to "normal" takes about a year, though some claim less. You will be limited to an extent--you'll never run again, for instance--but otherwise most functionality is there. It's hard, though, to control your weight, since exercise is so limited. I gained about 30 lbs during the process.

PM me if you have any questions.

[pavulon]

Originally Posted by madcorgi

~snip~

A total knee replacement is about 80% of the way to amputation--they remove a huge section of bone and joint and replace it with stainless steel, titanium, and polypropylene. The procedure is truly violent--I witnessed part of it when I came out of anesthesia during my second one. I was jarred awake by one of the docs pounding a titanium pin into my femur with a huge red plastic mallet. In my stoned state, I could feel the impacts, saw everything with surreal vividness, but felt no pain. Being of a mechanical bent myself, I was pretty interested in the proceedings, and must have grunted something out, because the anesthesiologist, eyes big as saucers above her mask, quickly reached over and adjusted something, and back off I went.

~snip~Speaking of walking, they had me up the same day as the operation, hanging onto a walker in absolute agony, despite near-lethal doses of morphine.
~snip~

really?

Originally Posted by pavulon

really?

Yup, really. It's standard procedure to get folks up and walking ASAP.