Thoughts on a new Knee

Discussion in 'Quackenbush's' started by Crockett, Aug 23, 2017.

  1. Crockett

    Crockett 5,000+ Posts

    I had a meniscus removed when I was in high school because of a middle school football injury. Ripped the ACL in that knee later ... probably high school... it's been resorbed. I've done pretty well for most of my life but gradually I gave up sprinting, then jogging, then any sort of activity that required sudden explosion involving my left leg. But I was fine walking and riding my bike ... my favorite exercise anyway. Now cycling hurts. I'm going to try another round of hyaluronic acid but maybe it's time for a new knee.

    My orthopedist was showing me a model ... talking about how it would tighten my ligaments, restore spacing and cushioning. Honest to God, watching it operate in his hands reminded me of my feelings the first time I saw a Datsun 280Z Pass me on the highway... a combination of excitement and desire. Anybody here had experience with a new knee?
     
  2. Phil Elliott

    Phil Elliott 1,000+ Posts

    I have not had any knee replacements but I do know a few guys who have. Mostly they have had good experiences. One guy who is a big proponent says don't wait too long because the pain and inflammation you build up while putting it off will make your rehab longer.

    OTOH, my cousin had her knee replaced about 10 years ago, and she has had an infection set in to where they had to remove the replacement and are waiting for the infection to subside and they will put in a new one. Her doctor traced (I don't know how) the infection to a time when she cut her gums using dental floss. I asked my friend who is the big proponent about this and he said oh yes that is a thing and he has to take antibiotics for 2 weeks before he goes to the dentist. Yikes!
     
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  3. Grant404

    Grant404 < 25 Posts

    Long time lurker here. I have some experience in this subject so I decided to register just to respond to your question.

    After years of being very active with things like biking and running, many times under less than ideal circumstances (ex military), I had chronic pain in both knees by my early 30's and repeated meniscus tears in my right knee. After four scopes by age 45 (and cortisone injections, and Synvisc) I was told there was nothing more that could be done short of a total knee, with a recommendation to put it off as long as possible. I made it another five years and when I could stand it no longer had a total knee replacement (TKR) done in 2009. In retrospect I probably waited TOO long, because by then my knee was so dysfunctional and used to operating in a limited range of motion I was not able to get a full range of motion back post TKR in spite of several months of physical therapy. Even so, that knee was mostly pain free for the first time in many years, so I lived with the range of motion issues and moved on.

    Four years later out of the blue the implant got infected and I was rushed into surgery to have the prosthesis removed. What followed was a year-long process. I was without a knee at all for the first three months during which time I was on daily antibiotic IVs with in-home nursing visits three times a week, regular blood testing, etc. Only after I was cleared by my infection specialist was I allowed to get a new implant three months later, which started a long, slow road to recovery (subsequent implants, aka revisions, typically have a longer recovery and physical therapy period). The process took about a year total, but on the bright side I did not lose my leg, any organs, or my life. An infected implant is a very serious condition. I've had my revised implant for four years now, and other than an increase in scar tissue resulting from the same areas being cut three times, it's working well enough (knock wood).

    Unfortunately, being one-legged for several months during that process accelerated the deterioration on my "good" knee, and I finally had to have it also done last December. That one has been a piece of cake so far (again, knock wood) compared to the first one. I passed the post op physical tests and was released from the hospital the next day, I was walking on it unsupported and without favoring it within a week, my PT time was minimal, and instead of the 9 - 12 month complete recovery time that seems to be the conventional wisdom for TKRs, I was going about my normal daily routine and not even thinking about it by about the third month post op. I have a little less range of motion than my formerly healthy, natural knee, but I think I just naturally get more scar tissue than some other people.

    One thing they did differently on my second knee which accelerated my recovery time was they closed it up with surgical super glue, which left nothing that had to be removed and almost no scar. The three times they were in my other knee they used big, ugly staples that looked like a zipper and had to be removed after a few weeks, leaving a very noticeable scar. I was told that the super glue wasn't available or very common back in '09, and only some of the surgeons were using it even last year when i had my latest TRK.

    Anyway, so far so good. The two things they worry about the most with TRKs are blood clots and infection, and I was unlucky enough to experience the latter (but lucky enough to survive it). I was told it's very uncommon, one doctor said it's like being struck by lightning. It's so uncommon that while I was in the hospital for five days having the implant removed, being put on antibiotic IV's, and being closely monitored, they brought new doctors (interns? residents?) in to see me so they could ask questions about what symptoms I had leading up to it, etc. Apparently they don't see it very often.

    Btw, they were never able to isolate and identify the infection or determine where it came from. The specialist said if he had to guess he'd say it was probably staph, which is one of the many things we carry around with us all the time. I asked if we don't know what it was or where it came from, how can I prevent it from happening again? He said "That's the dirty little secret. You can't."

    As a commenter noted above, I too have to take a oral dose of antibiotics before I go to the dentist for anything, even a checkup, but only an hour before the appointment.
     
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    Last edited: Sep 4, 2017
  4. Crockett

    Crockett 5,000+ Posts

    Well Grant404, if I was certain I'd have an experience like your second knee replacement I'd schedule it for October. I had a series of 3 injection similar to Synvisc over the last three weeks and the pain is much less. The extra lubrication is letting things move around -- in intended and unintended directions -- but the pain is comparatively negligible. I've been walking a lot (upper deck football tickets and around campus) and while I feel a little weak in the knee, I'm mobile not hurting.
     
    Last edited: Sep 8, 2017
  5. Hollandtx

    Hollandtx 250+ Posts

    One of my closest friends had both knees replaced almost a year and a half ago. At different times, of course. He had a wonderful recovery, and is now doing things he couldn't do for many years without pain.
    He lives in Georgetown, if you want I will find out the name of his MD, and what model they used. He is over the moon about his new lease on life, as he calls it!
     
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  6. ShAArk92

    ShAArk92 1,000+ Posts

    @Crockett ... I too know 3 who've done the replacement deal in the past two years. They've all said they should have done it sooner.

    I ripped my L knee cartilage in May 15 and had to have it regrown from bone marrow stem cells! I didn't know that was possible. But I lost the oil/fluid in that joint and have been doing semi-annual series of 3 shots 7-14 days apart. This Tuesday, I will undergo stem cell replacement of THAT fluid too! Amazing.

    I'm looking forward to it from a annualized cost standpoint ($250/pop for the "high viscosity" 6 times in 12 months; $2500 "for life") and ... I'm just not real cozy with getting poked. I've tolerated it, but I'd rather do one/done. Hopefully that's what this procedure will provide in the next 4-6 months. I was scheduled for my next series of "high viscosity" in November.

    Good luck!
     
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  7. Crockett

    Crockett 5,000+ Posts

    Thanks for all the encouragement. I had one bit of discouragement. I took a road trip with my dad, recipient of two knee replacements done in his early sixties. We went to Homecoming at New Mexico Highlands University where he was educated and played football. We and spent a few extra days vacationing in Northern New Mexico, a place we both love. He's been a studly man, 200 pounds of mostly muscle and sinew since I can remember. The artificial joints are worn out, he tells me. He's uneasy walking around. He's 83 and says he's not going to get new ones. Replacement of replacement knees is more problematic and he lacks the muscle to rehab that he enjoyed two decades ago. I'm younger and 60-70 pounds heavier than he was. I'm worried about the end game.
     
    Last edited: Sep 22, 2017
  8. ShAArk92

    ShAArk92 1,000+ Posts

    I understand ... but on the other hand, the end game is none of us escape. If you can get to 83 ish and be more mobile than you are now ... I'd consider that a good investment. Because ... how many 83 year olds do you know that do wind sprints anyway?

    Your dad sounds a lot like mine ... mine only made it to 72 ... cancer. So you never know. Dad always said "don't let geography hold ya back" ... I think that would apply to current health as well.

    I'm entering the phase where my X-ray vision is shot and I have to have help. What a NUISANCE! I'd do lasik but I understand that it's good for about 10 years. I have too far to go to have to do it again before I make "83" ... and ... too many liabilities to lose my job over a botched lasik effort at this point.

    If you're confident in the orthopedic surgeon ... I wouldn't hesitate. Pain in movement influences one to stop moving. You can stop moving at 83 because there's probably going to be other issues at that point, too.

    Al
     
  9. Phil Elliott

    Phil Elliott 1,000+ Posts

    Am I doing the math correctly here that you weigh ~250 lbs or more? If you could drop about 75 lbs that would help your knee pain considerably I would wager. I recommend doing low-carb.
     
  10. Crockett

    Crockett 5,000+ Posts

    I could certainly stand to lose some weight. Low carb works when I'm strict about it.
     

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