TKR - Total Knee Replacement

Posted by: Steve C

TKR - Total Knee Replacement - 01/15/19 11:28 PM

Well, this is it. My right knee has come to the end of the road. After about 25k miles of jogging over 50 years, and hiking maybe a thousand miles, it has worn down to the bone. I can no longer descend stairs without dropping quickly on the good (left) knee. Climbing a ladder hurts; descending requires a two step--use the right leg only to lower my weight.

So Thursday morning, 9 AM, it goes. I've heard several people's experiences and they are happy. One friend is still having trouble with one of his. The doctor says I can return to doing everything I did before -- except no running. It should last the rest of my life--he said 30 years!

Here are some pics:

Sasquatch's knees.


Xray: Note the lack of separation on the inner section of the left knee (that's my right knee).


Side view: Metal surface around the upper (Femur). Flat plate on top of the lower Tibia (shin bone), and a polyethylene plastic plate between, where the friction will occur.

There will also be a plastic surface glued to the back of my patella (knee cap) that will rub against the metal.

This is the Tibia part:


Here's an image from https://www.mykneeguide.com/the-knee/the-knee-prosthesis


So... I hope to be out hiking again by summer!
Posted by: wagga

Re: TKR - Total Knee Replacement - 01/16/19 01:13 AM

So, will you be awake during the procedure or is it lights out?
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/16/19 09:26 AM

Semi-awake, I think. I've been told I'll get a spinal block.
Posted by: Fran

Re: TKR - Total Knee Replacement - 01/16/19 10:00 AM

I sent a post but not sure it went thru. I guess it didn't. Would you mind telling me who the surgeon is? Thanks, Fran B.

Posted by: MtMikeR

Re: TKR - Total Knee Replacement - 01/16/19 10:29 AM

My step-mother had a knee replacement last year and she was up and walking around within hours of surgery. Within a few days we was back home and doing physical therapy. She could barely go up and down stairs without pain - now she is able to move freely with no discomfort at all.

Good luck and you should be able to be back hiking by summer no problem!
Posted by: bobpickering

Re: TKR - Total Knee Replacement - 01/16/19 11:22 AM

Originally Posted By: Steve C
So... I hope to be out hiking again by summer!

Me too! Iíve already applied for our August 15-19 permit for Emerald Peak, Mt. Henry, and Mt. Senger. Wishing you a speedy recovery so you can start hiking again. And hoping for a speedy end to the Trump Shutdown so USFS can issue our permit.
Posted by: Harvey Lankford

Re: TKR - Total Knee Replacement - 01/16/19 12:00 PM

goes well, Steve
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/16/19 12:14 PM

Originally Posted By: Fran
Would you mind telling me who the surgeon is?
Matthew Simons. Why?
Posted by: AndyC

Re: TKR - Total Knee Replacement - 01/16/19 02:46 PM

I'm guessing if you shaved that 20 pounds of leg hair that would reduce the wear and tear on your knee and ankle joints.
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/16/19 03:52 PM

Originally Posted By: AndyC
I'm guessing if you shaved that 20 pounds of leg hair that would reduce the wear and tear on your knee and ankle joints.

Those legs aren't mine! I think I accidentally stumbled onto a new Sasquatch sighting! grin grin
Posted by: G4u2

Re: TKR - Total Knee Replacement - 01/16/19 08:33 PM

Best of luck Steve. Hoping for a speedy recovery!
Posted by: MikeH

Re: TKR - Total Knee Replacement - 01/17/19 07:07 AM

Good luck, Steve. A family member had both his knees done and we have heard all positive things. He bikes, hikes, plays tennis, chases the grandkids etc.

Best wishes.
Posted by: wagga

Re: TKR - Total Knee Replacement - 01/17/19 05:32 PM

Just spoke with Steve in hospital. His surgery is completed, and went well, now he's floating in a wonderful haze of Oxycontin.
Posted by: bobpickering

Re: TKR - Total Knee Replacement - 01/18/19 09:40 PM

Originally Posted By: wagga
Now he's floating in a wonderful haze of Oxycontin.

Looking forward to his trip report.
Posted by: G4u2

Re: TKR - Total Knee Replacement - 01/19/19 09:40 PM

Very funny Bob!
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/20/19 07:33 PM

Originally Posted By: wagga
now he's floating in a wonderful haze of Oxycontin.

Ha!! Three days out, and I've made it through the day with only Vitamin I. First round of PT tomorrow... I think I'll pop the serious meds before that session.
Posted by: Paul

Re: TKR - Total Knee Replacement - 01/21/19 02:25 PM

Hey Steve.

Just saw this thread. Yikes..... Okay, all is well?

What's your time frame for layoff before hiking again?

How's the other knee?

Getting old is the pits. I turn 70 in April.

Good luck!!!!

paul
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/21/19 03:34 PM

Paul, I just got back from the first of 12 PT sessions. They tell me I'm already ahead of the average on the flexion measurements, so it's going well. I'll take a pain med before the PT, but Ibuprofen is all I will need outside of that.

I'm hoping to visit Mt Whitney maybe in June, if progress goes well. We will see...

The other knee has never even hinted at trouble. like!
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/22/19 02:54 PM

Swelling is sure making it sore!

Posted by: wagga

Re: TKR - Total Knee Replacement - 01/22/19 11:29 PM

Bella hopes Steve is feline better.
Posted by: pcieluch

Re: TKR - Total Knee Replacement - 01/25/19 06:37 AM

Love the cat Steve. Short hair all black cats are my fav. I had three in a row all and I named them all the same.
Posted by: Fran

Re: TKR - Total Knee Replacement - 01/29/19 01:36 PM

Hi Steve,

How are you doing? Painful rehab?

Glad to see you on the website.

Take Care, Fran
Posted by: Snacking Bear

Re: TKR - Total Knee Replacement - 01/30/19 08:24 AM

Originally Posted By: wagga
Bella hopes Steve is feline better.


laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh laugh
Posted by: Steve C

Re: TKR - Total Knee Replacement - 01/30/19 08:36 AM

Originally Posted By: Fran
Hi Steve,
How are you doing? Painful rehab?
Glad to see you on the website.
Take Care, Fran

Rehab actually helps! After the ice and (yes a bit painful) stretching, the pain is hardly there.

It's overnight and mornings that are more difficult. I'm taking narcotics to sleep through the night, but only Ibuprofen during the day. I'm back at work full time -- sitting at a desk all day is easy on the leg.

The monster bandage comes off in two days, Friday (at 2 weeks).
Posted by: Steve C

Re: TKR - Total Knee Replacement - 02/02/19 10:20 PM

Here are Xrays two weeks later:



Physical Therapy and working it on my own has gone well. The doc told me I'm well ahead of the average. Walked half a mile this evening.

Sleeping is still giving me trouble. Going to try a switch from Percocet to Vicodin tonight. No meds during the day.
Posted by: bobpickering

Re: TKR - Total Knee Replacement - 02/03/19 09:25 AM

Originally Posted By: Steve C
The doc told me I'm well ahead of the average. Walked half a mile this evening.

Wow! If this keeps up, weíll have to do two trips this summer, rather than only one.
Posted by: Fran

Re: TKR - Total Knee Replacement - 02/03/19 12:19 PM

You must be doing great because of being in such great shape. More power to you. Please be careful regarding the vicidin.(SP?) Keep up the good work!
Posted by: Steve C

Re: TKR - Total Knee Replacement - 02/03/19 02:11 PM

Regarding Percocet vs Vicodin: Made no difference. Both give me about 4 hours that I can sleep. Took the V at 2AM, P at 5AM. I'll be back to 1 P tonight -- have to be back to work at 8 AM.
Posted by: Marty

Re: TKR - Total Knee Replacement - 02/08/19 12:06 PM

Good luck with your rehab, Steve. Your MD says 'no running.' Question: Can you 'run' on an elliptical machine? Run in a pool with an aquabelt? Just thinking about how you would train for hiking the mountains....
Posted by: Steve C

Re: TKR - Total Knee Replacement - 02/08/19 10:08 PM

Rowing, using an elliptical machine, bicycling and spin workouts, walking, hiking and backpacking are all OK. Just no running as a training exercise. I quit the jogging two years ago due to knee soreness, and I was still good for major hikes. It will be the same once I get back to it after this little interlude. ;-)

I appreciate your concern!

BTW: I'm 3 weeks post-surgery now. Made a looong Marathon drive to southern Cal and back, 12 hours driving yesterday. The leg did just fine, except it got a bit annoying and somewhat painful during the always-present L.A. stop-and-go traffic jams. Moving the foot often from accelerator to brake and back was like PT. I really appreciated getting out of that and back to where I could use cruise-control.
Posted by: Marty

Re: TKR - Total Knee Replacement - 02/10/19 07:12 AM

That sounds great Steve and good luck the rest of the way with your rehab.
Posted by: Steve C

Re: TKR - Total Knee Replacement - 04/01/19 08:05 PM

Progress report: a little over 10 weeks after the surgery.

I've been riding my mountain bike about once a week -- can ride for 2 hours without any trouble. I can almost climb the steep slopes I did before, but not quite. There is still a little weakness in the quadriceps that is getting better.

Trying to hit the gym 3X per week, doing leg presses and knee extensions each time. The operated knee is definitely a lot weaker than the other. I can press 200 with the good leg, only 140 with the right. Knee extensions are about half the strength of the good leg. But I am able to add more weight in each of these exercises almost every week.

Going down stairs is still not steady. That leg press weakness really shows up going down. Heading upstairs is ok, but the leg is a little weak. I need to head out and try a short hike on a trail with serious inclines to see how well I can do.

I still have swelling around the knee cap area. When leg is extended and relaxed, I can move the knee cap around and it looks and feels like it is floating around in a bunch of mush. Going in to see the doctor in a week to make sure all of this is normal.
Posted by: zapanther

Re: TKR - Total Knee Replacement - 04/16/19 09:05 PM

Wishing you the best Steve!

Glad surgery went well. BUT, P.T. is what makes or breaks a full recovery vs. "as good as it can get". (granted no issues in the surgery part)

I think you will treat it with the intensity it deserves!
Posted by: Steve C

Re: TKR - Total Knee Replacement - 04/16/19 11:02 PM

zapanther, thanks! I went through all the PT my insurance would cover -- 12 visits over 6 weeks. I have done all that, and am pushing everything as much as I can. I got in some hike/walks this past weekend, 3 miles with some terrain, 2 miles including some sandy beach. The leg is only mildly sore from all of that.

I'll be hitting the gym again tomorrow.
Posted by: bobpickering

Re: TKR - Total Knee Replacement - 04/17/19 12:05 AM

Originally Posted By: zapanther
P.T. is what makes or breaks a full recovery.

Thatís what I would have thought. When my wife got her first TKR, she did a ton of P.T. and used a fancy machine that slowly flexed her knee for several hours a day. She recovered fine. When she got her second TKR, there was a communications and scheduling SNAFU. It was two weeks before she finally got to P.T. They did one session and sent her home with a few exercises to do on her own. Second recovery was better than the first. Go figure.
Posted by: Lewis Van Atta

Re: TKR - Total Knee Replacement - 04/18/19 12:42 PM

My wife had a total knee replacement about 2 years ago, and her surgeon said something interesting: He actually encouraged her to do low-impact weight-bearing activity (walking, hiking, etc...but no running). The reason is that the weight bearing maintains or increases the leg bone density, and serves to help lock the knee replacement implants in place more firmly.
Posted by: Steve C

Re: TKR - Total Knee Replacement - 04/18/19 02:11 PM

For me, the word was "you can do anything except no running". I asked about emergency run across the street examples, and that was ok. Just no jogging. I may try jogging "across the street" just to see how any emergency will work out.

Here I am at 3 months:
Workouts continue to show improvement.
Leg press is approaching the good leg's strength (150 vs 200)
Hamstring curls are almost normal
Leg extensions have a ways to go (40 vs 80)
Stairmaster until my heart can't keep up.
Rowing machine is as good as before.
Spin cycle: alternately stand at 23, rest at 13 for 30 or 60 second intervals is really helping.
Posted by: pcieluch

Re: TKR - Total Knee Replacement - 04/19/19 06:24 AM

When I tore my quad tendon to 90% I also found cycling really made the difference in regaining the strength in the leg. I knew I was back when I could stand up while peddling.
Posted by: zapanther

Re: TKR - Total Knee Replacement - 04/28/19 04:35 PM



Steve Wow, your 3 month numbers are remarkable! You lit it on fire indeed. LOL. You may get it "better" than before with proper rest and time.

It is hard, and a disservice, to compare someone's TKR to another as there are so many different ways, procedures, materials,etc.. to do this surgery now. Let alone the each person's tendons, ligaments, bone and muscle capabilities, age, circumstance is different each person.

Bob, I'm glad the wife's 2nd knee replacement went BETTER with a scheduling SNAFU, dang. Did she keep and use the passive flexion device on her 2nd while being left in limbo?
I got the flexion device as well and an internal cooling pump after surgery. My PT appts were the same time as a firefighter that had the same surgery 3 weeks earlier. He was pissed and provided a competitive motivation to our sessions because my range of motion was better my first day. PT said it had a lot to do with the passive flexion from day of surgery on that helped the most.

Lewis is right about surgeons wanting to keep weight bearing quickly. HOI total hip or knee procedures, they want pts. woke up from sedation and getting up and walking a few hours after surgery that same day.

But all this is just anecdotal info and anyone needing a surgery should find the best surgeon and P.T. they can find/ insurance approved for. Give as detailed history, share your desire, then listen and follow your specific path for your surgery they said.
Posted by: bobpickering

Re: TKR - Total Knee Replacement - 04/28/19 09:41 PM

Originally Posted By: zapanther
Bob, I'm glad the wife's 2nd knee replacement went BETTER with a scheduling SNAFU, dang. Did she keep and use the passive flexion device on her 2nd while being left in limbo?


No. She was renting the flexion device and returned it when she was done with it. The second surgeon said she didn't need one. They made her buy the cooling device the first time, so she used it again the second time.
Posted by: Steve C

Re: TKR - Total Knee Replacement - 04/28/19 10:43 PM

A friend loaned/gave me a "Cryo/Cuff with Gravity Cooler" ice pack system, and I sure used it for the first number of weeks. PT people said to ice it, but the Cryo/Cuff is way better.