Knee replacement

[Yardigan]

Been having pain in both knees for quite a while...had them x-rayed..both a mess, severe arthritis. Doc said, without even further study, about the left one, nothing much that can be done except knee replacement. (Had arthroscopic surgery about 30 years ago). For the right, suggested a MRI. Got the MRI - was told meniscus damage that they could operate on, and I might (might) get 6-12 months of relief, but...recommending knee replacement for that one as well.

Am not a big 'pain' guy, and watching a video of the operation online...kinda makes that seem inevitable.

Fortunately, I work at home (desk-type job), with single floor living and good home support. Trying to figure out if I should get both done at once, or one at a time and wondered if anyone here had experience with either strategy. Have read about the pro's and con's of both approaches (one at a time or both at once)...but interested in hearing from anyone that might have gone through it.

 

[BFieldHusky]

My father had both done at the same time 3 years ago. I highly recommend it.

He worked very hard to rehab before the surgery to get himself as strong as possible. Had them both done at same time. Stayed in hospital for 3 days then went to an inpatient rehab facility for a week. Then went home.

It's tough but he did great and eventually was fine. I know a lot of people who get one done and then put off the other one because of the rehab. And that makes the other knee worse.

Pm me if you want more details.

 

[Richmondhsky]

Been having pain in both knees for quite a while...had them x-rayed..both a mess, severe arthritis. Doc said, without even further study, about the left one, nothing much that can be done except knee replacement. (Had arthroscopic surgery about 30 years ago). For the right, suggested a MRI. Got the MRI - was told meniscus damage that they could operate on, and I might (might) get 6-12 months of relief, but...recommending knee replacement for that one as well.

Am not a big 'pain' guy, and watching a video of the operation online...kinda makes that seem inevitable.

Fortunately, I work at home (desk-type job), with single floor living and good home support. Trying to figure out if I should get both done at once, or one at a time and wondered if anyone here had experience with either strategy. Have read about the pro's and con's of both approaches (one at a time or both at once)...but interested in hearing from anyone that might have gone through it.

I had a partial replacement 2.5 years ago and know quite a few who had both done. The real question is are you getting two full replacements. The pain and rehab are much easier on partial vs full. All the guys who did both at the same time did it because they knew they’d wait too long to get the second one done. They both did fine and they aren’t the most fit physical specimens.
Definitely work hard to strengthen your legs prior to surgery, it will definitely make it easier.
Also, ask your surgeon how many replacements he or she does per year. If less than 150, find someone else. This suggestion came from doc who had scoaped my knee. He said it was too specialized. Good luck!

 

[Dove]

I thought two replacements at the same time was NOT a recommended way to go.

 

[Yardigan]

I thought two replacements at the same time was NOT a recommended way to go.

From what I've read...there's pros and cons... less total hospital time and cost...but, higher risk of more blood loss requiring a transfusion... shorter overall recovery time...but, no good leg to stand on during rehab...
Big risk for me is, if I have one done, and it hurts like hell (which, I'm thinking it has to)...I might not do the second....

 

[Rocktheworld]

I thought two replacements at the same time was NOT a recommended way to go.

Weight bearing precautions could make things difficult for recovery. If for example both limbs are non-weight bearing or toe-touch weight bearing that can significantly affect post-surgical intensity of therapy and thus rehabilitation of walking, which may go as far as being limited to passive range of motion without strengthening. That can result in serious atrophy essentially setting the patient back that much further (hence the recommendations for pre-surgery strengthening)

-Someone who works in acute rehab

 

[Danzz]

From what I've read...there's pros and cons... less total hospital time and cost...but, higher risk of more blood loss requiring a transfusion... shorter overall recovery time...but, no good leg to stand on during rehab...
Big risk for me is, if I have one done, and it hurts like hell (which, I'm thinking it has to)...I might not do the second....

I have a friend who had both knees and shoulders replaced at different times. The shoulder was much worse.
This is a guy who couldn't finish a round of golf without knees giving out. His knees are fine now.
The biggest danger is blood clots after surgery even with the meds. You will likely go to a rehab facility after surgery for PT. Good luck!

 

[Uconnrick]

Had a total on my left knee 16 months ago. I was lucky. Was walking without a limp in 4 days and was done with PT in 5 weeks. Only pain I had is when I pushed too far in PT.
Ill need my right one done within the next 18 months. My Doc is really emphatic telling me NOT to expect the same results. Every one is different.
He is my buddies ( who wanted both done at the same time) Dr. also. Dr gave home the big NO on getting both done. He says it's too invasive, invites too many potential problems and he likes your complete attention on rehabbing one joint. Not two

 

[Fishy]

Personally, I think you should take a weekend trip to Cape Cod.

But beyond that, knowing nothing about knee surgery, I think I would only tell you to get a second opinion.

Replacing body parts seem to be an area where you might want to get more than one expert opinion.

 

[Palatine]

One of the reasons both are done at once is because -often- the recovery and rehab is so hard many won't go back for a second knee. Lots of factors to consider.

 

[Yardigan]

Personally, I think you should take a weekend trip to Cape Cod.

But beyond that, knowing nothing about knee surgery, I think I would only tell you to get a second opinion.

Replacing body parts seem to be an area where you might want to get more than one expert opinion.

Well...we are taking a vacation to FL at the end of August, which is why this is getting put off til fall.
From the pix, it doesn't look like "if" is really an option if I ever want to walk around "normal"/pain free again...but "who" is definitely something that'll warrant a lot of consideration.

 

[Yardigan]

One of the reasons both are done at once is because -often- the recovery and rehab is so hard many won't go back for a second knee. Lots of factors to consider.

That's EXACTLY what I'm thinking...They hurt now, but I "know" that hurt...and if I get one done...and it hurts worse than "this" does now... they might have to lasso me and drag me in to get the second one done...

 

[Northbound]

My father had both done at the same time 3 years ago. I highly recommend it.

He worked very hard to rehab before the surgery to get himself as strong as possible. Had them both done at same time. Stayed in hospital for 3 days then went to an inpatient rehab facility for a week. Then went home.

It's tough but he did great and eventually was fine. I know a lot of people who get one done and then put off the other one because of the rehab. And that makes the other knee worse.

Pm me if you want more details.

So did my father - both at once, twelve years ago in fact. The guy now is out of the country 4 months out of every year riding bikes across Southeast Asia, the Dolomites, South American, etc. needless to say the worked out real well for him.

He did it a Morristown Memoria in NJ.

FYI everyone that I’ve know to have one then get the other all have said they’d do both at once if they could do it over again.

 

[Yardigan]

My father had both done at the same time 3 years ago. I highly recommend it.

He worked very hard to rehab before the surgery to get himself as strong as possible. Had them both done at same time. Stayed in hospital for 3 days then went to an inpatient rehab facility for a week. Then went home.

It's tough but he did great and eventually was fine. I know a lot of people who get one done and then put off the other one because of the rehab. And that makes the other knee worse.

Pm me if you want more details.

Thanks...I have a lot of questions...just not sure how to do the PM thing here....like..

...how old was your father when he had it done? Where did he have it done? Can he play golf now? (I haven't been able to play for a couple years ...I sucked at it...but still enjoyed it)

When you say he "worked very hard to rehab before the surgery to get himself as strong as possible." Did you mean working on leg strength? Upper body strength? (to be able to get around after) Both?

...wondering how long before I'll be able to get up and down the stairs after surgery (for hoops games)... my bedroom, bathroom, office are all on the first floor of my house...wife doesn't work (outside of the home)*...son (early 20s) is here most of the time...would I be able to avoid the rehab facility piece?

Thanks much!

*gotta qualify this...she takes care of me, which means she is grossly understaffed

 

[Da_Aisijimo_Gou]

Weight bearing precautions could make things difficult for recovery. If for example both limbs are non-weight bearing or toe-touch weight bearing that can significantly affect post-surgical intensity of therapy and thus rehabilitation of walking, which may go as far as being limited to passive range of motion without strengthening. That can result in serious atrophy essentially setting the patient back that much further (hence the recommendations for pre-surgery strengthening)

-Someone who works in acute rehab

Please clarify your comments, especially the 2nd sentence referencing non-weight bearing or toe-touch weight bearing. Knees and non-weight bearing: Are you referencing a part of a knee which may be non-weight bearing versus an entire knee? Thanks in advance @Rocktheworld or others with direct medical education and relevant experience.

 

[Yardigan]

Please clarify your comments, especially the 2nd sentence referencing non-weight bearing or toe-touch weight bearing. Knees and non-weight bearing: Are you referencing a part of a knee which may be non-weight bearing versus an entire knee? Thanks in advance @Rocktheworld or others with direct medical education and relevant experience.

Thanks...because...am looking at total replacement for both knees...and if'n I could figger out a way that that'd be non-weight bearing...seems that'd be pretty slick.

 

[Rocktheworld]

Please clarify your comments, especially the 2nd sentence referencing non-weight bearing or toe-touch weight bearing. Knees and non-weight bearing: Are you referencing a part of a knee which may be non-weight bearing versus an entire knee? Thanks in advance @Rocktheworld or others with direct medical education and relevant experience.

I mean the designation of the degree to which you can bear weight on the limb(s) on which/were operated

Talk to you doctor and you surgeron

 

[lrnltd]

I recommend exploring the new technology, where the new knee prosthesis is produced through 3D printing. This means that, rather than making an off the shelf prosthesis fit by reshaping the bone, your natural knee is scanned and a perfect replica is produced. This means that far less damage during surgery and a far better, easier recovery. I know several friends who have had it done by Dr. Wolfgang Fitz at Brigham in Boston. He is a pioneer with this technology and his protocol is so much easier on the patient than the traditional surgery and tough rehab. Don't wait. No need to live with pain that limits your life activities.

 

[sledog]

No knee, but did have a hip replace. Agree w above re; try to get in good shape before the op. First few days post-op were dead in water until some of the post-op effects (some pain, lots of stiffness, swelling) wore-off. Not sure how a bilateral (both hips) would have gone - would require lots of assistance.

 

[dogpause]

I had both done at the same time about 4 years ago. Best thing I've ever done that involved surgery. Dr. Paul Murray at Hartford Hospital did them. He's terrific, IMO, and probably does more knee and hip replacements than anyone in CT.

Minisectomy's are mostly a waste of time as far as I'm concerned, because removing cartilage, while it can offer temporary relief. only puts you that much closer to bone-on-bone.

A few things I learned:

If you need both (bi-lateral) and you are healthy, do them together. You are weight-bearing immediately.

Best Advice: Take your pain meds by the clock -- and you will be fine. Don't let the pain get ahead of you or it will be tougher to get it under control. My pain never exceeded a 2 out of 10.

Do the PT. Rehab is so important with joint replacement. Also, everyone focuses on degrees of flex, but extension is just as important, if not more so.

BoneSmart is a great online forum that will provide lots of info.

Good luck. You will wish you had done it sooner.

 

[Hankster]

I recall this same topic months ago. However, it is reasonable to be concerned. I had my left knee done. Totally. I had a huge bow prior to surgery. Knee and back sure played "h**l on my golf game. Now a couple of later, leg is straight and walking well. However, if anyone thinks you will not get sore or have pain occasionally after kneed replacement is dreaming. Rehab was tough. Whether it is good or bad to get both done at same time is debatable. Still, I have great respect to those that go through it. I think about my rehab, I sometimes think on how rehab would be with both done. During mine, my good leg was very useful.

Bad news. TSA.

 

[David 76]

My brother-in-law did both at the same time in his sixties. Went very well. He was/is in great shape, if that matters.

 

[Waquoit]

All I hear is that hips are easy but knees are much tougher, rehab-wise. My PT girlfriend recommends one knee at a time. Both at the same means double the pain. And if you do both, you will need a support system because you won’t be getting around for awhile..

 

[Rocktheworld]

All I hear is that hips are easy but knees are much tougher, rehab-wise.

Not sure why a PT would make such a blanket statement, any PT I know and work with would hedge every statement regarding a replacement as being a strictly case-by-case thing. Replacements happen for different reasons, with different interventions, for different people with different histories. I’ve seen plenty of hip patients that are the opposite of “easy”

Thinking of the pelvis as the physiological anchor for pretty much everything your body does from a mobility standpoint, and its complexity as a joint... would she (or any OT) say shoulders are easier than elbows?

 

[BFieldHusky]

Thanks...I have a lot of questions...just not sure how to do the PM thing here....like..

...how old was your father when he had it done? Where did he have it done? Can he play golf now? (I haven't been able to play for a couple years ...I sucked at it...but still enjoyed it)

When you say he "worked very hard to rehab before the surgery to get himself as strong as possible." Did you mean working on leg strength? Upper body strength? (to be able to get around after) Both?

...wondering how long before I'll be able to get up and down the stairs after surgery (for hoops games)... my bedroom, bathroom, office are all on the first floor of my house...wife doesn't work (outside of the home)*...son (early 20s) is here most of the time...would I be able to avoid the rehab facility piece?

Thanks much!

*gotta qualify this...she takes care of me, which means she is grossly understaffed

My Dad had them done at Hospital for Special Surgery in New York City. He also has had both of his hips replaced and recently had back surgery there as well.

Yeah he strengthened his quads and other areas to make his legs as strong as possible. You can work with a physical therapist to help get this in motion.

He went to Burke in Westchester and lived there for a week after the hospital. While he was miserable not being home, that week was critical as they really were on him about his rehab. He was playing golf 4 months later.

 

[August_West]

My mom had both done. 9 months apart. Conscious decision not to do both together.

I think both decisions suck. You win and lose both ways.

She was able to come home instead of inpatient after doing one at a time which is a main reason she decided not to do both at once.

But man going back for the second one had to be torture after getting through the first.

 

[Waquoit]

Not sure why a PT would make such a blanket statement, any PT I know and work with would hedge every statement regarding a replacement as being a strictly case-by-case thing. Replacements happen for different reasons, with different interventions, for different people with different histories. I’ve seen plenty of hip patients that are the opposite of “easy”

Are you for real? For one, the quote you commented on was my quote not the PT. And of course, some hips end up a tougher rehab than knees. But that is the exception to to the rule. Ask anyone with any knowledge of the subject outside a medical consulation "What's a tougher rehab, hips or knees" The answer will be knees. Unless you run into a knob that says something like dooshy like, "Replacements happen for different reasons, with different interventions, for different people with different histories."

 

[Rocktheworld]

Are you for real? For one, the quote you commented on was my quote not the PT.

My bad, figured you meant that given you followed that “I hear this all the time” with talk of your PT (PTA or DPT?) girlfriend. I don’t think that was a stretch but okay. The point remains that I’ve never heard blanket statements like that made by the DPTs I’ve known and worked with for years in acute rehab and acute care.

And of course, some hips end up a tougher rehab than knees. But that is the exception to to the rule. Ask anyone with any knowledge of the subject outside a medical consulation "What's a tougher rehab, hips or knees" The answer will be knees.

Lol why would I ask anyone who isn’t involved in medical management of joints and their replacement?

Better yet, why do you (seem to) reject those people’s opinions?

Unless you run into a knob that says something like dooshy like, "Replacements happen for different reasons, with different interventions, for different people with different histories."

The only way you can perceive that statement as “douchey” is if it somehow threatened your sense of your own intelligence. People, their surgeries, their histories, their responses to therapy, are all so varied that blanket statements like “hips are easy” are pointless. You don’t say that to someone going in to surgery because you really don’t know how the surgery will go and how they will respond to therapy.

 

[Yardigan]

I had both done at the same time about 4 years ago. Best thing I've ever done that involved surgery. Dr. Paul Murray at Hartford Hospital did them. He's terrific, IMO, and probably does more knee and hip replacements than anyone in CT.

Minisectomy's are mostly a waste of time as far as I'm concerned, because removing cartilage, while it can offer temporary relief. only puts you that much closer to bone-on-bone.

A few things I learned:

If you need both (bi-lateral) and you are healthy, do them together. You are weight-bearing immediately.

Best Advice: Take your pain meds by the clock -- and you will be fine. Don't let the pain get ahead of you or it will be tougher to get it under control. My pain never exceeded a 2 out of 10.

Do the PT. Rehab is so important with joint replacement. Also, everyone focuses on degrees of flex, but extension is just as important, if not more so.

BoneSmart is a great online forum that will provide lots of info.

Good luck. You will wish you had done it sooner.

Very informative site, thanks! Also like hearing "you'll wish you had it done sooner"....

 

[Waquoit]

Lol why would I ask anyone who isn’t involved in medical management of joints and their replacement?
Better yet, why do you (seem to) reject those people’s opinions?

You mean like how the OP asked the world in his initial post? And I was at the gym a while back at the same time as an orthopedic surgeon whe a guy was peppering him with questions on this topic. He said hips are an easier rehab than knees. I guess didn't feel the need to add a bunch of qualifiers, that it was obvious that some rehabs are easier or tougher than others.

The only way you can perceive that statement as “douchey” is if it somehow threatened your sense of your own intelligence. People, their surgeries, their histories, their responses to therapy, are all so varied that blanket statements like that are pointless.

It was douchy. I consider BY discussions the same way I view discussions at the local watering hole. It's casual conversation, not a grad school dissertation. Every once in awhile you run across someone who has to parse every word into mind-numbing boredom. Like you.