Total Knee Replacement - my experience might help you

[dcarver]

2017-12-15 New to Me Knee status update





dCarver's rides



Last October 13 2017 I got a new-to-me-knee. Thought I'd share some thoughts for those of you debating this option. It's now been 8 weeks. In no particular order:

1. I underestimated this surgery. Hell, I've had broken back, femur, Achilles, multiple ribs, foot, knee & calcified hematoma kidney surgery. Replacement knee hit harder and has taken longer than any of the above.
   
2. Mine was outpatient. In and out same day. Surgeon says less anesthesia, chance of staff infection (I work on healthy people with bad joints!) and being home leads to faster recovery.
   
3. Physical therapy consists of two parts. Getting 'flat' e.g. extended and flexion (bending). Good flexion is 120 degrees. I'm at 130 and flat 8 weeks later. The second part is strengthening the quads, calf, ham strings.
   
4. The hard part is going downstairs, not up.
   
5. I built a ramp from my stairs at the front door and glad I did. Yes, could have used stairs even when first arriving home but the ramp has been very helpful later in learning again how to walk downstairs.
   
6. Quad muscle shutdown. The PT's and surgeon all stated that even a bit of water or swelling in the knee and the quad muscle will shut down, be unresponsive even though your brain is sending the signal. Yes, the quad is an important muscle to have working. When I came out of surgery the first thing I checked was the quad and my was firing, but only a twitch, not a clinch.
   
7. It's not unusual for local swelling at knee to last 3 - 6 months AFTER surgery.
   
8. Most insurance will not cover a 'Cold Rush' machine that's essentially an ice bucket with pump, hoses and pad to circulate ice water to the knee. Insurance says an ice pack is just as good. True. But, no wetness or mess using the machine. I rented for $28 per month. Then I found out they can be purchased for ~140 all day long on Amazon. I'm not projecting to return the unit after 90 bucks or 3 months.
   
9. The first 2 weeks are in home PT for wound dressing, staple removal, exercises, monitoring. After 2 weeks, in town PT. Of course you still have to do homework too.
   
10. Percocet first, Norco second. Don't get opioid addicted. I can see why peeps do.
    
11. Getting an implant is like buying shoes off the rack. The cut you open, then try to find the closest correctly sized implant. I recall before getting knocked out looking at 8 feet of table with beautiful titanium implants of various sizes sitting in nice glass cases. Here's the point. If your a 'half-size' the surgeon and implant specialist (who is surgery with you) have to choose loose or tight which:
    If you get set up tight you'll have trouble with your flat and flexion degrees..
    
12. If loose, you most likely will have the 'Click-Clacks'. As you extend and retract the knee, you will hear and feel clicking or clacking. In my case 3 clicks on extension, one louder clack, almost a pop, on retract. I'm told that this too will go away as the joint is stabilized by muscle, tendon, connective tissue development and local swelling reduction At 8 weeks out, I'm still Click-Clacking although *some* times for short periods it's noticeably reduced if not quiet.
    

[*]Time line.

1. Initially, post surgery, you'll be dancing in kitchen. You'll feel GREAT. Then.. Then the surgery cocktail and more importantly, the nerve block will end and you'll find out what's in your future. P A I N. So don't get behind on the meds. Pain management is much better than pain retrieval.
   
2. Two weeks... swelling, ice, walking with a cane, wound maintenance. Staples out soon. In home PT.
   
3. Four weeks... swelling, ice, walking w/o cane. Staples are out, PT in town, can drive a car.
   
4. Four to Eight weeks... at 6 weeks was back to riding a DL650. At 8 weeks, now considering the FJR. My issue is 3 miles of (soft) dirt road. All surgery swelling in quad and calf gone. Local knee inflammation still exists. PT changed from flexibility to strength. Now at PT I get sweaty instead of just crying to mama as the Physical Terrorist makes your knee bend in positions it doesn't want to be in.
   

[*]Driving. My right knee was replaced, different if left. I decided to remove camper from truck so I had an automatic transmission. Good choice. Problem is the truck is 3500 Dodge dually e.g. high seats. So I got a milk crate, tied a rope to it... hold rope in hand, use crate as a step, use rope to fetch crate back into truck. It worked!

[*]Riding. See above. But..

1. 
   Some leg motions still hurt, most don't. Lifting bike to center stand no problem.
   
2. Off CS no problem either. Problem areas are mounting the bike while on CS e.g. 'swinging' the leg over the top case loads the inside knee with boot, riding gear weight and the leg no likee this.
   
3. On side stand, I still can't clear the seat with my boot heal; and I have to use this dismount as no way in hell is that leg clearing the top case.
   
4. No problem with not trusting the knee to hold the weight of bike or doing a 'foot stomp' should the boot hit sand or slippery surface. Factually, the joint is at max strength almost immediately after insertion into bone ID. Surgeon must use a fast-set epoxy..
   
5. On the DL650 I can post up using passenger pegs.. Which puts me into the perfect position to sit, raise, sit, raise, work the muscles. On a local ride a rider asked what the hell was I doing.. I replied getting both my phyical and mental therapy exercises done!
   

[*]I can feel the implant, tell I have metal in there. Sleeping... the left (good) knee got bruised when I was having a nightmare and slapped it with the bionic knee. Cold weather actually feels good, keeps the swelling down. Haven't had rain or hot weather to experience yet.

[*]Jacuzzi. I'm in now every morning. While there I do PT.. flat and flexion, flat and flexion. Afterwards, ice for 20 minutes.
[*]Ice - no more than 20 - 30 minutes per session per the PT doodes.
I hope this helps someone somewhere down the line..

Here's some video..

Right knee replacement video 2 hours after surgery..

Walking1 from dcarver220b on Vimeo.

https://vimeo.com/239284423

Walkin2 from dcarver220b on Vimeo.

https://vimeo.com/239284409

That's it for now. I gotta go work on Naomi's gas tank.

 

[FJReady]

Best of luck to you Don. Hopefully this recovery will fade to a distant memory in a few more weeks. I have a couple friends who are riders that had it done and they got back to normal fairly quickly. And both are over 60.

Good luck with Naomi too. Is that the bike you're putting the modified relay arm on?

Worried about all you CA folks dealing with fires..

And Merry Christmas.

 

[RenoJohn]

Wow. Phuck this getting old stuff sucks Don, but it does beat the alternative. At this hour my knees are good, but as you know it can change fast. When my time comes, I'll be taking your advice, I hope to avoid some of the cost and wondering if I can have first dibs on buying your old knee -the right one.

Thanks bud, let's cross paths soon. Race ya to the beer.

RJ

 

[K_Flyer]

Have two replacement knees, one three years old, the other two. Super happy with the results. If you are coming up for a replacement, go to the gym and build up those leg muscles, tendons, etc. My PT guy said I had the fastest recoveries he's seen and attributed it to pre-op workouts. Some click and clack noises but it seems others don't hear them.

When friends I haven't seen for a while ask how my knees are, I have to stop and think for a bit!

 

[thompsonian]

Good on ya DC! I'm on 3 years with both knees partially replaced. I agree to all the sentiments you listed! I also tell everyone I know who is considering a joint replacement to really work at the PT. Don't just do the motions. You're only going to help yourself heal better, stronger and faster!

 

[gregory]

Glad your "healing up" and +1 on pre replacement workout's Made a world of difference for my pops!

 

[hppants]

Wifey is now two weeks and two days post right knee total replacement surgery. Carver's comments seem to be spot on so far. Her two week visit was yesterday with the surgeon and I have to share this story. He sat on a stool in front of her and asked her to scoot up to the end of the chair. Then he simultaneously told her to extend her knee while he stuck his head and torso downward toward her. She almost kicked him in the head!!! He was not expecting that and I'm quite certain that he's done hundreds (if not more) of these surgeries. Tammy's at 110 degrees now, and working hard toward the promised land.

One thing she is experiencing is some unusual foot (arch) and lower shin discomfort (aching) at the end of every day. Surgeon and PT tell her the same thing - she spent years compensating for the bad joint by altering her walk, gait, etc. to minimize her pain. Now that she's re-learning how to walk correctly, these muscle groups are being used differently and they get sore. Makes sense to me.

She's 55 and the ortho surgeon tried everything to buy us some time - steroid shots, exercises, etc. The artificial knee has an average lifespan of 20-25 years and we were hoping to get to 60-ish, where she would likely only need the surgery once. Well, we ran out of options so she had the surgery and we are very pleased so far. She can't wait to get back on the tennis court!!

 

[harper]

Good on you for getting the knee replaced and plowing through the unpleasant recovery. You're a little behind Big John's and my recoveries, though. He did knee lifts with a Volkswagen tied to his leg a week after surgery. I pole vaulted 18 feet three days after mine. You'll catch up, though.

 

[Warchild]

This upcoming March will be the three year mark since I had both knees done (same operation). Rehab was a treat.

Even three years later, my knees still "click" when walking. It's two clicks per step. It "clicks" when I put weight on it, and "clicks" again when you take weight off.

I am sorta basically happy with them There is zero pain nowadays.

Here I am were the initial pain meds wore off:

Pretty blood bruising after 36 hours:

 

[dcarver]

Even three years later, my knees still "click" when walking. It's two clicks per step. It "clicks" when I put weight on it, and "clicks" again when you take weight off.

I'm hoping that's NOT my case, Dale. That's a bummer to hear.

...and you had two done at once? I don't, honestly, see how.

 

[bigjohnsd]

DC, you are doing fine, wait till the "Twingles" start.

Twingles are the reconnection of some of the nerves that were cut during surgery. I get these shooting zingers, not really painful, down my lower leg and especially on the outside of the right knee.

The Cement they use to glue in the titanium bits is actually Medical Grade Super Glue. I had my one-year checkup yesterday, the xray's show how the Super Glue really penetrates into the bone surrounding the Titanium Bits. The Doc showed me how they can go back in and replace the Polyethylene Wear Plates later on if needed in 20-25 years, much less invasive and much quicker recovery.

 

[dcarver]

Good on you for getting the knee replaced and plowing through the unpleasant recovery. You're a little behind Big John's and my recoveries, though. He did knee lifts with a Volkswagen tied to his leg a week after surgery. I pole vaulted 18 feet three days after mine. You'll catch up, though.

That's OK, I can kickstart a pahnead Harley....

DC, you are doing fine, wait till the "Twingles" start.Twingles are the reconnection of some of the nerves that were cut during surgery. I get these shooting zingers, not really painful, down my lower leg and especially on the outside of the right knee.

The Cement they use to glue in the titanium bits is actually Medical Grade Super Glue. I had my one-year checkup yesterday, the xray's show how the Super Glue really penetrates into the bone surrounding the Titanium Bits. The Doc showed me how they can go back in and replace the Polyethylene Wear Plates later on if needed in 20-25 years, much less invasive and much quicker recovery.

If they can do all that, then where the hell is the zerk fitting for grease jobs?

Hppants - good for your wife. She just has to keep after it. Great to hear she's doing well.

 

[101stpathfinder]

This is encouraging for me. I have been putting replacement off now for about 8 years since they told me I needed it.

The pain is getting to be too much.

Question for the Veterans; I was asked if I was former military (By the amount of wear on the knees) I'm kinda wondering

if the VA would help out on this with some benefits or disability?

 

[FJRay]

This is encouraging for me. I have been putting replacement off now for about 8 years since they told me I needed it.The pain is getting to be too much.

Question for the Veterans; I was asked if I was former military (By the amount of wear on the knees) I kinda wondering

if the VA would help out on this with some benefits or disability?

It's a long process cause the VA moves at a snails pace but if you stick with it and can document it's service related then you can get help. Your local VA clinic can provide you with contact info for the folks to get you started. You should get signed up for your VA benifits anyway.

 

[bigjohnsd]

This is encouraging for me. I have been putting replacement off now for about 8 years since they told me I needed it.The pain is getting to be too much.

Question for the Veterans; I was asked if I was former military (By the amount of wear on the knees) I'm kinda wondering

if the VA would help out on this with some benefits or disability?

You should have had a post service Physical at the VA, many of us did not

You have a County Veteran Service Officer, He/She can help you get through the paperwork to apply for VA Disability/Medical coverage.

PM sent

John

 

[08FJR4ME]

Somehow the military lost my sons medical records also. Sheeeeez He does have hearing loss and I am sure his knees will end up giving him issues down the road. Something about jumping out of planes with a 70 lb load isn't good for anyone.

After reading this I will do everything I can to not have surgery on any of my joints. It's a good thing I have a high tolerance for pain.

Dave

 

[harper]

After reading this I will do everything I can to not have surgery on any of my joints. It's a good thing I have a high tolerance for pain.Dave

Dave-

Not every knee replacement is a nightmare.What you hear are bad things about knee replacements. Most are success stories. People with strong knees and that are not overweight generally do well with them. I walked 1/2 mile day of surgery. I used a walker for six days because I was supposed to. It was a nuisance and got in the way. I talked my surgeon into letting me abandon the walker for a cane on my one-week check-up. I carried the cane with me...I didn't use it. I was left-over-right stepping stairs up and down in three weeks. I was two-stepping stairs in four weeks. That's when my physical therapist excused me.

Think about being in a casino, all the cheering, all the excitement. Those are the winners and there aren't very many of them but those are the people you hear. You don't hear anything from the people who are losing but they are in the majority. Now, interchange casino losers with knee replacement success stories and the casino winners with people who had bad experiences with knee replacement. Where's all the noise coming from?

 

[MEM]

Even three years later, my knees still "click" when walking. It's two clicks per step. It "clicks" when I put weight on it, and "clicks" again when you take weight off.

I'm hoping that's NOT my case, Dale. That's a bummer to hear.

...and you had two done at once? I don't, honestly, see how.

Knee replacement surgery is much more difficult to recover from than is hip replacement. I walked into an ortho room at shift change one day and was shocked to see a patient with one knee freshly done and the surgeon working on the other one. The response to my query of "why are we doing both knees today ?" was: "Because she agreed to stop smoking for one surgery, but not for two". What the f**k ?!

Yup, in Canada, our patients pretty much call the shots. (don't get me going ).

This patient was a woman - about 5'2" and 300 lbs. True story

 

[Tyler]

So Don, are you glad you had the replacement? Or is the alternative - where you were - better? Just curious..