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Should I or shouldn't I - Total Knee replacement
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BostonSuSu posted:
I have severe osteo in both hips and knees as well as severe stenosis. I have had 2 successful hips replaced and now the attention is on my knees. My left knee has, in the past, been quite painful and is severely restricted - unable to straighten it out and therefore walk with a limp. However, the pain has been less in the past few months. I am already on pain meds for my back.

My quandry is that I have heard that the only reason to have surgery is to reduce pain - and that the contracture is not a reason to replace the joint. But I am concerned that postponing the surgery will contribute to more contracture and therefore reduce my ultimate recovery of ROM.

I am only 55 years old and want to return to some semblance of normalcy. The posts in this board about post TJR pain and swelling are frightening me.

Any ideas? To operate now (already have surgery date) or wait until pain returns (possibly having to wait 4-6 months for a surgery date).
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DUKE MEDICINE
Michael P Bolognesi, MD responded:
Most people tend to develop a flexion contracture as the arthritis in the knee progresses. It sounds like this is what you are describing.... your knee no longer fully extends and stays somewhat bent and this makes walking a challenge. This flexion contractures should be addressed at the time of surgery. The goal for the surgeon is to resotre full extension to the knee. There are specific techniques that the surgeon can use during the surgery that should allow this to occur. It is likely that the pain will return as the arthritis advances. The decision to have surgery is a hard one but the procedure is elective and that is why you are not likely to ever come across a surgeon that will tell to have too have it or that it "is time to do it". We tell patients to think about how much their quality of life and function are truly affected and make decision based on those factors.
 
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BostonSuSu replied to Michael P Bolognesi, MD's response:
Does the degree of contracture have an impact on the post-surgery recovery and return of full ROM?


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