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First time poster and knee osteoarthritis sufferer
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girleypearl posted:
This is my first post and I wanted to talk about my experience as well as respond to everhlpf. It's been about 2 years since you discussed some of your health concerns. I hope you are feeling better and have received some relief.

I was diagnosed with mild knee osteoarthritis about 2 years ago, and in both knees. I didn't take it seriously and didn't lose the weight nor did I exercise regularly. Earlier this year my right knee started bothering me and the orthopedic dr. suggested an MRI and then synvisc shots. He said I had medium arthritis in both knees. I wanted a second opinion before I let anyone put the material in my knees and I didn't like his bedside manner. Long story short by the time I found someone and insurance approved it, my left knee started hurting. I had a series of 3 shots in both knees. My right knee feels pretty good but I have to be careful. But my left knee keeps swelling up, lots of pain and I've now had two cortisone shots. My new orthopedic dr. (whom I like a lot) said that if my knee doesn't get better after the shot I had today then he wants to consider orthoscopic surgery. Although he said this surgery doesn't have a great success rate for people my age with my level of osteoarthritis -- he thought it had a 40% chance of helping my left knee. I'm home with ice and elevating my knee. My knee really hurts right now, and I don't know if it is because of the osteoarthritis or if it is the effects of the cortisone shot. I guess I'll know that in about a day or two.

Of course I'm scared, I don't' want surgery and I know that eventually I'll have a TKR. Which scares me even more! I've been lucky, most of my life I've been healthy, able to do whatever I wanted to physically. Now I'm always sitting, icing and elevating my left knee (or sometimes my right knee). I've applied for short term disability and luckily I live in California so I should be receiving income replacement for a while. But I want a high quality life. I want to travel, I want to feel free to clean the house or go out and do things without always figuring out will this hurt my knee, do I use knee braces, how long can I stand without damaging my knee further. I'm losing weight but of course you can't lose weight over night.

Does anyone know how difficult it is to go through rehab on a TKR? I was thinking maybe I should just go for it. How successful in general is a TKR? I'm concerned about rejection, infection and continued pain even after TKR. Any information on this or links to more resources would be very helpful.

I'm looking forward to discussions and hopefully I can also help others.

Karen (also known as girleypearl)
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Caprice_WebMD_Staff responded:
Hi Karen and welcome to WebMD,

While you're waiting for responses here, try also posting on our Knee & Hip Replacement Community for more feedback.
We must let go of the life we have planned, so as to accept the one that is waiting for us. ~Joseph Campbell
 
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Scott Zashin, MD responded:
Sorry about the knee. Some of the recommendations I give my patients are the following.. First of all, good for you on the weight loss! Every lb of weight lost is 4 less lbs on the knee. Even one lb helps. Also, if joint replacement is needed, less weight may help in the recovery and longevity of the replacment. Accupuncture may help pain from OA.Certain braces and shoe orthotics may shift the weight of the knee giving pain relief. In my book, Natural Arthritis Treatment, I discuss some natural supplements which have helped my patients with their joint health.Finally, your ortho is correct that patients with moderate to severe OA are less likely to get a benficial effect from arthroscopic surgery but I would defer to the ortho docs on the whether the benefits of a scope outweigh the risks and the specific benefits and risks of joint replacement.Possibly there is an ortho expert on WebMD who can help with those questions.
 
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Scott Zashin, MD replied to Caprice_WebMD_Staff's response:
Addendum: Medical therapy that I use for my patients include analgesics such as tylenol and prescription tramadol, a pain med. NSAIDS such as ibuprofen and naproxen are also commonly used.NSAIDS are also available as topical therapy such as Voltaren Gel which is a prescription and is applied directly to the knee..As always, it is recommended you discuss any over the counter treatment or natural supplement with your treating physician.
 
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Harmony1623 responded:
Hello Karen,
I'm new to the community as well but wanted to share my experience thus far with having advanced stage OA in my right knee. I have had an arthroscopy and am waiting for Hyaluronate injection therapy. In the meantime, I use
  • ice for swelling
  • moist heat
  • elevation of the knee
  • rest, when needed, for pain/swelling management
  • I use a cane so as to not put as much pressure on the joints
  • I use a knee brace/sleeve, which aids in stabilizing the joint and as an added bonus I have found it provides a bit of warmth to the knee.
  • orthotic shoes for alignment
  • my pain meds (OTC)which I take only as needed, consist of acetimenophen due to a sensitive stomach.
  • I try to do gentle stretching movements, but due to the severity of the arthritis in the right knee, it's very painful.

Regarding your questions surrounding the amount of standing, activity, etc., I would consult with your orthopedic doctor on this. They will more than likely give you a program designed specifically for you in mind. I have also found that my left knee is now feeling the impact from having to rely more on it-I am extra careful now with this knee, especially now that I know what to look/feel for. I wanted to also add that I use relaxation techniques that include sound therapy, meditation, visualization and centeredness. These have aided in my overall well being while on this journey. I wish you all the best and hope this helps.
 
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janetsg responded:
Hi Karen, I had my left knee replaced last January and my right knee replaced at the end of March. Before I agreed to the surgery (which I put off for 15 years!), I had years of pain, sleeping with pillows under my legs and painful synvisc shots. With the first knee, I went to inpt rehab aftwerwards (which I hated, but should have done the 2nd time) and then had in-home rehab and then outpt. rehab. I did the exercises all the time. The 2nd TKR was a lot tougher. I lost a lot of blood during the surgery and was very anemic & thus exhausted all the time and let up on exercises. It is very painful -- I used to say that if I could only have a day off (from the pain) --- but I believe it is worth it in the end. I took so much Percoset that I worried about becoming addicted, but the pain let up and I just stopped one day (switched to Tylenol). I can go up & down stairs (which I couldn't do for 25 years!!) and walk for more than 2 miles a day. The surgery is the beginning of the process -- the rest is up to you -- if you don't really do rehab, you will limp and your knee won't do what you want it to do. Please let me know if you want any other information.
 
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lknightb responded:
Hi Karen,

I just had a tkr in May. It made all the difference in the world. It's still a little stiff but I exericise most every day. I should have stayed in the hospital for their 2 week rehab but I just wanted to come home. Now I have to have the same thing done to my right knee which will be worse because I can't sneak and drive like I did with the left knee. Really I came through it great. I got rid of the walker after a few days and used the cane for about a week and then nothing. The only thing that bothered me is for some reason my restless legs got worse after the surgery and now I have to take medication for that. Try to exercise and keep the weight down and it will be easier. From Linda
 
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pgt1956 responded:
Karen,

I had a total TKR on my right knee almost 2 months ago. I have a TKR scheduled for May 28th, 2013 on my left knee. As janetsg commented in her post, I also put my surgery off for over a decade. I, like you, and most everyone else with severe OA, started out with: (1)cortisone shots; (2) scopes of both knees(the rt. one twice); eventually (3)supartz shots (similar to synvisc);none of the above worked, which finally led to TKR. Both knees were SO bad, that my surgeon let me decide which one to have surgery on first.

To build up my body (and my mental state), I joined a Healthy Steps/Silver Sneakers at my local rehab center. I mostly swim, since I haven't been able to walk, sit, drive, etc. in any kind of normal fashion in YEARS.

Regarding my surgery, I am progressing very well. The main word to keep in mind: patience. You must, must, MUST go religiously to your therapy, and work as hard as you can both there and at home on your own. I'm a retired school teacher, so I don't have to worry about going back to work. There would be a whole new scenario if I thought I had only a small amount of time to recup. My physical therapist told me last week that a TKR attends 3 months of pt 3 times/week. I have land pt twice/week and water therapy once/week.

I think/know that the main reason I feel positive about my entire situation is the fact that I trust and respect ALL of the medical team that is taking care of me. From my much respected, acclaimed, and just a great Christian surgeon(someone that I really wanted in the OR with me); to his staff; to the surgical hospital & staff; all the way to all of the staff at the rehab.

As was also mentioned in a previous post, you start out with a walker, progress to a cane,and then eventually . . .you're walking . . .slowly . . .on your on. Every little advancement is a HUGE milestone (believe me, I felt how a little child feels when I was finally able to pack away my portable potty and use my own bathroom facilities - - -including the shower!) ; D

There is A LOT to take into consideration, and everyone has to choose and make their own decision. I hope that I helped in some way, and if there is anything that I can help with (just from my own experience), let me know.

Good luck and I'll keep you in my prayers.

Paula (also known as pgt1956)


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