Total Knee Replacement 12/4/18

[golf4less]

I usually head to sunny, warm southwest Florida this time of year. Instead I will be heading  to the hospital on 12/4 to have my right knee replaced.  I watched a video of the procedure, so I know what’s coming. (terrible idea BTW) 

Any forum members been through this? Hoping to be able to head south, driving 1300 miles, in 6-8 weeks. Achievable???

Lets here your stories. 

[Nickbarb]

Total or partial?


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[Nickbarb]

Total. I’m having a partial on my right knee on the 18th. Having already had one on my left in 2014 I’m prepared for it. I plan to be back to work in two weeks (desk duty) and in the field in three weeks. I was playing golf after eight weeks with the left knee and I admit I pushed a little bit more than I should of.


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[Derboesekoenig]

Why would you watch a video of it??? Hahaha that is seriously the worst idea ever. Well no going back now

[golf4less]

21 minutes ago, Nickbarb said:

Total or partial?


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Total

[golf4less]

16 minutes ago, Derboesekoenig said:

Why would you watch a video of it??? Hahaha that is seriously the worst idea ever. Well no going back now

That’s what the surgeon said, can’t unwatch it now ?

[golf4less]

22 minutes ago, Nickbarb said:

Total. I’m having a partial on my right knee on the 18th. Having already had one on my left in 2014 I’m prepared for it. I plan to be back to work in two weeks (desk duty) and in the field in three weeks. I was playing golf after eight weeks with the left knee and I admit I pushed a little bit more than I should of.


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Because it’s my right knee, Doc says 6 weeks minimum to drive safely. I’m hoping to push the envelope and head south as soon as my rehab is done, approximately 5 weeks after surgery 

[SigmundChurchill]

37 minutes ago, golf4less said:

I usually head to sunny, warm southwest Florida this time of year. Instead I will be heading  to the hospital on 12/4 to have my right knee replaced.  I watched a video of the procedure, so I know what’s coming. (terrible idea BTW) 

Any forum members been through this? Hoping to be able to head south, driving 1300 miles, in 6-8 weeks. Achievable???

Lets here your stories. 

I have given anesthesia for many total knee replacements, however, I dont see the patients once they leave the hospital,  They go to the surgeon’s office for follow ups, so I cant tell you if that drive is achievable in 6-8 weeks.  My biggest worry about it would be sitting in the same position for such a long time and forming blood clots in the legs that can break off and travel to the lungs, which then becomes a major problem.  I dont know if 6-8 weeks post op is enough time, but I would definitely clear it with your surgeon before doing it.

Other advice I would give is to get a nerve block with an indwelling catheter.  Without a catheter is a good alternative that will keep the pain at bay for about 1 day, but if they are skilled at doing the block with a catheter, they can hook up a pump with pain medicine in it that can keep giving youn pain medicine for several days.  You wont require nearly as much narcotics with the nerve block.

 

Also PT.  Do it as scheduled and dont slack on it if you want to regain the normal movement of the joint.  As a fellow golfer, I know how important that will be to you later on.

 

Lastly, please, don't ever watch a YouTube video of your surgery again.  It makes my job as an anesthesiologist much more difficult.  The people that watch these videos come in extra nervous, with increased heart rates and blood pressure for me to deal with.

[golf4less]

4 minutes ago, SigmundChurchill said:

I have given anesthesia for many total knee replacements, however, I dont see the patients once they leave the hospital,  They go to the surgeon’s office for follow ups, so I cant tell you if that drive is achievable in 6-8 weeks.  My biggest worry about it would be sitting in the same position for such a long time and forming blood clots in the legs that can break off and travel to the lungs, which then becomes a major problem.  I dont know if 6-8 weeks post op is enough time, but I would definitely clear it with your surgeon before doing it.

Other advice I would give is to get a nerve block with an indwelling catheter.  Without a catheter is a good alternative that will keep the pain at bay for about 1 day, but if they are skilled at doing the block with a catheter, they can hook up a pump with pain medicine in it that can keep giving youn pain medicine for several days.  You wont require nearly as much narcotics with the nerve block.

 

Also PT.  Do it as scheduled and dont slack on it if you want to regain the normal movement of the joint.  As a fellow golfer, I know how important that will be to you later on.

 

Lastly, please, don't ever watch a YouTube video of your surgery again.  It makes my job as an anesthesiologist much more difficult.  The people that watch these videos come in extra nervous, with increased heart rates and blood pressure for me to deal with.

Watching the surgery was a bad idea. In my defense, I watched it a year or so ago, before I knew it would be happening to me. Yes, the doctor said I would need to stop every 3-4 hours and walk around to help prevent any clots. I will definitely talk it over with him before hitting the road. Thank you for the advise on the catheter.

[RyviaUSA]

Sorry to hear about the knee replacement.  I haven't had mine yet, but I'll try to help.  I've been digesting everything I can on total knee replacements for the last 1+ year. 

My story:  I'm not even 40, and my left knee is a raging piece of shit.  I blew out my ACL in college.  It was repaired then ripped again.  I tore meniscus 3 times.  Currently, my left knee has moderate arthritis and no ACL.  I'm doing everything I can to postpone a replacement as long as possible.  I figure I have maybe 2-4 years depending on how well I can keep it moving and keep my leg muscles strong.  

The good news is that a total knee replacement today, in America, is about the most successful surgery there is.  Countless knee replacements are done every year, and the amount is rising every year.  Is your surgeon a knee replacement specialist?  You want a guy or gal that does 200+ knee replacements a year.  They'll have you in and out of the OR in less than 2 hours.  It's amazing.  The knee should also last you 20-30 years as long as you aren't careless and decide you are going to go back to hardcore basketball or tennis or running marathons.  Be good to your new knee.  It's tough, but it's not invincible.  

The bad news it that the recovery is different for everyone.  Whether you're 30 or 90, thin or fat, tall or short, you have no idea how long the recovery will take.  Everyone is different.  You may feel amazing by 4-6 weeks.  It may take 3-4 months.  There's no way to predict it.  You can't beat it by pushing yourself in therapy.  In fact, overdoing it in therapy may make you swell up and prolong recovery.  Do not let anyone force your knee during recovery.  Discomfort is okay.  Sharp and brutal pain is not okay.  

I recommend consuming all the knowledge on this forum:  https://bonesmart.org/forum/categories/knee-area.7/?source=main-nav - it's amazing how much info that place provides. 

Some general tips I've read:

• Stop alcohol and cigars now (the horror I know, but don't worry pain pills are coming!)
• Ice that knee like you are trying to acquire frost bite.  Ice will be your friend for the first few months.  
• Narcotics will also be your friend.  You'll need them for a while.  Are you okay with the normal oxycodone/vicodin type stuff?  For me, it constipates me to the point of wanting to murder someone.  Try to stock up on fiber and stool softeners.  Drink plenty of water and stay away from bread, cheese, etc.
• Rest, ice, elevate, etc.  Take it easy and nap/sleep a lot.  Don't rush it.  
• Expect pain, but it should be manageable.  You may have a few weeks of sleepless nights.  The aches and pains may keep you up.  

If you have any other questions, I'll try to help as best I can coming from someone who hasn't done it yet but has read mountains.  I wish you the best!  6-9 mos from now your new knee will feel like a million bucks.  

As for your original question, you won't know if you can make the drive at 6-8 weeks until you're there unfortunately.  Hope for the best, but plan to cancel if need be.  

[Dozerhead]

I rehab total knees quite frequently and I think you need to give your knee more time to heal. Sitting in a car for any period of time is tough on a knee replacement because the knee itself will stiffen up quickly and swelling can be an issue an issue for 2 to 3 months post surgery. If it was your left knew I might have a different opinion. What if you are still using pain medication when you start your trip? I would definitely advise driving for sure. Many patients are usually off prescription pain meds after 4-6 weeks but everyone is different. As mentioned earlier, do your PT and be compliant with the exercises. Either way, I wish you luck 

[RyviaUSA]

2 minutes ago, Dozerhead said:

I rehab total knees quite frequently and I think you need to give your knee more time to heal. Sitting in a car for any period of time is tough on a knee replacement because the knee itself will stiffen up quickly and swelling can be an issue an issue for 2 to 3 months post surgery. If it was your left knew I might have a different opinion. What if you are still using pain medication when you start your trip? I would definitely advise driving for sure. Many patients are usually off prescription pain meds after 4-6 weeks but everyone is different. As mentioned earlier, do your PT and be compliant with the exercises. Either way, I wish you luck 

Are you in physical therapy?  You guys are the best.  Been to PT so much for my knee, both after surgery and to manage arthritis.  I still do an exercise regime every other day to keep my hips and legs strong.  

[Dozerhead]

Yes, I am. Your post was spot on. Sorry about your knees. I recently had a 31 yo woman who had her left knee replaced. The technology has come along way.

[Bagman]

Total Hips and Knees, my world. 

The average surgery time is not 2 hours, but closer to 1:20.  We average 80 minutes per surgery.  The surgery is becoming so common that it is being moved to outpatient surgery.  No need to spend a night in the hospital.  The difference between a fast recovery and a long recovery is the exercises.    Do them, do more than what is recommended and you will recover quickly.

As for the video, most can take it until the implant is put in.  Cutting into the bone where the implant will go is not as bad as when the implant is placed in and a hammer is used to drive in the implant.  It just seems so unnatural.  I've seen people throw up at that part. 

[golf4less]

1 hour ago, RyviaUSA said:

Sorry to hear about the knee replacement.  I haven't had mine yet, but I'll try to help.  I've been digesting everything I can on total knee replacements for the last 1+ year. 

My story:  I'm not even 40, and my left knee is a raging piece of shit.  I blew out my ACL in college.  It was repaired then ripped again.  I tore meniscus 3 times.  Currently, my left knee has moderate arthritis and no ACL.  I'm doing everything I can to postpone a replacement as long as possible.  I figure I have maybe 2-4 years depending on how well I can keep it moving and keep my leg muscles strong.  

The good news is that a total knee replacement today, in America, is about the most successful surgery there is.  Countless knee replacements are done every year, and the amount is rising every year.  Is your surgeon a knee replacement specialist?  You want a guy or gal that does 200+ knee replacements a year.  They'll have you in and out of the OR in less than 2 hours.  It's amazing.  The knee should also last you 20-30 years as long as you aren't careless and decide you are going to go back to hardcore basketball or tennis or running marathons.  Be good to your new knee.  It's tough, but it's not invincible.  

The bad news it that the recovery is different for everyone.  Whether you're 30 or 90, thin or fat, tall or short, you have no idea how long the recovery will take.  Everyone is different.  You may feel amazing by 4-6 weeks.  It may take 3-4 months.  There's no way to predict it.  You can't beat it by pushing yourself in therapy.  In fact, overdoing it in therapy may make you swell up and prolong recovery.  Do not let anyone force your knee during recovery.  Discomfort is okay.  Sharp and brutal pain is not okay.  

I recommend consuming all the knowledge on this forum:  https://bonesmart.org/forum/categories/knee-area.7/?source=main-nav - it's amazing how much info that place provides. 

Some general tips I've read:

• Stop alcohol and cigars now (the horror I know, but don't worry pain pills are coming!)
• Ice that knee like you are trying to acquire frost bite.  Ice will be your friend for the first few months.  
• Narcotics will also be your friend.  You'll need them for a while.  Are you okay with the normal oxycodone/vicodin type stuff?  For me, it constipates me to the point of wanting to murder someone.  Try to stock up on fiber and stool softeners.  Drink plenty of water and stay away from bread, cheese, etc.
• Rest, ice, elevate, etc.  Take it easy and nap/sleep a lot.  Don't rush it.  
• Expect pain, but it should be manageable.  You may have a few weeks of sleepless nights.  The aches and pains may keep you up.  

If you have any other questions, I'll try to help as best I can coming from someone who hasn't done it yet but has read mountains.  I wish you the best!  6-9 mos from now your new knee will feel like a million bucks.  

As for your original question, you won't know if you can make the drive at 6-8 weeks until you're there unfortunately.  Hope for the best, but plan to cancel if need be.  

Thank you for the link to bonesmart, I just briefly looked over the site, very informative. I do have a back up plan to get south and may opt to have one of my employees drive my vehicle, while I fly south and get him a ticket back home. I’ve purchased a Ossur Cold Therepy machine for the icing and will follow my PT instructions to a tee. I have a Temperpedic adjustable bed and will hopefully be sleeping with my legs elevated and using it periodically to reduce swelling. I am aware that even with all that I will be doing, it’s possible that I may have an empty condo in Ft Myers, FL this year year and will spend a very cold golf less winter in Michigan. 

[golf4less]

17 minutes ago, Monterey said:

Total Hips and Knees, my world. 

The average surgery time is not 2 hours, but closer to 1:20.  We average 80 minutes per surgery.  The surgery is becoming so common that it is being moved to outpatient surgery.  No need to spend a night in the hospital.  The difference between a fast recovery and a long recovery is the exercises.    Do them, do more than what is recommended and you will recover quickly.

As for the video, most can take it until the implant is put in.  Cutting into the bone where the implant will go is not as bad as when the implant is placed in and a hammer is used to drive in the implant.  It just seems so unnatural.  I've seen people throw up at that part. 

The whole procedure is very unnatural, but necessary. Hopefully the sound of the hammering doesn’t wake me up ?

[Philc2001]

Two friends of ours had full knee replacements. One of them had both knees done, about 1 year apart. Both were overweight when they had the surgery, and both had extended recovery time. One of the two friends was dedicated to his PT, which helped his recovery, but due to his obesity he had a hard time with it. He is in sales so he spends the bulk of his day in a car on a daily basis driving to clients and taking orders, so that did not help, even though it was his left knee. The other person has a desk job, and was not as motivated to do her PT, so it definitely took her longer to get back to driving or walking semi normal. 

If you are motivated and you're dedicated to the therapy, you should be able to recover quickly enough to go on your trip. But I would be fearful of having complications, especially away from your therapist and your surgeon. If you are adamant on going south, perhaps flying might be a better choice than driving. Maybe you can rent a car down there, rather than driving down. 

[RyviaUSA]

10 hours ago, Dozerhead said:

Yes, I am. Your post was spot on. Sorry about your knees. I recently had a 31 yo woman who had her left knee replaced. The technology has come along way.

Thanks!  Luckily, it's only the left.  The right (knock on wood) has never been damaged.  Agree on the tech.  They used to refuse anyone under 50/60.  I'm hoping we eventually get a 50yr knee.  Hips are doing a lot better as far as longevity is concerned.  

8 hours ago, golf4less said:

Thank you for the link to bonesmart, I just briefly looked over the site, very informative. I do have a back up plan to get south and may opt to have one of my employees drive my vehicle, while I fly south and get him a ticket back home. I’ve purchased a Ossur Cold Therepy machine for the icing and will follow my PT instructions to a tee. I have a Temperpedic adjustable bed and will hopefully be sleeping with my legs elevated and using it periodically to reduce swelling. I am aware that even with all that I will be doing, it’s possible that I may have an empty condo in Ft Myers, FL this year year and will spend a very cold golf less winter in Michigan. 

You'll do great.  Don't worry!

Do you have friends/family to help?  Lots of people say they get the "post op blues."  Don't let the winter bum you out from Dec-Feb.  

Prep your house.  Get rid of the slippery stuff like rugs.  Be careful during a Michigan winter when outside.  Don't slip and fall!

Pro tip:  I hear a raised toilet seat is amazing for recovery.  I'll be getting one for sure, since I'm tall already and standing up from a low toilet seat sucks with a bad knee.

[CigarAsh]

I had bilateral total knee almost exactly 2 years ago. Yes, I did both at the same time. So glad I did because I just got it over with.   My knees were a mess from a lifetime of soccer injuries. Had 3 different knee surgeries in my younger days to clean out torn cartilage. Had a blown ACL that I never had repaired - just rehabbed and strengthened and went about life. I continued to play soccer until about 50, continued playing racquetball and snow skiing. Never let it slow me down. But mid 50s, the wear and tear finally took its toll and I got to the point where I couldn't walk up and down the hills necessary to even enjoy a round of golf. My friends told me it was painful just watching me try and get around. So I went all in and got both replaced at same time. The change it's made in giving me back my quality of life and mobility has been worth the couple months of pain and rehab torture I went through.

The nerve block is an excellent idea. They did it for me and gave me about 36 hours worth of no pain before it wore off. The first night after it wore off was pretty miserable until they got my pain meds dialed in properly (dosage and frequency).  Careful with the pain management afterwards. The heavy opioids are effective but a little addictive. And they'll give you crazy constipation - take a lot of laxatives. 

If you can - go into the surgery in the best shape you can manage, it will help you in the rehab stage.  I spent 3 days in the hospital, was discharged home and had a home health rehab specialist come into the house every day for 2 weeks. I told her I'd do everything she told me to do and more - I wasn't going to half ass the rehab and ruin the surgery outcome.  8 days after the surgery, a friend picked me up and took me to my favorite cigar place for an afternoon just to get me out of the house. I walked in and out with no assistance. It was slow and kinda goofy looking, but I wasn't going in there with a walker!

After about 10 days, I was able to get up and down the stairs in my house (about 15 steps up to the man cave). Once I hit that milestone, the rehab push intensified and my strength and stamina really started coming back. I went back to work at 3 weeks for half days or so - as much as I had strength for. I was driving myself to work and to rehab - short drives so no long periods of inactivity.

About 10 weeks after the surgery, I was on the golf course (driving range only - it was a nice February day) and hitting golf balls. Took it easy just because I didn't know what to expect but didn't have any pain from it.

At 12 weeks I considered myself pretty much over the worst of it and was really happy with the outcome. 2 years out now and I'm doing all the things I love - but have traded in racquetball for pickleball (a little slower paced). 

Good luck with your surgery - work hard and come back strong!

P.S. I've got a a gruesome picture of my knees when they took off the bandages before all the staples came out. If you want an idea of what it'll look like, I'll send to you. Don't think the rest of the board really wants to see that!

 

[golf4less]

Surgery yesterday, went well. Old knee sent to the trash heap and the new knee up and running. PT today and if all goes well, I’ll be home for dinner. 

[RyviaUSA]

2 hours ago, golf4less said:

Surgery yesterday, went well. Old knee sent to the trash heap and the new knee up and running. PT today and if all goes well, I’ll be home for dinner. 

Glad you're out of surgery!  Good luck on the recovery, and drop us updates every few days.

Remember, this is a marathon.  The new knee will take a year+ to fully heal, although within 6-12 weeks you should hit 90%+ feeling good.  

[Puros Y Vino]

Congrats and best of luck on the recovery. I've had arthroscopic surgery on my left knee a little over 15 years ago to clean up a torn meniscus.  Operation was free, but so was the waiting time.  About 2 months.  But the surgery was done in under and hour and within a month, my knee and the muscles in that leg went back to normal.  Not a fond memory, but well worth the effort, wait and pain. 

[Ken Gargett]

what a depressing thread. i'm told the right knee needs replacing. i am in no hurry. not a specific accident. just many years of wear and tear. was a wicketkeeper and a hockey goalie so years of up/down/up/down. 

not looking forward to it. 

good luck with the recovery. 

[RyviaUSA]

3 hours ago, Ken Gargett said:

what a depressing thread. i'm told the right knee needs replacing. i am in no hurry. not a specific accident. just many years of wear and tear. was a wicketkeeper and a hockey goalie so years of up/down/up/down. 

not looking forward to it. 

good luck with the recovery. 

Just get it replaced before it starts to slow you down.  The stronger you go in to surgery, the easier the recovery.  Some people wait until they can barely walk, and then all their leg and hip muscles deplete to nothing.  Recovery is not fun for them.  

[Gandolf565]

You will be good to go in 6-8 weeks. No problem.

Just make sure and do the physical therapy as prescribed. It will be uncomfortable at first but a necessary evil.

I had mine done the week before Christmas last year, was back to work after 3 weeks using a cane. I ditched the cane after the fourth week.

I commute an hour each way, and did an 8 hour trip mid January with no major problems. The biggest problem I experienced after ditching the cane was sleeping. Benadryl helps.

Good luck!

Allen