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Another TKA Surprise

Ed_Wischmeyer

Ed_Wischmeyer

Well Known Member
If you already know what TKA stands for, condolences -- it stands for Total Knee Arthroplasty, or knee replacement. Actually, I think that the "p" could be replaced with a "b" and it would be more descriptive. Mine was four weeks ago yesterday, right knee, and I'm just now getting strong enough to go places (as a passenger) and do things other than visit the PT clinic.

Previous preparations for first flight post-surgery included getting comfortable flying from both seats, and buying a little folding step stool -- a really great idea from VAF.

So this morning, I took my first drive. Once around the block, no traffic, slow and careful, in my Kia Stinger. About a quarter mile from home came the surprise, as my quads and glutes all started whimpering. Since the Stinger and the RV-9A seating positions aren't all that different, this means that I will also need to adjust to those seating positions. Fortunately, I've got two full months before planned departure to Oshkosh.

Today's good news is that I cut my Tylenol consumption to half of maximum daily dose. The bad news, one part of it, is that after the surgery, there are no days off from pain.
 
Ed_Wischmeyer said:
If you already know what TKA stands for, condolences -- it stands for Total Knee Arthroplasty, or knee replacement. Actually, I think that the "p" could be replaced with a "b" and it would be more descriptive. Mine was four weeks ago yesterday, right knee, and I'm just now getting strong enough to go places (as a passenger) and do things other than visit the PT clinic.

Previous preparations for first flight post-surgery included getting comfortable flying from both seats, and buying a little folding step stool -- a really great idea from VAF.

So this morning, I took my first drive. Once around the block, no traffic, slow and careful, in my Kia Stinger. About a quarter mile from home came the surprise, as my quads and glutes all started whimpering. Since the Stinger and the RV-9A seating positions aren't all that different, this means that I will also need to adjust to those seating positions. Fortunately, I've got two full months before planned departure to Oshkosh.

Today's good news is that I cut my Tylenol consumption to half of maximum daily dose. The bad news, one part of it, is that after the surgery, there are no days off from pain.
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Hang in there. A friend went through this recently and reported a similar post-op experience. But it DID get better and he was super happy with the end result. See you at OSH!!
 
Are you able to take anti-inflammatory medications? Aleve; Advil? There can be restrictions for these such as previous stomach ulcer, blood thinners, cardiac issues other things. Sometimes orthopedists don't want you to take them because they might slow healing. Not been conclusively shown to do that. Follow your doctor's recommendations. IMHO....
 
Dugaru said:
Hang in there. A friend went through this recently and reported a similar post-op experience. But it DID get better and he was super happy with the end result. See you at OSH!!
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Thanks for the encouragement! I’m counting on a great recovery, but there’s lots of work to get there.
 
My wife has had two knee replacements, and a hip (30+ years K9 SAR ) It's worth the temporary rehab and some pain; she was even able to go skiing and hunt for elk! Oh, and help drag my elk off the mountain too!



Elk retrieval.jpg Kubota Elk Hanging.jpg
 
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Roadjunkie1 said:
Are you able to take anti-inflammatory medications? Aleve; Advil? There can be restrictions for these such as previous stomach ulcer, blood thinners, cardiac issues other things. Sometimes orthopedists don't want you to take them because they might slow healing. Not been conclusively shown to do that. Follow your doctor's recommendations. IMHO.
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Celebrex, one per day prescribed. Didn’t seem to do much when I was taking it months ago for spinal issues. My body seems to be unresponsive to drugs. Better that than prone to addiction.
 
The Cox-2 inhibitors like Celebrex have been problematic through the years due to the potential for serious cardiac side effects. They should be used with caution, but are prescription-only so your doctor should know that. Meloxicam (Mobic) is more commonly used around here. Personally, I see NSAIDS as being only "sort of effective" in the treatment of post-op pain. More commonly they're used as part of multi-modal pain management, designed to mitigate over-prescription of narcotics.

I had a bilateral knee replacement about 15 years ago (both knees at the same time). I was back at work in 30 days, didnt' find it to be too disabling and not terribly painful (was done at the Mayo Clinic). The Mayo Clinic doesn't really emphasize post-op physical therapy after knee replacement. I went to PT for one visit only. They told me "work on bending your knees". More recently, my original knees were both explanted and revised (infection/sepsis) which was a much bigger deal and laid me up for a couple of months. Was not fun.

A lot of post-op knee or hip replacement pain goes back to the technique and precision of the surgeon. I'm a firm believer in the difference between a general orthopedist doing hips and knees compared to a surgeon who has done a post-graduate Fellowship in hip and knee reconstruction. The joint replacement orthopaedists around here do a knee in less than 30 minutes, even when using the Velys robot, and usually as an overnight stay, occasionally outpatient. I recommend that people choose their surgeon carefully.
 
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I had a left TKA five years ago and the results were phenomenal. I'll pass on the best advise I got from a friend who had both done a year apart and confirmed by my PT. Concentrate on extension and flexion during rehab. Spend the effort and pain now for full mobility downstream. It is extremely hard and painful to try to improve it after rehab. My left is better than ever and now much stronger than my right. Good luck with the recovery!
 
gyoung said:
I had a left TKA five years ago and the results were phenomenal. I'll pass on the best advise I got from a friend who had both done a year apart and confirmed by my PT. Concentrate on extension and flexion during rehab. Spend the effort and pain now for full mobility downstream. It is extremely hard and painful to try to improve it after rehab. My left is better than ever and now much stronger than my right. Good luck with the recovery!
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4.5 weeks post surgery, flexion is 135 degrees with the therapist pushing as hard as I can stand the pain. 129 when I use just my leg muscles. Extension is two degrees, goal is zero, and hurts like you know what. We’re on the same page. Thanks for the encouragement!
 
I had my Rt knee replaced 18yrs ago. Pain during the 1st few weeks was horrible and didn't get better when I had to go back to work. My office was on a 3rd floor and the building was very old so there were no elevators. I asked my Doctor for a note so I could get a temporary office on the 1st floor. He refused and told me walking up and down stairs was the best PT he could prescribe. I was angry but did as he told. Within a month I could go up and down the stairs with ease and eventually regained 100% of my pre surgery mobility. The knee has not bothered me at all ever since. Hang in there!

BTW, I got the Doctor hooked on flying. He got his private, instrument and commercial pilot's license about 15yrs ago. He built and flies a beautiful Lancair out of KSSI, just down the road from you. So I guess you can say I got my revenge. ;)
 
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As all the joints and muscles were jousting for prominent in th new knee new order, the SI joint on the other side popped loose while I was sitting still in a chair. Extreme pain developed, but fortunately the clinic will work me in this afternoon instead of a tw week wait. I don’t mind when the knee hurts, but resent the volunteer efforts by other body parts.
 
Much too long for full disclosure, but I got shots in both SI joints this afternoon. Insert needles, take X-ray, reposition needles, repeat as required Local anesthesia should work the rest of the day, steroids to take over afterwards. Looking forward to getting back to healing the knee. And all its neighbors.
 
MacCool said:
I recommend that people choose their surgeon carefully.
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This is very good advice, the challenge is that it's hard for someone not in the business to know a good surgeon from a bad one. For my knee (only an ACL), I found the surgeon that does the knees for the local professional soccer team - he was awesome, and so is my knee. I literally used nothing more than a few NSAIDs post-op. Was back at my office job on Monday after a Friday operation.

I can still climb into my RV like a 20 year-old, shame I can't do everything else like when I was 20!
 
rv8ch said:
This is very good advice, the challenge is that it's hard for someone not in the business to know a good surgeon from a bad one. For my knee (only an ACL), I found the surgeon that does the knees for the local professional soccer team - he was awesome, and so is my knee. I literally used nothing more than a few NSAIDs post-op. Was back at my office job on Monday after a Friday operation.

I can still climb into my RV like a 20 year-old, shame I can't do everything else like when I was 20!
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My surgeon was universally acclaimed by informed friends in the local medical community, and many other friends reported good results. In fact, people fly from Europe to small city Savannah for him to do their TKA.

Good advice for sure, and I have been blessed in so many ways.
 
rv8ch said:
This is very good advice, the challenge is that it's hard for someone not in the business to know a good surgeon from a bad one. For my knee (only an ACL), I found the surgeon that does the knees for the local professional soccer team - he was awesome, and so is my knee. I literally used nothing more than a few NSAIDs post-op. Was back at my office job on Monday after a Friday operation.

I can still climb into my RV like a 20 year-old, shame I can't do everything else like when I was 20!
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A good place to start is a review of your prospective surgeon's credentials....a review of their training (which is publicly available). Post-residency subspecialty training in an accredited one-year Fellowship program is an important component in assessing those credentials. If one is going to get a joint replaced, I think that they should maximize their chance of success by finding someone whose sole career goal is replacing joints, rather than the general Orthopaedist who does those operation as only a part of their practice. The important questions of "how many has he/she done?", or "how were they trained to do this operation?", "and who trained them?" are all less of a mystery if one selects their surgeon based on the extent and the nature of their training relative to the operation that they're going to perform on you. "Universal acclamation" is a rather slippery credential and one that I'm always skeptical of.

A lot of surgeons elect not to do post-graduate Fellowship training, and there's no rule that says they have to. Those surgeons have just finished 9 years of education after their college degree, the last 5 of which are grueling hours, stressful work, for $50K- $60K per year and crushing educational debt that they have to pay off, so an extra year of that is a difficult choice to make, especially for a young family. Not to mention the fact that Fellowships are highly competitive, and only the better residents get a shot. Those surgeons that do are committed to performing those complicated operations to the highest standards, and are trained to do so. Personally, if I'm going to have an operation (and I've had a few), Fellowship training is the first thing I look for in selecting who's going to do it.

college.mayo.edu

Adult Reconstructive Surgery, Lower Extremity (Hip and Knee) Fellowship (Minnesota) - Residencies and Fellowships - Mayo Clinic College of Medicine & Science

Mayo Clinic School of Graduate Medical Education offers the one-year Adult Lower Extremity Reconstructive Surgery Fellowship in Rochester, Minnesota.
college.mayo.edu college.mayo.edu
 
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