How was your TKR procedure done?

Bones, joints and muscles
1

I thought it might be interesting to see what the different techniques are currently around the World and within each Country. If you reply please can you state which Country you are in.

So here in Essex in the UK my surgeon's approach was:-

A spinal anaesthetic with a level of sedation of my choice - which was sleep, at least till near the end ! Interesting to wake up and hear them talking about closing up the wound and golf, a conversation I joined in. I believe he also injects the joint with something like the dental numbing drug Lidocaine. So it took under two hours and I was wheeled back to the ward after an X-ray. I felt great but slightly unnerved by being paralysed from the waist down. This gradually went away in the next couple of hours. No catheter so a bit of temporary loss of bladder control but a small price to pay. There must have been some sort of "high" drug in the mix because that night I got no sleep as I was so euphoric about getting through the op and had no pain. I was kept in for a further two days till I could get down stairs on crutches. Pain management was basically, Paracetamol, Ibuprofen and Cocodeine taken together every four or maybe six hours. Pain was never unbearable, just uncomfortable with some loss of sleep at night at first but not too drastic. 

Dave

 

2

I'm in the United States! For mine they did an EKG on me to make sure my heart was fine. Next, I was wheeled into another room where I was given a nerve block in my leg. Then I was wheeled into the operating room where I got a spinal block. After that I was sedated and the fun began. I woke up to different times during the surgery but just saw a blue sheet before drifting back off. I was wheeled back about 3:30pm for my surgery and woke up in recovery at 6pm. I couldn't feel any pain until later that night. I was given a mix of Percocet and torodol which helped ease the pain. I stayed overnight in the hospital and it was truly the worst night of my life. My surgeon doesn't use catheders so I was calling the CNA all night for the bathroom. Luckily the medication came on time and I got through the night. I did two sessions of PT the next day at the hospital and was sent home.

3

I'm in Australia .. with mine I had a spinal block and a light general so have absolutely no idea what went on for my op.  Just know that all the tools made for your particular knee are made in the States .. an MRI is sent over there and they make the tools necessary for each and every tkr done here .. wait time is about 4-6wks.  A few wks prior to op tho had every blood test imaginable, ecg and full on physical by a team of surgeons that look after you in the hospital.

Cheers

Tracey

4

Forgot to mention .. pain management was first and foremost their concern and they tried tramidol at first but I was allergic to it so I was on oxycontin and endone for 3mths.

5

The TKR was scheduled in three weeks so I had to stop meds right away that might cause bleeding.  I chose spinal block and towards the middle of the operation they injected something in my IV for nerves they said, which I guess may have been to ease my rising blood pressure, because when they started the pounding I really wondered if my hip would hurt there was so much impact.  I was given pain meds by IV later and sometimes orally which always upset my stomach.  Finally they gave me some antinausea meds, since I couldn't do PT the first day for all the up chucking and I couldn't eat anything but jello.  They did do a numbing shot before I left the OR.  They used a constant motion machine to move the leg and I was fine till they turned it up from 30 to 60 while I was sleeping and it woke me up with my knee feeling like it was on fire.  I didn't want to use that machine after that. I had to ring when my knee hurt, so they didn't keep me on anything; only when I asked.   PT had me walking up and down stairs the second day.  Second night I didn't need much in the way of pain meds and I took a shower at midnight because the room seemed hot and dry.  The night nurse was upset I didn't call for help and that the protocol was for them to give me a lesson on how to take a correct shower for noon the next day but I went home before that.  I was on aleve twice a day, a full aspirin twice a day, wore compression stockings till the two week checkup.  I'm 4 weeks post op and now bend at 90 and extension is the full -15.  PT says they will get me to 130 in 4 weeks.  I have pain meds to take before PT when they push the knee where it doesn't want to go comfortably.  It swells and I have to ice it for a day and rest at least two days but it does continue to bend further so I see it is necessary.  

6

Meant to include I'm in the NW of the USA

 

7

Here in US, I had a Makoplasty procedure.  This is a robotic laser procedure which customizes bone removal and implants based on a previous CT.  I requested a spinal, but somehow ended completely out.  In recovery given phentenal and discharged when I demonstrated bladder function.  Scripts for oxy and hydro (I never used). Oxy for the first few days, but then switched to Naproxen during the day and oxy to sleep.  Did PT starting 3 days Post Op, continued for 6 wks.

8

Hi Dave!

Great idea for a post!😊

Here's my story:

Diagnosed with osteoarthritis five years ago. Had physical therapy which made things WORSE, had cortisone shot which worked for four DAYS, got frustrated and quit doctors for four years until EXCRUTIATING PAIN hit and I needed crutches to walk during several days over Memorial Day Weekend last year. Made my doctor's appointment (finally!) expecting to continue the dog and pony show with arthroscopic surgery. I was pleasantly surprised that my knees were SO BAD (bone-on-bone, no cartilage left and bowed legs due to collapsed areas on my knee insides) that I got to SKIP to the head of the class and get Total Knee Replacements!🙌😊😁🙌

Went for Pre-Admission testing. All OK. Surgery scheduled on left knee for June 26th 2015. A VERY UNIQUE way to spend our 39th Wedding Anniversary!💟💟 Prep included a nerve block, IV, then rolled into the operating room. Had general anesthetic, and my surgery lasted approximately three and a half hours. Woke up and was rolled back to my room. Had ice water and applesauce. Pain meds and nerve block worked well. Family came in a few more hours to join my husband and me. Felt a bit nauseated and thought I might throw up, but it was just a big BURP!😁

Kept waking up and looking around. Must have dozed off! This kept happening and apparently was quite entertaining to my family. (They can be very strange sometimes!)

Everybody left so I could "get some sleep". HA!! Who needs sleep? Too busy calling for the nurses and aides to help me to the bathroom!😎 These treks to the bathroom were every half hour or so ALL NIGHT LONG! (I had my nurse, Cassie, write them down so I could get credit for WALKING and doing some EXERCISE from the PT People.)

Had my choice of additional pain meds in addition to the nerve block. I found Toradol by IV was the best for me. Dilaudid made me SUPER LOOPY!😰

Oxycodone did, too. Stuck with the Toradol.

PT people came in the morning. The best I could do was lift my TOES. They wanted me to march. I just laughed at that. Nobody seemed to be impressed that I had walked a million miles all night to the bathroom. Party poopers!😣😣

Was pretty hungry. Ate well. Leg felt like a TREE TRUNK FILLED WITH CEMENT. Needed help to get the tree trunk off the bed. Sat in a chair after PT. Very tiring, and with my legs down, my surgical leg began to SWELL. Very uncomfortable! Back to bed. Ahhhhhhh!😉

Pain not bad. Meds were doing their job, and the nerve block was STELLAR!😁

Was discharged on day three. Glad to be headed home, but everything took FOREVER to accomplish! Had GREAT FUN giving myself the blood thinner shots!😲 Did a lot of walking with the walker, had home health care come ( nurse and PT) for three weeks. Was discharged after three weeks to begin Outpatient PT. Had that until the day before my TKR on my other knee October 9th 2015.

Second knee was a LOT easier. More mobility from the beginning. Less swelling and no TREE TRUNK FILLED WITH CEMENT with this knee! Yea!🙌

Home in two days. Ice, elevating, walking around the house, pain meds, blood thinner shots.

Doing very well now! Enjoying walking and standing without pain. Stiffness there if I am in same position too long. Iove around a lot to help that. Stretching often helps, too.

Sending lots of love to all who are enduring the healing process.💟💟It DOES get better! Be patient and try to be as positive as you can. That really helps!

9

Oh...forgot to say where I live!

Am in NE Ohio, USA!🇺🇸

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Hi! I'm in kent in UK. Back in November 2014 I went to the gp because my knee hurt. Had an X-ray and was told that I had early onset oa. Given painkillers and one session with a pt who was useless and just said to do a couple of exercises. So basically I went away and got on with it! This year my work enrolled us all in BUPA so in April I went to gp for a referral. Sent for another X-ray, told by gp early onset blah blah (don't think he had a clue) tried to deny me a referral as I was too young - asked me what I wanted one for till I got grumpy and said I wanted a referral because my knee hurt and I wasn't a doctor they were!!!

saw a lovely consultant 2 weeks later who looked at the same X-ray and said it was bone on bone, need to skip the injections, arthroscopy etc and replacement was only option! So much for early onset! Scheduled for 2 weeks later but got scared and had it a month late on June 15.

had it with epidural and sedation but think I was talking too much as anaethetist said aren't you tired and knocked me out at start of procedure!

for first 24 hours nurses kept telling me I had wet myself and I said I hadn't as I was up and down to the toilet and using it!  They eventually agreed that huge amounts of excess fluid was leaking from my leg!!

they kept and top of meds while I was in, morphine etc but came home with paracetamol, ibruprofen and codeine which I still take if needed. Came home on third day.

rom and extension are rubbish, pt was weekly ish and they say they can't help me bend anymore and MUA is on the horizon - seeing surgeon Tuesday.

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Nice one Cheryl. Bone on bone, bowed and bent legs and OA was my scenario - although I put up with it for 20 years as pain went if I sat down and didn't do anything. In the end quality of life was going as couldn't walk or get out of chairs and in the morning so stiff and painful had to stagger to the bathroom. 8 weeks in and feels so wonderful to walk with no pain in one leg (other one on the to do list for nrxt year!). Wat to go with flexion but not worried.

Dave

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Keep me posted Kathryn. My flexion is stuck on 90 which is what it was before op. PT confident she can improve on that or it will on its own. I'm not so sure. Also seeing my surgeon Tuesday for first post op visit.

Dave

13

Glad to hear that you are already experiencing that wonderful relief from PAIN! After SO MANY years of agony it is a real GIFT to have that agony GONE!🙌😁😊🙌

Once you get your second one done next year you will literally feel like a new person! For me, my right knee was holding me back and I couldn't wait to get it done, too. Sure there is all the recovery and PT and learning how to walk again in a normal way, but the eventual benefits once all that is accomplished are DEFINITELY worth it!

Wishing you continued success with your recovery and a successful surgery #2 next year!😊

14

Hi, I'm on the Wirral Merseyside UK .I was bone on bone both knees for 10 yrs. They kept saying I was too young, but by last year my quality of life was abysmal so left tkr was june2015, I had spinal and light sedation. I heard the drilling,sawing and hammering but it didn't bother me, even chatted to surgeon. Op took 1 1/2 hours. My leg after spinal wore off was like concrete and I was put on blood thinning meds and 30/500 co codamol, I struggled with bending walking pain ect was discharged with 2 sticks after 3 days,I had to change to crutches for a few weeks. I had a lot of physio after in a knee club class at the hospital for a couple of months.its taken me 12 mths to get to 115 flex with a lot of pain and exercise.My right tkr was June this year and was text book. I was in ,48 hrs and only needed 2 physio sessions ,got same flexion as other knee in just a couple of weeks and minimum pain!!! Couldn't believe the difference. Now I'm having physio on my ankles they've become so painful due to the re alignment of my knees as I'm now walking straight instead of rolling side to side.and my ankles don't know what's going on

15

Dcweather,  I am in the states, Cincinnati, Ohio.  My surgeons approach was,  I received two nerve blocks...one for front of my knee, one for back.  Anesthesiologist did these pre surgery and used ultrasound to see what he was doing.  Then once in surgery and on table, I was put to sleep.  

With 2 nerve blocks, I had catheter.  Surgery was done at a surgery center, by hospital, and I stayed 2 nights.  I woke, leg was packed in ice to keep swelling down.  I was up and sitting on side of bed with legs dangling that evening.  Next morning PT started, walked down hall with walker and then sat in recliner by bed for several hours.  Next morning, nerve blocks removed, catheter removed, PT again, walked much further in the hall, back to room and rested in recliner.  

Then up up and showered.  Back down the hall with occupational therapist to be shown how to get in and out of car and navigate steps with walker.  They have a room set up so you actually do these tasks.

in home PT started 2 days after I came home, and they came 2x a week for the first month.  I continued to exercise at least 2x daily with what I was given to do.  Beginning of week 3, I was allowed to walk outside with my therapist.  I continued to exercise 2x daily and added walkin outside daily with walker.  By week 3 I was walking unaided indoors.  By week 4 went to cane only for outside.  Week 5 started outpatient PT and did this for 5 more weeks.  Borrowed a stationary bike and started riding 2x daily for 15 minutes at week 6.  I was 0% by week 3 1/2  and flexion was 95%.  By week 9, as I finished up outpatient PT, flexion was 130%.

it was not a bowl of cherries....I had lots of ups and downs but pushed thru.  I learned to pay close attention to how I walked and to listen to my body.  Overdid several times, learned my lesson the second time.  Also found the required 1 hour rest twice daily, in bed... ice(both sides of knee at same time), elevate required by my PT was good for the healing.

Pam

 

16

Will report back! I dream of 90 !!

17

Forgot to say.....was given Oxy and Valium in surgery center.  Was sent home with both.  Valium was for muscle spasms.

18

Pam - could you flex your knee at 130% in the years precedeing the operation? I am trying to establish if people are improving their PRE op flexibility or just getting back to how it was before. Mine is stuck at 90 but it was like that for years before so i would be surprised if the tendons and ligaments would let it go quickly to say 120?

Dave

19

Dave, no I was around 100% prior to surgery.

20

Dave, improvement depends on so many variables.....age, type of implant, weight,, and activity level to name a few.  I was given a 30 year knee replacement device called Verilast.  It is suppose to mimick a normal knee.  I am 55 years old and was very active and fit prior to surgery.  

Pam