Do I need a knee replacement?

[Guest guest]

, ( TKR) Thanks for the time frame reference. It is soooo helpful to

keep things in perspective. Appreciate any and all comments.

To all: I just realized that I am going up and down the stairs normally now

rather than 2 feet on each step. Upstairs came first, but now I can go

downstairs as well. I think I was afraid to do it for fear of the pain or

strain, but I turned my leg a bit sideways to ease the initial few steps and

realized I could go down with knees straight forward without pain. BIG

BREAKTHROUGH!!

I swam 20 laps yesterday with NO pain at all and did underwater walking for 15

minutes plus rode the stationary bike for 20 minutes. I was not sure how I would

feel today, but I feel great, in fact I feel better today due to the exercise,

stretching, getting out of the house in this damn snow, seeing other people, and

being patient with myself. I did the hot tub for 10 minutes and the sauna for 10

minutes, and just felt like I had a perfect day. I guess the lesson here is

patience and TLC make a huge difference in recovery!

Do I need a knee replacement?

>

> Okay, here is the thing. I'm scared.

> I have this knee that has caused me pain for a long time - like 20+ years,

increasing to quite a bit over the past year or two. Increasingly I am taking

more meds - codeine most nights to sleep.

> But I can get around okay if I have a quiet day where I mostly work (I'm a

writer) and don't get a lot of exercise I am fine. But if I try to do a lot -

like painting the house or going for a long walk or doing an aquafit class, it

hurts, sometimes a LOT.

>

> I guess I am answering my own question. But today I went to see one of the

top ortho surgeons here in Vancouver and he just came on sooooo strong it kind

of scared me. He said " We rarely see a knee in as bad condition as yours, " and

" How are you even walking - you're bone on bone. " He said there was no

alternative, my knee is shot and I would recover beautifully.

>

> But I guess it really took me by surprise. I even asked him if he had the

wrong xrays because his remarks seemed a bit extreme. So he took his pointy

little index finger and stuck it into a few places around my kneecap and when I

climbed back off the ceiling he asked if I still thought he had the wrong xray

I guess not but do orthos always come on this strong?

>

> Maybe if I lost more weight and did some more exercise? Except every time I

try to accelerate the exercise I end up hurting so bad I'm on crutches for weeks

......oy vay. I guess I am answering my own question again, but I'm scared.

>

>

>

> ------------------------------------

>

>

[Guest guest]

Hi ,

I did stairs yesterday also! It was a big breakthrough. However, today, I

think because of the weather, I am a bit sore in places I have not been before.

I don't think I overdid it at PT yesterday, even though I did manage ROM of 116,

and did 10 minutes on the bike at force 10, but I am distinctly more sore than I

have been in some time. Not great pain, mind you, but sore. Please tell me

it's the weather!

Joan

________________________________

From: Kohn <katiekohn@...>

Joint Replacement

Sent: Tue, February 16, 2010 9:50:19 AM

Subject: Re: Do I need a knee replacement?

, ( TKR) Thanks for the time frame reference. It is soooo helpful to

keep things in perspective. Appreciate any and all comments.

To all: I just realized that I am going up and down the stairs normally now

rather than 2 feet on each step. Upstairs came first, but now I can go

downstairs as well. I think I was afraid to do it for fear of the pain or

strain, but I turned my leg a bit sideways to ease the initial few steps and

realized I could go down with knees straight forward without pain. BIG

BREAKTHROUGH! !

I swam 20 laps yesterday with NO pain at all and did underwater walking for 15

minutes plus rode the stationary bike for 20 minutes. I was not sure how I would

feel today, but I feel great, in fact I feel better today due to the exercise,

stretching, getting out of the house in this damn snow, seeing other people, and

being patient with myself. I did the hot tub for 10 minutes and the sauna for 10

minutes, and just felt like I had a perfect day. I guess the lesson here is

patience and TLC make a huge difference in recovery!

[Total_Joint_ Replacement] Do I need a knee replacement?

>

> Okay, here is the thing. I'm scared.

> I have this knee that has caused me pain for a long time - like 20+ years,

increasing to quite a bit over the past year or two. Increasingly I am taking

more meds - codeine most nights to sleep.

> But I can get around okay if I have a quiet day where I mostly work (I'm a

writer) and don't get a lot of exercise I am fine. But if I try to do a lot -

like painting the house or going for a long walk or doing an aquafit class, it

hurts, sometimes a LOT.

>

> I guess I am answering my own question. But today I went to see one of the top

ortho surgeons here in Vancouver and he just came on sooooo strong it kind of

scared me. He said " We rarely see a knee in as bad condition as yours, " and " How

are you even walking - you're bone on bone. " He said there was no alternative,

my knee is shot and I would recover beautifully.

>

> But I guess it really took me by surprise. I even asked him if he had the

wrong xrays because his remarks seemed a bit extreme. So he took his pointy

little index finger and stuck it into a few places around my kneecap and when I

climbed back off the ceiling he asked if I still thought he had the wrong xray

I guess not but do orthos always come on this strong?

>

> Maybe if I lost more weight and did some more exercise? Except every time I

try to accelerate the exercise I end up hurting so bad I'm on crutches for weeks

......oy vay. I guess I am answering my own question again, but I'm scared.

>

>

>

> ------------ --------- --------- ------

>

>

[Guest guest]

Thank you for the info. Dr. Tria is located only about an hour from me. I'm

going to make an appt and see what he says. thanx again!

Re: Re: Do I need a knee replacement?

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[Guest guest]

Actually, I know more success stories than not. I am going to make an appt to

see Dr. Tria in Jersey. I'm sure there has to some way of managing the anxiety.

I'm sure anyone who has had surgery has some degree of anxiety. I'm 57 and have

never been in the hospital except to have my son and that only took 1 1/2 hours

and went home 6 hours later. LOL I'm hoping for quad sparing. It really is

becoming frustrating. Thanx for your input.

J

Re: Do I need a knee replacement?

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[Guest guest]

Good for you Judy, you're lucky to live so close to Dr. Tria. I would call his

office and ask how many quad sparing TKRs he has done and what is his infection

rate.

About your anxiety, you are already taking something for it, like Ativan or

Xanax? A lot of people who haven't had any major or even plastic surgery before

get anxious, it's not unusual. My husband had a lot of panic attacks before

being put on Lexapro (an antidepressant), now they are totally gone.

I don't know about Dr. Tria, personally but he did work to develop quad sparing

with my OS, Dr. Coon. He's all over the internet if you Google Dr. Alfred Tria

Zimmer quad sparing.

Some examples from a few years ago:

MIS Quad-Sparing Arthrotomy

The MIS Quad-Sparing approach to the knee joint is an innovative approach

initially pioneered by Dr. M. Coon, Dr. E. Marlowe Goble, and Dr. Alfred

J. Tria, Jr. There is no incision into muscle or tendon. The muscle is not moved

or disrupted. The suprapatellar pouch is protected. Zimmer Institute training is

available for surgeons interested in learning the MIS Quad-Sparing approach to

TKA

Alfred J. Tria Jr., M.D., a developer of the technique, an orthopaedic surgeon

at Saint 's UniversityHospital, and a clinical professor of orthopaedic

surgery at Wood Medical School, New Brunswick, New Jersey, is

serving as national spokesman for the public education campaign.

In a presentation to his peers at this year's 18th Annual Vail Orthopaedics

Symposium, Dr. Tria reported early findings based on a comparison of patients

who had received total knee replacement via standard open surgery to those who

underwent MIS Quad-Sparing TKA. Quad-Sparing TKA patients had shorter incisions,

less pain and shorter hospital stays, with no compromise in implant placement

accuracy. In addition, immediately after surgery, MIS Quad-Sparing TKA patients

averaged a more than 18 percent greater range of motion – the angle the knee was

able to bend (112.5 degrees for Quad-Sparing TKA patients vs. 91.5 degrees for

standard TKA patients). Six weeks after surgery, range of motion remained more

than 8 percent greater for MIS Quad-Sparing TKA patients. Quad-Sparing TKA

patients remained in the hospital about half as long as patients who underwent

traditional surgery – an average of 2.5 days, compared to an average of 4.8

days. Dr. Tria also reported that patients' pain scores were lower: 5.4 at start

of physical therapy for Quad-Sparing TKA patients, versus 7.0 for patients who

underwent traditional surgery.

" Our focus is patients, and before we introduce any procedure we work closely

with our surgeon development teams to standardize the technique, rigorously

study patient outcomes, and provide specialized training to qualified surgeons, "

Elliott said. " Surgeons such as Dr. Tria plan to continue making peer-reviewed

presentations and publishing additional patient outcomes in the months and years

to come. "

The results of a randomized controlled European study comparing Zimmer

Quad-Sparing and traditional TKA outcomes is currently being prepared for

submission for publication in a prominent peer-reviewed orthopaedics journal.

The findings corroborate Dr. Tria's results, showing statistically significant

reductions in pain, and increased range of motion in the early post-operative

period.

> Thank you for the info. Dr. Tria is located only about an hour from me. I'm

going to make an appt and see what he says. thanx again!

>

>

>

[Guest guest]

Joan, Isn't it funny that we both did the stairs at the same time? Congrats! I

have PT tomorrow so I will let you know what my ROM is, but I found that giong

to the gym and doing stretch moves in the hot tub made a HUGE difference in my

flexiblility and movement even in this lousy weather. I felt great all day

today, and I haven't said that in a long time. Now we will see how I feel when I

wake up tomorrow. Sometimes these pains appear 48 hours later. From what I have

read on this forum, my PT is not nearly as strenuous as others have described. I

was even debating whether or not to stay with it after Feb. since my insurance

only pays for 30 visits to the PT annually no matter what the issue!! (this

health care system is so out of whack). My number will be up soon and I think I

might want to save a few in the event I have a setback of some sort and need to

see him. For now, my plan is head for the warm water at the pool and work it!!!

Be well,

[Total_Joint_ Replacement] Do I need a knee replacement?

>

> Okay, here is the thing. I'm scared.

> I have this knee that has caused me pain for a long time - like 20+ years,

increasing to quite a bit over the past year or two. Increasingly I am taking

more meds - codeine most nights to sleep.

> But I can get around okay if I have a quiet day where I mostly work (I'm a

writer) and don't get a lot of exercise I am fine. But if I try to do a lot -

like painting the house or going for a long walk or doing an aquafit class, it

hurts, sometimes a LOT.

>

> I guess I am answering my own question. But today I went to see one of the

top ortho surgeons here in Vancouver and he just came on sooooo strong it kind

of scared me. He said " We rarely see a knee in as bad condition as yours, " and

" How are you even walking - you're bone on bone. " He said there was no

alternative, my knee is shot and I would recover beautifully.

>

> But I guess it really took me by surprise. I even asked him if he had the

wrong xrays because his remarks seemed a bit extreme. So he took his pointy

little index finger and stuck it into a few places around my kneecap and when I

climbed back off the ceiling he asked if I still thought he had the wrong xray

I guess not but do orthos always come on this strong?

>

> Maybe if I lost more weight and did some more exercise? Except every time I

try to accelerate the exercise I end up hurting so bad I'm on crutches for weeks

......oy vay. I guess I am answering my own question again, but I'm scared.

>

>

>

> ------------ --------- --------- ------

>

>

[Guest guest]

Judy,

I am about 3 years older than you with lots of anxiety. I had one knee done 3

months ago and am preparing to do the second one in the next couple of months.

I had never been in the hospital except to have a kids either and I really

didn't know what to expect.

I had a spinal and came out of surgery smiling. I read the book and had myself

prepared for several months out of touch. In two weeks I was back and moving.

Like so many who have had this done, I to would do it sooner next time. But I

did it when I could.

(PS on top of it I don't know MDs.)

Go for it.!

Donna

Re: Do I need a knee replacement?

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[Guest guest]

My PS should have said I don't LIKE MDs.

Donna

Re: Do I need a knee replacement?

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[Guest guest]

I really envy your pool activity. I really can't do that, so I have to rely on

the gym. I'm not sure how many visits I have left at PT, but we have our own

gym here, and a friend is a certified personal trainer, so I may be switching to

her soon.

I am also wearing a pedometer agian. My goal for now is 5,000 steps, which I

achieved easily yesterday. Not too ambitious when you consider that a usual

goal is 10,000. I hope to achieve that again by the summer. Dispite the bad

day yesterday, and all the steps, and a bad night also, I feel pretty good

today. Off to Physical Torture! Joan

________________________________

From: Kohn <katiekohn@...>

Joint Replacement

Sent: Tue, February 16, 2010 7:47:11 PM

Subject: Re: Do I need a knee replacement?

Joan, Isn't it funny that we both did the stairs at the same time? Congrats! I

have PT tomorrow so I will let you know what my ROM is, but I found that giong

to the gym and doing stretch moves in the hot tub made a HUGE difference in my

flexiblility and movement even in this lousy weather. I felt great all day

today, and I haven't said that in a long time. Now we will see how I feel when I

wake up tomorrow. Sometimes these pains appear 48 hours later. From what I have

read on this forum, my PT is not nearly as strenuous as others have described. I

was even debating whether or not to stay with it after Feb. since my insurance

only pays for 30 visits to the PT annually no matter what the issue!! (this

health care system is so out of whack). My number will be up soon and I think I

might want to save a few in the event I have a setback of some sort and need to

see him. For now, my plan is head for the warm water at the pool and work it!!!

Be well,

[Total_Joint_ Replacement] Do I need a knee replacement?

>

> Okay, here is the thing. I'm scared.

> I have this knee that has caused me pain for a long time - like 20+ years,

increasing to quite a bit over the past year or two. Increasingly I am taking

more meds - codeine most nights to sleep.

> But I can get around okay if I have a quiet day where I mostly work (I'm a

writer) and don't get a lot of exercise I am fine. But if I try to do a lot -

like painting the house or going for a long walk or doing an aquafit class, it

hurts, sometimes a LOT.

>

> I guess I am answering my own question. But today I went to see one of the top

ortho surgeons here in Vancouver and he just came on sooooo strong it kind of

scared me. He said " We rarely see a knee in as bad condition as yours, " and " How

are you even walking - you're bone on bone. " He said there was no alternative,

my knee is shot and I would recover beautifully.

>

> But I guess it really took me by surprise. I even asked him if he had the

wrong xrays because his remarks seemed a bit extreme. So he took his pointy

little index finger and stuck it into a few places around my kneecap and when I

climbed back off the ceiling he asked if I still thought he had the wrong xray

I guess not but do orthos always come on this strong?

>

> Maybe if I lost more weight and did some more exercise? Except every time I

try to accelerate the exercise I end up hurting so bad I'm on crutches for weeks

......oy vay. I guess I am answering my own question again, but I'm scared.

>

>

>

> ------------ --------- --------- ------

>

>