Total Knee Replacement, Anyone?

[ticketchecker]

Feel like I’m getting closer to getting one. Both knees are 2x acl survivors. One of them got started in the early 80’s when surgical tech wasn’t what it is today.

Long story short, not much meniscus in there, ACL is bomber but flexion is pretty limited due to stiffness. Pretty much hurts all the time.

I’m 56 now so been dealing with knee issues for almost 40 years.


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[WMD]

Anybody in the Jackson area needing joint replacement might want to check out Dr Lighthart at Teton Ortho. He was just brought out from VT to lead the joint replacement practice at St John's. I met with him and would feel good about having him do surgery on me. He seemed honest and open and confident but not too cocky. Has been doing over 300 joint replacements a year for awhile.

[PaganSkier]

https://rcmclinic.com/patient-inform...e-information/

Good info in this link for my fellow arthritic skiers. I've been grade 4 left knee since 2006, and had PFA on my right knee 4 years ago which was like voluntary mutilation. So much worse than the original product. I'm 5-10", 155 lbs, 63 yo who still drags knuckles. But damn do I pay for it after a few hours on hard snow. Contemplating if area skiing is worth the downside impacts on my knees, but the chemical cocktail that skiing serves up to my noggin is just too good to pass up.

[WMD]

I'll be the devil's advocate, Rod. After two meniscus surgeries and having had 40-60% removed, I was basically crippled because it was my medial meniscus and the fact that I was bowlegged exacerbated a knee joint that was not functioning correctly. Doc starts talking new knee and I'm like 'no more surgery until I absolutely need it.' Stem cells I received regrew enough of that meniscus for my knee to still be functioning 10 years later. I don't see a TKR as a whimsical decision cause if it does come out fucked up, it's gonna mean another surgery. I had a friend whose TKR totally went south for him. That might have influenced my decision to forestall my own TKR .

Just had a TKR April 1. I have been a candidate for one since 2009 when I had over 70% of meniscus removed, and was never the same again. I've done stem cells twice over that time and now agree with one of the surgeons I consulted with who said the stem cells don't seem to regrow the cartilage - yet, but that is coming- but do help alleviate pain somehow. I have a photo of my knee opened up in surgery that shows no cartilage at all in areas of my knee.

I knew it was time (long past time really) when I could only ski groomers and only when pumped full of Ibuprofen and with a stiff don-joy brace. My knee had become really unstable (grade 2 acl tear) and it started buckling on me, which caused lots pain for days, doing thing like loading bikes in the truck

I definitely don't recommend it unless you really need it. But if you do, nothing else will work other than stopping the activities you love.

Powdork I don't know how you did this alone.

[homemadesalsa]

@WMD congratulations! You're in the desperate stage right now, wishing you fast and complete healing. Call if you need any advice or encouragement. I was a year out this week and had a full ski season, pain-free finally.

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[Djongo Unchained]

WMD - Healing vibes out to you mag!!

I bet you bounce back quicker than you think. Def faster than a soft tissue surgery like acl replacement.
Maybe come over to the Tetons this summer for a walk in the Park...

[rod9301]

@WMD congratulations! You're in the desperate stage right now, wishing you fast and complete healing. Call if you need any advice or encouragement. I was a year out this week and had a full ski season, pain-free finally.

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How long after the operation that you could ski?

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[WMD]

Thanks HMS and DJ!

HMS I am doing ok right now, but I'll call you for sure sometime. It's awesome to hear you had a pain free ski season. That will make all of this worth it.

DJ, I'll be over that way sometime this summer and a walk in the Park would be great. Thanks! Yeah, it is crazy that getting your quad muscle and tendon sliced open, having your acl removed, and the ends of your bones cut off is quicker to heal than an acl repair. But it's true! (Glad your acl repair seems to be working out). Hopefully I'll be biking and hiking again before too long, and I am stoked beyond belief to ski again next year.

[WMD]

@Homemadesalsa, did you have to pick the conditions you skied in this year, or was your knee ok with whatever was out there? In other words did you need perfect pow or could you ski chop, crud, crust, and everything else the mountains throw at you? Did that change as the season went on? I'm guessing you were more tentative to start the season.

[homemadesalsa]

Hey there @WMD-
Beginning of the season I was super tentative, not much flexion. Then I took a fall and bent the bejeezus out of it, hurt like hell for a couple of days, then I had more flexion (like a MUA but NO anesthesia!!!). By the end of the season it was the strong knee and I could ski any kind of snow. Now I need new boots! Be patient and persistent, it will come. Biking last summer got me set up nicely for skiing.

[homemadesalsa]

How long after the operation that you could ski?

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Well my TKR was in April, so I could ski again in December when the snow started to fly. Started gravel biking the end of May, mountain biking by mid-June. Did PT or strength training every single day.

[WMD]

Hey there @WMD-
Beginning of the season I was super tentative, not much flexion. Then I took a fall and bent the bejeezus out of it, hurt like hell for a couple of days, then I had more flexion (like a MUA but NO anesthesia!!!). By the end of the season it was the strong knee and I could ski any kind of snow. Now I need new boots! Be patient and persistent, it will come. Biking last summer got me set up nicely for skiing.

Wow, so good to hear. If this knee that I've babied for so long ends up my strong knee, life will be very good, although it is no doubt going to take years to build up strength again.

I can't wait to get on the gravel bike - and hopefully the mountain bike before the season is over. I just took my first walk outside (calling it a walk is a bit of an exaggeration) since surgery, so I'm still pretty far away from being active again.

I'm going to need to remold my ski boots as I'm no longer bow legged!

[Norseman]

Wow, congrats on the new joint, WMD!

[rideit]

WMD, Hope it’s all going well overall. You will have good days/bad days like anything. If you ever want to go for a chill gravel/road ride, hit me up!

[homemadesalsa]

@rideit he lives in Lander now, so you might have to make a road trip and ride over there. Have you ridden any Lander trails? Some fun mileage!

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[WMD]

Thanks Norseman! Rideit, I'd love to ride sometime. Lander does have good riding. You all are welcome over here anytime!

[rideit]

I have never ridden in Lander I do know he is there...

[WMD]

It may be a while before I am ready for even mellow rides. I'm getting close to 0 for extension, but best I've done on flexion so far is 83 degrees. I'm still just a bit over two weeks out from surgery and have only had 3 PT sessions so far, so I'm not worried, but I can't bend enough to peddle yet. I've tried a couple times.

[Jethro]

I’m just checking into this thread now. I’m at five days after a TKR. I’ve got to say, it’s been way tougher than expected. We had to get much stronger pain meds than what I was sent home with and my mobility is pretty much limited to bathroom runs. I was not impressed with their pain management plan, but at least they amended it and sent in orders for stronger meds. I know people who have done two at once, but there is no way I could do that. Having one strong leg has been a necessity for getting out of bed and off the stool.

[Shredhead]

Who did yours?

They’ve really dialed back the meds, due to the opioid crisis.

Back in January, my knee was killing me.
I scheduled a TKR with Dr. Kim for 6/1.
But I was skiing really strong at the end of the season and ended up canceling.

Best of luck and hit the PT hard!

[homemadesalsa]

I'm gonna disagree with the "hit the PT hard" statement. Let your knee do what it wants initially. Don't push it or fight for extra mobility until it's ready. Keep after the icing for a long time.

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[WMD]

Listen to homemadesalsa here. I'm almost 3 months post TKR and I've set myself back several times by doing too much. This is very different from any other surgery or injury I've experienced, where hitting PT hard helps. The TKR is pretty traumatic surgery and you need to let your body heal most of all. My recovery has been difficult because the surgeon keeps telling me to do less so I can heal. I'm bored and going stir crazy and want to do more, not lie around, so every time I feel like I've improved a bit I push it and end up setting myself back. Taking it easy is so much more challenging than hitting PT hard, but it is what works. "Go slow to go fast" is the mantra my surgeon taught me.

Good luck. That early pain gets much better each week and should be way down by week 2 or 3.

[Jethro]

Who did yours?

They’ve really dialed back the meds, due to the opioid crisis.

Back in January, my knee was killing me.
I scheduled a TKR with Dr. Kim for 6/1.
But I was skiing really strong at the end of the season and ended up canceling.

Best of luck and hit the PT hard!

I have a long history of damage to that knee. I had a rod driven down the tibia in the late 80’s. It was pulled in 1990, and you could plainly see the channel on the recent X-rays. I had a few meniscus tears and the knee got really arthritic. initially I saw Dr Hackett at the Steadman clinic in Aspen. He didn’t think he could help me using my tissues, so he referred me to Dr Kim for a TKR.

My issue was with their hesitation to prescribe powerful painkillers. When you are nearly screaming in pain, you don’t really care about some “opioid crisis”. Give me some pills to cut the pain down. To their credit, they did that, but there was a day and a half of unnecessary pain. One of my issues with these pain pills is the dosage compared to body weight. I’m 6’-4” and 235 lbs now. I get the same dose as an 105lb adult woman. No wonder I was getting no less than two hours relief with pills that are to be taken 4-6 hours as needed

[gregL]

I have a long history of damage to that knee. I had a rod driven down the tibia in the late 80’s. It was pulled in 1990, and you could plainly see the channel on the recent X-rays. I had a few meniscus tears and the knee got really arthritic. initially I saw Dr Hackett at the Steadman clinic in Aspen. He didn’t think he could help me using my tissues, so he referred me to Dr Kim for a TKR.

My issue was with their hesitation to prescribe powerful painkillers. When you are nearly screaming in pain, you don’t really care about some “opioid crisis”. Give me some pills to cut the pain down. To their credit, they did that, but there was a day and a half of unnecessary pain. One of my issues with these pain pills is the dosage compared to body weight. I’m 6’-4” and 235 lbs now. I get the same dose as an 105lb adult woman. No wonder I was getting no less than two hours relief with pills that are to be taken 4-6 hours as needed

Yeah, the painkiller regimen is really conservative - my wife is 13 days out from a TKR, first week was pretty rough, largely due to pain ('If they were honest about how much this hurt, no one would do it") but we started doubling down on the oxy and naproxen (in a 3-way rotation with Tylenol) and it became bearable (ran out of both early, but they refilled - PITA, you have to physically go to the Dr.'s office and get a scrip). This week is better, she started on PT on Wednesday and ROM is getting better fast.

[rod9301]

I have a long history of damage to that knee. I had a rod driven down the tibia in the late 80’s. It was pulled in 1990, and you could plainly see the channel on the recent X-rays. I had a few meniscus tears and the knee got really arthritic. initially I saw Dr Hackett at the Steadman clinic in Aspen. He didn’t think he could help me using my tissues, so he referred me to Dr Kim for a TKR.

My issue was with their hesitation to prescribe powerful painkillers. When you are nearly screaming in pain, you don’t really care about some “opioid crisis”. Give me some pills to cut the pain down. To their credit, they did that, but there was a day and a half of unnecessary pain. One of my issues with these pain pills is the dosage compared to body weight. I’m 6’-4” and 235 lbs now. I get the same dose as an 105lb adult woman. No wonder I was getting no less than two hours relief with pills that are to be taken 4-6 hours as needed

What did they prescribe initially and what after you complained?

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