Knee Replacement

[Guest guest]

I'm a 66 year old healthy, fit male who had a medial side PKR (partial) and

replacement ACL done Nov 29 2010 then the same procedures for the other knee Jan

3rd 2011. At 2 months out for knee 1 I typically have 0 to 2 pain daytime and

0-1 at night in that knee with just Aleve. But knee 2 (at 1 month out) is still

0-2 daytime and 2-4 at night. I've been off crutches since week 3 on knee 2. I'm

considering going back on Ambien every other night. But the constipation from

Oxycodone or that damn 4 a.m. pain are the killers from these operations.

Post-op isn't complex, it's just frustrating. Buy a Kindle!

Regarding success rate...I understand the PKR is very high. The ACL success is

lower (80%). Australia did a valid study on success rates 2 years ago.

http://www.dmac.adelaide.edu.au/aoanjrr/documents/aoanjrrreport_2009.pdf

>

> Hi,

>

> Can anybody advice post operation complexity/ recovery period and success rate

in both knee replacement surgery.

>

> Thanks

>

> Jyoti

>

[Guest guest]

In a message dated 2/3/2011 5:34:41 A.M. Pacific Standard Time,

bschless@... writes:

damn 4 a.m. pain are the killers from these operations

That hit a note with me. I found that 4AM I would be wide awake, look at my

clock and it would be 4AM. What is the cause? Pain meds. time limit? I

quit the oxycontin type meds after one bottle but took Tylenol nearly every

night until just a couple months ago I just quit using compression socks and

I find that I still have a 1/4 inch swelling every day in my replaced knee

ankle.

(They have to be paid to use them)

That is the way my tree farm expenses work. I can pay insurance twice in

one year and deduct both expenses in one year. One of the reasons farms show

a loss nearly every year. My CPA said well you lost money again. I said

that after retiring as an Electronic Engr. why should I do all this manual

labor to get a tax deduction. He said a lot of the items are only paper

losses. They all looked real to me. After so many years of operating at a loss

our IRS will not let us deduct expenses as they consider it a hobby.

Brickey

[Guest guest]

-

> Hi,

>

> Can anybody advice post operation complexity/ recovery period and success rate

in both knee replacement surgery.

>

> Thanks

>

> Jyoti

I had mine December 17th. It has been the hardest surgery in my life. It hurts

like hell and I didn't push the PT enough in the first few weeks and now my knee

is having trouble bending. My muscles feel like they are twisted and cramped.

Basically the soft tissue leg problems I had before the surgery didn't just go

away and are very painful. I developed sciatica on the side of the TKR, which I

only had on the other side, so icing and tractioning my knee caused terrible

back and hamstring pain. The pain pills never worked well; they made me sleep,

but too groggy to function, and never made the pain go away. I eventually

settled on tramadol and ibuprofen at night, which helped me sleep and ibuprofen

during the day, so I could function. Ice was my only friend in the first month

and I slept with ice packs all night. I advise getting a heating pad. When you

are icing, you get cold, especially in the winter. And know that you have to

work really hard to bend your knee, so keep it moving and do PT several times a

day. Once your sutures are healed, water is your friend and a hot tub and a

warmish pool are a great idea. I encourage you to walk more than you want to in

the first weeks and have a PT show you how to walk toe-heel. I know everybody

has a different experience and I hope that yours will be better than mine.

Devora

>

[Guest guest]

Hello folks,

I have had both knees replaced due to psoriatic arthritis with in 10 years. I

am again having trouble with my knees but not so much with pain but with

stiffness, trouble walking up stairs, unable to move the joint up thus requiring

to pull myself up each step. Recently my psoriasis has come back to the knee

area but only on the back of both knees, whereas it had almost disappeared since

the knees were replaced. I am wondering if anyone has any knowledge and

experience with the disease affecting the knee joint area after replacement.

Thank you

[Guest guest]

Hello Chad,

First I would like to say that knee replacement is not an easy surgery, and recovery is very painful. I did not have the surgery, but for the last 4 years I have work in an orthopedic/rehab unit. We did have HIV+ patients with knee and hip replacement, and their recovery is not different than any other patients. Their age was from 40’s to 65, and all of them have recovered well form the surgery (no infections). The most important things to keep in your mind are:

1. Find a good doctor (low infection rate).

2. Do not touch or let anybody touch your incision bare hands (most infections occur like that).

3. If the doctor tells you too don’t shower for 2 weeks DON’T SHOWER. Use a wash cloth or have someone help you wash.

Remember that everybody is different and their body reacts different to fight infections.

Good luck to you, Dan

From: Vergel <nelsonvergel@...>Pozhealth < >Sent: Thu, June 9, 2011 5:44:03 PMSubject: Fw: Knee replacement

Email chadken@... if you have any suggestions

Vergel <nelsonvergel@...>Sent: Thursday, June 9, 2011 1:08 PMSubject: Knee replacement

Hi All! I am 56 years old, with HIV for 25 years. Non-detectable viral load (almost) and 195 T-cells. I probably will have to have a knee replacement soon. In the past, I read research suggesting high incidents of deep bone infection in HIV positive people getting knee replacemant. Has any body had a joint replacement recently? Any problems or suggestions? I would love your feed-back. Thanks - chad

__._,

[Guest guest]

Hi there,

I have had both of my hips replaced in last year without complications. My

t-cells were much higher than yours, not sure if that will be an issue or not. I

followed myDr.'s orders to the T! I did have a minor case of staph infection in

my incision but it was caught immediately . That was with my first

Hip replacement. My surgeon was excellent and now I can walk, stand up and sit

down pain free. It's like a whole new lease on life. I had a condition called

AVN or avascular necrosis. Just having HIV can cause it and it commonly affects

the hips but can affect other joints and I know several other Lizzie's who have

it but not bad enough to need surgery. I've been assured it was not caused by

Truvada, which can cause minor bone loss in the first couple of months of taking

it but stops after that.

Do you know the name of the condition that requires you to have surgery? Oh, I

am a 53 yr old female and was by far the youngest person in my pre-surgical

joint replacement class. My Dr also had me double up on doses of iron prior to

surgery. At the hospital they started me on coumadin (blood thinner ) to prevent

blood clots and I stayed on it for a month after.

Every persons surgery is individual, just follow your surgeon and HIV doc's

orders for surgery and your aftercare and you'll do fine!

Nena

>

> Hello Chad,

> First I would like to say that knee replacement is not an easy surgery, and

> recovery is very painful. I did not have the surgery, but for the last 4 years

I

> have work in an orthopedic/rehab unit. We did have HIV+ patients with knee and

> hip replacement, and their recovery is not different than any other patients.

> Their age was from 40’s to 65, and all of them have recovered well form the

> surgery (no infections). The most important things to keep in your mind are:

> 1.     Find a good doctor (low infection rate).

> 2.     Do not touch or let anybody touch your incision bare hands (most

> infections occur like that).

> 3.     If the doctor tells you too don’t shower for 2 weeks DON’T

SHOWER. Use a

> wash cloth or have someone help you wash.

> Remember that everybody is different and their body reacts different to fight

> infections.

> Good luck to you,   Dan

>

>

>

>

> ________________________________

> From: Vergel <nelsonvergel@...>

> Pozhealth < >

> Sent: Thu, June 9, 2011 5:44:03 PM

> Subject: Fw: Knee replacement

>

>  

>  Email chadken@... if you have any suggestions

>

>

>

>

> Vergel <nelsonvergel@...>

> Sent: Thursday, June 9, 2011 1:08 PM

> Subject: Knee replacement

>

>

> Hi All! I am 56 years old, with HIV for 25 years. Non-detectable viral load

> (almost) and 195 T-cells. I probably will have to have a knee replacement

soon.

> In the past, I read research suggesting high incidents of deep bone infection

in

> HIV positive people getting knee replacemant. Has any body had a joint

> replacement recently? Any problems or suggestions? I would love your

feed-back.

> Thanks - chad

>

> __._,

>

[Guest guest]

Chad,Can you send on the references for those articles. I work with knee replacements all the time and in my patient population infection is extremely rare, both for poz and neg patients.Larry Smyle, MA, PTOn Jun 9, 2011, at 2:44 PM, Vergel wrote:

Email chadken@... if you have any suggestions Vergel <nelsonvergel@...>Sent: Thursday, June 9, 2011 1:08 PMSubject: Knee replacement

Hi All! I am 56 years old, with HIV for 25 years. Non-detectable viral load (almost) and 195 T-cells. I probably will have to have a knee replacement soon. In the past, I read research suggesting high incidents of deep bone infection in HIV positive people getting knee replacemant. Has any body had a joint replacement recently? Any problems or suggestions? I would love your feed-back. Thanks - chad

__._,

[Guest guest]

I agree with you Larry! I have heard of people having some other issues after

joint replacement but not the bone infection he referred too. Not touching the

incision without having really clean hands

is important. I was able shower the first day after being home

from hospital (4 days after surgery) and I had a 12 inch incision.

During my right hip replacement I did develop a staph infection that surfaced

about 4 weeks after surgery. It was in a very small

area of incision. I went to Urgent Care where they took a

culture and put me on clarithromyacin right away and a topical

cream of AltaBax just in case it was staph. Two days later I

got a call saying it was, and I was told it must have come from

the hospital. But it cleared up right away and then I had my

left hip replaced 6 months later with no issues at all.

Recovery has been fabulous! I found that you need to find a

surgeon who has a good reputation of doing these and a good

team for all your aftercare. And I got excellent care all the

way around....

Nena

>

> >

> > Email chadken@... if you have any suggestions

> >

> >

> >

> > Vergel <nelsonvergel@...>

> > Sent: Thursday, June 9, 2011 1:08 PM

> > Subject: Knee replacement

> >

> > Hi All! I am 56 years old, with HIV for 25 years. Non-detectable viral load

(almost) and 195 T-cells. I probably will have to have a knee replacement soon.

In the past, I read research suggesting high incidents of deep bone infection in

HIV positive people getting knee replacemant. Has any body had a joint

replacement recently? Any problems or suggestions? I would love your feed-back.

Thanks - chad

> > __._,

> >

> >

>

[Guest guest]

I had my right knee replaced a week ago. DO IT!!!! The post-op pain is nothing

compared with the pain i lived with for years. I couldn't bend my knee the day

of the surgery; that night, the doc had me in a passive motion machine bending

my knee 45 degrees, 60 the next day and by the day i went home 90 degrees.

Unbelievable.

As for pain, I don't call it pain. It's discomfort -- sore muscles that are

being exercised for the first time in years; tenderness around the incision.

That's not everyone's experience.

I'm having to stay in a passive motion machine because he had to reattach my

tendons, so my therapy at this stage is very conservative, but in 2-3 weeks, i

should be healed up enough to start working on the knee and i'm told my pain

could get worse. but i don't care! this is wonderful.

and i'm realizing how much the old pain and disability really wore on me, making

me feel old and useless. Now i've got a list going of all the stuff i'm going to

do.

I was anxious and excited before surgery. i kept telling myself in 2 days (or

whatever) I'm going to have a new knee. In a month, i'm gg..... Just keep

telling yourself all the things you'll be able to do because as others have

said....after surgery, every day you get a little better; without surgery, every

day you get a little worse.

[Guest guest]

Congratulations on your progress.....sounds like you are certainly in the right

frame of mind about your surgery and recovery. You should do very well I would

think.

Pat in Pennsylvania

Bilateral TKR August 2010

re: knee replacement

I had my right knee replaced a week ago. DO IT!!!! The post-op pain is nothing

compared with the pain i lived with for years. I couldn't bend my knee the day

of the surgery; that night, the doc had me in a passive motion machine bending

my knee 45 degrees, 60 the next day and by the day i went home 90 degrees.

Unbelievable.

As for pain, I don't call it pain. It's discomfort -- sore muscles that are

being exercised for the first time in years; tenderness around the incision.

That's not everyone's experience.

I'm having to stay in a passive motion machine because he had to reattach my

tendons, so my therapy at this stage is very conservative, but in 2-3 weeks, i

should be healed up enough to start working on the knee and i'm told my pain

could get worse. but i don't care! this is wonderful.

and i'm realizing how much the old pain and disability really wore on me,

making me feel old and useless. Now i've got a list going of all the stuff i'm

going to do.

I was anxious and excited before surgery. i kept telling myself in 2 days (or

whatever) I'm going to have a new knee. In a month, i'm gg..... Just keep

telling yourself all the things you'll be able to do because as others have

said....after surgery, every day you get a little better; without surgery, every

day you get a little worse.

[Guest guest]

I couldnt help but nod " yes yes " with every word i read from you here.

Keep up the good spirits and when you hit a spell of defeat just remind yourself

of the concept x steps ahead might equate to xx steps back or something like

that. I would prefer it to always be the reverse of rhat but that is not real

life i guess.

L

>

> I had my right knee replaced a week ago. DO IT!!!! The post-op pain is nothing

compared with the pain i lived with for years. I couldn't bend my knee the day

of the surgery; that night, the doc had me in a passive motion machine bending

my knee 45 degrees, 60 the next day and by the day i went home 90 degrees.

Unbelievable.

>

> As for pain, I don't call it pain. It's discomfort -- sore muscles that are

being exercised for the first time in years; tenderness around the incision.

That's not everyone's experience.

> I'm having to stay in a passive motion machine because he had to reattach my

tendons, so my therapy at this stage is very conservative, but in 2-3 weeks, i

should be healed up enough to start working on the knee and i'm told my pain

could get worse. but i don't care! this is wonderful.

>

> and i'm realizing how much the old pain and disability really wore on me,

making me feel old and useless. Now i've got a list going of all the stuff i'm

going to do.

>

> I was anxious and excited before surgery. i kept telling myself in 2 days (or

whatever) I'm going to have a new knee. In a month, i'm gg..... Just keep

telling yourself all the things you'll be able to do because as others have

said....after surgery, every day you get a little better; without surgery, every

day you get a little worse.

>

[Guest guest]

I have a partner who replaces old worn out total knees several time a month!

T. Herrick,MD

Tampa Bay Orthopaedic Specialists

6500 66th Street North

Pinellas Park, FL 33781

USA

in Re: Weight/Strength Training after Knee Replacement

Dr. Giarnella,

You mean they get a replacement because of having previously experienced that

disabling discomfort, right? The discomfort is addressed by means of the

replacement, and patients experience improved function and a better quality of

life as a result of the replacement.

Sorry, I found the below a bit ambiguous. It could be interpreted to mean that

knee replacement causes/perpetuates/fails to correct restrictions in pain-free

function. (I don’t think that’s what you meant.)

===========================

[Guest guest]

I have a partner who replaces old worn out total knees several time a month!

T. Herrick,MD

Tampa Bay Orthopaedic Specialists

6500 66th Street North

Pinellas Park, FL 33781

USA

in Re: Weight/Strength Training after Knee Replacement

Dr. Giarnella,

You mean they get a replacement because of having previously experienced that

disabling discomfort, right? The discomfort is addressed by means of the

replacement, and patients experience improved function and a better quality of

life as a result of the replacement.

Sorry, I found the below a bit ambiguous. It could be interpreted to mean that

knee replacement causes/perpetuates/fails to correct restrictions in pain-free

function. (I don’t think that’s what you meant.)

===========================

[Guest guest]

Could share with us what are the difficulties if any in replacing worn out knees

and what are the major causes of failure?  As an Internist/Gastro I have not

seen many patients who have had knee replacements much less having them

replaced. 

 Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Herrick <rherrick@...>

" Supertraining " <Supertraining >

Sent: Friday, October 14, 2011 2:44 PM

Subject: Re: Knee Replacement

 

I have a partner who replaces old worn out total knees several time a month!

T. Herrick,MD

Tampa Bay Orthopaedic Specialists

6500 66th Street North

Pinellas Park, FL 33781

USA

in Re: Weight/Strength Training after Knee Replacement

Dr. Giarnella,

You mean they get a replacement because of having previously experienced that

disabling discomfort, right? The discomfort is addressed by means of the

replacement, and patients experience improved function and a better quality of

life as a result of the replacement.

Sorry, I found the below a bit ambiguous. It could be interpreted to mean that

knee replacement causes/perpetuates/fails to correct restrictions in pain-free

function. (I don’t think that’s what you meant.)

===========================