Knee replacement surgery

Mary19

Hello, I was told yesterday I need total knee replacement on both knees. The operations will be three months apart. I have OA and have been trying to avoid this operation for years. I am so worried.
I am 65 and live a very busy life caring for, an adult child who has a learning disability, my husband who has bone marrow cancer and my mum who is now blind and dependant on me. What are other members experience of this operation including rehabilitation, I would be grateful for any advice at the moment I do not know which way to turn.
Thank you.

stickywicket

Oh Mary, what an awful dilemma! Of course you ‘don’t know which way to turn’. I really feel for you. However, you’re looking for practical advice, not emotions, so here goes.

First of all, try not to worry about the operations themselves. I had two TKRs in 1981 and still have one of them. The other was replaced about three years ago. But – and it’s a big but – you will have to give yourself the time to make them work and that means exercises before the operations and exercises and rest and very little else for some time afterwards. Try to rush or skimp things and you run a very real risk of being not much better off than you are now. You’ll also be unable to drive for about 6 weeks after each op. Arthritis Care have a booklet on surgery which might help. Go to 'Publications & Resources' at the top right of the page.

You’re probably now wondering if you can go through with these operations at all. I think you must. If you read this forum for any length of time – and I’m sure you don’t have time for that :roll: - you’ll realize that lots of people are wanting, and needing, new knees but can’t even get on the waiting lists. If your surgeon is offering them it must be because you really do need them. One or two people have had both knees done at once which might speed up recovery but not all surgeons will offer this.

Quite how you’ll manage to delegate all your other commitments (and delegate you must) I honestly don’t know. Do you have family members who could help on a rota basis? I think you should ring our helpline people who I’m sure will point you in the right direction for such help. The only other thing that comes to mind is that Carers UK probably find similar problems cropping up and will have some expertise.

I do hope you can find some practical solutions, Mary. This is your time to be cared for and looked after. That’s the point at which you must start.

maria09

Hi Mary,
I have no experience in having a TKR but do have experience looking after patients post operatively.
Where I worked which now is over a year ago so things may have changed also surgeon to surgeon and region to region differ.
Most operations are done under spinal anaesthetic as recovery is quicker than having a general anaesthetic
On return from theatre your work practically starts straight away
Some surgeons use what's called CPM machine which stands for continuous passive movement they place your leg on the machine and set the angle at a certain degree usually 30 degrees to start with and it gently and slowly bends your knee without you having to do the work the length of time and degrees depend on your consultant and physio it can be uncomfortable but bearable
Make sure your pain is kept under control you don't want to get to the stage where you are in agony and can't perform your exercises they use a pain score of 0-10 0 no pain 10 the worst imaginable and makes you want to cry ( that was the easiest way I could explain it)
There some patients have PCA this is patient controlled analgesia. Attached to your bed is a machine which has morphine in it and is set to give you 1mg of morphine in a 5 minute period but only when you press the hand set if you press your hand set say 8 times in that 5 mins you will only get the one dose so you can't overdose on it
Other methods they use are morphine either orally or injection form usually only for the operation day then they go onto oral analgesia such as codeine or tramadol it all depends on you and how you feel.
Usually home 3-4 days but it does depend on how you are feeling and how good your knee flexion is.
Having a knee replacement is hard work as they concentrate on your knee bending and they certainly make sure you do your exercises
You may have sutures or clips or internal sutures in some people find it feels quite tight and feel like the wound is going to open up which is very rare if that does happen I've never known it in the 26yrs working on an orthopaedic ward.
I think I've gone through everything but if you want to pm me I'm happy to answer any questions.
Have you thought about involving social services to see if there s any help they can give your mum and husband whist you are in hospital and once you are home so you can concentrate on getting yourself better?
Just remember every hospital has their own ways of doing things so what I've said to you may be slightly different where you are.
You should be going to pre assessment clinic before hand so can ask any questions you have.
All the best and I hope all goes well
Maria

dreamdaisy

Hello Mary19, it's lovely to meet you and I hope we can help with information but, more importantly, support. No wonder you are feeling so bemused and uncertain, having a TKR is a big deal and the recovery can take a while even for those who don't face the home circumstances that make your daily life.

One thing is certain - you are going to need help post-surgery with all your carer duties but I don't know how to start organising that. You should talk to your GP, he may be able to point you in the right direction. Another useful call to make would be to the Helplines here (the number is at the top of each page) they are very good listeners and should be able to give you some good advice.

You need to be better, to be fitter, to be in less pain and more able to move. For the time being YOU are the priority; you may be very used to putting the needs of others first but now it's your turn. This is not being selfish, it's being practical and realistic. We will back you every step of the way (no matter how slow and painful those steps will be). DD

lizzieuk1

Hi Mary

Wow you really are amazing managing so much with obviously v painful knees.
I can't advise re tkr but some great advice already given - I agree if the surgeons suggested it you obv need it.
Just a thought have you asked your gp about Macmillan support for your husband? That may offer a bit of help for you.
As said def call social services they should be able to set up care to help not only your husband and adult child but also yourself, sounds like you've been doing a huge amount of caring and perhaps nows the time to get a support system in place long term,
Xx

barbara12

Hello Mary
And a warm welcome from me..gosh I really do feel for you,its strange how these things can come together...somehow you will get through all this...we have quite a few on here that have new knees and are so pleased with them...you will need help ..and maybe you have never put yourself first but there comes a time.
Now you can talk to us that might help you get things in perspective, when you have your first knee you must make it clear you need help at home...
I do wish you well with the future and the ops..you take care xx

Mary19

I am so grateful to you all, I cried when I read your replies, but in a good way, the way you do sometimes when you feel helped and supported. I have never used any forum before, but so glad I found Arthritis Care. I will get my head round this situation eventually, I will start by ringing this helpline and I will make an appointment to see my GP. The difficulty for me I am so programmed to be there and caring for my lovely family. In my head I have the answers, in my heart I am so upset.
Thank you again, because of your responses I feel more positive and will start to put things in place.

Helenbothknees

Hi Mary. I know nothing about caring for people, but you've had some good advice here. However, I do know about TKRs; I had both knees replaced during the same operation last July. I can honestly say it's the best thing I ever did; it's given me my life back and I can do so much more than I could before....and I'm almost pain free after being unable to walk at all without severe pain. So if you want to know about the op itself, what to expect afterwards, and so on, feel free to ask. I'm not here that often, as I don't consider myself to have arthritis any more, but I do drop in now and then - mainly to try to help people like you, as thanks for all the people who helped me.

chookgate

Hi Mary, I've had two TKR's, three months apart. I was terrified, and not a little upset when I was told that I needed it. But I am so glad I did, whereas before I struggled to get out of a chair, and standing for longer than a minute was very painful, now I take pleasure in just standing up!

As others have said though, you will need to set aside time to recover. You'll be out of hospital in 3-5 days, but you will need help for at least the first week as you will be on crutches and won't be able to do things like carry a cup of tea. It gets easier quite quickly though, as long as you stick to the exercises you get given to do - these are likely to be painful, but essential. You'll also feel physically very tired for at least a few weeks, and probably spend a lot of time sleeping.

When it's all over, and you're a couple of months down the line (after the second one), you'll wonder why you'd been worried.

dreamdaisy

Hello again, I have been thinking of you on and off all day - I suspect that this decision will be far from easy for you but please, please put your needs first. Your knees need mending and I hope you will be able to get yourself into a position re. help where that can happen. Everyone's arthritis is different, everyone's recovery is different but the benefits usually outweigh the relatively 'temporary' inconveniences of healing and recuperation. Your knees have probably taken years to get into this state - recovery will be faster than that. Take care. DD

blueknees

Well Mary you have certainly had some positive reports however I will put my experience on record here as being not so positive.

I'm almost a year post op following my new knee and still struggling with pain and stiffness. There has been a marked improvement over the past few weeks but it has taken a long slow year to get there.

You are a very busy person with others depending on you to look after them, you will not be able to carry on during the immediate weeks following the surgery as you will need some help yourself. If you go too fast it will slow your progress, in my experience too much hard physio had a negative affect on me.

I wish you all the luck in the world and hope you get through it well but be prepared for the hard part as it is major surgery.

Sorry if I appear harsh but I find the truth hurts but it is better to be fully prepared than not.

To fail to plan means you plan to fail.