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TKR surgery or not?

(21 Posts)
5together Sat 27-Mar-21 21:05:21

Hi Gransnetters, looking for some advice. Many years ago I had an accident that smashed up my knee area and was fixed with a bone graft, plate and pins. I haven’t been able to run since, range of movement was somewhat limited so I couldn’t fully bend the knee but otherwise it was functional and mostly pain free. As the years have gone on, it’s got twingier (is that a word? :-)) in the winter and I’ve had physio on and off for years as I subconsciously transfer weight to my other leg and end up with various aches and pains. Now I find it harder to go up as well as downstairs. Sitting so much over lockdown and no swimming won’t have helped. My GP referred me to our local hospital who confirmed I now have severe arthritis in my damaged knee and a TKR is advised. Because of my prior surgery and potential issues with an existing large scar I was referred to a complex care consultant at Guys hospital. She has also confirmed that my OA is severe and the only option is to replace the joint. But here’s my problem- the no 1 decision for TKR replacement is normally pain. I have very little- it doesn’t keep me awake at night, I can walk on the flat ok it is just up and down that is an issue. On the other hand I’m only in my mid 50s, so am I sacrificing quality of life? I suspect my mobility has been quietly diminishing for some time. I’m put off by major surgery and the thought of pain (I guess if you’re already in pain you’re no worse off?) and a long recovery and also the advice from the consultant 25+ years ago, who warned me that I would eventually need TKR but to put it off as long as possible! I think only one TKR was possible then. I’m on the list for surgery and the consultant has marked me as a priority case but she knows I’m hesitant and says I can turn it down if I’m not ready. I’ve been called for my pre op (no date yet, but they’re getting ready). I’m still in two minds and fear I will be when they offer me a date. Any advice? Thank you for reading the longest post ever!

Aveline Sat 27-Mar-21 21:16:07

I ended up going from seat to seat. It quietly crept up on me until I was actually planning my shopping list to fit the supermarket so as to use as few steps as possible.
Obviously, you're not in pain but something took to the GP and consultant... Are these problems going to get better? Most likely not. If the consultant, having examined you and looked at your X rays, has prioritised you then it's most likely that you'd benefit from a TKR.
I'm so glad I had mine done. I got my mobility back. The recovery isn't fun but it passes and is well worth it. Good luck.

Oopsadaisy1 Sat 27-Mar-21 21:32:00

DD2 had a Partial knee replacement just over 3 weeks ago, she is in her late 40s and a PKR was used so that if she needs another knee later in life she can opt for a TKR, as you say once you’ve had one of those you can’t get another one.
PM me if you want more details.
However because of Osteo Arthritis she was ( and still is in her other knee) in a lot of pain with walking as well as stairs and was unable to do her job.
Have you been told about the PKR?

Charleygirl5 Sat 27-Mar-21 22:08:17

I have had both knees replaced at different times and the second one was fabulous. I was mainly in pain in bed at night but my mobility was almost non-esistent.

Okay I cannot walk far but I (in normal times) can get on and off a bus and tube. I am now pain free, just the odd twinge.

I chose my consultant carefully but having worked with many I had a good idea who was the best.

A friend of mine was pain fee afterwards, I was not so lucky but after around 6 weeks I was a different person. If you want to PM me feel free.

5together Sat 27-Mar-21 23:17:25

Thanks Aveline. You’re right, I went to theGP because I have periods of pain. I tend to forget about it when it isn’t troubling me. I guess I hear about people in constant pain and I’m lucky enough not to have that. Glad to hear your surgery was worth it in the end.

5together Sat 27-Mar-21 23:21:37

Thanks Oopsadaisy1. My knee is not suitable for PKR - I have severe OA in all compartments of the knee. I actually saw a third consultant privately; the view has been consistent across all of them, the knee has had it and replacement, TKR, is the only way forward.

5together Sat 27-Mar-21 23:38:44

Thanks Charleygirl5. Was the post op pain greater than the pain you had pre op? That is the bit I know I’ll struggle with. After my original accident I had serious pain for nearly a year (to the point where I almost wished I didn’t have my leg). Gradually the pain diminished and I only really pay attention when the pain makes it difficult for me to walk but I really don’t relish the thought of pain like that again. I had the metal work removed after a couple of years and an arthroscopy a few years later, both went well but I had horrendous pain post op following an operation on my foot about 4 years ago and it’s taken a couple of years and a steroid injection for it to settle. I know my knee can’t get better and I suspect the longer I wait, the worse my mobility will be - and in the meantime my poor other knee (which does ache but only has mild OA) it taking the brunt...

Aveline Sun 28-Mar-21 10:13:22

Get that op ASAP. If its affecting your other joints because they are taking the strain that's not a good outlook. By delaying this you could go on to need another TKR and hip replacement.
Any pain I had after my op was managed by paracetamol as I didn't like the opioides. The hospital were very keen on pain management though. Really, don't delay. I'm glad every day that I had mine done. Check the Bonesmart website for first hand info. I found it a lifesaver.

Charleygirl5 Sun 28-Mar-21 10:20:04

5together the pain post-op for me was greatly increased but I knew eventually it would go away. Please get it done asap because the longer you leave it the more difficult it will be to do the op and you want the best possible result.

It sounds to me as though you have grade 4 OA so get a move on!

Aveline Sun 28-Mar-21 10:29:16

Charleygirl knows of what she speaks!!

jusnoneed Sun 28-Mar-21 10:32:29

My OH, his sister and his brother have all had TKR on both knees. All have got on well, each found one or other easier to recover from (took about 5/6 weeks) but all are now mainly pain free. My OH regular walks 5-6 miles across country, his sister walks the dog all over the place and his brother is still working although he had to slightly change his job as he used to climb about doing roof trusses!
All three are really glad they had the choice to have the ops. I think making sure the physio is done is one of the main helps, up and about asap.

hulahoop Sun 28-Mar-21 10:42:15

I worked on orthopaedics a long time all I can say was although there is some pain it can usually be managed well ,everyone is different but overall majority of people were glad they had had it done .

henetha Sun 28-Mar-21 11:06:28

It's great that your pain is quite manageable, but if you have been advised to have TKR then you must need it, in spite of you being rather young for this op. One problem being that these replacements don't last for ever so you would probably need it done again when you are older.
I've had two TKR's. One when I was 68 and the second one at 79. Both were entirely successul. I was very lucky and now have total leg mobility without pain, apart from the odd twinge recently in the first one, due I suppose to it gradually wearing out now.
So good luck with your decision. Personally I think knee replacements are wonderful and a whole new lease of life.
The physiotherapy afterwards is very important for the op to be successful.

Charleygirl5 Sun 28-Mar-21 14:29:32

Please choose an orthopaedic consultant who operates on knees and hips only. You do not want a jack of all trades who is master of none.

SueDonim Sun 28-Mar-21 15:56:00


Please choose an orthopaedic consultant who operates on knees and hips only. You do not want a jack of all trades who is master of none.

Next time I speak to my well-regarded orthopaedic consultant friend, I must remember to let her know that after 30+ years of experience, she’s only an inferior type of specialist. angry

To the OP, my mum has had both hip and knee replacements. Although she did have pain beforehand, making the ops necessary, there are other benefits, too. Her knee stopped ‘giving way’ as she walked and her general mobility and gait improved, too. Good luck!

annsixty Sun 28-Mar-21 16:00:27

I had my knee done at 79 and my hip, same side, at 83, to me it is a no-brainier.
You must expect some pain immediately post op but mine was very well managed and I only had paracetamol after my hip.
After a few weeks very little discomfort at all.

Aveline Sun 28-Mar-21 17:37:42

I was told after my last knee replacement that the new joints are lasting up to 40 years. I suppose a lot depends on what you do with them of course. I want mine to last so I'm not going mad in the gym! Aquafit, yoga and walking suit me fine - none were possible before my ops though.

5together Mon 29-Mar-21 22:14:53

Thank you all for your kind and encouraging messages. Time to ‘woman up’ and get on with it, I think. I’ve only just had my first Covid-19 jab, so I’ve got a good few weeks to get my head around it - and the planning ahead of a few weeks off week and my menfolk in charge of the house...

MissieandOllie Mon 29-Mar-21 22:43:34

I had a TKR (following a car accident) 5 years ago at the age of 57. I was told that you can have the original replaced as they don’t last forever. I understand the operation is harder though.

MissieandOllie Mon 29-Mar-21 22:54:23

I’m thinking of booking a cruise for September 2022 with partial Covid insurance. Basically if I get it I’m covered but if I have to shield I’m not covered. Anyone know any insurance companies for cruises that gives full Covid cover? Am I mad wanting to go?

Hetty58 Mon 29-Mar-21 23:07:33

5together, I'd definitely put it off for now (or anything not urgent) until there's more capacity in the NHS, less uncertainty about vaccine- resistant variants - and there's been a little time to catch up with all the operations that have been delayed.

If you're not in pain and can manage, there's no rush.