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Total Knee Replacement

scpsu76

Well-Known Member
Nov 7, 2011
530
127
1
Realistically, I am going to have to replace my left knee. Dr. Sebastinelli here in State College.

Any thoughts recommendations? Please share your experiences.
 
For any surgery, get someone who specializes

It's all about reps. Sebastianelli may or may not do a lot of joint replacements at this point in his career.

Do some research, who does a ton of these. You may, depending on what your insurance allows, want to have it done in Hershey or Pittsburgh or Philly or maybe Geisinger. Some place that does 10 or 20 or more every week. You want people who have dealt with every conceivable complication.

Have no idea what the odds are, but if the positioning is off by even a millimeter it can be a real mess.
 
Just had a friend stay with us for the first couple weeks after a knee replacement. From observation: do what the doctor tells, don't think you know better. Particularly the pain medication for the first couple weeks and the activity recommended and allowed. Use the crutches for as long as he tells you. Don't be afraid to call when he tells you to call, e.g. high fever or extended high temperature.
 
At the age of 52 during an indoor soccer league match I tore my ACL, broke a rib and dislocated my shoulder all in one fall. I didn't realize I tore my ACL because the pain was so great from my other injuries. Three years later due to instability, I ground my cartilage to bone on bone hiking, fly fishing, and doing all sorts of things with my active life.

so, at the age of 55, I had a total Knee replacement. you need to discuss with your surgeon what you want out of the balance of your life. Are you active, real active, sedentary ? These things matter.

Are you over weight, what sort of lifestyle do you envision moving forward. Do you hike, bike, play tennis, golf, ski? understand what you will be giving up and what you will be gaining.

I had mine done at a small surgery center by a specialist. There are many excellent facilities and surgeons out there for this operation.

Are you currently in Physical Therapy? if not, get there and get your leg as strong and flexible ( including making it straight ) as you can prior to your surgery.

good luck and go get em!!!!
 
Had my right knee done this past July. Entered the hospital

on a Tuesday for 7:30am surgery, left hospital on Thursday.

Points/Issues.....
My Doctor was spot on....it's a 6 month rehab time frameGet ahead and stay ahead with your pain meds.The tourniquet applied very high on your thigh will cause discomfort and swelling for a week or twoDaily life things will be difficult.....sitting down on the toilet, steps, etc.For the first 6 weeks or so, I slept in 1.5 hour shifts. Knee pain would waken me and then it was a battle to find a position that the knee would allow me to fall back to sleep. I slept in every bedroom and my recliner.Get out of the hospital asap and go home. Use hospital provided home healthcare(nurse and physical therapy). Don't go to a rehab facility.Physical therapy is very, very critical to your rehab.....drive yourself to please your physical therapist.Straightening your knee will be very important....do this early. Then, focus on bending. Don't be afraid to have your physical therapist force your knee to bend. It doesn't hurt, but your mind will suggest otherwise.Having the staples removed is a really cool process.When the hospital home healthcare program is over, go straight to a physical therapy facility for 3 days a week. Challenge yourself!
It's now almost 8 months since my surgery. I'm thrilled with my ability to live life, go for walks, etc. with no pain. I'm even jogging a bit....been 10+ years since I did that!

I have a Stryker knee.....it's fantastic!

Best of luck to you!
 
At this point my jogging is from the side door to the mailbox

and back....about 200 feet.
smile.r191677.gif


I'm most anxious to get back to golf. Really struggled the past 5+ years because I couldn't get my weight off my left side(I'm right handed). Knee would slip and sting! Developed an incredible snap hook!

I've never been a jogger per se. Jogging will place stress on the pads on each end of the new knee. The pads are where technology has really advanced and added life to the knee.

I'm 60, put off surgery for 5 years because I want to minimize the need to go through the surgery again. Rehab is a grind.

Attended physical therapy with a 66+ year old fella who over the past 10 years had both knees replace and most recently a hip. He said the hip surgery was a piece of cake compared to the knee replacement surgery.
 
Not my experience but that of several friends and clients over the years:

Get yourself, and especially your legs, in the best shape you can muster before the surgery. With a damaged knee that may mean swimming as opposed to running or biking. Whatever you can tolerate to get your muscles above and below the replacement site stronger will pay dividends in rehab.

The folks who did this has better results than those who did not. Several told me they were able to use a stationary bike for the pre-surgery exercise and it helped a lot.
 
I work in a PT clinic in MD and about 30% of the patients we see are due to knee replacements. Everyone so far has been spot on with suggestions. Find a doctor that only does knees, it isn't a hard thing to find out. Some do knees and ankles or knees and hips and those are fine, just don't pick a doctor because of a name find someone who specializes with total knee surgery. If that means gonig to Hershey or somewhere in Philly do it, you want this done right the first time, it will be worth the inconveince of travel. If you are a smoker stop now, that will drastically help your recovery. If you want and are able try exercising your legs now especially your quads and hamstrings, it will help speed up the recovery time. Now it won't make recovery only a week or 2 but we find that people who are in better shape before surgery recover much faster and better than those who aren't. Listen to everything your doctor says about your medicine and rehab. I know not all doctors are right, but if you find one that has done 50 or so of these surgerys they know better than you do about what to expect and what to do. PT is going to be at least 3 months, and the first few weeks will be the most unpleaseant. However, it is cruical to get the range of motion back in your knee as quickly as possible. Not to try and scare you but if your doctor isn't happy with the way the range of motion is after 4 to 6 weeks they will put you under and force your knee to move, not a fun thing to go through. Won't hurt while you are asleep, but I have heard some people say that the next day after that procedure was more painful than surgery itself. The success rate for knee replacements has drastically gone up over the last 5 to 10 years, they joint itself is made better and made to last longer. Good luck to you.
 
Re: For any surgery, get someone who specializes


I have had 3 knee replacements. Your knee will never be like it was when you were younger but you will not have to live with a lot of pain. You will have to protect the knee from injury because they do not stand up to a lot falls and such. You will have to avoid getting down on your knees because this places stress on the new joint.
 
Had my left knee replaced at age of 59 and now at 64 have just had my right replaced 9 days ago. Came home after 4 days in hospital. I am also an experienced RN. Length of hospital stay will depend on your doctor, you, and the insurance company. With no complications the average patient will spend two additional days plus the day of surgery. All the advice about strengthening your quads is accurate, if time allows. Pain is the biggest issue to overcome, as it is extremely discomforting postop. Make sure your doctor gives ample tools to the nurse for pain relief. I would suggest a PCA (patient controlled analgesia) for the first 12 hours or so for pain relief. Not having a PCA requires the RN to stay on top of your requests for pain medication. Not all nurses can be as prompt as you wish, depending on their patient load. The ideal PCA order would include a continuous amount plus a bolus feature to control breakthrough pain. Morphine is typically ordered. My preference is fentanyl, but a lot of docs will not allow the nurses to use this or hospital policy limits its use to critical care ? OR areas. If your physician is not comfortable with this method of delivery, then a PCA with bolus only feature is useless...you fall asleep and awaken in pain, and playing catch up is not a good policy. If you have specific questions email me tkelly@neb.rr.com and I will answer in between naps.
 
Had mine done in January of 2014. Some thoughts -

Be prepared for the first week or two to be pure hell --- lots of pain, toilet a real challenge (even with a riser), shower a challenge (even with assistance), not much fun and, to be honest, worse than I expected.

You'll actually start physical therapy almost immediately at the hospital, then for three weeks in home and then for several more weeks at an out patient location. Give it 100% and work your butt off. I had a great person in home and an even better team at my outpatient location. I've always been competitive and in good shape, so I actually looked forward to my sessions ("bring it on"). Because of my athletic profile and positive attitude my key therapist gave me a lot of "tough love" --- it hurt, a lot sometimes, but I needed it. After my medicare allotment of paid visits ran out, I joined the same Fitness Center and continued to work very hard on the recommended exercises and specialized knee equipment there. It's a slow process even under the best of situations, but improvement IS steady and DOES come. IMO, the two biggest mistakes people make are not embracing and maximizing their physical therapy and not continuing their exercises and physical therapy after the initial two months. I'm now a little over a year out, and I'm still working hard on my knee and legs. The actual operation is just plain "violent" and also affects the calf and the hamstring. It's important to also work them very hard, not just the knee. Bottom line is that I'm in the top percentiles on everything but bending, and that is due to a horrendous ski injury 40 years ago that won't allow me to ever have quite the same flex and angle of bending in my "new" knee, but, that said, I am very, very pleased.

Don't get discouraged those first several weeks, work hard, and embrace your physical therapy and exercise schedules -- and you'll be rewarded with a much better life after your knee replacement. By the way, I'm 72.

For the life of me, I still do not know how people can do both knees at the same time --- I can't imagine that.
 
so, now that I have read the thread again, here are some more things to consider:

physical therapy before and after is a must. the stronger your leg going in, the better off you are after. 3 times a week for PT as mentioned combined with same exercises at home.

get yourself the best joint cooling system you kind buy. go on line and get a professional grade ice or gel pack unit.

get a bathtub seat for taking showers. easy to get onto and you shower sitting down, really awesome.

make sure you have your walker, cane, crutches, etc before you come home.

if you already don't have one, now is the time to invest in an adult height toilet. you will start a new thread thanking me in 6 months. be the king, own the throne!

sleep with a pillow between your knees.

hard work will pay off.

I go hiking, kayaking, bike, paddle board, swim, fly fishing, etc, and I pursue my passions strenuously.

and again, if you are carrying extra pounds, lose them, I did, its fantastic.

good luck, I was driving myself to rehab 35 miles away within 3 weeks and got off the pain meds quick.

most of this stuff they will tell you or insist on, I am just repeating it. I live by myself and only had help for 4 days and managed.

now go get em Tiger.
 
Make absolute certainty do a pre-habilitation program. Get the leg as ....

Strong as possible. It makes post surgery rehabilitation a piece of cake. I had knee replacement 6 years ago and have not had any problems. I played nine holes of golf 30 days after surgery.
 
Dr. Kenneth Cherry is best in State College


Dr. Kenneth L Cherry is the best orthopedic surgeon in State College and specializes in Knee Replacements and is one of the best in Penna. and the country.

He co-founded University Orthopedics Center in State College in 1991.

Check out his credentials.
 
I had my left knee replaced Jan 2000, after 6 surgeries over 20 years I had bone on bone and my leg starting to bow out. I was a 10 handicap, weight shift to my left side was biggest fault. Now my handicap is 4 to 5, 15 years later. my rehab was compounded by a large amount of scar tissue + too much blood thinner for 2 days post surgery. My suggestion to avoid this would be to make sure your drains are working after surgery and monitor the coumodin (blood thinner) levels. The tremendous swelling i experienced stretched my rehab to 6 months 4 days per week as my leg atrophyed due to the swelling. Finally i tried a poultice like vets use on horses to reduce the swelling faster and it really helped. next, rehab with a facility to use ice, swimming and exercise combinations. My Dr prescribed indefinite rehab for insurance purposes and i took full advantage.
When i originally considered this surgery i was told the replacement would only last 10 to 15 years. at age 50 it was a big concern and several Dr.s really would not consider doing it. I am now past 15 years since surgery and in Jan i had an exam even though i had no problems just to see where i was in terms of condition. Xrays and mri show my replacement is still near perfect and should be good for another 10-15. When i pressed the issue Doc told me back in 2000 they didnt have enough data to truly estimate how long the replacement would last. So don't assume you need this done again.
One recommendation would be to use a compression knee brace (just a compression sleeve, recently tried the new Copper ones and they work fine) for activity. I've always used something when playing golf even though i don't need a brace it helps control any swelling and gives a sense of stability- I don't run, I learned to sleep on my back, and take I no meds.
Good luck.
 
I would recommend based on the rec of one of my best friends to seek a surgeon who performs minimally invasive knee replacements. There is also a technique called the quadriceps tendon sparing procedure which, if you're a candidate for this, would cut your rehab time and pain level quite a bit. The procedure takes 3-4 hours from what I've been told which is a lot longer than the conventional total knee replacement which takes approx. 30 minutes (again information I have been told). I am going to be checking into this as I am in need of a new knee but have been too busy to set up the appts et al.
Wish you the best of luck with this and good health down the road.
 
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