Choosing a surgeon and hospital for knee replacement surgery

[Deserterer]

Originally Posted by matisse12

I am directing the above to Deserterer because he or she mentioned that "plenty of people with no cartilage in the knee(s) have no pain" which I have never heard about, so I was hoping he or she might comment more on this.

read up on "total meniscectomy." It does increase the chances of developing arthritis, or hasten its development but I know someone who had it and was pain free for at least 20 years.However the long term effects are better known now and I don't think its a common procedure anymore. For much of the 20th century, it was much more common. My friend had it done in about 1980.



There are 2 menisci in each knee, I don't know if he had one or both removed but I worked with him and it was abviously not hindering him 20 years later. This was about 15-20 years ago so he probably had the surgery in 1980 or 85.

[PittsburghPatty]

About the “no pain” issue— pain is very subjective. One person’s agony is another person’s moderate discomfort. Pain tolerance varies.
Also, body weight, activity level, age, overall fitness all can influence your level of pain.

I’m “ bone on bone” now and Although I’m not waking up during the night in pain—standing in a grocery line or at the stove will create significant pain after five minutes. Getting up from a seated position is painful also walking more than a few minutes. Forget kneeling. Stairs are not only painful but requires balancing which goes out the window without cartilage.
Yes, I need a TKR but where and with whom needs to be determined.

[matisse12]

Originally Posted by Deserterer

read up on "total meniscectomy." It does increase the chances of developing arthritis, or hasten its development but I know someone who had it and was pain free for at least 20 years.However the long term effects are better known now and I don't think its a common procedure anymore. For much of the 20th century, it was much more common. My friend had it done in about 1980.

There are 2 menisci in each knee, I don't know if he had one or both removed but I worked with him and it was abviously not hindering him 20 years later. This was about 15-20 years ago so he probably had the surgery in 1980 or 85.

So you made your statement of "there are plenty of people who have no cartilage who do not have pain" based on ONE person you know who did not have total knee replacement surgery but had total meniscectomy and that was back in 1980 or 1985..... 40 or 35 years ago.....

and even if he did have total knee replacement, you're basing your very broad based statement about cartilage and pain on ONE person you happened to know.

[matisse12]

Originally Posted by PittsburghPatty

About the “no pain” issue— pain is very subjective. One person’s agony is another person’s moderate discomfort. Pain tolerance varies.
Also, body weight, activity level, age, overall fitness all can influence your level of pain.

I’m “ bone on bone” now and Although I’m not waking up during the night in pain—standing in a grocery line or at the stove will create significant pain after five minutes. Getting up from a seated position is painful also walking more than a few minutes. Forget kneeling. Stairs are not only painful but requires balancing which goes out the window without cartilage.
Yes, I need a TKR but where and with whom needs to be determined.

I have the same. I do not agree that this type of pain is particularly subjective though....both pre and post surgery. I would like to hear, though, from others who have the total knee replacement using the robotic method and less invasive cutting.

And if less pain with the robotic method is also due to having partial knee replacement surgery rather than full.
But if those with full using robotic had more pain with robotic than partial.

[Deserterer]

Originally Posted by matisse12

So you made your statement of "there are plenty of people who have no cartilage who do not have pain" based on ONE person you know who did not have total knee replacement surgery but had total meniscectomy and that was back in 1980 or 1985..... 40 or 35 years ago.....

and even if he did have total knee replacement, you're basing your very broad based statement about cartilage and pain on ONE person you happened to know.

That's what you read but that's not what I said. Total meniscectomy used to be common, and it did eliminate pain, often for years. It was thought to be a useless tissue. But then it was found that it leads to degeneration and pain.

Some people also have no pain with meniscus tears. Many older people show tears, even those who have no symptoms. This is why its always a good idea to think twice aboiut surgery or get second opinions when you are diagnosed with meniscus tears. They aren't necessarily the cause of the pain.

I am bone on bone in my medial compartment of my left knee, but its the lateral compartment where I still have cartiilage that hurts the most. Everyone is different but being bone on bone doesn't necessarily mean pain today, although it is a precursor to eventual trouble.

[karen_in_nh_2012]

Originally Posted by PittsburghPatty

Karen:
Your experience is amazing and I hope mine is as positive.
The only thing that worried me about it was your quick discharge from the hospital. I live on my own and I'm worried about how I will do without assistance. I wonder how other single people do it. I guess I am assuming I'll hire a home health type person for a few days but I'd prefer to stay a little longer inpatient and be in better shape when going home. My mom was in the hospital a few days after surgery and then sent to rehab for about 5 days. She went home alone at that point and did well. She had PT come home for a while also.

I'd like to hear how other single people managed.

I WANTED to get out of the hospital as quickly as possible!! Then again, I am EXTREMELY independent and HATED being an inpatient. YMMV!

I managed just fine on my own. With the first surgery, a friend drove me home and I had set up my TV room as a sleeping room since I knew stairs would be very difficult (I have a 2-story house). The TV room has a chair bed so I slept on that for the first week or two -- it was fine although the room has only a doorway, not a door, so I couldn't keep my kitties out! Also, I had to sleep on my back, which is my LEAST favorite position (and a position I never choose if I don't have to!) -- so that was hard to get used to (took probably a couple of months before I could sleep COMFORTABLY on my sides/stomach again.)

Anyway, the PT company came to me 3 times a week and we did the exercises in the first-floor rooms. When they weren't there, I did exercises on my own and otherwise just hobbled around on my walker. The walker was a pain to maneuver so I switched to a cane ASAP. I'd been told I couldn't be able to drive for 6 weeks (especially because my car is a stick-shift), but I tried after 2 weeks and I could so I did. (Note, I could do this ONLY because I stopped the opioids within a few days the first time -- they simply weren't effective AND I wanted to drive and knew I couldn't if I were on opioids.)

The second time went even better -- the opioids were once again totally ineffective so I was off them by day 2 or 3. (I wrote a thread about the opioids as NONE of them have ever worked well for me ... must be my body chemistry.) I was driving within a week. I did NOT have the PT company come back -- instead, I just did the exercises on my own. (The PT company was not reliable the first time around -- honestly, I'm appalled that the hospital continued to USE them.)

Originally my SO was going to be up here for my 2nd surgery or just after, but COVID changed that. He could have done things like cook for me () but honestly, I was totally fine by myself. The pain was bad but I knew it would be and I also knew it would go away eventually. Luckily, since my work schedule was COMPLETELY flexible, I could sleep whenever I needed to, so if it took me 2-3 hours to get to sleep at first -- and it did, many times -- I knew I could sleep as late as I wanted to the next day so I managed.

I really had no problems at all being on my own. Things like going upstairs took me longer (my home office was upstairs so I had to go up there 2-3 times a day), but I could still do them.

The only thing I remember as being impossible at first was lifting heavy bags. My main source of heat is usually my pellet insert, but it couldn't be that winter because I could not lift the 40-lb. bags -- I would not have even tried to! But everything else was do-able. Even when I couldn't yet drive, I could go to my doctor's visits because my little town has a door-to-door senior bus for $1 a ride (or free if you can't afford the dollar). But even if they didn't, I would have just taken a taxi (and been grumpy about it because that could have gotten expensive!).

Oh, my surgeon had done the surgery hundreds of times (maybe a few thousands) -- hence my confidence in him. For him, it was COMPLETELY routine.

YMMV, of course, and you didn't say how old you are so I don't know if that will make a difference for you. I was 61. I had REALLY bad, bone-on-bone arthritis in both knees and had run on pavement for 20+ years, which didn't help. I am still planning to run again, but likely only on my treadmill -- much easier on the knees!

I wish you the best!

[Sand&Salt]

Originally Posted by Deserterer

Well it certainly puts a new spin on the term "preventative medicine". I've never heard of such an extreme measure to "help" someone who wasn't in pain.

Yeah, it seems pretty bizarre in hind-sight. DH keeps telling me I would have needed it sooner or later, but who really knows. At least my knees don't crackle anymore, lol.