I am 68 and never had a problem at all with my knees (or really any other major health issues) until last summer when suddenly after sinking my knee into a bed to close a window, I saw stars. That resolved within a week with ice and ibuprophen but then a month ago I was stepping off a staircase on my way to a subway entrance when, again, I saw stars. I couldn’t put any weight on it at all and wound up in the emergency room where they took an xray and told me to see an orthopedist. The orthopedist said I’d need a knee replacement sooner or later, that I have severe arthritis (which my father had and brother has) and it’s bone on bone. He prescribed physical therapy and fitted me for a brace. I’ve been going to PT 2x/week and it’s definitely helped but I am still hobbling around with a cane and have to limit my walking and subway rides based on the number of steps. This is compounded by the fact that I live on the third floor of a walkup rowhouse.
I met the surgeon yesterday and he scheduled the surgery for December 20. My daughter will come home from college on December 17. He told me three days in the hospital and then they will likely send me home and order physical therapy with a home care agency which will visit my place before the surgery to check it out. I had assumed I would go to rehab but he said that the reimbursement rules changed recently for rehab vs home care but I can’t imagine how I’ll get up those steps!
So I am looking for feedback. I am reasonably fit but overweight. Before this, I walked at least a mile two or three times a week, plus the normal walking that New Yorkers who don’t take cabs usually do. Since my daughter went off to college 2+ years ago, I have become more active and ate more carefully and lost 30 pounds, including another 2 since my injury in anticipation of the surgery. And I haven’t missed a PT appointment and do the exercises they recommend between sessions. That has really helped and the PT tells me that I will be well-prepared for surgery. But I am worried about the pain. My surgeon told me that hip replacement patients thank him before they leave the hospital but knee patients are still cursing then, lol. I am confident that two months out, I will be very happy I had it done but I’d love to hear from others. Thank you!
Didn’t have knee replacement but did have knee surgery for bone cancer (removed, then a bone graft and stability plate) that was both worse and easier. Lose as much weight as you can before the surgery, it will make recovery easier. That’s advice from numerous friends who have had knee replacement as well as from me. My post-surgery pain was quite bearable, with drugs, which I took before PT. It certainly didn’t make me “see stars.”
Call the insurer about rehab. See what the options are from their perspective. A friend just went through this and felt fine, but did stay a few extra days in rehab, which not only helped but spared him the home stairs.
The only experience I have is with friends. The most active, fit person was at our house, walking 2 days after surgery for knee replacement, up and down steps…I did not even know he had his knee replaced and he was scheduled to do the other 2 weeks after he visited us. Another friend who is overweight /obese and not very active (to be generous) took months to recover and I worried about her because she barely complied with the PT. The rest of my friends are somewhere in the middle - moderately active and not obese – and were super glad they had it done and doing really well 4-6 weeks after surgery. Losing the weight was the absolute best thing you could have done, not only did he help your knees now it will certainly help after the surgery. I’m assuming you have someone who will get you up and into your home after you are released, or are you going to a rehab facility for a short stay?
A colleague of mine at work had both knees replaced and he said it was the best thing he’d ever done. He was super-happy with the way it turned out. I don’t exactly recall at what point during the process I talked to him, but I remember he had a brace on one knee but appeared to be walking just fine.
I had a partial knee replacement 4 years ago. It went well at first- I was up walking with a walker the next day and without a walker by the time I came home. I did PT at home and followed up with PT on site for a month. The first week was painful- mostly uncomfortable at night. It continued to get better to a point and then just didn’t improve and continued with mild pain. After 1-1/2 years, it started being more painful, and then one day got stuck in a bent position and was horribly painful. I ended up in urgent care where they found that the whole knee had shifted. When I saw a 2nd orthopedist, he said that he never does partial replacements as he has seen a high failure rate. I ended up having a full replacement at 2 years and when he did the surgery he found that the angle of attachment done the 1st time was not correct so the knee was not in correct alignment. The 2nd surgery went very well- a very quick recovery and now, 2 years later, absolutely no pain and I am very active. I will say that negotiating 3 flights of stairs to get to your apartment will be very difficult. After my surgery I did not go up our stairs for at least a week, maybe longer. I moved to a downstairs bedroom for a while.
As far as recovery, my husband was going to stay home a day or two after I got home and I told him to go to work. I could easily get myself to the bathroom and get something to eat without help. The first week was painful but not unbearable, and I never used anything stronger than ibuprofen. I will say the PT is a killer- I made myself do the exercises but I dreaded it! It helped strengthen the muscles and I could definitely see progress with it!
Note that I did a lot of checking on both surgeons before proceeding and still struck out the 1st time. He was highly rated; physician of the year, chief of surgery, lots of great reviews. I guess he had a bad day with me.
Going to follow this thread closely as I am in the same boat. I’ve been told it’s just a matter of time for me. Living alone is certainly tricky when one is immobile. Please keep us posted, OP, and good luck!
One of my friends had both knees replaced at the same time and was sent to a rehab hospital for 3-4 days. Said it was worth the hassle so he didn’t have to go through the whole process again but was glad his wife was home for a day or two after he was discharged…
I’m curious if you had to get a note from your dentist. I understand that it’s often required in an effort to prevent infection. If one has infection anywhere in the body, it easily migrates to the new device and obvious problems can result.
Very timely thread. My dh is scheduled to get his old bad knee done on December 6th and if all goes well, his other knee next year. I will let you all know how it goes. He is already doing PT so I hope that helps.
Thank you all for your encouraging responses. I have a Medicare Advantage plan which is all I can afford, and the network is limited, but this doctor and the practice are part of the Weil-Cornell network. I originally saw a doctor in the practice as referred by my pcp, and he read the xray report from the ER and said immediately that I will need this surgery sooner or later, wrote me a prescription for PT, and said to call him soon. When I called him back after a couple of weeks of PT and asked him why I would wait, he said that many patients postpone it as long as they can but since I am healthy and active, there was no reason not to go for it. He referred me to the doctor in the practice who specializes in knees and that’s who I saw yesterday. He sent me for xrays and showed me where the bone rubs on the bone.
He said that it used to be routine to send postop patients with this surgery for rehab but the reimbursement protocols have changed. He said when this happened, he worried a lot about how well the home care agencies would handle it, but that they have definitely stepped up to the plate with quality care including physical therapy. The agency will visit my place before the date of the surgery and the final decision won’t be made until after the surgery. I said I was worried about getting upstairs when I get out and he said that wouldn’t be a problem. He also ordered more PT for me right up to the date of the surgery. I figure that with my daughter staying with me, I won’t have to go back down those steps until I am ready. At least I hope so!
Friend one…knee replacement and NO PT. They told him walking was his PT. He was up and walking within 24 hours of his surgery. Had the second knee done 6 months later.
Friend 2…same orthopedic group. No PT for her either.
Relative living overseas…went to rehab for several weeks. Said it was like a country club. But she lives in another country.
Friend 4. Knee replacement and did go to rehab for a week. But she loved alone and her house was totally inaccessible.
Old mom,
I was 30 when I had an ectopic pregnancy. I too lived on top floor of. 3-story brownstone, tho in Boston. It was hard getting up 4 flights of steps, but I stayed in a week. Times have changed;you have your DD, my mom came up.
Professionally, I visit patients in rehab. The older people like all the attention, but the young ones, like you, wish they were home. I work with professionals at home health care agencies, and they are always personable and professional.
My BIL has had two knees replaced. Wasn’t wild about either one but the benefits far far far outweigh the advantages. Do it sooner rather than later. You should have your new knee forever. Best of luck!
Re the steps: Here’s something I learned how to do when I broke my leg 10 years ago.
Approach the steps. Turn around. Sit on the second step. Move the foot on your good leg to the first step. Put your hands on the third step. Using your good leg as much as possible and your hands as little as possible, move your butt up one step. Repeat as many times as necessary. On the second floor landing, scoot across the floor on your butt, pulling yourself along with your good foot and your hands.
This actually works. The problem comes when you need to get into a standing position on the third floor. If there are stairs to a fourth floor, it’s easy. Use the same technique you used on the other stairs to get your butt up to the second step on the stairs to the fourth floor. You’ll find that it’s not hard to stand up on your good foot from that position, with a little help from the stair rail or your daughter.
But if there are no stairs to a fourth floor, you may need to rig something special to enable yourself to get into a standing position. A stepstool with two steps and no rails might work. (Rails are bad because stepstools with rails are often too narrow for the human butt.) Make sure it’s up against a wall (or your daughter is holding it in place) so it can’t slip out from under you.
This procedure will ruin your pants, and your wrists and the heels of your hands won’t be thrilled with it, but it will get you to the third floor.
My mom had both knees done (separately) when she was in her seventies. She did PT, but did not go to a rehab for either. PT started in the hospital the morning after the surgery and part of it was making sure she could manage a few stairs, navigate the bathroom and get up and down from a chair, car seat or bed before she was discharged. It was amazing how quickly she was able get back on her feet. Good luck.
My H had his first knee done in September at HSS. He is 100 pounds overweight but after 2 years of trying, he couldn’t lose anything. He was in for 3 days and then in rehab for about 10 days. I fought for the rehab because we live in a center hall colonial with tons of steps. He had in home PT for a couple of weeks and is now getting an eval for outside PT. We are hoping for an approval for aqua therapy, which I think would be best for someone of his weight. He is supposed to have the other knee done in December. I had aqua therapy after knee surgery 30 years ago and highly recommend it.
He is down 20 pounds already. He is walking with crutches outside of the house and actually rode his motorcycle today, though not as a first choice. He had to get somewhere local and his car broke down.
He was bone on bone and, although he is in pain now, it is much less than before. He has barely taken any pain pills, though that is more out of his fear of substance abuse because of his family history.
It’s rough, I will not lie, but I am eternally grateful I had it done. You’ll do great. Do the PT 100% without fail and it will be a complete success.
That said, I don’t even remember how I got into the house (and our set up is very difficult) or how I went to the bathroom the first few days, it’s a blur. Ask for guidance on how to manage.
about the dentist…I have to take prophylactic antibiotics, yes. Dental work, even cleaning, introduces bacteria into the bloodstream and any foreign device can become a repository for them.
My mom, who had hip surgery in her 70s, said that it’s a good idea to use a cane when you go out even if you don’t need it at home. It’s very helpful as a visual signal that people should go out of their way to avoid bumping in to you. Crutches would work just as well.