Thursday, September 29, 2005

One-year TKR anniversary! 12 months of life after a total knee replacement and loving it.

Welcome! If you are reading this, you've found your way here from either a browser search (looking for TKR information), or from the Delphi "On Our Feet" forum.

This post marks the one-year anniversary of my TKR. Unilateral, right knee only (the left is fine, thank God). My experience has been exceptionally positive, and I certainly recognize how lucky and blessed I am to have an experience this positive. I posted a summary of my TKR experience here:

Actually, I've been told that my experience is not all that unusual, and that many TKR patients have positive TKR experiences. I am certain that t
his is true. However, it is human nature to focus on the negatives, and this is also true on the Web. A year ago, it was difficult to find positive TKR information on the Web. Furthermore, it was really easy to find TKR horror stories, and I found enough information to really scare me pre-surgery. I decided that if my TKR went well, I would try to blog about it on a regular basis, just so that there was some detail on-line of a real experience, from beginning through surgery and PT, to the one-year anniversary. That's what this blog is.

My TKR occurred on the morning of 29-September-2004. Please roam through the archives. All of the detail is there. My story actually starts in 1969, with my initial knee injury and old-style ligament and meniscus surgery. I kept a detailed journal of my actual TKR last year, and then posted the journal to this blog. You can read all of my fears (both realized and unfounded). Recognize that I am a scientist --- I included lots of details that may not be for the squeamish.

There are no pictures here except for the ones below from our recent hiking-and-biking vacation post-TKR. You can google pictures of TKR surgeries pretty easily, if you're looking for gore.

I've been asked about continuous-passive-motion machines. The surgeons in the practice I used do not use them unless the patient needs them. I suspect that ultimately, it's an insurance coverage issue. There are recent studies in the literature that indicate that PT without CPM is as effective as PT with CPM. At least, after 6 weeks post-op. What the studies do not tell you is that those 6 weeks of PT without CPM require a tremendous amount of effort on the part of the patient. If you don't (or can't) do the PT, you may not recover as quickly or as fully as someone who did (or can). If you are physically weak, if you tend to develop scar tissue, if you cannot take pain-killers --- talk to your OS about prescribing a CPM for you. It is not a perfect solution: you will still need to work hard at PT. But in some cases, it can help.

I've also been asked --- a lot --- about kneeling. This is a discussion you need to have with your surgeon. Not all TKR devices allow kneeling. Not all TKR recoveries will get to the kneeling stage. Mine did.

What are my current limitations, one year after my TKR? I'm not sure that I have any, except a fear of falling down and whacking my TKR knee. I walk. I hike. I bike. I mow the lawn. I garden, including tilling and kneeling.

I spent last Friday going up and down scaffolding on a Habitat house. I actually was on top of two stories of scaffolding, with my TKR knee bent over the toprail of the scaffolding so that I could lean out, and use both hands to install the framing for a soffit return. A year ago, pre-TKR, I could not have thought about climbing a ladder, let alone hanging from a scaffold.

If you have specific questions, you can email me at the address listed in the sidebar. I can't promise an immediate answer, but I do try to check that mailbox at least once a week.

I will also continue to post to this blog. Each month, the anniversary of my TKR still makes me realize what a tremendous change in my life the TKR has been. Thanks for allowing me to share that with you.