Knee Replacement

By snu5qq

1 min read

I have had RA and osteoarthritis for 21 years.

Multiple surgeries due to RA

Over the years have had several surgeries on feet, hand, and now my knee is bone on bone.

I've been getting steroid injections in my knee for the last year.

The last two times it really didn’t help. Knee replacement is the next option.

I am going to be 65 in December. I don’t want to wait until I’m much older but really dreading another surgery.

Any advice??

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Julie.Byers Community Admin
<inline-mention username="snu5qq" user-id="3148024"/>, I can definitely understand your apprehension around going through another surgery! It can be a difficult decision to have to make. While you wait for others in the community to share any advice they may have, I thought you might find this article from one of our advocates helpful <a href='https://rheumatoidarthritis.net/living/joint-replacement-a-chat-with-surgeon' target='_blank'>https://rheumatoidarthritis.net/living/joint-replacement-a-chat-with-surgeon</a>. Please keep us updated on how you're doing. Sending well wishes, Julie (team member)
clschriner Member
snu5qq I was in a very similar situation as you and decided to move forward with knee replacement surgery. It has been 6 days since the surgery and so far I am doing very well. I came home the day of surgery and started PT 4 days later. I can already flatten my knee/leg more than I was able to do before surgery and the bending is coming along with continued therapy. I was mostly worried about infection and pain control after surgery and I'm happy to say that it wasn't as bad as I thought it would be from a pain perspective. Best wishes to you as you look at your options. 
1. Erin Rush Community Admin
 <inline-mention username="clschriner" user-id="3150507"/> , I am glad you are doing so well post op! That's awesome! I hope your recovery continues to be smooth and thanks for sharing your experience with the community, and <inline-mention username="snu5qq" user-id="3148024"/> specifically! Keep healing and thanks again for sharing! Best, Erin, <a href='https://rheumatoidarthritis.net' target='_blank'>RheumatoidArthritis.net</a> Team Member.
sonial1t6 Member
snu5qq, so sorry to hear of your troubles. I, too, have RA and primary, congenital OA in multiple joints. I’ve also had umpteen surgeries. My right knee was bone on bone for many years, to the point where I was unable to straighten the knee and I walked with a limp. I was receiving whatever was the latest knee injection medication, which I still get in my left knee. My knee orthopedist wanted to wait until I was 57 to perform a TKR, since I was active with mountain biking and hiking at the time, and the thought was that any TKR would not hold up as long as a sedentary person’s TKR, and to decrease the likelihood of replacing the TKR every 5 years or so. So while I slept, I wore a torture device, designed by a knee PT, that ostensibly tried to lessen the permanent and increasing bend of my knee. At age 55, an MRI showed that the bones of my right knee were showing signs of RA-effusion, and my knee orthopedist recommended an immediate TKR. BTW, I have a host of other major health problems, any one of which is problematic for most folks. I elected to undergo the TKR. The recovery was bearable, and it helped tremendously to use a special knee icing device 24/7, for a newly inserted TKR produces inflammation and terrific heat. I had the support of my husband and my grown daughter, who each replenished the ice in my special knee icing device. I followed all of my PT’s advice and exercises assiduously. It helped that my legs were already strong from my mountain biking and hiking, though hiking downhill was painfully dreadful. I also followed my knee orthopedist’s post-surgery instructions to the letter and beyond, paying particular attention to keeping my wound clean. One of my buddies experienced an infection, which in turn infected his TKR. His surgeon removed the TKR, installed an insert, waited for him to recover from the infection, and than performed another surgery for the TKR. I had no side effects from my TKR surgery. I do recall being asked to walk (hobble) to the restroom while hospitalized post-surgery. They want you on your feet, using your new TKR asap. I also read two kindle books about TKR, Total Knee Replacement and Recovery: the knee owner’s manual by Daniel Brugioni, and Fast Track Your Total Knee Replacement: How to Eliminate Pain and Pain Medicine the Quickest Way Possible by Michelle Stiles. The first book IMHO is best for people who don’t exercise much. It will help those folks who lack experience with caring for themselves post-surgery or need a guidebook step by step to achieve milestones. It’s written by an MD who underwent a TKR. The second book helped me with exactly the book’s title. My seasoned PT remarked many times that I was hitting milestones early, and that I was far advanced along the road to full functionality faster than any other of his patients during his decades of PT. In a quick time, I was walking around the block, then walking up and down the hills near my home, and then mountain biking on super easy trails until I felt that I could safely ride steep, technical trails uphill and downhill. As for hiking, I know it will cause more wear and tear on my TKR, and I choose instead to focus exclusively on mountain biking. I was off opiate pain killers in no time, just as the author, Ms. Stiles, promised. I have observed that my TKR is slightly thicker than my natural left knee. One thing I learned the hard way: do not ever use an inversion table, for it can loosen the TKR. Also, never kneel, for it degrades the TKR. I also recently learned that I have the Dupuy artificial knee joint. The Dupuy cannot withstand an MRI 3 imaging, and so I must only be imaged with the lower resolution MRI 1 imaging. Your knee orthopedist will check your TKR every 6 months or so. It is also paramount to manage your RA symptoms. BTW, I’m turning 62 later this month. You may want to consider that the surgery entails that your knee surgical site will be open for 3 hours in the OR. That is a long time for your tissues to be exposed during this time of COVID. Another matter to consider is that the longer you put off your TKR, as you age, your healing time may take longer than at your present age. Also, RA and any RA biologic you may be taking can tremendously slow down the healing process, for this happened to me after I broke my humerus. Lastly, after watching friends age to 70, I saw terrifically active people slow way down, lose muscle mass quickly, and experience a longer recovery time from surgery or an injury.
Richard Faust Community Admin
Hi <inline-mention username="snu5qq" user-id="3148024"/>. So sorry you have had these knee issues and are potentially looking at surgery. As you can see from the previous responses, knee replacements can certainly be helpful and the surgery being completed while the patient is in better shape can also be helpful. I want to share with you a little different story. My wife, Kelly Mack (a contributor here), was diagnosed with juvenile RA at two years old, over forty years ago. She had both knees and hips replaced as a teenager (basically as soon as it was possible). The replacements have made a big difference in quality of life and the technology has only improved since then. She wrote about her experience here: <a href='https://rheumatoidarthritis.net/living/call-me-the-bionic-woman' target='_blank'>https://rheumatoidarthritis.net/living/call-me-the-bionic-woman</a>. She notes that "With more advanced joints and the ability to better treat RA damage (or prevent it), I think patients are in a better place than ever to benefit from joint replacements to maintain (or possibly improve) their quality of life. The best outcomes often come when the patient is in relatively good health and strength, as this gives you a leg up on the recovery." Of course, every case is different and it is up to the individual to decide when or if to proceed. Please feel free, if you like, to keep us posted on how you are doing. This community is here for you. Best, Richard (RheumatoidArthritis.net Team)
rhpass Member
Snu5qq my TKR’s(yes both 3 mos apart) are 4 1/2 yrs old now. At aged 62 I was so afraid of infection I took my collapsing knees to the limit. My ability to live with the pain , as well as the joints returning ‘ to neutral’ as my ortho called it.he said I was very close to wheelchair living. So off to surgery I was. My first TKR resulted in having ‘ revision’ after 10 days of rehab. Had a staph infection taken care of, and a sealed negative drain put on, and restarted rehab. That was when I insisted on the same drain after surgery #2. When my first rehab progress made it impossible to walk on other knee, #2 was scheduled for 1 week out. 2nd went smoothly, ‘like buttah’ ! They did find quite a bit of dead bone in there, so I have a few shims too! My knees have remained painful, also a feeling of numbness in both. But I progressed faster than expected, and I was able to push harder with the ability to walk minus braces, canes & walkers. I am due for new X-rays & evaluation come May 2022. I am back to the cane, but for balance issues. I don’t know if I’d do it again… Good luck to you, and don’t wait too long!
mkbutler39 Member
I had bi-lateral knee replacement last December at 65 years old. I have had RA treatment since 2013 with multiple cortisone injections, pain meds. I decided at my age and still working my next option was a wheelchair for my bone on bone two knees. I didn't want that, yet or ever. My knee surgery was a wonderful success! I tell everyone who will listen it was the best decision I have ever made. Was it easy, no. But all of us warriors can do hard things! I was back to work(desk job) at five weeks. Good luck and much success.
1. Erin Rush Community Admin
 <inline-mention username="mkbutler39" user-id="3211362"/> , I am glad your surgery was a success! That said, I know you had to work hard to get back on your feet! Congratulations and thanks for the input from someone who's been through it! Best, Erin, <a href='https://rheumatoidarthritis.net' target='_blank'>RheumatoidArthritis.net</a> Team Member. 
2. snu5qq Member
 <inline-mention username="mkbutler39" user-id="3211362"/> thx so much for the info. Big decision
klclear Member
I have had 4 knee surgeries- 2 replacements 10 years ago ( shortly after my RA diagnosis) and 2 more recent revisions. The first 2 weeks after surgery are the worst because you have to walk on the leg almost immediately. PT is difficult and painful because the knee wants to make scar tissue but if you don’t do the exercises and stretches the scar tissue can cause permanent problems with walking. You will need help at home or at a rehab facility. Once you get past the second week, the pain lessens and the goal of getting off of a walker to a cane seems more achievable. Many doctors order ice water machines that wrap around your knee postop and then are continued at home. Use it! Everyone I know who has had a knee replacement says the surgery is well worth the pain and most wish they had done it sooner. Some physicians are ordering an Iovera injection 2 weeks prior to surgery which helps decrease pain for up to 3-4 months. Post rehab you might have superficial skin numbness around the knee that lasts several months. The knee will also swell if you are on your feet too long. If all goes well, you should be relatively pain free with normal walking ability. Biggest problems related to RA: pain management, increased swelling. If you are on an IV or SQ drug for your RA, the surgeon may hold it for 1-2 weeks prior to surgery and 1-2 weeks postop. Good luck!
1. mkbutler39 Member
 <inline-mention username="klclear" user-id="3192524"/> a lot of really accurate, helpful information. 
2. snu5qq Member
 <inline-mention username="klclear" user-id="3192524"/> Thx for information
patricia Member
I had total knee replacement in July 2020. I did really well and I was 78 years old. It was done as outpatient; came home same day; I live alone and I stayed by self with no problems. I do NOT take the prescription pain med at all. I got along okay with Aleve and Arthritis Stength Tylenol. I was told not to drive for 2 weeks, so my sister drove me to therapy at a very good therapy center; I had reached the goals and was dismissed after 5 weeks of therapy...3 times a week for an hour per session for 2 weeks and 2 times a week for 3 weeks. I wouldn't hesitate to have it done if I were you.
Mary Sophia Hawks Moderator & Contributor
While we do not offer medical advice on this site, I will share my experience with you. I had a knee injury at the age of 17 with an invasive surgery to follow. The same knee was scoped at age 41 and shown to need a knee replacement. I held off as long as I could. My first surgeon refused to operate on me at 50, and said I had to wait until 55. By the age of 52, I could barely walk with a walking stick. I found a different surgeon and had the replacement. The first 2 weeks were very hard. Then it got better and better. I have never regretted that decision. 2 years later, my other knee got injured and I had a replacement right away. Great decisions. I am now 7 and 5 years post-op respectively and am grateful everyday. Mary Sophia, moderator
Lynn Marie Witt, MSOT Moderator & Contributor
<inline-mention username="snu5qq" user-id="3148024"/> thank you so much for reaching out. Sorry to hear that you haven't been feeling relief from the steroid injections in your knee. Totally understand your hesitation. Surgery is a big decision. I saw some other community members and fellow team members, provided some helpful information. I was just writing to check in on you and see how you are doing? If you have a chance, please reach out. We would love to hear back from you. Thanks so much for being part of our <a href='https://rheumatoidarthritis.net' target='_blank'>RheumatoidArthritis.net</a> family. Just Keep Swimming....Lynn Marie, "RheumatoidArthritis.net Team Member"
judyfe Member
I am almost six weeks out from my second knee replacement. This one was after my RA diagnosis. I can say that it isn't a walk in the park, but with a great surgical care team and an excellent physical therapist, I am doing okay. The pain meds and I didn't get along so I switched to Tylenol and Advil Liquid Gels with the okay of my care team. I tend to be a bit independent so the walker was gone around home after the first week and I rarely use a cane now. Right now I have exceeded three month expectations for bend and flat but that has come with diligence to my doctors and physical therapist's orders. First two weeks for rest, daily home exercises and ice. Key is to reduce swelling and pain. It makes a huge difference. One other thing is I did go for PT prior to surgery to get my leg ready for the surgery and that helped a lot. I was up and using the walker a bit three hours after surgery. I am almost 10 years older than you. It was rough going without my infusion for a few weeks, but I made it. It is a mind over matter thing and it's worth it in the long run. My other knee replacement was 14 years ago (same doctor) and it has been worth it every day. Best wishes for a successful surgery and recovery! 
1. Kelly Dabel Community Admin
 <inline-mention username="judyfe" user-id="3181309"/> thanks so much for sharing your experience. Glad to hear that your recovery is going well. Great tip to ask about prep that can be done before surgery for others here who may be preparing. Wishing you continued relief. Best, Kelly <a href='https://rheumatoidarthritis.net' target='_blank'>rheumatoidarthritis.net</a> team member