My sister had both knees replaced this summer about 6 weeks apart and is now planning to go back to work as a flight attendant at age 69. No problems so far.

A friend had both her knees replaced at the same time last winter and is doing very well but said that getting them both done at the same time was a mistake.

My friend who had both done at the same time also regretted it, but she is doing well now.

My other friend had one done about five years ago and didn't realize how bad she had gotten until she had her surgery. She was scheduled to have th other done last month, but it got delayed due to the hospital being full with covid patients.

If you choose to proceed, go woth a surgeon who does lots amd lots of TKR, volume matters, the more the better. Do not chose location over volume.

Agree with @Zalco/bring back Sophie!, even if you need to travel. This is a technical skill, you want the person who knees are their specialty, not the one who just does a few of them. Ask how many knee replacements they do per year (they will know).

Look for ortho doc @ med school, university affiliated teaching hospitals. If in Chgo area (alpha order): Loyola, Northwestern, Rush, UIC, UC.

However, credit to the doc you saw, too often they present surgery as only option; ortho likes to do surgery.

Good luck.

What Zalco said x 1000. The same is true for any kind of medical procedure.

Edit to add -

I agree with mdln's obviously informed recommendation to look for providers at medical schools or affiliated teaching hospitals. My wife and I have migrated over time to exclusively using faculty members at such places. We're lucky in our area to have two excellent ones to choose from. Both are not necessarily close but they have complimentary department strengths, one better at some things, the other at other things.

Medical schools increasingly operate group practices composed in part of previously independent practices that choose to affiliate with them. Doctors with such affiliated practices under the banner of the medical school practice are not the same as adjunct, research, or clinical faculty members for whom seeing patients is one of several school responsibilities.

First...the very, very best of luck to you. My sis had it done several years ago (so I imagine

they have even improved things by now). First...yes the very best surgeon you can

research for the job. And then...the after exercises are the most important of anything.

Do them as directed, often and keep doing them as you improve. They are hard at first,

but do them faithfully. The more you neglect

"working, the more trouble you will have. She said, it was the best thing she ever did

for herself...she had both done about a year apart. She couldn't believe the wonderful

change...back to a non-pain life and able to do anything.

I’m bone on bone and delaying the inevitable after having received significantly different recommendations from two different doctors. Both seemingly well-credentialed, highly rated surgeons within the same system. (Hospital for Special Surgery) The second doctor went so far as to flat out say the recommendation I got from the first was wrong. Very frustrating so I’ll see if I can get through another winter before addressing it again.

I am so sorry FOAS....hope you have an easier time soon. Hugs.

Best wishes for good outcomes to all so afflicted.

My husband suffered for years with arthritis. He did many of the steroid shots which would give him about 6 months relief. Then there was another gel type injection, can't remember the name. That would last about six months. Oh, and I forgot PT. Finally it was bone on bone and his surgeon told him that surgery was his decision. He had one knee replaced and four months later the other. Excellent results! I must say, he was diligent about the follow up PT. Many times it would bring tears to his eyes, but he kept going.

I feel it is very important to be mentally ready for TKR. It is NOT for sissies!

I had both knees replaced separately.

They have been a blessing. Recovery was quite easy compared to previous pain. Look for an experienced surgeon.

Seniorgal

I feel your pain, Satine, went on a hike today and going downhill was pretty rough. If you decide on surgery, like others said, it's extremely important to do the exercises after. Have taken care of a lot of knee and hip replacement patients and the worst thing you can do it lay in the bed or sit in a chair and do nothing. Having surgery hurts. Not taking your prescribed pain meds and then complaining about being in too much pain to do your PT isn't the way to go. The ones who do the best get up and do their PT, take their medication and go home in a day or a few.

A friend of mine had his knees replaced and he is thrilled with the outcome but he also was dedicated to doing his physio and not doing too much too soon.

He did have both knees replaced at the same time but the doctor only suggested it and agreed to it because my friend was in really good physical shape with a strong core and strong arms/legs and he knew that the patient would follow the physio guidelines. They also had a house that had an area in which he could live without having to deal with stairs.

Good luck with whatever you decide.

My sister had it done early this year after years of trying nonsurgerical treatments. She had the worse knee done and will do the other later. She had pain for years and got to the point of not being able to do much walking. She is a very active person who is always on the go. She wishes she would have done it sooner, even if was slightly painful right after the surgery. She did all the PT, even continuing doing it after the prescribed time. Check the surgeon's ratings and that this is what that doctor does the most. Wish you a fast recovery and good results.

Most people that I know, and patients that I have taken care of, have had good results with TKA. Many waited too long and suffered needlessly. There are a lot of techniques for nerve blocks that can keep you pain free for a couple of days afterward, but I agree 100% with Kath that if you don't do your therapy and exercises you will not heal properly.

I don't usually disagree with mdln but having worked in both university hospitals and private facilities, I would never have my surgery in a teaching facility. Many times the surgeon you are paying for may be teaching two residents at one time, or not even in the room. Look up "ghost surgery", there are many many stories about this. Private practice surgeons are just as up on the latest techniques and equipment. I hope that you find some relief from your pain, with whatever option you choose.

I had my right knee done in 2012 and had the left scheduled for 9/27/2021. But thanks to the unvaccinated Covid patients overrunning the hospital all elective surgeries have been postponed. Thank you to the selfish unvaccinated people 🤬

From 2012 to today knee and hip replacements are done quite differently. In 2012 I had surgery on a Mon and got discharged on Thur. Today, at least in my area (greater Seattle area) they're done as outpatient or a one night stay. Of course more days if there are complications.

In April 2017 my best friend had a "bilateral" knee replacement, meaning both done at the same time. She was 67. Then in Sept 2017 we went to Europe and walked everywhere. She'd be a bit sore in the evenings but just iced them.

Like others have said, make sure the surgeon specializes in knee replacements. There are all kinds of orthopedic surgeons but you want one who does hundreds a year. Their skill and expertise is more important than proximity to where you live.

Here's a good resource that I learned about in 2012. There's all sorts of information on knee and hip replacements. They also have a forum, similar to Houzz, where you can create a user name and password then ask questions. There's a section for pre-op and post-op questions.

https://bonesmart.org/

Thanks to everybody for your comments. I know that surgery is what I need but I swore after my last surgery "never again". I will have to go to a rehab facility after the surgery and I think that is a big part of my hesitation. I live alone and need to be able to take care of myself when I get home. I am not near a teaching hospital and will research my surgeon's history. He is with a group who I have seen before but the doc I saw previously is retiring. This group is used by many people in my area.

I haven't had a knee replacement myself but know a number of people who have. Most of them have done well with it, but they are all serious about doing the appropriate post operative physio and exercises. I know them because we are all doing hydrotherapy together, me for my hip replacement, them for the knees. If you have an opportunity to get into a hydro class I cannot recommend it highly enough (It's also excellent prep for a future operation)

Satine - 65% patient satisfaction seems a little low to me but I'm not a surgeon. I know many people who have had TKR who are thrilled with the results. The best advice I can offer is to start exercising before surgery (if possible) and make sure to follow through with PT afterwards. Strong quads and hamstrings are key.

Nine years ago at age 62, I had both knees replaced at the same time at HSS - Hospital for Special Surgery in NYC. I went in on a Monday morning and was discharged Friday to an in-patient re-hab facility for another week. I had at home PT for a month and then out-patient PT for another 2-3 months. Most people only do one knee at a time and may only spend a day or two in the hospital. Mine was more involved since I had both done simultaneously.

I don't think it's necessary to go to a teaching hospital but you do want a surgeon who does a lot of knees and who has an experienced team. DH researched hospitals extensively and we picked HSS because they are top-rated, specialize in orthopedics and have an extremely low infection rate. That's a question to ask your surgeon too. We interviewed our surgeon and picked him based on his expertise, the number of TKRs he has done. I live near Philly where there are many options for treatment.

FOAS - Sorry to hear about your poor experience at HSS. I hope you manage to get some relief soon. Message me if you want the name of the fellow I went to and hopefully it's not one of the 2 that you saw.

Maire

Thanks Maire, message sent.

I think patient satisfaction with a total knee replacement is very subjective. I'm extremely happy with mine - I obtained a range of motion of 124 degrees. 125 is considered great, and 135 is excellent. I did my physical therapy and worked to regain my range of motion. So many activities of daily living are dependent on having a good range of motion.

My sister, on the other hand, didn't do her physical therapy because "it hurt." No duh. She falls into the unsatisfied group. She can't take stairs the normal way, she has to go down one foot at a time. She's limited in what normal things she can do. She's no better off after having a knee replacement than she was before.

I didn't mean to "like" my own comment. Anyone know if I can delete that?

Just hit it again.

@sleeperblues, that used to happen a LOT; not so much anymore around here.

We have a couple high volume, assembly line private groups, that advertise heavily, in the area, with significant complication rates, and not so good outcomes; that keeps me recommending our teaching sites. Albeit, lucky to have 5 ortho residency programs in area. (Disclaimer: personal relationship with an orthopod.)

Thanks, FOAS, that worked. mdln, it's the opposite where I live. 2 hours from Minneapolis and 3 hours from Madison, which are the nearest teaching facilities. I worked in both of those cities, as an ICU nurse and a new graduate anesthetist. Oh, how could I forget the WFMC (world famous Mayo clinic, it's a slightly derogatory nickname because it ain't all that it's cracked up to be but that's for another day) The private practices in this medium sized college town (sans medical school) are exceptional and I would not hesitate to have any kind of surgery done here. I'm lucky to live in this great medical community, lucky for me I haven't had to partake in any of it. Knock wood

@sleeperblues, LOL, may have to use "WFMC." People travel from Chgo area to go there, never understood it.

To go back to the original question, whether the OP elects for surgery or not right now, she should do the physiotherapy. It won't solve the bone-on-bone issue, but it will strengthen muscles and make recovery faster. I found it a good learning experience too, since it taught me which exercises accomplish what, and forced me into a disciplined routine. That made it much easier, post surgery, to continue with regular strengthening exercises . And, as I mentioned earlier, hydrotherapy (with qualified physios) has become a critical part of my on-going battle with osteoarthritis.

I had my TKR last October. all went well and i would say the first two weeks were uncomfortable but manageable if i followed doctors orders and took my pain pills on time .

i remember seeing my surgeon after three weeks and asking him to put me on the list for the left knee. still waiting because of covid backlog. i could have driven after two months, but did not need to because my hubby was here so i really only drove at about three months.

i was 76 and not really in great shape but was very happy i did it.

i think you should go ahead.

"doc told me about 65% of the patients who have the surgery are happy with it, ie pain free." Your docs "65%" concerns me.

Agree, surgery sounds like best option. Many friends and colleagues had knee replacements (including both at once); NONE regret the decision.

Yes, have seen unhappy patients, while working in the ED, but estimate at most 10-15% are not happy or pain free.

Perhaps, a second opinion?

Edited to clarify

I didn’t know ED was painful. Kidding, but what is ED in this context?

Those of you who’ve had one or more TKR: how is kneeling? I asked my mom who’s had one replacement, and she said she only kneels on the other knee, but couldn’t say why.

What timing. i am in bed after a right knee tkr this afternoon. was terrified ( sorry stuck with odd typing on ipad). day surgery - went in at 2:30 and discharged at 6:30. full time help needed for at least a few days, they dont want you to fall. also staying on top of med schedule and activity is hard (well so far). PT is coming to house tomorrow. so far residual nerve block holding. doc mentioned some folks can eventually kneel, and others dont like sensation. i havent kneeled for years anyways lol. good luck wharever you decide.

edited to add: ask for the infection rate at any facility youre considering. i went to a surgical suite staffed byhospital that specializes in joints and thats all they do. impeccable protocols and the staff were superb…proud of what they do and how well they do it.

LOL, good point @foodonastump! Psychologically painful???

I think ED is the Emergency Department.

Ah kneeling! that's a biggy. I avoid it but when I do kneel I use a gardener's kneeling pad, which is a thick vinyl covered dense foam pad, or a few thick towels. I've also fallen a few times, not because of the TKR, I think I probably would have fallen anyway even with younger knees. The first time a running dog knocked me over and my knees slammed into the concrete sidewalk. I had visions of my knees cracking or chipping but they were fine.

My husband has had both knees replaced and is all the better for it. His first knee was done 3 times, due to incompetency on the surgeon's part for the first two. We then found the most amazing surgeon who does nothing but knees. He is also a germaphobe and a perfectionist - both good qualities for a surgeon. My daughter now works with him and tells us that he is the only surgeon in the hospital who insists on doing dressing changes on his patients, so he can see for himself how they are progressing. Bottom line - do a lot of research on the surgeons before you choose one!

I didn't read through all the responses, but I want to agree with Zalco completely. My family doctor recommended a surgeon....who was a specialist in backs and also quite old. I checked around on the internet, and found a surgeon who specialized in sports medicine. Also, judging from his photo on line, he just looked smart. You know how you can look at some kids, and they just look like they are very intelligent? He looked like he was probably the smartest kid in his class. He was young...but everyone looks young to me now. He was also connected with a local medical school.

I had zero problems. My right knee was bent and bowed, and so painful that three times I ended up in a wheel chair. I didn't know he could do it, but he straightened my leg. I didn't have really any pain to speak of, but this was before the crack down on opioid drugs. I stayed on hydrocodone until after my pt, and quit them. I had been on them, from my family doctor, because I literally was in constant pain prior to this. My surgeon said it was one of the worst he had seen....my bones had grooves worn in them.

I joined a FB group for total knee replacements, and I almost feel guilty because my knee replacement went so smoothly, and on there, so many people have problems that a lot of others are afraid to have it done now.

I didn't use a cane or walker in the house, and only used a walker once when I went to my follow up exam a week or so later, because I thought he would want me to use one. The only thing he said about my daily life, was I had to stay out of the barn for six weeks. Fortunately, my husband was able to take care of my horses for me.

I was in the hospital for three days....which I believe they don't do any more, but this was about 8 years ago. Started PT in the hospital. I even enjoyed being in the hospital. It was a nice rest.

I have had both knees replaced. The first 10 years ago (was damaged playing high school sports, was bone on bone). I stayed in hospital 2 days then came home. I had it done by an ortho who does it all the time, and has a good reputation with both patients and physical therapists. In the hospital they have a floor dedicated to joints and they get you up to do PT after your operation (sit it chairs and do exercises). The second was done 2 years ago - same surgeon. I stayed in overnight. They had just started doing outpatient TKR, but I did not do that. Another plus the second time - they had a new type of bandage and I could take a shower righrt away! The best advice he gave me was a script for physical therapy for 2 months BEFORE the operation. I had to get that leg stronger (it was bowed and I was using a cane at work). Besides getting the leg (and arms) in shape, when you go to physical therapy you have the advantage of seeing and hearing the stories of the other TKR patients - you will figure out quickly who the best doctors are. I am pain free, and wish I had done it sooner (which many people say). I do not like to kneel - it feels weird. I can kneel, I just don't like to. I got ROM 133 in both. But I did physical therapy BEFORE and AFTER surgery. I chose my own physical therapist, I did not use the doctor's. I had a good rapport with the PT and it was closer to home (you can't drive for a few weeks - depending on which knee and medication. i did notice with the second TKR they gave less pain medication, which can negatively affect PT. Take the pain meds, don't try to do without, once the pain gets ahead of you it's difficult to get it under control. You will be happy you did it - good luck. I'd be happy to answer any specific questions. I do not know how people can get both knees done at once - you'd be amazed what you need at least one knee and leg for!

I know several folks that have had TKRs and wished they had not waited so long. My own mother, (she just passed away a year ago) had both knees replaced, at the age of 75, She was in rehab 3 weeks, came home and never even used the ramp we built. We tore it down later.

I have had both hips replaced, and had zero issues afterwards. I think hips are easier than knees, but still, I think waiting until you can no longer walk, is a huge mistake. Check out the bonesmart.org forums for all the information you could possibly want on knee (and hip) replacements.

https://bonesmart.org/

My wife has had both knee joints replaced (at different times). She is very satisfied with the results and her debilitating knee joint pain is gone. She walks can walk again. Her only complaint is kneeling. She says that hurts and doesn't feel right. She doesn't like pressure applied to the knee cap. She is considerably overweight and has a collapsed ankle which are mitigating factors.

DH visited the Physician Assistant (PA) earlier this week as a preliminary to meeting with his surgeon at a nearby Orthopedic Group Center. His knees are bone-on-bone but expects to replace only one at a time. The PA mentioned their usual practice is to have the replacement partially done by robotic means.

Obviously DH will ask more questions about that when he meets with his surgeon, but does anyone here have an experience with this?

I just did #1, 9 days ago. And I have to say, hearing about the successful TKRs here is helping me to keep going.

I asked about robotics (which my surgeon offered Mako) and was told he feels he's just as successful/accurate without, and booking the facility that has the robotics is a much longer wait. Said he does upwards of 400 TKRs each year.

There are now many dedicated outpatient facilities that just do joints; the staff is usually happy having regular hours and working with set teams; ask about the infection rates. And you're not in a giant hospital fielding ... everything that walks in the door. On the other hand, ask how they handle any adverse events. How close is the nearest hospital then? (and uh, does it have any availability if needed).

While everyone is different, I have been pretty miserable for the past 9 days -- PT comes to your home from Day 1 (every other day or so) and everything that needs to be done, takes awhile. Exercise as indicated 3x per day. Ice. Try to get up and walk (with the walker) every hour. Eat. Rest. Take a crazy list of pills around the clock (short term antibiotic; pain pills (all sorts); aspirin (blood thinner); colace (stool softener); prilosec (to help your stomach deal with all the pills)... and push it is the order of the day in order to get full range of motion back. I learned that before they stitch you up, they put the new knee through all its paces to make sure its installed correctly -- so the new equipment works, it's just getting the swollen leg around it to cooperate. And when not moving, I have automated calf wraps that are motorized (they charge up like a calculator) and they inflate/deflate to help prevent blood clots....they get worn whenever you're not moving and all night for 2 weeks.

Oh, and a compression sock for the good leg, eventually for the bad leg too, that's for a long time.

And...I also wasn't aware that current standard practice is to use a tourniquet...but my thigh (nicknamed "shamu") is black -- and it hurt nearly more than the knee the first few days. Still hard spots and not comfortable to sit on that side...

So you've heard all my bitching and whining, PT says it gets better after the first two weeks. Sounds like many folks were up and going sooner/more easily.

i have bilateral hip replacements that will soon be 22 years old. i'm now looking at TKR very soon as i my right knee has been bone on bone for going on 4 years now and the pain is getting intolerable.

my problem is finding someone to stay with me post-op for as long as needed, hopefully not more than a few days. i live alone but have 2 great danes so i need to find someone who doesn't mind giant dogs. they are both very well behaved and not at all boisterous so i'm not worried about them "taking me out" with uncontrolled zoomies. i'm not even sure where to start looking. i do have a friend who used to come and stay with my dogs if i was out of town but that hasn't happened for a couple of years now. i'm still in touch with her but she also has a regular job and isn't able to spend 24/7 with me.

I don't know how long the procedure takes but I know from familial experience that busy orthopedic surgeons can spend 3 half days or more per week with scheduled surgery. When a family member had an ACL done by a doc who did many of the knees for professional athletes in my area, he had 2/3rds of a day surgery blocks scheduled on Monday, Tuesday and Thursday and often ran over and into the evenings. The ACL procedure, done arthroscopically, took less than 90 minutes. I suspect knee procedures are much more involved.

The better docs in metro areas also tend to specialize. Some do just shoulders. Others do just knees or hips. mdln would know better than I but just speculating from a distance, if only one procedure could be done each surgical day, that would be well over 100 per year. It's not 400 but if the procedure could be done with, say , 3 hours of less of a surgeon's time, it could amount to 10 or more a week which could produce 400 or more per year. Maybe the procedures take more time.

mdln

@H B, would be very concerned if your orthopedic surgeon actually "does upwards of 400 TKRs each year."

Not sure how accurate or useful that statistic is. TKRs take 1-3 hours, and THRs (hip) take 1-2 hours - so not a huge difference, but I could see the number of TKRs being a bit less. My surgeon, in his first 10 years of performing THRs, performed 4200 of them. It was the reason I chose him.

Top surgeons routinely perform hundreds of replacement surgeries every year. Those are the ones you should be looking for.

FWIW, I just spoke with a good friend who is having her TKR surgery on Nov 8. Hers will be done by partial robotic means. She is thrilled, as she will not have an overnight stay in the hospital. Unless there are unexpected complications of course. Her surgeon said she would be up and walking before she went home.

Our hospital system just opened a new Orthopedic wing, so she is thrilled to be able to even have her surgery, since she thought it would be after the new year due to the Covid delays.

“At HSS, our joint replacement specialists perform an average of 365 joint replacement surgeries per year.”

https://www.hss.edu/quality-surgical-volume.asp

Ninapearl, have you thought about having someone foster your Danes while you recuperate? I have a friend who has fostered several pups and kitties while people have been unable to care for their pets due to surgeries, illness, etc. It might be better than having them in your home for a week or so.

@OutsidePlaying unfortunately, i don't have anyone even remotely close that i would trust. one of my danes is 8+ years old and requires drops in one eye for glaucoma plus she has to have a low-protein diet (i cook for her) to keep kidney values in check.

my other dane is just 19 months old and while she would be easy peasy to care for, she is still learning and i would be very afraid that much of my training with her would go down the tubes if she had to be away for more than a day or two.

i live in a very small farming community, i'm so far out in the country that i should have my own zip code so finding anyone to help with pretty much anything is a lesson in futility. i do have a friend whose daughter is a CNA and not working right now so that is a possibility i will have to explore. thanks for your suggestion but it's just not something i'd be willing to do. the only people who i'd trust would be both of my breeders but one lives in iowa and the other in wisconsin.

I would absolutely board those dogs. It doesn't take a "zoomie' to accidentally make you lose your balance. One of the recommended preparations for of hip and knee surgery is to make plans for someone else to care for the animals while you recover. At the very least, for a week.

I wouldn't be surprised if I had that number wrong, but he does a lot and it's a specialized outpatient surgical facility. I think it's pretty rare that people get held over night anymore, unless there's a need; some people can go to rehab if their home isn't suitable for return straight from surgery.

I think there's a limit to how long a tourniquet can be applied, so that helps speed procedures along. At the facility I went to, you arrive; 2 hours pre-op; 2 hours surgery, 2 hours post-op and off you go again. And they want someone literally following you around for at least 24 hours (bathroom, whereever you go) in case of wooziness from drugs, etc.

And...my PT cautioned -- if you fall, the 'new' knee is stronger than anything else in there, so it's your body parts gonna give out if its a bad fall, and that is to be avoided at all costs.

I think what makes this so tough, as many surgeries you go through them, and then it's "rest up! Get well!" and this one is complicatd in that rest is needed -- but so is movement, from the get-go. So yes, you have to practice crutches a little in the facility before going home; have to demonstrate a few stairs...and you go home with instructions for some very basic PT to start that day or the next (home PT will show up the next day, and there will be a list of exercises to do, 3x per day at a minimum). It's a lot of work and well, if I'm average, it's pretty painful. It DOES get better -- I'm now 10 days out and feels like I turned a corner in the past day or so. And the "new" knee is so clearly better than the old (and other) knee.