Knee replacement

[tudorsailor]

It is some years since I did a knee replacemen as I have become an upper limb surgeon. However I would make the following comments
All operations have risks of complications and even death. TKR is no different. The decision to go ahead should be based on pain and not stiffness. If the pain is severe and your life is ruined by it then it is worth the risk
There is no special TKR privately that is not available on the NHS
Kneeling is a problem after a TKR as one does not usually achieve full flexion. THis is a problem for those who kneel to pray and need to be forwarned
TKR implant survival is at least as good as THR
TKR does not have the risk of dislocation as a THR when the hip is flexed maximally (and this scared me silly when I had a guest on board who had a THR and kept bending down. My prayer for her not to dislocate the hip while on my boat seemed to work)
TKR has a much lower risk of peri-prosthetic fracture than a THR ie fracture of the bone in which it is implanted

A joint replacement is not the same as changing a gearbox. It is not something that can be repeated at will if there is a problem. A revision is a different kettle of fish.

So if you really need a replacement, then have one, while accepting the small but real risks.
If your symptoms are not too bad and think that you might as well have a replacement sooner rather than later, do not have surgery.

TudorSailor

 

[johnalison]

At the risk of some upwards drift, may I ask tudorsailor about the prospects for a total shoulder? A friend has just had one done for OA. He is hoping to be sailing again next summer. He has bought an electric outboard to replace his tender's Honda but I am skeptical about him being able to cope with a 31footer as soon as this.

 

[tudorsailor]

At the risk of some upwards drift, may I ask tudorsailor about the prospects for a total shoulder? A friend has just had one done for OA. He is hoping to be sailing again next summer. He has bought an electric outboard to replace his tender's Honda but I am skeptical about him being able to cope with a 31footer as soon as this.

Hmmm, now there's a question. Never done a shoulder replacement on a yachtsman. Again, unlike THR, risks of dislocation or periprosthetic fracture are much less with a shoulder replacement. As with the hip, there are total shoulder replacements and 1/2 replacements (hemiarthroplasty) both of which can have a ball on a stem or just a surface replacement for the ball (humeral head). No replacement last for ever but TSRs last as long as THRs in general. If one abuses the replacement, then it might fail.

If he has a surface replacement hemi or total, I would be happy for him to try sailing. Its the hauling himself up into the yacht from the dinghy for example that would worry me. However he has been managing to sail with a knackered painful shoulder so should be more able following surgery. I think I would say, do what he can and he may be pleasantly surprised.

If he has a reverse total shoulder - because he also has a torn rotator cuff - then I bet he will not and should not go back to sailing

Not sure that this helps..........

TudorSailor/Surgeon

 

[johnalison]

Thanks. He is mid-late 70s now, so I don't think he will wear it out. From his description, he has a titanium head with a stem into the humerus. He keeps his boat on a mooring and boards from a fairly solid fibreglass dinghy, so maybe he will manage. I feel that he might struggle with getting the boat ready from its current laying-up ashore, though his Coppercoat should make it easier. He has lots of friends to help with getting his elaborate cover off, so maybe I am worrying unnecessarily on his behalf.

 

[tudorsailor]

MId-late 70s sounds ideal. A good Total Shoulder is great for giving pain relief. Patients are incredibly grateful

TS

 

[sailorman]

Lady Sm had the shoulder problems last year.
options
do nothing
have a clean out/ tidy up
full replacement

She opted for the clean-up as told less problems than the replacement. well she should have had the replacement as we think the recovery period would have been faster but certainly no longer than what she had done.

 

[Pagetslady]

After a fall last month when she landed on her knee on Tarmac, my wife is in considerable pain even walking.

she has had a couple of knee operations over the last 30 years. The consultant is suggesting a total knee replacement, about which she has some reservations. She is 59, and how long it will last is one of them, although her main concern is that she will not have a full range of movement and use of her leg.

She wants to be able to get about the boat easily, and walk the dog comfortably.

Any scuttlebutters have experience, either personal or friends/family, of knee replacement and the aftermath, and the amount of mobility they have?

Hi there sorry to hear of your wife's fall but rest assured that after a full knee replacement she will be as good as new sailing and skiing no problem, I had my left knee replaced when I was 61 and have done thousands of miles since then most of them solo in my Westerly Corsair Pagets Lady I am now 72 and hoping to get my right knee replaced in the next month or two, persevere with the Physio and all should be fine, I hope to be skiing again in 2016 but I am sailing back to St Helier next season, where I spend several years berthed in St Helier and Elizabeth marinas good luck.
Regards Mike

 

[kunyang]

I now wish I had both knees done. I didn't realise how much the right knee hurt until I had no pain in the left. I know i'll put up with it for a few more years. But the left knee, now seven months old is great. Kneeling isn't a problem. just getting up and down stairs without having to support myself with the bannister is worth the op. Trouble is, I still haven't found a replacement yacht, so limited sailing at the moment.