Hi friends. It has been three years and 1 month since my surgery. During this period I've spoken to many people who've had a TDK and found that
ONE THIRD had very positive results and would do it again (or do the other knee)
ONE THIRD are uncertain, and
ONE THIRD had a very difficult / painful surgery and would not repeat the TKR on the other knee.
I fall in the third group.
The general approach used by orthopedic surgeons in the US is "when your knee pain becomes unbearable, it's time to replace that knee." They mention 'bone on bone' in a way that's nearly an automatic response, and the four doctors I consulted didn't consider any other sort of treatment or any related factors that might be involved.
Upon further study and analysis, I believe that perhaps my abnormally high level of pain that lasted for months was due to thyroid issues or Lyme disease. The body's different systems are all interconnected, and 'arthritic pain' is associated with both of these so perhaps that was a factor. I had mentioned both of these to my surgeon but as a general rule they are focused on the surgery and not on each patient's total body health. Perhaps in your area you can find a holistic physician who can check for other interrelated factors and recommend massage / physical therapy to improve mobility and reduce pain, while looking into related health issues like weight / thyroid / etc.
Another issue for me was the 'lateral release'. This had been mentioned by an orthopedist I consulted while traveling abroad but was ignored by my surgeon, who didn't mention its significance in the surgery. However, it was an important detail! For 1/3 of TKR patients, when the new kneecap won't stay in its 'groove' but instead pops out, the doctor will cut 20 small incisions in the muscle that holds the kneecap in place, to loosen it. That pain lasted for two years, and it still aches when I have to stand for more than 15 minutes. I sometimes wonder if I should have just fixed this through minor surgery as the foreign surgeon had recommended, rather than replacing the entire knee. Or do targeted exercises to stretch that muscle so the knee would not pop out of joint.
My knee functions well now, but it still 'pops' as the plastic pieces snap in or out of position inside the new joint. I don't understand this and suspect it should not be this way.
My Dallas surgeon probably did a sufficiently good job in the operating room but that's only part of a physician's role in health care. Not seeing a patient who has had TKR for TWO months post surgery - and not even calling once to check on their welfare - doesn't indicate much care for their well being. His staff did not serve him well either. His cold-hearted and unconcerned (but beautiful) medical assistant is no longer with him. Her flippant attitude in delaying 3 to 7 days to refill pain medication reflected poorly on him. And when I urgently requested an appointment to see the surgeon about the extremely pain level that persisted 5 weeks after surgery, she made me wait 8 days.
I had searched for an expert surgeon and interviewed four before selecting this one. However, I have a sense that most orthopedic surgeons here in Dallas don't have much time for patient care because here they perform 3 to 7 TKRs each day. (That's a lot of $$).
My suggestion to you would be to check online recommendations for surgeons in your area and look for one with excellent ratings for patient care. Write back to the individual who has posted the rating (as you did here with me) and see what they say. Compare with comments on other forums for the same surgeon.
I know that I did post on YELP a less-than-flattering report on my experience. I also wrote a letter to the physician explaining why I felt his assistant did not serve him or his patients well.
Hope this is helpful.