My wife has had mild to moderate arthritis for several years, in several joints. In the past year, her left knee and right shoulder have gotten dramatically worse. She can hardly use her right arm at all, and she can’t walk more than a couple of blocks without knee pain. An orthopedic medicine doctor said her shoulder is in “end stage arthritis” and should be replaced. He also said her knee has very little cartilage left and is mostly bone-on-bone, and also should be replaced.
We saw a knee surgeon last week, and he agreed that the knee should be replaced. He said the lack of cartilage means that hyaluronic acid probably won’t help. We have scheduled the knee replacement for January (the soonest possible), and are on the waiting list if anything opens before then. We’ll see the shoulder surgeon in about a week, so we don’t yet know what the possible schedule is for the shoulder replacement.
So, I’m just looking for thoughts and opinions about which should be done first if we have a choice. I understand that the recovery from knee replacement is longer and more difficult than that from shoulder replacement. It also seems somewhat important to have a functioning shoulder during knee recovery, so she can use her arms to assist when her knee is less than functional. Any other general thoughts about the surgeries, recovery, PT, etc., especially from anyone who has experienced either or both surgeries, would be welcome.
Boy, that’s a rock and a hard place, for sure.
I think the knee would be first if it was me. Those shoulder replacements are difficult to rehab, from what I know.
Knee ain’t no joy rehabbing, she’ll need a careful PT.
Good luck. With your waiting lists so long, you’ll probably have to do what they offer first. I hope it goes well.
I’ve only had knee replacement. It was an overnight stay because they like to monitor your vitals to make sure there aren’t any issues. I was on oxygen during the night because breathing was an issue. The hardest part was getting up to use the toilet, which required assistance from the night nurse. My biggest issue was sleeping at home, as I’m normally a side sleeper. I could not get comfortable and was in some pain because I won’t take narcotics if I can possibly avoid them. Again, getting up to use the toilet was problematic because I couldn’t flex the knee. My wife had to help me get on socks and undies in the morning during the first week. I had a few weeks of in-home post op therapy and then was supposed to have on site therapy. For showers, I wrapped my surgery site with Saran wrap, which worked very well.
The two biggest problems were the drugs, which caused some rather painful constipation, so stock up on Mira-Lax, and I had seepage at the surgery area that caused me to stop the PT, as I didn’t want to get an infection (you REALLY don’t want to get an infection). The most painful part was when they took the staples out. You should be able to get at least partially covered for things like a cane and a walker. I needed a walker for the first week, then went to a cane for a couple of weeks. It actually takes a couple of years for everything to be completely back to normal, although you’re functional pretty quickly after operation. You’ll be required to take antibiotics prior to any dental work for the rest of your life, as infection at the surgery site would mean more surgery.
Bottom line: it’s uncomfortable, but worth it not to have to painfully struggle with stairs and even with ramps. I’m past two years now and the scar has largely faded out. I’m probably going to have to face surgery for one or both hips at some point, though.
This post may only make sense for patients in the United States.
My double-knee replacement surgeon was skilled at the surgery, but also skilled at getting insurance to approve going to an acute rehabilitation hospital after surgery. IMHO this is desirable. Especially if both knees are not done simultaneously (mine were done one week apart), there may have to be a good reason given why subacute rehab will be insufficient. Perhaps the shoulder situation could be the reason here.
The last paragraph of that article: “For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.” I don’t know if that includes high blood pressure and the like, but I take several meds for that.
Also this: “for patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.” The complications I had were the leaky sutures, and my surgeon is the one who said I need to take the antibiotics prior to dental work, so I guess I’ll stick with it.
My wife has had both knees replaced, a few years apart, and also one hip. I have no experience with shoulder replacements. She recovered fairly rapidly from each, though we know people who had a harder time.
Be prepared to wait on your wife at least a few days, and she should do her exercises and her PT, which really helped. Definitely worth doing. She can walk as quickly as I can now with no pain.
Her surgeon told her the magic words to use to get another night in the hospital which she found really helpful. Our Medicare supplement covered 100% of the cost, so that wasn’t an issue.