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knee replacement surgery for a PD patient with arthritis

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Posted 7/24/2007 4:29 PM (GMT 0)

Is a knee replacement surgery safe for a patient who is under treatment for PD for the past 4 years? The patient experiences rigidity, sluggishness, musculoskeletal pains and imbalance. The patient also has severe arthritis on both her knees and so has been recommended a total knee replacement surgery by orthopedicians. Would such a surgery affect and worsen PD symptoms? Is there any risk of undergoing the surgery in terms of drug reactions? Please help...

Posted 7/24/2007 4:56 PM (GMT 0)
I will probably have surgery in the near future and have been wondering about this.  I will be talking to one of the doctors tomorrow and I will post anything that I find out both here and in the "cancer treatment for PD patients thread".
Posted 7/25/2007 2:37 AM (GMT 0)
Sudha,
I don't know why but the knee replacement surgery for my mom-in-law made her symptoms much worse. The rigidity made her physical therapy more difficult and the pain was a problem as well. When the doctors suggested she have her other knee done she laughed at them. This is only one person, and only one result so you shouldn't base your whole decision on it, but when she was asked if she had it to do over again, would go thru it again she said no.

I guess the thing you need to evaluate is whether or not this person could possibly use a wheel chair or scooter instead of the new knee. Mom ended up in a wheelchair anyway so I didn't really see the point of the replacement. Sometimes surgeons figure they can fix things with their little knives, but they don't look at the total patient and the quality of life with or without the surgery.

If the patient decides to go ahead with the surgery one thing that would have made things better for mom is if she had strengthened those leg muscles before the surgery. She had so much knee pain that she didn't use them much and after the surgery they were stretched, sore and really mad at being asked to work so hard all of a sudden along with the pain. If her muscles had been in better shape the surgery may not have been so difficult to recover from.
Posted 7/25/2007 6:44 PM (GMT 0)
Hi Jeannie143,

Thanks a lot for your kind reply. My inquiry was also for my mother-in-law. Her condition is pretty much the same that you have mentioned, her muscles are weak due to lack of movement. Your reply has given us a lot of details about what we could expect and how we should prepare before the surgery. Thank you very much and hope your mom-in-law is getting better.

 

Posted 7/26/2007 4:49 PM (GMT 0)
Sudha,
My dear mother-in-law passed away in 2000 from pneumonia. This was about six years after her knee replacement. She had degenerative joint disease in every joint except her fingers and toes so fixing that one knee really didn't help much. The orthopedic surgeons wanted to put a rod in her back because she used to unfold and collapse like a jack-in-the-box whenever we would pick her up to transfer her from chair to commode or bed. She was in extreme pain but the doctors finally realized that she might not survive the surgery... Oh, and she had severe osteoporosis, too. This dear lady had it all!!!

Eventually she moved in with us and her life became a round of PD meds, osteo meds and pain relievers. We went thru all the time release patches, vicodin, oxycontin and eventually found morphine that gave her some quality of life. Her Parkinson's really did a double whammy on that knee replacement because she never was able to do enough physical therapy to make it better and the other knee hurt anyway. If your mom-in-law has a wheelchair or scooter (we also used a small office chair here at home) to get around with and isn't planning to start walking regularly I don't see how this extra pain will be worth it. If her PD is kind of in remission and her knee is holding her back from doing things, if she is youngish and wants the surgery... go for it. But it's a long road back...
Posted 7/27/2007 12:00 AM (GMT 0)
This won't be much of a contribution, but I promised so here is my situation.  I was diagnosed 6/06 with PD and I just found out that I definitely have prostate cancer.  I will have the prostate surgery around the middle of October.  The surgeon tells me that the PD will have no consequences at all in the surgery.  Obviously this would be different if the the PD was extremely advanced and my prognosis was poor.  In that situation there would be no reason to even have the surgery.  Since I am early with both PD and PC I should be able, after the surgery, to enjoy many years with our frind Peedy.
Posted 7/27/2007 1:10 AM (GMT 0)
 Goodluck to you, I know you can make it. Thanks, you're in the early stage of PD and PC. Just maintain your courage and determination to survive and to live and everything will be all right. Take care of yourself and I hope for you the best in life.

Posted 7/27/2007 1:09 PM (GMT 0)
Hi gtmriviera,

Thanks for your kind post. All the very best to you, your courage will definitely make you succeed in fighting the complications that you have right now.

Posted 7/27/2007 8:44 PM (GMT 0)
Sudha, Welcome to Healing well,Just to let you know I just underwent anesthesia,with no complications with my pd.If the knee replacement improves the quality of life for an individual,and the neuro ,anesthesiaologist,and surgeon approve.I'd go for it.My wife has had complete knee replacements in both knees,and the quality of life has improved 1000% for her.She doesn't have pd,and the complications that the disease causes,but it was a thumbs up on the new knees.Ed
Posted 7/30/2007 7:27 PM (GMT 0)
Hi Sudho, my experience for what it's worth. DXJan 2006 whilst recovering from a hip replacement but 'backdated to three eyars before that. My orthopods have informed me that if they thought there was any danger fo known reactions to surgery, on the pd, they would inform me but they know of none - that isn't to say there will be none - but there again all surgery carries risks pd or no. I go in for a second hip replacement in four weeks time and if the outcome on this hip is as positive as the last I shall be pain free and walking far far better. not withstanding the stiffness caused by the pd. The potential pros far outweigh the cons for me and I have no hesitation in haaving the surgery. Remember - you may have heard negative reports of kickbacks cos of surgery but the liiklihood is that they would haev hapened anyway pd or no. But as Ed always point sout - our progression, symptoms and effects of such are all different.

There is no way I would take a decision on future treatment based solely on another's experience. The informed experience is valuable as information goes but there are far more variables to take into consideration.

If we all didn't take chances in life - and I believe this to bethe smallest of chances - we may end up regretting it ever after.

Good luck in your decision making.

The Bear.

Posted 8/10/2007 2:54 PM (GMT 0)
Confessions of a speedreader:  I'm sure that many of you are able to read all of the postings, but some of us unfortunately do not have the time required.  I am one of those who read the recent postings and have to leave it at that.  If I am repeating something previously posted it is so that hopefully everyone anticipating surgery will see it.  The NPF Parkinson report, summer 2007, has an article entitled "Five Frequently Asked Questions about Hospitalization" and the entire article can be obtained online.  My doctor, Dr. Okun, is one of the authors and he called my attention to this article when I asked him about my upcoming prostate surgery.  The last two pages, a checklist for the patient and a checklist for the doctor, are especially noteworthy.  If you are wondering why this is in this forum, I do have PD, this article is intended for PD patients and we are discussing here PD patients who are about to have surgery for other problems.  Just thought maybe I should clarify that.  TGIF,  GTM 
Posted 9/13/2007 7:46 AM (GMT 0)
Once more unto the breach and jusut for the record.

I am now home from hospital after having a total hip replacement on Monday of last week - the non-cementation ceramic variety - and as far as I can tell there has been no noticeable difference in the way pd affects me. I did read the articles GMT and raised the odd question with the anaesthetist in particular the query about the use of tranquilisers and she seemed puzzled at this. She didn't understand why such a drug would be administered as it is not common practice to do so when using a general. Anyway, all has gone well with more vconcern being placed on my lack of mobility than my pd at the moment. If anything changes iw ill of course keep you posted.

The Bear

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