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I decided to have my knee replaced when..
How my life changed after knee replacement

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I apologize up front for my long story and possible over concern.
I’m a 69 year old male who has just decided to have my left knee replaced. I have been dealing/enduring knee discomfort/pain since 1995 when I had “scope “ surgery to remove a torn meniscus. Arthritis and pain have increased over the years till currently I’m having problems just walking. It has definitely limited my lifestyle. I have always been active - running in my early years, hiking, aerobic and strength exercises, even tried CrossFit for awhile, but my favorite activity by far is tennis. I have enjoyed playing tennis regularly from a social, competition, and exercise basis. I have had to stop though. I have over the years tried the remedies and band aids to keep me going like braces, NSAIDS, “rooster cone” injections, and steroid shots. I am now at the point of proceeding to the replacement surgery. In doing so I’ve been doing a lot of reading on the surgery and the implant devices. Generally speaking, it appears that 90% of all surgeries are classified as successful with patients having good results, but there’s the other 10% which have some sort of problem. 10 per cent seems high to me although I realize there’s a myriad of reasons that can cause a problem. So my interest is being in the 90% group. Most important is the selection of the surgeon and rehab therapy, but it seems somewhere in the equation is the implant device itself. There are quite a few implant manufacturers and it’s a huge business. Each has a lot of marketing stuff out there claiming to be the best. There’s two or three that have a large market share. Is that for a reason or do they have really good sales people. Most manufacturers have positive patient testimonials on their device so maybe at the end of the day they are basically all the same. Don’t know, but when the dollar is involved I get suspicious. Surgeons apparently select an implant company and hone their skills at installing that implant. The surgeon I go to; but not locked into for surgery yet, naturally uses a specific implant device manufacturer. The question I have is how much did the implant manufacturer selection weigh into your surgery decision, if any, and if it did, how did you address it? Any comments would be welcome. If I’m wrong in some of my statements, please correct me.
Thank you for sharing your story with us. This is very interesting question.

It is true that most surgeons will have a preferred vendor for their knee replacement. This happens for a multitude of reasons. Generally, the surgeon will want consistency with the instruments and vendors in the operating room for himself/herself and the operating room staff. With less variability, there becomes less chances for errors. Surgeons do not frequently change vendors once they become comfortable and if they are obtaining excellent outcomes.

With that said, it’s not the best idea to approach a surgeon and ask them to use a system that they are not familiar with to perform your knee replacement. Yes, they could theoretically use any system available, but that does introduce an unknown element which could ultimately affect the outcome.

We believe that ultimately the outcomes from this surgery is more dependent on the skill and knowledge of the surgeon, more so than the particular implant that is used. While there is some truth that each implant may have some theoretical advantage with “this or that”; but it’s been nearly impossible for us, as surgeons, to come to any consensus on the best prosthesis or even the best techniques to use. Remember that much of the information you may see online can be from marketing strategies in order to increase sales of a particular prosthesis.

We recommend to trust the advice of an orthopedic surgeon who performs this procedure frequently. Sometimes we call these “high-volume “surgeons. There’s no real definition for the number of surgeries that makes a surgeon “high volume”, but typically the surgeon who performs at least 50 knee replacements a year will have good experience and can maintain their high skill level in this procedure.

It’s typically safer (in regard to the chance to obtain consistent reproducing results) also when the surgeon uses a prosthesis from one of the major companies because these companies have vast amounts of experience in implant design, manufacturing, and research. However, it is possible some of the smaller companies could provide a good product, but they may not have hey significant track record to back them up.
I'm so glad to see your comments. This is my exact question: what about the device. The answer provided is the same as I've seen elsewhere & quoting research results: at the end of the day, it depends on the surgeon, one's knee, and how well one does the rehab afterwards. I"m nervous, too. Surg scheduled 9/25. Plus, as you have, I have consulted a different doc from the one I've been using for the care and treatments leading up to the decision to have surgery, but the doc I consulted with has done everyone else I know, and the results seem mostly very good, with individual variables. I'm working on psyching myself up for the (painful) recovery. That seems variable, too. Good luck!
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