Alternative to TKR

[Midnightvelvet]

Hi everyone, just wondering whether anybody knows of any appliance that would help me regain some strength in my knee please? I have had arthroscopy which showed my Left knee is graded at 3.5 out of 5 (I'm told this is how they grade severity) and need TKR but people I know who've had it done tell me they can't kneel down on the new knee, which is no good to me as I need to be able to kneel down to show my dogs!!
Is there an appliance I could use which would enable me to kneel down and get back up again, preferably reasonably discreet? My predicament isn't helped by having no achilles reflex on the right side which makes me pretty much out of the game as I have nothing to support me when trying to kneel down and rise again! I did think to just have injections but my pain isn't the problem, I can cope with that, but injections won't give me any reinforcements, so to speak, to lift me up and down.

Kind regards
Suzanne

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[Fyzzio]

Hi Suzanne,
I am not a specialist in this area and just answering because no one else has yet.
Let's try and sort through your post.

1) Arthroscopy/ diagnosis: The only grading system I am aware of assesses the cartilage condition inside the knee. However, this is a 5-point score (0 - 4) and a 3.5 there pretty much means that you have next to no cartilage left, leaving the bone exposed. Not a pretty picture. Therefore, the doctors will recommend a TKJR. It is not up to Physios to comment on whether this is the best option, nor whether there are alternatives. There is different kinds of implants and not all limit kneeling. You should discuss this with a surgeon or your GP.

2) Appliance to regain strength: sorry, pretty much a 'no'. Strength gain is done with a specifically designed exercise programme. Frequency, duration and intensity depend on your condition. This needs to be assessed, e.g. by a Physio, and you will have to do the work.

3) Appliance to help you kneel down and get up discretely: not sure what you mean. Which leg are you wanting to kneel down on? Do you have problems with that now, both down and up again? And why? I do not know any machines that could do this.

4) Achilles tendon reflex: this reflex is not a functionally valuable reflex, i.e. it does not help with kneeling down or getting up.

It seems that your goal is to be able to kneel down and rise again independently. Is that correct?
This function is rather complex and involves a lot of strategies, which are impacted by single factors which could have impairments (what e.g. is the stregth of your quadriceps or calf muscles on either side? how about range of movement? any inflammation?) . In order to help you, we would first need to know what your problems is at impairment and strategy level. For this, I'd recommend that you get yourself assessed by a Physio specialising in Orthopaedics.

Hope this helps a little,
good luck,
Fyzzio

[Midnightvelvet]

Thank you so much for your reply....when I say an appliance, I mean a support that I could wear under trousers that would give me something to "push against" when getting up. I am able to get up and down OK with something to lean on and I was just off on a mental tangent trying to think of anything that might help. Yes you are correct in thinking I need to get up and down independently. I will get a referral back to my orthopod and see what he has to say.
Thank you so much again for your reply....although there is no solution therein, it does light my path somewhat as to where to go/what to do.
Have a good day

[Fyzzio]

Cheers.
There are several bandage techniques, taping and pre-fabricated knee braces available that might be beneficial for you.
Again, this would require an assessment to see what suits you best.
As far as I know, in the UK you can go to see a Physio directly, you don't need a referral.
Your Orthopod will not assess your knee strength and investigate strategies of movement and function.
All the best,
Fyzzio

[Midnightvelvet]

Cheers.
There are several bandage techniques, taping and pre-fabricated knee braces available that might be beneficial for you.
Again, this would require an assessment to see what suits you best.
As far as I know, in the UK you can go to see a Physio directly, you don't need a referral.
Your Orthopod will not assess your knee strength and investigate strategies of movement and function.
All the best,
Fyzzio

Thanks again...I will investigate x