Knee replacement

[Spaniel]

Back in October 2020 I visited Ramkhahang Hospital, Bangkok concerning my right knee,  that I had recently twisted.  The doctor that I saw examined my knee, but did not order a x-ray. After several months of treatment which included monthly blood test, some rather expensive medication (only the imported version available I came to the conclusion that this doctor was not helping my condition

 

So about a month ago I had an appointment with Dr Panya at Bamrugrad Hospital.  He ordered a. x-ray and advised that a full knee replacement would be needed at a cost of B380,000..

 

I decided another opinion was needed so I went to a hospital near my home in Minburi, Synpact Hospital.  The doctor examined my knee but did not have an x-ray and said all that was required would be to drain the fluid around the knee and this procedure could be accomplished as an  outpatient service.  I told him I would let him know later about doing this.

 

Wife and I decided on another opinion!   So we made an appointment to see Dr Ekapong who is a Orthopedic doctor at Sukumvit Hospital on 21 April.   X-rays were taken and consultations with Dr Ekapong resulted in his advising only a partial replacement would be needed, utilizing a new procedure, UKA, or Unicompartment Knee Arthroplasty.  The cost for this procedure is about the same as the full knee replacement cost quoted by Dr Panya at Bumrugrad.  Dr Ekapong at Sukumvit. Hospital was very professional and I felt confident in his abilities.  Has anyone been treated by him and if so would you recommend him?

Also,  the. aforementioned UFA procedure.  Is anyone familiar with it?

 

I am considering getting another opinion!!!   Any suggestions?

 

Thanks in advance to those who can offer any help.

[faraday]

https://orthoinfo.aaos.org/en/treatment/unicompartmental-knee-replacement/

 

 

[faraday]

https://bonesmart.org/

 

I found this & other forums very useful when I had my hip replacement 3 years ago.

[Sheryl]

https://orthoinfo.aaos.org/en/treatment/unicompartmental-knee-replacement/

 

If I were you I'd have another consultation with Dr. Panya, tell him another ortho recommended UKA and ask him what he thinks. If he still recommends full replacement, find out why.

 

As UKA vs full replacement seems to be the issue here (disregarding the nonsense recommendations from some doctorts who did nto even see an Xray).

 

The choice between TKA (total knee replacement) and UKR as I understand it depends on whether the problem is limited to just a part of the knee joint vs the whole joint.  And one needs to consider whether, even if it is, there is a likelihood of the rest of the knee eventually being affected, especially if the patient is older. UKR is more often used for young patients with sports injuries. But discuss with Dr. Panya in detail. I'm sure he can explain to you the pros and cons of the two approaches.

 

Whatever else you do, do not keep going to random hospitals to see random orthos, this will yield only more nonsensical/ill informed  advice and add to the ocnfusion. If you feel you must discuss with another doctor, carefully select a western trained specialist in arthroplasty. Getting second, third, even fourth opinions is fine but only if obtained from real experts.

[Spaniel]

Sheryl,

   Thank you, for as expected, an excellent reply as well as those others that replied too.

 

   Dr Ekapong at the Sukhumvit Hospital did come highly recommended by a friend of my wife’s, who had a similar problem and was treated by Dr.  Ekapong.   The doctor at Synpact Hospital was also on a recommendation of a friend.   An the hospital is about 10 minutes from our home,

   I do agree one should never let hospital staff select the doctor.

 

  

[rodknock]

had total knee replacement done in 2010.

totally happy with results.

was done in a usa hospital in mesa az.

only you and your doctor can make a decision as to what type of surgery you have.

the only thing i have to say is "physical thearpy" got to put your heart into it, which ever you do.

i virtually had no pain.

did not do both knees at same time. 3months seperation.

surgery was on monday, out of bed walking tuesday.

tuesday shipped to a physical therapy hospital for recovery.

i still do physical therapy in the swimming pool almost ever day for an hour.

walk forward and walk backwards, different muscles for forward and backwards.

best of luck whichever way you go!!

 

[dddave]

5 hours ago, rodknock said:

had total knee replacement done in 2010.

Eleven years ago, any issues now at all with wear on the artificial joint?  Are you a normally active person?

[rodknock]

i am 73 now, as active as a 73yr old can be.

i was an active bowler until 4yrs ago when my back started giving me big pain issues. i have had back pain issues for 25yrs.

i was planing on flying back to the US to see about surgery. i am a vet so it is no charge.

the covid-19 virus stoped all plans to that.

as far as my knees i have had no problems or issues.

i have the DePuy, a johnson and johnson company. Sigma model.

as it was done with medicare i would think it is a simple knee.

the have all sorts of knees available now that improve range of motion now.

that is something you need to discuss with your doctor.

no issues with being checked for flying. they should also give you an id card for your knee. it has never been an issue nomatter where i fly or travel.

if you have any questions i would be happy to help if i can.

good luck whichever way you go.

how old and physically active are you?

the hardest problem i had was wipping my butt after the surgery.

i have the Sigma model installed, and as i said no issues.