Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 109: Five Products You May Not Need After Knee Replacement

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Episode 109: Five Products You May Not Need After Knee Replacement · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

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  A Cochrane review published in 2014 included
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  24 trials with 1 ,445 people. At six weeks, the
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  people who used CPM could bend their knees about
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  two degrees more on average. Are you ready to
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  get back to what you love after knee replacement?
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  The Total Knee Success podcast is your trusted
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  guide with practical tips, evidence -based strategies,
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  and no fluff. It's not personal medical advice,
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  just solid education to help you manage pain,
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  regain mobility, and get back to living the life
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  you love. Let's dive in. Welcome back to the
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  Total Knee Success Podcast. I'm Michelle. If
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  you're getting ready for knee replacement, you've
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  probably heard from someone who's already had
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  one. Before you finish telling them your surgery
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  date, they're telling you what to buy. They loved
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  their ice machine. They spent hours in a CPM
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  machine. Someone else says you'll want a new
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  bed. You appreciate the help and pretty soon
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  your shopping list costs more than the vacation
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  you're hoping to take when walking feels better.
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  I'm guessing you'd rather avoid buying a pile
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  of equipment you may use for a week and then
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  store in a closet. You're already putting money,
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  time, and effort into surgery. Today we're looking
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  at five purchases worth questioning before you
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  place your order. By the end of this episode,
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  you'll have a straightforward way to compare
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  an expensive option with a simpler one, along
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  with a general idea of what each choice may cost.
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  As always, this episode provides general education.
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  Your own needs, home, and medical instructions
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  may be different. Let me introduce you to Bruce,
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  who lives outside Detroit and has a lot of friends
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  with a lot of opinions. He likes his friends.
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  He also knows that asking one of them about knee
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  replacement can produce a 40 -minute equipment
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  review. before he's taken off his coat. One friend
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  sends him a link to a walk -in tub. Another recommends
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  an adjustable bed. By Thursday, he has recommendations
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  for an ice machine, a CPM machine, and a wooden
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  heel slide board. Bruce looks at the list and
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  says, at this rate, I'll need a second bedroom
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  for the equipment and a second job to pay for
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  it. Bruce takes the list to a preoperative visit
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  with his surgeon and asks about the two medical
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  machines. His surgeon has not prescribed a CPM
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  machine or a circulating cold machine. Later,
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  at a separate preoperative physical therapy visit,
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  Bruce asks about his bathroom, his bed, and the
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  exercises he will be doing. Bruce is fictional,
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  although his shopping list is completely believable.
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  I'm using rounded US dollar examples so you can
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  see the size of the differences. Prices change,
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  insurance coverage varies, and the amount you
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  pay may be different. These are examples, not
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  quotes or a prediction of anyone's expenses.
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  The first item Bruce questions is a walk -in
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  tub or a major bathroom renovation. He has a
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  bathtub with sliding glass doors, and he's concerned
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  about stepping over the side after surgery. A
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  walk -in tub sounds convenient until he sees
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  estimates that can reach several thousand dollars.
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  At his preoperative physical therapy visit, Bruce
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  describes the bathroom he already has and brings
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  measurements and a few photos. His therapist
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  checks whether a shower chair or transfer bench
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  could fit. A shower chair gives you a place to
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  sit once you're inside the tub or shower. A transfer
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  bench extends over the side of the tub, allowing
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  you to sit before moving your legs inside the
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  tub. The American Academy of Orthopedic Surgeons
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  includes a stable shower bench or chair and secure
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  bathroom handrails in its suggestions for preparing
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  your home. Bruce's therapist recommends a transfer
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  bench that adjusts to the height of his tub and
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  shows him how to use it. His sliding glass doors
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  make the opening a little too narrow, so Bruce
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  and a family member remove the doors and replace
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  them with a shower curtain before surgery. They
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  check the bench after adjusting its height and
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  discover that the lower track does not interfere
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  with the setup. Someone else's tub, bench, or
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  door frame may be different, which is why measuring
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  first saves a whole lot of trouble. For a broad
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  cost comparison, an installed walk -in tub can
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  cost several thousand dollars, and some projects
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  go well beyond ten thousand. A basic transfer
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  bench may cost around a hundred dollars. A curtain
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  and rod at a smaller expense if the doors need
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  to come out. Insurance may cover some bathroom
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  equipment when the requirements are met, although
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  permanent renovations are often handled differently.
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  Bruce checks his own coverage before buying anything.
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  The problem Bruce needs to solve is the narrow
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  opening and the high side of the tub. Once the
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  bench gives him a seated way across that edge,
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  the major construction project no longer fits
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  his short -term goal. Using a suitable bench
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  and making a modest change to the doors saves
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  Bruce thousands of dollars compared with a walk
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  -in tub estimate. Someone planning a long -term
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  bathroom renovation may still choose a walk -in
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  tub. Bruce only wants to solve the access problem
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  he has coming up. that he anticipates after surgery.
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  The second item Bruce considers is an adjustable
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  bed. When you're sore, tired, and trying to get
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  comfortable, a bed that moves at the press of
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  a button can sound wonderful. One of Bruce's
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  friends sends him a video and tells him the bed
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  changed everything. Bruce replies, for that price,
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  I assume it also changes the sheets? An adjustable
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  bed may be a purchase you already want for comfort
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  or another health reason. Bruce is considering
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  it only because he expects to elevate his leg
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  after knee replacement. His therapist shows him
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  how to use a leg elevation wedge on the bed he
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  already owns. An adjustable bed and base can
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  cost several hundred dollars, while beds with
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  more features can run into the thousands. A leg
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  elevation wedge may cost around $50. Bruce's
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  existing bed is comfortable and easy for him
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  to get in and out of, so the wedge solves the
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  problem that he is trying to solve. His therapist
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  shows him where to place the wedge so he can
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  follow the positioning instructions for his knee
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  and avoid prolonged pressure on his heel. Leaving
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  a pillow only behind his knee can hold it in
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  a bent position for long periods, which may make
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  regaining full knee straightening more difficult.
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  Bruce tries the recommended setup and he finds
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  it comfortable. Keeping his current bed saves
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  him hundreds or possibly thousands of dollars.
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  Someone who already wants an adjustable bed may
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  decide the added comfort is worth the price.
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  Bruce buys the wedge and takes the adjustable
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  bed off his surgery shopping list. The wedge
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  also has to work within the space he has. He
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  checks that it stays in place and that he can
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  move on and off the bed without catching his
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  foot on it. Those small details determine whether
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  a $50 purchase is useful or simply becomes another
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  object leaning against the wall. The third item
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  on his list is a circulating cold therapy machine,
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  often called an ice machine. Several friends
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  loved theirs, and you may have heard the same
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  enthusiasm. The machine circulates cold water
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  through tubing into a wrap around your knee,
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  allowing longer cold sessions without exchanging
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  a pack every time it warms up. A basic circulating
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  machine may cost around $200 to $300, depending
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  on the model and the wrap included. It also may
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  be covered by your insurance. Reusable knee packs
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  or wraps may cost about $30 each, using a rounded
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  example. A $250 machine compared with two $30
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  packs creates a difference of about $190 before
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  tax and shipping. Coverage varies, so Bruce checks
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  before assuming either choice will be paid for.
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  The research gives him another piece of the comparison.
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  A 2023 review combined seven randomized trials
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  involving 519 people after knee replacement.
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  The researchers compared circulating cold treatment
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  with traditional choices such as ice or gel packs.
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  They found no statistically significant differences
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  in pain, pain machine use, knee movement, or
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  swelling. That review looked at circulating cold
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  without added compression. Some machines combine
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  cold and compression, which is a different treatment.
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  If your clinician recommends a cold and compression
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  device, ask why that particular feature is being
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  recommended and what your plan or insurance may
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  cover. Convenience can be worth paying for. You
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  may prefer the machines wrap or appreciate having
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  cold available without repeated trips to the
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  freezer. Bruce has freezer space and help exchanging
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  packs. So he buys two reusable packs. His friend
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  still loves the machine and Bruce is perfectly
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  happy with his packs. The decision may come out
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  differently in your home. Reusable packs require
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  freezer space and someone has to exchange them
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  as they warm. A circulating machine needs water
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  and ice, has tubing to manage and may be heavy
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  when it's full. Bruce thinks through who will
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  set up each option and where the tubing or extra
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  pack will be stored. That comparison tells him
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  more than the price alone. Whichever option you
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  use, follow the instructions you were given for
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  the skin barrier, temperature, and length of
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  use. Skin around your knee may have areas of
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  reduced sensation after surgery. Check your skin
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  and stop using the cold if you notice a burn,
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  blistering, or a concerning color change. The
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  fourth item is a continuous passive motion machine,
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  usually called a CPM machine. Your leg rests
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  in the machine while a motor slowly bends and
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  straightens your knee. Bruce's friend rented
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  one years ago and remembers spending hours in
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  it. He is certain Bruce needs one too. Bruce
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  asks his surgeon directly. His surgeon explains
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  that CPM is not part of the treatment planned
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  for his uncomplicated knee replacement. Bruce
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  will work on knee movement through the exercises
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  and assisted movements his physical therapist
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  teaches him. The research helps explain that
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  decision. A Cochrane review published in 2014
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  included 24 trials with 1 ,445 people. At six
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  weeks, the people who used CPM could bend their
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  knees about two degrees more on average. The
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  researchers considered that difference too small
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  to support routine use and found no clinically
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  important benefit for pain or everyday function.
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  A 2024 review included six studies with 557 people.
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  Adding CPM to physical therapy did not significantly
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  improve knee movement or satisfaction compared
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  with physical therapy alone. The review also
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  reported higher hospital treatment costs when
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  CPM was added. Buying a knee CPM machine can
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  cost several thousand dollars, though that's
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  not usually what happens. Rental charges depend
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  on the supplier, rental period, delivery, and
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  insurance coverage. If your surgeon prescribes
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  one for a particular reason, follow that plan
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  and ask the supplier what you will owe. Bruce
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  has no prescription and no reason to arrange
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  a rental, so his additional CPM expense is zero.
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  This is where the source of the recommendation
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  becomes important. Bruce's friend is describing
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  what happened during his own surgery several
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  years ago. Bruce's surgeon is making a current
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  decision for Bruce's knee and the treatment planned
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  for him. The friend's experience can be interesting
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  without becoming Bruce's equipment order. When
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  his friend asks about the machine, Bruce says,
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  thanks for the suggestion. My surgeon wants me
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  to start with the exercises my therapist will
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  teach me. The fifth item is specialized equipment
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  sold for practicing heel slides at home. Bruce
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  takes a look online and finds a wooden heel slide
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  board with a moving foot platform, a lighter
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  foot sled, and several different straps that
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  he might purchase. These are self -moved exercise
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  aids, which separates them from a motorized CPM
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  machine. A wooden heel slide board costs about
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  $100, and a foot sled costs about $60. A looped
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  stretching strap costs about $15. Each tool feels
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  and works somewhat differently. The useful question
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  might be which one, if any, helps you perform
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  the movement your therapist has shown you comfortably.
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  Bruce tries the heel slide exercise with a loop
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  strap during physical therapy. The loop gives
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  him a comfortable place to hold while he assists
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  the movement. His therapist also explains that
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  some people use a towel or a clean dog leash
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  they already have at home when it gives them
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  a secure, comfortable grip. You'll see polished
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  wooden boards, plastic sleds, straps and other
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  exercise products online. Some people prefer
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  a guided track and are happy to pay for it. Bruce
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  is comfortable using the strap and likes that
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  he can fold it and place it beside his chair.
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  For Bruce, the strap costs about $45 less than
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  the foot sled and $85 less than a wooden board.
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  A person who already owns a suitable towel, a
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  dog leash or a strap that they already have may
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  not need to buy an exercise aid. Trying the movement
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  with your therapist can help you choose an option
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  that feels comfortable and works with the exercise
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  you were shown. Before Bruce finishes shopping,
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  one more friend sends him an all -in -one joint
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  replacement kit. The contents vary, although
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  many kits bundle several smaller aids, such as
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  a reacher, socket, long -handled shoehorn, dressing
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  stick, leg lifter, or stretching strap. Bruce
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  checks the contents one by one. A kit can really
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  be convenient when you expect to use most of
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  the items and the bundle costs less than buying
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  them separately. Bruce already has the strap
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  he wants and does not need every dressing aid,
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  so he skips the kit. After surgery, Bruce uses
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  his transfer bench, cold packs, elevation wedge,
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  and loop strap while following the care plan
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  for him. He attends his appointments and over
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  time, his knee moves more easily and walking
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  feels better. His progress comes from the care
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  and exercises he follows, rather than a promise
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  attached to any particular product. When his
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  friend asks how everything is going, he says,
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  my knee is moving better, I'm walking better,
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  and I'm glad I found the equipment that's right
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  for me. Your list may look different from Bruce's.
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  Some of these products may be useful to you,
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  and you may simply prefer the more expensive
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  option. Before you buy, identify the exact problem
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  you want the product to solve. compare it with
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  a simpler choice, and check your instructions
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  and insurance coverage. Bruce used the same three
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  questions for every item. What problem am I solving?
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  What less expensive option could solve it? And
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  has my surgeon or therapist recommended something
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  specific for me? Those questions leave room for
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  personal preference. They also make it harder
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  for a friend's favorite purchase to end up on
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  your next credit card statement. Check out the
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  show notes for the research references, general
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  price sources, and home equipment guidance used
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  in this episode. You can see the link to the
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  episode blog post in the show notes as well.
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  In episode 110, we'll turn the question around
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  and look at a few less obvious products that
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  can be surprisingly useful after knee replacement.
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  Thanks for joining me. I'm Michelle, and this
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  has been the Total Knee Success Podcast. This
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  podcast is for educational purposes only. Discover
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  more at TotalMeSuccess .com and be sure to subscribe
• 16:12
  and share because every step forward takes you
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  closer to living the life you love.