Knee Replacement 101
Let's talk about knee replacements - partial and total.
This is a major operation. I don't care how many are done in the US, I don't care what the results that your Aunt Mildred had, and I don't care that someone told you something on some idle Tuesday while you were waiting for an elevator - THIS IS MAJOR SURGERY. A scalpel cuts into your body. The knee is essentially cut out with a high speed saw. Metal and plastic are inserted into a previously elegantly constructed body space. Then the surgery is over and people expect to run marathons, bungee cord jump, or dance in Havana in X amount of time.
Here is the 411 on knee replacement surgery. There are many factors that affect your outcome of the surgery. What do I mean by "outcome?" I mean everything - your time to heal the wound, how much motion you receive and how fast, stiffness after 2 weeks to 2 decades, the kind of sports and activities you can return to, and everything else.
I would like you to look at a knee replacement as the absolute custom fitting of anything you will ever have in your life. The work and elegance in this brutal experience makes the most beautiful custom dress that any Hollywood star wears at the Oscars look like an off the shelf schmatta (definition: rag) from the thrift store.
Your surgery is unique, your x-rays are unique, and your experience is unique.
Fortunately, though, looking at large numbers of patients we can see trends and statistically give you good ideas on what to expect - what the milestones are and where many people can be at a certain times.
Dr. K.
Oh, one more thing- cement vs. cementless- does not matter in joint replacement. There is more information on that issue but surgeons argue this all the time. There are real arguments on both sides.
Related Topics: Common Knee Injury Linked to Knee Arthritis, Arthritis: Therapy in Motion
Technorati Tags: knee, surgery, jointreplacement
This is a major operation. I don't care how many are done in the US, I don't care what the results that your Aunt Mildred had, and I don't care that someone told you something on some idle Tuesday while you were waiting for an elevator - THIS IS MAJOR SURGERY. A scalpel cuts into your body. The knee is essentially cut out with a high speed saw. Metal and plastic are inserted into a previously elegantly constructed body space. Then the surgery is over and people expect to run marathons, bungee cord jump, or dance in Havana in X amount of time.
Here is the 411 on knee replacement surgery. There are many factors that affect your outcome of the surgery. What do I mean by "outcome?" I mean everything - your time to heal the wound, how much motion you receive and how fast, stiffness after 2 weeks to 2 decades, the kind of sports and activities you can return to, and everything else.
I would like you to look at a knee replacement as the absolute custom fitting of anything you will ever have in your life. The work and elegance in this brutal experience makes the most beautiful custom dress that any Hollywood star wears at the Oscars look like an off the shelf schmatta (definition: rag) from the thrift store.
Your surgery is unique, your x-rays are unique, and your experience is unique.
Fortunately, though, looking at large numbers of patients we can see trends and statistically give you good ideas on what to expect - what the milestones are and where many people can be at a certain times.
Dr. K.
Oh, one more thing- cement vs. cementless- does not matter in joint replacement. There is more information on that issue but surgeons argue this all the time. There are real arguments on both sides.
Related Topics: Common Knee Injury Linked to Knee Arthritis, Arthritis: Therapy in Motion
Technorati Tags: knee, surgery, jointreplacement
45 Comments:
Dr. K.,
Thank you for saying some of these things! At 3 months post-op from TKR there are times that I think I'm not doing well at all, but this post makes me feel better. The resulting hip bursitis seems to continue being my faithful enemy.
I've had several surgeries prior to TKA ( major surgery for invasive cancer and open Nissen fundoplication) to name two of them. Nothing compares to the recovery of this knee surgery. Although, I'm now starting to reap some benfits and have stopped swearing at myself for even having it done. I have a perfectly straight knee (don't know when the last time was that I had one) and I have NO arthritis pains in that knee. So, things are on the way up....:)
BTW, when you put your patients in the CPM after surgery do you begin them at 70degrees? My OS starts in recovery at 70 degrees to 85 degrees. Everyone in recovery (PT, nurses) told me he is the only OS in town that starts you out at 70. All others start much lower and then gradually go up? Even just waking up from the surgery this was VERY painful...Is my Doc. sadistic?
Welcome back.....
Madison (from your knee replacement board)
Yes your doctor is a sadist. Not.
He/She only uses those settings because he trained on them. The facts of CPM are: It make absolutely no difference in recovery. Every major study shows this. So why do I use it- because patients expect it and the patient next to them done by another surgeon uses it. How is that for raw honesty. My settings are: Start at 45 degrees, advance 10 degrees daily, use fr only 4h total a day.
A better thing to use is a floor based fott pedal machine. You actually can buy one for $99.00 on www.skymall.com (no royalties to me :-)) Also a very interesting machine is one made by C-Ped which is more of a manual motion machine.
Either way- if my OS put the machine at 75 deg on day one I would throw it at him :-)
Dr. K.
Shoot after reading these posts I think I would rather live with both my used up old knees. I am 52 years old and work in the medical field and wish I didn't hear how bad this surgery or should I say the healing process is after it. I call my knees "my wheels" and know I need a new set but does it have to be as bad as it sounds? Ro Tarpon Springs Fl.
RO, No, I don't think it is always bad..We are all unique and the course of arthritis has effected us all differently.
At almost 4 months now I can say that I'am glad I had this done and I will show up to have my other one done as well. My problem is that I really had no idea recovery would be this long or this painful. I also had post surgery complications that most people don't have. That in itself caused a hospitilazation and a set back.
Another problem for me is my OS is ready to retire and is almost 70. I believe, he, some where along the way,lost his compassion, He sure as hell doesn't use pain control.
I don't have any arthritis pain in that knee any longer and I can bend it back now further than I can my opposit knee..
Don't be discouraged by what you read, remember those of us who posts on these blogs and message boards are the ones who have experienced some sort of problem. We don't usually hear from the people who have a great outcome. I'm sure those outnumber us.
Dr. K, I have posted you a message on the message board a few weeks ago but you haven't been back to the boards!!!
I have a question kinda related to this post. I need a knee replacement but I also need a hip replacement. They are both on the same side of my body.
My hip is worse than my knee but I know that my knee will get more stiff with arthritis while I'm recovering from my hip replacement.
In the morning, my leg is completely stiff, it takes about an hr, before I can rub my knee enough to make it start to bend.
Is it out of the question to have both done at once? From what I've read the knee will take longer to heal than the hip. I've been thinking about buying those lazer therapuetic lights that they sell on tv for pain in joints to help me during this surgery.
What do you think I should do?
I too have a blog about Living with Autoimmune Diseases & Chronic Illnesses, if you get a chance it's http://www.blogger.com/wolfandbutterfly/
LOL....I wasn't even close on my blog addy!!!!!
http://wolfandbutterfly.blogspot.com/ it's on Webmd anyway
1998 I had a left femoral osteotomy. the pain was so excruciating I wished to die, especially when the physical therapist came to the house. i used the CPM machine. Hell I wasn't started out at any 75 degrees. I woke post op with my leg in the CPM machine. When I went home with it, I raised it, by perhaps 4 degrees per day. Why, you ask. BECAUSE my orthopod didn't understand about PAIN relief after surgery. So, for weeks I suffered with pain. I couldn't increase the machine more. Remember future patients surgeons don't understand about pain management. You must be your own advocate. I did end up just fine. Thanks to my yelling at the doc for better meds, and constsnt use of the CPM, my ROM is great.
1998 I had a left femoral osteotomy. Woke up in the hospital with my leg in the CPM machine. It was started very low. When I went home with the machine I found I could only increase it by maybe 3 degrees each day because of the excruciating pain. This is important, so pay attention you future surgical patients. Surgeons generally, don't understand pain management. They know how to cut. They are too worried about you ending up in a methodone clinic from drug abuse, hence the reason they give limited scrips. You must be your own advocate for your treatment and PAIN. When I hadn't slept for more than 2 hours each night, due to pain I had words with my doc. Pain was relieved due to prper meds and I was able to withstand increases in the CPM machine, and I was able to heel faster, due to better nights sleep.
Dear Dr. K:
I am a 48 year old professional trainer that has been living on a badly injured left leg for 28 years. Shattered a femur (skiing trama accident), total knee rebuild (skiing trama repercussion) with a thigh strand built as an acl, and a foot rebuild (motorcycle street accident) a year later. I have known that I need a knee replacement, but I'm so active - training HS kids, my own bodybuilding ambitions, working with lot of adults too. I don't run, I either bike or eliptical in gym, and have no interest in "squating" 300lbs or more for years (smith rack only). I have never taken steroids, no am I interested unless required medically. I now have come to a replacement time. What kind of joint replacement product should i investigate and get. I heard the Russians have been producing the best type of replacement joints for the athletic types and longevity. I need a product mfg and type of joint "direction" for my special construction... Can you help ??
Doug in Dana Point, CA
dougb@plyopros.com
7 weeks post op and had manipulation last week. Calf and back of knee swollen and black and blue. Have not slept more than one hour without waking in pain since start of this. Vicoden does not help much. Feels like very tender under knee cap. Doctor said he might revise with smaller plastic part and or do lateral patella release. I am going out of mind with lack of a good nights sleep and pain during the day. Is this the norm for some of us?
7 weeks post op and had manipulation last week. Calf and back of knee swollen and black and blue. Have not slept more than one hour without waking in pain since start of this. Vicoden does not help much. Feels like very tender under knee cap. Doctor said he might revise with smaller plastic part and or do lateral patella release. I am going out of mind with lack of a good nights sleep and pain during the day. Is this the norm for some of us?
after reading these blogs i feel much better, my mother at a the young age of 84 just had a tkr... 1 week ago, she is in so much pain and the meds she is on don't help, it's horrible , i was beginning to think she was imagining it, but now I know she is suffering, the toradol and demerol injections don't give her enough constant relief.. I am ready to give her my own meds ......She did do some therapy today, so things are looking up I can only hope
Just over 4 weeks and still no sleep. Tried sleep aids and pain meds. When will i get to sleep again. Trying to follow a rigorous therapy to keep thing loose. But I keep getting up from bed every 2-3 hours. How long is it going to last this way. Did I make the right decision???????????? Joe T'
Hello all,
October 31, 2000, I had bi-lateral knee replacements. (in other words, I had both knees replaced at the same time.) The first two weeks were hell. But I was determined to get up and get moving as soon as possible. I love to play golf and fish and keep moving! Attitude is everything. I just wonder now how long before the next replacements...
Barb :)
Dr. K,
I had a right knee replacement about 21/2 years ago. It didn't work. I was in constant pain. I had had the left knee done with titanium about 12 years ago and nevr had a problem. I tried to tell the doctor that I wanted titanium again, but he said no, and gave me another type of medical.Since then,I had a revisition on that knee and they used another type of medal, but I have constant bad pain now since the surgery for about 10 months. Can it be the medal? How can you convince the doctor that it is the medal?
P
Dr. K
I have had the worse TKR in history. At 50yr old I had a left arthroscopy followed by TKR. PT went well and I felt I had recovered and went back to work after 12 weeks. 10 months after TKR I developed the same pain. Dr. stated that bone scan showed replacement was not holding. Revision done 14 months after 1st TKR. This surgery was very difficult and I have not recovered and it has been 8 months. I have had 3 manipulations, edipural placement with meds for 3 days, spinal knee block and PT 3x week. My knee is stiff and will not straighten. The pain is horrible and I am thinking that my physician screwed this up. I know find out he has a history of failed TKR. I am in the process of trying to get my records and see another physician. Any comments, help or suggestions would be greatly appreciated. I am at my wits end and some days would rather have had the knee amputated the pain is so bad. Help please
Cindy C
I had TKR in 2002, Advance BiKnees, surgery went well Pt was very good. I felt like a new person. I now four years later have developed pain and stiffness in both knees. I had 110 degree bend now it isn't even 90. I find myself tripping alot and fear I may fall. I have heard where they can put you out and manually bend your knees. Does this break up scar tissue or something like that? Does it help get your bend back? I really miss riding my bike. Please advise
I am a 42 year old woman who had a TKR in July 1999, an orthobiologic implant in October 1999 and a TKR revision in January 2000! The first TKR at age 35 was because of arthritis which had developed out of various injuries from sports, a car accident and a fall. But my troubles really began after my TKR in July 1999, when 4 days after my surgery, an over zealous physical therapist tore my medial collateral ligament. I can no longer remember a day without pain and I'm so tired and lost, because nobody seems to want to help me. The prosthesis is loose in the tibia and every step I take is agony. Is there anyone in New York (who takes Oxford insurance) that you can recommend me to? The surgeon who did both TKR's no longer takes my insurance and I can’t seem to find anyone willing to do anything to help me. The last surgeon sent me for a 3 phase bone scan, the results of which were "consistent with loosening" of the stem in the tibia. He said he advised against surgery because of very high risks (80/20) of failure and infection. I am so desperate for help. I can't live like this any longer. I take oxycontin and oxi IR for pain (which doesn't work as well as it once did) and I'm really worried about what this is doing to my liver. I don't drink, I don't smoke and before all this, I thought twice about taking an aspirin for a headache!! Please, please, please can you help me with advice, a referral, anything at all? Sorry if I sound like a weakling. I know there are people out there who suffer a great deal but I'm just so desperate for help. I really can't go on like this. Thanks for reading.
hello i have had 4 operations on my left knee and now i have what my doctor call stage4 arthritis.i am 29 years old and my only option is a medial opening wedge osteotomy. if anyone knows of any other options out there i would like to hear them.my doc says i am to young for a partial or total knee replacement. i have no medial menicus and a acl from a cadaver.
I recently had total knee replacement surgery on March 13th 2007. I am wondering how long after surgery before i reach maximum medical improvement. I have already reached the max as far as bending of my knee as well as straightening of it. Now i am in the process of strenthening thru Physical Therapy. I am wondering when i will reach max medical improvement.
csad in wisconsin; I am 45 and i just had TKR, my doctor as well as another doctor said i was too young to have TKR, i had 7 operations on my right knee (2 for ACL and 5 for torn cartilidge) but the last injury cause a chip in the bone of my femor cradle, to where my knee was bone on bone. the second doctor wanted to do the same surgery as yours does, that type of surgery is only 60 - 70% successful, keep pushing for a total knee replacement, i did and i dont regret a thing! i now have hardly any pain in my knee compared to what i had before. i had my TKR on March 13th 2007 and already i have reached the max for bending and straightening of my knee, and very little need for any form of pain medication. good luck and keep pushing for your TKR.
I had TKR in Oct.2006. My doctor now says that the cement component in my replacement has failed. He says this has never happened and doesn't know whar to do. He only does Knee replacements. He is sending me to another specialist. Is this a product failure or a doctor error? Why has the cement failed in 7 months. Has anyone else experienced this problem?
I had bi-lateral knee replacement on Feb,13, 2007 What I would like to know is will I ever be glad I did this. I feel like it was the most stupid thing I have ever done. I've only seen my Dr. once since my surgery. I wasn't even told when I could get off my walker. I just did it myself in March. I never used a cane just started walking. He hasn't told me what I can do, what I can't do, or what I will or will not be able to do down the road. I don't have any pain now unless I move wrong but my knees are both very stiff and the clicking is driving me nuts. Will they always click?
I forgot to mention I've gone thru my physical therapy and they said I was great with my knee bending, and I was good to go, and they released me. My sister came down from NY after my surgery to help and has just come back down again. She said I don't walk right. She said I'm way to stiff. If I'm walking awhile I walk OK but if I just get up from sitting I am VERY stiff and I have to walk around a while. Is she right or am I where I should be, for being 4 months out?
Judy,
Please post your questions on Dr. K's Joint Replacement message board.
Thank you!
Had a TKR 2 years ago and did wonderfully. Now I have knee pain again. How does it feel if the replacement fails??? THanks
I had a TKR in Jan 07 and am now 10 days post-op on a TKR of the left leg. My PT says I'm doing wonderfully, but I would kill for a good nights sleep! My OS is good with pain management, but the vicaden only seems to take the edge off, never completely stop the pain.
Something to be aware of is that a lot of people who require a TKR at a realtively "young" age (I'm 51) have other, on going problems that complicate recovery. For me, it's fibromyalgia. I had to come off my daily meds 2 weeks before surgery and, consequently, spend most of the time feeling as if I've been beaten with a baseball bat. It doesn't help your overall view of recovery when *everything* hurts.
Talk to your OS and don't be afarid to try alternative pain relief. Medatation, massage (by a licensced professional!)and even a sitting version of Tai-Chi help me. It's not a miracle cure, but sometimes the medatation alone can help you nap enough to survive those brutal four to six weeks after surgery.
Meara
Hi! Going for left TKR Nov. 15 after reading these blogs I'm ready to cancel surgery.I'm 60 in fairly good health,exercise try to eat right and had bad knee pain over 1 year plus neuroma,heel pain in same leg..has any one had a good outcome? Help
My mother is 82 years old and 110 pounds. She has osteo-arthritis in her knees, but is able to climb up and go down stairs, and walks without a cane. Her doctor has recommended knee replacement surgery to alleviate the pain. She does not take Celebrex or any other pain medication. But I am not convinced that she needs surgery at this stage, especially when I think of the rehab time and initial pain after surgery. Can anyone advise me? She trusts her orthopedist and refuses to seek a second opinion.
Thank you!
I am 71 and a TKR on October 16th. I started walking on the 19th and came home on the 19th had home therapy for 3 weeks and after 2 week of that I was not even using a cane in the home. I started driving on Nov. 12th. Yes there is pain but not near what I had with my old knee. I am doing everything in the house, as a widower, and am assisting in the restoration of my 1950 Ford. If you have the operation expect some pain, my surgen had me on hydrocodone with tylenol and it works great. Now and then especially with damp cold weather in MO I can feel the discomfort, not pain. I for one recommend you go for it and do your therapy even if it hurts, it will get better quickly.
I am about 6 weeks post-op from my first osteotomey knee surgery and had to go back the day before Thanksgiving to have the screws replaced and I broke the bone that they leav attached. I have not started any rehab. I am 38 yrs old and to yound for a TKR as my knee cap is a mess. I was told this surgery would help but I have not seen any help as of yet due to the set backs. If I would of know this before hand would of delt with the pain.
Had my knee surgery on Dec 4th and went home Dec 7th. My surgeon is fantastic. First, he and the other orthopedic surgeons had the hospital set up a special ward for joint replacement patients. We could visit, compare notes, encourage each other and it made the procedure almost enjoyable. Attitude is important. Also, the ward nurses were specially trained to handle joint replacements. The ladies were fantastic. They anticipated every problem and handled them professionally. The Physical Therapist were also a great bunch. They challenged us to do more and made me want to get past the pain and gain the flexibility I needed. My doc believes in the no-pain approach and so far I have had none. Lortab or Hedrocodone works. I take one tablet every 4 hours. Only a couple times did I need a extra pill.
I have graduated from the walker to the cane and expect to start driving next week.
Before surgery I was a 68 year old limited by the pain in my knee. Now I feel relieved and unrestricted.
My best advice, check around get recommendations from those who have had good experiences.
Lots of luck and Merry Christmas.
Dave in West Chester, PA
Have any of the readers had any illnesses involving other joints in their bodies since their initial knee replacement? My surgery was 9 months ago and it has been a very slow recouperation time. I'm wondering if I may be having a reaction to the materials used in my knee surgery. I am experiencing severe shoulder pain, wrist and hand pain and weakness in there areas.
Help Please.
I'm 54 with bone on bone pain. My doctor is suggesting partial knee replacement. I'm in constant pain in one little spot on my knee. I have to use a cane to relieve the pressure. My family has a history of arthritis but I'm healthy otherwise. I've had the SYNVISC treatments and it was a big waste of time. I just want to be able to walk without pain. Is it worth it?...the partial knee replacement?
To those asking about their specific situations:
Please visit Dr. Kirschenbaum's Joint Replacement message board.
Thank you!
I had bilateral knee replacement on 12/12/07. All went well and I have had little pain. However, I think I am anemic. I can only walk a short distance without becoming fatigues and I have to sleep propped up because I can't breathe. Please help!
I am a 53 year old female. had bilateral knee replacement 1 month ago. The 1st and 2nd week was horrible, but every day gets better and more movement happens. I am still having PT and will for a couple more weeks. Recovery is tough but the bad pain I had before is GONE. I can see better days ahead.
RheA
I underwent a right TKR in November 2005. I did fine and was discharged from PT in April 2006. I was told that I had achieved range of motion of 100 degrees. I was not told that I had to continue home PT on my own. I am now back in PT because I lost some range of motion. When I restarted PT I was told that my range of motion was only at 85 degrees. After three weeks I am now at 92 degrees on my own and 103 with the help of the therapist. Apparently I have a lot of scar tissue that is preventing proper movement.
I had a TKR six years ago when I was 45. It was the best thing I have done and only wish I had done it earlier.
Yes, the recovery is difficult and the therapy painful but within 10 weeks I could ride my bike, hike, walk, etc. pain free which is a lot more than I could ever do before.
I had total knee surgery in October of 2007. The pain is still there with numbness in the knee cap area. I realize it's due to nerves. My complaint is that I have a clicking with every step and I would like to know if it will ever go away.
On March 10th I had TKR on both knees. My first bad reaction was to the pain meds that were prescribed. They greatly upsetting my stomach and I was unable to eat for almost two weeks. I lost almost twenty pounds! Finally, after seeing my gastro doc, we managed to resolve those issues. Now, I'm having a BIG problem that I desperately need advice on. I would ask my surgeon, but his nurse said that he doesn't have any appointments available in the near future! How am I supposed to recover if I can't even contact my doctor when I'm having a problem?? Well, now I've been experiencing unbelievable PAIN starting on the left side of the knee cap, then travels down to my ankle and into my heel making it almost totally impossible to even place my foot on the floor. My ankle is also swollen. This pain also continues when I sit in the recliner with my legs elevated. The pain was deterimed not to be a blood clot and my orthopedist keeps telling me to just go to my primary care doctor. Also, the amount of pain meds that I currently use is not enough to ease the pain and the doctor refuses to give me enough medication to relieve the pain, which is UNBELIEVABLE!!! After such major surgery, I cannot believe that doctors will ignore patients that are in agony due to pain. I cannot sleep at night, finally falling asleep due to exhaustion around six a.m. for only 2-3 hours. Has anyone ever experienced this before? I desperately need some advice on this issue. I would definately recommend to anyone that I would NOT have a double TKR unless that it is absolutely necessary. Doctors definately DO NOT give you enough, if any, information prior to the surgery concerning potential complications. Please help!! Very desperate!
I had TKR of the right knee on April 21, developed hematoma, and had to have surgery four day later. This has been the toughest thing I have ever done, had to sleep in a reclyner for a month, am two months out and knee is very tight, and swollen, somedays I wish I would have just lived with the the bad knee. PT says doing better, just baby steps. cant wait to walk again.
My 73 yr old Mother had a TKR on her right knee a couple months ago. She'd had TKR before on her left leg some years ago and thought she knew what to expect. This TKR has been extremely painful and worrisome for her; she has a history of blood clots in her legs and is concerned she has clots now after the TKR. In the swing-bed facility immediately after the surgery, she had an infection in the knee that was operated on. The doctor never noticed and she had to bring it to his attention. Another attending doctor (not the orthopedic dr) prescribed antibiotics for her and it lessened the redness. But it never completely stopped being red, swollen, hot to the touch and very sore/tender. I addressed these concerns to her orthopedic doc and he seemed miffed that I was asking questions and offered absolutely no advice or information-simply that it was not infected, there were no clots and there was no problem. Finally her family doctor requested a doppler test on the leg she'd had operated on, and the test detected superficial clots, but they only checked that one leg. Now she is having extreme pain in both legs. She's going to physical therapy and your post on the settings of the machines were very helpful to know about, I believe they've been setting my Mother's rates at close to 70 or 80, and she tells me its causing her more and more soreness. Please help to figure out what to do to help her....I appreciate any insight or advice you have and if you need more information please just let me know. I anxiously await your response, thank you very much!!!!
Im 39 yr old female who had a total knee replacement on 08/28/08. Since then I can not straighten or bend my leg, it is just kind of fixed in one position. Therapist was coming ot the house and I know see an outpaitent therapist, who has basically told me it just isn't going to help. The calf and thigh muscles are locked up tight like guitar strings. I called the Doc who advised he will have to put me to sleep and manipulate the muscles. Can someone please tell me what to expect and how this is done with out tearing the muscles. you can email me if you'd like justjuls68@yahoo.com. I am really depressed and afraid I've made a grave mistake with this replacement. HELP!
Im 39 yr old female who had a total knee replacement on 08/28/08. Since then I can not straighten or bend my leg, it is just kind of fixed in one position. Therapist was coming ti the house and I know see an outpatient therapist, who has basically told me it just isn't going to help. The calf and thigh muscles are locked up tight like guitar strings. I called the Doc who advised he will have to put me to sleep and manipulate the muscles. Can someone please tell me what to expect and how this is done with out tearing the muscles. you can email me if you'd like justjuls68@yahoo.com. I am really depressed and afraid I've made a grave mistake with this replacement. HELP!
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