OA in both knees no surgery date yet

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Cwaggie

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Hi all. I have a lot of questions so hope you can bear with me!

In 2013, I found out I had arthritis in both knees. I started using a cane and the OS said I was not a candidate for surgery.

My history is I fractured my femur in 1989. I developed a blood clot and have had four major clots in my right leg.

I also have lymphedema and post phlebetic syndrome.

Fast forward to last year. My knee gave out and I broke my big toe.

I have plantar fasciitis and my primary care referred me to the OS. I use a walker now.

The pain is bad enough walking the stairs hurts. I was given a Synvisc injection last week.

My concern is having this surgery with chronic infections in my right leg, gout, and blood clots.

If I elect not to have surgery then what happens? I am worried that I may get a blood clot during surgery or an infection. I talked to the physical therapist and he validated my concerns. He told me I didnt need to make the decision that day. I am waiting for approval from insurance for physical therspy on the knee. I have been seeing him for plantar fasciitis in the left foot.

Does anybody have any thoughts or similar circumstances?
 
Hello @Cwaggie welcome to the forum. I am not qualified to give medical advice, but our Nurse Administrator @Josephine will be able to give you the benefit of her expert opinion. You have a lot to take into account and obviously don't want to make any hasty decisions. We are a very friendly supportive group and hope you will feel at home here.
All the best,
Tabby
 
Tabby, is right, it would be best for Josephine to take a look at your post. You do have a lot of issues going on. Are you taking something daily for the clotting problem? I do know that the pain from your knees will not improve, it will only get worse.
I found that once the pain from my knees dictated how I lived my life it was time to have surgery, however I didn't have the problems you had. Let's see what Jo has to say...
 
Hi and welcome to BoneSmart! You do have a sorry tale to tell.
I have plantar fasciitis
PF is very often associated with knee problems. I suggest you read this Shin splints, shin pain, compartment syndrome.
I am worried that I may get a blood clot during surgery or an infection.
These are always a risk during any surgery, not just knee surgery. But because we know this is a risk, we take significant preventative measures.

1. Blood clots risk and anticoagulant is routinely used
2. special pressure pads are used during and after surgery

12.jpg


3. You can also have a Greenfield filter installed in your vena cava - the major vein leading up to the lungs. This prevents any blood clots causing a pulmonary embolism.

Greenfild filter-horz.jpg

If I elect not to have surgery then what happens?
Well not presently being in possession of a crystal ball, I can only make educated guesses.

You say your situation is now so bad you are having to use a walker in which case, your risks of it getting worse are significant. At best, you could end up in a wheelchair and requiring full time care.
the OS said I was not a candidate for surgery.
Was this because of the comorbidities you mention or did he mention age? In any case, I would strongly urge you to get a second opinion as I know in the past I've nurse a number of people who had TKRs and a history every bit as bad as yours.

I suggest you try this survey which will give you an assessment of your quality of life. Print it off and see what score you get. (This score only gives information to you so there is no point in posting it here.)
 
I appreciate your responses. The synvisc shot has given me some pain relief. I am now doing physical therapy.

I have two clotting disorders-protein c deficiency and anti-phospholipid antibody syndrome. I am on blood thinners for life.

I had a stress fracture of my femur in 1989. Subsequently I had three major clots in that leg.

The first orthopedic surgeon I saw told me that I would never be a candidate for surgery due to the blood clots.

The recent orthopedic surgeon told me that is the only surgery they could do. He politely told me the meniscus is obliterated.

I have to work on weight loss.

I have to be honest and say I am really afraid to have surgery.
 
Hello @Cwaggie
I'm sorry your knees are so bad. I do hope that you can find a surgeon who can help you.

Here is some useful information:

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries
 
Do you have a primary care doctor that you have a history with? You might want to discuss the pros and cons of having surgery with your comorbidities.
 
The first orthopedic surgeon I saw told me that I would never be a candidate for surgery due to the blood clots.
Don't take the ortho's word for this - get yourself seen by a cardio-vascular surgeon and discuss it with him! HE'S the expert on this, not the ortho!
 
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