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Too young for knee replacement?

Discussion in 'Knee Replacement Pre-Op Area' started by Racewalker45, Aug 30, 2011.

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  1. Racewalker45

    Racewalker45 Junior Member

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    Hello,

    I am also new to this forum. I came across it while searching for information on PKR and TKR

    I am 45, and was a racewalker (2 full, 6 half marathons numerous 10Ks), until aroutine 4 mile training walk left me in such bad shape I was wondering if I had RA. I was registered for the Rock N Roll Savannah 1/2 marathon and had to pull out.

    I have had knee problems since college (theatre knee), when I was thin and not running. Oddly, I have never had an injury of any kind that I can recall, or any previous surgeries. I had no idea that it would end up like this. I progressed from chondromalacia in 2004 to moderate OA now. I have no cartilage under my knee caps at this point, the rest of my knee is not in great shape, and have daily pain. During my most recent visit to my OS this summer, he told me to stop racewalking and take up cycling and water aerobics. I took up racewalking to save my knee ironically. He does not want to talk about surgery until I have tried everything else. He did not want to do physical therapy, but injected my knees with Synvisc and gave me a cane and Celebrex. I have refused to accept that I can no longer do what made me so happy and kept me in shape.

    Since that visit, I have become quite depressed, as my pain has not improved, so I decided to get yet another opinion and see yet another surgeon about PKR, as I was told I was too young for TKR.

    I saw my internist today and he suggested that I drop about 30 lbs before making the final decision to have surgery, since I am so depressed (I am 5'8" and 215lbs) Fortunately, he did not discourage me from considering surgery, but has encouraged me to make the decision when I am in a better state of mind. I am inclined to agree.

    So technically, I am not pre-op, but will very likely in probably in the next 6 months.

    I am grateful to have found this forum. I used to be quite active, and would like to be again. If surgery allows that, so beit.

    I would be curious about your thoughts about weight loss before surgery, and if it makes a difference. I understand the physics behind weight loss as it relates to what the knee sees, but at this point the damage is done. I have to lose at least 40 lbs either way for other health reasons, but was just curious.

    I look forward to any insight.
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  2. Josephine

    Josephine Administrator

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    Re: Hoping to keep moving forward, whatever that means!

    Hi there and welcome to BoneSmart! I've moved your post into a thread of its own so it doesn't derail MountainKat's thread and also, you will get your own replies.

    Your story is a very familiar one and told all too often.

    Couple of points
    1. you are not too young to have a knee replacement. We've had members here in their 40s, 30s and even 20s had TKRs done. Good surgeons will judge on the condition of your knee and quality of life not on your birth certificate!
    2. you are not too overweight to have a replacement. Your BMI is 32. Mine was 38 when I had my knee done! I once nursed a lady after a TKR whose BMI was 60+ and she did just fine!

    So I suggest you get another opinion! Only this time look for a surgeon who declares his interests as "arthritis in young adults". He will be much more likely to offer you surgery.

    And have no fear, you will get back to your activities again. There is a famous US runner who's had both his knees replaced and is doing marathons again! Can't recall his name but I'm sure someone will know.

    In the meantime, read some more uplifting posts you can find in the Library
    Stories of amazing knee recoveries
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  3. Racewalker45

    Racewalker45 Junior Member

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    Josephine,

    Thanks so much for the encouragement. I really appreciate it. I will certainly look for more uplifting posts on this forum. I have been actively searching for and OS who has an interest in younger patients and in those that are active.
  4. Gillyflower

    Gillyflower Junior Member

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    Hi Racewalker45! I am scheduled for LTKR on Sept 13. That is exactly one week after my 40th birthday. I also heard from several doctors that I was too young. My current doctor's perspective is that regardless of my age, a total knee replacement is medically indicated. Apparently, the insurance company agrees as they approved the surgery.

    As to weight loss, I had Lap Band surgery in 2009. I lost 85 pounds. I could stand to lose another 25 pounds to be within range according to the medical/BMI charts. My pain level is unchanged. And,I am still working on those last pounds.

    The folks on this site have been extremely helpful and supportive. You are in the right place.

    Good Luck!
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  5. toddlermama

    toddlermama Junior Member

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    Racewalker, welcome and the answer to your question is NO!! Lol!! I turned 39 in July and am having a TKR next Thursday. Am I over weight? Yup, I heard all of the things you just listed, although I have thoughly torn my knee up from sports related incidents ultimately it was about my quality of life and not my number. Basically it came down to this, HTO 6 years ago, 2 pregnancies back to back 2 years ago and now it's just down right awful. I did all the injections with no relief, got a second opinion then went back to my guy and he said it was time. I Ultimatly decided I need these years NOW and will take my chances later.
    It's not an easy process but you need to figure out how much you aren't doing vs how much you want to do and can do again. Take care and good luck.
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  6. Josephine

    Josephine Administrator

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  7. sheryl7

    sheryl7 Graduate

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    Hi and welcome Racewalker, I am in the same boat as you, they say I am too young, but admit i have severe arthritis in my knees, So i am seeking a second opinion. Have you tried looking on hereon the clinic finder. I found a few in my area that are on it and will try a couple of them and see how it goes.
    Click on Find a clinic up top.
    Please keep us posted to how you do.

    I too am a bit overweight about 5'4 and 200 lbs, . But its a viscous cycle, I need to exercise too help lose weight but i cant because my knees hurt.
    i hope to be pre -op sooner then later too.
    Anyway good luck to you.
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  8. bvaughn97

    bvaughn97 Junior Member

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    I'll just reiterate what's already been said - you're not too young! You may be "too young" for your current surgeon, but do what I did - request copies of your medical records from your current ortho, along with any x-rays/mri pictures and reports. You shouldn't have to deal with the ortho when you request your medical records. They'll have a specific employee who will make copies of your records.

    Once you have your records in hand, start making phone calls. Use the clinic locator on this site, or ask your internist or any other doctors that you might know who they would suggest. A good surgeon with a good office staff will talk to you over the phone, and they should at least allow you to talk to the surgeon's nurse. Tell them your story and let them know that you're looking for a surgeon who will consider TKR and not automatically disqualify you because you're "too young". A good nurse will work with you, and a great nurse will ask you to send in your medical records so the surgeon can take a look at them before you have to schedule an appointment.

    Keep your chin up, and work for yourself. Be your own advocate, and eventually you'll find the right surgeon.

    Last bit of advice - be sure to research the surgeon and make sure that they aren't desperate for business. I don't want you to find a surgeon who's willing to do a TKR on just anybody just because he needs the money and doesn't have better things to do. Make sure the surgeon's an expert at the system he uses. Ask questions and do your own due diligence through Google and other means.
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  9. Josephine

    Josephine Administrator

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    Well I never! I never thought of that. Gosh all mighty :hate-shocked:
  10. carousel66

    carousel66 Graduate

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    Racewalker
    I'm with the rest don't give up! the right Doc is out there for you.

    the first ortho I saw in 2008 when I was 41 told me I needed a TKR but to "loose weight as you might feel better and not need one LOL (where to they get that nonsense) and come back for a TKR when you are 50"
    So I lost 15# (I needed to loose more but lets face it it was depressing and I was so much pain and had NO HOPE)

    I then found a Ortho early in 2010 with the help of another one of my Docs he gave me all the pro cons and risks and told me while they do not like doing TKR on someone my age 43 that sometimes there is really no other choice as patient has such poor quality of life. I now had H O P E and started more seriously working on my weight issue, it was easier as the light at the end of the tunnel was no longer a train :th_heehee:

    Then ONE more Ortho (number 3) I saw based on a referral from my PT and I knew I had found my Doc! (now down a total of 35# since the first ortho in 2008 I asked my new Doc what a good weight loss goal would be as I was a woman on a mission, he said 30 more! and I told him I would call him when I had 15 to go to schedule my knee. Then 4 months after I met Ortho number 3 - January 2011 down 66# (5'9" and 200) I had my LTKR and it has given me BACK my life!

    I agree with others that the right "Doc" is out there for you! don't give up. I was 44 for my LTKR and I will be 1 month shy of 45 for my RTKR!

    Loosing the weight was good for me, and made things a bit easier? but loosing weight on its own didn't "fix" the pain I was experiencing!
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  11. amberpep

    amberpep Senior

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    Hi there .... I'm a lot older than you and had a RTKR in May. One time when I was in my surgeon's waiting room, I noticed a whole lot of younger folks. I asked him about it, and he said, "you wouldn't believe all the people in their 40's and 50's who need knee replacements. They've been joggers and runners and have totally destroyed their knees." He, also, tries everything else before he does the surgery, even on someone my age. So, you're not alone .... there's a lot of younger folks out there just like you.
    From what I understand losing weight will help the pain in your knees, both now and post-surgery. This figure may not be totally accurate, but to my understanding for every extra 1 lb. you weigh, your knee feels 4. It makes sense, extra weight pressing down on the knee is bound to hurt more. They can do the surgery, no matter what your weight, but it would really benefit you in many ways, both now and after surgery, to lose the extra.weight.
    I hear the desperation in your voice ..... I can well understand how upset you are .... my doctor told me that I essentially started this (the flattening and damage to the meniscus) when I was much younger. I used to be a competitive freestyle roller skater and a lot of the jumps land on the right leg. I did that for several years. So, take heart, you are certainly not alone.
    I wish you well, and I'm glad you found us. This is a wonderful, honest, group of folks, some who have been there already and some who are waiting to have it done. When I saw my surgeon 2 weeks ago, he discharged me and told me that YES, I could whitewater raft again ..... my favorite sport!
    Take care, let us hear from you again soon.
    abby
    5/24/11 - RTKR
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  12. Racewalker45

    Racewalker45 Junior Member

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    Wow! You guys are awsome! I really appreciate the level of support! I did use the clinic finder and found a couple of potential surgeons in my area. The way I see it, it won't hurt to make some calls to get a sense of what the practice philosphy is and if they will immediately dismiss me once they know how old I am.

    Thanks to everyone for your perspective on weight loss. I am in agreement that losing weight will only help me, so I have taken my internist's advice and will make the effort to lose 20-30 lbs before seeing a surgeon . I do also recognize that the damage has been done and weight loss in and of itself won't solve the problem. I had dropped about 20lbs in the last 6 months, but gained half of it back.

    I will keep you posted. I have to see my current orthopod tomorrow as my pain is increasing and am not getting any relief from my current meds. I also have to join a YMCA to get back into the pool.

    Warm Regards.
  13. FrogFeathers

    FrogFeathers Post-Grad

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    Welcome!

    I was 36 when I needed my surgery. I was 39 when my GP finally gave me the consultation letter to see the surgeon (I had to wait for the GP otherwise my insurance wouldn't pay for it).

    I was 39 and grossly overweight (which, incidentally wouldn't have been so grossly over had the surgeon just given me the consultation letter three years earlier). And my surgeon had no issue with giving me a TKR.

    I was a four-mile-a-day walker and I did yoga. When I slipped on the ice and tore up my right knee for the eighth time in 20 years, that's when I started to fall apart. I went through the gamut with "is it RA? Is it Fibro? What IS THIS!?" before I saw a surgeon. (of course, a year after the TKR, I was finally diagnosed with fibromyalgia- but that's a different way-too-long story).

    Every time I see someone say a surgeon told them they were "too young for a TKR", I want to punch the surgeon in the face.

    But then, I'd need a surgeon to fix my hand, so I probably shouldn't punch one in the face. :th_heehee:
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  14. KneedyinNJ

    KneedyinNJ Member

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    Racewalker,
    I just had Bilateral knee replacement at age 49. I was your weight when I went for my presurgical physical - and 6" shorter. My surgeon suggested dropping some weight also. I told him that would be much easier to do once I wasn't in so much pain. I got the surgery and I have started to loose weight already. I think knowing the arthritis pain is going away got me out of my funk, and has improved my outlook on my body.

    Basically I am trying to tell you, don't wait to loose weight before you meet with the surgeon. Get the whole process started, start meeting with surgeon(s) and start working at your weight together. It may take a few months to get your surgery scheduled and you can work on your weight during that time.

    Kathleen
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  15. Jamie

    Jamie Administrator

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    Hi, RaceWalker....welcome! I'm just now reading your thread as I've been gone from the forum for a few days.

    I totally agree with what you've been told. You DESERVE to be able to enjoy life NOW. Each day is a precious gift and if there is a way to allow you to drink it in....I say go for it!!

    I'm glad you successfully used our Clinic Locator. If you need any other assistance, just let me know. STAY DETERMINED!!!
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  16. Racewalker45

    Racewalker45 Junior Member

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    Hey everyone, thanks again for your support, it has been very empowering. Just an update. I researched a clinic and got an appointment in 2 weeks with a surgeon who, based on his profile, may be able to help me. I was surprised that I was able to get an appointment so soon, but not complaining! My goal is to first and formost know the extent of the damage in my knees and then discuss options, including surgery. I will be prepared with old X-rays and a long list of questions. Wish me luck!

    Angela

    P.S. I downloaded the book, Total Knee Replacement and Rehabilitation by Brugioni and Falkel to my kindle. Excellent book!
  17. Jazyb

    Jazyb Post-Grad

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    Hi Angela

    That is good news and I wish you luck with your appointment. You are now on your way to getting your life back!
  18. sheryl7

    sheryl7 Graduate

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    Hi Angela, Good luck at your appt, I have one in a couple of weeks too.
    Keep us posted. :wink1:
  19. Tykey

    Tykey Forum Advisor

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    Just a thought. Don't even mention your age when discussing it, just concentrate on your pain and reduction of quality of life which needs fixing. If they bring up the age question, shoot them down with the facts you get from here. Essentially, be assertive, not passive with them.

    Good luck, make 'em have it!!!:hissyfit:
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  20. MarkZ

    MarkZ Junior Member

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    Racewalker45 - good evening !

    At 46 I had my 7th surgery onm the right knee. My OS at the time told me the TKR was coming.....about 5 years down the road.....wait as long as possible. Well, I did what he said, essentially. What a FOOL I was ! I found a new OS with better credentials. By this age 50 I was walking with a cane, developed a 25 degree valgus, had -10 extension, 70 flex., and a mushroom looking knee. The problem with waiting is this - more problems develop, more work for the OS, possibly longer recovery time.

    My current OS told me there is no age associated with TKR. When the useful time of the knee has ended just get it done ! Get your life back !

    My OS did a fantastic job carving my knee, straightening it out and being totally honest with my recovery (12 months he told me). Today I truely do have my life back!

    best of luck !
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