Feeling out of options :(

ThomsoA

new member
Joined
Sep 23, 2018
Messages
4
Age
35
Location
Adelaide
Country
Australia Australia
Gender
Male
Hi all, I hope you are all doing well!

I am in the early stages of recovery for my microfracture and call already tell that things are still really bad with my knee. I know its only early but you just know!

When I first had my MRI towards the later part of last year everything wasn't too bad with only degeneration and chondral loss in my lateral compartment. After my recent procedure and reading the op report I can see I have moderate to severe degeneration in all 3 compartments.

As a result of this I am ineligible for an osteotomy and my surgeon said we want to get you to 50 and I'll be happy! He also went on to say that my days of running around with my daughter are numbered. That's 20 years away and I really don't know what to do.

I'm going to get a second opinion but being 30 what do you do if the surgeon thinks a TKR isn't the right option? Just keep searching until I find one that will? I'm just over it.

I've also loaded below my operating report so if anyone thinks it doesn't sound that bad feel free to comment!
 

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Hi and Welcome to Bonesmart.

I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.

You’re right, it’s hard to find surgeons who will look more at your knee and not your age, but we have had members in their 30s who do get TKRs.

Best wishes as you seek answers. Bonesmart is the best place for support.
 
I'm going to get a second opinion but being 30 what do you do if the surgeon thinks a tkr isn't the right option? Just keep searching until I find one that will?
Yes, you do keep searching for a surgeon who will look at the state of your knee before he/she looks at your age.

If your knee needs a total replacement, that's what you should have, regardless of your age.

To make you wait for up to 20 years is cruel.
Since a TKR done now by a good surgeon can last for 30+ years, there's no longer any need to fear needing multiple revisions.

These are the only ways in which you are "too young" to have a knee replacement:
  • You are too young to be living your life in constant pain.
  • You are too young to have your mobility so badly compromised.
  • You are too young to be giving up the lifestyle you enjoy.
  • You are too young feel so old.
 
Hugs. I agree with Celle. If your knee is severely affected your future will be challenging to manage.
A second opunion us a good idea especially if you can find a surgeon who operates on younger people.
I find the thought of young peoples lives being limited by pain and disability terrible but you do need to weigh up all the information whilst you have this time so you can make an informed decision of benefits and negatives of TKR.
Developing questions to ask your consultant based on your lifestylw preferences and hopes will help clarify your position. For example, how long does the prosthesis last and what does that mean for me, what activities will I be able to do and what must I avoid.
Good luck and best wishes. Rosie
 
Get second opinion and a third or fourth opinion if needed. It was amazing to me how different one surgeons opinion was from another. Try to find a surgeon with some experience with younger patients. I'm not as familiar with how it works in your country but you need a referral to someone who will at least consider surgery on a younger person.
 
Hell0! Reading your report, things do sound like your knee is in poor shape. I had a microstructure in the patello femoral joint compartment 8 years ago. I had my other knee evaluated and the surgeon said I had damage in both the pfj compartment and the lateral, as well. Interestingly, he said he wouldn't be able to do a microfracture to the lateral compartment.

Were your post up restrictions to be non-weight bearing and in a locked brace following your microfracture? Those were my restrictions and it was my understanding that is done to protect that area that was microfractured so the clot that forms can heal and harden into fibrocartilage. I was 40 when I had that surgery and he was trying to buy me time to get closer to 50 years old. It's held up well, but my other knee deteriorated soon after. I just had a tkr on the other knee and I am 48.

There are some other conservative measures you can explore such as gel injections. It's a temporary fix that will need to be repeated periodically. What is your pain level and how long ago was your surgery? It took me 4 months to finally say I was glad I had the microfractured surgery.
 
When you see other surgeons, it might help if you fill in this chart:
Score chart: how bad is my arthritic hip/knee

Print out the chart and take it with you to interviews. It will help to show how badly your arthritic knee is affecting your quality of life.
 
I've also loaded below my operating report so if anyone thinks it doesn't sound that bad feel free to comment!
Your xrays would be more informative to me.
 
@ThomsoA I am sorry you're struggling with the Microfracture recovery and dealing with a surgeon who is solely focused on your age. I was in your shoes the last 5 yrs and have been "sports surgeoned" to death with numerous microfracture/allograft surgeries and an ACI (autologous chondrocyte implantation) that failed after 3 yrs. I'm only 46 but have had 10 knee surgeries in 20 yrs,and FINALLY getting the right knee replaced next month.

I was told to find a Reconstruction/Revision Orthopedic surgeon who specializes in hips & kenes and does>300-350 replacements a year, as they are more likely to see patients of ALL ages and with complicated/long surgical histories. THat's how I found my TKR surgeon-to-be. :loveshwr: It took finding him to realize I didn't need to keep waiting, suffering, and missing out on life with my son and husband. My right knee should have been replaced 4 yrs ago, but I didn't know enough at the time, nor did I ask the right questions.

Best of luck to you, and I agree you need to keep searching for a Dr that cares about YOU and not your age.
 
I had an osteotomy in 2013 (with ACI) and had my knee done in January. The knee replacement is easier, in my opinion, than the osteotomy was. Like you, I was young when I had a major injury (27) and they didn't want to do a knee replacement. I struggled for 20 years before I had the ACI/Osteotomy which I only had because the doctor convinced me to do it. I SO wish I had done the knee replacement instead.

I can't disagree enough with the surgeon telling you to wait until you're 50 and that from personal experience. Life is to be lived to the max not watching from the sidelines.
 
I waited for 9 long, painful years before I had my first knee replacement, because my surgeon wanted me to wait until I was 60.

During that time, my life shrank, and I could gradually do less and less, until I was almost housebound.
I didn't know any better then, but I do now.

I believe that making someone wait until a certain age is cruel and unusual punishment. Why defer much-needed treatment because of some theoretical need for a revision at some undetermined time in the future?
Why compromise their current quality of life for that?

Deal with it now. Who knows, their replacement hardware could outlive them anyway. We never know what other medical problems might happen while we're waiting to be "old enough" for a knee replacement.

I've had one revision knee surgery and it was no worse than the original surgery. And nowadays you can have more than one revision, if necessary.
 
Hi @Josephine I have attached above some of my xray images. It was difficult to get a good photo but I hope you can provide an opinion. Thanks
 
I had a meniscus injury to my right knee which had been perfectly fine until then. the doctor tried to repair the meniscus, but it had folded over itself and basically, I lost pretty much the entire meniscus. My acl was torn the following year and my doctor agreed to replace it. However when I awoke from surgery, he told me that the knee was too degenerated and that i needed a total knee. He commented that sometimes after a meniscus surgery, you can get traumatic arthritis which speeds up the degeneration quite a bit. I was shocked and angry. I changed doctors, but the result was the same, I needed a tkr.

For your doctor to tell you that you will have to do the best you can for 20 years----and that you can no longer run after your daughter is just absurd. You need a new doctor with a more enlightened approach. The fact of the matter is that I had my right knee done much earlier in the process of wearing out and it was much easier to recover from and with a much better outcome too. If you wait until you are crippled, you will have a harder time coming back to full function. Yes, it is bad to have such a report at your age, but earlier knee replacements are becoming much more common as doctors see the results and the long term life of the replacements.
 
I have attached above some of my xray images
@ThomsoA they're not xray images, they are MRI images and I don't read MRIs. Sorry.

And because of the number, I had to delete them.

If you have one or two xray images, I'd be delighted to take a look at them.
 

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