32 Year Old with Knee Problem Needs Advice

[Rachel]

I have always been incredibly active and up until August 2006 I was running long distance. I had an injury to my left knee and after nearly a year of futile physio I had an arthroscopy.

The surgeon told me I had Chondromalacia Patella (very, very crumbly under the knee cap) and also a crack in my knee cap. He said I would not run again, that I must avoid all impact sports and that I would need knee cap replacement surgery around the age of 40.

Since this has happened I have become extremely depressed as I cannot do all the sports I previously enjoyed and am incredibly unhappy, especially since I miss running. I do still get knee pain after doing short flights of stairs, walking more than a couple of miles and using a bike.

In November 2007 I had a bone density scan which revealed the density is way lower that it should be for my age. To build my bones back up, I really need to be doing impact sports - swimming and cross-trainer aren't enough. I can't do impact sports, so I face a grim future with osteoporosis which my mother has just been diagnosed with at age 64.

Should I investigate a knee replacement to see if I can do more impact sports? Would a knee replacement allow me to run again - even just a couple of miles, or to do something with more impact?

Any help and advise would be hugely appreciated.

Thank you!

 

[joy]

hi rachel. sorry to hear about your knee problems and limited activities. i had a knee replacement last year at age 49, due to years of sports . I had to change my sports love, started cycling and swimming, a little easier on the knees, I hit the gym and did weights for toning. i do bone density exams, and see many women your age with the beginnings of bone loss,(osteopenia) can't give medical advice, but i know the physicians i work for recommend calcium with vitamin D, increasing foods high in calcium, do some research... weight bearing exercises can be hand-held weights too, does it hurt to walk, not run? your bones can get better, osteoporosis ,BMD, it can improve, but it will take a while. We screen every two years, and i have seen women slowly improve over the years. hope that is encouraging.

 

[Rachel]

Hi Joy,

Thank you for your email, that's very encouraging that you see women improve their bone density - it's given me a ray of hope. I am now taking Calcium and VitD tablets as despite my 'healthy' diet, it did lack in calcium somewhat as I have been avoiding dairy produce due to sinus/catarrh problems - if it's not one thing it's something else!

I can walk, though I do get some pain after a few miles.

 

[Josephine]

Hi Rachel. I would have said right off that your 'chondromalacia' was osteoporosis in origin. It is very unusual for adults to get this - it is much more common during the growth period, therefore in infants and adolescents. Since Joy has that extra experience in this, I personally would accept her advise. It sounds pretty good to me.

About the patellar resurfacing - I have to tell you that I have never seen this done. There has been occasions when I have discussed this with the surgeons on occasions for various reasons and the ones I talked with all said that they would not consider it. The reasons they gave was that if there was damage on the patellar articular surface then that will either have damaged the femoral articular surfaces it sits upon or be part of the general degenerative changes within the joint itself thus indicating the need for a replacement.

Plus which the patellar buttons are really only designed to articulate with the metal femoral prosthesis.

In other words, it is my humble opinion that ia TKR will be required ultimately.

However, what you can do for the time being is as has been suggested. You might also try glucosamine with chondriotin which has been reported to be very effective in restoring bone mass.

 

[referee54]

Rachel--I used to run 25-30 miles a week. That, combined with reffing college basketball, umping baseball, and reffing football burned our my knees. I had a double TKR done November 8th. When my arthritis hit, I changed my training regimen to cycling. I learned to really enjoy it, and, as it is low impact, it will be better for your joints or your repacement joint.

Tim C.

 

[Rachel]

Tim - thanks for the reply, I'm glad to hear you have found pleasure in cycling. It's a good sport, but not for me as it hurts both my knees after about 15 minutes. I could also do with something that works the whole body a bit more, so if you have any other suggestions, I'm open to ideas! I also need some impact work to build bone density.

Josephine - thank you also - TKR, well not nice, but expected. I am very encouraged by Joy's experience that bone can be rebuilt. And I will take on board your advice on glucosamine and give it a go as I've heard other positive comments about it.

Rachel