Athlete with Bum Knees :(

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diatom

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I'm a 56 yo fit, very active, athletic woman. Every OS that looks at my xrays says both knees need to be replaced- lots of bone spurs, very bow legged, can't flatten my knees when outstretched, etc. However, my OA is lateral (outside of knee) and also involves the knee cap. Partial Knee replacement is not an option even though the medial (inner) cartilage, which takes most of the weight bearing, is good! Given the good medial cartilage, and the fact that I've always been very active all of my life so have good muscle strength around the knees, I am still able to hike quite a bit (5 miles) and bicycle intensely without a lot of pain. I use hiking poles and knee braces (Donjoy Reaction and Donjoy OA Reaction) to hike or do longer walks. Good handrails are a blessing on stairs- I use my upper body a lot to haul myself up and guide myself down stairs.

However, the day to day symptoms are slowly getting worse- after sleeping, or sitting for awhile, it's often very difficult to walk. After a couple of minutes, however, I do okay. Getting up from the toilet is sometimes challenging. At night my right knee often aches, but not intensely enough to take meds. I sometimes use OTC creams. I do not take any pain/inflammation medications (OTC or scripted) and never want to get into needing to. I do use tart cherry juice and herbal/homeopathic supps (glucosamine, chondroitin, Boswellia), and lots of gelatin. I also follow a low gluten diet (family history of Celiac disease).

I work part time and my husband will retire in less than 2 years. After retirement we plan to travel a lot. Our travel always includes hiking. Last summer, with the help of cortisone shots (only had this done this one time) our family (includes 2 teenagers) was able to hike over 100 miles over a month long vacation to the west/southwest. I know this kind of hiking is not going to be feasible with my worsening knees, thus I am looking at a bilateral replacement.

I have a hard time grasping TKR, however, when I look at others who are in almost constant pain and can hardly walk...I'm so far on the other end of the spectrum, yet I need new knees also. There is also the concern about "waiting too long", so that deformities related to the arthritis make replacements more difficult and less successful.

What to do ?????? Anyone have input?????
 
Hi, welcome to BoneSmart.

BTKR was the best result for me. It's only running that's verboten (although plenty do anyway) hiking and biking are fine. It straightened my bow legs too (heels together I could fit my fist between my knees!).

I would go for it ASAP so that you're fully recovered and strong again when your husband retires.

Some more things to ponder:

- if your knees rule your life , it's time
- take charge, don't be dictated to; it's your knee, your future
- don't believe in either horror stories or miraculous recoveries that happened to 'a friend of a friend'
- there is no such thing as too young or too heavy or even obese for TKR
- choose a specialist surgeon who does several hundred TKRs a year. Ask the nurses, if you can; they know who's best
- all replacement knees are very similar, don't believe that a special new one will give magical recovery -- it's the skill of the surgeon that counts
- if you need two done, think carefully about the time gap between surgeries, it's not a trivial decision
- try to plan for at least 12 weeks off work
- your recovery is your time to be selfish and idle; plan to embrace this, you'll need it
- don't think you can work hard (even if you're an athlete ) to speed recovery, healing works at its own pace
- look at our FAQ (Frequently Asked Questions) thread and for full reference the Library index.

- finally, if there's any part of this that you aren't clear about, ask here; it's what BoneSmart's for.
 
Go for it! I can only speak from my own experience but I had a partial over 2 years ago and it's been brilliant. I recently walked 22 miles in 3 days with no after effects. I even run a walking group where we regularly walk 5-6 miles. I never got to the painkiller stage either beforehand but the locking and weakness was reducing my activities. If you wait too long, your muscles will be weaker and it might be harder to recover. As you are pretty fit now, that's a benefit too for any kind of surgery.

You will need a longish recovery period and have to be prepared for that - it's boring and tedious and you will need painkillers for some period but the rewards can be wonderful .Youve come to a great place for advice.
 
Hello @diatom

I second the advice you've already had. Go for the TKRs and get those bum knees fixed.

Your surgeon is right in saying that a Partial (PKR) would not be suitable, because you already have arthritis in two of the three compartments of your knee. Having a PKR would probably mean that you needed a revision to a TKR after a very short time.

Once you have gone through a period of recovery, you will be able to resume almost all of your activities. However, a word of caution: People who go into knee replacement surgery and are athletes often find the recovery period difficult, because it involves a lot of resting and very little activity. It will need all the patience you can muster, so you don't overwork your new knees that need rest and gentle treatment, so they can heal.

There is a huge difference between athletic training and rehabilitation. Complete recovery from a TKR takes a full year, although you will be able to do most things again by 6 months. This recovery is a marathon, not a sprint.

I will give you our pre-op articles in this post and the recovery recommendations adn reading list in a second post, so that you are well informed.

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
 
Here is the recovery reading:

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
The only thing you will regret is leaving it too long. Not because of the knees but because of all that lovely LIFE you allowed to slip by. Life is precious - don't let it glide by while you live in pain.
 
I would go for it ASAP so that you're fully recovered and strong again when your husband retires.
Probably not what you want to hear but I so agree with this. It's a perfect time to get this done. Then you will be ready for retirement - not dreading surgery and recovery. Get it done and get on with living.
 
We were in Patagonia this January and was not able to do any long hikes at all. So we only saw the sights from afar.This Saturday, my walking group did a 10 mile training for 1/2 marathon. I walk with them but am not doing a 1/2 marathon this year. I made it to the 4 mile marker and then turned around, so I only got 8 miles. I was sore and aching in the afternoon and this morning. I want to be able to walk some more 1/2s next year after my LTKR this November.

I'm what I would call an "early adopter" when compared to many here who undergo this surgery.
 
I say go for it. I'm 50 and went back and forth on it if I should do it or not but decided I was 50, not 90 and I should be able to do all the active things I've always liked doing without pain. Not having any regrets yet at 3.5 weeks after my RTKR. I'm planning on dancing all night (without pain) at my daughters wedding in July! Good luck!


Sent from my iPhone using BoneSmart Forum
 
@diatom More than a few people on this forum have talked about hiking mountains (i.e., Mount Kahtadin) after knee and hip replacement. I remember an article in an Arthritis magazine about a guy who climbed the Matterhorn 6 months after his TKA. I think my knees are 100% and look forward to cycling, hiking and whitewater kayaking as soon as my pesky hip heals. I used to go on week long bike rides where we'd do 400+ miles in one week and all the 60 and 70 year olds with knee and hip replacements were stronger than most of us. And why not? Their joints were the youngest! I was wondering about getting in and out of my kayak after my knee replacements because my normal method was to get in by falling into the seat and then bending my knees to slide in my long legs. One year after the first knee replacement, I was able to do that again. And I was getting out by myself long before that -- except on a slope. But then, a lot of people who didn't have surgeries need help with that! I think you will be very, very pleased with your new joints in time. Do the therapy and never stop moving! Good Luck!
 
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