I was told by one doctor that I might be a candidate for a partial knee replacement AFTER I dropped my weight by 55 pounds down to a BMI of around 26 from 34 BMI over the last 14 months. He really has only seen an x-ray of my right knee that is much worse than my left, but I'm pretty sure I'm only 1-2 years out from the other knee. In both cases, all my pain is on the medial side, and the arthroscopy done several years ago showed the medial meniscus had torn and separated from the bone and was floating around in my knee. But SynVisc injections and cortisone injections alternating every 3 months kept me mostly out of severe pain, but the recent injection in early November of cortisone didn't do much. I asked for the soonest appointment at TOC and ended up with the doctor who replaced my rheumatologist's knee 6 years ago. My appointment with him is December 31st, and I was hoping to get a SynVisc injection in both sides.
Today I got another sooner appointment with another surgeon for December 11th. I have seen him before and was going to do a total knee in 2017, but backed out after seeing the surgeon who did my THR in 1998 that is still doing wonderful. I hit the brakes when he advised me to first lose weight because he told me that while hip replacement are "slam dunks" that knee replacements are not, and 10-20% of people are not satisfied with the results. He said ideally my weight loss would prevent surgery, but as others have told me, despite weight loss, my knee has only worsened over the last year.
My physical therapist recommended this same surgeon as one who got his patients up on their knees on day one in the hospital. I like my physical therapist a lot and will use her for post op recovery she is the best PT I've ever known. I am worried about post op pain management in a case like mine if I go out of state. Plus Atlanta is 200 miles and 4 hours away from us. So a lot of travel for follow ups, which were not that often with the hip.
But I am not ruling out Vanderbilt either and I have a recommendation there. I also got a recommendation for a surgeon in Nashville. Both were recommended by a MD we know at Vanderbilt in the Orthopedics department.
I can't tell who does partial knees at one of the clinics, but I am hopeful that is all I need done to both knees, my right knee first. I also want to see if they can do stem cell work on my left knee as it is just now starting to hurt, but my rheumatologist told me I had 40% loss of cartilage in both knees back in early 2018. They have only xrayed my left knee when xraying my right knee, but it feels much the same as the early problems with my right knee.
I walk somewhat with 10-20 degrees of external hip rotation probably due to the arthrits in both hips. In fact, in 1996 they were telling me I would need 3 hip replacements per side over my life, which motivated me to find the ceramic on ceramic hip trial in 1998 that turned out to be the best choice I could made. I literally got the last hip in the Stryker Osteonics ceramic/ceramic hip trial, the same hip that Jack Nicklaus the Senior PGA golfer got.
I have not really gotten far in looking at knee implants, but I'm pretty sure I'll need at least a partial knee replacement on my right knee, as I think the osteoarthritis is too advanced for any type of platelet enriched plasma or stem cell bone bone marrow aspiration concentrate treatment, but I am wondering if it is possible in my case of medial damage only as far as I know.
Has anyone had any luck with either Platelet enriched plasma or bone marrow aspiration concentrate treatment for knee osteoarthrits of the medial side?
I have a lot of good choices and what is really concerning me is the post op pain management, especially as state governments tighten the rules, so I do not know what they are allowed to do in Tennessee and Georgia or if Emory or Vanderbilt has authority to better manage pain in a patient like me. I really need to know more about the rules in Atlanta and Nashville as they will exist in early 2019, the time of my likely surgery, or if I'm best put in my home city of Huntsville given my family PM is also my pain management doctor and said he would do what is needed to manage my post op pain.