Conflicting messages about bone femur/tibia inflammation

[petuniafish]

Just posted in a different thread, but different subject. Really confused about info I am getting about the benefits of postponing surgery for several months to a few years.

I am an RN. My husband is a physical therapist of 41 years. He has worked with more joint replacements than probably anything else. (But we've only lived in our state for 10 years so he really can't give a confident recommendation of an OS.)

My husband has always said that OS's try to postpone joint replacement as long as they possibly can. Because I see it everyday I know he's right. The last OS I saw last week said the same %$#! thing, "You are too young". Heck I am 57! And the quality of life sucks. I may lose my job, I can't walk without severe pain. I can't walk the beach I live on. When I said I'd lose my job this OS response was "so what". Jerk.

I work with a 52 year old who was told the same thing. She needed a PKR at 45, they postponed it til she was 50- then at 52 she needed a TKR.

My query is to Jo and anyone else who can chime in.....is there damage/inflammation done to the tibia/femur by waiting so long? My husband says a resounding yes. His PT friends say the same. I have asked two OS the same question and they say no. My husband says the biggest danger is the constant inflammation to the joint can spread to the opposite compartment and create inflammation and loss of articular cartilage on the opposite side.

I walk really funny and feel those bones on the medial side grind- pain. The last OS I saw withdrew 30cc of fluid from my knee. My leg hurts up femur down to ankle. Probably referred pain. My friend, the 45 year old who waited til 52, said after her first PKR her knee became so necrotic the TKR was the only option. It was probably a poor initial surgery but concerns me.

I am asking a lot of stuff and sorry. but I'd sure like to know what waiting is doing to the knee. Thanks.......Nancy

 

[Jamie]

Nancy, it is my belief that the longer you wait to have a surgery once the joint starts falling apart, the more difficult recovery will be. It only makes sense that your body will compensate for the degeneration and then it has to relearn what normal is once the joint is corrected. You are NOT too young for a joint replacement if you need one. Keep searching for a doctor who is more in tune with the lifestyle you want to live. Are you in a small town? Hopefully you have access to a number of orthopedic doctors. If not, DRIVE to a larger town. It's important! And it's YOUR life!!!

 

[Judles]

Nancy,,,,,hobble to another OS,,,,,fast! You have the benefit of having hubby on call,,,,,,Why would you want to be hurting if you can be HEALING now!
Good luck! Put all your energy into feeling better!!!

 

[petuniafish]

Oh, I am hobbling and looking hard- far far away!. And yes I live in a small town. But I am driving 3-4 hours to see the "big guys" in my state. I am giving a chance to two more (both of which are far enough away I have to get a motel the night before.) One is an 8 hour drive away. I would love to find someone whom my insurance would cover but there are no decent ones within my system.I'll just have to go into the retirement and eat it.

Thanks- I want to get this thing done and behind me and enjoy my family and life again.

 

[JudyS]

Nancy
I am a hippy, but my do not live in such pain. I can't believe what these doctors are telling you. I am 51 and my doc took a few talks with me to convince me I was not too young. I hope you find a surgeon like him. As far as damage to the knee, I can not give you any medical info.
But , I do know that your gait will be different do to your pain and that will effect everything.
Good Luck on that search
Judy

 

[Max Wallace]

See another DR. quickly.

I waited 10 years and it was not so much as being more damage or more rehab as much as the loss of mobility, giving up what I loved to do for 10 years. I did have severally bowed legs but they rutinely fix that during surgery. Some people probably do experience damage to other parts due to bed knees,feet problems,ankle problems,hip problems, spine problems not to mention weight gain from a sedentary life style. There are some legitimate reasons to wait but if they are not outweighed by the positive reasons to have the surgery they take second fiddle. I waited ten years because I am 46 and the knees that were available were not as good as todays and i would have had to have several revisions as it is know I may only need one and may not even need that one.

I would definately get a second opinion!

GOOD LUCK!

Max

 

[Josephine]

Well, I feel for you, sweetie! You are surely not getting the kind of sympathetic treatment you should.

But does delay damage things? Well, yes it does which is to say, it can cause more issues to arise.

~ the abrasion of bone-on-bone causes the bone to become inflamed. Bone can get inflamed, just like any other tissue, same as it can get bruised as well. If bone gets inflamed it can cause more pain (!), cause effusions, set up a situation where an appropriate bug roaming in the circulation can settle and cause a septic arthritis to flare up (this happened to my sister only 3 months ago).
~ bone-on-bone can also deform the bones which in turn can cause contracture of ligaments and other tissues resulting in difficulties in rehab
~ not to mention that the pain and disability results in contraction of one's life style, disturbed sleep patterns, over-use of pain meds and a whole host of other annoying, distressing and untenable side effects like losing one's job!

How do these surgeons justify their approach with all of the above? They deserve to be struck off!

 

[Jamie]

Nancy, you are quite a fighter and brave to work so hard to find the right surgeon to work with. I know it is a terrible inconvenience to do so long distance, but you won't be sorry. You'll know when you finally locate the right person. Keep posting here, okay!! We want to know how you're doing!

 

[petuniafish]

Thanks so much everyone.
I didn't think it would be this difficult! Jo, what you say is exactly what I was certain I'd read many times. Was thinking dementia was becoming more the problem than my knee after hearing these last two OS's views. My husband, the PT, usually sits over in the corner of the room covertly rolling his eyes at some of the things these guys say during appointments.
Two more appointments scheduled over the next 5 weeks with different OS's. I'm going to think positive that one will be the right person. And if not, I'm outta here and California here I come.....

Thanks so much for everyone's words of wisdom. Another forum member who could not do this without you.

Nancy

 

[Josephine]

My husband, the PT, usually sits over in the corner of the room covertly rolling his eyes at some of the things these guys say during appointments.

You tell him I do just the same when I go with my sister!

 

[GaryM]

I was 47 when I had BTKR. The problem I had was with alignment I think. Everything was so out of wack for years. I started with knee problems as a teenager playing sports. By the time I was in my late 30's I walked funny. Even walked with bent knees for sometime. Couldn't stand straight up. I had to battle this as I recovered. Everything hurt so much more because the ligs and other tissues were trying to staighten out.

 

[Nursepair]

PetuniaFish. Go for it girl. Don't let that idiotic doctor tell you otherwise. Implants last longer than they used to. That was usually the reason surgeons put you off. I think now a good 25 years depending on your lifesty;e.

Hope you find a good OS soon. Good luck!! Sue