I’m 85, mild knee arthritis, should I have surgery?

[HappyHunter]

Hello,
I’m an 85-yo woman with no health issues, except for arthritis in my knees. it bothers me most at night when I’m in bed trying to sleep, not every night, just sometimes, perhaps once or twice a week. It’s a deep ache at the back of the knees, especially the left one, and sometimes keeps me awake. Liniment often helps, and so does a heating pad.
Also, Tramadol works very well for me. Just 1 1/2 pills per day, taken in the morning, completely alleviates all of the pain, day and night. But I take it only every second day, trying to avoid tolerance.
i have no problems walking, standing or going up or down stairs. I can walk at my usual pace and feel quite secure on my feet. I am tall and thin. I studied ballet as a child and performed throughout my thirties, so I suppose I have strong leg muscles, if that would make any difference.
My GP encouraged me to see an orthopedic surgeon and I did. He took xrays and told me my knees were “bone-on-bone” and I needed surgery asap. So I have a date to have the left knee done in three weeks.
However, now that I have been reading here about the surgery, recovery, etc. I’m wondering if I should go ahead with it. If I was even ten years younger I might not hesitate, but I’m 85 and probably not many years left.
I would appreciate opinions on this.....if I cancel will I regret it, or might I regret going ahead even more?

Brenda in New York

 

[hawk2go]

Hi Brenda - this is a such a personal decision.

I found the KOOS questionnaire very helpful in supporting my decision (search for "KOOS Knee Questionnaire" on the web). There are versions of the questionnaire but they all ask several questions related to pain and daily living. For me, it was a straight forward decision because my life had gotten very small as I shunned activities that might require a long time standing, that had limited or no seating available, that required lots of walking downhill or down stairs and where walks greater than 1/4 mile might happen. The KOOS score just confirmed my experience.

I had my left TKR done in 2015. At that point, the surgical team thought they'd go in and do the right knee 3 months later because, although I had more pain in the left knee, the right had more deterioration. As you can see from my signature, the right knee held up until last year when the corticosteroid injections stopped working and I had it replaced last month. I chose to do the left knee first because my surgeon advised me to do the knee that gave me the most trouble. All that to say, diagnosed joint deterioration is not the only factor to consider.

 

[Jaycey]

@HappyHunter Welcome to BoneSmart! My suggestion - don't wait. Life is too short to limp around and take pain medication to be able to move. If you are bone on bone things can go from tolerable to horrid very quickly. Get that knee replaced and get on with living again.

 

[newlybionic]

Below are some readings for you to help you to decide whether to have your knee replaced now. Just tap on the blue print to be able to read each section.

Here is some pre op reading for you.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

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 appMy 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

 

[Jockette]

Have you had more than one opinion about the need to have a knee replacement?

 

[kneeper]

It seems like you're actually doing pretty well. I also think you're right that maintaining strong muscles around the knee and keeping active is helpful. Having strong muscles around the knee takes some of the pressure off the joint. Sometimes people have what look like terrible xrays but are managing pretty well and others have what look like "mild" xrays and are miserable. Go figure.

This is major surgery, so I think you're right not to rush into it. You've been given a couple of suggestions to help you as you consider.

 

[Jamie]

If your pain is only showing up at night a few times a week, you're right to stop and think about the surgery. It's all about quality of life. If you are able to do everything else you want to do (those surveys linked above will help you determine what limitations the arthritis is causing), you do have the option to wait.

Heat on the parts that hurt and taking the Tramadol are good responses to the pain. The amount of Tramadol you're taking shouldn't be a problem for you or cause you to develop a dependency. That is more likely to occur with someone who needs doses every 4-6 hours on a daily basis to control pain. If you can wait 24 hours or more with no problems, you're fine.

You are right that your lifetime of conditioning is probably what's keeping your bone-on-bone knees from really hurting all the time. It's why we recommend that people who are able to exercise pre-op in some type of prehab program do so.

It probably would be a good idea to get at least one more opinion on your knees. In the end, it's really a decision you must make for yourself.

Let us know how things go for you. If you do decide on having surgery, we'll be here for you.

 

[HappyHunter]

Thank you everyone for your helpful replies.

I did find the knee score chart and it told me I don’t need surgery.
So for now I’m postponing it. But I will make an appointment with an orthopedic doc, not a surgeon, and get another opinion.

i also read that the sleep aid, Zolpidem tartrate (Ambien) can cause knee pain. I was prescribed that after surgery a few years ago, and I’ve taken it about three times a week since then. It usually it works very well, with no side effects.

However, last night, after taking a little larger than usual dose, I awoke about 3 am with worse-than-usual pain-in both knees. First time that has happened. Usually I have no pain in my knees on wakening. So I’m going to stop taking it and see if it helps.

Has anyone here had, or heard of, knee pain from taking Ambien?

Brenda

 

[kate97497]

Muscle pain is a possible side effect from Ambien, not specific to knees. I took it for a long time for insomnia and finally weaned myself off it. I don't think that I ever suffered any of the common or rare side effects, but many do. I'd be interested to learn if stopping your usual dose eliminates the knee pain.

 

[HappyHunter]

I will let you know, probably give it about two weeks. I think it will take that long to see the effect of quitting Ambien.