Introducing myself

panammaniac

new member
Joined
May 24, 2022
Messages
12
Age
55
Gender
Male
Country
United States United States
Hello,

I just visited my orthopedist yesterday and he recommended this site to me. I'm 55 years old and have been suffering from left knee and hip pain for about the last 5-6 years. X-rays came back as Stage 3 OA in the left knee, but the orthopedist looked at the X-rays and said it is probably a bit worse than that - probably closer to Stage 4, and "it's almost always worse than the X-rays show once we get into the joint." I went into the appointment mostly expecting a regimen of injections, pain meds, and PT. I was pretty stunned, and perhaps not quite emotionally ready, when some of the first words out of his mouth were "it may be time to consider total knee replacement." I haven't signed up yet, but I have a follow up appointment in a month with the knee replacement surgeon to discuss it further.

I'm really not sure what to think at this point. I've heard some arguments that people under 60 are more likely to be dissatisfied with the results, and then there's the chance that I'll need revision surgery in 15-20 years or less. The doctor countered by asking how the pain is affecting my daily life. Well, when my family goes out for any kind of activity that involves walking, I can no longer keep up with them. Back before Covid we went on a European vacation. We'd be walking around a city, say London for example, and I found myself walking alone a good part of the time with my wife and daughter about half a block ahead of me, then they'd have to stop and wait up for me. I find that to be very frustrating. Because of the pain, and my inability to walk more than a couple blocks without hurting, I have become less active, which in turn has caused me to put on a little bit of weight, so it's a downward spiral. Still, it's not totally unbearable. I can still do most of my normal daily activities.

I have taken all of the "decision maker" tests. My Oxford score was 26. I don't recall what the other two were, but they were down in the moderate bordering on severe category. At this point I obviously haven't met with the surgeon yet, but I feel like I have a lot to think about before I do.

A doctor friend of mine is trying to talk me out of TKR, saying I'm too young and that the procedure has been oversold. He says I should try something called Genicular Radiofrequency Ablation, which is basically killing the nerve endings around your knee. From my little bit of research, that looks like a fairly new, and not yet fully proven bandaid fix to postpone the inevitable, but I'm still researching.

Anyway, I look forward to interacting with the community here as I head down this completely unplanned journey.
 

benne68

Staff member since February 2022
BoneSmart Staff
Joined
Sep 5, 2021
Messages
771
Location
Connecticut
Gender
Female
Country
United States United States
Hi @panammaniac and welcome to BoneSmart! :welome:

I'm so happy your orthopedist recommended us, because I know there are folks in our community who have had TKRs at an even younger age than you and are happy with outcome. I'm tagging one of our other staff members, @Susie-Q, so she will weigh in since about her experience: she had her 1st knee replacement at age 42 and is doing fine.

I've heard some arguments that people under 60 are more likely to be dissatisfied with the results,
Satisfaction with knee replacement outcome is more a function of how bad your knee was prior to the surgery and what your expectations are for the future than it is about age. I put off my replacement for years because I'd heard the same argument. But my knee was bone-on-bone and I was limping around with a cane. Now, I am 8 months post-op and very happy with the outcome because --like yours, my family loves to travel -- I will be able to walk around without a limping or a cane on our trip to Scandinavia next month!

then there's the chance that I'll need revision surgery in 15-20 years or less
That timeframe you mention is based on the longevity of replacements done more than two decades ago. The technology and the implants themselves have improved significantly since then. The newer implants are expected to last 25-30 years (although, of course, we won't know until a couple of decades from now!)

I'm sure you will get feedback from other folks about your concerns. In the meantime, please explore the forum, ask questions and let us know how else we can help you in your research and decision-making.
 

benne68

Staff member since February 2022
BoneSmart Staff
Joined
Sep 5, 2021
Messages
771
Location
Connecticut
Gender
Female
Country
United States United States
I just came across a post from another member that you might find interesting since he had both knees replaced when he was in his 50s:

 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,697
Age
66
Location
Delaware
Gender
Female
Country
United States United States
I've heard some arguments that people under 60 are more likely to be dissatisfied with the results
Another reason for this is, younger people don’t seem to want to take the time to recover properly. This recovery takes an average of a year, though most feel much better after 3-4 months. Younger, busier recipients often go back to work too early, or get back to activites before their knee is ready, which can cause set backs, frustrating them. You need to be patient, and give your knee time to heal, and gradually get back to activities.
He says I should try something called Genicular Radiofrequency Ablation, which is basically killing the nerve endings around your knee. From my little bit of research, that looks like a fairly new, and not yet fully proven bandaid fix to postpone the inevitable,
Once you are bone on bone, anything other than TKR will postpone the inevitable.

Here’s some pre op information 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?

Especially read the following article, which highlights some of the best of the best recoveries. Keep in mind most of us fall in the middle of poor and amazing recoveries.
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
 
OP
OP
P

panammaniac

new member
Joined
May 24, 2022
Messages
12
Age
55
Gender
Male
Country
United States United States
Thank you @benne68 and @Jockette for the warm welcome! It's a lot of info to take on, especially since it wasn't a course of treatment I expected to hear going into yesterday's appointment, but I know this site will be a big help as I ponder my decision.

A little bit of context - I refereed basketball (high school and some lower level college) for 28 years. I had some minor problems in the right knee up until I had arthroscopic about 6 years ago. That one was catching and popping quite a bit, so they went in and cleaned up some frayed cartilage and all has been good ever since. Then about a year later I was working a game when I felt a sudden pull on the left leg. I thought at the time it was a hamstring injury because that's what it felt like. But after taking some time off and treating it like a hamstring injury it never got better. I went through several years of seeing various specialists, cortisone injections, ibuprofen, various other painkillers, and PT, and about all we could come up with was a little bit of OA in the knee and hip, along with two compressed discs in my back. I finally had a doctor order an MRI. That came back showing that my ACL had thickened a bit, indicating that it had probably partially torn and healed itself. Nobody was able to pinpoint the source of the pain, basically saying it was probably a combination of all those things together. I'd get cortisone shots and they'd help for a couple months at most. Needless to say my basketball officiating career is over (fortunately just an avocation - not my main profession). I haven't been able to run since that last game when I felt the pull.

Now 5 years later the pain has gotten worse. PT did nothing for me at all. I'm tired of getting cortisone shots, and I'm really not fond of taking NSAIDs or pain killers any more than absolutely necessary. My family loves going to Disneyland - we live 15 minutes away, but I don't get excited about going anymore because it's a lot of walking and I know after 10-15 minutes I'm going to be hurting and making them wait up for me. It's frustrating for me and I'm sure it is for them too. That's what the orthopedist said - it's clearly affecting your lifestyle and family life, which is a major consideration. He also said that if I told him I had knee pain while/after refereeing a basketball game, he'd tell me to stop refereeing basketball games. But telling him I can't go on a brisk 30 minute walk with my family is an entirely different story.

I own my own business - a spa. Part of my fear involves the fact that I'll be away from it for a while during recovery, but I can also run certain things remotely if I need to, and I have an amazing staff that I know will keep things moving smoothly.
 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,697
Age
66
Location
Delaware
Gender
Female
Country
United States United States
I refereed basketball (high school and some lower level college) for 28 years.
My husband coached high school basketball for 20 years.


I own my own business - a spa. Part of my fear involves the fact that I'll be away from it for a while during recovery, but I can also run certain things remotely if I need to, and I have an amazing staff that I know will keep things moving smoothly.
 

Susie-Q

Staff member since February 2022
BoneSmart Staff
Joined
Jul 20, 2010
Messages
1,863
Age
54
Location
Washington
Gender
Female
Country
United States United States
Hi @panammaniac and welcome to Bonesmart!

I agree with everything @benne68 and @Jockette have said so I won't repeat what they wrote. I had my right TKR when I was 42 and had two young children. It was getting to the point that my life was greatly affected and I was in a lot of pain. Luckily my doctor at the time (he's since retired) said if I wanted to get on with my life I should get it replaced. I also tried the cortisone shots and Monovisc and neither worked. @benne68 is right that the old adage that knees don't last longer than 15-20 years is just that, old. 25-30 years is more the norm now. I managed to get my left knee to last another 11 years before I had to replace it too this last Aug. It's amazing how long it lasted, in 2019 I was walking all over Vegas with no problems and then less than 2 years later just normal housework and walking the dog was horrendously painful.

Please feel free to ask any other questions you might have. I will say it's amazing to now have two new knees and no pain walking or doing daily activities. We are planning another trip to Vegas in Sept and I'm sure my new knee will perform great! Best of luck to you :flwrysmile:
 

Claire56

member
Joined
Jun 8, 2021
Messages
161
Age
66
Gender
Female
Country
United States United States
@panammaniac One of the deciding factors for me was that I wasn't enjoying any activity that involved much walking. When your primary thoughts when you are doing something that is supposed to be enjoyable is the pain, time to do something about it.

I am still healing but am already able to enjoy many of the activities that had been getting more and more painful.
 

Jamie

OneStep AMBASSADOR ..Staff member since Feb 2009..
Senior Administrator
Joined
Mar 24, 2008
Messages
67,835
Age
73
Location
Kansas
Gender
Female
Country
United States United States
OneStep Ambassador Icon
I've had both knees replaced. The first was in 2008 when I was 59. The knee had become very painful in 2007 and and arthroscopic surgery was done, which actually made the arthritis worse. So I spent a whole year in pain, not believing that I needed a knee replacement because I wasn't "old enough." My knee was bone on bone, though, and waiting meant my surgeon had more work to do than if I just would have gotten the TKR in the first place. When you lose the cartilage, the rubbing of the bones together just makes the joint worse as the bones continue to wear away. You also make adjustments in your gait, which can impact other joints such as your hips or spine. On my second knee, I went ahead with the replacement the minute it became damaged and I believe it made a difference in the result. My second recovery was noticeably easier than the first.

So, if your knee is bone on bone and you try something like the ablation, just be aware that it may make the eventual TKR surgery more complex which can lead to a more challenging recovery. Not saying this will happen....just that it could.

I realize this diagnosis may have come as a shock to you. But, the truth is age is only a minor factor in deciding whether or not to have your knee replaced. Your body may be a young 55, but your knee is not. It's old and worn out. Your whole life is now revolving around it. That means you're wasting precious time you could be enjoying life.

Years ago, knee replacements were thought to only last around 15 years. But there have been so many improvements in both the implants and surgical techniques (even in just the last 5 years), that no one really knows how long today's implants will go before a revision might be needed. Estimates are 20 years or more.

Both my knees are going strong at 14 and 9 years and I expect them to continue to function well. I don't regret at all having them done and I don't have to worry about them when I want to do something.

You are the one who has to decide when you're ready. But please don't be afraid of this surgery. Close to 1 million knee replacements are done each year in the USA. It is a very successful procedure that enables people to regain a functioning joint and reduce or eliminate pain. While it is important that you not overdo things early in your recovery, most people are able to completely resume whatever activity they desire.....well, maybe not bungee cord jumping.....:heehee: but definitely enjoying life with your family like you describe.

If you have specific questions or fears about the surgery or recovery, please post them here and we'll help you resolve any concerns. We're here for you!
 

InkedMarie

post-grad
Joined
Feb 25, 2018
Messages
1,012
Age
61
Location
Gilford, NH
Gender
Female
Country
United States United States
Welcome! Glad to hear your surgeon recommended Bonesmart! I had my first knee replaced at age 57; second last month at 61. My surgeon told me not to wait and I agreed. Why be in pain & put your life on hold now? He also said that the longer you wait, the more debilitated you may become, making recovery harder.

Hopefully I won’t need a revision but if I do, I do. I’d rather be pain free until.....if.....that happens.

Marie
 

Layla

Staff member since November 2017
BoneSmart Staff
Joined
Jun 26, 2017
Messages
29,588
Location
Minnesota
Gender
Female
Country
United States United States
Now 5 years later the pain has gotten worse. PT did nothing for me at all. I'm tired of getting cortisone shots, and I'm really not fond of taking NSAIDs or pain killers any more than absolutely necessary. My family loves going to Disneyland - we live 15 minutes away, but I don't get excited about going anymore because it's a lot of walking and I know after 10-15 minutes I'm going to be hurting and making them wait up for me. It's frustrating for me and I'm sure it is for them too. That's what the orthopedist said - it's clearly affecting your lifestyle and family life, which is a major consideration
I am sorry for the physical and emotional pain you’re dealing with as you try to process all of this. The diagnosis can be unsettling. I remember it well.

To me, the quote above says it all. You’re not that young in the realm of joint replacement as I’m sure you’re understanding, but you are relatively young with hopefully a lot of life ahead of you. While this is going to sound like cold comfort, in reality none of us know how long our life will be, so you may as well live the best life possible, which sadly you’re not able to do right now. It’s obvious you're dealing with physical pain and it’s affecting many aspects of your life. Your wife and kids don’t want to see you suffering and missing out on creating memories together as a family. You’d be doing this for them, as much as yourself.

None of us went into this surgery without fear, anxiety or reservation. No one wants to lose their natural joint. But it's no longer serving you well. The odds are in your favor that you'll do well. We make this decision in hopes of a better life. You can put it off while suffering discomfort, or you can commit to a procedure that will give you a better quality of life. Joint replacement surgery is one of the most prevalent surgeries performed worldwide. The outcomes of these surgeries have become excellent based on a number of techniques changing over the years. The implants are durable and long lasting, with longevity much greater than before, offering an increase in the likelihood you'll never have to experience this procedure again.

We truly sympathize and understand as we all faced this decision. The choice was ours. We had to decide whether we wanted to continue struggling physically and emotionally or bravely move forward holding a brighter future as our focus.

Wishing you comfort, mental clarity and peace of mind as you weigh out your options and make decisions. We’re here for support always.
 
OP
OP
P

panammaniac

new member
Joined
May 24, 2022
Messages
12
Age
55
Gender
Male
Country
United States United States
Welcome! Glad to hear your surgeon recommended Bonesmart! I had my first knee replaced at age 57; second last month at 61. My surgeon told me not to wait and I agreed. Why be in pain & put your life on hold now? He also said that the longer you wait, the more debilitated you may become, making recovery harder.

Hopefully I won’t need a revision but if I do, I do. I’d rather be pain free until.....if.....that happens.

Marie
Thank you! This is a very good point. I’m not that debilitated, yet. I can still function, still run my business, do things around the house and so on. But the key word is “yet.” I’ve definitely become less physically active because I don’t want to walk anywhere, and that’s not good for the long term picture. My orthopedist said it would be wise to consider it now while I’m still otherwise healthy. We’ll see what the surgeon says next month.
 

Susie-Q

Staff member since February 2022
BoneSmart Staff
Joined
Jul 20, 2010
Messages
1,863
Age
54
Location
Washington
Gender
Female
Country
United States United States
When you lose the cartilage, the rubbing of the bones together just makes the joint worse as the bones continue to wear away.
This happened to me while I was waiting for surgery this last summer. I had been talking for months and months about getting my second knee done eventually and it was while preparing for my father in law's 90th birthday party last June (we had 35 people over for an open house-type party) that I finally wore out my left knee completely. I scheduled surgery right after that but had to wait 2 months. My knee got so bad that I feel like the bones were coming together to where there was no space anymore for the joint to bend. As a result, I lost range of motion and couldn't bend my knee as well without excruciating pain. I believe that led to not getting my ROM back as quickly after surgery as I had with the first knee.

I also remember prior to my first knee we vacationed to the Oregon coast and stopped at the Astoria Column, a tower with a winding staircase up to the top with 164 steps and a gorgeous 360 degree view of Astoria and the ocean. I knew I'd never make it up that staircase or would probably be blocking people behind me because I would be so slow. So I stayed down while my husband and kids went up to the top. When your knees are interfering with your life to this degree, it's time to do something about them. I could do those stairs now!
 

hawk2go

Staff member since January 2022
BoneSmart Staff
Joined
Jun 16, 2015
Messages
1,232
Age
63
Location
PA
Gender
Female
Country
United States United States
I refereed basketball (high school and some lower level college) for 28 years.
:yes!: I played in HS and college.

@panammaniac, you've come to the right place. We've all been in your position and Bonesmart has accumulated a ton of reliable info. You'll comb through a ton of information here and elsewhere while you make this decision (it sounds like you've already done a bunch of research). Here, at Bonesmart, you'll get the real deal from folks who have been there. Every TKR recovery is different, even different knees on the same person, but you will see similarities in experience and begin to chart your course. Ask questions if you have them.

I had my first TKR when I was 56. It was a big but relatively easy decision for me because I was pretty debilitated. The 3 questions I considered for every single activity - how far will I have to walk? is there a place to sit? will there be stairs to climb or descend (the descent was the worst)? I declined many invitations because of the answers to those questions. Back in 2014, I had to take a trip to Europe to hold one of my newborn grandkids (it's what I do). I can tell you, having been to Paris a few times, it's a lot less fun when seen from the back seat of a cab or the inside of a tour bus. Navigating The Metro and The Tube was almost impossible, just changing trains was a serious challenge. I also recall my own frustration when family tried to accommodate my disability. I feared my pain was limiting them!

I got 2 second opinions before deciding to go ahead with the surgery and choosing my surgeon. The high profile, highly advertised OS practice that treated my OA would not do the surgery, despite suggesting it, because of my BMI. I remember being distraught wondering how to lose weight when exercise, especially walking, was so painful. The surgeon I selected is with a world class hospital system and told me the BMI factor is over-rated and out of date. Studies showed that general health is the bigger factor in a good recovery. The 3rd surgeon agreed with my selected surgeon.
 

InkedMarie

post-grad
Joined
Feb 25, 2018
Messages
1,012
Age
61
Location
Gilford, NH
Gender
Female
Country
United States United States
Thank you! This is a very good point. I’m not that debilitated, yet. I can still function, still run my business, do things around the house and so on. But the key word is “yet.” I’ve definitely become less physically active because I don’t want to walk anywhere, and that’s not good for the long term picture. My orthopedist said it would be wise to consider it now while I’m still otherwise healthy. We’ll see what the surgeon says next month.
My second knee is five weeks old tomorrow. I knew it needed to,go but wasn’t sure when. I’m the kitchen Manager at a small elementary school. There used to be two of us; other person left & it was just me this year. School started the end of August; by October, I had made the appointment for the new knee. My view is to fix things.

Marie
 

kneeper

Staff member since January 2014
BoneSmart Staff
Joined
Dec 11, 2010
Messages
13,822
Location
USA
Gender
Female
Country
United States United States
While you don't want to leap into this surgery (if you're able to leap with the state of your knee :heehee: ) it does sound like it is worth thinking about. It was good that you did the Score Chart, which can help you really think about how the knee is affecting your life. Many surgeons say "you'll know when it's time."

For me, it was pain, loss of function and instability that led my OS to say it was time for a tkr. I could have hugged him. I was younger than 50 and he usually doesn't like to do tkrs on younger folks, but no "band aid" fix was going to help me. I will be hitting year 11 with that knee soon and I am so happy I did it.
 
OP
OP
P

panammaniac

new member
Joined
May 24, 2022
Messages
12
Age
55
Gender
Male
Country
United States United States
I had my first TKR when I was 56. It was a big but relatively easy decision for me because I was pretty debilitated. The 3 questions I considered for every single activity - how far will I have to walk? is there a place to sit? will there be stairs to climb or descend (the descent was the worst)? I declined many invitations because of the answers to those questions. Back in 2014, I had to take a trip to Europe to hold one of my newborn grandkids (it's what I do). I can tell you, having been to Paris a few times, it's a lot less fun when seen from the back seat of a cab or the inside of a tour bus. Navigating The Metro and The Tube was almost impossible, just changing trains was a serious challenge. I also recall my own frustration when family tried to accommodate my disability. I feared my pain was limiting them!

Yep, that's about where I am. Today for example the knee is actually feeling pretty good, but I haven't done a whole lot except for sit in my office. I know if I were to try to go out for a long, brisk walk, I'd make it about to the corner and then be turning back because it hurts. Back before the pandemic we had Disneyland annual passes, so we went all the time. There were times when my wife and daughter would want to go do something that was a bit of a walk away, and I'd say I'll just sit and wait for you here instead of going with them. Now we haven't been in a while, mostly because Disneyland got rid of the annual passes, but on the opportunities I've had to go I have declined because I didn't want to be on my feet all day.

I agree about the BMI thing. My BMI is a little bit out of optimal, but it's mostly due to me putting on a few pounds from being less physically active. It's hard to exercise and lose weight when it hurts!
 

Susie-Q

Staff member since February 2022
BoneSmart Staff
Joined
Jul 20, 2010
Messages
1,863
Age
54
Location
Washington
Gender
Female
Country
United States United States
how far will I have to walk? is there a place to sit? will there be stairs to climb or descend (the descent was the worst)

Yep, remember this well. Now I don't even think about any of that except for maybe where's the nearest bathroom? :heehee:
Many surgeons say "you'll know when it's time."

This is exactly what my surgeon said too.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011
  • Jockette
    Staff member since March 2018

Members online

Forum statistics

Threads
59,716
Messages
1,504,137
BoneSmarties
36,497
Latest member
Bhoova
Recent bookmarks
0
Top Bottom