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Knee pain advice

Discussion in 'Knee Replacement Pre-Op Area' started by Fireman, Jan 8, 2017.

  1. Fireman

    Fireman New Member

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    Hello. First a little history.

    In 1992 I was shot in the left knee with a .38 hollow point. The bullet entered the side of my joint and travelled clean through, destroying three of the four knuckles of the joint. In the emergency room I was told by the surgeon that I would never walk again with out a total knee replacement.

    I was young, dumb and in shock and refused the knee replacement believing that it would heal and I would recover. The Surgeon removed all bone and metal fragments.This took three surgeries to get it all. I was then discharged to my home where I was given a machine that kept my leg in constant motion. I secured the machine to a sheet of plywood and laid that on my bed. I was to use the machine 14 hours a day.

    I also had a one year old son and a four year old daughter to care for as I was a single parent. I worked hard at recuperating. I returned to work six months to the day with no medical restrictions. I worked in law enforcement and also as a member of the states Emergency Response Team. I also worked as a volunteer firefighter and Paramedic for the local ambulance service. I did all this and retired after 25 years service. I am still an active firefighter.

    Two years ago I went to bed feeling fine. I woke up the next morning unable to bend my knee at all. It felt swollen. It took about three days before I could walk somewhat normal. I went to one good knee surgeon who took xrays and said I shouldn't be able to stand let alone walk on what I had. He said s replacement was my only option. I didn't like his answer and a year later I went to a different surgeon. After x-rays he told me pretty much the same thing adding that I have no space? I am now considering retiring from the fire department as I feel my knee is making me a liability.

    With it going south overnight I still think maybe tendon or ligament? I can't find a doctor that will go any further than the x-rays. Once they see them they figure they have the answer. My sleep is pretty poor as now my knee keeps me awake as I can't find a comfortable position

    Weight doesn't bother it. Weather doesn't bother it. Sometimes stretching seems to help but not for long. What do I do or where do I go from here?
     
  2. Celle

    Celle Forum Advisor

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    Hello @Fireman
    I'm sorry to hear you have had such a lot of trouble with your knee.
    It sounds to me as if you need to get it fixed, once and for all.

    You know that you received severe damage to your knee bones when you were shot. I think that is the cause of your current problem. If you have no joint space, you have no cartilage left, to soften the impact of walking or doing anything else. Your knee can't do anything except continue to deteriorate, unless you get it fixed.

    You've had the same answer from three different surgeons. What makes you so reluctant to accept that advice and have a knee replacement?
    It isn't just an operation for old people. People in their 30s and 40s have had them, and returned successfully to their job. We currently have a paramedic who is recovering from having her second knee replaced and will be going back to the same job. We have nurses who go back to working 12-hour shifts after having a knee replacement.

    Do you have any copies of your knee X-Ray that you could post? I'd like our Nurse Director, @Josephine , to have a look.

    If you'd like some more reassurance about what some people can do after having a knee replacement, read some of the stories in this section:
    Stories of amazing knee recoveries

    I have had 3 knee replacements (one was a revision, after a partial replacement that lasted for 11 years and gave me back my active life). My knees now are strong and reliable, with full range of motion. I seldom have more than the occasional, short-lived twinge of mild pain from them. I don't regret for one moment having had my knees replaced.
     
  3. Fireman

    Fireman New Member

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    In 92 I just didn't want to believe the doctor. I lost all cartilage then. I proved him wrong then and for the next 23 years was fine. I returned from fighting a house fire and went to sleep only to wake in the morning not able to bend my leg. The pain was incredible for three or four days. That was two years ago and it's still painful.

    The reason I don't want to believe the surgeons now is all they have done is look at xrays. I'm more inclined to think I damaged s tendon or ligament? It would seem to me if it was just a bone issue that weight or the weather would affect it. Neither one does. And sometimes stretching alleviates the stiffness for a while! Does that sound like a bone issue?
     
  4. Celle

    Celle Forum Advisor

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    If it was tendons or ligament damage, they would have healed by now.

    If you have no cartilage, you are experiencing bone-on-bone pain, from bones that were severely damaged years ago and will continue to deteriorate.

    What other tests do you think the surgeons should do? Have they showed you your X-Rays and pointed out the defects?
     
  5. Jamie

    Jamie Administrator

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    Hi, Fireman! Welcome to BoneSmart. I do hope you can post your xrays for Jo to review. It will make it a lot easier to talk about your knee if we can see what it looks like. But, frankly from what you describe, I think you've been one tough and fortunate person all these years! You've definitely made lemonade out of a bag of lemons and defied the odds with a severely injured knee.

    But, a person's body in not invincible. Eventually with no cartilage, your joint wears to the point where you do experience bone on bone pain. I believe that's where you are now. Your joint just reached the point of no return. The thing about arthritis (and with no cartilage, you do have osteoarthritis), is that it never gets any better with time....only worse. You are young at 54 and why not take the step of having the joint replaced so that you can really enjoy the rest of your life? I'm not sure I understand why you wouldn't want to do this. Perhaps you can explain more about your concerns with the surgery.

    With a knee replacement, you wouldn't have to retire unless you wanted to. People do go back to demanding jobs like police and fire work after surgery and recovery. You might need to phase back in after about 12 weeks or so off, but it can be done.

    Although it may seem like a simple examination method, the xray is really the best way to determine the health of a joint. Sometimes MRIs are taken to look at the soft tissue, but when you have a situation like yours, I doubt any doctor would learn more by requesting an MRI. Most work strictly with xrays. At some point you are going to need to put your faith and trust in one of the surgeons you're seeing. After all, these are the experts in joint health and problems. If they tell you your joint has reached the end of its ability to function properly, I'd say that's probably the case.
     
  6. lennie

    lennie Member

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    Fireman, I believe that you need a TKR. I am a paramedic with 35 years experience and injured my right knee arresting a suspect years ago. That and lifting patients 35 years and my knees were shot. You have even more reason to suspect you need a new knee. I had RTKA October 11, 2016 and LTKA December 13, 2016. I go to the doctor Thursday and hope to get an idea of when I can go back to the truck. You have a lot of good years left. Don't give up on yourself. My final straw was pain that woke me up at night and kept me awake. I can walk unassisted at three weeks out but I am using a cane at present. The downtime is worth losing the pain. I turned 57 between surgeries. I am going back. Believe in what the doctors have said and pick the one you like most to do the surgery. Ask the question why are you sure just from X-rays. Tendon and ligament pain would be over by now. The only question you will have after the surgery is why did I wait so long.


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    Last edited by a moderator: Jan 9, 2017
  7. skigirl

    skigirl Moderator

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    I have been a ski instructor for the last 20 years, when I was told in 1991 that I needed a knee replacement, i fought it like you have. By 1995, my knee was hurting me daily and I grew afraid that one day I would wake up in the middle of ski season and not be able to ski. So, with great dread and reluctance, I had the surgery on May 1.

    It is now 8 years later and I have not missed a ski season, plus now I can do the hikes that I stopped doing too. Don't be scared, this surgery is not as debilitating as you think, you can do it and you won't have to retire unless you want to do it.
     
  8. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    Listen to all those people - they are not recommending a knee replacement for the heck of it but because they, like me, know what they are talking about!

    Let me have a look at your xrays and I'll tell you what it is they see that is so profound.

    I'll also leave you this questionnaire which you should complete, just for your own information. It will give you a jolly good idea of what's what.
     

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  9. UACats70

    UACats70 Member

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    @Fireman - have a look on the internet for a really good orthopedic surgeon. Do your homework/research and find the best one you can in your area. Meet with them and if you don't feel comfortable, seek out a second opinion.

    I was bone on bone for years and could tolerate the pain. When my sleep started to be impacted, that's when I knew it was time to get the surgery.
     
  10. Jaycey

    Jaycey Moderator

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    @Fireman The reason why the surgeons are not doing any other tests or diagnostics is probably because a bad knee is pretty obvious on an x-ray. Surgeons look at these things everyday, all day. They can tell from one look that there is no more cartilage and your knee is finished.

    Find a surgeon you trust and work with them to get this fixed and get on with living!
     
  11. Laurenkate

    Laurenkate Junior Member

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    Hello Fireman; I've felt the same way you're feeling now. I had an MRI in October, 2015 for a suspected torn meniscus - and that isn't a cheap test. The meniscus was repaired, knee was "cleaned out" and the doctor did that manipulation under anesthesia. I went to physical therapy for 3 months, the doctor said everything was on track until my last visit in May, 2016. He ordered a new x-ray and came in the door saying "man that's a really bad knee; a really bad knee; it's going to have to replaced". This was very surprising since knee replacement was never discussed and I didn't even know it was a possibility. When I left the office, I told myself I wasn't having a replacement, the pain was tolerable, blah, blah, blah.

    Since then, the pain has gotten much worse; I've gone to three other orthopedic surgeons and have been surprised they didn't order an MRI. The last surgeon I saw took the time to go over the x-ray with me and explained in great detail what he saw and why he thought a knee replacement was necessary. I'm not happy about any of this but am tired of living a very restricted life because of the stupid knee. I AM happy about not having to shell out another $1,000 for an MRI which is unnecessary.

    It sounds like you've done an amazing job for years on a worn out knee. It is weird how (literally) overnight it'll work and the next day, the knee has said "enough". The thing which really convinced me to have the surgery has been the long, sleepless, painful nights. That starts taking a toll on your brain; the sleep deprivation is starting to make me wonder if I have some form of dementia. As the knee gets worse, the rest of your body has to compensate for it so then the opposite side of your body and your lower back starts aching all the time. If you can afford to have it replaced in the near future, do it while you're in good enough shape to recover a little more quickly.
     
  12. little red canoe

    little red canoe Senior

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    Fireman you didn't prove your doc wrong.. I had cartilage removed in 1971 and for 44 years got along just fine and working as a paramedic in prehospital care.. That involves carrying people sometimes down lots of stairs. I dont know why I got along just fine...maybe there was enough synovial fluid for me to ignore the whole thing.

    Then last year it all became instantly painful.. Yes the door can slam shut just like that. I know if I wanted to after TKR I could return to my former field but frankly am too old and tired of seeing people younger than me pass.
     
  13. KarriB

    KarriB Forum Advisor

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    I went to bed one night with moderate knee pain and woke up the next morning unable to bear weight. It can happen that quickly for some. With no cartilage you are born on bone and that pain won't go away.
     
  14. lennie

    lennie Member

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    Fireman I was told in 2008 I needed knee replacement. I lost 100 lbs and gained 2+ years after being told again in 2013. You have gotten much more time out of your knee then I did. Head up!


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  15. Fireman

    Fireman New Member

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    Does it make any sense that stretching sometimes elevates the stiffness and pain? Lets me move around and walk normal? weight bearing does not hurt? Changes in the weather make no difference?
     
  16. KarriB

    KarriB Forum Advisor

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    Not surprising that weather doesn't bother you, it doesn't bother everyone. So you're in no pain at all and just can't bend your knee? Why not get a second opinion?
     
  17. FlaGranny

    FlaGranny Graduate

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    If you are bone-on-bone, you definitely are a candidate for replacement. One other thing to mention is that at the time they do the surgery, if you do have damage to your ligaments or tendons, the surgeon will take care of that then. From my personal experience, my bone-on-bone actually caused tendinitis which has much improved since my TKRs.
     
  18. lennie

    lennie Member

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    Weather was irrelevant to my knees. It makes sense to me about the stretching especially if you have a cyst. I had those.


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  19. Fireman

    Fireman New Member

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    oh no there is pain but it is not when standing or carrying heavy stuff. It is just bending, sometimes it feels swollen although it is not and stiff. or sometimes it will feel like someone is holding a match to the side of my knee. or the pain will actually be below my knee on the inside? extending about two inches down. but the actual Joint doesn't seem to hurt?? The more i think the more confused I get.
     
  20. lennie

    lennie Member

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    I could lift people fine right up to my last day before surgery. I just had trouble getting in and out of the truck.


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