Knee replacement question

[Traci]

Hi,

I am a 34 yr old woman. I have had 3 Arthroscopic procedures on my knee. This problem has been going on for 20yrs. Almost 21 yrs. I have been in pain at least 3 times a week. OTC meds don't seem to be working very well. I am at the point of just wanting to rip my knee out to stop some of the pain. I don't sleep very well at night due to the pain.

I do have an appointment for and MRI on Friday Sept. 14 and Orthopedic Dr appointment on Wednesday the 19th. But my question is in your opinion as a nurse would knee replacement be an option for me?

 

[Josephine]

Hi Traci. Sorry to hear you've been having such a tough time and I can well understand your frustration.

To start with, why are you still struggling with OTC meds? Why hasn't your doctor got you on some stronger stuff like diclofenac, co-codamol or codeine phosphate? There's a myriad of stronger analgesics out there that you should be trying out. A mixture such as diclofenac and co-codamol taken regularly can give excellent relief.

As far as actual treatment is concerned, I would say that 34 is a tad on the young side to be going for a replacement. The prospect of revision gets stronger the younger the patient and that is a very real, if long term, consideration. Personally, were I in your shoes I would be doing almost anything to avoid a TKR just yet.

There are other options - did you have much improvements after the scopes? If so, why not another? Have you ever had injections of depomedrone* or similar into the joint? Have you ever thought of trying a TENS** machine? I have used one extensively on my knee and often used to go to work with it in use when I was working in the OR! It was great. You can't use it during sleep, however, but the build up of its effect during the day can have knock-on benefits for the night time.

Do let us know how you get on.


* steroids
**Trans Epidermal Nerve Stimulator

 

[Traci]

Why hasn't your doctor got you on some stronger stuff like diclofenac, co-codamol or codeine phosphate? I have two young children and I don't like the way the drugs make me feel.


did you have much improvements after the scopes? There was very little improvement. I have just been dealing with it. I go about my day as any other day.
As for another scope, I don't tink I want that. I am tired of having a scope done then a year or two later having to have anohter one done.

Thanks for the advice. I will let you know how things go.

 

[Josephine]

Well, they aren't the only ones, just the ones I happen to use. I have found that things like co-codomol do have a little bit of a sedative effect in the early days but now, after having taken them for over a year, that side has worn off completely. Sometimes it pays to persevere.

And there's a whole book full of different stuff out there. Have you actually tried diclofenac? It has no sedative properties whatsoever. Though it is an NSAID* and so if you have gastric problems that could be an issue.

I am sorry you've not had relief after the scoping. I and many others of my acquaintance, have had extraordinary relief. One gentleman I know has had his knee scoped every 8-10 months for around 5 years because he'd sooner do that than have a TKR. Last time I saw him - in August - he was still trotting about without even a cane for support! But these things don't always work like that for everyone though, tis true.

I would also say that the fact that you can go about your day as any other day is something to be grateful for. I pray that they manage to get you sorted before you get the point where you can't get out of your chair without crutches and can't even stand and cook some cheese on toast for yourself. That's real down-time.

All the best there, Traci


*Non-Steriodal Anti Infammatory Drug