PKR Newbie with knackered knees and various options to consider

[Legseleven]

Hello I’m new here and live in the UK. Age 66.
Knee pain (L) since February. Eventually saw trainee GP and eventually had X ray. She said chrondocalcinosis = pseudogout, I disagreed as the pain had gone on too long. It was 9 weeks at this time and she said previously it’d clear within 2 weeks. I asked to be referred and she said everyone has bad knees at your age (!), but eventually she agreed to refer me to physio… and my appointment is through but not until the end of August…..
Meanwhile the knee pain got worse and as I very luckily have medical insurance and I had been referred to MSK was able to see a specialist. He said X-ray normal for someone my age, and ordered a scan. Scan showed severe meniscal tear and severe Patellafemoral arthritis, bone on bone. He described the symptoms at which point I went ah yes, the other knee is like that too, so it’s been scanned too and I got the results today. It’s even worse than the left one but the pain in L is from the cartilage flap which keeps getting caught up. There’s almost no cartilage left behind either knee cap.
Saw surgeon today, and now almost too much to think about….
1) meniscus repair L knee together with
2) Patellafemoral resurfacing/ replacement L knee
Plus
3) Patellafemoral resurfacing/replacement R knee
Can be done singly or bilateral.
The worn patella is due to patella maltracking on both knees and at least I know now why some transfers have been so hard for the last three+ years. I always thought pain would be the main symptom, not locking and sticking. So the results have actually been quite shocking to little ol’ me! I had no idea I was this bad.

Usually I know what’s best for me and this time I have no idea, and my son’s wonderful wedding is in November, so that’s a great goal.

I’m in awe of what so many of you have been through and achieved and I remember how useful the health forums were to both of us on hubby’s cancer journey. Now it’s just me and I need all the help I can get. I live alone with lots of stairs, and I’m determined to get through this. I have no wish to leave my home and end up in a bungalow, well not until I’m in my dotage and I absolutely have to. I’m an artist some of the time and the attic on the second floor is my studio. That will surely make me do the stairs. I’m still working part time, although have cut my days a bit as it’s a physical job and I’m on my feet all day.
I also went to see a convalescent/respite place today and they’ve had a lot of joint replacement patients staying for a couple of weeks afterwards. I’m doing my best to take care of myself and considering all options before making a decision.
The surgeon was optimistic and confident, his numbers are good with the Joint Registry but I know these consultants don’t see their patients at their lowest moments when they’re home alone and in pain.

Your thoughts and suggestions will be much appreciated, thank you and best wishes on your own health journeys.

 

[benne68]

Welcome to BoneSmart, @Legseleven. I'm so glad you joined us.

I'm sorry to read that you are struggling with your knees -- but know exactly how it feels. I've had both knees replaced in the past few years.

Only you can decide what is right for you, but -- once your joint reaches bone-on-bone stage, it's only going to get worse and more painful.

We have members who have done bilateral (both knees at once) and others who have staged them months (or even years) apart. I'm sure you'll hear from members who've done both.

For now, let me share BoneSmart's helpful pre-operative guide here -- it's a lot to read, but I'm sure you will find many of these articles helpful as you consider your options.

Knee Pre-Op Guide

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?

Good nutrition is just as important during both the pre-operative period as it is during recovery. Check out this helpful information on Pre-surgery Dietary Tips and on Nutrition Basics.

Regardless of where you are in the process, the website and app My 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

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

So feel free to ask any questions you have about this surgery and recovery; our members will be happy to share their experiences with you.

 

[Legseleven]

For now, let me share BoneSmart's helpful pre-operative guide here -- it's a lot to read, but I'm sure you will find many of these articles helpful as you consider your options

Thanks for this, I’ve just printed the questionnaire to fill in. Much to think about, too much really. I thought I’d be older before something like this happened… still I ought to know better as hubby died age 60 after a long cancer journey.

Thanks again to everyone for reading and supporting.

 

[benne68]

As you go through the material, please don't hesitate to come back to us with questions or concerns.

I was about your age when I had my first hip replaced. It was so hard to make the decision to proceed. But, in retrospect, I'm so glad I did because it really gave me back my life! (And, as you can see from my signature, I've had two knee replacements since then and am about to embark on hip #2.

 

[Legseleven]

I was about your age when I had my first hip replaced. It was so hard to make the decision to proceed. But, in retrospect, I'm so glad I did because it really gave me back my life!

Thank you Benne68. I want to be able to enjoy time with my granddaughter and not feel I’m slowing everyone down. I’ve already had to reduce my part time work days. Good luck with the hip op, I’m sure you know exactly how to cope now. For this of us new to this it’s all unknown. Thanks again.

 

[benne68]

For this of us new to this it’s all unknown.

The first time is scary, for sure. But, by one year out, most of us are asking ourselves, "Why did I wait so long?"

By the way -- I had my left TKR in December 2023 and was able to "dance the night away" at my daughter's wedding last September. So, dreams do come true!

 

[Legseleven]

one year out, most of us are asking ourselves, "Why did I wait so long?"

Thanks again. Just trying to work out the logistics while syncing my head, heart and soul. The wedding is November this year so I don’t have as long and I will have to coordinate Eyelea injections every 8 weeks into my eye, and the recovery process, as they stabilise the vision after a retinal bleed. Next jab tomorrow, they’re not fun, but a lot easier than knee surgery! Still I have to be able to attend those while recuperating from the PKR’s. Onwards….

 

[Layla]

Hello and Welcome Legseleven. Thanks for joining us as an Insider! I am sorry you're dealing with painful knee issues and facing surgery. It can feel overwhelming. I am also sorry for the loss of your husband at such a young age and the eye injections you're dealing with after a retinal bleed. I wish you comfort.

Joint replacements are happening at younger ages these days. With longer life expectancies and the active lifestyles many are living, people aren't waiting until they're in their seventies anymore to have joints replaced, but instead choose to schedule surgery so they're able to get back to the lifestyle they were accustomed to before their joint deteriorated.

With the help of transitional care, friends, and family if they're nearby, you will make it through PKR's and be happy you had the surgery. It can feel like a lot to process initially, but that fades after you figure out how you will function in the early days and weeks, what it means in regard to your independence and how long recovery may take. Once you feel more informed, I believe you'll feel more comfortable proceeding.

Your surgeon will consider your overall health to determine whether you can safely handle bilateral surgery. Weighing out the benefits and any risks, but you decide what you're willing to handle, bilateral, or staged.
Also, you want a surgeon that's experienced in bilateral procedures if you choose that option.

I will leave a link to the threads of members that experienced bilateral PKRs, if interested. I look forward to following your journey and supporting you along the way!

Knee Surgery Recovery Area

For post-operative knee patients, on the "other side"

bonesmart.org

@Legseleven

 

[Jamie]

Oh my…..you DO have a lot on your plate right now! I’m so sorry, but you sound like a person who is taking a logical approach to it all, which is good. You’ll get there. We’ll try out best to help you along the way, so lean on your BoneSmart family when you need to. We’re here for you.

 

[Legseleven]

Thank you @Jamie, @benne68 and @Layla for your kind words. It’s a lot to take in and process. I do feel like all I now think about are my poor knees! I also have some back issues and am just recovering from a trapped nerve from my spine into the deltoid muscle. That’s taken a few months, so I guess looking at the ‘whole of me’ one knee at a time is the safest option. Although the worst right knee may struggle with the added strain of recovery of the left one. The pain is in the left because of the additional cartilage tear, so it’s left first.
My surgeon has done over 3000 knee replacements of every type. I didn’t have Josephine’s list when I went yesterday but I can ask his PA some of the questions.
My knees now appear to have taken over every aspect of my life and sadly are even clouding some of the good things I have planned for June including a mini holiday with my family and grandchild. It also means I can’t get the surgery til after that, and for my headspace, the quicker it is done would have been better and easier to deal with. Not forgetting the current limitations from the pain.

For the past seven years I’ve got very good at living in the present and not looking too far ahead, but again the knees are now challenging me on every level and I’d like to be able to restore my equilibrium asap. I expect time will help, so patience will be key, and you all on here, thank you so much.
I also know from when I worked as a mental health professional that new challenges can stir up old traumas and I think that’s partly what’s happening here. So I will keep breathing, work through my lists, remember to enjoy every day and know that I will be ok.
With gratitude to this forum and to you all.

 

[Legseleven]

Just had a good chat with the secretary, and got lots more info. He doesn’t offer a bilateral to everyone, only if he thinks you’re suitable. The hospital has one of the lowest infection rates in the country. The prosthesis is ceramic. Still thinking.
Off to eye department now. More reading helpful posts on here later.

 

[Jamie]

Ceramic implant is good. Surgeon experience is good. The fact that he thinks you’re a good candidate for a bilateral knee replacement is a plus and you really want to consider that. One recovery and you’re done. You can read about other bilateral knee replacements by searching the forum for threads that have the BTKR prefix. That may help you have less fear about this option.

 

[Legseleven]

Thanks @Jamie very helpful. Funny how one’s life changes completely in ten days from ignorance to knowledge, but knowledge gives choices, and some big ones. One recovery is tempting.. and challenging. X

 

[Jamie]

Let us know if you need help finding the BTKR threads to read. Hearing how others coped with it will help you fear it less. You’d be surprised how many people talk about how glad they were to have done it that way. It is possible to recover from a BTKR without feeling like it’s twice the effort. Just about everyone who has it done will say (you’ll see in the threads) that they are glad they did it and got things over with. Recovery is NOT twice as long, so don’t worry about that.

 

[Layla]

There is a link to the Bilateral PKR threads in Post 8...if interested.
Click on the blue "Knee Surgery Recovery Area" to find them.

 

[Legseleven]

Thanks @Jamie and @Layla I’m steadily reading through them.

 

[Jockette]

You can also do a search, upper right corner of the page, specifically for Bilateral Patellofemoral, which is what you said your doctor recommends. I just did that and found quite a few. Our PKR prefix doesn’t specify which PKR it is.

Best Wishes as you collect information and make your decision.

 

[Legseleven]

Thank you @Jockette. Currently I’m still on the fence.

 

[Roy Gardiner]

He doesn’t offer a bilateral to everyone, only if he thinks you’re suitable

You have to be fit and healthy. It's good news.

I'm 100% for bilateral. See my BILATERAL TKR Recovery Diary

 

[Legseleven]

He doesn’t offer a bilateral to everyone, only if he thinks you’re suitable

You have to be fit and healthy. It's good news.

I'm 100% for bilateral. See my BILATERAL TKR Recovery Diary

Thanks @Roy Gardiner I have read your recovery with interest. Well done. I appreciate your input. How is it now?
I’m 66 and not as strong as you, and not as fit as I was as knee pain since February has reduced my activity somewhat. I woke up with a plan today and will soon be seeing a very recommended local physio to discuss options as I do have some back issues, currently recovering from a trapped nerve. I’m worried that two at once might be a bit much for the back.
He will also know all the local surgeons including mine.
Plus my son’s November wedding is the goal so if unilateral, it’d have to be one before and one after.