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TKR in your 40's, pro's & Con's

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wrappergirl

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I am 47 and I have a very crooked leg, its knock kneed (valgus) to the point that its visibly crooked and causing a lot of pain and swelling. Because the knee and leg are so crooked it has caused the foot to become what they call a skew foot, the bones (metatarsals) are now all crooked and twisted. I have tried orthotics in my shoes and an unloader brace, both cause even more pain, one aggravates the other and because my knee is swelling so much the brace becomes too tight constantly to even put on.

My ortho. and foot dr. both told me I need to straighten the leg before they can reconstruct the foot and the only way to straighten the leg is to replace the knee.
The osteoarthritis is really bad now, I've been told on x ray it looks worse than most in their 80's.

My concerns are, 1. I heard that being younger when you have a TKR is much more painful than having the surgery at an older age. 2. I'm worried about need revisions, how many I might need and what problems that could cause.

The pain is now at a point where if I'm on my feet for more than 10 to 20 minutes just walking or standing, the swelling and pain increase instantly. My right knee is about 5 inches larger than my left knee from the swelling and my left knee is also slightly swollen all the time (both need replacing).

So I'm wondering if anyone my age has had this surgery or if anyone has had similar problems with a valgus (crooked or knock knee) knee and how they di or are doing? How they found the surgery and recovery to be also ?

I'm facing both knees being replaced and then my foot reconstructed so its all a bit overwhelming, I'd love to hear advice or stories from anyone, thank you :)
 
Welcome to BoneSmart, wrappergirl! Hope you find what you're looking for here.

As for your question, I've nursed dozens of people who've had TKRs at 40 and much younger than that too! In fact we have a couple of 20 yr olds on this forum who had them, one even had bilaterals (both knees) as well! I'm sure he'll stop in and post for you.

Now recovery for 'younger people' being tougher usually refers to people in their 20s or 30s. In the late 40s you're actually at the lower end of a prime age to have joint replacement BUT this should be dictated by the condition of the joint, not the patient's age!

But what puzzles me about your post is that you describe the most appalling set of circumstances with your legs and then worry about having revisions which may well be 20-25 years down the line! How much of your life do you want to waste away before you get this sorted?

Many years ago when I started out in this business, knees replacements were generally reckoned to have around 10 years in them. Now an awful lot of those people have yet to need any revision. So were we wrong to tell them that? Not really, because we then lacked any statistical data telling us any different. Nowadays we tend to say maybe 15-20 years because that's how far back reliable current data goes. I would venture to suggest that it could now be even a lot longer than that because technology and
the manufacture of the implants is so much more advance than it was then.

So you're now almost 50. If your knee lasts 25 years, you'll be 75, if that one lasts 25 years, you'll be 100!! Now do you really think it's something you need to worry about too much!

Get'm done and get your life back. All you'll do is swap this present life of unremitting pain and disability for a few more weeks of a different pain and then be back on top form again! (Once you've got your feet done, of course!)
 
I agree with you completely. I had problems with my left knee for years, I am 57. I broke the tibia bone when I was 17, I fell off a horse. I had pins put in and taken out after a year. My knee was always a problem after that. I had a bend in the knee since. I had physio different times in the past 40 years. I started to go the my OS around age 49. I had a scope at 50.
I went almost every year after that. And he kept saying wait until your 60.
I didn't go to see him for a year because my 31 year old son had a ruptered brain aneurosym(I know that is incorrect spelling) and I spent the days with him to keep him busy. He has a 3 and 5 year old and wherever he wanted to go we went. I dragged that darn leg everywhere from play structures to sledding, you name it we did it. After that year I went back to my OS. I had an xray and he said it definitely time, but could I wait longer. I flatly told him no, all I want to do is walk. I don't want to run or anything like that. We agreed and I think I am starting to see the positive here. The kind of pain I had prior to surgery is no longer there. I have other pain but it is due to the surgery and my recovery. I say have it done. I missed out on some things with my family, although I tried very hard to keep up. The pain drained me I think, looking back. Oh, and by the way, my son is a miracle. He should have died but he came through with flying colors.

Deb
 
Welcome, Wrappergirl! You should hear from a number of folks on the forum soon who are near your age and some younger. I'm voting to go for it too! Your life is meant to be lived and if there is a procedure that can help you get mobility back.....I think it would be worth it. From what people say here, I think recovery depends on a number of things: age (ever so slightly), attitude (lots), willingness to work hard at rehab (but it gets much easier after the first 3-4 weeks following surgery), and your physical condition prior to surgery (this seems to be very important). So if you plan the surgery, do what you can to build up your leg muscles with non-weight bearing exercise (stationary bike, water exercises). But even if this extra prep work is not possible because of the state of your knees, you should be fine. Many folks here came through the surgery and recovery just fine who were not regulars at the gym! Please post any questions or concerns you have. No doubt someone here will have experienced it and will reply! You will have TONS of support from our BoneSmart family.
 
Hi Wrappergirl. I am currently 47. I had my first knee replaced 16 months ago and the second, last summer. My first replacement showed my leg to be 20 degrees out of alignment (bowlegged) and I also have an ankle and foot problem on this leg. I've already been told that ankle replacement is in my future. (I refuse to consider fusion). I'm trying to pretend like the problem's not there while I take care of everything else but darn! The ankle/foot keeps reminding me all the time!

I also plan to have a hip replaced within the next year as this pain is getting worse and worse by the day but first, I'm having another scope on my first knee replacement on February 11th. Yes, they even do this on metal knees. Actually, it's more of a soft tissue repair and I am still optimistic that my knee will stop hurting after 21 years.... I do have to tell you, however, that this knee pain is nowhere near what it was before the replacement and I am absolutely glad that I've had both of them done.

You asked if it were true that tkrs were more painful for someone on the young side? I don't think age has anything to do with it. There are several factors such as the skill of your surgeon and his technique, how bad of shape your knee was going into the surgery and things like that. The recovery from my first knee was really bad and as you can see that I'm having more surgery, I'm still recovering at 16 months. I also had a manipulation on this first knee. My second knee is now, hmm? I have to think.... yes 8 months old and it is better then the first knee. This second recovery was amazingly easy compared to the first. I would have to say that the speed of my recoveries could be based on how bad my knees were going into the surgery.

Like Jo said, don't worry about revisions. Life is too short to spend it in chronic pain like we all can unfortunately relate to on this forum. Keep reading and asking questions. Replacements are definitely worth it. Karen
 
Josephine, Jacques1, Jamie & Jt1@atime,... ThANK YOU SO MUCH!
It is so good to hear that other people my age and younger have had their knees done and all feel it was worth it. I have a young grandson, 19 months old and another on the way and love to get down on the floor to play with him but boy getting up is a joke! I feel like a 100 year old person!, its sometimes makes me laugh cause I'm there figuring out ways to get up off the floor without looking like a fool if others are around, if I'm alone then I know I look like a fool ! LOL!
You all mentioned pre op exercising. I swim at the Y 2 to 3 times a week and that is one thing making me think the time has come, I use to swim pain free but lately its painful just to swim, I sometimes have to drag one of my legs along cause it hurts to use it even in the water. Sometimes its not even the knee that was hurting the day before, guess the other one gets jealous and needs its time in the spotlight! Ha ha!

Both knees are bad, problem is the worst one that is so crooked is also for some reason my strong one, the one I rely on on stairs and curbs and to lean on, the other although straight has had a modified hauser procedure years ago and it kept that leg straighter but the knee never responded well to it so as a result its is difficult to use it on stairs. That's a concern when I get the right knee done, I'm concerned about the left knee being able to handle me using it more while I heal and being able to use it on stairs cause sometimes now I can't.
It seems from what I read that once you have a joint issue like this it affects other joints too, one of you mentioned needing a hip done too, I found that interesting cause I have a lot of hip pain, maybe using your legs wrong for so long wears on the other joints connected?
My husband is a full time college student and we have an 18 year old high school senior still at home and my daughter and son in law moved back in till their term in Graduate school begins in the late summer so because of all involved I think I might have to wait until next summer after my husbands college graduation in May before I can do the first one.
The way my knee has been lately though makes me think it will be a very long year.
Thank you so much for all your advice and support it is very comforting to hear it all, the good, bad and unkown, it comes from the heart not a medical book and that means a lot, thank you :)
 
Wrappergirl, I think you will find that recovery pain is not what you are expecting. The new joint will be VERY firm and stable. Your "good" leg must pick up some slack - especially in the early days - but it's maybe not what you are thinking. You are not really using that leg to "take over" for the TKR knee. If that were the case, it would be impossible for people to have both knees done at the same time! And we have many folks on the forum who come home from the hospital with TWO new knees and do quite well in recovery.

In my opinion, what is more important might be your upper body strength needed for the first month or so to lift you to a standing position (using a walker). If you have that, you'll be fine. You might want to chat with your surgeon about both your knees. I know it's scary, but if they are both bad, at least consider having them done at the same time.....only one "pain" and recovery versus two.

I know from my own experience, it's hard to believe how your new knee will feel. Once you are in a standing position, there is NO PAIN. As you walk, you have no joint pain at all. There is muscle discomfort, some pain if there is swelling, and you have to work to get your range of motion back, but having no pain when walking is fabulous.

It sounds like you have a full house, but all the better to have a crew to take good care of you while you recoup.....consider not waiting and instead taking good care of yourself as soon as possible!!!
 
Dear Wrapped Girl...I am 54...my right knee was replaced when I was 52 (after the healing was completed, it was nothing short of miraculous!) ....my left was done 12 days ago! (still dealing with some pain, but time will take care of that...i am walking on my own now or with a cane!) I am a bit older than you, but I think, at 47, it's a great time to start the process. It seems like you'll have a number of things to do before all is said and done. I am wondering if it might not be a good time for you to go ahead and have it done while you have your family members staying with you? It would be a great help and I am sure they could all pitch in and make that first couple of weeks a pretty smooth recoup for you. I have an 18 year old daughter, (she has an apt but comes over) and she has been great as far as running errands, walking the dog, etc. And my first week, I had friends, relatives here with me, cooking, helping with the simplest things, but not so easy when you're at the beginning of the post op period. What I'm saying is, if possible, take advantage of the family staying with you to help you...if you are a typical mother, I am sure you have gone above and beyond for them through the years...let them help you now...AND JUST DO IT!!! You will not regret it, but the longer you wait, the more time is lost to pain and a compromised life style...you are too young for that! good Luck!
 
I, too, had to have my "strong" knee done first. I think it went so quickly when it did go bad because I had relied so heavily on it to do all the lifting. At first it was difficult to get the "weak" knee to lift. The funny thing is, that caused me to rely on the strength of the replaced knee even sooner. It didn't take more than two weeks for me to start relying on it again. Old habits die hard. :-)
 
I was thinking the same thing Kanoneli was thinking. Get your knees done while you have the extra support at home. With so many able bodies around to help out, you will be less of a burden on just your husband as they can all pitch in one way of the other.

My hip problem is seperate from my knee/ankle/foot problems. I was in a bad car accident years ago and had multiple injuries and broken bones. They are all just falling apart again at the same time. Karen
 
Hi Wrappergirl,

Just wanted to add best wishes to you.

I'm 49 now and had a hip replacement Nov '07 and just had a knee replacement Nov '08. I say Go For It! Yes the recovery from the knee is slow and a bit uncomfortable but you improve all the time.

I don't worry about revisions as I figure even if I only get 10 years out of them, I'm thinking there will be advancements in that time, and the improvement in my life and mobility even now 10 weeks after has made it all worthwhile.

Good luck,

Chris :)
 
Wrappergirl -
Turned 43 this month but had my right knee replaced this summer. That uncovered FAI in both hips which I am in the process of having corrected through arthroscopy (right was done 12/18 and left will be done 3/2). I figured get it all done this year so my knee can get the most benefit! I would like to keep my new knee as long as possible. DO IT!!! I have had spurts of "normalcy" and cant wait to get all this out of the way and get back to my life adn NEVER look back. Healing is a process but it is well worth it in the end!!!!-

Marianne
 
Lord, I remember those Hauser operations! Always thought they were a bit 'iffy'!
 
not​
I am 47 and had bilateral knee replacements four months ago.* I have rheumatoid arthritis and wished I had done them a year ago.* Before the knee replacements, I could only stay at the gym for about forty five minutes but now I can stay almost two hours.* It was the best think I could have done.
 
Thank you all again so much for your advice and personal stories.
1jt@atime, so sorry to hear about your car accident. I hope they are able to get all your joints doing well.
I have thought about doing it while my kids are here, problem is, all the bedrooms are full till the summer when two of them go to college (daughter & Her husband, going back to grad school) and hubby has to go to bed at 7 and gets up for work at 2, I'm notorious for being a bad sleeper when I have any knee surgeries cause I'm normally a stomach sleeper so I would have to sleep in the other bedroom which is occupied now or on the couch which is about 60 feet away from the living room... Do any of you think it would be a problem the first few days or so home to be able to go that far to get to the bathroom? I have one step from my living room to my kitchen also so its that plus the distance, if that's not a problem than that's one obstacle out of the way.
My mom was 75 and 77 when she had hers done (she comes from a family of 7 and they all had to have tkr's) and it was 14 years ago but she was in the hospital for 2 weeks, what is the normal time now and did any of you get in home help after you got home or have to go to a rehab first?
Has anyone used crutches instead of a walker ?
Thank you all so much for answering all my questions, its helping to put my mind at ease about the whole thing, the doctors all keep saying how bad it is to have this done at my age so its made me very nervous about the whole thing. Thank you :)
 
Hi, I agree and I was awake during it cause I was having a bad jaw (TMJ) flare up then so they didn't put me under. There I was watching the surgeon with a saw in one hand and an open book with instructions in the other!!! YIKES!! I wanted to run, but couldn't! LOL!
Thanks again :)
 
Wrappergirg,
I am 46 and just had BI-TKR on november 13th. Prior to the surgery I had foot problems (not as severe as yours) and both legs were bowed out. Standing straight legged I could not make my knees get closer than 3 inches apart. Following the surgery both legs are straight and when I stand with my legs togather they now touch from top to bottom. A couple of strange things happen after my surgery that were foot related. the first was the first time I went shopping with my wife at a local mall I noticed both of my feet were hurting very bad after about an hour I went into a shoe store tried a pair on and walked around the store for about ten minutes and my feet quit hurting immediately. Long and short I have had to replace about 70% of my shoes. Also my heals started hurting very bad but that went away within a week felt like plantar faciatis which I had surgery for years ago and I thought it was coming back but it went away.

I have been amazed at the other body parts that have been effected by this surgery, Feet,heels,ankles,hips etc.now that the knees are working correctly every thing else that was compensating can go back to normal.

Good luck! This surgery will change your life for the better.
 
wrapper girl its a diffictult question, you have to ask yourself what if I don't get it done....I am 30 years old and had avoided it for 12 years and to be honest I wish I had not as the damage was very bad... I used crutches after day two and found these ok and could also walk to the toilet etc at a distance... It is important to be well prepared for it, thats perhaps where I lots out a bit and am a bit impatient but we can all understand your fears and they are very valid. My surgeon has said with a lot of activity ie cycling I should get 15 years from my joint, good luck whatever your decision is...
 
It would seem to me that you (as the person who would be recovering from surgery) should get the bedroom, but some of the people on the forum actually have been more comfortable on their couch or in a recliner. It seems to be a very personal thing. Walking to the bathroom should not be a problem for you, but you will need to go slow, use crutches or a walker (much more stable) and go slow on the step. Therapists will show you how to negotiate steps immediately following your surgery.

Some people opt for in-patient therapy after about 3 days in the hospital. Some go home and have in-home therapists and nurses come (that's what I did). And still others go home and have someone drive them to out-patient therapy. Again, it is dependent on how your recovery goes, who is available to help you when you get home, what your insurance will cover, and what you choose to do. The staff at your hospital and your doctor can help you decide what is best.
 
Hey Wrapper, I also have a step down livingroom and managed it multiple times a day without a problem. I pretty much slept in my recliner chair for the first two weeks for each replacement. I just wasn't comfortable in bed but once I did start sleeping in bed, I drove my hubbie crazy, but then I always drive him crazy. He is the lightest sleeper ever!

Crutches vs. a walker is a matter of preference. I've spent close to a year of my life on crutches and consider them a second set of legs so if you have more experience with the crutches, go that way. If they are foreign to you then I would recommend the walker. I just couldn't get the hang of a walker.

When it comes down to it. You have to consider how much pain you are in and the intrusion to your everyday life these knees are causing. I could barely walk across the room before I stubbornly gave in. I should have done it much sooner. Don't be like me and put it off until it's so totally out of control. Karen
 
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