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To wait or not???

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bumleg

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Hi, I'm a newbie here. I'm 50. I had a partial meniscectomy in Dec 07 and now have left medial bone on bone. I am still walking with a limp and having problems getting around. I am unable to work or do much of anything that requires standing and walking for an extended period of time without my knee,right hip and lower back hurting. My ortho doc told me that my last option is for a uni knee replacement. He suggested I put it off for as long as I can. He left the room before I got to ask him why? Does anyone have an idea as to why he would have suggested that? I will see him again on April 17th. I'm thinking that since I am as young as I am that to not have it would be wasting some still productive years. I have had the Synvisc injections and they helped briefly but now I 'm back to where I was before I had them.
Thanks
 
bumleg, your situation sounds exactly like what I went through a year ago....surgery for torn meniscus, then complete loss of cartilage on the inside of the joint. Even though you are relatively young at 50, if you are like me (I'm 59), you might not be willing to accept this greatly reduced activity level and lose some good years of your life. Corral your surgeon and get him/her to talk to you. Write out your questions ahead of time so you don't forget anything. Be sure you understand everything about what you are hearing. And maybe think about getting a second or even third opinion. This is too important not to have all the information possible! Check out the threads and posts on this site - especially the part about choosing a physician. Make sure the person you are talking to does LOTS (like hundreds) of knee replacements every year. Are you in a big city where you have access to multiple orthopedic doctors? Hope so! Good luck and stay with this forum. It's an EXCELLENT resource! ....Jamie
 
I am 53 and had a bilateral TKR---here is why they tell ou to wait as long as possible---some of the reasons---

1. These knee joints do not last forever---I hope to get 15-20 years out of mine---but sometimes they only last ten.

2. This is major surgery---lots of cutting, drilling, and sawing---trauma to the body

3. Lots of PT---it takes about a year to get back to what will be normal.

4. SOme doctors want you to wait until there is no other course of action---I was on Synvisc and cortizone, although I knew that I really should have just said to him, "cut me."

5. This is a BIG STEP---there is no going back, and there will be things in your life tha willchange forever---most for the good---some will be life-changing---kneelnig, types of exercise(although because of bad knees, many do not get enough exercise befor ea TKR...)

Tim C.
 
Welcome--
Jamie is so right--- corral that doc and make him answer your questions and get other opinions if you don't feel good about the answers you get.

Why waste a few years at our age (I am 51) in pain and disability that could be healthy and active--- just to have the knee replacement later? In a similar situation I chose the uni-knee last December. My doc says I will need a revision to a TKR eventually, but no one really knows how long these new knees are going to last. Maybe 10, 15, 20 or more years of time that I can be healthy and active NOW.

Uni(hemi) knee replacements usually result in quicker recovery and ROM return, but it is still MAJOR surgery--- just on one side of the knee instead of both sides. I won't kid you there. But I believe it is worth it.

Good luck!



bumleg said:
Hi, I'm a newbie here. I'm 50. I had a partial meniscectomy in Dec 07 and now have left medial bone on bone. I am still walking with a limp and having problems getting around. I am unable to work or do much of anything that requires standing and walking for an extended period of time without my knee,right hip and lower back hurting. My ortho doc told me that my last option is for a uni knee replacement. He suggested I put it off for as long as I can. He left the room before I got to ask him why? Does anyone have an idea as to why he would have suggested that? I will see him again on April 17th. I'm thinking that since I am as young as I am that to not have it would be wasting some still productive years. I have had the Synvisc injections and they helped briefly but now I 'm back to where I was before I had them.
Thanks
Click to expand...
 
Hi Bumleg, I first found out one of my knees was bone on bone when I was 43. The surgeon said I was too young and to put up with it as long as I could and sent me on my way. I had all the shots and PT to strengthen the legs and just happened to gain 50 pounds in three years because I could hardly move. Now my other joints are worse then they were from all the limping. I had my first tkr last Oct and I'm scheduled for the 2nd in June with a surgeon that knows bone on bone joints aren't going to get better, only worse. He understands the pain.

I'm 47 now and the new knee is great! Listen to the advice from Jamie and Ref above. There's a lot to think about before you jump into something like this but you definitely have to consider quality of life. We are too young to not get out there and have fun.

Welcome to the site! Karen
 
Gosh! You guys are putting me out of business! About everything has been said. Except I would echo ref - no going back, and you really can't beat the knee God gave you until - until it is making life so bad the alternative is better. Remember, this is not like a pair of shoes you can take back if they don't fit well.

But since your quality of life already seems to be on a downward spiral I would suggest that the time for putting it off is past and the time for action is here. Most surgeons adopt this attitude to make sure the patient REALLY wants it and is not just 'going with the flow' of the consultation.
 
Dittos on the above. I think if I had to go 10 more months never mind years in the pain I was in i would have hurt someone... when my life was reduced to sitting on the couch and watching TV I knew it was time no matter how old I was or how much I weighed.
 
hehe!!
[Bonesmart.org] To wait or not???
 
I think many ortho's still take the conservative approach for many of the reasons listed above. It's certainly true that a replacement won't last forever. However (IMHO), I will gladly swap "might wear out in the future" for better quality of life NOW. I'm 47, and just found an ortho (with lots of experience) who agrees with me. My first ortho, 3 years ago, told me I'd have to wait til I was at least 50. I did my time with meds, Supartz (similar to Synvisc) and cortisone but I'm already bone on bone and starting bone loss. My new ortho believes "the sooner the better" so he has more to work with. Makes sense to me.

Good luck!
 
Josephine, time to be proud of your little EDUCATED chicks!!! We have learned so much from you! But.....you will ALWAYS be needed here! ALWAYS!!!
 
Bumleg, I agree with the others. I waited until I couldn't stand the pain of bone on bone anymore (I am almost 54). I think the newer knees last a little longer nowadays. I would rather be younger than older to tell the truth because of all the effort needed after surgery.

Goodluck with your appointment on Thursday. Keep in touch....Sue
 
Hello bumleg, as I see it your leg at the moment is not good and probably worsening each day. After you,ve had the operation it,ll start getting better each day. I,m 51, 6wks post-op and wish I,d of had it done a couple of years ago instead of "should I shouldnt I?" So now get some homework done,ask lots of questions and go for it kid!! cheers klinger.
 
Thank you all for your replies. I am more convinced that this is something I really need to have done. I have a nickel allergy and from reading I have learned that there is a company that makes the prothesis with Zirconium and Oxygen. These are supposed to last longer than the other ones. I can understand why someone might want to wait because of the need for a TKA in 10-15 yrs. I don't see that as an option for me. Why should I be disabled for those 10 years and then get pain relief from a replacement. That is a waste of the life I have now which is totally unacceptable. I have a 16 year old I'd like to be able to do things with besides sit on the couch and watch TV. As for my Ortho telling me to wait as long as I can, he is the kind of doc that likes his patients to make their own decisions based on information he provides. He doesn't want anyone having surgery just because he says they need it. He outlined my options for me of course uni knee being the last resort. I can't see spending big bucks on a brace which may help a little but the result will still be the same. I will still need a replacement. The question is Do I want to wait until I have further damage to the knee and have to have a TKA? UH NO!!! The city I live in has several ortho docs. After I talk to mine, I will decide whether or not I need to search further. I'm thinking I will anyway because this is major surgery and I do want the most experienced surgeon I can find to do it. I will keep you posted .
Raye
 
Well Bumleg,
I'll let you know what happens to me. I'm 55, did the Synsvic thing, have a little bone-to-bone and will be getting the PTKR on 5/20. Naturally I'm scared, but now everything I do is centered around my knee. I would like to not have to be so concerned with the little things like taking a walk. I'll be having my sugery at Cedar-Sinai here in LA. I had my daughter there 23 years ago with a C-section. If that's any indication...I can expect the best care. But, the whole pain/recovery /PT thing is really freaking me out and I only hope I can be as strong as some of the people here. My daughter is coming home from school for my first week home...I don't want to look like a helpless baby when she gets here.
 
Okay, TJ, first thing you need to do in your mind is learn to accept some help as you are recovering. It's very important and it makes your family feel needed. (That was the lecture!)

But I think you will be surprised at what the pain is like in recovery. It's different than what you're feeling now....."good" pain that you can work through and that subsides versus "bad" pain that continues no matter what you do and gets worse. You sound like a determined person and I'm betting you will do just fine in recovery. Be sure you follow all the instructions regarding activity levels and take your pain meds on schedule. You'll surprise yourself and your family!!! I think by the time your daughter sees you, you'll be getting around better than you think. Best of luck to you. We'll be praying for a successful surgery. Be sure to let us hear from you once you're home and don't hesitate to post again if you develop any concerns or questions in the meantime!
 
Hey Tj, you'll do great, and on bad days, here we are!
 
Hi;
This is for those who are going into surgery. Try to get a little strength built up in your quads before you go in. It sure helps a lot, and after surgery, listen to you doctor and your physio and do your exercises faithfully. Some of them are going to hurt, but it will be worth it. And make sure you stay on top of your pain. Don't let it control you and you'll be just fine. Good luck to you all.


XX
Angel
 
Thanks for that comment on pre-op exercise, Angel. I am scheduled for surgery in June and have started a vigorous exercise regime which includes lots of leg lifts either on the floor or on a chair, preferable with ankle weights. I'm also using a kick board at the pool to strengthen my legs along with trying to build up upper body strength. As we all know, being fit not only makes us feel better physically, but also helps mentally. I have gained way too much weight over the past year not being able to walk or do much cardio, so hopefully going to a swim center will help.
 
Funny how they are willing to cut our stomachs and do bypass surgeries to have us loose weight but they try to put us off as long as possible to cut our bones and make it so we can move and burn what we eat. We gain weight as we become less and less mobile.
 
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