to young?

[kdavis1048]

I am 48. Three surgeries on my right knee. Two in two years. The last was don 8-30. Found grade 4 trochlear erosion. Chondromalacia (trimmed surface). Femur has much cartilage missing. Medial and lateral meniscus was torn. Osteoarthritis has set in. Quoth the Dr. "only going to get worse". Left knee has tears in both menisci. Patella condromalacia. Oh yeah a bone cyst on right femur. I work in a chemical plant and must climb stairs, ladders, and pick up sometimes heavy items. I have a farm with cattle and hay operation. Most importantly a 12 year that likes to do activities. Double TTR or ? Have done prescription and OTC meds. Cortisone does zip.

 

[Josephine]

Well, that's what I like. Brief summary of stuff which gives me all the info I need in a trice!

Fact of the matter is you need knee replacements, no doubt about it. And I wouldn't think 48 is 'too' young, Perhaps the lower end of acceptable but definitely within bounds.

As to whether you have them done one at a time or together is a matter for you and your surgeon to decide. There are people who have posted on here having had a bilateral TKR done and are very pleased with the result. I think the primary consideration would be your general health which, since you haven't mentioned it, I take to be good.

Only trouble with have them done one at a time would be going through it all again - anaesthetic, surgery, rehabilitation. The other way it's all done and dusted.

Let us know what you decide.

 

[smithj8]

Where does the "lower end" stop? My name is Josh and I'm not quite 32. I've always been very athletic, and I'm in the military (not sure how long they'll keep me at this rate), but am starting to gain weight as I've had several knee operations. 8 to be exact (4 on each knee), including 4 in 10 months. My left knee is the worst and it's had 2 ACL recons, medial meniscal repair, partial medial meniscectomy, and most recently a 10-hr operation with a medial meniscal transplant, autologous chondrocyte implantation (ACI) in 3 spots including the trochlea and patella, as well as a fulkerson osteotomy, but not for varus/valgus but rather to decrease stress on trochlea/patella. Anterior pain is much worse now. Motion is very good (non weight bearing). I have awful, awful crunching which is sometimes painful. Trouble w/stairs or anything which requires weighted flexion passed about 45 degrees. Wondering if TKR is warranted? Rheumo thinks I may have Ehlers-Danlos, but only the hyper joint mobility variety, no skin symptoms.

 

[Josephine]

Another excellent summary, thank you!

Well, I would suggest that the 'lower end' actually does stop around 48 but it can be off set by various other considerations such as length of the condition, for example, a patient with rheumatoid arthritis might be operated on at a much earlier stage as the prognosis for their general health is poor.

However, your situation has been precipitated by the amount of damage from the torn cruciates and subsequent surgery (the xrays were very helpful, thank you). It is an almost inevitable consequence of such surgery, I am afraid.

The Fulkerson osteotomy I knew as an Elmslie and is for a transposition of the tibial tubercle on which the patellar tendon is fixed. Now this is interesting as this procedure is usually carried out for teenagers with a laterally displaced tubercle and therefore tendon. The patellar tendon is a principle support structure for the stability of the knee joint so the fixator - the tibial tubercle - is moved over the increase the tension. Much like you would move a tent peg to increase the tension on a guy rope to tighten a tent. It does, of course, also shift the weight bearing to a different area of the joint surfaces. This might be in concert with your physios suspicions that you have EDS though I doubt that, overall, it has much bearing on the condition of the knee joint itself at the present time.

But as to what can be done now - well, IMVHO, a TKR would most certainly not be an option at your age. Have you asked your surgeon about having arthroscopic washouts? This would rid you of all the debris that is cause much of the scrunching and pain and enhance the quality of your life. At worst it cannot make things worse. Losing weight would almost certainly help as well though I suspect you have already been advised of this. However I would urge you to set this as a priority in your situation as you are now battling for your quality of life and whilst surgery is not an option for you for maybe the next 14-16 years, a loss of as much weight as you can would very much be your salvation just now. It's a tough break for you as the inactivity caused by your condition is the very thing that causes the weight gain and vice versa. Your actual catch 22 situation.

I wish you all the best and only wish I had something more encouraging to tell you. Having gone though all that it seems hardly fair that you are faced with such a rotten result. I wish you all the best. Please come back and chat sometime if it would help.

 

[JuneBug88]

I am 41 and just be scheduled for my total knee. My brother-in-law had his knee done in his 20's. His was a result of a skiing accident and they had no choice. I would get a 2nd opinion.
Debbi