Too heavy for knee replacement?

[Josephine]

I'm here! Sonja tagged me so I'd come along - thank you Sonja. But I do visit nearly all the threads almost every day - just like matron doing her ward rounds!

First you need to tell me where you live - not your address, just your town - and which hospital you have already attended. The name of the surgeon would be helpful too.

 

[scarlett]

Hi Josephine! Nice to meet you and thanks for replying. I am in Canterbury, Kent in England. I have seen Mr. P. Housden privately at the Chaucer Hospital as I was desperate for help, and he was very dismissive- sent me away. That cost £150! Prior to that I had seen several different doctors at the iCats centre in Wincheap, which is supposed to be a half-way point between the GP and specialist. They got me x-rays and MRIs. They said that my left kneecap is at the wrong angle and gliding wrong- as a result it has worn out the cartilage underneath. I strap it up with k-active tape every day. The outer side of this knee joint 'went' yesterday - felt like it had gone slightly out of joint. So painful, and kept slipping out last night. Today I have barely moved as I HAVE to work tomorrow. The other knee (right) is properly arthritic. Painful under the kneecap, the outer side gives way and has 'stuck' in the past. I had a ligament reconstruction on this knee at 13 years old (now 42) so big scar. I have knock-knees and ankles don't meet when I stand up, they are about 12" apart. Both ankles are weak and painful and often give way, like when you twist your ankle. The soles of my feet fizz and throb all the time.
My GP is still going on about painkillers- which I don't take cos I also have ulcerative colitis, and I teach choirs, so I cannot be dizzy and be responsible for children.
Hope that's enough info! Over to you!

 

[Josephine]

Are you going private or NHS?

I think I've found you someone who specialises in people with patellar malalignment and also does knee replacements. His name is Mr Anan Shetty but I don't yet know where he works NHS-wise. I'll check that out tomorrow. Otherwise, Kent seems a bit og a hinterland for knee surgery. I shall keep looking!

 

[scarlett]

Has to be NHS unfortunately, but I usually try and see the specialist privately to save the huge wait. I am going to see my GP on Tuesday and I will insist that I get referred to a different knee person than the one I just saw. By the way, Mr. Housden said to me that arthroscopy would not help, not would steroid injections, nor would a knee operation. Unless I was within normal weight. He then suggested I think about surgical weight loss- ie- gastric band. He must know how hard it is to lose weight when you can't exercise. But I was quite insulted. And then came on here to see that lots of heavy people have had the knee ops! Maybe USA is more forward thinking than UK!

 

[scarlett]

http://www.bmihealthcare.co.uk/hosp...nt=305&p_hosp_id=292&in_page=TreatmentDetails I've found a link with local surgeons, so I will go armed with their names to my GP. No idea which one to try though.

 

[Josephine]

Did you not read my earlier post? Lots of heavy people in the UK have hip and knee replacements! There are just too many surgeons who look at the weight and not the quality of life! But there are as many who don't and operate on us biggies! You were unfortunate to bump into one, doesn't mean they're all the same.

 

[scarlett]

Oh yes sorry- I didn't realise it was you who wrote the earlier post. Thanks- I will keep pushing.

 

[Josephine]

Well here's what to do before you see your GP. Go through that list and make a note of the surgeons that do knee replacements and their telephone numbers. Then phone them and ask if weight is an issue with him. The secretary will most likely know. Then you can choose a name. However, I would think that most if not all those people are known to your GP if not golfing buddies!

 

[RestAssured]

Good luck to you! You deserve a knee replacement and no OS has the right to say you should have gastric bypass first! We will be here for you because it doesn't matter where you live, you are a part of our BoneSmart family now!

 

[Jebsw]

The attitude of the doctor you saw makes me see red! As everyone has said, find someone who will treat you with respect. We are more than our weight. Good luck!!

 

[DiMcQ]

Hi Scarlet, I have been reading your posts. I too am new here and I weigh 265pds at 5'6". About 3 weeks ago when I went to my doctor he said the next step for me would be knee replacement. The first thing that came to my mind was my weight. He said it was possible to do it at this weight. But it is so hard to see how. People here have been so helpful but I just can't get that worry out of my mind. Along with all the other fears I have about it. And yet, at times when I am so tired of the pain, I think-yes this surgery is painful and a long recovery but maybe it would be worth it to be out of pain.
I just wanted you to know I'm thinking of you and wondering how your doing. Do you think we could do this at our weight and still have a great outcome?

 

[DiMcQ]

Another question--I also have neuropathy in both my feet. I was tested a couple years ago. I don't have diabetes and they don't know where it's from. They said some people just get it. Would this effect knee replacement? My feet feel numb--not 100% but enough to feel it. Add this onto the extra weight (265pds) and it's a huge worry.

 

[Josephine]

Well I did! And I nursed ladies who were even bigger! The knees are well up to it so put it out of your mind and get it done. Anyway, you really think any surgeon would be idiot enough to contemplate doing it if he thought it would fail?

And no, the neuropathy wouldn't be an issue - lots of people have it.

 

[Titianlady]

Definitely keep looking. My surgeon said nothing about weight. I brought it up and he told me the day before he did a tkr on a 350 pound woman and only needed a 3 1/2 inch incision. It wasn't an issue. Now other health issues could matter, but if otherwise a healthy candidate, weight is not a limiting factor.

I just have a terrible time knowing surgeons would refuse a knee replacement to someone that is heavier. Why? Because they think the results won't be there or recovery will be tough? That just infuriates me!! When I went for my checkup, there was a man leaving the office who was very tall, and didn't look all that overweight to me, and his wife said to me, " Well,no knee replacement for him..Dr said he needed to lose weight first". Now, I love my surgeon, but I lost a bit of respect for him after I heard that. When I go back in January for another checkup, I'm going to ask him about this.

 

[Jebsw]

I had/am having great recovery from my first TKR in February. The only time weight was brought up was when I asked the surgeon about it. He agreed it might be better if I weren't overweight but said that was no reason not to do it and that I needed to get my quality of life back. He did the TKR on my other leg four weeks ago, and I still am heavy. Don't let one man's insensitivity talk you out of this...I did and lost over a decade of my life, seriously.

 

[lh25]

Do you think we could do this at our weight and still have a great outcome?

I'm about 5 months out from my TKR. I'm 5'4" and weigh about 290, which is what I was at the time of surgery. And I think I'm having a good outcome. I did a garage sale this weekend, two days of standing, walking and hauling stuff around(OK, and some sitting and talking to neighbors.). A year ago, pre-TKR, no way could I have done that.

From my own story so far, and what I've heard from others, yes you can.

And you are lucky enough to have found an OS that agrees.

 

[RestAssured]

Gosh I guess if mine was willing to do mine at 435 pounds and 5'9 1/2, both of you should be a "piece of cake"! Quit worrying about the weight and realize there is a whole world out there to experience once you are free from pain! You will want to get out and get moving and in no time, if you wish, the weight will start dropping. It is up to you! Life is too great to watch from the sidelines! I'm an active participant now!

 

[RestAssured]

Another question--I also have neuropathy in both my feet. I was tested a couple years ago. I don't have diabetes and they don't know where it's from. They said some people just get it. Would this effect knee replacement? My feet feel numb--not 100% but enough to feel it. Add this onto the extra weight (265pds) and it's a huge worry.

I have a question for you. Is that your baby in the picture? If so, don't you want to get back on your feet again so you can take that precious child places? I would if I had a baby.

 

[Elsie Yan]

Scarlett, Yes, you will definitely benefit from TKR and you seem to be a candidate for one. It will also correct the alignment of your legs and it would be advisable to do a bilateral as both of your knees are affected otherwise, movement will be difficult. Of course, this depends on your medical condition as well. As you say, your knees are half your problem, then with TKR half of your problems may be solved.

 

[scarlett]

I love this site! It is so great to get so many interesting and intelligent responses. I am seeing the pain clinic and a neurologist (privately) tomorrow, re. pain control but I am going to tell both that there is no point putting this off with pain killers- I need new knees NOW as I have NO life. I'm seeing my GP Friday for a referral to a different knee surgeon. I found one, Josephine, who looks good on paper (does 'signature knee replacement'?) but his secretary said he won't be able to comment on BMI without seeing me, so I have to either get a NHS appointment in 3 months time or pay again £150 to see him privately. Either way, I am not letting this go. I will keep you informed of what happens.