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Too young for knee replacement?

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Jazyb

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I really can't remember his name as it was a few years ago now Josephine. He was nice enough and did the last scope I had on my knee. He told me I would need a TKR at some stage and told me to put it off for as long as possible as my own joint would always be better than anything they would put in. He said most people were disappointed with the final outcome of a TKR!!! The whole conversation frightened the life out of me, as I didn't realise I would need a TKR at that point in my life.

The next guy I saw 2 years later scared me even more with his comments. Sometimes these guys don't realise how frightening this whole process is to us. To them it's just their job but it so much more for us. The OS I am seeing now has a wonderful manner and I have total confidence in him. It took me a couple of years to come to terms with the fact my knee would need to be replaced and I know for everyone it's different but I wish everyone good luck with their own decision making process.
 

Josephine

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No, I meant the one you are seeing now, who gave you all the info and such.
 

sunflower

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Sometimes these guys don't realise how frightening this whole process is to us. To them it's just their job but it so much more for us.
You're right and I do wish some of them had an inkling as to what is involved in the recovery from a TKR. It would make them more empathetic and probably a little more patient.
 
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Racewalker45

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Well if it isn't one thing it's another. I am waiting to see my OS on January 17th, 2012 to finally get some insight as to what to do about my arthritic knees, but since then have developed severe L hip pain that was so bad I had to crawl up my stairs in my condo. I was told to stop all physical therapy and had an MRI of the hip last week. I found out today from the PA that I have a subchondral cyst in the hip socket. It's not very large, but can get bigger and the source of my hip pain. Bottom line, it's a sign of early osteoarthritis of the hip ( I also have bone spurs on both sides). This is the first time I have been told I had any degree of OA in my hips. Surgery is not an option, just watchful waiting, because if it gets larger it will cause the hip joint to further deteriorate and necessitate a THR :sigh:. In the meantime, no PT, no walking, only biking, swimming and elliptical machine. Walking only if pain free will be allowed sometime down the line, but no race walking for me. :sigh:.

Right now, I am virtually pain free (hip and knees), but that's because I have been pumped full of steroids for an upper respiratory infection, so it will take a couple weeks to see what my pain level will be after that. Not being active lately has been frustrating, and getting sick over the last 2 weeks doesn't help either.

Fortunately for me, the OS I will be seeing in a couple of weeks does about 700 joint replacements per year, and has a wait list of at least 4 months for appointments, so I plan to take advantage of this upcoming appointment. He also has a much better bedside manner than the last jerk I saw in October. I am hoping that this will be the last OS I will have to see. My questions for him will be:

1. Since I have a patellar tracking disorder and there's no cartilage under my knee caps and moderate disease in the rest of my knees, is a TKR or PKR(patellar femoral arthroplasty) the right option for me?
2. How do you feel about such either surgery for someone my age?
3. Are my race walking days over?

I think that's enough for now, just wanted to give an update. This forum has been the best thing to happen to me, so I will at the very least keep reading.

Regards,
 

Jazyb

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Hi Angela

Wow, you certainly are going through it. I am sorry you are having a horrid time with your hip pain and chest issues to boot! I hope it all settles down soon and good luck with your appointment in January.
Wishing you a Merry Christmas and a Happy New Year.
 

Josephine

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Oh dear, poor Angela. Never rains but it pours, eh? Well I certainly do hope you get some answers. Though you should have a look at this article first as there are a lot more questions you need to consider before you decide on the final list! How to choose a surgeon and a prosthesis
 
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Racewalker45

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Thank you both! Josephine, the article you linked was one of the first ones I read and will definitely print it out and bring it to my visit with the OS. The first 3 questions I listed were a start. I got alot of information from his surgical PA (he has 2 PAs, one for his medical cases and one for his surgical cases) a couple of weeks ago on how long he as been doing joint replacements and the proportion of hip/versus knees he does, so I am at least comfortable with his volume.

I need to get a feel for whether he recommends PKR/TKR for me first before I dig deeper with questions regarding his implant of choice, complication rates, etc. At this point, I have no idea what he will say when he sees my most recent films and Knee MRI. He is in the largest orthopedics practice in the state of GA, that has several dedicated orthopedic sugery centers around the state. It's amazing how much baseline information you can get from a practice website and even from my insurance company.

Anyway, I am flying home to Bermuda this week to hopefully have a stress free Christmas with family and friends. Have a Merry Christmas and Happy New Year!

Regards,
 

sheryl7

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Hi Angela, I hope all goes well in January. I hope you feel better soon.
Have a good trip to Bermuda.
What part of Georgia do you live in. I live in Walton County, out towards Athens.
Happy Holidays:xmasclap:
 

Josephine

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hmm, be careful about the PKRs. They tend to have an unacceptably high rate of early conversion. An awful lot of surgeons are abandoning them for that reason. As a matter of fact, I have been keeping a record of members here who have had to undergo conversion and I have a list of nine names this year alone. At least, if he is thinking of a partial for you, make sure he is in a position to abandon it and do a total if the need arises when he gets in there. Often the true state of the joint isn't really revealed until one 'eyeballs' it. Having said that, my sil had a partial done about 5 years ago and is still very happy with it. Not so happy that her other knee required a total earlier this year! :snork:
 
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Racewalker45

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Excellent point Josephine! I am not sure whether I qualify for a partial, but your point about being able to abandon it for a total once "inside" makes sense.
 
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Racewalker45

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Hi Angela, I hope all goes well in January. I hope you feel better soon.
Have a good trip to Bermuda.
What part of Georgia do you live in. I live in Walton County, out towards Athens.
Happy Holidays:xmasclap:
Thanks Sheryl,

I live in Sandy Springs (North Fulton County)
 

sheryl7

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I'm am a little familiar with that area, my son has a doctor there, we go to. Nice area:thumb:
 

Bumpa

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Ten-year survival of cemented total knee replacement in patients aged less than 55 years
A. C. M. Keenan, A. M. Wood, C. A. Arthur, P. J. Jenkins, I. J. Brenkel, and P. J. Walmsley
J Bone Joint Surg (British) July 2012 94-B:928-931.
Abstract
We report the ten-year survival of a cemented total knee replacement (TKR) in patients aged <55 years at the time of surgery, and compare the functional outcome with that of patients aged >55 years. The data were collected prospectively and analysed using Kaplan-Meier survival statistics, with revision for any reason, or death, as the endpoint. A total of 203 patients aged <55 years were identified. Four had moved out of the area and were excluded, leaving a total of 221 TKRs in 199 patients for analysis (101 men and 98 women, mean age 50.6 years). Four patients required revision and four died.

The ten-year survival using revision as the endpoint was 98.2% (95% ). Based on the Oxford knee scores at five and ten years, the rate of dissatisfaction was 18% to 21%. This was no worse in the patients aged <55 years than in patients aged >55 years.

These results demonstrate that the cemented PFC Sigma knee has an excellent survival rate in patients aged <55 ten years post-operatively, with clinical outcomes similar to those of an older group.

We conclude that TKR should not be withheld from patients on the basis of age.
 
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