Total Knee needed - age 52 - recovery and activity questions

[paradiddle]

I just got back from OS. He says I need TKR as I am bone on bone after viewing x-ray with no gap on one side. I'm not in great pain but I knew something was wrong. I have been trying to workout harder and it has become difficult. I only feel good on a bicycle.

I tore my ACL in 90 playing b-ball but did not get reconstruct - only meniscus repair at the time. Tore meniscus again and did another scope in 93. It's been ok until past year or 2.

I am thinking of putting this off until I can't stand it. Do the Aleve/Celebrex thing. I have had 2 surgeries this past year. (Neck and carpal tunnel). Haven't worked since April.

I can do some activity ok. Shoot some hoops in the yard. Walk the dog with minor pain. I'm just 70 lbs overweight from when I first tore up knee and that is what is making things difficult. I think with weight loss I could go on with no surgery for awhile. TKR sounds ok, I have the insurance and time to do it as I am not working. (I'm 5 months post op from 3 level acdf neck fusion surgery in july - I guess I'm falling apart).

I am concerned that TKR will not last that long as I am a big guy. (6 ft 295lb)
and that I may be dissappointed in results as I am not too bad right now.

Doc said if I wait I could wear the bone on one side and make it harder to realign (bowlegged). That sounds like the only need to do soon because the pain ain't that bad. I am going to get a 2nd op anyway. The doc I went to is top notch with a big firm. He has a great resume. Concentrates on knee, has done TKR, UKA ,meniscal transplantation, autogenous cartilage transplantation etc. ( he said UKA would have been good if I had a good ACL - so TKR is my only real option.

Just looking for some thoughts....I'll be 53 in March and soon to be first time DAD - I am a very young 52..... ( I hope )

 

[referee54]

I just had a double knee replacement in November. I am 53. I played college football, ( a long time ago and in a galaxy far, far a way, and I, too, tore my ACL after college while I was officiating and never had it repaired. THen the fun began. I reffed college basketball for 17 years, and I have umped HS and college baseball for what will be 35 years. I also reffed HS football, as well.

To make a long story short, I burned up my knees: I tried the SynVisc; I tried the Cortizone (yeah, I did it backwards) and I knew what had to be done. I am now driving and walking and rehabbing---I will be umping again this spring.

I had trouble sleeping due to the pain, and I too was becoming bowlegged. Remember, When you become bowlegged, the muscles have to re-allign themselves becasue your leg gets straightened out ( a tad bit more pain there) so the more bowlegged you are,well, you get the picture.

You say your are "just 70 pounds overweight." Lose the weight---as much of it as you can! When you run or jog, 3 TIMES YOUR BODY WEIGHT IS DELIVERED TO YOUR HIPS KNEES, AND ANKLES! Also, please think of your cardio-vascular system. Both your knees and your heart will thank you for the weight loss.

I cannot tell you when to have it done; only you will now when it is "time." I wanted my life back; I was tied fo the shots, the limping, the twinges, the burning pain at night, etc.---and I am glad that i had it done. (I had mine done at the Cleveland Clinic.) If you are concerned about the results, talk to your MD about your wieght and activity level---and let him help you out with the decision.

I won't kid you you having a TKR isn't fun---I wasn't in any pain afte surgery, but the PT can be a butt-kicker. Your recovery and rehab is not measured in days, but rather weeks and months. I used to jog to get in shape; now I ride a bike during the summer and an exercise bike in the winter---lifestyle changes will be important.

It is up to you; I knew both had to be done and I just said "do it." Only you and your body will be able to tell you when "enough is enough." Best of luck to you.

Tim C.

 

[Josephine]

Can't add much to that - Ref's showing up as more of an expert that I am!!

Joking aside, he said everything I would have said. However, I would emphasise what he said about the weight issue. By my reckoning your Body Mass Index is 40 - 20-25 is generally considered a normal average though it would be unrealistic to make that a target right now! But any weight you can shed would be good. On the plus side, just before I retired last year, I looked after a lovely lady of 72 who had her knee done and she weighed in at 450lbs which gave her a BMI of 72!! However, remarkably she did wonderfully well and became active enough to embark on a fitness programme!

 

[paradiddle]

Thanks for responses - I know my weight is the #1 issue. I can handle the knee for now. I'm not visually bowlegged but I see where this will lead.

Through good family genes I don't have high blood pressure or high cholesterol which has given me an excuse not to watch my weight or activity. When I was playing B-ball at the Y I was at the top of my shape!
210#, 136 cholesterol , low blood sugar.....

B-ball was such a good activity for me as I didn't have to think about exercise. I just did it. But then I got hurt in 1990.

In 94 I got involved in a marching drum & bugle corps and that was good activity. Since 2000 I had a desk job, no marching, got married (no more gym to keep looking good !). The pants sizes kept going up and I maxed out my digital scale this year. (300#).

I live in Fla. so I have no excuses. It's a beautiful day today and I bought a new bicycle 2 months ago. I do find biking so much easier than walking the dog. Easier in the fact that once I am on it I can just ride and ride......

I guess I have to give up the idea of playing b-ball - even though I still like to shoot hoops in the driveway.

Thanks for the support.....any thoughts on when I should do this? Like I said I am not in distress at this time....

 

[referee54]

I can't tell you when to do it---as everybody told me, "You will know when the time is right." I will tell you though, that almost everybody that has had it done wished that they had had it done earlier! Only you---you know your body---can tell when you are ready for it.

Cycle---do whatever it takes to lose the weight---your knees, ankles, and hips will thanks you for it! (Not to mention your heart!) Also, When you do have the TKR done, you want to be carrying around a little extra weight as possible. Trust me on that...

i didn't think I was bowlegged until the MD showed me the X-rays---and then after surgery I felt it. The muscles that had been worked had to be reworked a different way.

Best of luck to you---I am off to PT right now.

Tim C.

 

[Doug]

I'm right there with you. I'm 55 and have torn my knee up through a lifetime of contact sports. Football, judo, karate, powerlifting. When my knee really started hurting I had to cut back on aerobic types of working out which has resulted in a big time weight gain. Taking it off isn't as easy as it used to be.
I also have the same "risk factors" as you. High everything though controlled.
I'm getting mine replaced on Jan 17 and am getting more than just a little jittery about it.
Best of luck with yours. Glad I found this site about 15 mins. ago.

 

[Josephine]

Hey Doug! Welcome to the forum! Lucky find, huh!

I shall be thinking of you on the 17th, promise! Just keep thinking of the future and how free you'll be!

 

[referee54]

I'd like to tell you it is a piece of cake, but it is not. However, if you do your therapy religiously and follow what the MD's and the PT's tell you to do, you will be much better than before. Remember, your body did not get like this overnight---and itwill not be an "overnight" mend. I am just a day over 7 weeks post-op and my quads still stiffen up and get sore---but I am improving everyday. Measure your success in increments--tiny ones---and you will feel much, much better.

I had both knees done and I am glad that I went through with the procedures!

Best of luck, and keep in touch,

Tim C.

 

[paradiddle]

Great responses.... I have been giving it some thought and I'm going to hold off for awhile and concentrate on weight loss - bicycle - being active stuff.

Even though the x-ray don't look good I am still functioning fairly well with mininal/no pain. I am just coming out of serious neck/disc surgery. In my 5th month from that and I don't need another 3-6 months off. If I was in agony I would do it. If I had an ACL I would do that Partial knee (UKA) but I don't have an ACL.

Like it's been said I'll know the time when it comes. If I don't make an effort to remove weight now then when this does come down to surgery I'll be in even worse shape.

 

[Josephine]

Good call, para! I hope your new year will be a positive new beginning with a great outcome!