Whats involved

[digrazio]

Hi all, New to this forum.

I'm looking for a bit of advice. Im 33 years of age & Live un UK. I've been told I require a partial knee replacement or an arthroplasty, doc said it is my choice...how nice of him..what a joke. I'm also appearentley too young & to last as long as I can...well I wouldn't be going to see him for the hell of it! I'm in constant pain & not active at all. Its difficult to get info from doctors almost as if they dont want to tell you due to costs etc. Is there much difference between the proceedures partial knee replacement and what is the likel recovery time do you have to register as being disabled etc..just worried as I have 3 key hole ops which trimmed my cartlidge then I was told I had a scuffed bone & now this!

I have private health care but have to prove that my original 3 cartlidge ops are not the cause of this bone defect in my knee or god knows how long I have to wait on the NHS as this has been going on for over 2 & a half years.

Please help!

 

[beachcomber]

In a partial replacement they replace only the damaged part of your knee and you get to keep the healthy parts. I had a medial PKR in December due to severe osteoarthritis in only the medial compartment of my knee. The other compartments and all ligaments were sound. The advantage is shorter surgery and hospital stay, less anesthesia, less blood loss, and that most people recover full use of their knee more quickly than with a TKR and have all the advantages of their own natural knee. My OS told me to expect to need a revision to a TKR in 9-10 years, depending on the progression of the arthritis. At my age, 51, I will someday need a replacement anyway and he felt the revision from PKR to TKR was the best decision for me. I am very satisfied with my partial new knee. It is now my "good" knee. Recovery was not easy and I worked hard at it, but the outcome has been very good.

I would suggest you "Google" partial knee replacement and/or visit the BoneSmart information sections to learn more about the technical aspects of the surgery and results--- but be aware that they make the recovery sound easier than I found it to be.

I cannot speak to your health system in the UK, but Josephine, our moderator is a retired orthopedic surgery nurse and can advise you best. I can only say that as a PKR recipient--- I am sure it was the right decision for me and I am hoping that the OA in my other knee stays where it is in the medial compartment because I would choose to go that route again when the time comes.

Good luck with your search and decision.

 

[Josephine]

Im 33 years of age & Live un UK. I've been told I require a partial knee replacement or an arthroplasty, doc said it is my choice...how nice of him..what a joke. I'm also appearentley too young & to last as long as I can...well I wouldn't be going to see him for the hell of it! I'm in constant pain & not active at all. Its difficult to get info from doctors almost as if they dont want to tell you due to costs etc.

Hi, digrazio, - I'm in the UK as well. So I can address a lot of your questions and the first is, I'm sorry to have to say, many surgeons will still say you are too young for a knee replacement. But, the partial replacement may be a reasonable option provided the condition of your knee is appropriate.

Is there much difference between the procedures partial knee replacement

The difference between the two procedures is this

...............................1. partial .......................................2. total
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​

In order to be suitable for a partial, the damage needs to be confined to the one compartment.

There are three compartments in a knee, the medial where the implant is in fig 1, the lateral, where the implant isn't! and the patellar compartment which is between the knee cap and the femur.

If even one other compartment has a poor condition such that a revision will be required before 8-10 years has elapsed, then most surgeons would be very unlikely to consider it.

what is the likely recovery time

Recovery time is somewhat less with a pkr but can still be tedious.

do you have to register as being disabled etc..

Do you mean after the op? Certainly not! The whole objective is getting the patient back to as near a normal life as possible. Only a few weeks ago I saw a man for a routine works medical in a factory and he walked in spry as anything. When I examined the questionnaire he had filled in, he'd had a total knee only 18 months before! He was back riding his bike, going to the gym and walking his dogs, not to mention holding down a full time job in a factory that makes trucks! In fact, he'd almost forgotten all about it. He was 53.

I have private health care but have to prove that my original 3 cartlidge ops are not the cause of this bone defect in my knee or god knows how long I have to wait on the NHS as this has been going on for over 2 & a half years.

Please help!

Yes, doctors can put on their white coats and go all superior on us at times! That's where a forum like this is a valuable resource because you can get answers to most questions.

As far as proving that the previous surgeries (arthroscopic menisectomies, I presume?) were not the cause of your present condition, that could be tough. They may not have caused it as such but they will certainly have contributed to it. Any intrusion into the joint will set up or even exacerbate the degenerative condition we know as arthritis. One follows the other as surely as dawn follows the night.

But, the good news is that things have changed a lot in the NHS these days. There are caps on how long a patient must wait. First you must be seen by the specialist within 8 weeks of the date on your GP's referral letter and then you must be offered an admission date not more than 6 months after being seen by the specialist and having your name put on the waiting list. Many people get a date after only 3-4 months. There are no 2 year waiting lists now.

Would you like to tell me the name of the hospital you are considering going to, and/or where you live? I can advise you about choice of surgeon hospital if you like.

 

[digrazio]

Thanks for getting back to me everyone. I Live in the glasgow area, my local hospital is Monklands & the private hospital is the Nuffield.

I must admit I do have a high pain tolerance, but I just can't do much without my leg aching, Surely no matter what age you are, if it needs done ...it needs done? I must admit I am finding the whole process really slow and every Doctor I speak to all say " oh your too young to be going through this" But what options do I have? Its geting to the stage where i'm having to think about buying a walking stick to try to take some of the pressure off my knee.

Any advice or people to see would be much appreciated!

once again thanks for all your useful info.

 

[Josephine]

I am unfamiliar with Glasgow's hospitals but I found a site where they are listed as using computer aided joint replacement, so my guess is that there are committed joint replacement surgeons there. However, whether one of them will be prepared to consider you as a patient is another thing.

The other place I would recommend is in Edinburgh. I would recommend that if you could make the trip - it's only about an hour's drive from what I can see. If you strike out there, you could always try Newcastle Nuffield Hospital where I could strongly recommend Mr Shaun O'Brien. I know him personally and worked with him for many years. He is, in fact, looking after me with my knee!