When is the right time for knee replacement?

[Cat_Girl]

Hi everyone,
I’m new to this forum and this is my first post. I’m a 51yo nurse and am scheduled to have a left TKR in 3 weeks. My history is:
2010 micro fracture surgery
2011 medial unicap
2017 lateral menisectomy & plica removal
2017 medial menisectomy
Since my last surgery my pain has never gone away. I have stage 3 Chondromalacia and more areas of cartilage breakdown on the medial side. I’ve seen several surgeons who told me that my arthritis isn’t bad enough and I should wait about 5 to 10 years. I finally found a very reputable OS who felt that a TKR would help me and was certainly justified. I’m very frustrated and confused about what to do. I’m scared to have major surgery and I’ve read some of the posts on here of surgeries that didn’t go well or chronic pain. I have tried so many things to make my knee better but nothing helps. It has continued to get worse and now my right knee is bothering me. Should I just live with this pain until I am bone on bone? One dr said that maybe I don’t handle pain well or in order to appreciate heaven I need to experience hell first! All I know is that for the past 2 years I have had very little quality of life and I have been severely depressed. I really wish that I could just suck it up and deal with it but I’m just not capable. I know that my knee will just continue to get worse. Has anyone else ever had a surgeon tell you that your arthritis isn’t bad enough for surgery or that you are too young? If so, did you eventually find a surgeon to do your surgery and did it help? Any advice or words of wisdom would be greatly appreciated. Thank you.

 

[Jamie]

@FloridaRN ... please see the Personal Message I just sent you. It's in your INBOX (link at the top of the page).

 

[Jamie]

One dr said that maybe I don’t handle pain well or in order to appreciate heaven I need to experience hell first!

Well, that's a compassionate attitude....not! I think you were wise to run from that surgeon.

Has anyone else ever had a surgeon tell you that your arthritis isn’t bad enough for surgery or that you are too young?

First of all, you are not too young. You're right in the prime age of patients we see here on BoneSmart. People in their 50's and even younger are figuring out that age is not the factor that determines whether you should have your knee replaced or not. You may be only 51, but your knee can be in it's 70's. The real factor is how your knee pain is impacting your life. And it sounds like it is making you miserable. Why in the world would anyone suggest you should just live that way when it can be fixed? Today's knee replacements can be expected to last 20 years or more. Frankly, we don't know how long they will last because not enough time has passed to measure the longevity with all the recent advances in implants and surgical techniques.

We actually see a fair number of BoneSmarties who've had doctors tell them their knee doesn't look that bad on the images. But the xrays are just one diagnostic tool. They are not the whole world. In fact, some people actually have knees that look like absolute trash on their xray and yet they report very little pain. It's a very individual thing. So, if you are in pain and want to get your life back, then I think you should consider going ahead with the knee replacement with the surgeon who understood your situation. Here is some additional information for you to consider as you make your decision.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?


If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries

 

[Jamie]

One other thing to remember when reading posts here on BoneSmart is that we're more likely to get members who are experiencing some type of problem. Over 600,000 knee replacements are done every year in the USA. Most people who have them do just fine and never think of searching out a forum like BoneSmart. They just have their surgery, go through recovery and return to their life. So please don't focus too hard on the number of people you see here with problems. It's not a fair representation of the overall knee population.

 

[Celle]

Hi @FloridaRN,

You'll see that I've moved your thread from the Social Room to the Knee Replacement Pre-Op Area, because that's where we talk about pre-surgery knees.

Please will you tell us the full date of your planned left TKR, and I'll add that date to your signature. Thank you.

There are some surgeons who still tell their patients that they're "too young" for a knee replacement, but their opinion seems to be based on the idea that a replacement will only last about 10 years.
Nowadays, a TKR can last for 30+ years, so the possibility of needing a revisions has decreased.

A surgeon should look at the state of your knee and that impact that has on your quality of life before he looks at your date of birth.

These are the only ways in which you are "too young":

• You are too young to be living your life in constant pain.
• You are too young to have your mobility so badly compromised.
• You are too young to be giving up the lifestyle you enjoy.
• You are too young feel so old.

 

[rosieNZ]

You have had frequent surgical interventions with a deteriorating quality of life. Personally I think if you have a reputable and skilled surgeon prepared to operate then seize your opportunity.
Bone on bone damage and pain is something to avoid. Its horrible. I pretty much ended up with a very limited life.

I used to think maybe I didn't need the surgery even though I was so limited by pain and disability. Crazy eh! I think because our joints are removed it feels so final. There's no going back nor would you want to return to pain and disability.
If you live longer than your new knee be assured that by the time thats required surgical advances will have changed and improved from where we are now (and that's already fantastic anyway). I don't think repeat TKR are the challenge they used to be.

 

[luvcats]

We're the same age and I'm 7 weeks out from my first TKR and heading in to the second. So, not too young. No, it's not ideal, but if I think about how much surgery has changed and improved in the last 20 years, even if my new implant only lasts 20 years, they may have a much better solution when I get there.

If you are miserable and in constant pain, then it's time. I was told at first I was too young and too fat and I wound up having to go on tramadol just so I could keep my life going. Find someone who understands you need your life back.

 

[kneeper]

I had my first tkr in my 40s after living with arthritis and increasing pain and disability for years. Then on top of that my meniscus blew so I was referred to an orthopedic surgeon.
My OS said "ordinarily we like to wait until patients are older but..." basically only a knee replacement will fix what's wrong. No point in trying to deal with the meniscus with all the other damage in there. I could have hugged him. Finally something they could do.
He was up front that I "might" need a revision at some point but that tkrs are lasting 20 or more years these days.

So no one wants to rush into this surgery, but when you need it you need it.

8 years and going strong on knee #1 for me.

Like others have said, most people have a "boring" recovery. What's great about this forum is you can check in on all those little "is this normal?" questions and for support for those having more challenges.

 

[Cat_Girl]

Wow!!! Thank you so much to everyone for all the encouraging words. I personally have made up my mind that I am moving forward with my surgery on September 11th but unfortunately I’m not getting a lot of great support from the people closest to me like my mom and my sister and my boyfriend. I think the fact that several surgeons that I saw had said I was too young or my arthritis wasn’t bad enough has them convinced that I shouldn’t have the surgery. Even though I have had 2 surgeons say yes and one of them has an excellent reputation and is very well respected and experienced. They also keep telling me that maybe if I just got on some new “meds” then I could deal with the situation better. By meds they are referring to antidepressants and/or anti anxiety meds. I have suffered with depression and anxiety most of my life and this knee problem has literally pushed me over the edge. I think that a change in meds might be helpful but that is not going to take away my pain. Today for the first time ever I had a very sharp pain under my kneecap in my good knee. I know it’s just a matter of time before my right knee is going to need a scope and it wouldn’t surprise me in the least if I have similar problems in that knee. I’m sure because I’ve been walking “abnormally” for the past 2 years and favoring my bad knee that I have most likely accelerated the arthritis in my good knee. Just out of curiosity, does anyone know what the standard length of time is that you have to wait before getting the other knee done. Also when I post a reply in this forum does it automatically go to everyone that has sent me a message? Thanks again!

 

[Celle]

I personally have made up my mind that I am moving forward with my surgery on September 11th but unfortunately I’m not getting a lot of great support from the people closest to me like my mom and my sister and my boyfriend. I think the fact that several surgeons that I saw had said I was too young or my arthritis wasn’t bad enough has them convinced that I shouldn’t have the surgery. Even though I have had 2 surgeons say yes and one of them has an excellent reputation and is very well respected and experienced.

Tell them it's your knee and your decision. You are in charge of what happens to your knee, not your Mom and not your boyfriend. Neither of them knows what your knee feels like and how that is affecting your quality of life.

We've had people here on BoneSmart who have had a knee replacement in their forties and even in their thirties and that replacement has improved their quality of life no end. THe surgeons who say you're too young are still of the old-fashioned mind-set that a TKR will only last for about 10 years. Nowadays that's not so and a TKR can potentially last for 30+ years.

So why wait now and continue to suffer increasing pain and disability?

I know from bitter experience that waiting until you are "old enough" is a very bad idea. I was told I was "too young" and I waited for eleven pain-filled years, during which time I became more and more disabled, until I was almost house-bound. My first knee replacement gave me back the life I wanted and, once it was healed, I was able to travel the world.

Also when I post a reply in this forum does it automatically go to everyone that has sent me a message? Thanks again!

The people who have responded to you will probably be reading your thread anyway, because they'll want to know how you're getting on.

If you want to address one particular person, you can tag them, by putting the @ sign in front of their username. Make sure you don't leave a gap between the @ sign and the name, but do leave a gap after the name - like this: @Celle .

This article may help, too:
How to tag another member; how to answer when someone tags you
Other helpful articles are also in this area:
How To Use This Forum

 

[InkedMarie]

Welcome! You are not too young. I was 57 just about a year ago when I had my TKR and I had two THR ‘s prior to that.

Knee not “bad enough”....if your surgeon says it’s replaceable, it is. My other knee has some arthritis under the kneecap and I don’t have much pain. Barely any. But....it’s been my “bad knee” since I was 14. It dislocated very badly at that time and I’ve had dislocations since. Going downhill/incline is scary for me. According to my surgeon, instability IS a reason to replace. Phew!

Regarding your family: explain that this IS going to happen and you need their support. This is major surgery and everyone has a different recovery. You will need many weeks of icing, elevating and recovering.

Good luck!

 

[luvcats]

Just out of curiosity, does anyone know what the standard length of time is that you have to wait before getting the other knee done.

I don't think there is a standard. I wanted to get mine done as soon as possible, so my surgeries are scheduled 8 weeks apart, but I can think of at least one person around here to had her second done in about 3 weeks? That's between you and your surgeons.

Changing your meds is not going to fix your pain, and frankly your pain might be exacerbating your issues, rather than the other way around. Pain makes everything a little harder to deal with. If you have had two reputable surgeons tell you it's time, then the choice is up to you, not anyone else.

I'm only 7 weeks into healing so my new knee is still whiny and needs a lot of extra attention, but the surgery has already improved my life. I can't wait to have my 2nd knee done.

 

[Tykey]

Hi Cat Girl. The full recovery from a TKR can be extended, and maybe a bit difficult for a day or two, but don't think of the operation being "major" surgery.
For me, it just involved 15 mins of preparation as they administered the local anaesthetic, then they wheeled me through the door, and 30 minutes later I woke up feeling great in recovery asking for a cup of tea. No issue. So don't worry about that part of it.
Just 12 sleeps until my second TKR, and I have absolutely no doubt it's the right thing to do.
I've tried physio - made no difference
Injections were suggested, but we all knew that any improvement would be temporary - rejected.
A clean out by arthroscopy was suggested, but x rays showed my medial cartilage had disappeared, and I'd be bone on bone by Xmas.
Nobody else has the discomfort, nobody else's life is restricted.
My choice. Nobody else's

 

[InkedMarie]

I definitely disagree with Tykey. I had an easy recovery but TKR IS major surgery.

 

[Cat_Girl]

Thank you so much to everyone that has responded to my post. I agree that everyone has their own individual and personal experience with recovery but I am actually not afraid at all. It’s really crazy to me that I am looking forward to having a major surgery in less than 3 weeks. I think that’s because I finally feel like I have some hope and I’m starting to see a light at the end of the tunnel!

 

[Cat_Girl]

I’m also really trying to not focus on my good knee so much right now. I want my bad knee (left knee) to get better first. But I really think it’s inevitable that my good knee (right knee) is going to need to at the very least be scoped in the very near future. I’m also very sad right now because I feel like certain people have abandoned me in my time of need. I think it’s a combination of them either not agreeing with my decision to have the surgery or their frustration with my negativity and depression that I have suffered for the past 2 years. Either way I know that with Gods help, my perseverance and my small network of people that support my decision I will get through this. I am more determined than I ever have been that I want my life back!!!

 

[newlybionic]

It’s good that you have a OS that is willing to do replacement surgery. When I was 50 I was told I had to wait until I was 60 to have the surgery. Those 10 years were the worse 10 years of my life. You’ll be able to enjoy life again. You have all of us in your corner.

 

[kneeper]

It’s really crazy to me that I am looking forward to having a major surgery in less than 3 weeks. I think that’s because I finally feel like I have some hope and I’m starting to see a light at the end of the tunnel!

I can relate. I had to wait quite a while for my first tkr (due to work schedule) and I was counting down like I was waiting for Christmas! Nervous, sure, but excited.
A few months into my recovery and for sure by a year I realized I felt like a weight had been lifted off me. I hadn't even realized the extent that the pain and instability etc. had been dragging on me.

I think you're right. Different meds may help in other ways, (and just where your friends and family got their medical degrees is unclear ) but a shot knee is a shot knee.

 

[Cat_Girl]

Thank you for your support. Your comment about where my friends and family got their medical degree made me laugh and to be honest I haven’t been able to laugh in quite a while.....so thank you! And may God bless you for your commitment to this forum and for your responses to my posts as well as many other I’m sure. You’re dedication and passion is duly noted!!!

 

[Jajakio]

Opinions are cheap, true knowledge is expensive. I had my first knee replacement 2 years ago and like many of us I got a lot of opinions and free advice. This is a difficult decision to make and only you know how bad you hurt. If you choose surgery, it won't stop there. Family, friends and slight acquaintances will tell you aren't healing fast enough, exercising enough, pushing yourself enough, etc, etc. You just have to own it and not expect much from others. It is major surgery. It is going to be painful for a while. It is going to be a slower recovery than you expect. But for many of us, in the end, it was the only viable choice. I have my life back. Also in my case, my other knee was hurting to the point I was trying to talk my surgeon into doing both at once. He would not and told me the other might well feel better once I got my worst one replaced. I didn't believe him but he was right. The second knee straightened right up and I've had 2 good years although the second one will needed doing someday. So go ahead and get the second knee checked but you may or may not find the replacement helps the non operated knee to function better when you aren't depending on it to compensate. Once you commit and have the surgery you may find family steps up to help more than you expect.