In need of two TKR at 45

HERO

new member
Joined
May 1, 2019
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2
Age
50
Country
Canada Canada
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Hi to all,

I am 45. I have met with 3 surgeons up to now and they all tell me the same:

My condition is like a 80 year old person, bone on bone stage 4 OA;
I am 5'6" and 250 pounds now;
I used to walk a lot and ride a motocross;

I am told that due to my weight and age, we could do the TKR but they will last 10-15 years. Then they may not be able to replace them. So what happens to me then??

I am suggested to stay as is. I am in pain all the time. Trying to avoid opiods but not many regular meds can relieve me. Will stand for max 2 minutes and walk 25m max. Been declared handicapped. I cant go in my office anymore and have to work from home. I am even looking into buying a wheelchair as i cant do what i like anymore and i am very isolated (walk, see friends, camping...too hard to stand). This is destroying my life.

I would like to hear from cases like mine and what you decided to do.

Thank you,

Helene.
 
Hi Hero - i am 48 and have been told i need a knee replacement. I injured my knee when i was in my 20's and ruptured my ACL which was repaired. Roll on 20 years and a few ops later and now my knee is not in a great state. I have been been active running/ surfing/ mountain climbing etc but over the last couple of years has been getting worse and worse.
My surgeon has suggested a patella -femoral - they have had bad press but the national joint registry 2018 (England) did show better results for some makes of implants - so am going for that for now as fits with the issue with my knee.. but have resigned myself that i will probably need a revision at some point in the future. But there are lots of people on this site in their 40's who have had really successful TKR.
I am sure many will provide you with advise but for me i could not continue with activities being limited by pain, and always thinking of my knee all the time so went for a surgical option after trying everything else - booked in for the 4th June.

I am sure there will be a OS who is more sympathetic to you that the one you have seen.
Good luck.
 
@HERO ,
Welcome to BoneSmart, glad you joined us!

We have members in their twenties having knee replacements, it is not your age it is how you limited you are leading your life.
You weight is no obstacle, again it is how limited your are leading your life. Here are two articles over turning commons assumptions about weight.
TKR in Morbidly Obese - Study Overturns Common Assumptions
Weight Issues and Joint Replacement Surgery

Recent studies show most TKR's are still in place and doing well at 25 years.
I am told that due to my weight and age, we could do the TKR but they will last 10-15 years. Then they may not be able to replace them. So what happens to me then??
This sounds like a scare tactic to influence your decision, you may want to locate a different surgeon more sympathetic to you and your quality of life.

In the articles below you will find a score chart, fill it out, print a copy and take it with you to your doctor appointments, so both you and the Dr can see just how limited your life as become.

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?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

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
 
My surgeon has suggested a patella -femoral - they have had bad press but the national joint registry 2018 (England) did show better results for some makes of implants - so am going for that for now as fits with the issue with my knee..
We tell people all the time here that it's not the make of the implant but the skill of the surgeon that is the biggest factor in having a successful knee replacement.

Make sure that you have a surgeon who has a good track record of success with patellofemoral implants before you have this surgery.
 
My condition is like a 80 year old person, bone on bone stage 4 OA;
I am 5'6" and 250 pounds now;
I used to walk a lot and ride a motocross;

I am told that due to my weight and age, we could do the TKR but they will last 10-15 years. Then they may not be able to replace them. So what happens to me then??
While your TKR may only last 10-15 years, it could also last for over 25 years, as many do.

It's not true that they won't be able to replace your first TKR. Any competent surgeon who specializes in doing revisions would be able to do one.

MY first knee replacement was a partial (PKR) It lasted for 11 years. My surgeon had no problems at all in revising it to a TKR, which is now 7 years old and works beautifully.

I am suggested to stay as is. I am in pain all the time. Trying to avoid opiods but not many regular meds can relieve me. Will stand for max 2 minutes and walk 25m max. Been declared handicapped. I cant go in my office anymore and have to work from home. I am even looking into buying a wheelchair as i cant do what i like anymore and i am very isolated (walk, see friends, camping...too hard to stand). This is destroying my life.
Suggesting you stay as you are is cruel. Don't even think of it.
Your quality of life is already severely diminished and if you don't have a knee replacement, it will get worse still.

There are no pain medications that will relieve the pain of bone on bone osteoarthritis in the long term, so your pain will increase as your mobility decreases and your life shrinks.

I suspect that it's not just your weight but also your age that has made these surgeons disinclined to help you. Of course it might help if you could lose some weight, but I know how hard that is when your mobility is compromised.

The idea that you are "too young" for a knee replacement is old-fashioned. It came from the incorrect idea that replacements would only last for 10-15 years. Now we know that they can last much longer (even 30+ years) , there's no need to wait until you reach a certain age.

Look for another surgeon, one who will look at the state of your knees before he/she looks at your birth date and your weight.
The only ways in which you are too young for a TKR are these:
  • 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.
 
I had surgeons tell me I was "too young" for a while. I told them I was too young to have to wait until 60 to be able to be comfortable and physically active again! I just had my left TKR last Nov at 45. I was thankfully referred to this physician by esteemed spine surgeon, who knew I would be in the right hands and not get anymore run around nonsense.

I see you're in Canada, perhaps there are some young Canadians here that can steer you in the direction of a doctor who is more sensible?
 
I had my first tkr in my 40s. My OS told me that usually they don't like to do tkrs in someone so young because you might need a revision at some point. He also said that tkrs are looking to last at least 20 years these days and bottom line was I needed it. I was so relieved that something could be done.

For me the difference post surgery was amazing--from hobbling around, clinging to the grocery cart for dear life etc. to being able to do daily life activities without thinking twice.

Hopefully you can find a surgeon who is more encouraging.

Some weight loss could take some pressure off the knees but when your knees are that bad weight loss alone isn't going to do the trick. And I well know how hard it is, particularly when you can't be active.
 
Messages received! I will get other opinions . A life like this in my state is almost unbearable.

My weight is hard to control as i cant move much, i am going through something very hard so i eat to compensate and...i have suffered bulimia/anorexia years ago so for me loosing weight is a trigger.

If there are any canadians or americans that can give me info , i am willing to travel to meet better surgeons.

Thank you for your answers.

Helene
 
Best wishes as you seek a doctor to help you. :console2:

There are many surgeons out there and I’m continually amazed at how different their opinions are. Persevere to find one that will help you.
 
I am similar to you in needing both knees replaced in my mid-40's due to lots of sports in my teens and 20's, plus some really bad genetics. My right knee has been bone on bone since I was 43, and my left knee declined severely last year in <5 months to where it's <this> close. Surgery prolonged things for a couple more years, but it's only a bandaid and hasn't done much to help the pain. My surgeon said not to let it go much more than a year or two.

I also was given the runaround and told I was too young. It was total scare tactics!!!! I was told the implants would loosen in 5 yrs and needed replaced in 10 yrs. Little did I know I was being told old information by a sports surgeon who just wanted to keep doing fancy cartilage repair surgeries on my knees---most of which failed because I was too old for them to have a chance at success.:tantrum:

I finally got a referral to a surgeon who does only knee and hip replacements, and is well respected in our large metropolitan area and from afar. He takes on everyone 45 yrs and older, and some younger if their case is severe enough. He agrees there's nothing else that can be done, and no one should be forced to wait 5-10 yrs in misery when knee replacements can last 20-25+ yrs for most people.

Best of luck in finding a Dr to listen to your knees and not your age.
 
I’m 44 and have had both knees replaced in the past 8-9 months. The new knees aren’t great, yet. I’m going to give them a year to achieve greatness. However, they are sooooooo much better than my old knees. I’m glad I did them both.
 
Howdy,

Some great advice here. I am in my 50's and have needed new needs since early 40's... At that time they said I was too young and I have held on as long as I can. Roll forward 10 years and so much has changed in the joint replacement field. As I understand it from my surgeon the TKR are 'modular' and the bits that wear can be replaced later without the need for a full TKR.

AS for your weight, been there done that... I had a gastric sleeve back in 2013 and it was the best thing I could have done not only for my knees but my overall health. I nearly ( I said nearly) feel guilty how easy the weight fell off after it, no exercise, no hunger.... I went from 120kgs to 88kgs (at my lowest) and settled around 92kgs. The hardest part to be honest was the mental side having such a small portion and feeling full !

It gave me another 5+ years before I have really needed to have my knees done, I am happy with the result.

BTW, love motorcross, I think I learnt to ride before I could walk !

Good luck.
 
All of these replies are right on! I concur! Don’t wait another second... go get it done and regain control of your life back! You only live once.... don’t waste this precious time in pain and suffering!
Good luck! You can do it!
 
I am 48 and just had my right knee replaced. My OS did a cementless implant and said it would possibly be good for 20 or even 30 years. I want to try to take off some weight to up the odds that it will last as long as possible. There are plenty of doctors that will replace your knees. Hope that helps!
 
Hello! I'm a fellow Canadian who is going to undergo knee replacements in both knees, this year: R knee in June and L knee in September. I'm 50, live in Toronto and like the original poster, has been living a very limited life due to shrinking mobility over the past 4 years. I've got severe OA in both knees and pretty significant knock-knee misalignment in my right knee.

Back in December, I finally hit my breaking point and asked my family doctor to refer me to the Sunnybrook Holland Center joint program for an assessment. I was stunned when the advanced practice physiotherapist took one look at me and my x-rays and said "what took you so long to get here? How have you managed?" I nearly broke down in tears. I was expecting to be told "I'm too young, suck it up and do some exercises". That's not the response I received at all - I received a timely recommendation and referral to the surgeon for a TKR consult. Since then, I've seen the surgeon who was fully on board with the need for surgical intervention, with no hesitation. Fingers crossed I get my surgery date confirmed shortly - I'm ready to get this done!

Hero, I'm not sure where in Canada you live, but my advice would be to go to a major city near you that has an Academic Medical Center or teaching hospital that does a large volume of joint replacement surgeries. Your family doctor should be able to help you and direct your referral to a joint clinic that does a wide of array and volume of TJRs. You don't have to live in pain like this. Canadian surgeons WILL do TKRs for those of us that are under 60.

good luck!
 
Hello @mtmtoronto - and :welome:

When you have your surgery dates, please will you tell us the full date of each knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:
 

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