Knee Replacement fills me with Dread.
Discussion
Hello,
Not a third world problem but .....
My back ground, 60yr old male , fitness is a big part of my life style, running, weights in gym. Hurt my knee 18 months ago after running on last day of holiday and then doing a hit class soon as I was home. Went to physio must have been 50+ times it did improve but soon as I started back running managed about 4 miles before starting to ache. I then swapped the running for more hit sessions in the gym.
Always k taped it for support etc. Decided to get a Mri scan and specialist said I had a partial torn medial ligament and my cartilage was worn out and that in the short to medium term would need a knee/s replacement..
So couple months ago had a Arthroscopy, surgeon repaired the ligament and cleaned out knee. Got back exercising after a week, and a little bit of running. All seemed well so around 5 week Mark tried a longer run, used k tape and knee sleeve to give some support. Did around 5 miles. Slight ache in knee nothing major. Then next day and for rest of the week knee was really sore. Had 6 week follow up with surgeon, he showed me the pictures before and after surgery.
Repair to ligament went well but no cartilage in knee and he suggested knee replacement.
My knee is now clicking when I walk and if I do too much it aches and feels like it’s locking. Now wish I’d never had it done as it’s worse than before, at least then it’s didnt click or ache apart from when I’d been running.
Been scouring the internet and the thought of a total knee replacement fills me with dread...
The thought of it the rehab, month/s before I’m back in gym, it not being a success etc.
I’ve put it off till October as I’ve a few holidays booked. I just don’t know what to do, you read some horror stories it’s frightening.
I’ve come across this web site https://www.rnoh.nhs.uk/our-services/joint-reconst...
( my surgeon hadn’t mentioned it as an option) where they take a small culture from your knee and then grow it in a laboratory and then put it back in your knee. Reading it say mainly done on patients under 40s.
I’m going to ask him if it’s something available for me. I suppose anything rather than a new knee.
Is there anyone here who’s had a knee replacement and been happy with the results.
Not a third world problem but .....
My back ground, 60yr old male , fitness is a big part of my life style, running, weights in gym. Hurt my knee 18 months ago after running on last day of holiday and then doing a hit class soon as I was home. Went to physio must have been 50+ times it did improve but soon as I started back running managed about 4 miles before starting to ache. I then swapped the running for more hit sessions in the gym.
Always k taped it for support etc. Decided to get a Mri scan and specialist said I had a partial torn medial ligament and my cartilage was worn out and that in the short to medium term would need a knee/s replacement..
So couple months ago had a Arthroscopy, surgeon repaired the ligament and cleaned out knee. Got back exercising after a week, and a little bit of running. All seemed well so around 5 week Mark tried a longer run, used k tape and knee sleeve to give some support. Did around 5 miles. Slight ache in knee nothing major. Then next day and for rest of the week knee was really sore. Had 6 week follow up with surgeon, he showed me the pictures before and after surgery.
Repair to ligament went well but no cartilage in knee and he suggested knee replacement.
My knee is now clicking when I walk and if I do too much it aches and feels like it’s locking. Now wish I’d never had it done as it’s worse than before, at least then it’s didnt click or ache apart from when I’d been running.
Been scouring the internet and the thought of a total knee replacement fills me with dread...
The thought of it the rehab, month/s before I’m back in gym, it not being a success etc.
I’ve put it off till October as I’ve a few holidays booked. I just don’t know what to do, you read some horror stories it’s frightening.
I’ve come across this web site https://www.rnoh.nhs.uk/our-services/joint-reconst...
( my surgeon hadn’t mentioned it as an option) where they take a small culture from your knee and then grow it in a laboratory and then put it back in your knee. Reading it say mainly done on patients under 40s.
I’m going to ask him if it’s something available for me. I suppose anything rather than a new knee.
Is there anyone here who’s had a knee replacement and been happy with the results.
About 25 years ago I tore my ACL playing footie and that resulted in my knee clicking and/or me collapsing in a heap every now and then! Might it be that eg a different injury to what you think? I had it repaired back then and today it is mostly fine for running, get a bit of pain after although I put that down to my ageing years rather than the previously f
ked up knee.
TX.
ked up knee.TX.
3 points to the general readership
1. 80-90% of people who receive a total knee replacement report satisfaction. And their mean age is mid 60s. It hurts a bit, but you get 20yrs out of it.
2. That cartilage technique you have found is very experimental . It may represent the future. You might find they are doing it on a very restricted number of patients.
3. Have you looked into Joint Preservation?Osteotomy surgery puts off doing a total knee replacement and in many cases is just as good, if not better. It isn't experimental, it's established. This is what to look into.
Talk these over with your knee surgeon
1. 80-90% of people who receive a total knee replacement report satisfaction. And their mean age is mid 60s. It hurts a bit, but you get 20yrs out of it.
2. That cartilage technique you have found is very experimental . It may represent the future. You might find they are doing it on a very restricted number of patients.
3. Have you looked into Joint Preservation?Osteotomy surgery puts off doing a total knee replacement and in many cases is just as good, if not better. It isn't experimental, it's established. This is what to look into.
Talk these over with your knee surgeon
Have you thought about avoiding impact sports? ( A big change, I know). My knees, particularly my right, are not good. I had an arthroscopy some years ago and the consultant told me to avoid all impact sports going forward unless I wanted to accelerate needing a new knee. I was never much for running, football, etc so that wasn't a big thing for me. I do ski, and he said I may as well continue as it's for a limited time every year, but otherwise do things like cycle and swim.
When I climb a set of stairs my knee sounds like a pair of maracas, but generally it's not painful. I do wear braces for skiing and for enduro (motor)biking, and it can play up a bit for a few days after but not it's particularly painful. I'm 59 this year, and my plan is to continue as-is until or unless it becomes too painful on a daily basis.
When I climb a set of stairs my knee sounds like a pair of maracas, but generally it's not painful. I do wear braces for skiing and for enduro (motor)biking, and it can play up a bit for a few days after but not it's particularly painful. I'm 59 this year, and my plan is to continue as-is until or unless it becomes too painful on a daily basis.
For knee cartilage repair, a quick search on PubMed suggests that things like stem cell therapies could be here before long.
Google shows that there are already private clinics offering stem cell therapy for knee cartilage repair, albeit the evidence base is still developing.
I wonder if it’s worth preserving the knee for as long as possible (e.g. switching to swimming) in the hope of new treatments moving from experimental to mainstream.
Google shows that there are already private clinics offering stem cell therapy for knee cartilage repair, albeit the evidence base is still developing.
I wonder if it’s worth preserving the knee for as long as possible (e.g. switching to swimming) in the hope of new treatments moving from experimental to mainstream.
Don’t shoot me down as I know it’s not the same thing but I like to watch The Supervet Noel Fitzpatrick on TV. I’ve seen him use the stem cell treatment on a few dogs and it seems to have great success.
Got to be worth investigating surely, even trying it as if it fails you’ve still got the replacement to fall back on.
My stepfather had both knees replaced in his 60’s after a lifetime of sport including being a pro at Everton. He had mahoosive scars from cartilage removal from years before. The knee replacements left him pain free for the first time in years but meant he couldn’t kneel down properly.
Got to be worth investigating surely, even trying it as if it fails you’ve still got the replacement to fall back on.
My stepfather had both knees replaced in his 60’s after a lifetime of sport including being a pro at Everton. He had mahoosive scars from cartilage removal from years before. The knee replacements left him pain free for the first time in years but meant he couldn’t kneel down properly.
I'm almost 66.
Ten years ago I had an mild arthroscopy on my right knee, (it used to "click")….it has been OK since then, (last year I walked up five lake District summits around 3,000ft in a week), but three or four months ago the pain started again, and this last three weeks I can't walk more than a few hundred yards before resorting to limping and being in great pain..
I have been to the docs (three times) in the last few months and they said just exercise and take pain killers but to no avail.
I am going to see about another MRI scan, I don't really want a knee replacement, but if that's the answer I will have to seriously consider it.
Ten years ago I had an mild arthroscopy on my right knee, (it used to "click")….it has been OK since then, (last year I walked up five lake District summits around 3,000ft in a week), but three or four months ago the pain started again, and this last three weeks I can't walk more than a few hundred yards before resorting to limping and being in great pain..
I have been to the docs (three times) in the last few months and they said just exercise and take pain killers but to no avail.
I am going to see about another MRI scan, I don't really want a knee replacement, but if that's the answer I will have to seriously consider it.
CAPP0 said:
Have you thought about avoiding impact sports? ( A big change, I know). My knees, particularly my right, are not good. I had an arthroscopy some years ago and the consultant told me to avoid all impact sports going forward unless I wanted to accelerate needing a new knee. I was never much for running, football, etc so that wasn't a big thing for me. I do ski, and he said I may as well continue as it's for a limited time every year, but otherwise do things like cycle and swim.
When I climb a set of stairs my knee sounds like a pair of maracas, but generally it's not painful. I do wear braces for skiing and for enduro (motor)biking, and it can play up a bit for a few days after but not it's particularly painful. I'm 59 this year, and my plan is to continue as-is until or unless it becomes too painful on a daily basis.
Pretty much covers me, did mine playing footy..now don't run, but cycle and weights.When I climb a set of stairs my knee sounds like a pair of maracas, but generally it's not painful. I do wear braces for skiing and for enduro (motor)biking, and it can play up a bit for a few days after but not it's particularly painful. I'm 59 this year, and my plan is to continue as-is until or unless it becomes too painful on a daily basis.
I know the replacement knee is coming but at 50 hoping it will.be at least 15 years away.
denzilpc said:
my missus had a replacement knee last year after years of pain and being unable to walk any great distance ! best thing she ever had done now pain free and can walk for miles
I'd say similar. I had a full knee replacement two years ago, everything went fine, I rather enjoyed the recovery process (change in life routine, gave me a taste of life for the retired, etc etc), I had no pain, very little discomfort really, I now have my life back, I can walk, cycle, swim etc though I don't run and I avoid impact stuff.The whole thing went like a dream for me.
Best of luck with yours.
I’m pretty sure I will need my right knee doing in the next 10 years (3 ops so far, crunchy, arthritis well underway).
I’m also fairly desperate to keep mobile as the job I love (opera singer) means I absolutely have to be mobile on stage...
To those who have had it done, how long before you were up and walking again?
I’m also fairly desperate to keep mobile as the job I love (opera singer) means I absolutely have to be mobile on stage...
To those who have had it done, how long before you were up and walking again?
My story: running was my main activity for many years. I had knee problems on and off then 10 years ago an MRI and X-ray showed grade 3 OA so I went in for a left knee arthroscopy to clean out the joint. Only 3 weeks later when I saw the surgeon did I learn that he'd done a debridement (hammering the ends of the bones to create 'fibrocartilage' from the bone marrow). Not the most useful time to be told, as meanwhile I'd lifted some furniture that must have damaged the new fibrocartilage before it had fully hardened!
I tried much gentler running for a couple of years on soft surfaces but reluctantly concluded it wasn't doing the knee any good so stopped. I had several visits to a good osteo who worked hard to rotate the knee so that the pressure would be taken on a different area of cartilage but I can't say that had much effect. The surgeon had previously said that aggressive running puts 6-7x the body weight through the joint.
So I took up cycling, late in life, as a low impact activity. Eventually walking became painful, especially any load carrying, and this was definitely impinging on my lifestyle. After a lot of reading I went in 2017 (age 63) to a good sports orthopedic surgeon. He told me I should be able to get away with a left partial replacement (medial compartment) as scans showed the patella and lateral compartment had decent cartilage, though grade 4 OA (bone on bone) on the medial side. I went ahead with this in September 2017 and the op was successful with a good outcome. In April 2018 I cycled in Mallorca (hills aplenty) and by summer was cycling faster than before the op. The surgeon said that if I'd postponed surgery another year or two it might not have been possible to correct the bow-legedness that was developing from cartilage degeneration.
However, by late 2018 similar pains were developing in the right knee. I opted for exactly the same surgery on the right, which took place in late May this year. Recovery/ rehab protocol was different this time and I felt I was making slower progress initially. That said, I was discharged on day 2 and perhaps overdid walking in the first week. It's a fine balance between under- and over-doing exercise. Anyway, I was cycling indoors by day 18 and outdoors on day 27. Last Sunday (day 33) I managed 30 miles with the slowest group of the cycle club. So things are looking up again. Photo shows the wound this evening, nearing the 6 week point. I won't post the gory post-op pics!
But I won't understate the pain post-op. It seemed worse this time, most especially in bed (nothing to distract the mind from it) and particularly after the morphine bottle the hospital gave me was drained!
I fully accept that the partials may well have to be converted to totals in due course, but Zimmer Biomed's latest research on joint longevity is promising. I went for partials in order to have maximum functionality in the meantime.
I gather a key marker for when to bite the bullet is when pain significantly interferes with your daily activities and/ or your sleep. Certainly I was very apprehensive the first time round - psychologically it's the realisation that almost every medical condition you've had up to now has been temporary/ fixable whereas severe arthritis is a one-way street to old age and decline
Yes, I'm sure stem cell cartilage repair will become more commonplace. A friend in the cycle club had both knees done under Gorav Datta's Abicus clinical trial at Southampton and is extremely pleased with the outcome. However, Datta told me it's suitable only for small areas of cartilage damage and that my symptoms were too advanced http://abicus-trial.com/
A useful resource is https://www.kneeguru.co.uk/ especially the forums ('Community' page). These make one realise that our problems are small beer compared to some people (whose profiles have long lists of past procedures!).
Sorry I've wittered on for so long!
I tried much gentler running for a couple of years on soft surfaces but reluctantly concluded it wasn't doing the knee any good so stopped. I had several visits to a good osteo who worked hard to rotate the knee so that the pressure would be taken on a different area of cartilage but I can't say that had much effect. The surgeon had previously said that aggressive running puts 6-7x the body weight through the joint.
So I took up cycling, late in life, as a low impact activity. Eventually walking became painful, especially any load carrying, and this was definitely impinging on my lifestyle. After a lot of reading I went in 2017 (age 63) to a good sports orthopedic surgeon. He told me I should be able to get away with a left partial replacement (medial compartment) as scans showed the patella and lateral compartment had decent cartilage, though grade 4 OA (bone on bone) on the medial side. I went ahead with this in September 2017 and the op was successful with a good outcome. In April 2018 I cycled in Mallorca (hills aplenty) and by summer was cycling faster than before the op. The surgeon said that if I'd postponed surgery another year or two it might not have been possible to correct the bow-legedness that was developing from cartilage degeneration.
However, by late 2018 similar pains were developing in the right knee. I opted for exactly the same surgery on the right, which took place in late May this year. Recovery/ rehab protocol was different this time and I felt I was making slower progress initially. That said, I was discharged on day 2 and perhaps overdid walking in the first week. It's a fine balance between under- and over-doing exercise. Anyway, I was cycling indoors by day 18 and outdoors on day 27. Last Sunday (day 33) I managed 30 miles with the slowest group of the cycle club. So things are looking up again. Photo shows the wound this evening, nearing the 6 week point. I won't post the gory post-op pics!
But I won't understate the pain post-op. It seemed worse this time, most especially in bed (nothing to distract the mind from it) and particularly after the morphine bottle the hospital gave me was drained!
I fully accept that the partials may well have to be converted to totals in due course, but Zimmer Biomed's latest research on joint longevity is promising. I went for partials in order to have maximum functionality in the meantime.
I gather a key marker for when to bite the bullet is when pain significantly interferes with your daily activities and/ or your sleep. Certainly I was very apprehensive the first time round - psychologically it's the realisation that almost every medical condition you've had up to now has been temporary/ fixable whereas severe arthritis is a one-way street to old age and decline
Yes, I'm sure stem cell cartilage repair will become more commonplace. A friend in the cycle club had both knees done under Gorav Datta's Abicus clinical trial at Southampton and is extremely pleased with the outcome. However, Datta told me it's suitable only for small areas of cartilage damage and that my symptoms were too advanced http://abicus-trial.com/
A useful resource is https://www.kneeguru.co.uk/ especially the forums ('Community' page). These make one realise that our problems are small beer compared to some people (whose profiles have long lists of past procedures!).
Sorry I've wittered on for so long!
Edited by millen on Friday 28th June 20:23
My Mum had replacent knee, it is a case of you get out of it what you put in i.e. you need to follow all the exercises, etc to get the best out of it.
Other advice would be find a good surgeon and make sure the joint being fitted is good quality. Fantastic pieces of engineering, a colleague brought in a sample kit from one manufacturer so we got look at knees, hips, elbow and ankles joints. Aparently they have to use special alignment equipment to make sure everything is straight, must have the right toe setting ;-)
Personally I wouldn't want to be awake for this sort of operation as it is quite physical, I heard a story of a patient having a single hip replacement but ended up with 2 as they came off the operating table during the operation and broke the other hip.
Other advice would be find a good surgeon and make sure the joint being fitted is good quality. Fantastic pieces of engineering, a colleague brought in a sample kit from one manufacturer so we got look at knees, hips, elbow and ankles joints. Aparently they have to use special alignment equipment to make sure everything is straight, must have the right toe setting ;-)
Personally I wouldn't want to be awake for this sort of operation as it is quite physical, I heard a story of a patient having a single hip replacement but ended up with 2 as they came off the operating table during the operation and broke the other hip.
gottans said:
make sure the joint being fitted is good quality.
Realistically, this is impossible for the lay public. Could you pick an ODEP 10A prosthesis out of a line up?
And spinal plus sedation is often the best anaesthesia. You could sleep through the whole thing.
Most people snore their way through my work.
The_Doc said:
gottans said:
make sure the joint being fitted is good quality.
Realistically, this is impossible for the lay public. Could you pick an ODEP 10A prosthesis out of a line up?
And spinal plus sedation is often the best anaesthesia. You could sleep through the whole thing.
Most people snore their way through my work.
Err.. no but I know someone who would.
https://www.rnoh.nhs.uk/our-services/joint-reconst...
I had cartilage harvested 10 years ago at RNOH under Prof Bentley and sent off (back then) to the US for growing/replication for reinjection into an OCD lesion. Sadly, my insurance company chickened out at the last minute and it didn’t happen.
Since then they have done some 1500 procedures, but they are more aimed at relatively small lesions rather than “no cartilage” and they take a long time to settle down ie 12-15months before full activity such as sports again.
My last op up there - April 2018- my surgeon, Mr Donaldson, had just been speaking on the BBC about stem cells for knees and they are undertaking trials now. I offered myself up, but apparently I was “too old” > and my knee “too buggered” which I believe is a technical term among bone carpenters/ orthos 
.
TKR coming up for me soon too I’m just trying to get the last out of what remains for now (I’m 57) although that won’t stop me skiing next year. 2 full knee reconstructions on the one knee and lots of arthroscopies so far, so in a way I’ll welcome the eventual knee replacement.
The Doc above is a knee surgeon so a very good man to have on here.
I had cartilage harvested 10 years ago at RNOH under Prof Bentley and sent off (back then) to the US for growing/replication for reinjection into an OCD lesion. Sadly, my insurance company chickened out at the last minute and it didn’t happen.
Since then they have done some 1500 procedures, but they are more aimed at relatively small lesions rather than “no cartilage” and they take a long time to settle down ie 12-15months before full activity such as sports again.
My last op up there - April 2018- my surgeon, Mr Donaldson, had just been speaking on the BBC about stem cells for knees and they are undertaking trials now. I offered myself up, but apparently I was “too old” >
and my knee “too buggered” which I believe is a technical term among bone carpenters/ orthos . TKR coming up for me soon too I’m just trying to get the last out of what remains for now (I’m 57) although that won’t stop me skiing next year. 2 full knee reconstructions on the one knee and lots of arthroscopies so far, so in a way I’ll welcome the eventual knee replacement.
The Doc above is a knee surgeon so a very good man to have on here.
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