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Author Topic: 40 year old....toooo young for TKR? Scheduled 6/30/09!  (Read 38097 times)

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #15 on: November 02, 2008, 11:33:53 PM »
Mike...

I hope to hear that the TKR gives you pain relief plus allows you to use a stationary bike or elliptical and get something out of it!   I guess there are no guarantees on that...so I suppose I will have to be in much more severe pain to get one???  ??? 

Look up "digginit"s posts about her TKR...she didn't wait till she was in severe pain and already she is able to bike OUTSIDE for 45 min.!  I can't do that!  :o

This is what I am afraid of...if I wait too long, the TKR won't allow me to exercise, it will only relieve severe pain.

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline digginit

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #16 on: November 03, 2008, 01:46:31 AM »
Francine:  even though I had more cartilage damage than they've found in your knee, it's clear that you are more impaired by your arthritis than I was.  However, after my second arthroscopy when we SAW the damage, I knew pretty quickly that I wanted to fix it now rather than go through years of little clean-up procedures. 

As it was, I was putting steroid shots in my own knee every couple months, and I wasn't able to do things I wanted to do with my son, but day-to-day I functioned okay.  But not being able to hike, ride my bicycle, and just keep up with an 11 y/o son was not acceptable to me.

I'm glad my bone doctor agreed to do the surgery.  He doesn't think I'll be limited all that much.  Of course no skydiving or running.  No high impact activities, but he says I can snow ski.  We have plans for a trip at the end of Feb.  I intend to be in shape for it.  ;D
 
Of course you know that knee replacement is nothing to take lightly.  Quality of life is important too.  It's a big decision.  You're thoughtful about stuff, though, and I know you'll make a good decision for yourself.

Peace~
dig

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #17 on: November 03, 2008, 03:31:43 AM »
Thanks so much for the support Dig!  I really appreciate it.  I definitely am NOT making a rush decision about getting any sort of replacement right now.  Besides, I have yet to find a doctor who will recommend it!  They don't have to walk in my shoes...that is the problem!!   :o

If things stop improving or (heaven forbid) get worse...then I know I have to do something because, like you, I am not willing to sit around, do nothing cause I hurt too much, and get fat!!!  >:( 

I am really glad you are able to have fun with your son...that is SO important at this age.  My daughter (21 yr. old) still likes to spend time with me once in a while...this usually involves shopping.  We both LOVE it.  ;D This will tell you that my problem has gone on for a LONG time now: she accepts that my knee is on a timer and will leave the mall when I say we have to go!  Then again, maybe she is finally maturing.   :)

Mike: definitely keep us posted on your saga...I am really rooting for you!   ;D

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Plumb

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #18 on: November 03, 2008, 11:27:45 PM »
That is a great visual.  The knee is on a timer.    Last year I was able to do a full days work.. Go shopping and do an hour walk.
This year I notice the timer slowly not allowing me as much time..  Last week before cortizone shot. I was bearly able to walk into work with out insane pain by the time I got home.  Going to the grocery store sent my pain levels up to where two vicodin did not control the pain. So I was hobbling around the house with an ice pack.. two blue pills. and a cane.  The thought of trying to go up 15 stairs to get a pepcid had me in tears and distraught.  Also limping around like crazy.  my knee cap feels like it is pushing in and killing me.

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #19 on: November 03, 2008, 11:41:06 PM »
Sorry you are in so much pain, Plumb...and you are much younger than me.  How did this happen if you don't mind me asking?  For myself, I have knock knees and I guess it was only a matter of time.  My mom is literally crippled with arthritis all over her body...but she is also 89 but she has had it since her 60s and she wasn't active.  I was VERY active so I started having knee problems at 45.  Hopefully the rest of my body won't go to hell!  :o  I have already had some back and hip issues but they are under control right now.

If you have to have knee replacement #2, you can be pretty sure that in a few years the technology will be much more advanced so that by the time you need any revisions, the next new knee will be even better than the first!  :)

Hang in there!  This arthritis stuff just sucks!  >:(

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Plumb

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #20 on: November 04, 2008, 05:18:05 AM »
Thanks for your concern Skinnycatz. I had aches and pains in my knees as a child where bengay would be stinking up my room at 11 years old. I am knock knee'd and flat footed.  My right leg was vargus

 I would have to say that my left knee took the grunt  after a full year of waiting to heal after I had chrondroplasty on my MFC and LFC and partial meniscus removal on my right knee.  This turned into my first TKR.   in 2006  I was told my left knee would need to be replaced  by several OS's .  It just seems that the bone rub is getting to me.    Bone pain that equals that of replacement bone pain.  That is the thing that I noticed the most that the bone pain after TKR was a lot easier to manage.  Nothing  felt better than standing upon the implant..  I was in shock that after a year of struggle.. That I was healing properly.   

My OS asks about my implant each visit and I am proud to say .. I do not have a care in the world with it. After a year of hard work to get to that pain free spot.

 I also told him my fears about cement and spacers.. He just laughs and says..   I will have this knee for 30 years with out an issue.. It's comforting you know when you read all  these rotten things that can happen. 

My Os is really there for me.   I must say never disappointed me at all under his care.  Always remembers me and my case.. and you know these guys see  45 people a day.  Even he recalls offhand how bad my xrays are from memory.

I just need two pain free knees. I hear it is all the rage.  Meanwhile.  When my peers are trying their first implants.. Hopefully,  My knees will last longer than what the manufacturers could even project.

one day my knees will be great. 

Offline JAYHAWK

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #21 on: November 04, 2008, 01:38:17 PM »
Mike....feel complelled to comment on your situation as it closely parallels my condition.  I am sixteen weeks post surgery for a total arthroplasty on my left knee and have just re-scheduled the surgery on my right knee from November 10 to February (you can review my situation in another section of this site).  I played multiple sports and really abused my knees....result was four surgeries on my left knee and one on my right knee.  Arthritis developed and I too was bone and bone and have run the gammut of therapuetic treatments for my arthritic knees.....my sports medicine doctor and I have tried everything....multiple artificial synovial fluiid injections and finally cortisone injections every three to four months for about three years.   However I got to the point where the injections no longer provided any benefit and my quality of life deteriorated to point that I finally had no other option.  While I was 61 when I had the arthroplasty I delayed for several years because I wanted to wait as long as possible in order to prevent the need for an additional replacement(s). Over the 7-8 years that I delayed the surgery my knees really became severely arthritic!!!

When I finally decided to have the arthoplasty I spent many, many hours on research of the surgery, doctors in the Houston area who only perform joint replacement surgeries and finally the knee manufacturers.  From the research I developed a list of questions and then met with three doctors (from a list of eight doctors) to review the questions.....each doctor performed at least 500 total knee arthroplasties a year!!  Finally, I selected a sports medicine physical therapy center for the rehab where they had experience working with knee replacement surgeries.  (Note:  The hospital where the doctor I selected practiced had a formal physical therapy program in the hospital.....started at 4:00 am the morning after surgery....walked out of the hospital two days after the surgery).  I started physical therapy at he sports medicine center on a Monday three days later.

My advice.....select a qualified doctor who only performs joint replacement surgery, ask questions and then attack the physical therapy agressively.


Steve
Spring, Tx.

Offline Janet

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #22 on: November 05, 2008, 12:19:41 AM »
Francine:

I'm glad you explained more about how limited you are. I wasn't trying to tell you not to have the surgery! I just wanted to make sure you weren't jumping to it too soon, since you've had surgeons tell you it's not time. But from your description, it definitely sounds like your life is very limited by your knee. Of course you should be able to ride your bike and walk without your knee on a timer.

Yes, most people are much more active after a TKR than I am. I am limited with my TKR because of other tendon/soft tissue pain. Because I have patella baja, my patella tendon gets sore. And after the TKR, I developed tendonosis in my biceps femoral tendon (lateral side). My OS told me only 5% of the population has knees like mine (I won't try to explain), and the tendon is irritated where it travels over the prosthesis. This isn't something we anticipated, in fact, I'm the only patient he's had that developed this problem except after a revision. Great LOL! The bone pain is totally gone, and I definitely have my life back. I can shop, go up and down stairs (down is more difficult because of the patella baja), sit with my knee bent. But I still have discomfort (2-4 on the pain scale) every day. We're still trying things to get rid of it (I just posted about my 2-year checkup).

Good luck to you as you make the decision about having a TKR. It can definitely change your life.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #23 on: November 05, 2008, 12:52:58 AM »
Hi Janet...

I am sorry you have had problems with the TKR but it sounds like maybe some of your issues might be resolvable...there is always hope!  I also have a tendinosis problem with my patella tendon, probably as a side effect of surgery #3 or just as a reaction to more arthritis pain over the last few months.  I have no idea how I got it but I do know it was not on my pre-surgery MRI, only on the one I had done at about 3 months post-op.  I have been getting cold laser treatments for it and it has gotten somewhat better but may always have more of a "thickness" that the other side.  I am not ready for any other surgery right now.  My current OS has talked about debriding the tendon but I still have hope that it will improve some more with conservative methods.  I don't think the tendon is causing the heat in my knee, I still think it is the lack of cartilage under the kneecap.  I had heat before surgery 3 and I still have it although it doesn't hurt as badly when it heats up...I usually don't let it heat up because I am so proactive with the icing though!  I don't want to feel the heat! LOL

Ah...sitting with my knee bent!  :o  What is that? LOL  I haven't been able to do that in a LONG time...probably since before surgery 2.  This is such a pain...it affects my work, going out to eat, at least there are spaces next to the slot machines in Vegas so I can prop up my leg!  It is just that I can't always "pick" the machine I WANT!!! LOL  We love Vegas and this stupid knee has spoiled a lot of my fun...now that we have a timeshare there too...I am hoping that the next trip (end of the year) we go on I will be able to enjoy it more....I will still have to drag ice around but I am getting really used to that now!

Did they replace your kneecap with the TKR and they still couldn't get rid of the patella baja?  I know of that condition...I hope they can do something to fix the problem sometime.  :)  I will read more about your checkup! 

As I said before, I haven't gotten any OS to actually recommend any replacement surgery, mainly because they see my MRI and don't find severe damage.  I know that these arthritis conditions DO get worse...mine already has since last year.  After surgery 2 (2007), I could walk quite a bit without thinking about ice, my knee didn't heat up, I could do low impact aerobics and enough biking so that it was somewhat of a workout.  I say somewhat because I wasn't able to do step classes anymore, haven't jogged since 2002 either and those were REAL workouts to me!  ;D  My knee started getting worse in March of this year...more pain and the heat in the evening...the knee turned red.  It really scared me! I am on anti-infammatories now and the knee can still turn red now if I don't ice at the right time...like if I fall asleep on the chair in the late evening and I haven't iced for a while....hot knee!  :o  I do think my pain is better than it was a couple of months after this surgery maybe because I am stronger now...I just don't know if I can totally overcome the problem.  I really doubt it.  I am not really up for living the rest of my life with the way things are now or worse.  If it does get worse, I am really going to seriously investigate the replacement option before I can't function because of pain.  I don't deal with pain very well.  I also can't take pain meds either so that is another problem!

Thanks for writing...I really hope things get better for you!  :)

Francine

Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #24 on: November 05, 2008, 03:31:53 AM »
Hey Plumb...I have a question (sorry Mike for taking over your thread! LOL)... I was wondering if the TKR straightened out your leg??   You mentioned you were knock-kneed.  So am I and I am wondering about this because one of my PTs said my leg would be straight with a TKR. 

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Plumb

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #25 on: November 05, 2008, 04:19:42 AM »
Yes my right leg  is straight now.  I was about 8 degress off prior to the TKR.

 I am sure Mike or whoever wanders upon this thread  realizes that expanding the dialog and including other questions only helps others who may wander upon this thread.  I know I had a ton prior to my TKR. There is just a lot to seep in.. and wrap your head around the whole thing.   There are doctors who do computerized alignments and they say that with those percise measurements your knee could last over 40 years.   There are medical white papers that discuss the importance of allignment in younger patients.  So many things to have sink in and think about before making a big step on replacing body parts with metal bits.  I found the more I was able to dig up.. the greater the comfort I had with my decision ..  Plus I was very disabled with pain that was intolerable.   


Here is an xray of my implant



This is a photo of my knee not even 24 hours after the operation. 



I hope this helps you somehow.

Your PT is right.   With a skilled OS they cut the bone just so .. that your leg is straight again.   some people have an HTO to correct the knock knee.  However for me it was not the right type of surgery to help me out.
« Last Edit: November 05, 2008, 04:31:57 AM by Plumb »

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #26 on: November 05, 2008, 05:22:21 AM »
Wow...Plumb...thanks so much for this information.  The more I learn now (before I REALLY need to do something), the better.  I appreciate it!  ;D

Hope your other knee calms down some...  :)

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline ehv74

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #27 on: November 07, 2008, 11:19:15 PM »
Knee replacement in young patients
Total knee replacement in young patients

Total knee replacement is generally performed in older patients. For the first time in India, a new prosthesis for young patients will be introduced. This prosthesis made of a wonder material called Zirconium, a ceramic coated metal ensures longer survival of the prosthesis after implantation. The introduction of this prosthesis will hopefully encourage more number of young and middle aged Indians and Westerners to undergo knee replacement in India.

Advantages of Zirconium
1) The significant advantage of Zirconium knee implants is that it is considerably harder. On testing it lasts 85 times longer in tests that simulate the stresses inside the actual knee.
Additional advantages are scratch resistance.
2) When it is wet, ceramic can glide smoothly along plastic, making for smoother motion than with metal-on-plastic. As a result, the Oxinium total knee replacement will not generate the quantity of plastic wear debris that cobalt chrome will, and the implants should last considerably longer.
Zirconium is one of the six most biocompatible elements know to man. So, your immune system will more easily tolerate your new implant.
3) Lastly, patients who are allergic to nickel, the metal most often used in the current implants, cannot currently receive total knee replacements. The ceramic implant, however, can be implanted safely in patients with nickel allergies, since it uses a zirconium alloy with no nickel. Implants made of Oxinium have been implanted in larger number of patients in the UK Australia and the US with great success.
Who would benefit most from an Oxinium (zirconium) total knee replacement?

Three types of patient have been identified as the "best" candidates for an Oxinium total knee replacement.
"Younger" patients: Because Oxinium knee implants offer significantly less wear compared to cobalt chrome implants, they are expected to last considerably longer. In the past, orthopedic surgeons have advised patients less than 65 years of age to wait to have knee replacement surgery because the life span of the cobalt chrome knee implants is only 10-15 years. Now, surgeons have a viable option for a younger patient who previously would not be a candidate for a total knee replacement because the Oxinium knee implants should last much longer. Therefore, a patient under the age of 65 who has advanced arthritis of the knee no longer has to suffer for years until he reaches an appropriate age for total knee replacement surgery.
"Active" patients: Patients, who desire to return to an active lifestyle, including sports, dancing, gardening, or other strenuous activities, may also benefit from an Oxinium knee replacement. As a result of their high activity level, this patient population will put more "wear and tear" on their knee replacement, which can cause the implants to wear more quickly. An Oxinium knee is better able to tolerate this high activity level and last longer that the traditional cobalt chrome knee.
Metal allergy patients: Because Oxinium is one of the most biocompatible materials known to man, it is the only choice for patients who exhibit metal allergies. Patients who have needed total knee replacement surgery, but could not tolerate the cobalt chrome implants due to their nickel content, can now have the surgery they need to return to an active lifestyle without the fear of an allergic reaction.

The first patient will be a 34 year old dutch male with postraumatic osteoarthritis.
Whereas normal knee prostheses cost about 80,000 rupees, this new prosthesis may cost about 1. 25 lakhs, but it is comparable to the best in its category. The higher cost will be offset by the longer survivorship of the implant.
A Total knee package at Chettinad health city is available for Indians and foreigners with normal and long life prostheses at affordable costs http://www.youtube.com/watch?v=L_-nzQN_MxY

Offline EOD1

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #28 on: November 07, 2008, 11:31:25 PM »
I don't know how old the info from India is but both of my knees were Journey Knees by Smith & Nephew.  These use the Oxidized Zirconium technology.

I certainly hope thy last longer than 10-15 years because I do lead a very active life style and I'm not that terribly old (57).

Offline Skinnycatz

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Re: 40 year old....toooo young for TKR? Need advice!
« Reply #29 on: November 07, 2008, 11:49:40 PM »
Hi EOD1...

I am curious as to what activities are you able to do with your TKRs?  How long have you had them?

Thanks...

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10