Hi Matt,

First, I'd highly suggest NOT going ahead with the TKR until every other option (both surgical and otherwise) have been tried (not just thought about) and failed.  They had contemplated doing a partial knee replacement on me about 2 years ago and opted to try everything else first.  Knee replacements don't last forever and each subsequent replacement lasts for a shorter amount of time so for me (at the time I was about 28, now almost 31), they said they'd probably end up doing them at least 3 times in the span of my life, if not more.  Not to mention possible revisions, etc.

OATS might be a good place to start but even before that, have they suggested doing any type of ACI surgery where they harvest your own cartilage cells, regrow them in a lab, and then fill the defect with your own cells?  They did this for me and it worked and I had about 70% of my cartilage, if not more, under my patella missing.  OATS was going to be the second step, if the ACI didn't take, as they prefer to use your own cells first (at least my doc did).

I'd definitely seek a second (or third or fourth) opinion, even if it's just consulting via e-mail with some of the top docs.  Where do you live?

Beth

I hope that your new OS can give you better options and if they say those dreaded words of "there isn't anything else we can do", go elsewhere.  I live in IL and have hiked the 5 hr. drive up to Dearborn, MI for 2 MAJOR surgeries and many pre and post-op visits because there is one of few surgeons who do what I needed done up in MI.  There is an excellent cartilage doc in Chicago, IL that I'd highly recommend you contacting if this other OS doesn't have any advice (or even if he does and you just want a second opinion).  You can usually get in to see him fairly quickly with office hrs. on Monday and on Thursday.  Although it would be a long day in the car, you can conceivably came down, see him, and get back home on the same day (this is how I did all of my doc visits to MI-surgeries were always inpatient for multiple days so that wasn't possible but office visits were always a day trip).

Stay positive and read up on both procedures (OATS & ACI to see the differences and similarities re: outcomes, rehab protocols, etc.) so that you can ask a ton of questions.

I agree at 27 you should prob try OATS, Maci and ACI  even HTO  or partial replacement before jumping to the big TKR guns.

Or even try Supartz and the like and cortizone and ride it out until you are 33 ish or so ..  Jump into the TKR as close to 40 ish if you can hold out..

One thing I would like you to wrap your head around is doing multiple surgery's with long recovery times of non weight beariing.   At least if you wait it out for a TKR or PKR  you are weight bearing as tolerated pretty quickly.   I had my first knee replacement  at age 36 and having my other knee done next week at age 42. 

Not the spot I want to be in I am not a candidate for the oats maci or aci treatment.  or HTO.   I had a zimmer gender knee in 2006  and will have a zimmer gender knee  in 2012. 

The 2006 operation was a huge blessing.  Took about a year plus to feel normal again but the best 6 years of pain free ever... 

Whatever comes your way. Do not be afraid of the TKR at a young age. If it comes down to it.   Most folks recover fast