KNEE ARTHRITIS - Total Knee Replacement :
PLEASE... If anyone has any suggestions it would b - - Posted by Confused_in_Texas (Confused_in_Texas), 18 October 2003
I need some help trying to figure out what is the best course of treatment. I have seen 5 different doctors and have gotten 5 different treatment plans. 
A little background: 18 years ago, at the age of 10, I was struck by a motorcycle and fractured my right femur at the growth plate. I have had 16 surgeries to correct damage and to preserve my natural joint. Over the past 2 years I have had increasing pain, and I am now to the point that I am no longer able to care for my children or perform normal duties such as grocery shopping. Since
the initial injury I have been told that a TKR would be needed. I have a 18 degree curve in my femur just above the joint from the trauma, and a length difference of 3.5 cm. I am 28 years old. The differences in treatment plans are remarkable and extremely frustrating.
Dr. #1 - Correct malalignment and hang out for at least 10 years. Knee is shot, but I am too young for replacement.
Dr. #2 - Contact Social Security Disability and wait at least 10 years for replacement. Do not correct the malalignment, it is in my favor. The majority of the weight is concentrated on the side of the joint with the most cartilage left.
Dr. #3 - Remove screws from osteotomy 12/02 and lose weight. Too young for replacement. Do not change the alignment, he also feels it is in my favor.
Dr. #4 - Correct malalignment with another osteotomy and hopefully it will buy me a little time before TKR. If it fails to relieve my pain considerably, then he advises a TKR. States that the alignment would need to be corrected before a replacement can take place. If
an artificial joint is done with the deformity it will most
certianly fail.
Dr. #5 - I have 3 choices... A. Live with it. B. Fuse my knee joint. C. Replace the joint. He suggested the replacement. I questioned the curvature of the bone and its effect on the replacement and he said that he could correct it with the joint. He demonstrated cutting
both the tibia and femur at angles to offset the 18 degree turn.
I have a copy of an x-ray if it is needed to paint the picture more clearly. You can request this at jrmkbrown@yahoo.com.... Any advise you could give would be greatly appreciated. I feel like I am all alone
in this. I also feel like I have exhausted all my options in surgeon selection.
I know that I cannot wait 10 years like some of the physicians suggested... I can't see having a horrible quality of life now, while my children are young just to improve my quality of life later. I guess what I am needing to know is about the femoral osteotomy. Is this something that I should have done prior to TKR or should I allow the deformity to be corrected with the artificial joint?
Thanks!
Posted by ozzybug (ozzybug), 18 October 2003
Ok- sounds like you have been overloaded with information and treatment options, so naturally- you are confused. This would be a hard decision to make even if you were only given one or two options.
You are young and I'm sure you are hoping to make the choice that will leave you with the best quality of 'life". Meaning being able to run/play with the kids, do the shopping, run errands and so on and so on.
I wouldn't even begin to tell you what choice would be best for your situation, but I can tell you that my husbands father was severely bow-legged. He just last year had bilateral knee replacement and also had corrections made to the femurs & tibias at the same time to eliminate the bow-legs. It did take him a while to recover, but he has not regretted his choice since.
This work also made him about and inch taller for some reason and he is really happy about that.
Anyways, what ever choice you make- just know that there are some very nice people here who are willing to lend moral support as well as encouragement.
I am very sorry that I can't give you any more info. Just wanted to let you know that someone cares.
Lezlee
Updated Thu Apr 29 2010
