KNEE ARTHRITIS - Total Knee Replacement :

Young and in need of a TKR - - Posted by Jan_L. (Jan_L.), 8 March 2004

Prior to having a TKR  I discovered there are many types/brands of implants.   I was lucky to see an ad for an Oxinium knee and checked out their web site. (www.strongasanox.com)

This implant is fairly new and it's expensive so it's not being used very much.  But the wonderful aspect of the Oxinimum implant is that it is 4900 times more abrasion resistant than the cobalt chrome implant.   Which means that it could last much longer making it an ideal implant for someone in the past was considered to be too young.  

After doing some research and speaking with my OS I went with the Oxinium knee because of my age (I'm in my 40's.)   When I first spoke with my OS about this knee he wasn't very knowledgeable about them.   After checking into it for me, he agreed that it was the best option for me.  I am hoping this implant will last for the rest of my life.  

So if you are young and in need of a TKR and/or your OS has said you were to young you might want to consider getting an Oxinium knee replacement.
Posted by wmcknight (wmcknight), 8 March 2004

I saw a news story about the oxinium tkr. I am also in my 40's, an active person that loves to ski and bike. Any info on how this procedure affects those activities after the surgery?
Wmckski@comcast.net
Posted by Jan_L. (Jan_L.), 8 March 2004

I have quite a bit of printed material about the Oxinum knee that I got by calling their 800 phone number (which is 1-877-694-6486).  This is what they have to say about sports and the Oxinium knee.

"Patients who desire to return to an active lifestyle, which can include low demand sports, dancing, gardening, or others activities, may also benefit from Oxinium replacements.  They can have more confinence in the longevity of the device since the Oxinium material demonstrates such low wear rates.  The Oxinium implants are better able to tolerate activity and may last longer than the traditional joint replacements."

I think you would have to give up skiing, check with your OS.  I would think the risk of damaging the implant from a fall would be too high.  One of the main reasons I went with the Oxinium knee was becasue I ws hoping it would last a very long time.  The problem with most TKR is that they  wear out in 10 to 15 years ( usually in 10 years for someone young becasue of the increased activity level.  People in their 40's tend to be much more active than people in theri 60's.)  I was told that the sucess rate for each addtional replacements drops significantly, which is why OS will often say someone is too young.  I was told their was a good chance I would be able to have two replacements.  I was told that the suscess rate for the thrid replacement wasn't very good.  

I would think it would be tragic to fall and  damage the implant, especially when there's a chance that the implant couldn't be replaced sucessfully.  So my plan is to do everything I can to protect this implant.  I want to be able to walk for the rest of my life.

When I called Oxinium's 800 number I got a lot of very helpful infomation.    Along with a list of OS in my area that are using the Oxinium knee.  My OS had never used the Oxinium so he went through a training session so that he was able to do my surgery.  He said that the surgery wasn't much different from one brand of knee replacement to the next.

I hope this is helpful.
Posted by stefanie (stefanie), 9 March 2004

I'm 33 and in need of tkr.  How did you finally come to the decision to just "throw in the towel?"  My arthritis is getting out of control & I stay frustrated!  

Thanks for sharing the info, it does give one some hope!

Posted by Val_M (Val_M), 10 March 2004

Jan

I'm in my 40's and may need a TKR soon.  I asked my OS about the hardware you mentioned above but she said something about it not being FDA approved.  Do you know much on that?

Did you look into any other options before going with the TKR? like osteochondral allograft (??) where they put in new articular cartilage from a donor body - kind of like a live knee transplant.

How did you get into the position of needing a TKR, was it a car accident?
Posted by Jan_L. (Jan_L.), 10 March 2004

Hi Stefanie,

My doctor made the decision for me.   Over the years both of my knee continued to deteriorate.  I slowly had to give up activities because I couldn't handle the pain.  By the time I went in for the TKR I was using a wheelchair to do my grocery shopping.  I had trouble just doing the walking necessary for daily living.  

I had a scope done in Aug. and my doctor was shocked at how bad my knee was, the x-rays never showed the extent of the damage.  While I was in the recovery room from the scope my doctor told my family that I needed a TKR right away.  Not only was I bone on bone and had been for a long time.  Most of the time when someone is bone on bone, the bones grind against each other and sand the bone down.  My bones were breaking off  in chunks and the pieces were floating inside my knee.  At least this explained all of the pain I had been having.  I had trouble getting my doctor to hear me at first, that my knee was that bad.  My doctor was apologetic for not listening to me sooner.

I had been considering having a TKR on my left knee but after my OS saw the inside of my right knee, he decided that the right knee should be done right away.

For the past 10 years doctors would tell me that I needed a knee replacement (for the left knee) but I was too young.   I was told that I could end up in a wheelchair latter in life if they did the TKR too soon.  Back then the doctors explained that although I was in a lot of pain, I was still able to walk.  So when my knee got so bad that I was no longer able to walk short distances he was willing to do the surgery because at that point I had nothing to lose.  

I know it's very difficult to be young and unable to particpate in activities that most people your age take for granted.  Hang in there and I would suggest you do whatever you can to put off getting a TKR for as long as possible.  

Good luck coping with your knee!

Jan


Posted by Jan_L. (Jan_L.), 10 March 2004

Hello Val,

Yes both of knees were damaged in an auto accident in 1985.

I am surprised your doctor said that.  These implants have been on the market for several years now and are not experimental by any means!  Your doctor must of  confused this with something else.  

My doctor wasn't that familiar with the Oxinium knees either at first.  I called the 800 number and received a packet of info that I took to him.  Then he called the company and met with the local rep.  The company sent my doctor a  box of materials of these implants, which included videos and several packets of info.  After my doctor checked this out, he told me if he had to have a TKR this is the implant he would want in his leg.

These implant are very expensive which is why they're not being used very much.   The hospital billed my insurance company around $9,600 for the part alone.  I am waiting to see how the insurance company is going to respond.  But considering my age, this implant could last so much longer which could save the insurance company the cost of an additional surgery in the future.

To answer your question on osteochondral allograft.  No I hadn't checked into this.  But I would love to learn more about this because I will need a knee replacement for my other knee  soon.  It would be nice if that could be avoided.  I would love it if there was another option.  Please pass along any info you have on this.

Thanks,

Jan
Posted by Val_M (Val_M), 15 March 2004

Hi Jan

I've got two web links, one for osteochondral allograft (live articular cartilage with bone transplants) and autolagous chondrocyte implantation (growing articular cartilage in the lab and transplanting this "good" cartilage to where it's needed in your bad knee).  They're both rather complicated but apparently are viable alternatives to TKR if you meet their criteria for the operation - discussed in the articles I believe.  I was told that in my case I would have to go 1 year NWB with the OA procedure which seems a bit harsh.  Anyways, something to think about.

http://medicine.ucsd.edu/ortho/genallog.htm

http://www.physsportsmed.com/issues/2000/11_00/wroble.htm

I have an OS appointment coming up and am going to bring up the Oxinium implant.  I'm in Canada so the toll free number doesn't work.  Do you have an email address for them?  Do you know for sure that it's FDA approved?  I checked the FDA website but couldn't find anything...any suggestions.

Thanks for your help.  Hope all is going well with the knees as always.
Posted by Jan_L. (Jan_L.), 21 March 2004

Hi Val,

The Oxinium web site is:    www.strongasanox.com

Thanks for the web site info.

In term of the FDA approval the topic just didn't come up.  In the same way it doesn't come up when your doctor writes a Rx for a med that's been on the market a long time.  This implant has been on the market for years.

I have some good news.  My insurance company paid for this in full without even a discussion.  So maybe the insurance company recognizes the value of an implant that last longer even if it is 4 times as expensive as the traditional implant.  

I really believe that this is the best implant for a young patient, my doctor agreed.

I hope this helps.  It's a tough decision.

Feel free to contact me if you have any more questions.

Jan

Posted by Val_M (Val_M), 22 March 2004

Thanks Jan,

I had an OS appointment with my OS a few days ago (in Canada) and specifically asked her about the Oxinium TKR implant and brought their October 2003 press release with me for her to read.

She seemed to know what I was talking about a bit more this time.  She's pretty sure the Oxinium isn't used in Canada yet.  She went to a conference on such things a month or so ago in the States and said she saw alot on the Oxinium implant there.  In her opinion the implant is still too new for any definative determination on it's long term benefit.  She said it seemed good but unless she seems something on paper about long term effects she'd still be skeptical.  My OS has TKR specialists in her office working with her but she herself isn't a specialist I believe.  At some future date I'll likely talk to them about this as well.

I still have a bit of time before its imperative to have a TKR.  Hopefully more info will keep coming out on this implant as I'm in my early 40's and will likely need to make a decision before I reach 50.  

Thanks for your info Jan and do post if you hear anything further on this.

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