The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: lanageuse on December 26, 2007, 09:31:48 PM

Title: Knees of a 50year old at 32...
Post by: lanageuse on December 26, 2007, 09:31:48 PM
Hi everyone.  I'm new here- any advice appreciated. My son is 33 years old and has recently been told he has the knees of a 50year old ( a 50year old who needs knee replacement) He has had a few consulatations with a new surgeon, Mr Spalding.  Firstly,  He needs to have his legs broken and realigned- because his surgeon believes his gait has to a great extent caused his knee probs. 

Operations on both knees of 10 years ago  made his knees worse.  He has lived with the pain and swelling the locking and giving way, which many of you here have too, since the age of 11.  Always  a sportsman, he is now pretty disabled. Last month he went in and had  both knees opened up for a look.  He was told there is  no cartilage in left knee and some in right. He is to haveACI and OATS  cartilage surgery , but his knees are in a real state - he needs knee replacement really, he's been told.  But he has also been told he is too young for a knee replacement. So it's like you have to wait to be old enough for the replacement - main issue against this being the 'life span ' of the replacement. He has confidence in this new surgeon.  Any advice appreciated so he knows what to say, ask, expect, in order to get the best out of this. 10 years ago, he went in trusting the doctor, I want to try and help him prepare better this time. 

Any experiences to add for help would be fantastic.  Thankyou. Jacquie
Title: Re: Knees of a 50year old at 32...
Post by: jathib on December 26, 2007, 09:53:19 PM
First, putting an age on a body part is something that has always baffled me. My mother literally has the knees of an 82-year old and has never had knee problems. Both of my knees are almost 50 years old but my one bad knee is the result of an injury at age 15 and not the result of my age.

Many doctors are getting away from the "too young for a replacement" mindset. They have come to realize that quality of life is more important than some magic age. There's also the fact that the technology for joint replacements is constantly improving and they are lasting longer and longer.

If I were your son I'd get several more opinions before having such extensive surgery. I'm not really clear on what's wrong with his knees and what kind of surgery he's having. Generally they will realign a leg if one side of the knee is bad and the other is in good shape. The surgery (osteotomy) is designed to shift your weight from the bad side of your knee to the good side. This surgery will make the inevitable TKR more difficult in the future. However, it is often recommended for younger, more active people. If both sides of his knee are bad then I don't think he would be a candidate for that surgery.

He should see as many knee specialists, specifically joint replacement specialists, as possible. Here's a pointer to a blog by a WebMD surgeon that lists some of the critieria you should use to pick a surgeon.
Title: Re: Knees of a 50year old at 32...
Post by: DeborahinNC on December 27, 2007, 04:04:22 AM
Hi Jacquie,

I agree with jathib, many, but nearly enough surgeons are realizing that it is not necessary to wait until late in life to have replacements.  I'm 52 and I got the same statement and after two years of other surgeries and options finally got a partial which so far is doing well (4 months out).  Look on the web for articles and studies that show that replacement at a younger age may improve quality of life.  Most OS's want to wait so they either don't have to do a revision due to aged out deaths or if they do it may only be one. 

If it really the only option left for your son you may need to really shop around and find a surgeon that is willing to do it on someone so young.  Again, I think you can find resources on the web.

Good luck to you and your son.  Quality of life can be so affected by joint issues.

Be well,
Title: Re: Knees of a 50year old at 32...
Post by: Plumb on December 27, 2007, 12:25:27 PM
Crutches helped alot for me before my TKR and having proper pain management.  It  may come down to really listing the things your son can not do safely.  Getting out of a burning building. Getting to the bathroom on time.  Getting across the street safely.  Caring for children. Being independent.  At one point I started to call doctors and made appointments but first asked the receptionist.or Pa what the doctors mindset  is on younger people having knee replacments and quality of life.   One doctor told me his bench mark was when people started to tell him they couldnt do the things they loved.   He also added he couldnt feel the type of pain a patient was having.  Hey I had a horrible gait I couldnt extend my knee while standing and wore a unloader brace ,, had canes.. had crutches.. Anything I could think of falling short of a wheelchair ..   I had problems walking a half block.   About to fall on my face half the time..  but I worked around all these limitations for a full year Perhaps any new OS would want to meet with a patient a few times before they can honestly say .. I am going to hammer rods and cut bone on a younger person.  For the last two years my longest run with out seeing my OS has been three months.  Now that I had to compensate for a long time on my other leg.. It is getting bad.. but I am not in any mood to deal with surgery failed or successful.   

Title: Re: Knees of a 50year old at 32...
Post by: lanageuse on December 28, 2007, 11:52:11 AM
Thankyou all so much for your responses.  Deborah and PLumb- You sound very positive about knee replacement...  Does it generally work well ?  Has it worked for you or in your knowledge?  I think my son is having a partial replacement.  In the op last month where th surgeon took a look, the latter also took time to do some 'cleaning up'- removing calcification etc.,..this has helped a lot...before my son could barely walk 20yards...he has been told now to exercise and get fit- has put on a lot of weight too- before the next himself up.  we went on a 2 hour walk yesterday...and he enjoyed it...was good, with no ill effects....though of course he still has pain...he was free to actually walk...  His work involves setting up and running projects with young kids who have gone off the rails- the type who set fire to schools and get excluded :-\ he needs his fitness and his knees.  If he had Knee replacement and it worked that would be so good and mean he could carry on. I suppose and hope in the future this surgery will improve more and more...and that that wont exclude people who have had the earlier types of surgery.  Hopefully they will be able to benefit too.
Title: Re: Knees of a 50year old at 32...
Post by: Plumb on December 28, 2007, 09:42:01 PM
The first year might be the most challenging after a replacement.  I was camping and walking in river banks and climbing in and out of tents about six months after my replacement. I was on a bike. I was standing on uneven rocks in the delaware river.  I am able go get down on the ground and have fun with my three year old.  I was able to push him on his big wheels . The first year like I said is slow going  Getting up from the ground is not my most graceful moment.  I can sit cross legged

Doctor always tells me not to kneel ..  Always with a pillow
Title: Re: Knees of a 50year old at 32...
Post by: jathib on December 28, 2007, 10:01:55 PM
I'm not sure of the exact statistic but I believe the success rate for knee replacements is over 90%. Hip replacements are over 95% successful. The key is to get a good surgeon.

I had a partial knee replacement one year ago at the age of 48. I'm very happy with the results as I have no pain at all most of the time. At night sometimes I have some stiffness but I would not really call it pain, not like I had before surgery. It really is like having a new knee.
Title: Re: Knees of a 50year old at 32...
Post by: DeborahinNC on December 29, 2007, 03:50:56 AM
Hi There,

I am really pretty happy with the replacement.  It has and probably will be a longer rehab than I mentally thought it would be although my surgeon was very honest about it.  I had a medial partial done and think that it will solve my immediate problem.  I had been thinking about having to change careers since my injury first happened and am really putting effort into lining up more teaching.  I currently work as a paramedic and should be released to return by mid January.  I'll go back for a while but think for the sake of both of my knees (the left has started to give me some minor problems) I'll move more to teaching than working in the field.  But, as far as the replacement it has been fine.  I am walking without any trouble, never was a runner anyway so that is not a goal, can ride my stationary bike and I swim a lot. 

Feel free to e-mail me if you need to talk.  Its not an easy surgery and I certainly would not tell anyone to do it unless there are no other options.  As my surgeon said, once the bone is removed there is no going backwards. 

Good luck to your son and to you - its as hard to be the family involved with someone in pain.

Be well,
Title: Re: Knees of a 50year old at 32...
Post by: lanageuse on December 29, 2007, 02:30:03 PM
Thanks again guys for your responses.  I've been reading the osteoarthritis section on this site and my son basically has the latter, and all of those causes- hence the 50year old label I suppose.  I know he had jumper's knee, cruciate tears,  since 11 has had extreme reactions in his knees, with locking, massive swellings- many repeated sport induced injuries.  He has rarely knelt on them as it would be too painful.  I will talk to him again about exactly what is suggested by the surgeon. But I know the new information was that the surgeon believes the way he walks, the way his legs are formed, has actually caused many of the inital problems which then  have developed into this chronic condition. Hence the need for the breaking of the bones in the femur to set the bones correctly. I know he only finally confronted his doctor with the problem this year because it has got so bad he basically couldnt do his job.  At last to have had a response- been listened to- hadnt even been given an MRI scan previously.... I am cheered by the fact he now has a  surgeon who has helped by clearing up the knee a bit in the last observation op. and has a good dialogue with him.
We are in th UK and the health service is not at its best at the mo.  Are you guys all in the states?  I'm hoping that the work being done here is as good as you have reported from your surgeries in the USA.
Thanks Deborah- I will email you-
And Many Thanks to All.   Jacquie
Title: Re: Knees of a 50year old at 32...
Post by: metballnut on December 29, 2007, 08:33:31 PM
Well, I was a 50 year old with 80 year old knee! (left) until Nov 15th of this year when I had TKR. It has been great..outside the pain and physical therapy ;D...
Seriously, I had a torn acl, mcl meniscus and 99 % osteoarthritis from too much basketball at a younger age and a hiking accident where my knee absorbed a direct hit going uphill at night....
Anyway, I had been wearing a brace for 1 year (it was terrible) had the rooster injections (didn't work) and was living on vicodin and cortisone shots everty 6-8 months for 2 years...not fun.
I am now walking 2-3 miles a day on the treadmill and can do 3 miles on a stationary bike in 8 minutes. The physical therapy although VERY painful has helped immensely.
I coud not afford not to work, so I went back to work on Nov job is in telecommunications installation and network I was able to work the help desk for 3 weeks...but I am now back out in the field. I am in the states. The price of the surgery was 31k JUST for the hospital stay and parts...the doctors fees was around 6k...I have a total out of pocket for the year of 6k so that's what it ended up costing me.
Was it worth it? Yes, because the pain I am experiencing now HAS an end point..the lingering pain of the ongoing knee isuues was  to be never ending.
I can now bend my knee 128 degrees (just today) and that is better than the 118 I had before the surgery and can straighten it t 12 degrees, lower than the 18 degrees post op.
I hope your son can do the surgery...don't let the doctor determine should be his decision.
The doctor tried to tell me to wait as the replacement has a shelf life of 10-15 years...but seriously, I want to live and do things NOW, not at age hiking (which I will be doing in JULY.)
Good Luck,