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Author Topic: Only 40 , do I really need a knee replacement?  (Read 1785 times)

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Offline kgunlock

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Only 40 , do I really need a knee replacement?
« on: September 06, 2005, 03:36:06 AM »
I am 40 but have had a bad knee problem for almost half of my life.  I tore my ACL (right knee) in 1986 and had a reconstruction in 1989.  Re-habed and did pretty well for 5-6 yrs but have had increasingly bad pain for the last 10 years.  I had two other surgeries (one in 1987, one in 2000) in which they removed cartledge.  With the pain getting worse, I saw yet another doctor this summer.  He took an exray and showed me that I have no cartledge left on the interior side of my right knee.  The bone is touching!  However, the exterior still looks ok.  That made sense to me because that is exactly where my pain is.

At that point, the doctor breifly mentioned partial knee replacement, but proceded to inject a steroid shot.  I was told this should ease the pain for several months.  It did seem to work for the first week or so, but that was about it.  Other than that one injection, I have not taken any types of pain medications at all and feel strongly that I should stay off of them as long as possible.

I would love to hear from anyone who has had experience with the partial knee replacement.  Is this even a good option?  Should I be delaying surgery untill absolutly necessary?  Are there any other options?

I am located in central US. 

Thank you for the feedback.


Offline stgiles16

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Re: Only 40 , do I really need a knee replacement?
« Reply #1 on: September 06, 2005, 03:45:34 AM »
Depending on the size of the lesion (the spot where you have a hole in the cart) there may be several options. There is microfracture, ACI, Maci, OATS. Not all OSs do all of these procedures but before I let them put in a partial knee replacement at the age of 40, I would get a second or even third opinion.

As for the cortizone, I had one last year and never felt any relief from it. Some people love them and get months of relief, but I didnt get one single day out of it.

good luck and dont just jump into that replacement thing without lots of research and some more opinions. YOu can also check out the arthritus section at the bottom of the site. Read thru some of the threads for more info

2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
LOA & PKR 2/15/06
in pain mgmt
TKR JAN 2012

Offline kath

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Re: Only 40 , do I really need a knee replacement?
« Reply #2 on: September 06, 2005, 04:42:15 AM »
Hi kgunlock,

Missy is absolutely right in recommending you get a second and third opinion with knee specialists to determine what your options are.  It truly depends on the extent of damage you have on the medial side as to what procedures will possibly work for you.

Some OS's will look at an osteotomy as an option to realign the leg so that the weight-bearing is distributed more evenly throughout the knee. 

I've had partial knee replacements done on both knees at the same time due to bone on bone in the medial (inside) compartments.  Due to the extent of the damage, my only options were osteotomies, or PKRs.  My right knee had the possibility of needing a total knee replacement.  My OS highly recommended I go for the PKRs as he determined that an osteotomy would probably not have as good an outcome for me.  I had the surgery 10 months ago at age 49, and am extremely happy with it.

You may wish to read the posts on the ARTHRITIS BOARD under Unicompartmental Knee Replacement.  One of the members, Stefanie has had PKRs and she is in her 30's.

It's very important to do lots of research and get opinions from those who have been there, done that, so you can ask the questions of your OS that need to be asked...especially concerning what options are available to you.  Your pain level and quality of life are good determining factors for having any type of surgery.  Remember too, that there is no going back once you have a PKR...the next step is a TKR.

Hope this helps!.. Glad to answer any questions you might have re my experience with PKRs....kath

Bi-lateral unicompartmental Nov 2004

Offline Crackers71

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Re: Only 40 , do I really need a knee replacement?
« Reply #3 on: September 06, 2005, 02:49:46 PM »
Mate, I live in Australia and like you am only young.  I have had 11 ops on my right knee with the last two being the major ones.  No cartilage on medial or lateral sides and I have worn through the joint surfaces (femur and tibia) on the lateral (outaside) of the knee.  All the small ops were arthroscopies and repairing ACL injuries.  The last two have been Femoral Osteotomy at the knee to realign the lower half of the leg and level the weight bearing more through the centre of the knee, thuis easing my pain on the outside of the knee. The surgeon did a fantastic job and I had to go back in 6 months later for lateral release so the patella would track through the centre of the knee also.

This was to prevent a knee replacement.  suggest you might want to speak with your surgeon to consider a tibial osteotomy (as I think your problem is the reverse of mine) and this will buy you time.  I am currently being told a partial or total knee replacement will last anywhere from 10-15 years depending on age/weight/activity level etc and would want to put it off for as long as possible as they are saying based on current technology you will get around 3 replacements in a life time, regardless of a partial or total repalcement.

Ask if youve got any other questions about rehab etc etc