Worn Out Knee - what are the options?

[Bubba]

I am 33 years old and I have no cartlidge left on the right side of my right knee.  My Doctor is very conservative, he says I need a Total Knee Replacement.  He will not do the procedure due to my age.  What other options do I have?  I have heard about a new implant for people with my condition, but I have been unable to find out any information about it.

[jathib]

I don't know a lot about the transplants or implants other than they do exist. No idea how successful they are. My doctor says I'm too old (44) for such things and it wouldn't work for me. The option he gave me is an osteotomy. You can only do it if the meniscus on one side is still in good shape which mine is. This surgery basically realigns the knee so your weight is on the good side of your knee instead of the torn up side.  It's not a permanent fix. My doc said it will buy me about 10 years before I need a total knee replacement.

[Iona_-Uk]

My dad has very little cartilige left and has been told he needs a TKR and his surgeon is very reluctant to even consider doing it at his age, 44, the o/s say doing it now would mean repeating it again in 20 years time.

My dad was reluctant to consider other options but has been referred to an orthpaedic centre where they are discussing have a cartilidge transplant grafted from the ceells of his own cartilidge or having a synthetic one put in.

The surgery is quite major and the success rate at this centre is mediocre because of the very little research done in this area of orthpaedic. My dad is going ahead with this as a first resort.

I cannot advise strongly eough  to find and o/s who's speciality is knees, the difference between a knee surgeon and a orthpaedic surgeon is tremendous, in my experience.

Wishing you lots of luck
Iona

[The KNEEguru]

It would be good if you read up about the following newer managements for worn out joint surface:
synvisc injections (Hyalgen)
abrasion arthroplasty
microfracture
OATS (osteo-arthritis transfer system)
mosaicplasty
ACI (autologous chondrocyte implantation)
The main site has quite a full section:

http://www.kneeguru.co.uk/html/knee/knee_arthritis_02/diet.html

but there is much more detail on the web if you use the Google search engine.

[ChanderB]

I had the same problem back when I was 36.  I has already had 4 operations on my left knee and was in terrible pain.  I had abrasion arthroplasty done in 1983 September followed within 6 weeks by ACl repair.  It kep the knee going till Feb 2004.  There are many doctors who do not believe in this procedure, and few know how to do it right,  It worked for me, but I was lucky to get the originator or the procedure to work on me - Dr. Lanny Johnson.  I have also had the same done on my rt knee and it too is doing well.  Note that I had to curb my activities to cycling and nothing more strenuous than that.  Good luck.  Feel free to e-mail me or call me at 708-763-9661.  I have had good experience with AA.

Chander

[hilaryr]

Cartilage transplantation (cell-engineering)  has been done for 6 years at the Royal National Orthadedic Hospital in Stanmore and they say their success rate is 75%.  It has been done for about 10 years in other parts of Europe.  Hope this helps.

Hilary

[blackbeltgirl]

I have a similar situation on the lateral side of the knee, and I've been told that ACI is my best option.  (I'm only 30.)  There is a message board in the arthritis section with some really helpful posts.

[UofRSpider]

Unicompartmental knee replacement (partial knee).

[Mr.F]

I am 35 with bilater knee problems.  Like you I have no cartlidge in either knee.  No OS will perform TKR on me.  I did find an OS who after physical therapy, pain killers, knee braces, and synvisc (all failed to provide relief), on Friday (Sept.9th) suggested patellar-femoral replacement.  I just started doing research on this.  It sounds like if you have this surgery and down the road you need TKR the same parts that are already in your knee can be used in TKR surgery.