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Author Topic: Knee replacement for young adults? Need advice  (Read 10388 times)

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Offline Shamby66

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Knee replacement for young adults? Need advice
« on: October 03, 2008, 02:07:55 PM »
Hello my name is Shawn.  To make a long story short, i am 26 yrs old and  i have had 3 knee surgeries on the medial side of my left knee in the past 2yrs.  I have been living in pain that it has effected the way i work and the way i live.  I have no cartilage and when i walk its bone on bone, and i have fluid that wont go away.  I have a severe defect and svere osteoarthritis.  My doctor with sports medicine at the University of Miami has treated me with antiinflamatories, a brace, gel shots to help cusion the knee, and theropy with no improvement what so ever.  He said the only option for me at this point was to have a osteotomy and i have read that the operation has very poor results.  He tells me that a knee replacement surgery is not anoption for my age.  I dont want to live in pain anymore and im tired of being on the medications and having the injections.  I have been in the coast guard now for 6 yrs and now i am getting a medical discharge.  I dont want to live my life in pain after i get out.  I havent been physically active in over a year and a half and i feel very much out of shape.  Also not only do i have the knee issue but i walk with a limp and now my back is starting to have problems.  Can anyone give me any insiight on knee repacement for my age? If its a procedure to stable me and let me live a better life i dont see what the problem is.  I know the operation is intended for older men and women, but i have a sever case that wont get better in time and i feel that i have exhausted all means to improve my quality of life.

Thanks,

Shawn H.

Offline JAYHAWK

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Re: Knee replacement for young adults? Need advice
« Reply #1 on: October 03, 2008, 06:11:22 PM »
Shawn....while I am significantly older than you could use your diagnosis as my situation is almost identical.  I fought progressively worst arthritis for years....had four menistecomies on my left knee and one on my right and was bone on bone.....tiried all the non-surgery procedures (multiple Hyaluronic acid injections and cortisone on a quarterly basis).  I delayed a replacement because of the brutal rehab and the fact that I didn't want to wear out the prosthesis and have the surgery multiple times.  But like you got to the point that my quality of life had deteriorated and finally had my left knee replaced in July and plan for my right in November.  Fortunately, over the years that I waited the minmally invasive quad sparing procedures were prefected.  I believe the key factor in your age is that you will most likely wear out the prosthesis and will need to have it replaced multiple times. 

My advise is to do the due diligence on the total knee arthroplasy, doctors in your area that are joint replacement specialists (should do hunderds of knee arthoplasties a year) and even research the specific knee manufacturers.  Once you have identified the key doctors....go meet with them and ask questions....they will be your best source of information on age related issues.   I have a sports medicine orthopaedic surgeon but he did not do replacement surgery...more important I would not have used him anyway even though he is a friend. 

Good luck....remember knowledge is power.   

Happy to share any information or my experiences with you.


Steve
Spring, Tx.

Offline Shamby66

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Re: Knee replacement for young adults? Need advice
« Reply #2 on: October 03, 2008, 07:46:19 PM »
Steve,

Thanks for the info...Yeah the doctor that I am seeing wont do the knee replacement, but i feel like its my only option.  This is the second doctor i have been to, because the first one had wanted to do the knee replacement.   Thats when I didnt realize how much of a serious problem that i had, so i wanted a second opinion.  From what i have read about having the surgery for younger people is that the parts wear out over time and thats what i am afraid of...but then again if it last for 15-20 years with good results then id rather take that route, all i know is i dont want to continue to live the way i am living cause im afraid that it might lead to greater health problems if something doesnt change.  Im just trying to get info and some results from the younger generation to see how the surgery has helped them afterwards.  Thanks for the info Steve, and i wish you the best of luck on your upcoming procedures.

Shawn H.

Offline jathib

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Re: Knee replacement for young adults? Need advice
« Reply #3 on: October 03, 2008, 08:35:56 PM »
I urge you to get more opinions from 2-3 more orthopedic surgeons. For one thing, if only your medial side is damaged you could be a candidate for a partial knee replacement rather than a total knee. That's a much better option for you. I'm not sure where you read about the osteotomies having a high failure rate though.  I think there are several people on here that have had good results. I was almost 49 when I had my PKR. At the time my doctor said I was a "tweener". I was at an age where I could have opted for either an osteotomy or PKR. An osteotomy would have allowed me to continue with high impact sports and whatnot if I was so inclined. Since I was only into swimming and biking that didn't matter at all. My doctor told me either way the surgery would buy me 7-10 years before I'd need more surgery. In the end, I opted for a PKR because I didn't want my leg realigned. I was also told it was easier to convert a PKR to a TKR than it was for an osteotomy.

If I was your age I wouldn't rule out an osteotomy though. But I would find a doctor that had done a lot of them.

Offline maryc

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Re: Knee replacement for young adults? Need advice
« Reply #4 on: October 03, 2008, 08:40:02 PM »
Shawn - first let me say thank you for your service in the Coast Guard.  I appreciate what you have done for our country.
I did a quick google of "Total knee replacement in young people" and got a variety of results.  The main themes seem to be that young people are more active and wear out the joint faster, the revisions are not always successful.  The other item that is not often mentioned is insurance.  Some insurance companies won't cover it for anyone less than 50.  Some will only cover 1 replacement and 1 revision.  
Whatever you decide I wish you the best.
Sending healing rays your way
8/4/07 fell
8/5 diagnosed TPF
8/6 surgery plate and 6 screws
8/12 out of hospital NWM
8/21 staples removed
9/18 OS appt - WBAT with crutches
10/10 - WBAT with cane
10/27 - back to work w/cane
12/26 - no cane, slight limp when tired
1/25/08 - released from PT, no limp
2/3/09 - Released by OS

Offline ehv74

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Re: Knee replacement for young adults? Need advice
« Reply #5 on: October 03, 2008, 09:36:41 PM »
Knee replacement in young patients
Total knee replacement in young patients

Total knee replacement is generally performed in older patients. [Edited by KNEEguru] For young patients [edited]  Zirconium, a ceramic coated metal ensures longer survival of the prosthesis after implantation. [Content dedited by the kNEEguru]

Advantages of Zirconium
1) The significant advantage of Zirconium knee implants is that it is considerably harder. On testing it lasts 85 times longer in tests that simulate the stresses inside the actual knee.
Additional advantages are scratch resistance.
2) When it is wet, ceramic can glide smoothly along plastic, making for smoother motion than with metal-on-plastic. As a result, the Oxinium total knee replacement will not generate the quantity of plastic wear debris that cobalt chrome will, and the implants should last considerably longer.
Zirconium is one of the six most biocompatible elements know to man. So, your immune system will more easily tolerate your new implant.
3) Lastly, patients who are allergic to nickel, the metal most often used in the current implants, cannot currently receive total knee replacements. The ceramic implant, however, can be implanted safely in patients with nickel allergies, since it uses a zirconium alloy with no nickel. Implants made of Oxinium have been implanted in larger number of patients in the UK Australia and the US with great success.
Who would benefit most from an Oxinium (zirconium) total knee replacement?

Three types of patient have been identified as the "best" candidates for an Oxinium total knee replacement.
"Younger" patients: Because Oxinium knee implants offer significantly less wear compared to cobalt chrome implants, they are expected to last considerably longer. In the past, orthopedic surgeons have advised patients less than 65 years of age to wait to have knee replacement surgery because the life span of the cobalt chrome knee implants is only 10-15 years. Now, surgeons have a viable option for a younger patient who previously would not be a candidate for a total knee replacement because the Oxinium knee implants should last much longer. Therefore, a patient under the age of 65 who has advanced arthritis of the knee no longer has to suffer for years until he reaches an appropriate age for total knee replacement surgery.
"Active" patients: Patients, who desire to return to an active lifestyle, including sports, dancing, gardening, or other strenuous activities, may also benefit from an Oxinium knee replacement. As a result of their high activity level, this patient population will put more "wear and tear" on their knee replacement, which can cause the implants to wear more quickly. An Oxinium knee is better able to tolerate this high activity level and last longer that the traditional cobalt chrome knee.
Metal allergy patients: Because Oxinium is one of the most biocompatible materials known to man, it is the only choice for patients who exhibit metal allergies. Patients who have needed total knee replacement surgery, but could not tolerate the cobalt chrome implants due to their nickel content, can now have the surgery they need to return to an active lifestyle without the fear of an allergic reaction. http://www.youtube.com/watch?v=L_-nzQN_MxY  A Total knee replacement may sometimes be advised in young patients with advanced joint destruction. [Some content edited out by the KNEEguru]
« Last Edit: October 04, 2008, 08:52:13 AM by The KNEEguru »

Offline Shamby66

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Re: Knee replacement for young adults? Need advice
« Reply #6 on: October 03, 2008, 09:42:09 PM »
Thanks alot for the info....im not all worried about the insurance cause i am fully covered through the military, its just a matter of finding a treatment to stable my situation....i understand reguardless of what i do...im going to have knee issues for the rest of my life, but i just need to find the best option for my condition.....Its just funny how so much technology we have, but yet we dont have a complete cure for people that have my diagnosis

Offline stephenfharris

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Re: Knee replacement for young adults? Need advice
« Reply #7 on: October 22, 2008, 05:50:51 AM »
Shawn,

I'm 35 and had a tkr last year due to a snow skiing accident which resulted in a tibial plateau fracture.  I didn't walk for 2 years and went through numerous surgeries to repair my knee.  I am now walking again and have returned to a somewhat active lifestyle.  Retired from skiing but playing golf!  I too was told I needed a tkr, but was too young.  I had 3 surgeons through it all.  My current surgeon decided it was time to do the tkr, but encouraged me to get 2nd opinions so I was comfortable with what we were going to do.  Knowledge is power.  You will always have uncertainty, but being educated is your best directive of fate.  Just keep getting more opinions and don't jump into anything too quickly.  For me, the tkr was an absolute necessity and it worked.  Am I as active as I was before...nope.  But with my new knee, it's for the better.  I cannot abuse this gift and my second chance at mobility.  The better I take care of this knee, the better and longer it will take care of me.  Who knows how long it will last?  But I had lost my quality of life and I knew it was worth the risks. My hope is that down the road, if needed, there will me medical advancements to help me out in the future...i just didn't want to wait and say "what if."  Best of luck to you.  Stay strong and positive.

Stephen
Fredericksburg, TX

Offline bavage

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Re: Knee replacement for young adults? Need advice
« Reply #8 on: October 25, 2008, 04:04:13 AM »
I prefer to believe that age has nothing to do with living a productive life. If life has given you bad knees...then by all means replace them!!

Your medical pros seem to be nibbling at the problem and generating fees while doing you no good.
If the problem can be solved with TKR,then go for it. It's not life-threatening and the result is lots less pain and worry.
Certified Dietary Manager, ServSafe Proctor, Options Trader.           

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Offline bumknee83

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Re: Knee replacement for young adults? Need advice
« Reply #9 on: April 19, 2011, 09:14:02 PM »
Hey Shawn I have the same prob as you but Im 2 years older.  I had four knee surgeries including a fracture.  I have bone on bone arthritis on the medial side of my kneee....I mean you litterally see NO space between my bones on that one side of the knee.  Going to ortho later this week to find out my options....my case is a little different though, I had a srtroke due to multiple heart defects so i dont walk right anyway and theres no way for me to put extra stress on that joint should they decide to replace it but now as it is Im in severe pain daily, i live in an upstairs appartment and i have to go up one step at a time or you can actually hear crunching sounds......I will let you know what i find out....
Apr 05-right MPFL repair
May 08-tore right medial meniscus
Jun-Sept 09 4 patella D/L
Aug 09-had CT scan
10/15/09 rt medial closing wedge HTO/MPFL recon w/ transplant
12/4/09 rt patella fx
12/7/09 rt ORIF
6/10 shifting hardware and non-union
7/10 patella h/w removal
7/12 need tibia h/w removal

Offline Jill M

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Re: Knee replacement for young adults? Need advice
« Reply #10 on: April 21, 2011, 02:28:41 AM »
Shawn,
 I too had multiple surgeries. I had an osteotomy with a meniscus transplant 2 years prior to my TKR. The osteotomy and transplant didn't fail, instead I developed athrofibrosis (severe scar tissue) and had to have multiple operations and was never able to fully extend by knee. This was life altering and causing pain. I wasn't happy living that way. That goodness I found this site. I started to seek opinions from multiple orthopedic surgeons. I was not a normal case because of my previous osteotomy and even at the age of 40 some were still hesitant to perform a TKR. After several opinions I found a surgeon that I trust and really believed that could really help me. I had a TKR 1/20/11. So far I am doing well.
I would urge you to seek multiple opinions. Before I had my osteotomy I saught a second opinion for a possible PKR. At that time the didn't advise performing that since my bone on bone was in the lateral compartment. He told me that if the osteotomy/transplant were to fail then I would always have a back up to convert to a TKR. Once you have a TKR there is no going back. The major concern with performing a TKR in a younger patient is the future replacement surgeries.
There is a Mayo clinic in Florida that might be worth looking to. They are cutting edge with medical procedures. You can go to the website and find information. You may have to travel out of state to find the care that you need. I traveled over 6 hours from home to have my TKR.
 Best of luck to you as you make this difficult decision. 
Jill
« Last Edit: April 21, 2011, 02:31:08 AM by Jill M »
8/07 Right subtotal meniscectomy
4/08 Chronic meniscus tear, grade 4 changes
10/08- R distal femoral osteotomy, lateral meniscal transplant, tibia microfracture, osteochondral allograft femur
12/08- AF noted, LOA
2/09- MUA
8/09- extensive LOA, patella baja
1/20/11- TKR

Offline Redwing

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Re: Knee replacement for young adults? Need advice
« Reply #11 on: April 21, 2011, 07:12:49 PM »
I'm just pointing out that this is an old thread.  Shawn has not been on the board for over two years.
« Last Edit: April 21, 2011, 09:17:43 PM by Redwing »
2001: first referral to OS for osteoarthritis in knees after about 5 years of OA pain.  Told I was too young for knee replacement.
July 2009 Bilateral arthroscopy
Jan 2010 TKR-right knee















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