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Author Topic: PKR at 38?  (Read 4149 times)

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Offline caroline889

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PKR at 38?
« on: February 08, 2011, 10:43:13 PM »
I have grade 5 arthritis the the patellar-femoral joint. should i have a pkr. If I do what happens  in 20 years time?

thanks
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline caroline889

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Re: PKR at 38?
« Reply #1 on: February 08, 2011, 10:48:19 PM »
its supposed to read grade 4
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline Caroline109

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Re: PKR at 38?
« Reply #2 on: February 10, 2011, 02:37:43 AM »
At your age, I would worry about the rest of your knee becoming arthritic over the long rest of your life. A PKR is much easier to recover from (having had a PKR and a TKR and about to have the PKR switched to a TKR, I have a lot of experience), unfortunately! My PKR lasted about 1.5 years before arthritis showed up elsewhere in my knee, but I had to wait until now to get it switched out as I had the TKR in my other knee. I do know at least one other person, someone who has posted here (his screenname starts with ROtten-I think it's ROttenkid or something like that) who also got a PKR (though his replacement went in a different knee compartment-mine was the medial, I think his was the PF), who is now getting ready also to get his PKR revised to a TKR.

And, btw, I like your name (notice my screen name!)/
Caroline
Chronic low platelet count
Men. surgery, both knees 2003,2007,2008
R PKR Sept. 17, 2008 - Biomet Oxford Partial
LK-TKR 4/21/2010 Biomet Vanguard Signature Knee
Scar tissue issue next to TKR knee
March 2, 2011: PKR to be revised to a TKR

Offline TwoBadKneesUSA

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Re: PKR at 38?
« Reply #3 on: February 10, 2011, 03:15:35 PM »
If the arthritis is strictly behind the kneecap (patella femoral joint), then maybe a PFJR partial may work for you.  The reason for the wear of cartilage should be addressed too.  Tilt, maltracking, etc should be fixed too or the partial will just wear out the same way as the original stuff.  I was 39 when I had mine and am very happy with it.  I waited until I could no longer really do daily activities before I went ahead.  I also know that down the road the rest of the knee could get arthritis and I would need a TKR.  The type of PFJR I have can be converted pretty easily to a TKR if needed.  Hope this helps.
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline caroline889

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Re: PKR at 38?
« Reply #4 on: February 11, 2011, 12:09:33 AM »
thanks to two bad knees and caroline  (great minds think alike caroline) for the advice. Im thinking carefully  about whether to have an osteotomy or pkr. It is a dilemma.

Caroline
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline pegleg78

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Re: PKR at 38?
« Reply #5 on: February 11, 2011, 12:29:45 AM »
I had a medial PKR at 26 and I know that is very young, but it changed my quality of life! I'm so glad I had it done it made a great difference.
99 ACL, med, lat men repair
00 Med menisectomy, lat men repair
01 med, lat meniscus transplant, ACL rev, LR
01 chrondroplasty, manip & debrid
02 med, lat partial menisectomy
03 Arthrotomy,  LOA, LR
05 chrondroplasty, lat men repair, shrink ACL
05  med menisectomy, chrondropla
05 med PKR

Offline KW

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Re: PKR at 38?
« Reply #6 on: February 11, 2011, 01:34:31 AM »
I had a PFJR at 34 and have not looked back one day since.  I had no signs of arthritis in any compartments besides the PF area at the time of the PFJR and 1.5 years later I still have no additional issues.  If (when) the time comes to convert my PFJR to a TKR it can be done pretty easily since I lost very little natural bone with the PFJR. 
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Joanna

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Re: PKR at 38?
« Reply #7 on: February 21, 2011, 12:17:15 PM »
Hi,

I have a similar problem.  I am 39 and have grade 4 arthritis in my right knee after two failed MACI operations.  I had a HTO which has helped with the pain but now my left knee is going the same way and probably needs a HTO as well.  My main problem is terrible back pain which is usually worse that the two knees.  The back pain is due to all the knee problems and will probably only get better if I get a PKR to the right knee.

The surgeon said they would do the knee but really don't want to do it until I am at least into my 40s.  It is encouraging to hear that there are some much younger than me that have had a PKR with good results.

I think I will do a bit more research.

Joanna
3 Arthroscopies; 2000 - Shaving and clean out; 2001 - Wash Out; 2002 - 1st Stage ACI. 2nd Stage ACI - 2002; Arthroscopy to check ACI graft - 2003; ACI failed - Jan 2005; High Tibial Osteotomy & MACI - March 2006; Hardwear removal - 2007; MACI failed - 2009.

Offline Lottiefox

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Re: PKR at 38?
« Reply #8 on: February 21, 2011, 05:24:54 PM »
I have worn out kneecaps (Grade 3-4) but function OK for the majority. I will need replacement parts at some stage - my medial compartments are also thinning and I suspect that I will one day need TKR rather than the PFJR as replacing the PF section won't see me through for the longest time. However, speaking with my OS last week he was talking about new PFJRs parts that are being used now, with life spans of 20 years and made of ceramic with a much simpler (relatively speaking!) insertion and capacity for adjustment around them. as said, your doc must look at any alignment issues, or the new parts won't work any better. I will definitely need to untilt my kneecap, and possibly a shift of the tubercle tendon insert -  but ideally not. Its a skilled job getting a PFJR properly working, if you go for one, make sure you're not the guinea pig for your OS!

Joanna, where are you based? My OS says he won't decide when I need one based on age, but on function and life quality. I'm a fit, active 42 year old (as active as you ever are without any impact activity and some creaky kneecaps!).

Good luck

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Joanna

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Re: PKR at 38?
« Reply #9 on: February 22, 2011, 07:48:03 PM »
I am based in the UK and go to the Royal Orthopaedic Hospital in Stanmore.  The surgeon I spoke to said that they would put me on the waiting list but he advised that I should wait as long as possible - that was about 18 months ago now.  I decided to see how long I could last but I was diagnosed with arthritis in my other knee last year and this has kind of knocked me for six.  I am getting to the stage where the pain killers just aren't working as well and I don't want to take any extra.

I have to weigh up the time of work required - I have probably had about a year off work over the last ten years due to all the knee surgery I have had.  They are good about it but I feel really guilty.

I keep myself fit - I love walking and riding my bike so this helps.

Best wishes
Joanna
3 Arthroscopies; 2000 - Shaving and clean out; 2001 - Wash Out; 2002 - 1st Stage ACI. 2nd Stage ACI - 2002; Arthroscopy to check ACI graft - 2003; ACI failed - Jan 2005; High Tibial Osteotomy & MACI - March 2006; Hardwear removal - 2007; MACI failed - 2009.

Offline caroline889

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Re: PKR at 38?
« Reply #10 on: February 27, 2011, 09:27:26 PM »
H iJo and Lttie

Thnaks for your posts. It does make you feel better when you know there's others going through the same thing but you feel like the only one. I'm scheduled for a osteotomy and AMIC on my right knee.  Hopefully this will put off the PKR for 10 years if it works. Then I will have to see whats happening in my left knee. Ive read about cartilage transplant (CARES) but my consultant said it is unlikely to work in my case. I wondered whether you have been told anything about this.

Thanks and good luck to you both

Caroline
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline dotzysmom51

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Re: PKR at 38?
« Reply #11 on: March 05, 2011, 03:55:45 AM »
I had PKR  at 45 was walking aid free within 5 days of being home.  Make sure u get a cpm it is wonderful for rom I can touch my knee to my nose and kick as high as i could in high school.  My problem now is a 5mm long by 3mm wide bakers cyst which has been drained 3 times and now the ortho is talking surgery to remove cyst.  I keep reading it is caused by other problems....not a nmice surgery to have.  As for PKR i say it did a world of good for me.  Good luck to you