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Author Topic: TKR w/out a Knee Cap  (Read 2336 times)

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Offline Surfingkelly64

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TKR w/out a Knee Cap
« on: April 28, 2011, 05:38:01 PM »
I'm a 47 year old male that had a patellectomy 30 years ago. My knee is gradually falling apart, I currently have significant arthritis in the joint as well as bone spurs and a tear in the meniscus. Is it possible to have a successful TKR without a knee cap. Do you know of any such surgeries and how long the TKR will last compared to a knee with a knee cap.  ???

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #1 on: April 28, 2011, 06:03:49 PM »
I'm a 47 year old male that had a patellectomy 30 years ago. My knee is gradually falling apart, I currently have significant arthritis in the joint as well as bone spurs and a tear in the meniscus. Is it possible to have a successful TKR without a knee cap. Do you know of any such surgeries and how long the TKR will last compared to a knee with a knee cap.  ???
I'm awaiting to find out the same myself. I had mine removed 23 years ago and now my knee constantly gives way, although it was never that strong to start with. I have an appointment to see an O/S on the 26th May, there does seem to be some light at the end of the tunnel for those who have had a patellectomy. A Femoral Trochlea Replacement is one of the few options for us, what has your O/S said?
« Last Edit: April 28, 2011, 06:17:57 PM by Solar Cycles »

Offline Surfingkelly64

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Re: TKR w/out a Knee Cap
« Reply #2 on: April 28, 2011, 06:21:46 PM »
I just saw a doctor yesterday. I'm going to try a Medial Unloader Brace and OrthoVisc injections. My doctor would like me to wait as long as possible before doing a TKR.

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #3 on: April 28, 2011, 06:24:38 PM »
I just saw a doctor yesterday. I'm going to try a Medial Unloader Brace and OrthoVisc injections. My doctor would like me to wait as long as possible before doing a TKR.
For what reason? If he's suggesting that your too young, then get a second opinion.

Offline Surfingkelly64

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Re: TKR w/out a Knee Cap
« Reply #4 on: April 28, 2011, 06:31:34 PM »
He is one of the best surgeons around. He likes to have TKR patients as close to 55 as possible, just because TKR's only last so long. The longer we wait, hopefully the technology will get better. We're going to try the knee brace first. If that doesn't work then we'll try the OrthoVisc injections. I've had past doctors who were all too eager to do surgeries as a first suggestion. I appreciate a doctor who likes to wait as long as possible. I think he has my best interest in mind.

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #5 on: April 28, 2011, 06:38:53 PM »
He is one of the best surgeons around. He likes to have TKR patients as close to 55 as possible, just because TKR's only last so long. The longer we wait, hopefully the technology will get better. We're going to try the knee brace first. If that doesn't work then we'll try the OrthoVisc injections. I've had past doctors who were all too eager to do surgeries as a first suggestion. I appreciate a doctor who likes to wait as long as possible. I think he has my best interest in mind.
I would certainly get a second opinion, TKR'S these days last for up to 20 years, and making you wait until your some magic age is denying you quality of life  now. I'm also 47, and there are many younger than us who have had a TKR.

Offline Surfingkelly64

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Re: TKR w/out a Knee Cap
« Reply #6 on: April 28, 2011, 07:37:50 PM »
This is my third opinion, and they all say the same thing, wait as long as possible.

Offline Lottiefox

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Re: TKR w/out a Knee Cap
« Reply #7 on: April 28, 2011, 07:43:33 PM »
The magical age concept is a contentious one. I guess it depends on your current quality of life. If you function OK and can LIVE then try other methods. If you can't, then age shouldn't preclude you from a TKR. Why wait to start living life? You might drop down dead of a heart attack/be run over/get abducted by aliens at age 54 after many years of compromise with a worn out knee. Clearly every surgeon has their own preference and ethos, and every person has their own views. No right view, but if my life were curtailed I'd risk a revision than wait til I'm older (and won't heal as fast, and may have other health issues....).

In answer to the TKR after patellectomy my Aunt had patellectomy about 28 years ago - aged around 50 IIRC. She had TKR some 12 years ago on the remaining compartments. She has a lot of other health issues, and trashed the TKR falling in the snow last winter and breaking her femur. Prior to that she was doing well, for an 80 year old with poor health. At a younger age and with the right surgeon then I think it can be a succesful outcome.

Good luck anyway. Solar - good luck in May, keep us updated.

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 Surfingkelly64

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Re: TKR w/out a Knee Cap
« Reply #8 on: April 28, 2011, 07:49:50 PM »
I've had over 20 surgeries on that knee! If I can postpone another surgery and get by with a knee brace in the mean time that will help me with a better quality of life until I reach 55, so be it.

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #9 on: April 28, 2011, 07:55:09 PM »
Good advice from Lottie, just too add to that, I would keep on searching for as many opinions as possible. If your knee is as compromised as you say it is, then waiting around for another 8 years will be 8 years of your life gone, which you will never be able to reclaim back. Good luck!


Ps Thanks Lottie I'll keep you informed.  :)

Offline Surfingkelly64

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Re: TKR w/out a Knee Cap
« Reply #10 on: April 28, 2011, 10:21:20 PM »
If I can regain a good quality of life with the Unloader Brace, I'm not losing 8 years of my life. I don't do jack diddly squat anyways, so what am I losing? I haven't been able to run, jog, squat, or kneel in the last 30 years. About all I can do is ride a bike and take gentle walks.

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #11 on: April 29, 2011, 10:06:31 AM »
If I can regain a good quality of life with the Unloader Brace, I'm not losing 8 years of my life. I don't do jack diddly squat anyways, so what am I losing? I haven't been able to run, jog, squat, or kneel in the last 30 years. About all I can do is ride a bike and take gentle walks.
But if you had a TKR now then surely your quality of life would improve tenfold, just sitting back and excepting your predicament until you reach some magical age is plain daft. Sorry too sound harsh, but I know the Unloader Brace won't improve things much for you as I have one. When I had my patellectomy my surgeon told me I wouldn't be able to run or play sports, I proved him wrong as I was determined to get some quality of life back, I even had a bash at Rock climbing, and up until recently was an avid hillwalker. But alas my knee is just not up to it no more, and even walking from A to B is proving a challenge. But no way will I be told I'll have to wait until I'm over 55, I'm struggling now and want quality of life now, not later.

Offline Lottiefox

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Re: TKR w/out a Knee Cap
« Reply #12 on: April 29, 2011, 01:12:51 PM »
I think it is a tough one and quality of life is of course very subjective. The Unloader brace works for some folks, not for others. The issue sounds also that since the patellectomy your knee has been compromised anyway let alone the fact it now has arthritis? Why was the original patellectomy done? Have things got much worse over recent years/months? I think if you're not 100% sure of the TKR then the right thing to do is to delay it - but age shouldn't be an issue for surgeons or for the individual. If you don't want the op and the recovery at this time in your life then all well and good. But if the surgeon says that actually a TKR WOULD get you better function/less pain BUT its better to wait a while I'd be making the choice for sooner than later. But everyone is different!

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....

Solar Cycles

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Re: TKR w/out a Knee Cap
« Reply #13 on: April 29, 2011, 02:39:29 PM »
I think it is a tough one and quality of life is of course very subjective. The Unloader brace works for some folks, not for others. The issue sounds also that since the patellectomy your knee has been compromised anyway let alone the fact it now has arthritis? Why was the original patellectomy done? Have things got much worse over recent years/months? I think if you're not 100% sure of the TKR then the right thing to do is to delay it - but age shouldn't be an issue for surgeons or for the individual. If you don't want the op and the recovery at this time in your life then all well and good. But if the surgeon says that actually a TKR WOULD get you better function/less pain BUT its better to wait a while I'd be making the choice for sooner than later. But everyone is different!

Lottie  :)
Now that's a far more diplomatic response than mine Lottie, mental note to one's self there :)

Lottie makes a valid point about the reasons for you waiting for a TKR, I'm sorry if my post came across a little obtrusive, I get carried away sometimes :) Only you can decide what's right for you, good luck!

Offline Redwing

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Re: TKR w/out a Knee Cap
« Reply #14 on: May 01, 2011, 07:16:09 PM »
Lottiefox makes some very good points.  It depends on how the quality of your life is now. How much can you do?  How far can you walk now?  Do you wake up with pain in the night? How badly is it affecting the quality of your life?  TKR is mega, it is painful, very painful and the recovery is hard.  You will be out of action for at least three months and probably longer.  It will affect your relationships with the people close to you.  I know, I had one at age 58. A year on it was definitely worth it but at six months I was still unsure about whether I had made the right decision.  I wrote about my experience in this thread:

 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=50460.0

It would be a good idea for you to read some of the threads in the TKR section of the forum.  Most people have good results eventually from TKR but a few don't.  The TKR  forum is a mine of information and it may help you in your decision if you re-post your questions there.  You will get some replies form others who have been through TKR. There is a huge amount of help and support there. 

Good luck in whatever decision you make.

« Last Edit: May 01, 2011, 07:18:08 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