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Author Topic: I NEED A KNEE REPLACEMENT.. at 37  (Read 3130 times)

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Offline kerristevenson

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I NEED A KNEE REPLACEMENT.. at 37
« on: August 09, 2011, 09:28:38 PM »
I am 37.. have 2 junk knees.. had a fulkerson with LR in 09.. lost 4o lbs this year.. blew  out my back because I cannot kneel and have issues using my legs to lift stuff because my KNEES SUCK SO BAD..

SO . got a herniated disc now in my lower back.. which they want to send me to pain management for.. (BULLCRAP) and they say I need to lift properly with the KNEES.. (OK lady.. Look at my knee.. can you see all the scars) NOT gonna happen..


ANYWAY... What can anyone tell me about knee replacements at my age of 37.. which I think is YOUNG

The back doc is telling me that you can get as many knees in your lifetime because they can now replace PARTS of the TKR without having to replace the whole joint..

ANY IMPUT is appreciated please

Kerri
Pain started at age 20.... I am 36 now
Years of PT.. what a joke
4-2009 Fulkerson w/ LR right knee
11-2009 screws removed
Left knee is a mess still..

Offline subwayknees

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #1 on: August 10, 2011, 04:10:14 PM »
As someone with eight knee sugeries actually 12 if you count arthroscopic, and a failed knee replacement who has been to no less than five top teaching hospitals in th US and is now seeking a final decision or revision, athrodesis or amputation due to off the chart pain I will try to answer your questions.  I have a number of responses under (subwayknees) which can help.
First NEVER have a total knee replacement without getting at least three consults from three different doctors.  Knee replacements are cash cows for docs and hospitals and I feel are highly overrated.  If you look just at Knee replacement at this site you will see how many people suffer after them.  While some do get relief once you start you are going down a road blindfolded.  First I NEVER heard a doc say you can do as many revision and "part changes as you need to.  You have issues of post operative infection, of loosening etc which can cause too much damage to the bone to do more than one revision.  Also all the literature states that with each additional revision attempted the chances of a satisfactory outcome drop sharply.  You should google (risks of revision total knee surgery) and hit enter and you will see hundreds of articles in journals dealing with the difficulties if not impossiblities of doing multiple revision surgeries.  Yes you can exchange the poly insert but that is only for one problem and I have heard of tibia only revisions, but usualy it is the whole thing.

I am sure there are conditions where a tkr is needed at 37 but I would highly suggest you seek a consult or two from physicians tied into a Teaching Hospital.  You can simply get a list of Medical Schools in your area and call their Hospitals and get the names fo their knee docs.
Also if you look at patient satisfaction reports online for total knee replacements you will quickly learn that for every slick television advertisement showing a knee paient playing tennis or swimming after a replacement, there are patients who cannot walk, are in worse pain than before and regret the procedure.

I am not saying that some people cannot benefit, only that every time I see an orthopedic surgeon I meet patients who regret they ever had the surgery, there are braces that can help. there is physical therapy and life style changes that can help delay when the first replacement is done.  I would not even consider it until I had attempted those options. True you could be one of those lucky ones who relly benefits but it is a real chance at your age long term.

Also if peoperly managed pain management can be helpful.  I have been on it for many years and it has kept me going.  I am in a wheelchair and cannt walk but pain meds do make it possible for me to do a few things.

Not all pain docs start with opiates right away, there are nerve stimulators, injections etc that can help, and frankly if you had a total knee replacement that did not work out as is the case rather often you would have no choice other than pain management, only then you would most likley need the heavy duty meds that can be addicting.  Botton line for what it is worth do a lot of your own reseach, see several University affiliated surgeons, not just a local doc from a local hospital
and check all your options.  In the end you may need the surgery but I would only consider it at your age after I did a lot of research, asked a lot of question and seen a number of knee surgeons.  It is easy for some docs to say "we can do multiple surgeries" they make their living that way, but what about infection, what about bone loss, what about issues in tissue closure from impeeded blood flow due to scar tissue, and then the ever present concern for blood clots after every knee surgery, they can kill you.  How many doc's advertise that, in fact about six months ago a woman who was posting on the knee replacement site passed away from a massive blood clotting issue after a revision, or it may have been a primary, but she did die. In  my humble but well researched opinion I would start calling Medical Schools, and hit the net, not the junk web md sites but the orthopedic journals,  posting general statements like I suggested will give you access to hundreds of asrticles.  Go slow, know your options and ask as many questions to as many different doctors as you can, and don't hesitate to ask me anything else on this post, I am far from a doctor but have spent years seeing the top docs, in my case I have very few options left and I was 56 when I had my first tka, and they thought I may have been too young then,  I was.
God Speed

Offline eaglemom

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #2 on: August 10, 2011, 04:14:12 PM »
I hear ya......... knees suck and sometimes people make the stupidest statements - use your knees. If I could I would!!  Anyway, has your surgeon recommended the replacement?  There are numerous schools of thought on does age or pain determine replacement.  Personally its quality of life matter for me.  How do you deal on a daily basis and what about support from family?  Your the one determining the "when" because I'm sure you know you "will" have one.

As for your back that's a whole different item.  My other half just went through neck issues - 3 epidural surgery's and finally a major neck surgery with plate, etc.  There are lots of opinions there also - but please shop around for the correct surgeon when dealing with back.  We are fortunate to have a wold class place here and the care has been fantastic.  Instead of pain management have they tried physical therapy on you - about your back?  Just a thought.

Don't want to ramble on - do yourself the honor of lots of homework, referrals, etc when anyone messes with your back.  Or your knee for that matter.  As for replacing parts of the TKR I have read it "can happen" but don't know of it happening.  Again questions you'll have to as.  Each doc has their own "rules".  Hang in there & let us know.  eagle

Offline subwayknees

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #3 on: August 10, 2011, 08:33:40 PM »
EAGLEMOM SAID IT 100%

Offline kerristevenson

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #4 on: August 10, 2011, 08:35:26 PM »
SUBWAY AND EAGLE.. THANK YOU FOR YOUR REPLIES.. you have both given me a lot to think about.

I do not really want surgery .. but I am in pain all the flipping time..  The supratz injections are working for the pain in my knees.. to a DEGREE.. They want to start injections in my back. which I am very scared of that close to my spinal cord..

I just do not know what direction to go in ..

Pain meds (orally) do not seem to give me a boat load of relief.. unless then can possibly UP the dose

Does Pain Management really help ?
Pain started at age 20.... I am 36 now
Years of PT.. what a joke
4-2009 Fulkerson w/ LR right knee
11-2009 screws removed
Left knee is a mess still..

Offline subwayknees

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #5 on: August 10, 2011, 09:35:21 PM »
Like everything else it depends on your condition and the doctor you use.  In my case I have major lower back pain along with major knee pain.  I have gotten a number of epidural injections and radio frequency burns for mu lower bak which I find very helpful.  As far as the knee is concerned it depends on the origin or your pain.  It could be cause by your lower back issues or you could be bone on bone, there is a major difference. You may find that if you can get control of your back pain your walk may be different and take some of the strain off the knee.

If the knee pain is either due to bine on bone rubbing no back injections that I have heard of will help that.  If however the knee pain is neuropathic, or from nerve damage  issues injections may be helpful.
In my case after nearly 12 surgeries on my right knee I am dealing with both types of pain, mechanical from the loose tibia and neuropathic from scar tissue and nerve damage from all the surgeries,  I have had several attemps surgically to eliminate the scar tissue and it keeps coming back.  Pain management will only buy you time, and as my pain doc likes to say "it is pain management, not pain dissapearence"  In my case the only way I can live now is with high doses of morphine.  I have tried patches, stimulators, pain pump drops and antil inflamatory drugs, and I still could not walk.  With high doses of morphine on a good day I can walk a little in my house for maybe a total of a half hour then it is back to the super duper scooter store power chair, however without the morphine I would not be able to do that.  On bad pain day's and I never know when they will hit, buit it is at least 3/4 of my life the pain is so bad the morphine even on the high doses i take does little to help, it gets it from a 10 to maybe a 7 or 8 on a pain scale.
Pain management I suggest should be your first route before jumping into surgery.  When I said I have seen and read far too many stories like mine about failed total knee replacements I mean it.  Yes I have a bias, but I have spent so much time researching and reading and have traveled up and down the East Coast to a number of University Hospitals and have found the the really honest and well thought of teaching physicians will be very careful not to over sell knee replacement surgery.  I have found a major difference with the attitude of many private practice docs.  In fact I have found only two private pratice surgeons I have seen out of about ten who did not suggest a revision.  However at the University hospitals where the doctors are paid by the Hospital and are not on a fee schedule for their income they seem to be less revision oriented or if they say it is my only chance they are ALL very careful to tell me it may help, it may not help and there is a fair chance it could make things worse, but they do not make their living by the individual procedure.
I was less than three days from revision surgery when on the final pre op visit to a surgeon I pushed him hard asking if he really felt the surgery would help my pain level.  When I was totally blunt and firm he ended up saying that even if he did the most technically perfrct revision he did not think I would benefit in terms of pain, I would have a stronger knee but the pain would no be reduced.  I thanked him, rolled out and cancelled.
The reason I mentioned The Hospital for Special Surgery is that even a few University docs say I should go there, but my situation is far different than yours.  12 surgeries unable to walk or drive, living on morphine, the feel if anyone has the answers it would be the doc in New York, also the Redskins team doc that I will see in late August studies with The Hospital for Special Surgery and knows their to team doc.  But if you want to see the best and can travel to New York for a day it is worth it.
All I can stress is that you at a very young age will be replacing major portions of your body with man made artificial products.  If you watch t.v. many law firms are advertising for clients regarding recalled knees.  God fobid you get a defective product and need a revision with a year.  There are posts here that talk about people having revisions due to the wrong size knee, infection, falling, in just a few months after their first surgery.  No one not even your doctor can tell you what YOU should do, but if you ask enough questions, do enough research, and see a good number of doctors like a jig saw puzzle it will fall in place and you will know what to do.  The most important thing is NOT to let your doctor push you into major surgery where he picks up a good piece of money for three hours work and you have to live with it forever.
If after several med school consults you feel ok about it you will be much easier in making your decision, but now is the time to research, consult and plan and also give pain management a try to see if you can buy three to five years.
God Speed

Offline ausforce

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #6 on: August 11, 2011, 06:08:29 PM »
I had my first replacement at 43 and Im now 53 and both knees have now been done twice, the last one was operation 50 starting back in 1982ish. My right knee seems to be fine thou it has taken a few years to get going however my left knee is the problem child during rehab I ruptured patella tendon had it repaired then it went again. I have not had any back trouble yet but I've been warned that it may come. Good luck.

Offline eaglemom

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #7 on: August 11, 2011, 06:28:08 PM »
I just had a thought - what about a TENS unit.  Sometimes they can really do the trick.  Or at least it masks the pain and thus less oral medication.  Research research research.......eagle

Offline mamalama

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #8 on: August 12, 2011, 01:05:44 AM »
Hey Kerri,    I had a partial knee replacement at 39, too youg for full knee replacement.  I am 8 months post -op and doing o.k.   looking at my other knee now getting same procedure, pkr.   so i can tell you that i have no bon on bone pain to my pkr at all.  thr right one is barking bad due to compensating so much and stairs....uggghhhh...

As far as I know my  OS, said that at this age they tend not to do full knee replacements due to the fact that it won't last forever and 15 years later they have to do it again.  there is only so much bone they can cut each time.

so hope this helps, take care and good luck.

Offline Kmcsmiles

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Re: I NEED A KNEE REPLACEMENT.. at 37
« Reply #9 on: August 19, 2011, 03:16:00 AM »
Hi Kerri,
  What is your knee injury?  I am 33 and had a mpfl reconstruction along with a lpfl repair last Sept.  My OS said this surgery was more difficult than a total knee, but she did not want to do a total knee at my age.  I wonder what other options you have?  My surgery was very painful and difficult but more permanent from what she said and I read.  I have also had back pain related to what they think was how I walked, etc.    Good luck with whatever you decide!

Kendra
12/20/89: diagnosed hypermobility joint syndrome
88-96 numerous checks/mri's on knee pain
91- left knee dislocate
93-96 rt and lt knee lateral release, plica removal
12/09 dislocated rt knee
09/10 rt knee mplf and lpfl reconstruction
06/11 rt knee repair nerve damage and ligament
10/10 MUA
6/11 r