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Offline pdlucky

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Whats in store?
« on: October 25, 2011, 11:10:31 PM »
I am 36 years old male 6'1" 260 lbs.  I recently had arthroscopic knee surgery due to a tear in my lateral meniscus and overall knee pain.  The tear was from an injury that occured about 10 months ago and my knee pain was just too much for me to ignore.  During the surgery the doctor did a complete meniscectomy and he told me I had grade 3 arthritis under my kneecap and on my tibia and grade 4 on my femur.  The surgeon told me that from now on the only excercising I can do is swimming bicycle riding and yoga.  He ordered me an unloading brace and said with that I will be able to do some very light hiking.  This is horrible to me.  I have a 13 year old son and an 11 year old daughter.  We like to play basketball together and soccer and we are pretty active as a family, so the thought of not being able to do these types of acivities with my children is extremely depressing.  The surgeon told me that I'm basically to young for a knee replacement due to the fact that they only last 15 years.  He told me that if I lose some weight it will help with the pain but I will need to learn how to manage it and where the unloading brace.  He wants me to go to 6 physical therapy appointments to get some excersices to strengthen my quads and I'm just supposed to come back and see him in a year so he can get some standing x-ray's to track the progression of my knee degenerating.  Does anyone have any info that might help me wrap my head around a complete lifestyle change.  Should I get a second opinion?  The doctor was going to try to do a microfracture but since the arthritis was on the tibia also he couldn't.  He was also going to snip a piece of good cartilage so they could grow some in a lab to put back in but he said that my knee was too far gone for me to be a candidate for it.  The surgeon seemed very sincere and he felt seemed to feel bad for me but he really didn't give me any hope that things would get better until I get a replacement that apparently I can't have for quite some time.  If anyone on here has been going through a similar situation and have any advise or things to try please let me know.  The doctor gave me 150 vicodin and told me to go back to my regular physician after those run out.  I am in a ton of pain.  I had my first physical therapy appointment yesterday and I guess I shouldn't have taken pain meds before going in because it didn't seem like he was hurting me very much but as the night went on my knee pain got worse and worse to the point where I couldn't sleep and it has been extremely painful all day today.  I am frustrated and hurting and don't know what to do.

Offline brianwith2ndknee

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Re: Whats in store?
« Reply #1 on: October 26, 2011, 12:52:37 AM »
Hello ,
Sorry to hear about your situation . Im a 35 year old male on my 2nd go around on the right knee . I had an OAT's procedure with reconstruction this go around . It has been very rough for the last three weeks , but with focus and time it is getting better . The pain has now started to subside alot in the last couple of days . Enough to where I only take 1 or two pills a day . You really need to take your time with the rehab and focus on not letting the atrophy set in on your muscles . Every little thing you can do as silly as it seems as far as moving your feet as in pushing the gas pedal and etc , will help you in the long run . One product that I swear by is Glucosimine Chondrotin with Lotril . It will help your cartlidge and bones through out your body . It takes about 2-3 weeks to fully start working and be absorbed into your body . You will definitly benefit in the long run and can get it at your local grocery store . Let me know how you progress and if you have any questions . We all here can give you our own experience and self knowledge , but of course we all have different scenerios .
Knee Scope and Microfracture 03-2010
OAT's procedure , Reconstruction , Femoral nerve block 10-2011


Wishing everyone a healthy speedy recovery and good luck to all...
Brian S

Offline pdlucky

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Re: Whats in store?
« Reply #2 on: October 26, 2011, 04:58:59 AM »
Thanks any info i get helps.  I have read a few places about the glucosimine I will give it a try.  So you are 35 and they did a reconstruction?  Is that like the knee replacement that my doctor said I need?  I am trying to do some of the exercises tonight I just iced it so I can give it a try.  I am definitely having trouble with my quads and my knee feeling really unstable.  My surgery was on 10/7 so Friday will be 3 weeks, and my knee is still really painful.  Especially after my 25 minute drive home having to push my clutch in.

Offline pdlucky

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Re: Whats in store?
« Reply #3 on: October 26, 2011, 04:49:50 PM »
Has anyone had such a doom and gloom outlook like I was given?  I just seems crazy to me that in this day and age my life has to be altered so much due to this and I can't get a replacement because of my age.

Offline brianwith2ndknee

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Re: Whats in store?
« Reply #4 on: October 26, 2011, 05:28:58 PM »
I had forgotten to mention that with the quads given you an issue , which is one of my problems also , you might want to try doing quad sets if they have not mentioned that . You would be laying down or sitting up with your legs extended out . You then use your quads and upper leg to try and flex your knee downwards to the bed etc . This seems as if it is a minimum excersise but I have been doing it for two weeks now and have seen a big difference . Another scenerio is to see if you can get your dr to prescribe a TENZ portable unit . This unit is about the size of a pager . You can hook up to four electrodes up at the same time . It can be used as stimulation of the muscle along with muscle / post surgery swelling and pain . I have been using it at night to assit me in doing my straight leg raises as it fully tightens the muscle for me . Let me know how you make out .
As far as the procedure I had done , it was a bone and cartlidge transfer / replacement . They then did some re working for the alingment of the knee and all the other goodies inside . It was the last step prior to a full knee due to my age and work .
« Last Edit: October 26, 2011, 06:09:46 PM by brianwith2ndknee »
Knee Scope and Microfracture 03-2010
OAT's procedure , Reconstruction , Femoral nerve block 10-2011


Wishing everyone a healthy speedy recovery and good luck to all...
Brian S

Offline pdlucky

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Re: Whats in store?
« Reply #5 on: October 26, 2011, 07:05:28 PM »
The physical therapist has given me some similar excercises and I found if I iced my knee then I could do them but since my first visit on Monday I have been hurting.  I wonder if other countries have the same age issue when it comes to replacing the knee.  i have been told that I'm to young but I can't find a magic age that makes it ok to do.  It seems to me that I would rather have it now and enjoy the next 15 years and deal with what comes when it wears out after I have had time to do the stuff I want to do with my kids. 

Offline briceryant

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Re: Whats in store?
« Reply #6 on: October 26, 2011, 08:09:08 PM »
Consider than I"m 29, slightly overweight but much slimmer than you (ie. same weight but about 7 inches taller), not even married let alone with kids, have just had shaving of Grade 2 cartilage damage, and even I am switching to low-impact.

I understand your situation is tough but you're not a kid anymore and you've got to accept reality. You're talking about Grade 4 degrading of the articular cartilage - this means your BONE is showing, literally sticking out into the joint. So don't underestimate the level of your injury/disease. It is quite serious and there is as yet no cure.

You should consider that it's better for your children that you remain able to walk around the house and the park and do basic activities without pain or discomfort rather than feats of athletic prowess. You don't want to reinjure or start talking about chronic severe knee pain and then your children are bringing you food and water in bed, which they will eventually tire of and come to resent you for. The old saying - "pleasure is a dream while pain is very real." So be cautious, and avoid the worst-case scenario rather than dreaming of athletic Sundays in the park. Your kids will understand if you can't play soccer with them and such - you've got a bum knee! Make light of it and concentrate on activities you CAN do with them.

Cycling is a great sport; if you bought both of your kids nice bikes and took them for rides or vacations, I"m sure they'd come to love it. Maybe your family is not currently big on cycling but at 11 and 13 I doubt your kids are going to be against picking up a new sport, especially if they know you have to be careful with your knee. Look on the bright side!

Also, LOSE WEIGHT, and no excuses. I'm going to do this to help my knee out and you must also. This is just such a simple thing and our knees were designed to support lean hunter-gatherers, not technological monsters with chocolate pudding and bacon in the fridge 24 hours a day.

DOn't mean to be tough or overly pessimistic but I think the advice I'm giving you is sound, considering the negative situation. Be brave, but most of all, be smart.


Offline Lottiefox

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Re: Whats in store?
« Reply #7 on: October 26, 2011, 08:56:14 PM »
Being told you've got a joint that is prematurely aged is a tough blow. It is hard to deal with especially if you're active. yes you could seek a second opinion but to be honest your surgeon sounds pretty straight up and on the ball. If you have kissing lesions e.g. damage to the femur and tibia that meet then it is tough to repair using things like microfracture. Sometimes procedures like ACI can be done (the harvest and growing you mention) but you need enough good cartilage around the areas of damage to make it worthwhile and for it to have a hope of working. It is pretty new still and a LONG rehab with no guarantees.

People on here have had TKR at young ages. Some at 35 upwards. But it isn't a quick fix and you do need to bear in mind that should you need a revision in 10, 15, 20 years time then you will be facing a larger surgery with more risk of failure. However if your quality of life is SO compromised that there is no choice then I fall firmly into the group that says replace regardless of age. HOWEVER - the question comes as to quality of life. Not being able to do impact sports probably wouldn't be a big enough reason. Lots of people on here have had to shift their exercise and leisure activities because of premature wear and tear. Me including. I would rather not run now and be able to walk later......Yes it is frustrating if you have kids who want to do a lot of the hard on knees activity. But look at alternatives, seek out options. Even with a TKR you are not usually advised (or able) to go back to high impact activity as it places even more stress on the joint.

Once your knee has settled down from the recent surgery look at conservative measures. If you're serious about dealing with this, try and lose the weight. You will be AMAZED at the difference that reducing the sheer load on your knees has on your pain and function. Imagine wandering around carrying four heavy bags of shopping all day - your knees would not thank you. Well, if you are carrying extra weight that happens all the time. Eat smart, do what exercise you can - and even with bum knees there is a huge variety of stuff to choose from including resistance work that will build lean muscle and burn fat.......and explore measures such as the glucosamine, things like visco injections that lubricate the joint, decent anti inflammtories that can bring a falre up under control.....stick with PT, it takes a long while.

If you exhaust all conservative measures and your quality of life is still not what you want (in realistic terms) then hunt around on here for people who have had TKR at a young age., They can tell you warts and all.

good luck, stay smiling, stay fighting. Knee pain is exhausting. But you need to keep fighting.

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 pdlucky

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Re: Whats in store?
« Reply #8 on: October 26, 2011, 10:14:39 PM »
Thank you for the comments.  I guess when I heard the news about how bad my knee is and that things will change as dramatically as it seems they are has gotten me down.  I have day two of PT today and I will keep going and moving forward the best I can.  As for losing weight I have lost 20 lbs this year so far and plan on continuing.  I will just need to modify my activities to keep from making my knee any worse than it already is. 

Offline vickster

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Re: Whats in store?
« Reply #9 on: October 26, 2011, 10:53:08 PM »
Has your surgeon explained why you have this damage to the bones?  Has he checked how the bones are aligned in the knee - is it the outside (lateral) bits of the femur and tibia that are damaged, or the inside (medial) bits - if the latter, you could be bow legged or the former, you could be knock kneed - from what I have read, this type of damage is more common in people who are overweight.  Did you have the whole lateral meniscus removed, this isn't great as that shock absorption is gone, but it's not insurmountable.

I too have damage to my lateral femur (caused by a fall from my bike around 2 years ago, currently filled with naturally generated fibrocartilage/scar tissue) and also extensive softening to my lateral tibia - so kissing defects on that side - I am knock kneed and am also missing a bit of my lateral meniscus.  After my second arthroscopy (cartilage tidied again plus a visco jab) when it was determined that due to the wonkiness I am not a candidate for cartilage repair of the type you described, my surgeon said that the next option would be to do an femoral osteotomy to offload the damaged areas.  I was pretty down about it all back then  :-\  The OS told me to go away, strengthen my legs and see how it went for 6 months - that was 9 months ago.  I am incredibly glad as the thought of a big open surgery involving tools and metal terrifies me!!

My knee is basically pretty good, I can even squat now briefly, can't kneel comfortably but hey.  I am not really cycling much outdoors, but I try to do at least 10k a day on the static bike in front of the TV.

I am still 15 lbs heavier than I would like to be but have lost about 35lbs since the tumble - my weight has been stable all year, I am much trimmer now and my legs are stronger having cycled 1500+ miles this spring/summer.    I am still wonky but I am hoping I can keep my knee well for a while.  I am sure at some point I'll need something fixed as the cartilage is damaged but if that is in 10 years time, great!

Based on my experience, keep up the weight loss - it is bloody hard but very rewarding - do PT to help strength, flex etc , try to exercise as much as you can without pain, cycling is great for muscle strength as well as flex (and helps the weight loss too), focus on all the good stuff, enjoy what you can do and don't focus on what you cannot :)

Good luck  :)
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline pdlucky

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Re: Whats in store?
« Reply #10 on: October 26, 2011, 11:15:56 PM »
It is my lateral side and the OS completely removed the meniscus on that side.  Looking at the pictures it was a mess in there.  My OS didn't say that my alignment was bad but he did order me to get an unloading brace to take the pressure off the lateral side.  He did also tell me that losing weight will be the best thing for me.  During his examination he said that my right knee has arthritis also so I need to get the weight off or I will end up with two bum knees.  He told my that some of the sensations I was telling him about was a kissing issue before he even went in there.  Does anyone have a similar situation that can give me some more good news as to how life goes on with taking the extra weight off and how much you can do?

Offline vickster

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Re: Whats in store?
« Reply #11 on: October 26, 2011, 11:27:33 PM »
I thought I did  ???  9 months ago, I was looking at major knee surgery, a summer of cycling, and I am not now

How long ago was your arthroscopy?  The pain from just the trauma of the surgery can easily take 3-6 months to ease off - a complete menisectomy is a big op, notwithstanding any tidying up of the bones that the OS also did while in there 

Did you get the unloader brace - is it helping?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline pdlucky

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Re: Whats in store?
« Reply #12 on: October 27, 2011, 05:56:36 PM »
I haven't gotten the unloading brace yet I've been still waiting to get some more of the swelling down.  Friday will be 3 weeks since the arthroscopy.  I had a great PT last night.  He didn't do any manipulation but he did do some electrical stim on my quads and then put a anti-inflamatory patch on my joint and used electrical stim on that, and today I am feeling much better.  I'm not in nearly as much pain as I have been the last couple day's. 

Offline vickster

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Re: Whats in store?
« Reply #13 on: October 27, 2011, 06:11:15 PM »
Great news. 

You'll see many folks on here say that recovery from surgery or living with knee problems is a marathon not a sprint - you can't rush it, just follow the advice of the professionals, take the meds, listen to your knee and be careful :)

If swollen - ice and elevation (above the heart) are definitely your friends  :)
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline brianwith2ndknee

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Re: Whats in store?
« Reply #14 on: October 27, 2011, 06:30:03 PM »
That is great to hear your feeling alittle better . Like I had mentioned about the TENZ unit , you can use that for stimulation of the muscles along with pain and swelling relief . The great thing about it is you can use it on your whole body . In my case the lower back and hip from compensation of the knee surgery . Good luck with the recovery and just remember not to rush it time this go around is your friend .
Knee Scope and Microfracture 03-2010
OAT's procedure , Reconstruction , Femoral nerve block 10-2011


Wishing everyone a healthy speedy recovery and good luck to all...
Brian S