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Author Topic: When do you give up and get the knee replacement?  (Read 1492 times)

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Offline nursedeb

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When do you give up and get the knee replacement?
« on: November 06, 2011, 10:42:57 PM »
Thank you in advance to everyone who reads this post and responds: Any advice or suggestions is greatly appreciated.
Brief Summary: April 2010 went to surgery for a supposedly torn meniscus, ended up with microfracture: 2.5x2mm defect medial femoral condyle.

Since surgery, pain every day, way worse than before surgery. Tried many modalities: ice, heat, drugs, Synvisc, Cortisone, PT, custom made medial unloader brace, had PRP last week. Schedule for stem cell in January 2012.

Went back to original surgeon who claims, "defect is 95% healed".
Went to two other orthos who both said defect is still there. One is offering Carticel, the other OATS. Going to see surgeon next week to discuss PKR.

Heres my dilemma: Im not sure if I can go through the long rehab of either Carticel or OATS, especially with mixed results and if they work, only buys you time (about 10 years).
PKR has about 95% success rate and also buys you about 10 years. Shorter recovery and rehab.

If I thought I could live with this for another 20 years and then get a TKR, I would. But thats not an option. According to a very reputable knee surgeon in my area, if I do NOTHING, then my knee will continue to deteroriate and end up with advanced osteoarthritis and have no choice but to get a TKR.

So, I feel like the clock is ticking, and Im forced to make a decision very soon. I really want to give stem cell a try, but its $5000 and if it doesnt work I cant afford to get a second injection.

Has anyone else been given similar scenario? "If you dont make a decision on treatment soon, you will miss your "window of opportunity" to get a PKR and end up with a TKR? I guess that would also be missing your window off opportunity to get OATS or CARTICEL.

Thanks,
Debbie, Tampa FL 43yo

Offline Jond

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Re: When do you give up and get the knee replacement?
« Reply #1 on: November 07, 2011, 09:27:32 PM »
Don't most PKRs turn into TKRs eventually

Most surgeons try to persuade us to put off any form of KR for as long as possible,
So a lot depends on your pain and function levels

Good luck

Offline KW

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Re: When do you give up and get the knee replacement?
« Reply #2 on: November 07, 2011, 10:55:01 PM »
Most OS's want to do everything possible to save the natural knee.  Once you go to a replacement there is no going back.  I tried every possible salvation procedure and got a good 10 years out of the Fulkerson done on my Rt knee.  Never had much luck with the work on my left but was not going to give up without a fight.

I was very young when I had my PKR (34) and had I not tried every alternative there is no chance my OS would have been willing to do the PKR.  You will probably find your age is a issue if you go right for the replacement.

Best of luck,
KW
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 WonkeyDonkey

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Re: When do you give up and get the knee replacement?
« Reply #3 on: November 08, 2011, 10:23:42 PM »
Hi Debbie

I was going to have microfractue but then diagnosed with a torn meniscus back in March, also grade 4 OA amongst other things. Cut a long story short I am having an osteotomy on Friday in order to relieve and move the weight-bearing from the inside of my left knee. I was told I was too young at 48 to have a PKR, and was given a choice of waiting on painkillers etc until I am about 60, or basically having this op. This op will bide me time until I have a TKR, but I can have some good years in between! I have not made the decision lightly, and have done lots of investigation into the op, asked loads of questions, met up with a couple of KG who have had this op and then made my own decision, based on my life etc. I want my life back and am fed up with not being able to do the things I want to do!

It is always good to read the experiences of other KG who have had similar conditions and treatment, and also read the information hub on this website as it is full of insights into conditions and operations etc. As you will read on this website it is always better to keep your own bones etc as long as possible, as once they are gone they are gone!

Good luck in whatever you decide to do, remember to keep up with the pain relief and base the decision on how you feel and not on anyone else.

WD


Offline Cla11

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Re: When do you give up and get the knee replacement?
« Reply #4 on: November 09, 2011, 03:10:06 AM »
Hi Debbie,
I am 51 yrs old had bilateral PKR done this year. First one in May and second in Sept. I have two forms of arthritis Psoriatic and Osteo. I was in so much pain and tried all the other modalities ( PT, cortisone, synvisc ect). I must say that this is the best thing that I have done the pain is greatly diminished and I am able to walk with out a limp that I have had for over two years. I had a slight set back with the second knee and had to have a second surgery last friday. The medial retinaculum ruptured and I had that repaired. I am back to walking with a cane and driving no problem. Was just an outpatient procedure.

My PKR are custom made by a company called Conformis. You can go to their website and get great info and also they have Drs listed that use this type of PKR if you are intrested.

Hope all goes well for you what ever you decide
Carrie :D

Offline aaa

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Re: When do you give up and get the knee replacement?
« Reply #5 on: November 09, 2011, 02:47:50 PM »
i would suggest to find out, if it hasn't been evaluated properly already,  was there some reason for the defect / arthritis to occur in that particular area in the first place?

sometimes an osteotomy to unload that area might help to get rid of the pain, and a knee replacement doesn't really address any underlying alignment problem that might exist.

see: http://www.kneeguru.co.uk/KNEEnotes/node/559

i think its a very good overview for patients, and even OS's I've talked with were unaware of a lot of the procedures and analysis described there.   A lot of OS's mean well, but they are often limited because they only have a limited set of 'tools' to work with ... i think its important to find a surgeon who really can understand the underlying cause of the problem





Offline ravick

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Re: When do you give up and get the knee replacement?
« Reply #6 on: November 10, 2011, 06:17:01 AM »
Hi,

You should check into the arpwave at: arpwave.org.  It has helped many actually avoid knee surgery.  It is approved by the FDA, and is in use by many prof. athletes because it works so well.

Best wishes!

Offline ultra1

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Re: When do you give up and get the knee replacement?
« Reply #7 on: November 10, 2011, 01:14:50 PM »
Debbie,

I have just had STEM CELL.  Last week actually. Bone marrow, fat stem cell injection. I wont know if it works far quite a while........still very sore from it.
I would try it first.........at least its non surgical....but it is new















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