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Author Topic: 25 years old, TKR comes up....  (Read 1137 times)

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Offline mdk

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25 years old, TKR comes up....
« on: May 19, 2012, 09:53:00 AM »
Hey everyone. I've been here for a while but I think this is my first time outside of the PF section.... close to it anyway. Based on the thread title, hopefully it's pretty obvious why I'm venturing outside -- I need some more eyes on this. For the record though here's a link to my more recent thread. The short version is I had a traumatic injury several years ago, which over time got worse and worse and eventually started getting in the way of work. First surgery was last August, a meniscus repair and lateral release. That one soured real fast and real bad, and ultimately came down to a Fulkerson TTT in January. The results have been..... well let's just stick with understatement. The results of my Fulkerson have been unspectacular.

This week I got myself to a new physical therapist who, upon our initial conversation, concluded that "From what you're telling me, physical therapy can't fix this -- you're going to need another surgery." He proceeded to do a quick exam, and this time the results WERE spectacular -- I think at one point a little mushroom cloud actually popped out of my knee. It was so painful the whole block lost power, you know, it was THAT kind of an exam. When I woke back up (slight exaggeration, but only slight), he said "Sorry for being blunt, but.... You need a Total Knee." To which I replied something along the lines of "Don't apologize for THAT, apologize for BLOWING UP MY LEG" or something, I don't really remember, it actually is all a bit foggy.

Anyway.

The PT is not the doctor, I understand that. And I understand too that at 25 years old, even just saying the words "Total Knee Replacement" is being really drastic. I'm not buying in just because Mr. Guantanamo Bay here can make me squeal -- I'm going to go through the whole complete process, get all kinds of more and better info, etc. before I make ANY decision on this. But I figured I could probably get some kind of headstart on all that, and talk about some of my bigger, weightier questions with the community here before I get ambushed by a doctor. So, I'm gonna fire away.... please answer anything you can. Remember, this is all under the assumption that I'm going to get at least two professional and actual opinions from people with x-ray vision and whatnot, and hopefully they steer me down a different path entirely -- but IF the actual doctors say I actually do need a TKR.....


#1. What's the real, actual lifespan of "TKR treatment?" By which I mean, I'm 25 years old and pretty super-active.... counting tune-ups, revisions, etc., how long could I really expect to be walking, grand-total wise?

#2. My prior hobbies, before this all started, were extreme paintball, soccer, basketball, dirtbiking, martial arts and P90X (but I was terrible at that). Based on what I've read, pretty much ALL of that is over. What activities am I REALLY able to do with a TKR, and how much does that impact #1?

#3. If you followed the link, you saw that I'm giving some serious thought to, well, the other thing. I don't like saying it, but.... well, yeah. I've managed to convince at least a part of my brain that elective amputation might be better in the long run, assuming a TKR is the only alternative. I figure it's in my nature to push the limits of what I *should* be doing, and if nothing else, they can fix up a prosthetic leg without cutting me open again (I've had bad luck lately with people cutting me open). So to the people who've had (or otherwise experienced) a TKR -- is my head on straight here? Actually scratch that. Hang on. Answer 4 and 5 instead (or still tell me I'm crazy, that's cool too)

#4. How much 'maintenance' does a TKR really, actually take? As in, if you accidentally chase your dog down the alley, is that gonna make a screw pop loose and they have to open you up to fix it?

#5. On a perfectly average day during an average season (like "Sprauntemmer," a combination of spring, autumn, winter, and summer), doing average things, how much does your TKR-knee "bother" or otherwise limit you?

#6. I suppose this is the money-question. Young guy, not done living yet, wanna go out and do all *kinds* of stuff in *all* kinds of places -- I know that not *all* of that is going to be possible, probably, unless someone finds a better answer than the two options I'm talking about now. And that can still happen -- I'm still gonna try to make something else happen. But let's suppose for a second that I've got either TKR or... I'm just gonna call it TLR and let you sort out the acronym, I *really* don't like writing it. HYPOTHETICALLY, if I HAD to choose, which do you think would limit me less? I won't make you choose for me, but just talk purely in terms of functionality if you can.


((PS -- I've seen another thread on the same subject by a different user, and I really didn't want to hijack it with my different priorities or whatever -- but "that guy," if you're reading, pretty pretty please weigh in, your opinion would mean a lot; same goes for anyone who's had... uh, TLR. Your input would be absolutely invaluable))

((PPS -- I don't know why I can't make myself say it now, I must be nervous or something))
Also, I'm Batman.

Busted since 2008.
left LR/Meniscus repair August 2011
Fulkerson TTT January 2012
Scope/cleanup September 2012



"Gimpin' Ain't Easy"

Offline c3neely

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Re: 25 years old, TKR comes up....
« Reply #1 on: May 19, 2012, 04:06:39 PM »
what was the injury that makes u need a TKR/the doctor to even  bring that up?

Im young (28) and this total knee thing scares the s**t out of me as well.  I had a tibial plateau fracture a year ago...and just, realizing the harsh realities of what that means for my current/future. 

Its weird because ud think that getting a TKR in theory would make u pain free...but its talked about like the devil of knee options

I wish u the best...i know for myself, ive given up my desire to get back to my hobbies ( i did mine doing brazilian jiujitsu...played college baseball..catcher of all things)...and all I ask is that Im not summoned to a desk job for the rest of my life...and i can just "walk" pain free.  I hope ure not in this situation...and make sure u get as MANY opinions as possible on the state of the knee..its crazy how u can go to one doctor and hear one thing..and another one will say something completely different


Offline mdk

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Re: 25 years old, TKR comes up....
« Reply #2 on: May 19, 2012, 05:36:43 PM »
Original injury was, incidentally, hand-to-hand combat related, during one of many combative classes for the Air Force.
Also, I'm Batman.

Busted since 2008.
left LR/Meniscus repair August 2011
Fulkerson TTT January 2012
Scope/cleanup September 2012



"Gimpin' Ain't Easy"

Offline silverghost

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Re: 25 years old, TKR comes up....
« Reply #3 on: May 19, 2012, 05:52:35 PM »
Hi mate well i have a oesteoathritis and have been offered 3 options either you live with what you have and then need a TKR eventually no timescales just more pain, a biological rebuild option (which i taking in a couple of weeks involving meniscus transplant) or straight away having the TKR.

My surgeon advised that even at 37 having a TKR would mean if normally active a TKR then every about 7 years. So you work out that would be a few operations for you.  I think having an amputation is a bit drastic as looking at your activities most if not all would become even more difficult for you.  Im having the biological rebuild because I want to be able to do things with my kids like riding a bike which is impossible at the moment although this option if it works can only give me 10+ yrs extra.

If you can I would definately try to keep your own knee for as long as possible thats the message I have had from doctors and physios alike.  Whether they can offer you some kind of bio rebuild is up to your docs. not sure where you are but I had to write to over a hundred hospitals in the uk before i could find a consultant that would look at me due to funding.

I think you need to get lots of second opinions and especially approach university/college clinic hospitals who have the funding to look at you.

You take care and good luck with your options
'96 ACL reconstruction
'09 Arthroscopy/cartilage repair
Diagnosed with Grade 4 OA no medial cartilage and significant varus alignment
'11 fitted with off loading knee brace
'12 HTO, meniscus transplant, acl reconstruction & microfracture all in 1 go!















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