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Author Topic: Advice TKR alternatives  (Read 947 times)

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Offline Jerseyjem

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Advice TKR alternatives
« on: October 04, 2014, 09:17:42 AM »
Hi, just needing some ideas please!
I've had long term problem with my knee (over 40 yrs) with arthritic type problems which caused locking/giving way etc but managed to continue life as normal and keep active all the time etc. I was always advised to exercise glutes/quads to keep the knee in alignment and this helped when I was running a lot. More recently the locking and giving way has not been a problem just pain and reduced flexibility especially on kneeling.
About 4 years ago I re-started running after taking up other sports for a while and experienced pain in the knee when running longer distances, especially at night and an x ray showed minimal degenerative changes, so my GP suggested I continue as I was; running but also doing the muscle strengthening exercises. However, in the past few months the pain has got a lot worse and movement is more restricted than before - I haven't been able to sit on my heels to kneel for a few years now and now can't straighten my leg without pain and night pain is more severe. I have however just done 3 marathons in 18 months so I know that will have aggravated it! But, a new x ray reveals ' marked loss of joint space with a lateral tibial osteophyte; a 2cm calcified loose body in the posterior knee joint; small knee effusion and minor degeneration at the medial femorotibial joint'  :(
I have an appointment with the orthopaedic consultant in 10 days time, my GP thinks he may suggest a TKR or at least an arthroscopy with removal of the loose body. Are there any other choices though?
At 52 I don't honestly feel ready for a TKR and although I have pain in the knee now I blame the marathon I did last week on it and feel as in the past some of the pain will subside over time. I would really love to continue running again 5 km not marathons - this year I did duathlons and felt the cycling really helped the knee and had only minimal pain. I'm not sure what my options are, but is it possible just to continue until the pain is really bad, or is there an 'optimum' time to do a TKR? I've had pain in the knee for so many years now that I've just got used to it and although I'm taking painkillers at the moment I hope to stop them soon!
Apologies for the mega long post I just feel a bit unsure of what to ask at the visit and what my options are etc, what damage will there be if I continue running, but at the end of the day will it make a difference to the knee anyway??

Thanks in advance  :)

Offline vickster

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Re: Advice TKR alternatives
« Reply #1 on: October 04, 2014, 12:54:43 PM »
Have a read through the arthritis primer in the information hub.  There are surgical alternatives to TKR if indicated and also there are non surgical options such as steroid and visco-supplementation injections which might provide some relief (but not likely a long term solution)

Only the consultant can suggest what you should do or not in terms of activities, swimming (less so breast stroke kick) and cycling are usually seen as more knee friendly than running due to the forces transmitted through the knee joint with every step, if you have narrowed joint space that will have more impact / cause more damage to the articular cartilage on the bones

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