too "young" for knee replacement!

too "young" for knee replacement!

Posted in the Knee Replacement Forum

First Prev
of 4
Next Last
Alison

London, UK

#1 Nov 7, 2007
I have had ongoing knee problems since an acl rupture around 14 years ago... i had an acl reconstruction about 4 yrs after the original injury, followed by a lateral release and 8 more arthroscopies over the ensuing years... I had janother arthroscopy last December tidy up the damaged joint ( debridement) and to assess the suitability for a knee replacement.. My surgeon told me that the knee was in need of a replacement but that he was reluctant to do it now because I am too young!.. I am 49 yrs old and I fully understand the wisdom of being conservative with treatment before proceeding to major surgery and I was pleased that he was not scalpel happy!.. However, the situation deteriorated and I was having problems with maintaining my job as a cardiographer at the hospital.. I wrote to him explaining my situation and thanked him for all the care and treatment i had received but i felt it was time to think a bit more about proceeding with the replacement as my quality of life was suffering.. apart from the work issue I have a 4yr old grandson and a 3month old grandaughter and I cannot be a proper grandmother to them due to the unreliability of my knee.. as a result of my letter my surgeon was kind enough to see me again and reccommended that I have yet another arthroscopy and possibly microfractures to build up new bone...I have just had that and on looking inside he found the area was far too large to do the microfractures but did quite a bit of tidying up.. I am still having frequent acute intermittent pain and have been unable to go back to work since the operation.. I would like to know what the thoughts are on the benefits/drawbacks of continuing to delay the replacement.. I personally feel that I need to get it done now so that i can get back to work and be able to look after my grandchildren if they come to visit.. I would be grateful for any response.. Thanks..Alison
Joon

Fort Myers, FL

#2 Nov 7, 2007
Alison, you are asking for the answer to a very personal question. No one can tell what is best for you. If you feel the time is right, and your surgeon does not, seek another opinion. One cannot know how well you might progress after TKR, and there is no way to predict if you will be better or worse as a result of replacement surgery or even if you will be capable of doing all that you hope to do in future. It sounds as if you have done everything possible to date. Age has very little to do with the necessity of joint replacement. Get to another o.s. and see what he says.
All the best. Joon
Alison

London, UK

#3 Nov 8, 2007
Thanks for the response Joon.. as you say, its very difficult to predict the outcome of the TKR and its not something I would consider if I didnt feel so down about how painful and unreliable the knee is...I will speak to my surgeon at the follow up in a couple of weeks..thanks again for your helpful comments.. PS... I am from England and was lucky enough to be in Cape Coral a couple of years ago..Its beautiful!:)..all the best Alison
Terri

Austin, TX

#4 Nov 23, 2007
Have you considered a Unicompartmental Knee?
I am 35 and am getting one next month. I too am a candidate for a foll knee replacement.
Joon

Cape Coral, FL

#5 Nov 25, 2007
The success of a partial prothesis (uni) has to do with candicacy, not age or choice. If Allison has been recommended for a TKR she is NOT a candidate for a unicompartmental knee replacement. Only pataients with damage on one side of the knee can be given this procedure. Joon
Alexis

AOL

#6 Nov 26, 2007
Alison, I understand how you feel. It was right before my 47 birthday of this year, when I found out, how badly shot my knees are. I have the knees of a 75 year old woman, and right now, my life is on hold, due to pain, and barely being able to walk.

I have decided to have them both done, next July, when I will be 48 by then. The doctors feel that you can't say what age is too young for TKR, only how much pain you have.

I thought I was way too young, thinking only people in their late 60's and up got them, but I was suprised to meet people, in the doctors office, one was a guy, 21, had his done, and the other was a 43 year old woman, had them both done.

I really don't want to do it, but the pain is unbelievable, the pain meds aren't strong enough, and I feel my life is basically on hold.
Terri

Austin, TX

#7 Dec 3, 2007
I have to disagree with Joon.
For years I was told by different surgeons that I needed a TKR,... I was even told that back in 2000 at the STEADMAN HAWKINS CLINIC in Vail, CO, however, I now have a more efficient surgeon who has a fantastic reputation that is a supporter of partial knee replacements. Before him.... many doctors told me that I would need to wait until I was older until I could have a TKR, and I would just have to deal with not being able to use stairs, hop, or many of the other things I cannot do at 35. Remember, EACH of us is unique... be sure to see a doctor who has ALSO performed partials. With my partial... we are buying time so that I can gain more comfort until I have no choice but to get the TKR.
Joon

Cape Coral, FL

#8 Dec 4, 2007
Terri,
Disagree if you choose, however you should do some research first. The uni has just recently found a place in knee surgery in North America, although it has been a successful procedure in the UK and Europe for over 20 years. As such some surgeons are not yet qualified in the procedure.
Having said that, the procedure is only performed on patients with damage limited to the inside portion of the knee. If your damage is greater than that you are not a candidate. I agree it pays to determine just exactly where your damage is.

The partial knee surgery may be possible if the arthritis in the knee is confined to a limited area. If the arthritis is widespread, then the partial knee replacement is NOT appropriate, and should not be considered. In addition, the partial knee surgery is recommended in patients who are:

Older than 55 years
Not obese
Relatively sedentary
Have intact ligaments (specifically the ACL)
If these qualifications are not met, then the minimally invasive partial knee surgery may not be as successful. Unfortunately, many patients are therefore ineligible for this minimally invasive procedure.
What is the problem with most patients for the partial knee replacement?
Most patients who seek surgical management have arthritis that is too advanced for the minimally invasive partial knee replacement procedure. Because surgical treatment is considered a 'last-resort' by most patients, by the time surgery is necessary, their arthritis is too advanced to consider this minimally invasive procedure. If partial knee replacement is done in a patient who is a poor candidate, failure rates can be high, and conversion to a traditional total knee surgery may be more difficult.
Joon
Becky

Kansas City, MO

#9 Dec 4, 2007
I agree with Joon, but I also think you should check out the unicompartmental knee. I'm scheduled for surgery in January for my right knee, and if it works, I'll do my left later. I'm 52 and have had crappy knees now for about 5 years. I can still do most activities but with pain (more severe with exercise). Women wait longer than men to get joint replacement than men. I'm going to be much more active between 50-70 than 70-whatever. My health is better now, my recovery will be shorter than when I'm older, so why wait? I want the least amount of surgery that I need. Allison, if you need a new knee, total or whatever, go for it. It's a hard rehab, but it will be worth it. Find the best surgeon in your area and make an appointment. Best of luck.
Terri

Austin, TX

#10 Dec 5, 2007
Thanks for the info Joon. I do extensive research as do you I can clearly see. Every one of our circumstances are different. Fortunately, I have a fabulous surgeon who is a pro at Uni's... it's buying me time. If I were to wait just a bit longer, I would not have this option.
Good luck to you all.

“268th Attack Hel Bn”

Since: May 07

AH-1S Cobra

#11 Dec 6, 2007
HI guys,
Well I finally got the VA to authorize a TKR at the civilian hospital of my choice.(literally took an act of Congress and 7 months of BS. but thats another story for another thread LOL)
I had it done Oct 2 and I can not express in words how happy I am! Pain? you bet! PT? tons! right now I'm at 137 degrees! the other goes to 147 so 10 to go!
I too fought tooth and nail to convince the Dr's that this is what I needed. Once the surgeon did it, he agreed that my knee was totally wore out and that I had made the right decision. There are risks, sure, and one must make decisions in something like this with full knowledge, but I think it was the best thing I have ever done!

Good luck to those that are in pain. may you all get relief one way or another.

Happy holidays
Mike

Willow Grove, PA

#13 Jun 21, 2008
Hi,
I am a 43 year old carpenter. I have had eight knee surgeries over the years. I tore all the ligaments and miniscus in my right knee playing football in 1982. I had a complete reconstruction done by Dr Scullin who was the Doc for the Cleveland Browns @ the time. That was 26 years ago! I have virtually no swelling some occasional pain, and a little arthritis, when I turned 40 I could feel the bone on bone rubbing, but got used to it. Now my left knee has been diagnosed w/ tri-compartmental arthritis and as of my last scope( about 4 years ago)the doc said he "saw no evidence of an acl in there" he also had to make a bigger incision to get everything out. Now I have tremendous swelling and pain in the area of that incision everyday. I use plenty of ice and have tried to scale back my working as it's my own buisness & I try to manage more. I weigh 220 lbs ,the same as I did when I was in college. Does anyone have any suggestions to get me through a couple more years until the docs feel I am ready for TKR. Thanks for any ideas!
knee

San Francisco, CA

#14 Jun 22, 2008
Alison wrote:
I have had ongoing knee problems since an acl rupture around 14 years ago... i had an acl reconstruction about 4 yrs after the original injury, followed by a lateral release and 8 more arthroscopies over the ensuing years... I had janother arthroscopy last December tidy up the damaged joint ( debridement) and to assess the suitability for a knee replacement.. My surgeon told me that the knee was in need of a replacement but that he was reluctant to do it now because I am too young!.. I am 49 yrs old and I fully understand the wisdom of being conservative with treatment before proceeding to major surgery and I was pleased that he was not scalpel happy!.. However, the situation deteriorated and I was having problems with maintaining my job as a cardiographer at the hospital.. I wrote to him explaining my situation and thanked him for all the care and treatment i had received but i felt it was time to think a bit more about proceeding with the replacement as my quality of life was suffering.. apart from the work issue I have a 4yr old grandson and a 3month old grandaughter and I cannot be a proper grandmother to them due to the unreliability of my knee.. as a result of my letter my surgeon was kind enough to see me again and reccommended that I have yet another arthroscopy and possibly microfractures to build up new bone...I have just had that and on looking inside he found the area was far too large to do the microfractures but did quite a bit of tidying up.. I am still having frequent acute intermittent pain and have been unable to go back to work since the operation.. I would like to know what the thoughts are on the benefits/drawbacks of continuing to delay the replacement.. I personally feel that I need to get it done now so that i can get back to work and be able to look after my grandchildren if they come to visit.. I would be grateful for any response.. Thanks..Alison
I cannot believe you have endured the amount of surgeries you have to date. I would think you would be so tired of temporary relief. I totally believe knee replacement will be my best bet and also yours. I haven't even had the first surgery, but I don't have any thing left to re-construct! Good Luck!
Bruce the postman

North Bergen, NJ

#15 Jun 22, 2008
I walk about 10 miles a day. My left knee is bone on bone and I'm having more and more troubles on stairs about 2,000 a day. My Dr. recommended getting a TKR. Are there very active people out there with good results or is it a crapshoot? And what are my odds of making it back in 3 months
Preddi

Chicago, IL

#16 Aug 8, 2008
Hi, I have been battling knee pain for about 4 years now. I had a MRI done, and it showed that I have advanced degenerative arthritis.(Mind you all, I'm only 31 years old). I have had cortisone shots, naparoxen, every medication in the book. The shots only last about a week. My doctor is saying that I am not a candidate for TKR due to my age. He's pretty much telling me to deal with it until I am about 50 years old. I walk with a limb, I cant go up and down stairs, I have three young children, and I feel so lost. I am scheduled for a second opinion next week Aug 12th. When I went to this consultation, this doctor said that I probably would do good with an osteotomy? Anyone know about this procedure. I am very knock knee'd. He said that if it is really severe after havining an arthoscopy, that I may need a TKR. He said that the second one will be much severe though. I am so scared, but I'm tired of the pain. Any advice?
Joon

Toronto, Canada

#17 Aug 9, 2008
Preddi... get yourself to another doctor! Spending 20 years in debilitating agony does not make sense. You need to get off drugs and strike a plan of action NOW. Good luck. joon
Todd

Santa Rosa, CA

#18 Aug 11, 2008
I had a meniscus cartilage surgery 30 years ago. I have been in moderate pain up until 2 years ago. The pain the last 2 months has been excruciating. This past weekend, I turned direction while walking down the sidewalk. The pain was so bad I nearly fell over. I was in bed with a knee brace (immobilizer) all weekend long. I did lots of research the past few months and cant see to find anything about how long the TKR will last. Today my doctor told me I should wait until I was 65 or so as the TKR may only last 10-15 years. My doctor specifically mentioned that is was the plastic and the glue that would deteriorate as the bone looses its tight fit. Does anyone know if there are new procedures and materials that will last 20 30 years Thank you for your advice!
Joon

Penetanguishene, Canada

#19 Aug 12, 2008
Tod, there is no way to determine the actual life expectancy of a replacement knee. Much depends upon how you use it and how your body reacts to it. People can tell you many things about the limitations of the various substances but it is all variable. If you cannot do anything, and you are in pain all the time, why screw around. You will be fully inactive in no time if you continue this way. You didn't say how how old you are, but if you had meniscus surgery 30 years ago (although that could be a typo and it really is 3 years ago) either way, you are "ready" to do something else. You need help. There's no such thing as "old enough". If you are damaged and the body cannot heal itself, you are ready. See as many specialists as it takes to understand your condition and get working on some quality of life. Joon
Preddi

Chicago, IL

#20 Sep 17, 2008
My doctor recommended that I have the Unicompartmental knee replacement. When he went in to do the diagnostic arthroscope he noticed that I had a lot of arthritis on one side of my knee and under my knee cap. I am only 32 years old. I notice that people are 50 years old and are worried about having a knee replacement. I'm agreeing with Joon that maybe it depends on the individual and that you have to have arthritis on one side only vs the whole knee which would require a TKR. I also heard about an operation called Osteotomy for people who is fairly young with arthritis. Does anyone know of any outcomes
with the Osteotomy procedure. My doctor explained to me that is was cutting of the bone?
Another question, I am somewhat overweight, If I lose weight, would that decrease my knee pain too?
Joon

Hamilton, Canada

#21 Sep 17, 2008
Preddi, Good to hear you have another opinion vis a vis your condition. YES!!! Yes, excess weight does contribute to your discomfort. In terms of the suggested immediate solution to your knee, here's some information.

An osteotomy is a surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment. The operation is normally done under a general anaesthetic.

Osteotomy is one method to relieve pain in arthritis, especially of the hip and knee.

Due to the serious nature of this procedure, recovery may be extensive. Careful consultation with a physician is important in order to ensure proper planning during a recovery phase.

Knee osteotomy is commonly used to realign arthritic damage on one side of the knee. The goal is to shift the patient's body weight off the damaged area to the other side of the knee, where the cartilage is still healthy.

Surgeons remove a wedge of the shinbone from underneath the healthy side of the knee, which allows the shinbone and thighbone to bend away from the damaged cartilage.

Think of the hinges on a door. When the door is shut, the hinges are flush against the wall. As the door swings open, one side of the door remains pressed against the wall as space opens up on the other side. Removing just a small wedge of bone can "swing" the knee open, pressing the healthy tissue together as space opens up between the thighbone and shinbone on the damaged side so that the arthritic surfaces do not rub against each other.

Osteotomy is also used as an alternative treatment to total knee replacement in younger and active patients. Because prosthetic knees may wear out over time, an osteotomy procedure can enable younger, active osteoarthritis patients to continue using the healthy portion of their knee. The procedure can delay the need for a total knee replacement for up to ten years. Good luck with everything! Joon

Tell me when this thread is updated:

Subscribe Now Add to my Tracker
First Prev
of 4
Next Last

Add your comments below

Characters left: 4000

Please note by submitting this form you acknowledge that you have read the Terms of Service and the comment you are posting is in compliance with such terms. Be polite. Inappropriate posts may be removed by the moderator. Send us your feedback.

Knee Replacement Discussions

Title Updated Last By Comments
Euflexxa or Synvisc (Hyaluronic( injections for... (Jan '10) Sat steve 109
post tkr adhesions/scar tissue (Jan '09) Jul 22 Kandi R 95
Blisters after surgery? (Jun '08) Jul 21 bunnygirl 102
Burning sensation after TKR (Dec '09) Jul 20 no Jdwiseman 48
Kneeling after Tkr (Nov '09) Jul 20 Joanne 34
Popping and clunking sounds coming from new knee (Jul '07) Jul 20 notalone 306
3 1/2 years after TKR still with pain in knee (Jul '13) Jul 20 free shirley 170
More from around the web