Knee sugery

[TomMcC]

As I've gotten older my right knee has become progressively more painful and unstable. The doc says it's becoming arthritic from injuries over the years. The first time I injured it was in my 20's and I had it operated on (cleaned up the cartilage). The doc through a physical therapist gave me some exercises to do, but this has only helped in a minor way. I'm thinking of surgery again as a last resort. Anyone have a similar situation? Any advice? And the outcome? Thanks

[TAZ]

Not similar, but I'm kind of in the same boat. No ACL in the right knee, damaged MCL and patellar tendon on left. The left creeks pretty bad sometimes. I've been lucky in that regular PT has helped keep me from being cut open. Eventually it's going to need to happen, just hoping to postpone as long as possible.

Are you talking about knee replacement or more clean up work. There are some alternatives to surgery aside from PT. You have Cortisone and the synthetic lube they inject, but I haven't gone that far yet.

[Enoch]

Once the cartilage has been damaged, cleaning it up just removes any loose pieces and frees up the joint, but you have permanently lost some of that shock and abrasion resistance and over time the bone on bone rubbing of the joint will cause increasing arthritis, joint deformity, and even instability. When it gets to this point there really aren't any effective choices with good, lasting outcomes aside from replacing the joint.

The good news... most people have really good outcomes and are happy they had it done.

The bad news... it's usually a fairly painful rehab process and can be a good 8-12 weeks before you begin to resume relatively normal activities, although people who are relatively fit and have higher pain tolerances can shorten that time frame. Many surgeons will tell you 6-8 months for FULL recovery, meaning no swelling, no pain, normal strength etc.

[Hmac]

Been there. Done that. A youth misspent in a wide variety of crazy activities left me with complete cartilage loss in both medial knee compartments. Did the whole shtick....arthroscopy and cleanup (bullshit), knee braces, PT, steroid injections, synvisc injections...all pretty much bullshit that ultimately made little or no difference. Maybe bought me a little time, but mainly what bought me time was enduring increasing pain and elimation of activities that I otherwise loved to do. About 5 years ago I had bilateral unicompartmental knee replacements. For the first time in 20 years I can run, water ski, climb, jump without pain. Fantastic. Postop, I was off work for 30 days, then returned full schedule. Pain is subjective, but I had very little throughout the process...an advantage of unicompartmental knee replacement, even bilateral. I used about 20 tablets of the 60 oxycodone tabs that they prescribed.

[will_be]

If the pain is effecting your life that much I say get the surgery. Injections, steroids or other, are typically temporary. If your ortho doc does a bunch of knees I'd take his advice, otherwise I'd look for a doc that does joints a lot. That can make the difference in your surgical experience and recovery in my opinion.

[Hmac]

Yes, there are orthopedists who sub-specialize in joint replacement. There are specific Fellowship training programs where a standard residency-trained orthopod does an additional year of training in just joints. That is the orthopedist you want to see...the guy whose practice is joint replacements and does 350 total knees per year, as opposed to the typical general orthopod who does maybe 50.

[TomMcC]

Thanks all. My boss at work (my age, and a dirt biker) gets the shots multiple times a year and they do bring temporary relief. I think I'll ask my doc about those just to get me through 6-12 months. I can see surgery a comin' though. Although knee replacement sounds like a more permanent fix, I'm hesitant. A fellow I work with had both done and he was much better, BUT, his doc didn't want him squatting and our job requires quite a bit of it. In the end he was forced to retire over it and I have at least 5yrs before I want to retire. Much to think over.

[weggy]

I have had both knees replaced, 32 years of walking a mail route did me in. It was not as bad as people like to say. The first couple of days are tough, but the drugs are GOOD! Did not have both knees done at the same time, about 6 months between operations. The second was easier than the first. The therapy is a must, if you have the operations don't cheat on the therapy. It was one of the best things that I have ever done for myself. Being pain free and "mobile" is a joy. I'm 68 and had the operations about 10 years ago.

[Hmac]

I have had both knees replaced, 32 years of walking a mail route did me in. It was not as bad as people like to say. The first couple of days are tough, but the drugs are GOOD! Did not have both knees done at the same time, about 6 months between operations. The second was easier than the first. The therapy is a must, if you have the operations don't cheat on the therapy. It was one of the best things that I have ever done for myself. Being pain free and "mobile" is a joy. I'm 68 and had the operations about 10 years ago.

My experience as well...good to have my life back. Uni-compartmental knee replacement, even bilateral, was a breeze, however. I had exactly two PT visits post-op...both to measure range of motion and both ending with the PT telling me "you're doing fine". Basically, for my operation, PT was superfluous. Not necessarily true for a total knee. At the hospital where I work, they utilize a "rapid recovery program". Average length of stay for a total knee is 1.5 days.

[will_be]

Hope that works for you. Don't wait too long. Sounds like you've already got some wear on those knees! I've seen many people who waited longer than they should have end up with a more brutal experience all around after the anesthesia wore off. Good luck!!

Thanks all. My boss at work (my age, and a dirt biker) gets the shots multiple times a year and they do bring temporary relief. I think I'll ask my doc about those just to get me through 6-12 months. I can see surgery a comin' though. Although knee replacement sounds like a more permanent fix, I'm hesitant. A fellow I work with had both done and he was much better, BUT, his doc didn't want him squatting and our job requires quite a bit of it. In the end he was forced to retire over it and I have at least 5yrs before I want to retire. Much to think over.