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Old 03-10-2009, 03:20 AM   #1
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Osteoarthritis of the knee

Hi, I am new to this site and I hope someone can help me????
I am 46 years old with knee pain and problems that seem to have been with me forever.
Last January I had an arthroscopy on my right knee to stabilise my knee cap as it gave way and dislocated quite often, also to try and find out why I was in so much pain. Anyway they stabilised my knee and scraped it out. When I went to my follow up appointment at the hospital the Consultant told me that I have grade 3 Osteoarthritis, and this was causing most of the pain.
I am on quite a lot of medication including Morphine MST, Dicofenac and Co-Codamol. The pain is still really bad and nothing seems to shift it. I have had Cortisone injections into the knee, and quite recently Synvisc.They said it could take up to 3 months for the synvisc to kick in, that's if it does????
Can anyone give me any advise or help in what I could do or be doing to help. I also use a cane to walk.
I would be happy with any replies or advise no matter how small.

 
Old 03-10-2009, 10:51 AM   #2
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Re: Osteoarthritis of the knee

If the Synvisc doesn't work you really are looking at a total knee replacement. I was 47 when I had mine done and wish I hadn't waited that long. I believe the insurance companies will okay a TKR at stage 3 after all medical therapies have been tried and Synvisc is about your last option. Ask your ortho. If he/she won't do it at age 46, get a second, third, fouth or however many you need to find someone who will do it. 46 is NOT TOO YOUNG!

Let us know.

 
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Old 03-11-2009, 03:18 AM   #3
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Re: Osteoarthritis of the knee

Thank you so much for your reply Jennybyc. I must admit I had been thinking towards the TKR but everyone tells me I'm too young!! How long ago did you have yours done and why? I would just love to be able to get up the stairs without having to pull myself up because of the pain and discomfort. With me being in the UK, I don't know if the procedures etc are different from where you are? I don't go back to see my Ortho surgeon until May, so I have a lot of thinking time until then. I'm sure it's only going to get worse, but you never know, the synvisc might just kick in.
Thanks again for your reply.

 
Old 03-11-2009, 10:01 AM   #4
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Re: Osteoarthritis of the knee

hi there was quite interested reading these posts ,my husband has had many problems with his knee he saw his specialist nearly 2yrs ago at the age of 54 and he said although his knee did need replacing he was extremely reluctant to do it because he was to young , he has been suffering so bad with it we are now off next monday to see the specialist again to see if he will do it now at the age of 56,ithink reading between the lines they have a very different view on the age thing in america to what we have here but how long does one have to suffer for .

 
Old 03-12-2009, 05:08 AM   #5
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Re: Osteoarthritis of the knee

Hi, thanks for that. I know what you mean about there being differrences here in the UK. I wonder why they are so opposed to doing the knee replacement on "YOUNGER" people? I don't really know where they get the age guidelines from, if the patient is suffering so bad then surely treatment should be given.
I hope all goes well with your husband next Monday, please let me know how you get on.

 
Old 03-12-2009, 08:40 AM   #6
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Re: Osteoarthritis of the knee

I can explain a little of the situation. Artificial knees last just so long. It used to be that the average was 10 years and they they had to put in new ones.Each time the ortho had to "revise" a total knee, you would lose about 10% of the knee function. So they really wanted you to wait.

But the newer knees last a lot longer. And it helps if you remember that although you need to keep it moving, you can't abuse it. As my ortho put it, total knees are like tires. If you buy a set of tires good for 30,000 miles(or 50,000 K)then you can be pretty sure they will wear out after that much mileage. Total knees also wear out and the more you do, the faster they'll wear out. Same for hip replacement. I met a woman in the hospital who was getting her 4th set of hips. She had been a long distance runner and kept running after her first hips. Those had to replaced in less than 2 years. So she went to running but no more than 5 miles......another set was put in after 2 more years. She was told to STOP running and she didn't and 2 years later....back for more hips. She was vowing to give up running this time but I bet she was bacK for more. Lucky for her, hips are easy compared to knees, much less painful and you don't lose function. If she destroyed her knees after 2 years and had to have them done all over again, I bet she'd stop running really quickly!

So the docs want to make sure you are ready to change your lifestyle and have realistic goals for your knees. Also, the newer knees are far stronger and lasting longer.

My knees are 10 years old and the latest X-rays show them to be in great shape. I had to have them both replaced at the same time as both were so bad I wouldn't have a leg to stand on for rehab. My right knee was stage 2+ but my left was a 4(on a scale of 1-4). I had actually gone through the bone surface and had bone marrow leaking into the joint. Under anesthesia, they could lift my foot straight up to a 90* angle at the knee. There was nothing left of my knee joint.

So I had no choice with my left and it just seemed logical to do the right at the same time. But my doc had done patients younger than me and even a 16 year old with severe JRA.

So some docs will do it and even prefer to do it while you still have good muscle strength. Others want to make sure you are ready to slow down your lifestyle and old enough that you won't ever need another one. And of course, there are insurance regulations. I grew up in Canada so I'm aware of the medical services in Canada and similar services in the UK. Your medical system may have a say and criteria by both age and stage of deterioraton. We face that here in the US with insurance companies but they tend to be easier.

So if you get "NO", ask why. Is it the stage if arthritis, is it age. Why? Is this a limit placed by the medical services or by the ortho? I know my brother, in Canada, couldn't get a heart by-pass until he hit 95% closure of the artery. That was set by the government. In the US, they'd be screaming at that but they have to ration the health care since they pay for it. The UK is much better from what my British friends tell me.

If it's an ortho personal restriction, go elsewhere. Look for a younger surgeon who is more familiar with the newer procedures and new knees. If it's a health service restriction, then you may have to wait.

by the way....I LOVE MY KNEES!!!!!!!!!!!!...............Jenny

 
Old 03-20-2009, 10:34 AM   #7
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Re: Osteoarthritis of the knee

I am 55 and had TKR on my left knee in December. It's doing well and I am doing everything I was doing before the surgery and more. My legs and knees are stronger than ever from the PT and I will have the other knee done in May. I, too, had osteoarthritis since about the time I was 45 (a gift from my gene pool). I was also told I was too young, but I have learned that you have to advocate for yourself. I learned Ithat I wasn't taking enough anti-imflamatory meds, so when I upped that it helped me for years. Then I did a round of Synvisc and that helped for a while, too. However, the x-rays tell the tale. Insist on getting one when you go in for an exam. Sometimes it surprises the doc to see how bad it has become, even though you are younger than most. Those assumptions about age just don't cut it when you are crippled by arthritis. I was also concerned about how many times I might have to get replacements if I started too early, but have since learned that the new models are lasting much longer than they used to. Best wishes! I am loving this new knee!

 
Old 03-20-2009, 05:48 PM   #8
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Re: Osteoarthritis of the knee

Hi, I am a 46 year old who had TKR 4 weeks ago today. I was told I has bone on bone osteoarthritis. Doc said my knees looked like there were from a 70 y/o. My Doc had me do cortisone and symvist. Both were very temparary solutions and didn't last long. With great reluctance I went ahead. The Doc told me that my knees ended up being worse than he had thought and they had to take an additional 1/4 in bone off of the knee. A computer navigational system was used in the surgery which I would insist on. Insurance's don't always cover it though. Other than that, the Dr. said I was classic textbook, everything went perfectly. I was up walking and doing stairs the first day. Went home on day 3. I did had allergy problems with the pain medications after surgery and had intense itching. So I came out of recovery with nicks and scrapes all over me, including a black eye. My eye itched bad, I guess. My husband works out of town during the week, so my Mom and kids helped alot! I was using a cane by end of week 2. A few days later I woke up extremely dizzy and had to go back to the walker for stability. I now walk with no assistance and only a slight limp. Most people don't notice it. My thereapist thinks 1 more week of PT and I will be done with that. I rode my bike 3 miles today. My knee still aches and throbs, especially at night. I do use 1/2 of a pain pill at night and only occasionaly. I am looking forward to it improving and will continue working it after PT is done. I was off of meds during the day at week 2 and driving then as well. Today I also rode my 4 wheeler and it was so great to get out of the house. Good Luck. Look for the best Doctor before you do it.

Last edited by taberrose; 03-20-2009 at 05:51 PM.

 
Old 03-23-2009, 04:18 PM   #9
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Re: Osteoarthritis of the knee

I'm 42 and trying to avoid a TKR on my right knee. My insurance won't cover synvisc, the cortizone didn't work so well, but I have found daily loyal use of glucosamine chondroitin (and over the counter supplement) has helped. I've been told that for it to work you have to take it every day loyally and so far so good. Now, if only I can get it to last 8 more years. My doctor is the same age and I am and says "when we're 50 we'll think about a new knee". I said "great, If I can't work due to knee pain maybe we can use your money to pay my bills". Luckily he laughed.
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