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Old 12-28-2018, 09:54 PM
 
Location: Brawndo-Thirst-Mutilator-Nation
15,705 posts, read 15,638,092 times
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If I was to have a ct-scan of my whole body, and a osteopathic-surgeon was to go over the whole thing.....LOL, the surgeon would probably recommend enough surgeries to turn me into a
robotic-man.

I get around fine, I function fine, my pain is minimal.........good enough for me.
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Old 12-28-2018, 11:46 PM
 
Location: Backwoods of Maine
6,983 posts, read 7,805,815 times
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OP, if you are not overweight and have not come by your troubles due to an injury --

What is your diet like? Are you getting plenty of protein, calcium, and magnesium? Plenty of natural fat? Your skeleton and muscles all need these things. Healthy bones and cartilage do not just start degenerating for no reason. If you have a lot of joint inflammation, that is largely dietary also. Maybe look into reducing your sugar and carb intake.

What we can get away with eating in youth does not always work after age 40 or 50. However, age alone does not lead to infirmity, if the dietary intake is appropriate. You will find that your bones and joints will meet you more than halfway, if you give them the raw materials to heal themselves. Your own body works better than any doctor....and for free.
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Old 12-29-2018, 05:49 AM
 
Location: Northern VA
425 posts, read 547,179 times
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Quote:
Originally Posted by Nor'Eastah View Post
OP, if you are not overweight and have not come by your troubles due to an injury --

What is your diet like? Are you getting plenty of protein, calcium, and magnesium? Plenty of natural fat? Your skeleton and muscles all need these things. Healthy bones and cartilage do not just start degenerating for no reason. If you have a lot of joint inflammation, that is largely dietary also. Maybe look into reducing your sugar and carb intake.

What we can get away with eating in youth does not always work after age 40 or 50. However, age alone does not lead to infirmity, if the dietary intake is appropriate. You will find that your bones and joints will meet you more than halfway, if you give them the raw materials to heal themselves. Your own body works better than any doctor....and for free.
I'm not overweight and both my wife and I try to follow an anti-inflammatory diet as recommended by our doctors. That means fish (mostly salmon) 2 or 3 times a week, lots of fruits and vegetables like spinach and kale, and whole grains, etc. We've cut back a lot on red meat and and eat a lot of chicken and pork when we're not having fish. We've also added some supplements like turmeric and krill oil.

I haven't had any specific injuries that I can point to as the source of my issues. I suppose its a combination of genetics and the 22 years I spent in the military (7 falling out of airplanes).

I'm ok with eventually getting a knee replacement if that's what it comes to. I'm not ok with having another surgery every year or two. What worries me the most about both my knee and my back is how rapidly they seem to be deteriorating. Comparing MRIs 15 months apart for my knee, they show things that were non-existent or mild to moderate are now moderate to severe. Chondramalacia in multiple spots advanced from grade 1 to grade 3. Similar progression with my back.

I have a follow up next week with a neurosurgeon to discuss options for my back. I had an RF ablation done in November which only helped for about a week. When I last saw this neurosurgeon (who recommended me to pain management for the ablation) but he also mentioned that there were other options if the ablation didn't help.

For the knee I currently have 3 more PT sessions in January and my 3 month follow up with the orthopedic surgeon. My knee is feeling better than it did before the surgery, but it still isn't right. Based on where the pain usually is, I'm thinking there's still some meniscus issues going on. I'll ask about getting another MRI to see what's going on.
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Old 12-29-2018, 09:15 AM
 
Location: equator
2,829 posts, read 1,220,052 times
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OP, I could not follow your medical descriptions and diagnosis, but I have two knee replacements, done at the same time, in 2013. I had no cartilage left at all and my knees were getting increasingly weaker. But surprisingly, no pain at all. The ortho doc said I should be in a lot of pain. It all went well but it's a slog of rehab. I was back to my physical job in 3 months. But, there is NO change and NO improvement. I feel I should not have done it, since I was in no pain. Kind of got talked into it by an overeager surgeon, and looming insurance issues. DH disagrees and said I would have needed it eventually anyway. My knees are still very weak, and often feel "unnatural".

OTOH, I had excruciating pain and could barely walk, when my hip decided to go. Also no cartilage (same with shoulders, but not gonna address them). The hip replacement was easy and painless with next to no recovery time or rehab. It's doing just fine and I never think about it.

So it can vary even within a person, joint to joint. Bad joints run in our family, so there's that, too.

Don't do it until you can't stand the pain, is my final word.
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Old 12-29-2018, 11:07 AM
 
204 posts, read 94,286 times
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I used to work with at a large orthopedic practice for a hand surgeon. I did once work with another orthopedist and assisted on one total knee replacement (I quit that job after one month . . . too far to drive, too much busy work, too little pay).

I think the general theory is to delay TKR as long as possible because TKR will wear out. I just found an article that says TKR lasts twenty years: https://www.verywellhealth.com/how-l...s-last-2549612

But you need to hear this from a total joint replacement orthopedist -- in most major metropolitan areas, there are orthopedists who specialize in two surgeries: TKR and THR (total hip replacement). Best wishes to you.
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Old 12-29-2018, 03:20 PM
 
Location: Texas
3,752 posts, read 2,956,018 times
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Quote:
Originally Posted by townshend View Post

But you need to hear this from a total joint replacement orthopedist -- in most major metropolitan areas, there are orthopedists who specialize in two surgeries: TKR and THR (total hip replacement). Best wishes to you.
Absolutely. In my husband's group of 7, there are 3 guys that do knees. But they don't all do the same things on knees. One is a generalist who does just about anything and everything, one is Sports trained and does most of the scopes, the other guy is Total Joints trained and does only TKA's and THA's. Meanwhile, the other partners don't touch knees at all. That's how sub-specialized most groups are these days. As you say, it should be relatively easy for OP to find someone who does tons of knees if their current surgeon doesn't do a lot of replacements.
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Old 12-29-2018, 06:54 PM
 
Location: too far from the sea
18,463 posts, read 17,638,062 times
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when did you (or your doctor) decide that enough was enough and it was time for the TKR?

Topic. Please reply to the OP's topic. Do not ramble on about your own experience and complaints. Keep your comments helpful and pertinent.
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my posts as moderator will be in red. Moderator: Health&Wellness~Genealogy. The Rules--read here>>> TOS. If someone attacks you, do not reply. Hit REPORT.
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Old 12-29-2018, 10:41 PM
 
Location: Philadelphia/South Jersey area
2,557 posts, read 1,171,129 times
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It was a 2 year journey for me. I have a wonderful orthopedic surgeon who does not do knee replacement surgery until every thing else stops working.
I was bone on bone and by the end it was either surgery or a life on opioids
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Old 12-30-2018, 11:28 PM
 
630 posts, read 229,743 times
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Quote:
Originally Posted by nightlysparrow View Post
Think carefully about knee replacements:

https://khn.org/news/up-to-a-third-o...in-and-regret/
Yup. I am very afraid of knee surgery. I had my cartilege removed over 50 years ago. It was torn because some lovely classmate thought it was right to throw me down during a basketball game. That's what they did years ago--took out the cartilege. For some reason my leg began hurting real bad a few years ago. I think it is a nerve. I could even feel something in my thigh above the knee snap into place kind of, sometimes. I saw an orthopedic surgeon but all he said was that I need a replacement. No explanation, no nothing after that. I did not like his manner, maybe he was in a bad mood. I have seen people with bad outcomes but it's hard to keep my balance now, I hang on to everything and often take a cane and walker. But I don't think they (the doctors) can help me.
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Old 01-02-2019, 10:41 AM
 
4,751 posts, read 10,652,947 times
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Quote:
Originally Posted by djplourd View Post
Right now I'm still recovering from my second left knee surgery in less than a year and a half.

The first surgery was in June 2017. The initial diagnosis was a medial meniscus tear (based on an MRI). During the surgery they discovered a tear in the lateral meniscus as well. The MRI also showed mucoid degeneration of the ACL. They looked at the ACL during the surgery but said it was ok. They also diagnised me as having some grade 1 chondromalacia of the patella and some grade 1 chondromalacia of the trochlea, as well as some grade 2 chondromalacia of the femoral condyle.

Fast forward to this year. My left knee started bothering me again in February/March. I tried cortisone and synvisc injections but nothing helped. Another MRI in September showed tears in the medial and lateral menisci again. The specific diagnosis from the MRI was:
  • Complex nondisplaced tear at the junction of the posterior horn and body of the medial meniscus
  • Nondisplaced tear involving the anterior horn of the lateral meniscus near its root attachment.
  • Mild tricompartmental chondromalacia with small focal high-grade chondral defect at the medial patellar facet with small underlying subchondral cyst.
  • Mild to moderate joint effusion.
  • Moderate to severe mucoid degeneration of the ACL fibers which otherwise intact.

The second surgery was in October. Along with fixing the menisci tears, this time they also debrided the ACL. The surgical findings were:
  • Plica suprapatella pouch
  • Grade 3 chondromalacia of the lateral patellar facet
  • Grade 3 chondromalacia of the trochlea
  • Degenerative fraying of the posterior horn of the medial meniscus.
  • Degenerative fraying of anterior horn of medial meniscus
  • Degenerative fraying of anterior horn of lateral meniscus

The recovery from the second surgery has been harder than the first. After the first surgery the knee felt stiff for a while but it didn't really hurt anymore. After he second surgery it was still swollen and painful until the last couple of weeks. It still bothers me occasionally but it has gotten better.

I've been told by an orthopedic surgeon and a physical therapist that eventually I'll need a knee replacement. I'm not there yet, but the rapid deterioration of my knee makes me think that it will need to happen sooner rather than later. I've read most of the threads on TKR, along with searching the web, and I'm ok with it if its likely to help. So here's the question: when did you (or your doctor) decide that enough was enough and it was time for the TKR?
I'm sure you have heard this or read this in your research but the answer to your question really is "You'll know when it's time"

It sounds like a cop out but it really is the best answer....

In order to be a candidate for knee replacement you need to have the x ray evidence of severe joint deterioration AND symptoms severe enough to justify the risk.

At your age I would certainly put it off as long as possible and exhaust all the non surgical options such as exercise, keeping your weight down, avoiding high impact activities, managing symptoms with topicals, ice/heat, NSAID's, injections, bracing, etc...

When symptoms can no longer be managed and pain is severe and interfering with your activities of daily living then its time to consider joint replacement

Some people worry it will be "too late" if they wait too long....the only real risks in waiting would be developing other medical issues that make the surgery too dangerous for you, gaining too much weight (most surgeons have a weight cut off above which they will not operate)

This is really an elective procedure and you should never feel pressured to proceed, a good Orthopaedic Surgeon will lay out your options and tell you to call and schedule when and if you are ready
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