Bugger all to do with shooting......

[lancslad]

All, just after any comments from anyone on here who has undertaken a partial or full knee replacement.

 

Due to a wake boarding accident years ago, Ive been left with no cartidlege in my right knee, after 3 arthoroscopies Im now left with the option of having a Knee Replacement.

 

So, anyone out there had this done, what was your recovery like......been told its upto anything to 12 weeks.....

 

Does it make you cry like a big girl.

 

How long before you were driving.

 

How long were you off your feet,

 

How long did it take you to get back to normal...

[Gandy]

Hey mate not me personally but my mates old man had one a few years ago was out for 8 weeks ish but was mobile quite quickly, now plays golf has been sking and it really has given him a new lease of life.

 

Guess he would have been about 50 ish tips when he had it done and really could not get around at all.

 

About as much as I can say but don't seem to remember it being particularly traumatic for him as it was only going to better how his knee was before op

[ds1]

I would try to avoid or delay the op. I would first ask if biological medicines are available - in my case I am taking Enbrel. The quacks will not be enthusiastic percsribe it as it cost about 1k per month but in my case I have been able to avoid a knee replacement op.

 

David.

[Finman]

Hi,

 

the option of a knee replacement has to be considered carefully, given that they have a limited life span (i.e. if you are very young- and by that I mean around 40-and lead an active lifestyle, it is almost certain that the artificial joint will wear out and you will need to have it done again). The second time things are not that straight forward as the first time (from an operative point of view).

 

If you are left with no other options for conservative management (exercise, use of analgesics, modification of your lifestyle etc), and go on ahead with this, you will have a period of rehabilitation which will range from 1 to 3 months (depending on your general fitness, complications of the surgery etc). Usually the return to normal activities is full although you will find that you will need to modify some of the activities, as your 'new' knee will not have the same mobility as the other one.

 

things progress fast in this field and we now see knee replacements lasting much longer than expected. however, in an active person, getting 5 years out of one is exceptional. Ask your surgeon what will happen in the future, not only what will happen after 2-3 months from the surgery. And, remember: he gets paid every time he does one...

 

Hope this helps,

 

Finman

[eldon]

My uncle has a false knee joint with his own kneecap. He is disappointed by it as he can get about but it isn't pain free. When he enquired how long that would last, he was told maybe indefinitely. With hindsight I think he would have gone on as long as possible similar to what DS 1 said.

 

Maybe it is all about who does the operation. (His was done in Harrogate)

[lancslad]

cheers lads...36 years old, 15 stone......Need to lose a bit.......lol....

 

 

I have a good surgeon, so fingers crossed it should all be good. Not heard of enberel,,,,,but Im going private....will need to have a discussion with the surgeon on my next visit..

[lancslad]

Has come from my GP, he does a lot of rugby players, last time they have been "pick of the bunch" jobs.....Given the history of the joint, the GP refered me to "his top guy".

 

So, just have to see what comes of it...

 

 

Yup. 36,,,,Ive had a hard paper round..........lol

[Barrelsniffer]

Jon..i will do you a favour as you have done a few for me..pop round mine when im home...and we will just take the leg off at the knee..do a johny rambo stitching..and make a improvised wooden leg..Sound good ?

 

Ha Ha.

[lancslad]

Can you whittle me one in Oak mate........

[bluebell]

Well last year my father in law had both knees done and I had my cruciate repaired - he was back on his feet within 6 weeks, as was I however, it has taken us both nearly a year to get back to anything like full movement and strength. If you have no ligaments it may well take longer as there is nothing to hold the joint stable. I was offered a knee replacement but warned that I would almost certainly be in a wheel chair by the time I was 70 as they can only replace twice with expected life span of around 10 years.

 

Best tip I would give you is if you go ahead build up muscle/ fitness as much as you can before and buy a static bike for use at home as rehab I got one on ebay and it has been invaluable in getting movement and strength back.

 

best of luck

Jan

[dannywayoflife]

Mate i know exactly how you feel! Im 27 and due to an old undiagnosed injury i developed osteoarthritis in my hip, i had an arthroscopy 3 weeks ago but it was much worse than expeceted. I am now in the position of needing a new one at 27! Still could be worse.

[bluebell]

Mate i know exactly how you feel! Im 27 and due to an old undiagnosed injury i developed osteoarthritis in my hip, i had an arthroscopy 3 weeks ago but it was much worse than expeceted. I am now in the position of needing a new one at 27! Still could be worse.

Sorry to hear it mate I have a few years on you and will admit to having been hard on my joints through falling off of horses/ competative judo etc. Best I can say is try glucosimine and crondroitin , preferably with hyloronic acid as I have found these to be a great help especially this time of year. Thinking of trying cider vinegar as well as Im told that is good for soft tissue/ cartlidge.

[kneedoc]

The effects of Glucosamine and Chondroitin are currently under debate, as there is recent academic evidence that suggests that the products may not be as effective as thought. In any case, ensure that you obtain the sulphate moiety, not chloride, as the latter has never been shown to be effective.

 

As regards total knee replacement, vs uni-compartmental knee replacement, you need to ensure that your surgeon is a knee specialist, rather than a general orthopaedic surgeon. I am biased, I accept, in view of the fact that I have only operated on knees, and nothing else, for the last 10 years, and work in a large central London teaching hospital, but I firmly believe that you should see a specialist knee surgeon, about a knee problem.

 

As regards your choice of knee implant, then not all knee designs work in the same manner. As a general rule, provided you do not suffer an infection in the early post-operative period, then you should expect between 15 and 17 years duration of use, before requiring a revision of the knee replacement, consequent to wear of the device. This figure varies depending on:

1. Body weight

2. Activity rate of the patient

3. Age at implantation (which has a relation to point 2.)

 

Your feeling of "security" and trust-worthiness of the knee is dependent on the specific design of the implant. I would advise you to talk carefully to your surgeon and ensure that he/she is using a design that utilises conformity, which is a close matching of the implant surfaces, as this ensures that you are able to remain active and trust the knee of uneven surfaces/slopes etc.

 

I would be happy to provide you with any more specific information, if it would be of any help to you.

 

As regards the comment that the surgeon is obviously going to recommend surgery, as they get paid for it........if you are an NHS patient, then there is absolutely no financial incentive to operate on any individual. If you are a private patient, then I personally try to avoid carrying out knee replacements, in my private practice, as to be honest the medical insurance companies do not reimburse the surgeon to a degree that makes it particularly attractive to perform a joint replacement procedure.

 

Hope that is of some help.

 

All the best.

 

James

[dannywayoflife]

I have been taking glucosamine chondroatine and msm collegen for a while now. But as James has said there is debate as to the effecivness of this supplementation at this time. I personally am looking into hip reserfacing at the moment as dont fancy a THR. I have found a recent news story about the university of alabamma who have made a break through with diamond coating of the colbolt alloy which prostetics are made from. the seem to think that they will be avaliable in around 3 years and shpuld last a lifetime without the need for revision surgery.

[brown dog]

Danny,

Get a couple of opinions - don't just go with the one fellow.

 

I had a labral tear.

 

My GP thought it was a swollen bursar and was going to inject it; I asked for a referral to a hip consultant.

 

First hip consultant didn't know what it was - and directed a course of physio that was, in hindsight, actually damaging.

 

Went to 2nd hip consultant; he wanted to do the full arthroscopy thing AND break and reset my femur.

 

Quickly went to 3rd Hip consultant who did what was needed.

 

I was, and remain, stunned at the muppetry of the first consultant; and the keeness to butcher of the second.

 

[For reasons of ego control, I shouldn't really mention that kneedoc -a pal of many many years - correctly diagnosed the condition & solution over the telephone (he'll be even more insufferable now that I've said that publicly ) and it isn't even his area!]

 

Make sure that you get a couple of opinions before anyone puts a knife to you - particularly as a resurface is, I understand, more painful than what I had done, and what I had done was (I was told by the anathestist) more painful than a hip replacement - so it'll be up there for being a bit 'distracting'. - Good reason to avoid getting the wrong op done!

[terryh]

Heres some answers from my good lady who worked as a nurse on an elective orthapedic ward:

 

Does it make you cry like a big girl. - Yes (ask for lots of pain relief)

 

How long before you were driving. - when you can do an emergency stop (4-6 weeks)

 

How long were you off your feet, - get up as soon as the anathestic wears off, use it or loose it, the sooner you're 'up' the sooner the pain goes away.

 

How long did it take you to get back to normal... -do as the physio says, excersice then rest - state of mind!

 

Terry

[kneedoc]

Danny,

 

Hip resurfacing may not actually be the ultimate solution and is not applicable to every case. There are some results coming through that suggest that in fact it may be something of a "blind avenue", in certain surgical settings. However, I am a knee surgeon, not a hip surgeon, so I would find time to talk to sub-speciality hip surgeon. However, I spend a lot of my time talking to rather good hip surgeons (I don't get out much) who seem to confirm this impression.

 

As regards pre-coating for hip resurfacing, in a "diamond-like" material, to improve the tribological properties, then the jury will be out for some considerable time as to the merits of this application and differing pre-coats and surface treatments have been available before, with mixed responses.

 

James

[kneedoc]

Lancs,

I forgot to ask as to whether your knee surgeon has discussed the option of an osteotomy (surgical re-alignment of bone), rather than arthroplasty?

James

[ds1]

Kneedoc, I would like to ask if you have any information on medicines such as Enbrel.

 

Thanks, David.

[dannywayoflife]

Hi thanks brown dog, i was advised to see my surgeon by 3 different surgeons 1 a knee surgeon 2 hip surgeons(i had to self fund) and still speak to them about my on going treatment as i have all my scans and mris etc. All have said the same as the surgeon. Knee doc, having spoken to my surgeon and others reserfacing seems to be the best proceedure for me. I am aware that it has recieved some bad press recently and du puy have removed the asr from the market, but having spoken to several surgeons they were all confident that the recent problems highlighted are most likely due to poor patient selection. Mind you if you could shed any light on any other treatment which would help put me back to normal would be greatly apprecialted!!!!

[kneedoc]

David,

I don't use disease modifying agents/ anti-TNF drugs, as they are usually prescribed by my rheumatological, non-surgical colleagues. My experience with it is based on the slight increase in surgical complications, related to infection, at time of prosthesis implantation.

James

[ds1]

James, thanks for the reply. I asked the question as I have had several synovectomies before being treated with Enbrel. In my case the results have been very positive with lower sedimentation rates, no pain, no complications and improved knee function. I only wish the treatment had been available in the UK when I needed it rather than going through several operations which have limited my knee mobility and may have been unnecessary.

 

The point is when one is sent to a specialist by ones GP, even if you look for second and third opinions they tend to be down the same avenue regarding treatment. I guess I am a typical example, I received the cheapest treatments, methotrexate and cyclosporin before an open synovectomy was recommended. However no mention of anti TNF type drugs was made as it was not the surgeons field and my GP was following his standard procedure for knee problems. The problem is where does one find a very well informed holistic opinion.

 

David.

[bluebell]

The problem is where does one find a very well informed holistic opinion.

 

David.

 

Yes if anyone has the answer to this I would be interested to hear it as I am sure that my knees are now causing problems with my hips and achilies tendon - even if it only because they have changed the way that I move, but no one wantes to talk to me about the whole of me....

[kneedoc]

Bluebell, it's a difficult point, as there is a contradiction between the knowledge base of the sub-speciality "expert", who only deals with one area of complaint (knee, hip, whatever), but who has an in-depth experience and expertise in that one area, versus and the general opinion, who is lacking in detailed knowledge and expertise about everything!

 

However, there is no doubt that altered loading patterns, such as knee injury, will alter the loading through other areas and can result in secondary dis-ability elsewhere, as you have found.

 

James

[Finman]

James, thanks for the reply. I asked the question as I have had several synovectomies before being treated with Enbrel. In my case the results have been very positive with lower sedimentation rates, no pain, no complications and improved knee function. I only wish the treatment had been available in the UK when I needed it rather than going through several operations which have limited my knee mobility and may have been unnecessary.

 

The point is when one is sent to a specialist by ones GP, even if you look for second and third opinions they tend to be down the same avenue regarding treatment. I guess I am a typical example, I received the cheapest treatments, methotrexate and cyclosporin before an open synovectomy was recommended. However no mention of anti TNF type drugs was made as it was not the surgeons field and my GP was following his standard procedure for knee problems. The problem is where does one find a very well informed holistic opinion.

 

David.

 

DS1, you should change GP, unless the story you relate is rather old. The current guidelines for the management of autoimmune/rheumatoid inflammatory arthropathies is to go straight to DMAs and skip the usuall tat that you describe. It may well have been that, at the time of your diagnosis/presentation, the knowledge just wasn't there. All this stuff is not without cost or side-effects and before a physician is secure in the knowledge that they will not harm their patient they cannot jump on the www bandwagon, despite what the tabloids would like us to think (the average cost of DMAs per patient is around £10k pa).

 

bluebell, your only chance is to be refered to a specialist centre (as opposed to specialist practitioner), which routinely deals with conditions such as your own. The volume of information is such that no-one can be completely up-to-date with all areas of medicine and, as kneedoc says, you are more than likely to find someone who is either a true specialist in their field, or someone who thinks they are a specialist in many fields (rare, too good to be true most often, and usually to be avoided).

 

Let me put it to you another way: how can you be sure that it isn't your hips and achilles tendon that is causing you knee pain? The combinations are endless and, with the best will in the world, we can all find cases where we messed up, despite our expert, confident and (in our 'expert opinion') competent initial assessment of the problem.

 

best wishes,

 

Finman

 

PS: I am 'sporting' a lovely torn medial meniscus in my right knee for almost 2 years now, after standing up awkwardly from shooting my longest bunny todate. I know that I must have it operated on, or at lease MRI'd, but I persist on trying to manage it conservatively. Do I know better? or am I being a wimp? We all have our own ideas sometimes on what's best for us...