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Petros

Hi everyone

I am a 53 year old male and was diagnosed with osteoarthritis in both knees back in 2019 this has now progressed to stage 4 but have been advised by my GP that I would not be considered for surgery as the NHS trust I come under have a policy barring anyone overweight or an above average BMI,

The East and North Hertfordshire Clinical Commissioning group (CCG)has agreed a revised policy on the management of obese patients requiring routine elective surgery who may require a general or spinal/epidural anaesthetic. The new policy replaces and builds upon the hip and knee arthroplasty policy adopted by NHS Hertfordshire.

After discussions with stakeholders, a review of the evidence for the risks of surgery in obese patients and the benefits of weight loss, this new policy was agreed. Patients with a BMI over 40 (or with a BMI between 30 and 40 with metabolic syndrome) are expected to lose weight and will not receive surgery untiloThey reduce their weight by at least 10% over 9 months Or to a BMI less than 30 .

I have had knee physiotherapy classes and have made many changes to diet etc but with very little improvement. The pain is now severe and debilitating , I manage the condition using over the counter pain relief medication, Flarin, Paracetamol, Nurofen Gel, TENS and a heat delivery and vibrating knee support pad......

In terms of exercise I walk as much as I am able even to the point where the pain is severe and I participate in Yoga classes weekly, I understand that good weight management can be beneficial but there are times when I can barely stand because of the pain.....

sorry to drone on, I have explored private options for treatment for total knee replacement which averages around £13,000 per knee, I am continuing weight loss options but now feel that I being held hostage to the trusts policy......I just wanted to share my current experience, sorry for droning on.

Brynmor

Hi @Petros welcome to the Online Community, great to see you here.

I understand that having been diagnosed with osteoarthritis in both knees you are now having difficulty being referred for surgery as you are now required to lose weight to qualify for this. Weight loss can be extremely difficult as your mobility is affected by not being able to exercise properly because of debilitating pain - a real Catch-22 situation.

Are you able to get an appointment or GP referral to a dietician? Is your doctor able to prescribe drugs to enable pain relief such that you may then be able to exercise?

We have a great page of information on the web site that you may find helpful, including suggestions on managing osteoarthritis of the knee, reducing the strain on your knees and drugs and pain relief.

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-knee/

Do join in across the Community, ask questions, relate your experience, or just call in for a chat to say how you are getting on. You will be most welcome.

All best wishes

Brynmor

Petros

Hi Brynmor

Thanks for your response and welcome. I was referred back in 2020 to a dietician but never had any response and then of course Covid came along, since then trying to contact my Practice has been almost impossible. I will be contacting them again to see if I can get a call to discuss the options available for stronger medication. Thank you for the information I will take a look as it will be great to see what options are available.

I love a really long walk so it can be so distressing when even using stairs is painful and yes when your mobility is impaired it feels like you can't win, even driving a short distance makes the knee grate and grind.

Just to say that I was prescribed XLS Medical a few years ago, whilst following a rigid controlled diet I experienced sever stomach upset and the results were bitterly disappointing.

I appreciate you taking the time to say hi and welcome me to the site, thanks.

Petros

stickywicket

Petros, I can sympathise and empathise as I've had three knee replacements (I started young) and mine were at their worst when my sons were little.

Even before the pandemic many trusts were refusing joint replacements on obese patients partly, I'd guess, to keep the lists down a bit but, to be fair, also because the operations are more dangerous and the success rate lower.

I agree that seeing a dietician would be a good plan. We had a lady on here, confined to a wheelchair, who lost 5 stones and we've had several Slimming World successes. I'm lucky in that I've never been overweight and also I actually dislike creamy, cakey foods and meat. I only eat the latter to keep my iron intake up.

One man on here had very painful knees. He took up cycling and, after saying how much it helped (The weight is supported by the saddle so it's easier on the knees than walking. As is swimming where the water supports) he eventually rode off into the distance saying his knees felt great. Such success is rare but I do know that exercise has contributed, as much as new joints, to me being still able to walk.

I hope you can find a way through this and I wish you the best of luck.