To replace or not to replace....

jonr

Hi all,

I am due to have the first of 2 TKRs in October but I'm having second thoughts and I'd welcome members' opinions based on their own personal experiences.

I've worked hard to get my pain under control and am leading a very active life swimming, walking, cycling and gymwork. I'm seriously considering putting it off until I have to because I know these implants don't last forever (I'm only 56) and I'm managing really well.

Is it worth the risk?

Trish9556

Hi @jonr

I have no personal experiences to call on and I think it's a decision only you can make.

However, I am very much a live for today because none of us knows what may be landed firmly on our plate tomorrow.

Me? I would go for it. You say you're only 56? Make the most of being only 56. I wish I was only 56 instead of being only 67 and feeling 99

Love n hugs

Trish xx

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jonr

Apologies @CatherineCarer, I forget I shouldn't use acronyms - it's a "Total Knee Replacement".

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stickywicket

Wow! A tough question.

I've had three TKRs and two THRs and, luckily, all have been no-brainers. I had my first TKRs in 1981 when my kids were young and I'd had RA for twenty years. And OA for a bit less. All my ops have been very successful and I imagine yours would be too as I know how hard you've worked on your fitness which makes success more likely. But there are no guarantees, of course.

My first TKR lasted 27 years but it had one careful owner😉 The widespread RA prevented me from doing anything stupiid with it and the regular exercises kept it in good nick. But its mate is now totally knackered and can't be fixed unless the THR above it (also totally knackered) is replaced first. that's very unlikely to happen. My consultant passed me on to his boss who passed me on to his boss who said that making me a customised implant wasn't a problem for 'the big guns in ....' but the op was as it could easily crash my pelvis since it's shifted towards it. Fortunately, the hip is painfree but I wish I could say the same abut the knee. However, it has served its purpose. I just wanted to get my sons to independence and, at either side of 50, they're there😁

I don't know if any of this is any use to you. I'd certainly do it again (I was 35 at the time) but there are consequences to having them at a younger age. Apparently, younger people expect more of them.

Thanks to your very wise regimes of exercise and diet your knee seem to be doing very well as it is but, of course, no-one can predict how long that will last and, more annoyingly, how soon you could get a TKR once things start to unravel. Actually, currently, a long time. I guess you could always proceed with one and back out at a later stage if you still felt you didn't need it immediately. Otherwise, I think it's just a matter of how much you need it and what for. Your choice (I'm pleased to say!) and good luck.

jonr

Thanks @stickywicket,

You've clearly got a lifetime's experience to tap into, I'm fortunate that I don't have the sort of job where I'm on my feet all day long and as I'm not involved in Sport professionally my condition isn't causing any impedement.

What got me thinking was a conversation with a lady who handles the GP Exercise Referral Programme in Oxfordshire where I live. She is in exactly the same position as me but has had 2 Arthroscopies to delay surgery which by all accounts left her in agony and off her feet for over 2 months, plus the Surgeon who said that surgery is the very last resort. Both said to delay if I can. I have got myself into this relatively luxurious position of having really good pain management which has allowed me to do a great deal of exercise and physio. I'm always in pain but it's generally low level unless I do something stupid like I did on Saturday night (which was to dad-dance around my living room with some friends who were over for the night)

I've somehow been fast-tracked through the NHS (my surgery will be performed in one of the Ramsay Healthcare Hospitals), I've already delayed once and it seems they book 4-6 weeks in advance for my particular surgeon, so mercifully if I do decide to delay I won't go to the back of the queue, fingers crossed.

Cheers,

Jon

jamieA

Hi @jonr

I think it's only you that can come to a decision. However there's a couple of experiences I'd relate. First is my own - I've had an issue with my right foot/ankle since early 2021 where it permanently feels like the after effects of a sprained ankle. Then at the start of this year I found I was having episodes where I couldn't point or scrunch my right toes whilst doing my exercises. I was referred to a rheumatology physio who said my right foot problems are being caused by my left knee due to a change in gait and weight bearing. I was told in early 2022 that my left knee needed replaced 'sooner rather than later' but I've been trying to avoid that as I'm still able to walk 50-60kms a week - albeit with a limp. I'd also had a friend of a friend who used to walk with us who's knee replacement went wrong and was in and out 5 times due to infection. Second I met a guy at the Nuffield gym who told me he was 71 and had two knee replacements at 59 - he was still doing weights and using the machines for all kind of exercise and was very fit. He said it was the best decision he'd ever made. I'm now waiting the 42 week lead time to see an orthopedic consultant.

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stickywicket

Two other hings spring to mind.

1. I've been lucky enough to always have top surgeons at an excellent teaching hospital. I know many people are so anxious to get an op they'll take the place with the shortest wait. I'd never do that. The best men have the longest lists.

2. Re your colleague's arthroscopies. I was fairly sure I'd read somewhere that many surgeons don't offer them as they feel they're not worth it. I had a google and found articles from BMJ and Harvard Medical both discouraging them for anyone with actual damage. So, just because her arthroscopes didn't work, it doesn't mean a TKR wouldn't.

frogmorton

Thanks @stickywicket for this: "..Re your colleague's arthroscopies. I was fairly sure I'd read somewhere that many surgeons don't offer them as they feel they're not worth it. I had a google and found articles from BMJ and Harvard Medical both discouraging them for anyone with actual damage. So, just because her arthroscopes didn't work, it doesn't mean a TKR wouldn't...."

I was trying to find that information too I think it was maybe 2/3 years ago possibly more?

So the Dr you spoke to @jonr 's experience might not be as relevant as it sounds.

My own daughter had a shoulder replacement at 19 I knew the risks and fear still for her future of probable revisions. We had no choice the pain she was in was too great to delay. No point trying steroid jabs all had gone far too far.

Main thing though is the decision has to be yours and yours alone.

Best of luck

Toni x

debster

Hi jonr, you do have a big decision but as others have said only you can make. My husband had a tkr in February this year, I'm due to have 2 knee arthroscopys and on my way to needing replacements. My husband probably was like you he could do everything and had the pain under control but was bone on bone. He's 63. But it's a major operation and long recovery. It wasn't a pleasant experience but it's 6 months on now and he's now glad he's had it done as it would have to be done at some point being bone on bone. I have also read tkr is really pain relief but if you are bone on bone the operation will need to be done and they say they last 25 years now. But I think after the operation you will definitely feel worse to begin with. Good luck with whatever you decide.