Confusing feedback from consultant

CindyRella

Hi everyone. I am new to this forum but have been reading other posts and wondered if I can ask for an opinion from others.

I was referred to a consultant and he told me I have bone on bone arthritis in both knees, one has arthritis in the front and back and the other has a bone misaligned from arthritis. He then said I was too young (I am 60) for a knee replacement and that if I was 75 years old he would do the operation in an instant. He also said I needed to lose some weight. I am in the overweight category according to the BMI. He suggested weight loss drugs (yes really). He said even 1-2kg would help and he would see me in 6 months.

My problem is that I was so shocked about the being too young comment that I didn't ask the question I needed to. If I am too young now, what is the point of seeing him in 6 months? I won't be 75years old in 6 months. I am finding life difficult, I can't walk properly (one knee won't straighten and the other won't bend) and I constantly feel so tired. Actually I am in tears most of the time.

If anyone has any advice I would be really grateful. I am going back to the doctors to ask for help too. Just don't know what help I need - is it losing weight, second opinion, accept I am disabled until I am 75?

Ellen

Hi @CindyRella welcome to the online community.

So your consultant suggested two issues one being your weight and the other your age.

The age issue has to do with the fact that replacement joints may need revisions after a period of years and obviously the younger you are the more likely that is. Having said that if the pain and debility is extreme your surgeon may well decide it is worth going ahead. There are people here who have had joint replacement surgery much younger than 60. Knee revisions are known to be trickier and less successful than initial joint replacement.

If you were to lose weight of course your knees will have less work to do. I wonder whether perhaps the consultant hopes you will feel happy to delay surgery if that proves to be true for you. In addition as and when you do have your surgery there is evidence that we recover better if our weight is in the normal range.

A couple of links which might be of interest?

https://www.versusarthritis.org/about-arthritis/treatments/surgery/knee-replacement-surgery/

https://www.versusarthritis.org/news/2021/september/top-tips-to-manage-your-weight/

best of luck

Ellen.

Bryony

I presume you are an NHS patient? This sounds very much like you are being fobbed off, to keep the waiting list figures / length of wait for treatment statistics down - an underhand way of rationing care. That was done very blatantly to me. I was too shocked at the time to challenge it. I had already been bone on bone in both knees for 2 years, and had waited a year for the first consultation as it had been cancelled numerous times by them. I wasn't in the overweight category so they couldn't use that to delay being seen, which happens in some areas. By not seeing you for another 6 months and then if they decide then you are suitable for knee replacement then, it is likely a further year wait, as you are back at the bottom of the waiting list, and the clock will only start then. You've been 'disappeared' off the waiting list statistics.

You are not in North Yorkshire are you? What you were told sounds remarkably similar to my experience - I was told in the second sentence I would not benefit from knee replacement, before they had asked me any questions or had looked at my X-rays. It was a deliberate waiting list manipulation tactic.

Yes, it is worth trying to lose some weight - any little helps. Also, 60 is not too young.

My advice would be to go for a private consultation elsewhere, at one of the private hospitals that are also contractors for the NHS, and get a second unbiased opinion (they won't be trying to ration care as at this point they'll be seeing you as a private patient, and not as a potential NHS patient). Then if they say that they think you are suitable for knee replacement then ask to be put on their NHS list. OK, you are starting back at the bottom of the list, but at least won't be waiting a further 6 months to end up back on the bottom of your original consultants list.

Check out the National Joint Registry which lists the hospitals and consultants - both private and NHS hospitals to check out the experience of the consultants - it has lots of information, and then check for reviews of the consultants that look suitable. It is often just a week or two to be seen for the first consultation. It cost me about £300 for the first consultation, and I'm now with a very experienced surgeon who I trust, instead of one I couldn't trust as far as I could throw him. Request a copy of your X-rays from your hospital and take a copy with you. I printed out a copy of the x-ray images.

Motherhen

I was told that I was too young for a knee replacement and I was the same age as you. So much pain slow walking with sticks. Luckily I am on the slim and dare I say can’t put weight on🙈. I have now got two knee replacements and I thank god I have. My consultant saw how much it affected me before and it was with NHS. But mine were done in a private hospital but by NHS. I think it dare I say depends on where you are in the country on how quick you get it. Do as much as you can as they advise you to. But don’t do anything that you don’t feel comfortable doing. Even if you lose a little weight he will see you have tried and I hope you get your replacements soon. But recovery takes a lot of time. Longer than I thought and still ongoing. Take one day at a time.