Knee replacement

[Bathdave]

After a fall last month when she landed on her knee on Tarmac, my wife is in considerable pain even walking.

she has had a couple of knee operations over the last 30 years. The consultant is suggesting a total knee replacement, about which she has some reservations. She is 59, and how long it will last is one of them, although her main concern is that she will not have a full range of movement and use of her leg.

She wants to be able to get about the boat easily, and walk the dog comfortably.

Any scuttlebutters have experience, either personal or friends/family, of knee replacement and the aftermath, and the amount of mobility they have?

 

[Tam Lin]

My dad's had three knee replacements. One wore out and had to be replaced. It is quite a serious operation and takes a while to get over. However, he was able to get about better. Like any operation, not to be taken without due thought and consideration. (Which is, I have just realised, exactly what you are doing!)
Good luck!

 

[LadyInBed]

I'm working up to one. Surgeon reluctant to do it yet as I am still playing badminton and sailing, so deferred me for six months.
I get pain if I put any side pressure on my knee when in bed and restricted movement doesn't make sailing easy, so I'm starting to think I will push for the opp even though he reckons that two out of ten people who had the opp still get pain and wish that they hadn't.

 

[properjob]

I had a total knee replacement 5 years ago. The first 6 months were hard going and not much fun, but since then I’ve had no problems. It’s important to do the exercises that the physio will give you, I also had hydrotherapy which I found very effective. I can do very nearly everything that I could before, I always wear knee protectors if I kneel down but apart from that I make no concessions to it. I have no pain at all and I really don’t notice that it’s a metal knee. I would recommend having it done.

 

[mikemanor]

I had a total knee replacement at the beginning of June this year. I now have 130 degrees of bend which I am very happy with BUT it is still sore around the muscles, ligaments etc. The "knee pain" has completely gone. I can easily get around on the boat and walking is no problem. My physio says I should be ecstatic with the progress I have made - others in the group have not done so well. One lady only has 90 degrees of bend. Not everyone gets the same results.
The life of the replacement knee depends what you do. For a couch potato it may be 20 years. Much less for a very active person. In all things of this nature there are risks - and you need to fully understand what they are.
Happy for you to PM me for greater discussion.

 

[estarzinger]

My wife had one done last spring, and the other to be done in a couple weeks.

The first "went well" . . . Good bend angle, still some pain and swelling.

She is now unsteady around the boat, and can not kneel easily.

We don't know yet for sure, but I strongly suspect it is the end of our sailing.

 

[RobbieW]

A mate of mine, a couple of years younger than your SWMBO and a builder/chippy by trade, is facing the same questions. The advice he has been given so far is to try and ensure that he gets treated within 'mainstream' NHS rather than going to one of the outsourced clinics. Why? because the outsourced clinics remit is closer to the idea of giving older folks a bit more mobility rather than giving someone with an expectation of another 20+ years of active life a lasting product.

EDIT: I note that the OP is in the CI so NHS comments may not apply. Underlying thought is to ensure that whatever is proposed is aimed at long term use rather than short term mobiility

 

[Easticks28]

I had a 'total' in March 2008 as a result of osteoarthritis. I was 61 at the time. I've never looked back! As has been said, the first six months or so post op were tough, but absolute adherence to the prescribed exercise regime was essential. I now have total free mobility in that knee, no different from the other natural one - and absolutely no pain. The only thing which I find to be a minor irritation is that kneeling on it is not possible ( on a hard surface anyhow} but there are ways round that.
Tell her to 'go for it' .

 

[johnalison]

It won't be possible to guarantee good knee bending but most people get a good result these days. Several of our friends have had new knees and three of the on both sides. One chap had had seven new knees, from many years ago. He was still sailing his Moody 31 abroad in his 80s.

59 is on the young side but, actually, replacement knees tend to last for longer than hips, because the weight passes straight through the joint rather than being cantilevered, so 20 years is quite common. It might make sense to see if your wife's recent injury settles down over a few months and then make a decision

 

[doris]

I had a complete replacement at 59. Best thing I ever did cos the constant pain disappeared and the heavy use of anti inflammatories and painkillers ended. In the six weeks before the op I did as much muscle build up exercise as possible and was in the pool two days afterwards. The hydro-therapy was brilliant and v helpful. I had almost daily physio for about four weeks, then eased back to two/three times a week. At five weeks I was in despair about the continuing pain but was told six weeks is the critical period and low and behold after seven weeks I realised that for the first time in years I was pain free.

I have since been skiing, no powder or the like but reasonably grown up on piste, can do whatever I like on the boat and generally all is good. What I don't cannot do is run or walk long distances but then I never was a rambler anyway.
The only people I know that have had bad results, two of them, both left it too long before the operation. I was warned that I had a maximum of two years before the deterioration of the old joint would permanently impair the fitting of a new joint. I chose to go pretty much straight away. Was the correct decision.
When chatting to physios, it was made very clear that any extra weight carried is very detrimental so obesity is a no no if you want to get the best out of the new joint. But that applies to knees and hips across the board anyway. If the OP's missus is carrying condition, she should seriously work at getting rid of it.

After six and a half years I'm not needing a new one yet.

 

[Quandary]

I got mine done two years ago (I had had an arthoscopy? earlier but my cartilage was too far gone) and I am now back working as a canal pilot which involves lots of heavy walking and pushing. A bit restricted when rough hill walking, particularly coming down, but I do a lot of cycling. I was given the option of having an epidural instead of a general anaesthetic and it was a hoot, chatting to the cheery Australian anesthetist while some guys were drilling and sawing at the other end of the room. ( I think they were making a kitchen) though I smelt some scorching bone at one stage.
Out and walking the next day as soon as I demonstrated that I could get off the WC pan and go down stairs. Fit enough now to have given myself a hernia, another op. for that on Thursday
Prior to the knee op. the surgeon told me 'You are the ideal age, you will be dead long before it wears out'.

I would second the advice about getting really fit before the op. makes all the difference to recovery time. I cycled about 10 miles min. every day for about 4 months and continued afterwards as soon as I got the knee past 110 degrees of bend.

 

[johnalison]

Oddly enough, gross obesity isn't a bar to having a total knee. They found that people like my late MIL who are broadly spherical are mostly too lazy to wear their new knees out.

 

[Bathdave]

Thanks to all who have replied so far ....a slightly mixed set of responses, tipped towards the ' go for it' ...but we understand there is about 80-90% proportion who have a positive response, which leaves between 1 and 2 in 10 with no improvement or a deterioration in knee function.

Quandary ...how old are you (your surgeon thinks your the perfect age...)

 

[mikemanor]

.. which leaves between 1 and 2 in 10 with no improvement or a deterioration in knee function.

My surgeon told me, as part of his risk information, that after 1 year 20% of patients (nationally) wish they had not had the operation. This reduces to 10% after 2 years. The mortality rate is 1 in 400. These are tough decisions for your wife to make. I admit that I entered the theatre with some trepidation, but as per my earlier post it has gone well for me at just under 6 months post op.

 

[Quandary]

Quandary ...how old are you (your surgeon thinks your the perfect age...)

I do not like to reveal my age on here in case my daft ramblings are attributed to senility, but I was 72 when I had the op. The 'perfect age' thing was a bit of a joke as I had asked the surgeon was there an upper age limit. I do have a friend who had been going about in agony for years because in his late forties he was considered too young, though this is exacerbated by a very active lifestyle.

If your wife's boating activity includes a lot of hopping on to pontoons when berthing you would need to address that, either by a change of roles or a suitable ladder or platform. Jumping or falling, from even moderate height, can be very painful and potentially damaging.

 

[PetiteFleur]

A close friend of ours had both knees done about 2 years ago. Before that he was v active, initially rock climbing then a lot of walking before bothe knees were very painful and he could barely walk 300 yards. The op was verysuccessful and he is now back to walking(but not rock climbing!).

 

[doris]

These are tough decisions for your wife to make.

I disagree. For me it was an easy decision, a no brainer in fact. The pain killers and anti inflammatories I was on would have killed me and the relief was total. Probably the best decision I have made in later life. Absolutely normal life afterwards.
Rule one though is do as you are told re. pre op exercise and post op physio.
Rule two, see rule one.

 

[Easticks28]

I disagree. For me it was an easy decision, a no brainer in fact. The pain killers and anti inflammatories I was on would have killed me and the relief was total. Probably the best decision I have made in later life. Absolutely normal life afterwards.
Rule one though is do as you are told re. pre op exercise and post op physio.
Rule two, see rule one.

and Rule three - see rules one and two !

 

[kunyang]

I had a total knee replaced in May this year, i'm 56. Best thing I had done. No pain now. It is important to use the time when you are on the pain killers (i had strong ones to take home) that you get as much movement as you can. Don't whimp it. I had 120 degrees before I went to physio, and now,no discernible difference. My father in law is a physio(retired) and he gave me the advise.

I had a Vanguard knee keeping with the nautical theme, through the NHS. Had an MRI scan before the op and they made the knee following a 3D print of the leg skeleton, and all the jigs to do the cutting. Great service/ Op took an hour and out of hospital the following day. Mind you, it hurt like f***

 

[chrisb]

The problem with a replacement is kneeling which as a single hander I do frequently so I persevere with the old wrecked one. I don't believe the NHS can provide a good replacement ( after 30yrs working for it) and they then come expensive