1. < Bones, Joints & Muscles

No cartilage left in knees

Posted by chesh @chesh, Jun 22 8:45am

I have been told by my orthopedic surgeon that I have no cartilage left in my knees. Walking is beginning to be more difficult but not terrible. Stepping up and down even a curb is awkward. Stairs are a one step up or down with one leg and then bringing the other beside it and slow going.
I am having hyaluronic acid injections six months apart that help some. I am now wearing the right kind of shoe. I had been wearing a rubber soled platform sandal that I figured (because of all the rubber) cushioned my knees). Recently I developed tendon pain in both legs which I was told was due to shortening of the tendons behind and inside of my legs below my knees. I think the platform shoes might have been responsible for this because ,with running shoes now ,I feel the tendons stretching.
I do NOT want knee replacements!
What do others of you do in my situation that helps?
P.S. I know that losing weight would help. My weight has been a challenge all my life.. I am 5 foot seven and weigh 185. I am 73 years old.
I do swim laps regularly with no problem. I haven't tested whether I can still walk around a block.

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absoluteroyalty1 | @absoluteroyalty1 | Jun 28 9:36am

Why would you not want to improve your quality of life? You’re causing more damage to your knee joint not to mention hip, spine injuries. I had a TRK replacement in 2015. Best decision I made. Well, also my knee gave out while walking up steps and I wound up in the ER. I’m 70 and will have a left knee replacement probably this fall. I want to participate in life not watch it from the sidelines. Get your info. Get referrals from your friends. Interview surgeons. Get moving. Talk with a dietitian: nutritionist. Good luck.

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1 reply
heyjoe415 | @heyjoe415 | Jun 30 8:21am
In reply to @absoluteroyalty1 "Why would you not want to improve your quality of life? You’re causing more damage to..." + (show)
@absoluteroyalty1

Why would you not want to improve your quality of life? You’re causing more damage to your knee joint not to mention hip, spine injuries. I had a TRK replacement in 2015. Best decision I made. Well, also my knee gave out while walking up steps and I wound up in the ER. I’m 70 and will have a left knee replacement probably this fall. I want to participate in life not watch it from the sidelines. Get your info. Get referrals from your friends. Interview surgeons. Get moving. Talk with a dietitian: nutritionist. Good luck.

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Excellent advice. I had both knees replaced in 2022 at age 68 (knees were replaced 4 months apart). I worked very, very hard before and after surgery to get my legs in shape and do the rehab exercises obsessively. The results are better than I could ever imagine.

I get that different people have different outcomes to TKR. I do believe that most bad outcomes are the result of the patient not putting in the work post-surgery. There are always going to be exceptions - a poor surgeon, an infection, and on - but these are rare IMO.

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heyjoe415 | @heyjoe415 | Jun 30 8:24am
In reply to @mabfp3 "If possible, I would hold off on knee replacement until you can’t take the discomfort and..." + (show)
@mabfp3

If possible, I would hold off on knee replacement until you can’t take the discomfort and pain. Go for cortisone shots as long as you can and do exercises to strengthen your upper quads. TKR is a very rough surgery. Although many people have success with it, I didn’t. The recouperation is long and difficult. My replaced knee still gives me trouble. I told this to the surgeon and his words to me were “Well, it will never be the knee that God gave you.” I am not doing my other knee. I will live with the bone on bone pain, keep exercising, use a knee brace, get a cortisone shot……..Anything but knee replacement surgery!!! Put it off until you can’t stand the discomfort any longer. Wishing you the very best with whatever decision you make.

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I am sorry for the way your TKR turned out. That said, the procedure itself is fairly common and straightforward. It is vitally important that the patient put in the post-surgery rehab work starting immediately after surgery. And it is a major surgery and the first two weeks post-op can be painful. I had a diluted nerve block for the first three days. But it will get better if the rehab is done properly.

Again, I’m sorry for what you have gone through. I still strongly advocate for this procedure to end a lifetime of suffering when knees are bone-on-bone. Suffering is an option.

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1 reply
h2marcia | @h2marcia | Jun 30 9:23am
In reply to @heyjoe415 "I don't understand why you don't want knee replacements. I'm 70 and had both knees replaced..." + (show)
@heyjoe415

I don't understand why you don't want knee replacements. I'm 70 and had both knees replaced when I was 67. I too was bone on bone. All the pain is gone, I go up and down stairs with no problem. Joint replacement is extremely advanced. Why bother with the pain and ineffective treatments?

It's up to you of course. Unless there are other reasons precluding it, you sound like a great candidate for knee replacement.

And your weight is on the high side, but not that high. What does your surgeon say?

Finally, it's great that you swim. Do avoid the breast stroke as it is very hard on the knees to kick out at an angle as required by the stroke.

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I was told after TKR I cld play doubles. I did with a sleeve but now, 2 years out, my knee buckled in tennis, so I stopped, but the knee is very painful even after walking. I asked the surgeon for a 2nd opinion and he said we don’t do that for knee replacements. He said it was nerves from my back most likely.

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2 replies
absoluteroyalty1 | @absoluteroyalty1 | Jun 30 11:09am
In reply to @h2marcia "I was told after TKR I cld play doubles. I did with a sleeve but now,..." + (show)
@h2marcia

I was told after TKR I cld play doubles. I did with a sleeve but now, 2 years out, my knee buckled in tennis, so I stopped, but the knee is very painful even after walking. I asked the surgeon for a 2nd opinion and he said we don’t do that for knee replacements. He said it was nerves from my back most likely.

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There are knee surgeons who do revision total knee replacement surgery. In this procedure, doctor either remove or replace a part of the original prosthetics. Get more information and make an appointment with such a specialist in this area. Good luck.

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2 replies
h2marcia | @h2marcia | Jun 30 11:36am
In reply to @absoluteroyalty1 "There are knee surgeons who do revision total knee replacement surgery. In this procedure, doctor either..." + (show)
@absoluteroyalty1

There are knee surgeons who do revision total knee replacement surgery. In this procedure, doctor either remove or replace a part of the original prosthetics. Get more information and make an appointment with such a specialist in this area. Good luck.

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The surgeon showed me on the xray that the implant was fine, but I wonder about the surrounding tissue. Wouldn’t an MRI show the condition of them?

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1 reply
heyjoe415 | @heyjoe415 | Jul 1 6:42am
In reply to @h2marcia "I was told after TKR I cld play doubles. I did with a sleeve but now,..." + (show)
@h2marcia

I was told after TKR I cld play doubles. I did with a sleeve but now, 2 years out, my knee buckled in tennis, so I stopped, but the knee is very painful even after walking. I asked the surgeon for a 2nd opinion and he said we don’t do that for knee replacements. He said it was nerves from my back most likely.

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Hi Marcia,

I'm shocked that your surgeon would green light tennis after a TKR. My surgeon told me to not participate in sports resulting in impact to the knee - so no running, no court sports. On top of impact, tennis puts a lot of lateral stress on the knee.

And I'd get a second opinion on what to do. Did your Dr even take an Xray? There are ortho surgeons who specialize in what is called "revision" knee replacement surgery. I'd seek one of these surgeons out.

All the best to you. FWIW I'd stay away from court sports, even pickleball. Joe

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1 reply
heyjoe415 | @heyjoe415 | Jul 1 6:46am
In reply to @h2marcia "The surgeon showed me on the xray that the implant was fine, but I wonder about..." + (show)
@h2marcia

The surgeon showed me on the xray that the implant was fine, but I wonder about the surrounding tissue. Wouldn’t an MRI show the condition of them?

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Just saw this. Yeah an MRI would show soft tissue damage. That might be a torn or severely strained ligament on the inside or outside of the knee, or the patellar tendon.

Again, find a surgeon who specializes in revision surgery. And please, get away from impact sports. I know that's hard. I ran marathons before my TKRs. Now my knees feel great and there are a lot of other things to do, like spinning, rowing, etc.

Marcia - is the knee swollen? You've probably done this but I suggest a heavy course of icing the knee to reduce inflammation. As far as diet, cut out any added or refined sugar. Sugar increases inflammation in the body and you don't need that. If you're diet is sound, ignore.

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1 reply
tarmansbks | @tarmansbks | Jul 1 9:48am

I have no musculature in my left quad due to infantile paralysis (polio at 9 months) and no orthopedic surgeon will agree to do a TKR. I have had a genicular ablation, hyaluronic acid injections, cortisone injections, ultrasound etc all to no relief of pain. I have been studying PRP - platelet rich plasma - injections. They have good results but not covered by insurance. I have an appointment with someone at Hershey Med Center who does these injections and am hopeful about getting some help. I would encourage anyone resisting TKR or unable to qualify for TKR to look into this treatment. I had also investigated stem cell and those results were not encouraging. Wishing you well and do keep swimming!

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rashida | @rashida | Jul 3 4:10am
In reply to @heyjoe415 "Just saw this. Yeah an MRI would show soft tissue damage. That might be a torn..." + (show)
@heyjoe415

Just saw this. Yeah an MRI would show soft tissue damage. That might be a torn or severely strained ligament on the inside or outside of the knee, or the patellar tendon.

Again, find a surgeon who specializes in revision surgery. And please, get away from impact sports. I know that's hard. I ran marathons before my TKRs. Now my knees feel great and there are a lot of other things to do, like spinning, rowing, etc.

Marcia - is the knee swollen? You've probably done this but I suggest a heavy course of icing the knee to reduce inflammation. As far as diet, cut out any added or refined sugar. Sugar increases inflammation in the body and you don't need that. If you're diet is sound, ignore.

Jump to this post

@h2marcia and @heyjoe415 - as far as I am aware, MRIs cannot be done on anyone with any sort of metal implant.

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