No cartilage left in knees

Did you have these knee surgeries at Mayo?
How long do you have to stay in town for post op care & PT?
How can a patient be sure if they need a partial knee replacement or full?
How would you know?

Thank you Joe, you’re so kind! Yes the MUA was to break up scar tissue but I wouldn’t recommend it because that knee was done in January and still not at zero, 5 degrees shy and bend is at 120. My surgeon said if he got it straight on the table then I should achieve straight after replacement. I struggle with chronic low back pain and I think I’ve developed a habit of bent knee to ease the pain? Haven’t lost hope that my new hips and knees all in a year will provide me a healthier and stronger future. Still going to PT, who says due to my back issue, rehab will take longer. It just scares me when you read about only having so much time to achieve the ROM and after that you’re stuck with where you’re at!

I just had an MRI and have a tkr

Chesh you don’t want to hobble about on bad knees for the rest of your life? You’ve obviously had this for a long time and have been putting it off hoping it would go away. You need to decide to live a happier last years of suffer painfully. When I was a teen, I’m 72 now, I had an open procedure of my left knee for a meniscus tear before arthroscopic surgery. In my 30’s I was scoped on both knees and diagnosed with chondromalacia in both. But I’ve always been a walker and didn’t stop. I apparently regenerated tissue in my knees and only now am I beginning to get knee symptoms. My PT says my knees are solid though so I keep on walking.

Hi Chesh. I was bone on bone too. I had both knees replaced in 2022 when I was 67 y/o. Best thing I've ever done for my body.

Considering how much your knees affect activities of daily living - taking stairs one at a time for example - I mean check with your doc but I would get them replaced. I have no pain and no regrets.

I worked with a trainer for six months to get my quads and hamstrings in shape to best support the knee and aid post-op recovery. And then I did every exercise they told me 3x day for 6-8 weeks.

Please reread Jenatsky's reply as he says it best. Live life as pain free as possible. Everyone is different but TKRs were life changing for me.

All the best yo you Chesh.

Joe

It is difficult to have successful knee replacements when you are overweight and don’t do much exercise. You have let your situation go too far.
Your muscles have atrophied and they will still be atrophied after surgery.
Not having surgery will only lead to a sedentary life and withdrawing from participating in a healthy lifestyle. Hips and back will suffer.
Be proactive in working towards an active, healthy lifestyle. Get professional guidance from your doctor
When I was in my late 60’s I had two knee replacements 3 months apart. It took me two years to find the perfect surgeon. I was not overweight and did regular exercise and was in great physical condition and now at 74 I can hike for miles, spend the day with grandkids and do volunteer work without pain.
You have the capacity to have successful knee replacements but you have to be willing to do the work.

Interesting background, thanks. I think your walking, and probably other things, have strengthened your legs so the previous problems aren't as noticeable, or aren't noticeable at all. Well done!

I only say this because cartilage can't be regenerated. There are large "cushions" in the body - the menisci in the knees, the soft discs between vertebra, and then soft cartilage that covers the end of bones in our joints (articular cartilage).

When that cushioning tissue is damaged or lost due to a tear, or worn down by use or arthritis, it doesn't come back.

That said, joint replacement is the last resort. Strengthening the muscles around a joint, a strong core, cortisone and other lubricating injections can all push surgery off.

My knee surgeon said surgery is always up to the patient. The best guide is when a joint has devolved to a point where the pain from daily living is constant. That's how I made the decision to get my knees replaced. I had trouble sleeping, stairs were impossible - hell stepping up or down a curb was painful.

I am exploring CardiHeal AgiliC. It is an FDA approved treatment. I am 76...no cartilage left in rt knee. The sports medicine doc was trained in this procedure and says that is used now for healing cartilage that has broken off. He wants to see if I will get any relief from hyaluranic acid injections first but might be willing to try this with me if all else fails. I really do not want to go through another tkr although it was a successful surgery on my left knee. While you are interviewing surgeons for tkr make sure what their infection rate is. My surgeon is regarded as one of the most meticulous in my area

Did you have hyaluranic acid injections prior to tkr and if so did it give you relief and for how long?

I hope you can put off the second TKR. I had to have both of mine replaced in 2022 and now I'm doing fine, just no impact sports/exercises. But very happy with the recovery and results, and the total absence of pain/swelling in my knees

Infection rates overall for orthopedic surgery are about 1%. That sounds low but not considering the thousands of procedures one surgeon does each year. That said, I believe infection rate is more a function of the surgical facility than the surgeon.

By all means, check the infection rate for a surgeon. I'd also check the infection rate for all orthopedic surgeries at the hospital as well. I don't know where to find this info, but I would think it only requires asking for it.

Bottom line is that the longer the incision is open, the grater the risk of infection. Personally I don't worry about it in the big, modern hospitals. It doesn't hurt to check it out either.

I hope your knee responds to treatment so you can avoid the TKR. If not, well you at least know the drill. All the best. Joe