No cartilage left in knees

Hi Kris,

I'm sorry about the pain you are in. Having to literally haul yourself up a stairway with your arms is just too much.

I'm 70 now. Like a lot of others on here, I have osteoarthritis everywhere. To add to it I ran a lot of marathons in my 30s and 40s. In 2022 I had both knees replaced. I worked with a trainer for six months prior to the surgeries to strengthen the muscles that support the knee - primarily the quads and hamstrings. I selected a young surgeon experienced in knee replacement with a robotic (Stryker/Mako) assistant.

After the surgery, I did all of the suggested rehab obsessively for two months. It's over two years now, and getting my knees replaced has been life changing. I can't run anymore, but I'm in the gym everyday and I spin 5x/week. It feels so much better after all the pain I was in.

So please don't rule out knee replacement without doing some more research. I realize that forums like these attract a number of people who have had a bad experience, for a number of reasons. But a great deal of the outcome is in the patient's hands. Find a great surgeon, ideally someone in their 30s or 40s with a solid med school/residency pedigree - a surgeon who has already done thousands of these procedures. Look at the surgeon's reviews, ask questions, get in the best shape you can and go for it.

PRP, cortisone, and other injections are band aids, and temporary band aids at that.

I wish you the best, regardless of your decision. I really believe that we don't have to live with the pain and inconvenience of worn out, painful knees.

All the best. Joe

Hi Joe,
You were probably a great candidate for the knee replacement. You did all your homework and motivation kept you going. I am older than you and wondering how much longer I will live in the first place. So, time is not on my side. With a host of other conditions, it is not likely I will go for knee surgery. I keep on hoping I will wake up one day with a sudden cure. It has happened before with other conditions that have presented as painful reminders of the body's fragile nature. Good health is a balancing act. Some of us have good genetics and a lifestyle that prevents infirmity while advancing through life. Others carry a host of genes predisposing them to issues that may be moderated (or not) by lifestyle. I wonder what I did in my 30's to create my issues of the 70's. Could I have prevented my osteo-arthritis? I wasn't a runner. Genetics? No one in my family had any type of bone and joint problem. So, chalking this one up to fate, luck of the draw, whatever.

Thanks Kris. You make a lot of good points.

We've heard it before - some people are just blessed with good genes. For me that has been a mixed blessing. I did inherit a disposition for osteoarthritis (both big toes fused, both knees replaced, next year I'll have my right hip and left shoulder replaced, my lumbar spine is a disaster area and in need, at some point, of multiple fusions).

But I was also blessed with whatever gene endurance athletes have. I could run miles and miles, and did until OA took out my knees at age 48. So now I spin and again, my endurance genes allow me to do what others can't, or at least it's easier. So I don't complain too much.

And age is certainly a factor, as you mention. I feel relatively young at 70 - but if I were in my 80s I'm not so sure I'd want to go through the grind of TKR rehab and rehab.

I wish you the best Kris, and all others who suffer with joint pain. I have to wait three months to get my hip replaced. In the meantime the pain is certainly messing with me, along with my shoulder. Even so I consider myself fortunate.

Joe

I also cringed at the thought of knee replacement so got 2 more opinions
& it turned out I have "Bursitis," & don't need a knee replacement, but
not sure what to do about it. I hate taking pain meds every day & sometimes they don't even work. Any suggestions???

Did the doctor who diagnosed give you a treatment plan? I wonder if it would be helpful to have physical therapy

I think hormone replacement therapy is the answer. using estrogen, progesterone and testosterone. I am 76 and will soon be getting a referral. I tried to do this for years.

Good luck to you Joe. You are a person who endures and is just keepin' on, keepin' on. I think many of us are like that, but we can't exactly recognize one another on sight in the grocery store or in the park. I look at myself while I am grocery shopping and say that none of those people who are walking by can have any idea of how painful each step I am taking is. I try not to show it and blend in with the crowd most of the time. Once in a while when my knee twists slightly I let out an unexpected groan. Luckily, I am usually not close enough to draw attention! Same goes for those I pass by. There is no way most of the time for me to know what ills their faces don't reveal. So, here we are on this site sharing our woes and our appreciation for the opportunity to talk it out with like minded people. It is a very good thing.

Hope it won't be a bore to share my knee experiences. Just going to list them with outcomes. Have R/A and post polio syndrome. Due to polio I have essentially no left knee quad strength. Neurologists and two ortho surgeons doubted I would have a good TKR outcome and won't operate. I tend to agree with those opinions despite fact I am well motivated. Hence, lots of pain and limited ambulation.

2 cortisone jabs to knee - no pain relief and opinions differ on whether or not cortisone over the long haul is damaging
1 hyaluronic acid injection - no lasting relief
1 genicular ablation to medial portion of knee - helped somewhat but not lasting and no relief of lateral pain
iontophoresis laterally to knee - 4 visits to P/T - no immediate nor lasting help
1 knee brace - upper thigh to below knee - not intended to help pain and I couldn't manage it and fell - now sitting in closet
many visits to P/T to strengthen leg and improve gait - no improvement
2 platelet rich plasma jabs - not much improvement from 1st on Aug 31 and had a second on Oct. 31 with same effect and surgeon recommended no further as the lateral bone on bone will gain nothing from further jabs. Highmark did pay for my 1st and I am waiting to see if the second will be covered

I am not on medication for R/A as I am hesitant to try biologics pr methotrexate since I get medication reactions. Was in hospital 4 days with acetaminophen toxicity and everyone claims acetaminophen is safe and I did not go beyond the RDA.

Swimming was the best relief but is no longer available to me.

Apologize for length here but my experience shows the extent some of us go looking for a port away from the storm of pain. It helps to keep trying and an open mind to treatments but acceptance in the face of unsuccessful procedures means you come to terms and make the best possible you in whatever way it takes to cope.

@chesh
I just came from my orthopedic surgeons office.
I have some osteoarthritis in my knees too.
He suggested PRP ( Platelet-Rich Plasma) plus Hyaluronic Therapy injections.
This not my Dr. but this link explains a lot.
https://www.lkaplanmd.com/combined-hyaluronic-therapy-for-the-knee-knee-hip-replacement-scottsdale-phoenix-az.html#:~:text=Combined%20hyaluronic%20therapy%20is%20the,tissue%20in%20your%20knee%20joint.

I had PRP in both knees mid -summer. Absolutely no improvement. I have read that those with more recent sports injury's, less arthritis and less erosion have benefited. It was not as painful as expected seeing the horse syringe that holds the centerfused platelets bearing down on my knees. The site is numbed just before the injection. It was inconvient following the instructions not to stress the knees for a period of time, but I took advantage and got caught up on reading and relaxing. $1,800 for both knees out of pocket, the doctor would charge $1.200 for one. Medicare had already approved knee replacements and I have a supplement that pays 100% of what Medicare doesn't cover but determination was made after my allergy blood testing that I would reject the implants in time. I had judiciously paid out of pocket for a blood test to determine allergies to the inplant componets, $600 cash before my sdcheduled implant surgery. Best decision I ever made getting that test as I tested positive to metals. Of course the surgery was canceled because even the ceramaic coated implants loose their coating over time and metal is exposed.
I have read mixed reviews about bone marrow stem cell transplant for knee rejuvenation. One friend of a friend swears by them. They are also an out of pocket expense, about $10,000 per knee and this person has had this procedure multiple times over the years because it only helps her for a limited number of years.