Therapy for knee arthritic knee

Posted by lou1130 @lou1130, 2 days ago

Has anyone been successful in preventing the need for knee replacement surgery by actively working the knee with physical therapy .
Since I am of advanced age I would like not to have surgery . I’m working out every day and going for physical therapy twice a week . Other than a bit of awareness of the arthritis in the knee I yet to have suffered severe pain .though X-ray show lots of damage .
I hope to build the muscles in my thigh and calf to support my leg so that I’m not putting pressure on the knee bones .
I’m told by those that had surgery it will not work and eventually it will be necessary to have the surgery .
Wonder if anyone out there has had success using this method .

Interested in more discussions like this? Go to the Bones, Joints & Muscles Support Group.

Profile picture for Ray Kemble @ray666

@sstopalian Thank you both for your post regarding bad X-rays and TKR, and also for encouraging core work in addition to leg strengthening. Quite some time ago, I set out an array of dumbbells halfway between this laptop and my kitchen Mr. Coffee. Now, every 30 minutes, when the timer goes off, letting me know it's time to get up from writing and do a little walk-around––and get a coffee refill––I can't possibly get that coffee refill without first pausing at my dumbells for a few minutes upper-body strengthening … Speaking of that––the timer just went off. Time for a coffee refill and a little dumbbell lifting! Have a great day, @sstopalian. Cheers! –Ray (@ray666)

Jump to this post

@ray666 Thanks Ray looks like your coffee gets you moving , good incentive .

REPLY
Profile picture for Ray Kemble @ray666

I'll follow this thread closely. I'm 81. I have idiopathic large-fiber polyneuropathy, o no pain, but an unsteady gait. My right knee is a no-problem, 20-year-old TKR. My left knee, however, is packed with arthritis. Curiously enough, although my knee X-rays show serious damage, my left knee doesn't bother me much during my daily chores. When it does bother me (painful, yes, but hardly a crippling pain) is in the hours after I do PT with my once-a-week therapist. He and I focus almost entirely on building leg strength: weight bags, sit-to-stands, etc. My orthopedist is offering me a second TRK. I'm stuck at thar juncture, wondering: Do I get that second TKR? Or do I trust that long-term PT will eventually provide me with adequare leg strengthto counter my poor gait? Whenever my orthopedist asks that traditional question: "Is this situation (arthritic knee) so bad that it's interferring with the tthings you want to do?" My honest answer (at this moment) is: "I don't know." That's why I began in saying I'll be following this thread closely.. –Best wishes all around! Ray (@ray666)

Jump to this post

@ray666 I have recently become aware that RFA (Radio Frequency Ablation) can be done on knees as well as the spine. It should be longer lasting than cortisone injections. Has anyone considered this approach?

REPLY

97-- Doctors will not operate on patients over 90

REPLY

I am 70 years old and would really like to avoid TKR, but I am beginning to doubt that is possible. Both of my knees are riddled with arthritis and bone on bone. I did not realize that my left knee was worse than the right until I had X-rays on both. In early June, I had cortisone injections on both because they were giving me some pain and limiting my activities just a tad. Within four hours of having the injections, everything headed south and has spiraled out of control. The pain in both knees lasted for weeks causing issues with my hip and back from compensating when trying to walk. All of my normal daily activities were greatly affected. After 3 to 4 weeks, I returned to see the PA. I honestly believe that during this timeframe I tore or damaged something in my left knee. I declined any additional injections and requested physical therapy. The physical therapy has Greatly improved my hip and back pain, but the left knee has constant medial pain. I feel like physical therapy is helping, but sometimes it seems to be aggravating the situation as well. Until this happened, I was riding my outside bike 10 miles a day several times a week. I did venture back out on my bike last week. It was challenging but possible. My current issue is the constant medial pain in my left knee. Due to the condition of this knee on X-rays, nobody seems interested in doing an MRI or pursuing this further (other than TKR). Has anyone experienced something similar? I am committed to another 6 weeks of PT until I see the surgeon to make a decision on surgery. All suggestions are welcomed. I am sorry for this lengthy comment.

REPLY
Profile picture for steveinarizona @steveinarizona

@ray666
Well...I am 81 and had my right TKR at 80. One of the best decisions I have made in my 81 years of life. But the recovery can be difficult and that must be factored into the decision making.

To me, the most important decision, after deciding to go forward, was surgeon selection. Find an extraordinary surgeon and follow her direction.

Jump to this post

Hi, Steve (@steveinarizona), I commend you on your decision and follow-through. May I ask? How bad was your knee pain prior? Mine is relatively slight, aggravated mostly by the PT I do to improve leg strength (i.e., balance). What has me iffy on the question of a second TKR is my knee pain, such as it is: Is it just going to get worse (as I get older)? Or is it as bad as it's going to get? On the plus side, I have what I believe is an excellent orthopedic surgeon (his whole team is phenomenal); he has been extremely detailed in laying out what I would have to a arrange (i.e., a friend staying with me for 7-10 days) should I green light a TKR. ––Here's wishing you a good day, Steve! –Ray (@ray666)

REPLY
Profile picture for dna41 @dna41

@ray666 I have recently become aware that RFA (Radio Frequency Ablation) can be done on knees as well as the spine. It should be longer lasting than cortisone injections. Has anyone considered this approach?

Jump to this post

Good morning, @dna41. No, no one has mentioned RFA, but now that you've told me about it, I'll look into it and ask at my orthopedist's office. Thank you! –Ray (@ray666)

REPLY
Profile picture for Ray Kemble @ray666

Hi, Steve (@steveinarizona), I commend you on your decision and follow-through. May I ask? How bad was your knee pain prior? Mine is relatively slight, aggravated mostly by the PT I do to improve leg strength (i.e., balance). What has me iffy on the question of a second TKR is my knee pain, such as it is: Is it just going to get worse (as I get older)? Or is it as bad as it's going to get? On the plus side, I have what I believe is an excellent orthopedic surgeon (his whole team is phenomenal); he has been extremely detailed in laying out what I would have to a arrange (i.e., a friend staying with me for 7-10 days) should I green light a TKR. ––Here's wishing you a good day, Steve! –Ray (@ray666)

Jump to this post

@ray666 I had two levels of knee pain. I had moderate continuous pain from the knee. But I had extreme and unpredictable pain if I stepped the wrong way running down my leg because I was severely misaligned and it was causing a nerve impingement. Fortunately it never happened when I was crossing a street as I had to stop and freeze when it happened.

Is your pain from arthritis. If it is, it will likely keep getting worse. You like your ortho, what does he say.

One unsolicited thought about your ortho if you decide to go forward with a TKR. Surgeons, especially great ones, tend to be narcissistic and not especially good at communications. My view is that I don't care; I just want the very best mind and hands available.

My view is that the surgeon I want does a minimally invasive procedure (subvastus or midvastus), does not routinely use a tourniquet, does a modern alignment (Functional or at least kinematic or inverse kinematic), has great hands, has a great mind, and HAS EXTENSIVE EXPERIENCE DOING THE EXACT PROCEDURE I AM GOING TO GET. I would add a robotic assistant if there is any chance that the surgery will get complex and if my surgeon does a Functional alignment (which involves soft tissue work so the added precision is critical).

But your surgeon must be available for you if anything goes wrong. So I do add an element of the surgeon's availability and that of his team. For example, when I came out of my surgery and was in the recovery room, my surgeon gave me a one page sheet detailing my first week recovery protocol and providing a phone number which he promised would be answered 24/7 by either himself or his principal PA.

If your surgeon meets all of these, you are well on your way to maximizing your chance at a successful surgery and recovery.

REPLY
Please sign in or register to post a reply.