What’s the criteria for getting a knee replaced?

Hello @ecook -- Welcome to Connect. I am in a similar situation and have had the same thoughts except I'm a lot older at 75. I had surgery on my right knee to remove torn cartilage back in the mid 70s and have had trouble with the knee off and on for many years. I have degenerative arthritis in both knees and the right knee is bone on bone. I have trouble walking and was at the point of using a cane daily and a walker at night when I had to make trips to the bathroom so that I can support/balance myself. I know each of us are different and I describe my pain at around 3 or 4 max for the knee which is subjective. A month or so ago I thought I would be a candidate for a knee replacement but after meeting with Mayo ortho docs they did not recommend it at this time. They suggested physical therapy which I had already been doing on my own and a shot as the next step...well, I had the shot last month and felt great up until the past few days. I over did it one day and did some kneeling working on the edge of the driveway. Now the knee is really tender again and I'm probably going back to using the cane for a few days until I see if it gets better. I still have better range of motion than before so that part is OK.

I'll give you what I think the answer to your question is but it's only my own opinion and I have no medical background or training. I think when the pain is unbearable (10+?) they probably would recommend the knee replacement. That and it will only last so many years and if they replace it now you might need another one and rehab is probably a lot harder for us old follks ☺

I'm tagging a moderator @JustinMcClanahan who is a youngster with a lot of experience and knowledge that I'm hoping can provide some enlightenment for both of us.

John

Hi @ecook! I am 52 and had to have my right knee replaced in May and now need to have the left knee replaced. I can tell you what my situation is. I was diagnosed with osteoarthritis in 2009 and I had a cortisone shot then. My knees were often stiff and sore, but I kept going. In February of 2018, my right knee began to lock up and was painful. It was at that point that I went to go see about the orthovisc shot. The doctor compared my x-ray to the one from 2009. I had no cartilige left and was bone on bone. At that time I told them I wanted the shot and there was no way I was going to have a TKR. They tried for months to get the shot approved. I finally got to a point where my knee was locking up constantly and at one point was walking from a restaurant to my car and it locked up so bad that a friend had to drag me to the car. It was then that I realized that I had no other options. When I went to see the doctor, he told me the same thing. I was at a point where the shots would no longer work and a TKR was my only option. I went to the doctor on May 2 and had the surgery on May 14. Normally there is a 3 month wait, but My right knee was severe. My left knee was not in great shape either and the shots won't help. So I need to schedule that surgery. If the doctor says the shots will help, then I would take the shots and hold off as long as I could. They will let you know when the shots wont work. Because of my age, I will have to have both knees done again at some point. If you have other options, I would consider them. See what some of the others in this group suggest. Good luck to you. Let us know what you decide.

John this is Beryl another nut that over does things in the garden and suffers after, don't do it again .....ha ha ......I know we are just human and think we can get away with it......I bet the drive looks nice though.......

Hi Beryl @beryl, I wish I was done. I did smarten up a little and bought some knee pads. Now just need a power lifter to get me off my knees. Have to take a break and get an adapter and 45 pvc elbow and some drain pipe to extend the drain out into the woods a little. Guess I should have paid more attention when I had the concrete work done.

Glad you have a sense of humour John, my Mum used to say "You have to laugh or you will cry". That is quite job you have had done there think maybe you need some help with that ! Try not to hurt yourself ......Beryl

My wife is diabetic and overweight and has severe knee problems. Deterioration. Surgery is a higher risk for her. Does anyone have any suggestions? Or tried stem cells?

Hi Rob @robseverson, I've thought about stem cell treatment for my right knee but insurance doesn't cover it so it's all out of pocket cost. There is currently another discussion on Connect about stem cell treatment for the knee that you might want to read through and talk with others who are thinking about getting it done.

Groups > Bones, Joints & Muscles > Cost of stem cell therapy at Mayo
-- https://connect.mayoclinic.org/discussion/cost-of-stem-cell-therapy-at-mayo/

John

Hi ssbionicknee, Thanks for your insight. The shots work for less and less time and the uncertainty of knowing when they stop really is a pain. I thought if I could just get the TKR then I could plan again. I was an avid hiker who has recently retired and one of my bucket list trips was to hike in Switzerland. Not able to do that even when the shots work as they do not give me that much improvement that I would risk hiking again.

Hi John, thanks for your reply. There have been periods of time when I’ve had a snap in the back of my left knee which had me using crutches for two weeks. I couldn’t even put any weight on it. The pain will gradually become worse as the cortisone wears off. So, I gather from most here that waiting is best. Still frustrated though.

Hi @ecook, I don't blame for being frustrated. I am too. I hate not being able to do simple tasks that require kneeling down and having to get up from sitting slowly before taking a step to make sure the knee is OK. If I had the money I would try the stem cell therapy although the ortho doctor I talked with didn't think it would help much if you have bone on bone - didn't think it could grow any new cartilage for the joint. Probably my biggest fear is not being able to get the knee replacement until I'm even older than I am now and that will make rehab even more painful. I just take it one day at a time and try to keep moving the best I can.

John