Alternatives to knee replacements

@rorygrabowsky, I tore the cartilage in my right knee back in the 1970s and had surgery to remove the torn cartilage. I was good for quite awhile after the surgery until I developed arthritis. I had a cortisone shot in the knee when it started bothering me sometime around 2010 but don't remember exactly and it lasted a long time. The arthritis made it worse after about 5 or 6 years and I had another cortisone shot but then I made it worse by kneeling on concrete while working and the pain came back big time. I looked into a stem cell therapy clinical trial but was too old to qualify and not able to afford the out of pocket cost especially since it might not work at my age at the time. From my experience, the cortisone injections only help with the pain and I'm not sure they would do anything to help with balance that's creating pain in other parts of your legs.

Have you discussed your concern about the clicking sounds in your knees and that your knees are affecting your balance and creating pain in other parts of your legs?

Yes John. Thanks for getting back to me. The orthopedic surgeon said the clicking is the arthritis. I just want to avoid knee replacements. A very Happy and HEALTHY New Year. May I ask your age and what did you finally do for your knee/s?? I'm 71 and the out of pocket after Medicare might be more than I can afford. I tell everyone that they shouldn't get old and poor, which I am. Let me know your thoughts.

I'm 77 and had my right knee replacement done April 2019 at Mayo Clinic Rochester. I'm really happy that I finally got it done and did the pre-surgery and post-surgery exercises faithfully which I think made the surgery go much better. I am extremely lucky that I have a good Medicare Advantage plan through Minnesota UCare and my out of pocket was less than $300. Of course I guess I could factor in the cost of the UCare plan at 217/month but I bumped it up to a more costly plan in 2019 specifically because of the knee replacement and the better hospitalization coverage. I was fortunate enough to still be working full time from home in 2019 but retired at the end of the year so my fun money has disappeared so I'm old and now on a fixed income 😊

Here's some information that may be helpful for making a decision. If you have a supplemental or advantage Medicare plan, it would be worth calling and asking them about your options and the cost.

Does Medicare Cover Knee Replacement Surgery Costs?: https://www.ehealthinsurance.com/medicare/coverage-all/does-medicare-cover-knee-replacement-surgery-costs

I went With United Health care Senior Plus. No out of pocket but I double dip as a Veteran and get free meds except in an emergency like this case of this Isymthus that flared up quickly

Have you called United Healthcare? Saves me alot

I'm satisfied with Cigna. and can't change until next October.

can you tell me bout the replacement, how long was the rehab, what was the pain level after the surgery and when were you able to walk without assistance. Just tell me what you can and remind me why you didn't do injections of any materials.

@rorygrabowsky : Just adding a few comments.... Had knee pain due to some arthritis, and partially torn Meniscus, and some cartilage floaters in knee. Cortisone injection did not help, so had knee “clean-out” surgery in 2019. Did not really help matters, even after another cortisone shot, and a series of hyaluronic acid injections. Caved, and had knee replacement surgery September of 2018 at age 69. Quite a bit of pain, as is to be expected from a major surgery. Ditched walker within 4 days of surgery, and was walking short distances on neighborhood streets within a week. Rehab is a bitch, but having been in good shape generally, and being able to join a facility with a heated indoor pool helped matters a lot. However, I did not know about PRP or stem cell treatment before my 1st surgery, or the replacement decision, otherwise I might have tried those first.

@rorygrabowsky, My reason for not having any more injections was that they would not have helped me. I had bone on bone pain before the replacement and was told an injection would no longer help. I had one about six months prior to the knee replacement and it helped for about a week and then I did some more damage to it by working on my knees on concrete and the pain was back like it was prior to the cortisone shot. That's when I decided I needed to do the knee replacement. I think you have to wait for 3 months after a cortisone injection before you can have a knee replacement.

When I met with the surgeon he gave me some pre-surgery exercises to do while waiting for the replacement surgery which was scheduled a month later. I actually think the exercises are good for all of us elderly types to maintain mobility and flexibility. Here's some cheat sheets that explain the different exercises.

Before surgery knee exercises: https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/preparing-for-surgery/before-surgery-knee-exercises
Post Op knee exercises: https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/after-surgery/knee-exercises

I also have an exercise bike at home which helped a lot during the home rehab. I had my TKR on the 1st of April, 2019 and the weather was not great in Minnesota so it put a crimp in outdoor walking for the most part although I was able to get out and walk in my driveway using a walker the first and second week after my surgery. I then used a cane for about a month until I was able to walk OK without it. I think I felt I was almost back to normal about 2 months after my TKR. I still take stairs gingerly but I think that's more due to my degenerative arthritis and my age (not wanting to fall or trip!).

The goal of the surgeon and care team is to get you out of the hospital the day after your surgery so the the physical therapist at the hospital gets you up the morning after the surgery and starts you on the post op exercises and makes sure you can walk OK and shows you how to go up and down a small staircase they use for post op. The most important lesson I learned from my post op rehab was icing and elevating the leg. This helps control the swelling and reduces the pain. I wasn't having much trouble with the pain but the swelling was there and my follow up with the surgeon about a month after the surgery, well lets just say he gave me the what for because I was not elevating and icing the knee enough. So anytime I wasn't exercising or doing something, I iced and elevated my leg. I did it when I was watching TV, reading, working on the computer or just napping on the sofa.

Questions you might want to ask your surgeon or care team before the surgery...
- 8 Questions to Ask Before Knee Surgery: https://www.arthritis-health.com/blog/8-questions-ask-knee-surgery
My personal thoughts for questions...
- What type of hardware do you recommend/use for the knee replacement?
- Will I get an allergy test for the bone cement, metals, etc. used in the replacement components?
- Can you explain the risks - possible nerve damage, etc.. ?

Other members may be able to provide other questions, but I would make a list and take it with you when you talk to the surgeon.

Best of luck whatever you decide!

Rory. I would strongly recommend not doing anything until Covid is under control. My husband
had TKR Oct 27. Then had a revision due to suspected infection(extreme pain)
He contracted Covid in hosp or rehab center, and it has been a nightmare Hospitalized 5 times. He is just starting to feel a little better. Lost 30 lbs. No appetite. Does not sleep well. Huge setback on knee PT. Kidney damage due to antibiotics (high creatinine level) which I had to administer by PICC line. He is 78.
Wait till corona is not a risk.
I think one is able to change from Medicare and a supplement to an Advantage plan at any time. Not just during open enrollment.
Joan Flynn