A little help please, I have a bad knee

[dasher]

yes I had a series of 3 injections ,1 a week for 3 weeks ,It did work for awhile on one knee. I am 57 years old

I'm 65

 

[sufandu]

I'm 65. the things is, I had no problem, until all of a sudden one day, it was bad. There was no leading up to this. LOL To sort of get my used to the idea that there was a problem.

You probably had a problem that you just didn't feel. The engine in your car doesn't suddenly wear out when it starts smoking. It starts to wear the first time it's fired up. Our bodies aren't all that different. Everybody over 40 has some level of osteoarthritis. It's the life long wear and tear of the joints. Genetics, environment, nutrition, and activity level all play rolls in how it progresses.

 

[sufandu]

I'm 65

You're at what I think is pretty close to the ideal age for a knee replacement. If the injection doesn't work or once it wears off I suggest pulling the trigger.

You mentioned the xray showed a gap on one side of your knee. Did it show no space between the bones on the other side? Is your leg straight or does it have a sideways bend either in or out at the knee?

 

[dasher]

You're at what I think is pretty close to the ideal age for a knee replacement. If the injection doesn't work or once it wears off I suggest pulling the trigger.

You mentioned the xray showed a gap on one side of your knee. Did it show no space between the bones on the other side? Is your leg straight or does it have a sideways bend either in or out at the knee?

It was a gap on one side and no gap on the other. Plenty of fluid was drained from my knee. Is this knee replacement an out patient operation?

 

[MCC]

Well I didn't have fluid but I did have knee arthritis that saw me getting cortisone shots every 3 and a half months like clockwork for several years. No longer. An OTC B3 variant called nicotinamide riboside sold as Tru Niagen, did the trick. Starting it was the only change that could have/did result in now well over 3 years with zero pain. Zero. Highly likely it's due to its alleged anti inflammatory properties. It is an NAD precursor. I could go on.

Absolutely no clinical data, clear evidence, or well controlled studies in humans on NAD enhancers and joint condition, osteogenesis, or arthritis (data from the 1996 McAlindon, et al. study with 72 patients is sketchy, subjective, and was never reproduced). Even the 2020 Mehmel, et al. paper (authored by employees of a supplement company marketing NR products) doesn't make any definitive statements about OA or any other condition. With respect, you have no way of demonstrating / proving efficacy here. Might as well say you started feeling better on a Tuesday, so whatever we do... try starting on Tuesday.

Dasher, my opinion: waste of $. Go for a TKR once you've discussed with your physician and met with an ortho, and collectively determined it's the best course forward.

 

[sufandu]

It was a gap on one side and no gap on the other. Plenty of fluid was drained from my knee. Is this knee replacement an out patient operation?

You usually stay in the hospital one or two nights. If you get it in the morning, you'll likely start rehab in the hospital that afternoon. If you get it in the afternoon, it'll be the next morning. When you discharge from the hospital you can go home or to a rehab facility initially. Traditionally, rehab facilities can be nice because you get therapy everyday. With covid, I've heard mixed things due to all the social distancing rules and restrictions on visitors. If you discharge home, you can either start outpatient therapy right away or get home health, if you don't have transportation to outpatient. Your therapy would likely be better for this type of thing in outpatient. I did outpatient therapy for a few years before going into home health. Home health clinicians have a variety of backgrounds. In my opinion the clinicians that don't have a background in orthopedics often don't do as well with ortho surgery rehab.

 

[mickbird44]

Mine is bone on bone.

Had bone on bone since I was sixteen from lax have skied agressively since now 59 , injured my other knee in 2002 also ACL and Cartilage in 2002 still ski mostly the same (less bumps) and figure I need to see my Ortho soon but delaying as long as I can! Did last ski day for the season today!!

 

[jgeorge322]

Oh. And sufandu.

what about me, I stayed in a holiday inn last night

 

[OttoinGrotto]

This sounds brutal, Dasher. I hope you get some peace from the pain.

 

[jgeorge322]

FYI, I know someone who has a knee replacement, said it was terrifically painful, apparently they cut the top of your tibia and the bottom of your femur, that said, once you get through it, it’s worth it

apparently the hip isn’t nearly as bad

best of luck to you, the good news is it’s better to have a bum knee than a bum organ.

 

[Toga]

Absolutely no clinical data, clear evidence, or well controlled studies in humans on NAD enhancers and joint condition, osteogenesis, or arthritis (data from the 1996 McAlindon, et al. study with 72 patients is sketchy, subjective, and was never reproduced). Even the 2020 Mehmel, et al. paper (authored by employees of a supplement company marketing NR products) doesn't make any definitive statements about OA or any other condition. With respect, you have no way of demonstrating / proving efficacy here. Might as well say you started feeling better on a Tuesday, so whatever we do... try starting on Tuesday.

Dasher, my opinion: waste of $. Go for a TKR once you've discussed with your physician and met with an ortho, and collectively determined it's the best course forward.

Excuse me for sharing my personal experience.
Jesus.

 

[Obie9]

Hospital stays are more regional now. In CNY, few patients stay overnight unless there are complications. The patients I see (I’m an outpatient orthopedic physical therapist) schedule their initial evaluation for outpatient physical therapy within 72 hours of surgery.
If you have questions, you can PM me.

 

[AZOrange]

Wait is that you Sid?

 

[sufandu]

FYI, I know someone who has a knee replacement, said it was terrifically painful, apparently they cut the top of your tibia and the bottom of your femur, that said, once you get through it, it’s worth it

apparently the hip isn’t nearly as bad

best of luck to you, the good news is it’s better to have a bum knee than a bum organ.

Yes, it is brutal. I tell any of my patients to expect to regret it and think they made a mistake for about two weeks, then the pain begins to improve and activities start to get easier. The hardest part is you can't wait for the pain to decrease before doing therapy or your knee will be really stiff.

 

[HOFCeluck]

FYI, I know someone who has a knee replacement, said it was terrifically painful, apparently they cut the top of your tibia and the bottom of your femur, that said, once you get through it, it’s worth it

apparently the hip isn’t nearly as bad

best of luck to you, the good news is it’s better to have a bum knee than a bum organ.

Accurate.

You can get it done outpatient now too depending on the surgeon and how healthy you are. I think that’s the way to go if possible. Eat your own food and sleep in your own bed.

 

[NKR1978]

the x-ray showed a gap and my Orthro drained my knee (there was a lot of fluid) and gave me a cortisone shot. The shot didn't work. Not for nothing, but he gave me the shot in the knee and it really seems that the pain is on the other side of the knee. Anyway, on Friday, I had a gel injection. he said that it might take two weeks until we know if it worked. Well, yesterday, my knee felt great. But today, it is worse yet, Anyone evr have the gel shot before? And I think if surgery is next (I sure hope not) I may ask for a different dr. Thoughts?

I’m a little late here, but ask about PRP (platelet rich plasma) injections. I’ve taken testimony of many doctors who stated that they help to stave off surgery.

 

[STEVEHOLT]

It was a gap on one side and no gap on the other. Plenty of fluid was drained from my knee. Is this knee replacement an out patient operation?

When you’re describing gap on one side and no gap on the other it’s probably referring to the medial compartment having bone on bone arthritis and the lateral compartment having a lesser degree , as is generally the case in classic osteoarthritis due to weight bearing mechanics ...

Was there description in the report regarding degree of spurring ? Subchondral cystic change ? If these are severe on X-ray , and you have severe medial compartment narrowing , you’re going to need Arthroplasy ..I can predict the MRI will show degenerative meniscal tears and high grade chondromalacia without you even getting one .. it’s not needed

 

[STEVEHOLT]

I’m a little late here, but ask about PRP (platelet rich plasma) injections. I’ve taken testimony of many doctors who stated that they help to stave off surgery.

This is more for chondral disease or tendinous/ ligamentous pathology ... if you have advanced osteoarthritis , you need the healing of cold steel

 

[Shenexon]

One of my brothers has had both knees replaced, several years apart. Physical therapy is the key to success I think, at least from my limited observations. Both were painful. The first was more successful from the PT standpoint. He was more ready for it and committed to the process. He had miniscus removed from both knees off and on over time before replacement. The second time he didn't get quite as many degrees of flexibility as with the first, via the PT. You only get one real opportunity to stretch the knee enough. That series of PT takes dedication. Both were bone on bone and painful before their replacement. Now both are much better. He used a refrigerator of sorts with both knees to help reduce swelling and pain after replacement, after his PT appointments. He liked it a lot. It was a rental. He had both replaced in his early 60s. I'd be happy to put you two in contact if you'd like 1st hand info, but beware...he's a Syracuse fan...

 

[4evaOrange]

Feel better brosef!!!!

 

[CuseFan]

I've had knee issues for 30 years since tearing my ACL playing basketball, and then tearing it again and again. I tried everything including the injections. They helped for 3-5 days at most, and then really nothing. I think it depends on how bad your knee is as to whether they will work or not.

Four knee and replacement surgeries later, I couldn't take the pain anymore and had the total knee replacement almost 5 years ago. It is SO much better. Surgeon said, and I quote: "Your knee was riddled with arthritis, and much worse than we could tell with the MRI and X-Rays." I am not in constant pain anymore for the first time in years. That surgery is not easy and took 3-4 months of recovery, but it was so worth it.. I do miss shooting hoop though.

 

[realorange]

It was a gap on one side and no gap on the other. Plenty of fluid was drained from my knee. Is this knee replacement an out patient operation?

It can be at a top clinic, likely with robotic help.

 

[dasher]

When you’re describing gap on one side and no gap on the other it’s probably referring to the medial compartment having bone on bone arthritis and the lateral compartment having a lesser degree , as is generally the case in classic osteoarthritis due to weight bearing mechanics ...

Was there description in the report regarding degree of spurring ? Subchondral cystic change ? If these are severe on X-ray , and you have severe medial compartment narrowing , you’re going to need Arthroplasy ..I can predict the MRI will show degenerative meniscal tears and high grade chondromalacia without you even getting one .. it’s not needed

Okay. First, what is Arthroplasy? Second, after the gel injection on friday, my knee is actually much worse. Is that justa side effect. It feels like my knee is going to buckle.

 

[HOFCeluck]

Okay. First, what is Arthroplasy? Second, after the gel injection on friday, my knee is actually much worse. Is that justa side effect. It feels like my knee is going to buckle.

A knee replacement

 

[HOFCeluck]

Also, and take this fwiw robots are fine but they haven’t been shown to be superior (though it’s still early) and most surgeons use robotics as an advertising tool.