Young Patient and Total Knee Arthroplasty

[mchtkr]

Wondering if anyone might be able to share some success stories with a total knee and resuming activities like climbing, skiing, backpacking? Although at 37 I am younger than most TRA patients, I'm a candidate. I've had to give up skiing and within the past year, pain management on a daily basis has become challenging. Although I can do some moderate hiking, I've lost most of the enjoyment of my favorite activities.
Ive made the decision to do it. I have searched the web for young patients and their TKN success stories but there aren't many of us out there yet! I'd love to hear all the great things that folks were able to do post TKA!

[babybear]

My brother just had his knee replaced this spring and he's the same age- or maybe 38 -can't recall
He had a bad acl/meniscus tear back when we were teenagers, had surgery then but it has caused him tons of pain in his adult life mostly from bone on bone contact
His doc suggested the knee replacement and said he was one of the youngest patients he has done the procedure on.
He used to snowboard and hike all the time but has not gotten a ski pass in the past couple yrs bc it would just put him in too much pain after a day snowboarding (he's a chef too so lots of time on his feet)
Long story short- he had it done in April and he's stoked. He was back to work and running around with his little kid after just a few wks really. It's only been about 6 months and you wouldn't even know he used to walk with a limp and he basically has no limitations anymore.
LMK if you have any specific Q's too and I can ask him

[jma233]

If you do a search you should find a bunch of first and second hand accounts of folks skiing hard on tka's. Conventional wisdom is that the harder you use the new knee the faster it will wear out but I don't know of any studies that have confirmed that. Fretting of the plastic surface is the biggest concern and shear across the joint (from things like squats) are thought to accelerate the process but again, I'm not aware of actual studies confirming this. One thing most drs seem to agree on is to opt for a unilateral compartment replacement if you're young and a candidate for one. Good luck!

[chewymix]

also.... if you can go for a replacement thats designed for your anatomy rather than something off the shelf - reason being is that hardware thats made for you means less of your own material is removed at time of implant and therefore more is preserved for future procedures if you should require it. The implant thats custom also MIGHT last longer as the fit COULD be better and therefore less wear and tear and also a more natural feeling of the joint - something from Conformis are generally held in high regard at the moment.

[mchtkr]

Thanks to you both for the feedback. jma233, lots of searches I've done have revealed folks skiing which is encouraging, I also know at my age I will outlive the life of the entire prothesis, hence my interest in the younger crowd. However, it sounds like, as you mentioned, careful monitoring of the plastic spacer is important to keep up on so as to prolong the integrity of the whole prothesis, especially in younger folks b/c we inflict more impact over a longer period of time. I'll also follow your suggestion to understand what prothesis is recommended, makes complete sense that it should be as tailored to the patient as possible. Thank you so much for your thoughts.

baby bear; fantastic! I am so happy to hear that your brother has had such success, his condition sounds right in line with me, good for him! He must be so relieved with his decision, I expect he had some hesitation in moving forward with it but it is so encouraging to hear he is better than before. Quite honestly I don't have any more questions, at least at this time. I'm so ready to be in his shoes I can hardly wait! Thank you a ton for taking the time to share his experience. Super exciting.

[Maker]

are you bone on bone on lateral and medial side or just one side? usually an interim step for young patients is an osteotomy....shift weight to the good side of your leg.

I am 34, had bad Tibia Plateau Fracture + Meniscus + Cartilege damage. Had an Osteotomy and it has helped. Still in rehab so not back to regular activity and may never be because of my injury but pain has subsided.

[spook]

my medial meniscus is gone and the surgeon said that 20 years after acl reconstruction and meniscus surgery and 15 years after having the rest of the medial meniscus taken out that i've got advanced arthritis and bone spurs and that going in again will only make it worse. so she said i'm basically trying to avoid a total knee replacement and of course it's been a pain issue for a long time. they gave me a valgus unloader brace which has made a huge difference. i haven't snowboarded with it yet but fortunately my worst knee is my forward leg and i don't get pain snowboarding. it makes a huge difference walking, playing golf, etc. i'm just putting it off as far as possible to get whatever advances occur by that time.

[bourbonisgood]

Mchrkr-
As jma mentioned, unicompartmental replacements tend to work very well if you are a candidate. So well, that very few surgeons (in this area) are sending their patients to rehab.

[chewymix]

its also pretty common for there to be only damage to one compartment but the patient ends up with a total for no good reason. If you need to go for a uni compartment that is designed to fit you and you may be surprised about how long it lasts. The thing i hear all the time is that the patient is 'waiting' until they are old enough but in that time their quality of life could suck. Truth is some people dont live to be 'old enough' for whatever reason so time to get living!

[mchtkr]

bourbonisgood/Maker- yes bone on bone. Stage 4 patella compartment, stage 3 medial & lateral w/ bone spurs so unfortunately partial replacement isn't an option. But, thank you for the suggestion. My OA is due to trauma sustained at 10 yrs old, a car accident that resulted in bilateral femur fracture, severe joint damage, etc. I was put back together and couldn't be luckier, but knew this day was coming. chewymix; exactly! I want to do all the things now and not just keep waiting. Waiting for what? a cane, total loss of mobility? I want to enjoy life now! Plus, we are so lucky the orthopedic world continues to progress so quickly.
Spook; sounds like you are fighting the battle as well. You'll make the decision to do it when you're ready, not sure how old you are but you're right, the advances they are making are amazing. Good Luck.

[spook]

48 in december. i just don't want to lose snowboarding. and although the doctors i talked to suggested that it should be okay, they weren't exactly enthusiastic about it.

[fiddler]

A not exactly young friend of mine had a total knee replacement and is skiing again. He wears a brace on that leg and is happy to be on the snow at the age of 77.

[spook]

wow, that's impressive.

[RCC55125]

37 is pretty young for TKR. TKR is not reversible and at your age you will be looking at another replacement in 20 years.
There may still be alternatives.
Please research this (link below), it's classified as experimental which is why you don't read a lot about it. One reason is it is your own body material and can't be patented.
http://www.tetongravity.com/forums/s...lder-Yesterday