Had Medial ligament repair and cleaned out. Good news/ bad

[gregs1959]

I’m 60yr old and consider myself very fit. Fitness is part of my lifestyle. I’ve had the above op today, surgeon came to chat afterwards..

I’ve good and bad news for you he said, the repair went well, also had a tear in the cartilage, and he cleaned out what was needed. Then went on to say my knee cap is very/ extremely worn and need a new knee cap/s

He said I’ve 2 options. Either carry on as I am, said I would hopefully see a little improvement from today’s surgery but nothing too drastic due to the wear and tear of my knees.

Cartilage is non existent in places. I like running as well as doing hit/weight in the gym. Been struggling with say lunges in gym and struggle bending down on my knees. Oh the joys of growing old eh....

12 months ago I could run 6 miles no problem and even pushed half marathon distance but generally kept to the 6 miles. Since I tore the ligament struggled to do 4-5miles before knee started aching even with k tape and support.

Surgeon wants to see me in 6 weeks and talk through my options. He did say at the outset the Mri showed my knee knackered....and in short to medium term will need it replacing.

If he says I will see a noticeable improvement then do I consider it. ? Would hate to think I would go backwards from exercising 5 days a week to .......🤢🤢🤢🤢

Obviously I’m gonna need both doing separately.

He said recovery times vary but given I’m fit and driven would be 3 weeks in pain... then at 6 week period no reason to start exercising.....

Question is do I ? or don’t I ?

Thanks for any reply’s
Mark

[dynosoar]

Hi,

Possibly not very helpful directly but I have several friends in Canada who love to spend their retired lives on the ski hill.
I think three of these have visited the same surgeon who performed double knee replacements and gave a physio regime to allow them to get back to the ski slopes the next season.

So it is possible but it is probably a case of finding the right surgeon etc.

Regards

A

[millen]

My understanding is that most NHS surgeons favour a total replacement as a 'standardised' procedure. But partials are available covering just one or two compartments eg https://patients.stryker.com/knee-replacement/proc... These might give better functionality if the arthritis is localised, though may well have to be revised to a total knee after some years. I'm heading off for my second partial in two weeks' time

[The_Doc]

millen said:

My understanding is that most NHS surgeons favour a total replacement as a 'standardised' procedure. But partials are available covering just one or two compartments eg https://patients.stryker.com/knee-replacement/proc... These might give better functionality if the arthritis is localised, though may well have to be revised to a total knee after some years. I'm heading off for my second partial in two weeks' time

Not quite, there's nothing wrong with a good partial. The Total is not inherently "better"
Osteotomy needs to be considered too
You need a surgeon with experience and skill, including Joint Preservation

[The_Doc]

dynosoar said:

Hi,

Possibly not very helpful directly but I have several friends in Canada who love to spend their retired lives on the ski hill.
I think three of these have visited the same surgeon who performed double knee replacements and gave a physio regime to allow them to get back to the ski slopes the next season.

So it is possible but it is probably a case of finding the right surgeon etc.

Regards

A

The result after arthroplasty is a mixture of surgeon's skill, the design of the implant (and we don't have the correct design yet), and luck.
80% of people are pleased with their total knee, compared to 95% who are happy with their total hip.
There are idiosyncratic results, and there is no such thing as a Great Surgeon when it comes to TKR, we all suffer the disappointments. Some have better marketing than others
The 5 implant designs that make up 90% of the world market for TKR are all much of a muchness and still only get 80% satisfaction
We've tried Computer Guided surgery, it made no difference. We are trying bespoke, patient specific cutting jigs, but the early research shows they are no better either.
The knee is just too tricky to duplicate whole, currently.
The hip is a very forgiving ball and socket, totally different.

Edited by The_Doc on Saturday 4th May 15:55

[millen]

Yes, I'm on the Oxford 'Signature'/'Drive' which has the custom made drilling and cutting templates based on a whole-leg MRI scan supposedly to give optimum alignment and correct some of the varus collapse. The price differential over the basic Oxford knee isn't huge and it struck me as worth paying for a hopefully more predictable outcome.

The surgeon offered me the Mako robot-assisted surgery but wasn't wholly convinced it would be better and a recent Glasgow RCT I read about suggested there's little difference in pain scores after 12 months (despite some improved scores in the early weeks).

Not looking forward to the whole process and painful rehab but I have the benefit of experience, eg will ignore the ignorant instructor at the lower limb exercise class at the local hospital who last time kept trying to force me to flex the knee more than it was physically capable of until the swelling had reduced sufficiently!