Knee replacement surgery

Discussion in 'Professionally Qualified, RAMC and QARANC' started by CRmeansCeilingReached, Mar 5, 2006.

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  1. Hope you don't mind if I post this in here as well as the Health & Fitness forum?:

    Having done a fair bit of long distance running and basketball during my career, in addition to all the normal Army stuff, it's caught up with me after 16 years.

    Suffered worsening chronic knee pain over recent years. MRI scans etc have resulted in me being permanently downgraded (still deployable to base locations) but excused BPFA / CFT for the rest of my career, to preserve what is left of my knees.

    Basically, the ligaments etc are ok but the bones have worn down and the damage is irreversible. I have been told that I will have arthritis by the time I am 40, and will require knee replacement surgery in both legs.

    Has anyone had this surgery before? Is it something you leave as late as possible, or is it something to try and get done early? I have seen some websites which seem to show two themes:

    1. They will only do one leg at a time (i.e. full recovery on one before doing the other)

    2. It can take a year or more to fully recover from each operation.

    Firstly, has anyone got first hand experience of this? The doctor suggested it would wait until I was in my 40s or 50s, but I will be very surprised if I can still climb stairs in ten years (I'm 33).

    Secondly, any thoughts on getting it done whilst still serving vs waiting till I'm out? In the NHS partnership days, I'm sure the old "Army butcher" reputation has been left behind...?
     
  2. All is not olst - no matter how bad the 'wear and tear' is, keeping the surrounding muscles strong will minimise the pain. Lots of cycling, swimming and specific Quads exercises ( ask to see aPhysio or RI about those). The stronger your muscles are - the better outcome you'll get if/when you end up needing surgery.

    There are a few options for surgery - complete replacement being the most drastic one. If your Dr thinks you are anywhere needing surgery he/she can refer you while you are still serving. Sometimes an arthroscopy to wash out the debris can relieve things for months or years and is a simple op that we send soldiers for all the time.

    PM me if you want any more info.

    Hope that helps

    LH
     
  3. thank you m'lady :) PM inbound.
     
  4. Having recently had surgery on a different joint I would strongy advise doing some very thorough research on the internet and going private for a consultation with the best surgeon you can find. The £80 or so that it will probably cost will be money well spent. I wouldn't criticise Army doctors but you have to live with your knees for the rest of your life. You may therefore wish to go and see someone that specialises in doing knee surgery with a successful record of hundreds, if not thousands of patients operated on.

    As to your knee, it sound as though the cartilege is fcuked. If so, there is a technique called ACT (from memory autologous chondritin transplantation, or something like that) that can repair cartilege if the damage is not too advanced. The advice I was given for joint replacement is that it is OK for pensioners as they will wear out at the same pace as the joint. As you are still young joint replacement done too early may line you up for a lot of surgery throughout your life. Again, I am not a doctor and what I have been told may not apply to your condition. You will also find that there is a lot of stuff around about arthritis on the web and a number of theories that diet plays a large part in its severity. Gout is a related condition and there are trigger foods for that. You may find that a change of diet or trying acupuncture could alleviate your symptoms.

    However, the main lesson is to get researching, learn about the surgical and non-surgical options and talk it through with an experienced surgeon and also a phsyiotherapist. Start taking glucosamine. Good luck.
     
  5. Just had ''the works'' done on my knee , Physio tomorrow stitches out on wednesday .Patella has been re-aligned with my femur
    cartlidge transplant and they have ''cut'' a ligament to make a bit of slack for my patella to sit properly .
    Please excuse the lack of medical lingo i am in germany and i dont get the full reports back from
    being translated until tomorrow . Not too sure what advice i can give you really except if there is anything that
    needs to be done , get it done right away . I worked really hard to get where i wanted and now due to me being
    too bloody macho , its all over . I am on the road to recovery (i hope) . Seems that the army are really behind
    when it comes to physical training . I am paying for it now .
     
  6. mr logic - thanks, cartilage is fine according to MRI report. but i'm already taking glucosamine ("Chondromax" - 500mg glucosamine, 400mg chondroitin). had never heard of it, my folks sent me it out of the blue.

    paveway - how did your unit treat you? what's your long term prognosis? permanently downgraded? hoping to recover to FE?
     
  7. I was really really peed off with my unit .At first it was hinted that i was a bluffer and that i had a ''pathetic limp''(my oc)
    Now their whole attitude has changed , ive been told to get back to work as soon as you can get fit . Ive had no dramas at all
    i tip my hat at my SQN a few times a week .I have just come back from physio , it is getting better , i now can move my leg 90' but i have no strength in my quad at all . I will be back up to fighting fitness within 6 weeks , and i should have no effects in the long term . I am just gutted to have missed out on so much ,
     
  8. The general rule with total joint replacements is hold out as long as possible for them as they themselves only have a certain 'shelf life' as it were, once they are in place, and every time they have to be repeated the surgery is more technical and as a result the outcomes are not always as good as the previous replacement.

    Would definitely echo the advice re physio, and you really want to ensure to you see a specialist musculoskeletal physio preferably with extensive knee experience. As far as surgeons are concerned there are some quality military knee surgeons with very good national reputations. PM me if you want more details specific to your location. Secondly with any rehab Headley Court offers far superior rehab to anything available on the NHS. Hope that helps

    Pongo
     
  9. Definately echoing the physio idea and getting to see a surgeon reference a less drastic operation.

    But I'd just like to add get it done before you leave! Firstly it could mean the forces remain responsible for this aspect of your health after you leave and secondly you will probably get a far better standard of treatment/after care than a civi.

    I've had several knee ops and am fully fit now thanks to fantastic treatment from physios and RIs. I have a civilian colleage who's had the same op and still walks with a limp and has been discharged from physio!! She's younger than me and only had one knee done (while I had two) yet the civi physio thinks that is the best she can do - she is now considering giving up her job as it is too physically demanding. A job that I can perform with ease. I know that no two cases are the same but it seems they have given up on her.

    I got physio every day and RI input for a year. She got physio once a fortnight for three months! I was back at work within a month and back to BFT/CFTs in a year. She had three months off and even now can only work part time. I know which treatment I'd choose.
     
  10. There is also a sort of half-knee replacement which they can do when only one side of the knee joint is badly eroded - its called a oxford unicompartmental prosthesis - if the wear and tear is mostly on the one side this can put off the (k)need (sorry - bad joke) to have a total knee replacement for a considerable amount of time. The rest and recovery period for this procedure is less than for a total-knee and the procedure slightly less invasive.
     
  11. thanks potential, very interesting. what is the difference between rheumatoid- and osteo-arthritis? i can't remember which one the doctor told me i would be getting lol

    thanks for all the advice guys and gals. i went to the doctor this week and he is referring me to an orthopaedic surgeon (have i got that right?) to examine them and advise on surgery.

    i was mistaken in saying i've been permanently downgraded - been downgraded for a year and will be put to a permanent downgrade board after this consultation, if necessary. they were going to go straight to that, but i wanted advice on the surgery before writing off my last 6 years.

    the main question i still remain unsure on is this: if i have surgery early rather than later in life, will this enable me to get back to running and basketball? cos at the moment i can not run at all - last time i tried was in the summer, and i managed a few hundred metres before it felt like someone stuck a red hot knife in my left knee from the side. will the surgery enable me (long term) to do things i can no longer do? i asked the doc and he said "they probably wouldn't advise it" i.e. they wouldnt want you working the artificial knees too hard.

    other concern now is - what is the score on permanent downgrade boards? one concern is the possibility that they might decide to sling me out completely on a medical discharge. is this likely? so there are plenty of relatively sedate jobs i could do in my trade that do not require running. if you can still do your trade but not run, what's the likely outcome would you think? i'm hoping i will become LE but at least deployable to base locations or something. how does that work?

    questions, questions, i know. sorry :)
     
  12. Don't know much about what you're allowed to do after recovery - you'd have to ask the surgeon about that.

    Rheumatoid arthritis is an auto-immune disease that causes inflammation of the joints in the body - you can get flare-ups and have to take lots of anti-inflammatory drugs.

    Osteoarthritis is caused by general wear and tear on the joints that leads to destruction of joint cartilage and once that's been worn through it wears away the bone.
     
  13. ah, it was osteoarthritis then. thanks. anyone got any opinions on the medical boards?
     
  14. I work in theatres and we regularly do bi-lateral knee replacement, usually on the over 60s.

    Chances of being operated on by a military ortho surgeon? extremely remote these days. most are out earning mega-bucks doing as clinical directors in the NHS and doing private work without the risk of deployment losing them clients.
     
  15. just make sure you go through the british legion as soon as you leave the forces, you will be due quite a wedge from the war pensions lot. as even sport is classed as military duty, my advice to you is to get a copy of your med docs asap.... cos they will go missing !!!!!