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Knee & Hip Problems Message Board

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Hello. am 26 yrs old. Looking to try to find some advice and insight to my unique situation.
When I was 3 years old I jumped off a swing and landed on my knee. It instantly swelled up and I was rushed to the emergency room. While there the doctors decided they wanted to go into my knee to biopsy some of the tissue. After they stitched me up they immediately sent me home. That night my knee continued to swell and was very hot to the touch. After returning to the hospital several times and being dismissed by the doctor my knee finally burst. Once this happened the doctors finally realized that something was wrong. I had gotten a staf infection. But it was now too late. They had to fuse my knee together. So from the age of 4 up until now I have never been able to bend my leg.
I've always wanted to know what it would be like to have full range of my knee, or even just limited range. Enough to ride a bike. That's all I want.
I've always been told that knee replacement surgery was not an option. So I just never even thought about it. Until I had my first child. It really sucks not being able to keep up with him. To play down low on the floor with him. Even giving him a bath is hard sometimes.
My legs are uneven so I do have back pain. Surprising though it's really not that bad. Or maybe it's just because I don't know any better.

I started to pursue the knee replacement option about six monthes ago. I traveled three hours to Spartanburg to meet with a surgeon who specializes in this procedure. I was really ready for him to tell me that it wasn't an option. But he didn't. He told me that I was a candidate! Could not believe it.
So since then I have been going to physical therapy twice a week. He said I needed to strengthen my thigh muscles. If not my leg would just give out on me.
So here is the problem I am facing. I am absolutely scared to death. I want this so bad. I know the recovery is going to be a kick in the butt but I'm ready and determined. The only thing that worries me is that the doc said that there is a slight chance of amputation if the re:confused:placement fails and it causes too much damage to be replaced again. I really just do not understand that. If he could tell me that he could fuse my leg back together if it failed then I would be all for it. At least then I would have a brief time of experiencing what it would be like to bend my knee.
So what I am hoping to find is someone that may have had a knee replacement at a young age. Around 20-30. Maybe even someone who has had a fused knee and did the knee replacement. Any insight would be so greatly appreciated!!
Thank you so much for reading!:confused:
Hi Rachel902,

Welcome to this support board! Let me see if I can give you some reassurance.

For starters, let me tell you that I am a middle-aged lady who developed severe osteoarthritis in BOTH knees about 7 years ago. In Sept. of 2005, when I stepped up on a chair in a weird way, I heard and felt the cartilage in my right knee tear on me! I was going to a different Orthopedic surgeon at the time (in the former group of my current Ortho surgeon who left in '95 to form his own practice. Why I didn't follow him at the time, I don't know, but I changed back to him in Oct. of 2010 so better late than never.) Anyhow, the former surgeon scoped my right knee in Dec. of 2005. It was "okay" for about 4 and a half years - (HOW, I don't know, but I'll get to that.) In June of 2010, the right knee started hurting again and "buckling" on me on occasion. So I went back to the former Ortho surgeon, because I also wanted a renewal of my handicap parking permit. He x-rayed the knee and told me it was fine and stable so no new permit.

Unsatisfied with his lack of caring and poor surgical skills (I KNEW SOMETHING WAS VERY WRONG WITH THE KNEE), I switched back to my current Orthopedic surgeon in his current practice in October of 2010. (When he was with the group of the surgeon who did my 2005 scope, he had treated me for a mild tear in my left shoulder rotator cuff). He welcomed me back to his care with open arms, and got right down to "business". My current surgeon took ONE LOOK AT THE EXACT SAME X-RAYS THE OTHER GUY HAD TAKEN FOUR MONTHS EARLIER, AND TURNED TO ME IN ABSOLUTE HORROR AND SAID, "Carol, you need a total knee replacement ASAP! You have NO CARTILAGE LEFT AND IT'S BONE ON BONE IN THERE! (I remember when the other surgeon did the '05 scope, I had only a spinal with no sedation, so I had to watch the entire surgery! I remembered him "vacuuming" out the torn cartilage for at LEAST TWENTY MINUTES!) Fast forward back to October 2010, when my current surgeon told me I needed the TKR and why. My first thought was that I was going to SUE the other surgeon for taking out TOO MUCH CARTILAGE to the point that the remaining cartilage wore away by 2010! He totally damaged my knee!

My current surgeon had me go for pre-surgery physical therapy to build up the muscles, both in my knee AND my thighs, so I would have a better recovery and outcome post TKR. We scheduled it for 4/5/11. About a month before my right TKR surgery, my left knee started bothering me because I was "compensating" with that knee since the right one was so painful. Turns out I'd developed a torn medial meniscal tear AND torn ACL in the left knee. My surgeon agreed to scope the left knee and repair it at the end of my right TKR surgery while I was still on the O.R. table. Because I literally didn't have a leg to stand on since both knees had required major surgery, I had a fairly long recovery period. BUT, the right TKR, after just 3 1/2 months, was almost completely free of the soreness of being worked on in surgery. Unfortunately, 8 months to the day after he scoped the left knee, through NO FAULT OF HIS SURGICAL SKILLS, the osteoarthritis in the left knee got severe enough to COMPLETELY WEAR AWAY THE CARTILAGE AND ACL!! I needed a left TKR this past March (3/23/12). Since I knew what to expect this time around, I went in HIGHLY MOTIVATED. I even told my surgeon, in January, when we scheduled the March surgery, that, since I was his first case of that Friday in March, if I got to my Ortho Unit room early enough in the afternoon of the day of surgery, I was planning to get up on the walker that day! He was thrilled at my motivation. Well, I did EXACTLY WHAT I SAID I WOULD DO, AND WALKED 200 FEET ON THE WALKER THE SAME DAY AS MY LEFT TKR SURGERY!!! Since my surgeon had a full day of cases after mine that day, no one had the chance to tell him how far I had walked. When he came on rounds that Sunday evening, I told him how far I had walked the day of surgery, and he was ecstatic! He has since nicknamed me "Rascal" because I was always up on the walker my entire hospital stay!! I had home PT for the first two weeks post surgery, but then, when I got my staples removed two weeks later, he gave me the okay to drive since it was NOT my driving leg. (Last year, since I had the right one done first, which was more urgent at the time, and it was my driving leg, I was NOT allowed to drive for SIX WEEKS! I had home PT that entire time.)

This year, following the left TKR, I had a much faster recovery because I had the other TKR that was all healed and stable to help me with my rehab. FOUR WEEKS after surgery this time, I was walking up and down stairs normally, one foot after the other with very little discomfort! (Normally, that ability is the LAST thing to come back post TKR.)

I am now FULLY HEALED and if I didn't tell you that I had both TKR's, to see me walk normally, you would NEVER KNOW I'D HAD BOTH KNEES DONE!! This is MY story. My surgeon has the most amazing bedside manner! I've been through many surgeries for other problems in my life, but my Orthopedic surgeon is the most kindhearted surgeon I've EVER HAD MY ENTIRE LIFE! HE'S MY MEDICAL HERO!!!

Now, to your issues. It sounds like you have found a very skilled Orthopedic surgeon who IS willing to do the TKR, even at your age. I seriously doubt though, that it will come to an amputation if your surgeon takes all the anti-infection precautions during surgery. MAKE SURE THEY GIVE YOU ANTIBIOTICS DURING SURGERY VIA IV! That SHOULD CUT DOWN THE CHANCE OF THE PROSTHETIC KNEE BECOMING INFECTED. Then, post TKR surgery, MAKE SURE YOU DO EVERYTHING THAT IS ASKED OF YOU REGARDING PHYSICAL THERAPY IN ORDER TO GET A REALLY GOOD OUTCOME!!! THIS IS EXTREMELY IMPORTANT! (One of my aunts had both her knees replaced last May - 2011. Thinking she was "smarter" than her surgeon, she did NOT DO ONE FRIGGING THING HE TOLD HER TO POST SURGERY and now, more than a year later, SHE STILL HAS PROBLEMS WITH THE PROSTHETIC KNEES LIKE CONSTANT SWELLING AND, SHE IS STILL AWARE THAT SHE HAS PROSTHETIC KNEES!! If you do everything that's asked of you post surgery, by the sixth or seventh month, you will start to "forget" that you have a prosthetic knee!!! MY AUNT DIDN'T AND IS SUFFERING THE CONSEQUENCES OF HER OWN DOING!!! Matter of fact, this aunt stopped calling me about a month ago, because I think she's JEALOUS that I had such good results with both my TKRs!!!)

One suggestion that might ease your mind, is if you ask your surgeon HOW LONG he's been doing TKRs (should be at LEAST TEN YEARS), and how many per year he does (should be AT LEAST 200/YEAR.) This way, you know you can trust him completely to do the best job for you and get your knee bending once again!!! The ultimate goal in PT to work toward following a TKR, is a range of motion of at least 125 degrees. That's how far back a person with a healthy knee can bend his/her knee. If you're really lucky, like me, and work REALLY HARD IN REHAB, you might even be able to eventually get a range of motion of 135 to 140 degrees!! (which is what each of mine are! - right one is at 140 and the left is about 135!)

Hopefully, you have a supportive family to get you through the surgery and re-hab emotionally and be willing to help out around the house while you're recovering.

I found going through the first one last year very emotionally scary because I didn't know what to expect. (Even though my surgeon sent me to a Pre-op class at the hospital where I had both done, and the nurses and physical therapists explained EVERYTHING to us that would happen starting with Pre-op, the O.R. and Recovery Room. That helped calm me A LOT!) Because the hospital Ortho Unit, of which my surgeon is Chief of Orthopedics, started a GROUP THERAPY in-house program just in time for my left TKR this March, it was actually kind of "fun" because we had fellow patients encouraging each other and knew what I was going through because they were too.

The ONLY caution I would give you is, that because you are having this TKR at an unusually young age, you MIGHT have to have one more in about 25 years, if you are NOT particularly a super athlete. The newer prosthetic knees (made of titanium and plastic) tend to last longer than the old metal on metal ones. BUT, your surgeon will probably tell you - NO RUNNING OR JOGGING or other high impact sports post TKR! The reason for this is that if you run or jog with a TKR, every time your foot of the leg of the TKR hits the hard pavement, it can eventually dislodge the prosthetic and/or wear away pieces of the plastic component that acts as the cartilage. You WILL BE ABLE TO do things like outdoor and stationary bike riding (once he clears you post re-hab), swimming and water exercises (which is the BEST therapy post TKR surgery), bowling, and of course WALKING!!! (including on the treadmill, which the therapist will have you do during rehab. JUST NO RUNNING ON THE TREADMILL!), using a leg press machine and other physical therapy machines that you'll be introduced to during rehab.

One other VERY IMPORTANT PIECE OF INFO THAT YOUR SURGEON WILL PROBABLY TELL YOU POST TKR: In order to prevent an infection traveling to your prosthetic knee and damaging it, you WILL NEED ANTIBIOTICS FOR ANY DENTAL WORK AND OR MAJOR INVASIVE PROCEDURE, EITHER RIGHT BEFORE (DENTAL) OR DURING A PROCEDURE VIA IV, THE REST OF YOUR LIFE!! You also will need to have the TKR checked once a year around the anniversary of your surgery, again, the rest of your life, to make sure the prosthetic knee is intact, in place, and no pieces have broken off and gotten into your bloodstream. Just things you need to be aware of. Make SURE you ask your surgeon to confirm this!!! It's CRUCIAL to the integrity of your prosthetic knee and your general health!

Hope all this helps calm you about going ahead with the surgery. I know SOME of my info is "tough love" kind of stuff, but, believe me, you'll appreciate knowing it ahead of time!!

Good luck and let me know when you are scheduled for surgery! Keep me posted on your progress.

Carol (2012 carol)

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