knee replacement - young person

[ted]

I am a 20 year old man, requiring a knee replacement. Have been told I am too young for this procedure and basically nothing else can be done. I would like to hear from any other people who are or know of someone experiencing similar problems or have had surgery. My knee has no cartilage and kneecap is shot!
Would be happy to hear anyone else’s experiences good or bad, also saw a cartilage regrowth technique someone where in the forum, could the poster perhaps PM me some more details on this?

Thanks

[Josephine]

Hello, Ted. Yes you are most certainly too young for this procedure. I doubt you'd find a surgeon that would be prepared to risk it.

I had the info about the mosaic-plasty and found this website that explains it very nicely. http://www.active-trial.org.uk/ACTIVESite/ChondralDefects.htm

I see you're in the UK. Do tell me where - or pm me if you prefer and I can probably tell you where you can find an appropriate unit.

[ted]

Hi Josephine,
Thank you for your reply, and your link. I am in Mid-Wales.
Regards

[Josephine]

Then the place for you is Robert Jones & Agnes Hunt Orthopaedic Hospital, Gobowen, OSWESTRY, Shropshire, SY10 7AG and the surgeon Prof James Richardson, tel: 01691 404386. I suggest you give them a ring and speak to his secretary to find more details.

Let me know how you get on and if there's anything else I can do to help. Best of luck.


You can see all the hospitals taking part in this from this list
http://www.active-trial.org.uk/ACTIVESite/ACTIVEHospitals.htm

[ted]

Hello Josephine,
Thank you for your helpful information, posted about the mosaic-plasty procedures, unfortunately after contacting that department I have been told I would not be considered because my issues are caused by disease and not trauma!
Will be going to see my original surgeon in a few weeks, he performed a clean out on my knee which helped loads, I will be asking him about a half knee re-placement as im not sure what else I can do now, so any more ideas/procedures you think could help me, would be gratefully received. :-)

[Josephine]

Hmmm - that's a great shame. Perhaps the unicompartmental would be an option though it depends how wide spread the damage is. If it's more than just local to the medial compartment, then that might not be on either.

This shows you the ideal situation with the damage confined to the medial (inner) side of the joint where you can see I have outlined them in red and blue.

http://i21.photobucket.com/albums/b286/flagady15/knee_arthroplasty_uni_intro01.jpg

Not a lot more I can add, I'm afraid although there's no reason for you to rush into a replacement yet a while. If you found the arthroscopy was beneficial, why don't you discuss with him the option of having it repeated a time or two? I know folk who have postponed the inevitable for a number of years that way.

[ted]

Thank you again for your reply and information! I will take it onboard, and reply with what happens after my consultation :-)

[Gee]

Kia ora Ted
I have just had a knee replacement finally. I hurt my knee young and like you was told until I was 26 that there was nothing they could do except give up all sport.
Fortunately I met a new surgeon who was prepared to give other ideas a try as he would definately not replace it until older. He did a distal femoral osteotomy(hope that is spelt right). This procedure took the pressure of the more damaged outside joint and put it down through the inside joint so that this would wear to the same level. It required him to cut the femur and turn it with hardware to hold it in place. This was meant to last me until I was old enough to get a new one.
I must say that it was not the easiest of operations and unfortunately I did not heal well so there were another three operations after that including bone grafts etc. Please let me say that this was due to MY body not healing well not anything the surgeon did. It has bought me another ten years or so with less pain and an ability to do low levels of exercise.
I am now 40 and have just had a full knee replacement so there is a light at the end of tunnel. I would be happy to chat to you about the above any time. Good luck and don't give up hope as there are new procedures coming out all the time.

[Josephine]

Hi, Gee - welcome to the forum!

So you had your osteotomy 20 years ago, then, Is that right? Well, I remember those ops very well. They were checkered with problems such as you describe and, overall, it was finally realised that they are not a good choice for the knee.

See, they used to be done in the hip with great success. It was called a McMurray osteotomy and we did them by the dozen. Then they came up with the bright idea that if osteotomy worked so well for the hip, it might be beneficial for other joints.
They couldn't have been more wrong! Sure some people got some benefit but in the long term it was short lived and not without serious problems.

So, I am afraid, they just don't do them any more. The checkered history, plus the difficulties that ensue when trying to convert it to TKR - it's the same with the McMurray. They proved to be horrendous when converting to a THR so they quickly fell out of favour.