Knee arthritis - dont know what to do?

[deffonamechange]

I'm mid 40s and got diagnosed with bone on bone knee arthritis earlier this year. Its awful. I've gone from marathon running and hiking to not being able to hobble round house and constant painkillers. Put 2 stone on in 6mths cos cant move and think its made worse weight wise from doing loads of exercise to nothing in short space of time.

I've been told theres no much anyone can do. Is this it now? Disabled before I'm 50?

Anyone any experience of this? Any advice?

So sorry OP. This is a long post, but info I dearly wish I'd know about a year ago. I really sympathise and could have written this exact post myself a year ago. At 40, I was told I'll need a knee replacement, but was advised to do what I could to hold off as long as possible. I too had put on weight due to immobility which obviously doesn't help.

The worst was when I was on a holiday and walking everywhere more than usual- museums, galleries etc. The pain was dreadful. Even in bed with my leg absolutely still, it would throb and ache. I literally strapped a hot water bottle around my knee, tried heated packs, adhesive heat things and analgesia. Nothing helped, and I was at the point of thinking an amputation would be better!

Do you have arthritis over the entire knee, or just half? Mine is mainly on the inner half and under the patella. Did they say a full knee replacement, a half or something else for you? As a minor, passing comment from 1 of the 3 orthopaedic surgeons I saw, he mentioned a specific off-loader type of knee brace. It moves my weight to the 'good' side of my knee and opens up the bone-on-bone part. I also had physio, but this was basically giving me a sheet of exercise pictures and telling me to do them at home!!!

The brace has meant that I can walk again, return to work and now lost 10kg! I did go on a keto diet, but wasn't absolutely strict, and feel the increased exercise was the main help. I'd read that every extra kg of weigh you carry, actually puts 4kg of pressure on the knee joint, so I was determined to get my weight down. I found swimming helped (when pools were open!)

My brace was provided by the hospital, but there are 2 main types I know of- but they will likely only be of any help if you have arthritis only in 1 half of your knee. The 1st is called a thusane action reliever off loader brace:
thuasne-store.co.uk/product/action-reliever/
I started at their largest size 6, but as I lost weight, it became lose and non-supportive. I then had size 5, but it too lost shape and became loose very quickly. Its also VERY expensive unless you can get one from the hospital. It is discreet though, and wasn't as obvious under trousers.

The next type I have is similar to the 1st one in this list:
thereviewal.com/best-unloader-knee-brace-for-osteoarthritis/
Its bulkier under clothes, but allows more range of tightening/losing as my weight fluctuates.

I'm now able to do 3hr walks with no pain at all and no analgesia (with the brace on).

If you have any questions, just ask

Thanks so much for replying. That's really helpful. So it sounds like the brace has meant you dont need knee replacement?
I think I need a better understanding of where the arthritis is.
Thanks

I've had 2 knee replacements and, while not easy, they stopped the pain and immobility. I was a little older than you but in so much pain. It's so counter productive. You hurt , do you dont exercise. You hurt so, in my case , you eat and put on more weight. I try to swim and exercise in water ( in normal times) . I had both knees relaced in separate operations 18 months apart. It's a lot better than before but not perfect. It's a big operation with long recovery but worth it. There isn't really an alternative. You've worn out your knees.

have they offered cortisone injections ?
get it done in the right place and they are a god send

Mine is very early stage, but the consultant advised that using an analgesic gel for 2 weeks without stopping when the pain was relieved would help.

2nd the unloader braces that @Elouera has recommended.

There is also the possibility of a partial knee replacement - my aunt had these late 40’s.

Other than that pain management and coping techniques.

Swimming is brilliant exercise (I’m missing it with the pools being closed) trampoline is surprisingly good for cardio without impact (running is completely out)

Pain medication - it can be tricky to get this right, I take high dose anti inflammatory and codeine daily, some days I don’t need the codeine but the anti inflammatory is non negotiable - I can tell by lunch if I’ve forgot to take it in the morning.

Also, magnesium flakes and sprays, flakes for use in a warm bath, sprays for direct application, I was surprised how well they work.

And keeping warm in general - my knee HATES the cold, enough to make me consider emigrating somewhere warmer if I’m honest.

@deffonamechange- Hi. No, the offloader knee brace wont prevent a knee replacement, but holds it off. I saw 3 different orthopaedic surgeons, in 2 countries (I live/work abroad part of each year) and they all said I'd need a replacement at some point. Due to being young, still working etc, a replacement will get worn through much quicker than if I was say in my 80's.

Replacements only last so many years. Longer if you aren't very active, but maybe only 10-15yrs in a young, active person. I was told that the best replacement is your 1st, but each time they need to re-do it, its never as good. At my age, I might need 3 or more replacements, so hence why I'm holding off getting the 1st as long as possible.

My osteo is mainly on one side of the knee, so they said I could have a partial or half replacement. Its less recovery time, but eventually, I'd need a whole replacement done at some point. The brace has certainly helped me get back to work and exercise, and meant losing weight, which is turn made it painfree now. Something I'd never imagined.

I also asked about steroid injections, lubricants and even stem cell injections. Stems cell injections have little medical evidence, but some private clinics will take your money and do it. none of the surgeons I saw wanted to inject steroids or anything else into my knee, but I'm not sure of the reason behind it or if it would have helped? Some people do find steroid injections provide some temporary relief.

Wear and tear arthritis in both knees. Was on daily small dose codeine but have found losing half a stone has helped. I cycle 50 miles a week which is non weight bearing and my doc told me regular walking will help ( mine hurt more when not moving)
Sadly I've found the best painkiller was developing arthritis in my collarbone, the pain in my knees has paled into insignificance.