my dh has arthritis in his knees, they cause him huge amount of pain. but hospital won't operate on him

[SparklyGothKat]

I don't know what to do, he can't move when his knees swell up, his leg sometime locks when driving and he hates feeling so old at 29. But the hospital won't do anything, waht can he do to relive the pain?

is he on any meds?

My mother says the cold makes her arthritis worse, maybe heat packs? Not very practical day to day, but might provide some relief when he's at home?

I'm assuming he under the care of a consultant rheumatologist ?

Can he seek a second opinion ?

Has your DH's consultant (assuming he under one) discussed the possibility of regular injections into the joint to relieve his pain ?

just painkillers, the consultant said that his knee joints need replacing, but they won't do it on a young man

trouble with knee replacements in the young is that they need re-doing. Most knee replacements last an average of about 20 years. Some last less than 10, some more than 30. But every implant eventually wears out. This is more of a problem in younger patients, who live longer, and typically place more demands on the implanted joint.

If the joint wears out, a revision replacement may be performed. This is a more complicated surgery, and with each revision surgery, the life-span of the implant decreases. This is one reason why physicians often delay joint replacement surgery as long as possible, especially in younger patients.

have they given him a reason as to why they will not operate on him ?

There are many ways his pain can be managed day to day but lots of the extra strong pain meds have nasty side effects

he hasn't been to the hospital for ages because they said there is nothing they can do

sorry, I didn't realise you'd posted that his age was a factor. I have to say that it is rare in our trust for such a young person to be operated on.

surely if his pain is that bad then he should be on a follow up programme ? I would suggest he goes back to his GP and either gets re-referred to another consultant, if he has been discharged, or asks to have his next follow up expedited (brought forward) on grounds of worsening symptoms.

he just puts up with it, but he is in sooo much pain

have made him realise he needs to go back to gp tomorrow.

youngest patient I have dealt with is in late 40's maybe, but most are 50+. Is it rheumatoid arthritis or osteo? I imagine Osteo, but ice to reduce swelling for 15 mins every 2 hrs, plus activity balanced with rest and regular analgesis - even before pain starts might help.

On a brighter note the motre he reports to GP saying it is dirupting his activities of daily living, then the GP might refer him to the orthopaedic surgeons. Its fair enough for the Gp to say they wont do a replacement, but that isn't the same as an Orthopod saying it!

they may not be able to do anything to cure his condition, but they can sure as hell offer him better pain management.

I look after the rheumatology service outpatients in my local Trust and we see lots of patients on long term review who come in for adjustments in their medication etc

youngest patient I have dealt with is in late 40's maybe, but most are 50+. Is it rheumatoid arthritis or osteo? I imagine Osteo, but ice to reduce swelling for 15 mins every 2 hrs, plus activity balanced with rest and regular analgesis - even before pain starts might help.

On a brighter note the motre he reports to GP saying it is dirupting his activities of daily living, then the GP might refer him to the orthopaedic surgeons. Its fair enough for the Gp to say they wont do a replacement, but that isn't the same as an Orthopod saying it!

i think it osteo.

sorry, adjustments to their meds.

HIs mother has arthritis too and they help her more. It seems so wrong that a young man with young children can't be helped

and what drove me mad was he was signed off work and was getting IB and then the DWP doctor said that he could go back to work so stopped his benifit, but the consultant at the hospital refused to sign him back to work so we are in a no win situation. He can't do any manual work anymore and thats all he know.

Sparkly,

This is a clear cut case, I'm afraid, of the NHS treating those who shout loudest.

Yes they prefer not to do joint replacements on younger people, because they do wear out and need replacing again, which is not only expensive, but technically more difficult. But my surgeon took the view that if my mobility was SOO severly compromised then it was probably better to do the replacement now, and worry about the further replacement when needed. Probably the technology will have improved by then anyway, and replacing the replacements will be less problematic than it seems today.

Your dh needs to go back to his consultant, and point out that he can't go on like this. His quality of life is VERY badly affected, it's affecting his ability to partake in family activities, can't drive, etc etc.
He needs to persuade them to do something, not just let them send him away with 'nothing more can be done', which suits their budgetry constraints.

Is he doing everything he can to help himself? If he's overweight, he needs to lose it, which will help his knees, and make the surgeon more sympathetic to his case.
Also try taking cod liver oil and/or glucosamine tablets, which may ease things a bit.

Just googled Knee resurfacing for you -

Why not talk to the consultant and ask if it is an option, acknowledge that due to his young age you dont expect a lifelong cure, but likewise you dont expect not to be able to woprk and enjoy your family...

Question: Is knee resurfacing a viable alternative to joint replacement surgery?

Answer: Knee resurfacing does not replace the need for total knee replacement. In those patients, however, who are not candidates for a total knee for medical or other reasons, and whose only other option is total knee arthroplasty, resurfacing may be a good interim procedure. Because the procedure requires minimum resection, anesthesia and surgery time are shortened, and risk from complications of surgery are lessened. The trade off is a less than optimum solution, and the knowledge that failure will occur earlier than would be expected from a total knee prosthesis. (

no he isn't overweight, he is slim, this happened because when he was 14 he badly damaged his knees and his parents didn't take him to his appointments.

That's good at least Sparkly....

Honestly, he just has to fight for himself, the NHS doesn't work for people who can't argue a case for their treatment.

Please please tell him to go back to the consultant and say that "there is nothing we can do" isn't good enough.
If he can't get any other response, then go back to the GP and ask for referral to another consultant for a second opinion. Again, point out that 'nothing we can do' isn't acceptable.

And if he can't do his job any longer he needs to consult a jobcentre Plus, who should be able to help with appealing over IB and retraining for a job he can do despite his disability.