Knee replacement - should I do it? Will I be able to run again? Can't decide. If you've had it done in your 40s/50s can you come and talk to me?

[HelenHywater]

I have osteoarthritis in both knees and the doctors have been trying to persuade me to have knee replacement surgery for a few years.

The main reason for me doing it is that I want to run and ski again - I really miss running. I'd like to be able ski with my children.

But on a daily basis, I'm in no pain at all. I can walk for hours and do most yoga moves. Pilates has hugely improved the range of movements I can do - I've been doing it for 6 months and have seen massive improvements. My knees really don't place many limitations on my life. The only thing I can't do is sit on my heels or deep squats (would love to be an amazing yogi too!).

I have a vanity reason for doing it in that I've become increasing knock-kneed as my cartilage has disappeared but I'm in a dilemma - if you've had it done, has it hugely improved your quality of life. Were you in daily pain before?(I'm not!). Were you able to kneel, run, ski, afterwards?

I met a lady opposite me in a hospital ward, she was 79 and had just had a fall and broken her femur. She said it was because she refused surgery on her arthritic knees when she was younger and she deeply regrets not getting it done when she was younger and able to recover.

I have 2 friends both about mid-50s when they had the operation and one was back horse riding 6 weeks after and they both had great outcomes and are much more mobile and active as a result of the surgery.

Just through I’d share as the chat with the lady in hospital was just this week.

Are you in the UK OP? I'm having my pre-op in September and I've recently joined a Facebook page called UK Total Knee Replacement and Recovery UK. It's a great group with really supportive people. Most have already undergone the op and lots are waiting their dates. You can ask any question and will get honest answers from those who have already gone through it and who are varying stages of recovery.

That sounds like an almighty big leap I wouldn't believe as an anaesthetist who's done 10y of anaesthetising for hip fractures, it doesn't make medical sense

On a personal level I'd leave joint eeplacemerns as long as possible when young as there's only a finite time they live for and can be rereplaced.my mum had her hips done at 38 and on her 2nd set of revisions at 68...but you need to talk to your drs as to why they're suggesting now as we can't guess that info

What are the doctors’ stated reasons for recommending you have it done now?

It’s unusual that the doctors have been trying to persuade you for years to have replacement surgery when you’re not in pain and you aren’t being limited in day to day life. You seem like you’re very active.

I don’t read it that there was a physical connection between the femur and the knees - but that she fell because of the knees and hurt her femur when she fell…

Honestly you are very young and if you can manage without at the moment then I wouldn’t

I think it's because on the ultrasounds, I have zero cartilage so it looks pretty dire from that perspective. But my day to day life is ok - in fact much better since I took up pilates. The doctor is a bit sceptical about that (because I suppose, no amount of exercise can replace the cartilage) but I really think that building up my leg muscles (and they're far from built up yet) has helped a lot. I took up yoga when I couldn't run anymore and am pretty good at that too apart from some of the poses that are too hard on my knees. I'd like to be able to do yoga more - but am unsure whether knee replacements will allow that given the inability to kneel on the fake knees.

I am in the uk and I will go and look at the facebook page.

So I think I am relatively young and fit so hopefully my recovery would be speedy, but I'm really not looking forward to the pain or the weeks of recovery. And I'd need my second knee doing at some stage soon too, so it's a bit a long haul.

I tried to persuade them to do both my knees at once, but they refused!

And then yesterday I was reading posts about the level of pain and that terrified me!

I had my knee replaced in my mid-forties after having PVNS for 20 years. My quality of life prior to that had declined so much and I’d gone from active to a recluse, found stairs difficult and on massive amounts of pain killers. I put the op off as long as possible as I was concerned the tumour could go to another joint.

Anyway I had it done and it’s the best thing ever and I regret waiting for so long. I promptly leant to ski (I now spend every winter season in the Alps), mountain bike, run, swim, sail, do Pilates & yoga and walk the dogs for miles. I can’t sit back on my heels though.

Recovery was really fast and relatively pain free. I was walking the dogs on a shingle beach (with crutches) after a few days.
Tell your surgeon about your activities and future hopes - I’d known my surgeon for years through the PVNS and I’m sure he put in a heavy duty one!

Skiing yes, but I don't think they recommend you to run with new knees. Have you been told this is OK? Plus does the operation get more difficult the longer you leave it?

oh can you get different ones? I assumed that top sportspeople can pay for better knee, but didn't know there were different ones on the NHS.

Yes I think one of the advantages of having it now is that I am younger and will be able to recover quicker maybe. But then again a disadvantage is that a knee will last like 25 years and then I'll need another one and I will be old then.

I think tye orthopedic surgeons dont like you to run on replacement joints. My dh had a new hip at 54 and wanted to get back into running, the surgeon advised against it, might be different with knees i dont know?

That what’s she had said yes, that because of her age and weakness in her knees one gave way and resulted in her fall. It was just a story I thought would resonate with the OP potentially and from of mind.

If you aren't in pain, what sort of symptoms caused them to do the scans etc in the first place? Are those symptoms likely to affect you more?

I know a couple of people with new knees who are back walking, hiking, cycling, etc, though none of them run. The physio seemed pretty important, and I think they both paid for private physio, to get the range of movement back quickly.

I have recently been diagnosed with osteoarthritis in my knee. The GP said I’d need a new knee replacement but that I’m too young (mid fifties) because they only like to do one replacement per joint and I’d probably have problems later down the line.
When I told the physiotherapist this, they raised their eyebrows and said they try to keep people away from the operating table for as long as possible.
I was referred to a physio pain management group, where they educate you re osteoarthritis and also encourage you to build your muscles up in their gym. It’s been so helpful!
They also said that you can have bone on bone and no pain but you can also have some cartilage left but be in loads of pain.
Personally, if you’re pain free, I wouldn’t have the surgery.

When I ran, there was a lot of pain and at that stage my knees hurt to walk up the stairs and to do long walks. But I've improved that now. I can even run again although haven't tried running properly. (I couldn't even run for the bus before).

Oh I didn't know that @rainbowstardrops - that's really helpful. I did a course of physio at the hospital and the knee surgeon was really sceptical about it. But honestly my pain levels have transformed as I've built up muscles in my legs (glutes mostly but some quads as well). I'm more motivated to do pilates than the leg exercises that my physio shared with me, but a lot of them are very similar anyway.

I did ask about having another surgery in 20 years or whatever when the first knees wear out and they're fine about that.

Oh that’s interesting because at my GP surgery and the hospital where I see the physiotherapists, they both say the current recommendation is only one replacement per joint. Maybe different areas vary?

My dad had his knees done when he was late 60s. He was getting around fine and so was advised to leave it as long as he could manage because they can only really do it once. He recovered well and is active but I think he was advised not to run on his new knees.

The surgeon told me that they can do it more than once and would expect to replace mine again when I'm in my 70s. I'd rather not get it done twice or when I'm that age.

I'm 35.

I've had both hips and both knees replaced. 27 for 1st hip, 30 for 1st knee, 32 for 2nd hip and 33 for 2nd knee.

Although my mobility is still not good, it has drastically improved my life. I was in absolute agony though by the time I had each done. Knees were triple the size they should have been etc. I will certainly never be able to run again though.

The recovery for knees is a bit of a slog for the first 2 weeks. And I wasnt prepared for after my first as I thought it would be on par with a hip and I was wrong.

I joined the FB group mentioned and it was a really good support group for the weeks and months after my surgeries.

If your quality of life is being impacted then I would say its a no brainer. Also, the wait list is long, so getting on it would be wise as in the interim, like me, your joint could get a lot worse. I wouldnt wait until you can barely walk before you say yes.

I need a new knee and even my private consultant won't do it until I'm 60. They don't want to do it twice. (And privately at £18k I don't want to pay twice!) So I'm waiting patiently and will see how it is in a few years time....

have you asked them whether, if you decide to wait longer could that make the replacement a more complex operation? It might be that a straightforward operation now and a redo later down the line might be easier than doing the primary replacement once the joint's even more knackered, impacting the mechanics in that leg and affecting your fitness?...might be a question worth asking. Big operation either way, and needs a lot of patient engagement to work well, but it's not wildly uncommon to do them on people who don't seem to be taking masses of pain relief or severely limited. (merely an anaesthetist's PoV though not an orthopod's)