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?

@Greybeardy I hadn't realised until I read some posts yesterday, just how painful it is. And needs morphine and stuff! I was very committed to doing all the exercises though as I want to be up and running (not actually running) as soon as I can. Plus I'm a single parent with kids and pets so can't take time out.

@SleepingisanArt @K0OLA1D I am 55 and they have wanted to do the operation for at least 4 years. I ran through covid, but at the end just couldn't do it anymore and my knees were really painful then which was the motivation for getting referred to the hospital. I agreed to be put on the waiting list at my appointment in February and was offered a date in March! I've been offered two more since - so the waiting list mustn't be long, or they must think I'm a priority.

It’s hard to say how anyone will recover from surgery but a friend of mine had her knee replaced 2 years ago and is still struggling with pain and swelling. She is meant to have had the second knee done by now too but is in no rush to get it done. If you have no pain I wouldn’t go ahead as you won’t be able to run or kneel again once it’s done.

My Dad is now almost 80. He refused knee replacement surgery when he was younger. Now he really needs it, but with all the other health concerns at nearly 80, it’s too risky to do. It’s now really affected his quality of life - he can’t even go for a short walk to a park with us.

If you're not in pain, and building muscle, and supporting the joints with muscle, then it would be insane to have knee replacements done - just because the scans don't look good.

I had both mine done approx 9 and 10 years ago when i was 58/59.

Recovery is VERY painful for the first few weeks - i did pool therapy for 3 weeks after followed by another 3 weeks of exercises which was included in the package which was on the NHS but done at a private hospital. I dont think you get that normally with the NHS. I was also sent home with a wrap around knee icer which is very important but you can buy these on amazon. I knew someone who had the same operation through the NHS and they only provided ice in a bag which is ridiculous so make sure you get one.

i was told they would only do both together if the patient already could not walk at all. You REALLY DONT want to do both at the same time! I could only walk a few yards at a time which upped gradually over a 4-6 week period after the op. You cant drive for 6 weeks after.

i used to do yoga but found i couldnt put my weight on my knees after and still cant kneel on a hard surface 10 years later. I do tai chi these days.

i still have stiffness in my knees so take paracetamol twice a day which helps. I wouldnt try running but I was never a runner before.

When I say run, I’m talking 5 to 8k, not trail running. My surgeon said skiing, no snowboarding, so now I do Alpine skiing, Cross country (skate) and a bit of ski touring.
If you aren’t in pain and still mobile, then wait. There was a lot of history with my knee, but I went private in the end to the surgeon I had trust in and didn’t use the NHS one who’s attitude was wait until you can’t move at all and are totally fucked, then I’ll only have to do it once.

You can run with a replacement knee. My DH does. I think a hip is a different matter. The physios will help you.

Obviously you don't overdo it, he just does parkrun once a week. No marathons! And he waited over a year post op to try running again.

He recovered very well - he did all the exercises they recommend religiously and also had a device called Heliotherm (or something similar) which is like a glorified packet of frozen peas! It was much less of an ordeal than he thought it would be. His was a partial knee replacement though and he had stitches. When he had physio he met someone who'd been stapled and he was in much more pain

I agree, definitely wait. DH waited about three years until he couldn't walk for more than half an hour without being in a lot of pain and he was worried about the effect on his other knee and hips.

But if you time it right and get as fit as you can before the op you will recover well.

I had mine done 6 months ago and it's not great at all. I have osteoarthritis and had pretty chronic pain in my knee (bone on bone, locking and sticking) for over 3 years. Had 3 injections and various physio exercises over the 3 years so surgery was the only option left really.

I now have awful stiffness and lateral knee pain and a big patch of my knee in numb. Sleep is also not great. I would say I'm in almost as much pain and discomfort as I was before but it's different. I have done so much rehab too with hospital physios and a PT for 4 months but it's not improving. I'm now booked in to see a podiatrist/physio specialist in the hope that they can shed some light on what else I can do. I would absolutely not get my right knee done unless it got to a stage where I could not physically walk. I thought I'd be hiking and dancing again and living relatively pain free but I'm not. I'm gutted.

@HelenHywaterwould you be able to share what pilates exercises you are doing for your knees?

(Great username)

I’m also surprised at surgeons encouraging surgery as IME too they want you to delay as much as possible. Personally I wouldn’t if I wasn’t in pain, it’s a very painful op, with risk of being no better / worse than you are now. I will only take that risk when I feel it’s worth it because current situ is unbearable.

I have an arthritis in a knee, in my mid 50's. Consultant said I am too young for a replacement as they aim to do only one (in this instance, left knee) replacement in a life time! I was offered injections if the pain gets worse. Advised to have physio and keep exercising.

I'm having a partial knee replacement and have been told I will need a full knee replacement in 15 years. I'm currently mid-50s but I can't hold on any longer.

I had one 4 years ago, I was 54, surgeon put a ceramic one is as it lasts longer so might not need another ! Was told I couldn’t run unless I wanted it to wear out ! I joined the FB group mentioned at about 10 days as was convinced it had gone wrong with the amount of pain I was in.

now I can kneel on it on a soft surface but don’t like the feeling of it.

I’m 59 and have had both knees done over last 4 years. Both surgeries went well for me. It’s one of the worst you can have for pain and recovery but so worth it. I’d be surprised if you can run again, it’s not advised as the replacement can wear out quickly. I also ski and haven’t since replacement as again it’s not advised. However, I walk miles most days with my dog (which I hadn’t been able to do).

I had one done at 53 as my quality of life was appalling. I could barely walk more than a couple hundred feet. Max 5 mins. Bone on bone.
Recovery was ok. Needed 8 weeks off work and lots of codeine. Lots of physio. Not much pain in the daytime but nights were hard.
But now my life is so much better. No comparison. Just need to get the left knee done now …

The pain really scares me @Macaroni46 !

You see I can walk miles with my dog already @Remagirl19

I'm interested in the point @rainbowstardrops made upthread about it being possible to have no pain and be bone on bone, because that's pretty much me. I did an exercise yesterday at pilates which was just bending and straightening leg over and over while on your back, and that hurt a little bit, but honestly I think that was the only time I felt my knee.

@24Seconds2Go I just do standard pilates classes - I do them probably at least 5 days a week though and many weeks I'm there every day. There are a lot of glute and leg exercises there. The physio gave me some that I did at home as well for a while, but I saw more improvement going to pilates.

You get the surgery because of pain. Then you will be in severe pain afterwards. After recovery, and much extremely painful physio, you may be in no pain (but unable to kneel at all), or you may be in some pain, or as much as before. And I think it is 5% who need revision of the original surgery (not a later replacement 15 years down the line, but immediate revision) as something went wrong.

But you are not experiencing pain. Follow the advice of the physio, not the surgeon, whose job is to operate.

In my opinion, if you’re not in pain, leave things alone. A replacement knee is a wonderful thing but it’s not a normal knee. Kneeling, as others have said, is almost impossible, and it still feels a bit clunky. In hot weather, my operated knee swells a bit and feels uncomfortable and long car journeys, if I’m driving, cause fatigue in the operated knee and tightness.
I think you’ll know when, or if, it’s time. When your daily life becomes unbearable due to pain and your mobility is severely compromised. For me, the before and after are incomparable. Yes, the op was painful but the pain I was experiencing on a daily basis was excruciating, unbearable and unmanageable. No painkiller would touch it.

I’m pushing to have my other knee done before it becomes unbearable.

I sound a bit like you OP. 56, healthy weight but no cartilage on either knee. I have had arthroscopy in both which helped a little.

I cannot crouch/hunker down anymore. Or squat really deeply. I was not a big runner before but I will never run again. I can however still ski OK.

I have no pain that keeps me awake, just a thickness/stiffness that makes me a bit clumsy and prevents me from closing my knee properly. On a hike I need poles coming downhill. I cannot kneel right down with closed knees. I just adapt what yoga poses I do. On a long day out at a festival/hiking I would take ibuprofen before.

if I was in daily/nightly pain I would be considering TKR but I'm not, it's bearable. So for this, I'm not having a circular saw taken to my knees just yet!

im surprised your Dr is saying you should really.

Personally I would not have surgery unless you are in debilitating pain.

After surgery you will not be able to kneel and may not be as flexible as you are now. The surgery removes pain.

I have no meniscus in either knee and also bone on bone in my knees. However through exercise I am pain free and able to do most things. I wil not have the operation until pain stops play!

If you can walk for hours and miles then I would look at increasing this to slow running with a sports physio heping you to do this safely.

I run with my knees.

I am very surprised that your Dr is pushing the op to be honest.

I couldn't walk or live with the pain anymore. I think if I wasn't in pain then you wouldn't get the benefit of the replacement.

I know my knees aren't mine. With every step I take. They are better then my actual knees were but they're far from perfect.

This is a very good point. You can't kneel with a knee replacement. That was something DH knew before the op and has definitely experienced since - even 3 years later. So if you have to kneel for any reason you need a very fat cushion.

Had left knee done in January. Pain both knees was severe and painful after eg longer walks. First few weeks post op v painful.l but as expected like having a newborn do not expect peaceful restful nights. Keep up exercises.

I had booked a weekend event 8 weeks in and had booked disability hotel room and train assistance etc. Didn't need the train station assistance by then but walk in shower was still useful . Was able to make full use of swim and spa at hotel.

Mine is textbook great recovery.

Will do 2nd.

Thank you everyone - I've emailed the hospital asking to delay the operation until I've had a conversation with the consultant. @lionbrain you sound really similar to me - how do you run? What exercises have you done? Until recently I couldn't even run for the bus, but I can now and can also do hiit at the gym. I should try running longer I think.

@ConstitutionHill you sound like me too. I used to have to take naproxen for long days, but don't anymore.

I remember a few years ago walking up and down a volcano in Iceland and it took a toll on my knees. This year I walked on the Great Wall of China - hundreds of steps (up and down) and it was fine. No pain at all. I'm evangelical about pilates improving my knee function and pain levels!