Osteoarthitis Knee and new operation called Makoplasty

Posted , 4 users are following.

I am 59 and have had pain in both knees for many years now. I used to go to exercise classes but had to give them up as I couldn't do lunges, squats etc., as they aggravated my knees and would then hurt all evening. A few years ago I woke on holiday and couldn't bend my knee to walk. I ended up walking with a stiff leg for a couple of days and then the pain went as quickly as it had come. Over the past year or so I have had sharp pain in the inner part of my knee and something seems to get stuck and I can't put pressure on my knee at all. Only lasts for a few minutes at a time but I've noticed that it seems to happen when I am leaning slightly forward on my knee. I feel really stupid when I'm out shopping on my own as one minute I am walking fine and the next can't walk at all. I went to see an Ortho Consultant about three months ago and he x-rayed the knee and found two fragments of loose bone. I was expecting this as my doctor had also previously x-rayed the knee and found the same thing. I thought he would arrange for me to have an Arthroscopy to remove the bone but instead he looked at the x-ray and told me that I was heading for a total knee replacement as I had lost most of the cartlidge in the medial section. I was really shocked as I wasn't expecting this. I guess I knew I had arthritis in my knees as I have it elsewhere in my body and the pain in my knees had to be due to something, but I wasn't expecting him to say that I would need a total knee replacement in the near future. My mother had her knee done a couple of years ago and she is 86 now. She took a long time to recover and in fact still has limited mobility (some of that is probably due to the fact that she didn't persevere with her exercises). I told him I thought I was too young for this procedure and he agreed. He didn't think removing the bone with keyhole would be very beneficial, I think because he thought I had other bigger problems, and I was too taken aback to say that I would still like the loose bone removed even if it meant further knee surgery somewhere in the future. It might be vanity but I already have a three inch scar of the outside of my knee due to surgery in my early 20's, and my mum's scar is huge and I really don't want that at my age! The other things that really put me off is that some people can't crouch or kneel down afterwards and to me that is being disabled!

Today I did some googling and found a fairly new procedure called Makoplasty which is mainly performed in the States (typical!) It involves partial knee re-surfacing, so a much smaller scar, is less invasive, much quicker recovery etc., etc., Something to give me hope I thought. I think at the moment there is only one hospital in Strathclyde, Scotland who is performing this surgery, but I am hoping that eventually other hospitals in the country will be buying the equipment (robotic arm) and training their surgeons. It is aimed at people of a younger age with mild to mid osteoarthritis which is me at the moment. I don't know whether anyone else out there is in a similar position to me. Perhaps if we all lobbied our doctors they could push for surgeons in the UK to start performing this lesser surgery. To me it makes sense as it can even be done in outpatients for some people, and you can get back to normal activities such as working and driving within weeks rather than months. If the arthritis eventually gets worse of course you can still have a full knee replacement surgery at a later stage.

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  • Posted

    Hi Sandie 59, yes I'm in the same position as you I'm 52 and having been just recently diagnosed with OA inmy right knee, but both knees can be extremely painful especially when I'm going up/down steps,and also going from sitting to standing position, but my doctor told me I'm too young to have knee replacement surgery and didn't think it necessary for me to have x-ray or MRI I have suffered for the last 10 years with painful knees and I'm concerned for my future prognosis as I am a full time care for my disabled husband, should I push my doctor for for further tests and treatment, I'm just on pain killers now so would be grateful for some advice,

    I also think this Makoplasty procedure would be great for people like us, I don't know much about it and don't know if lobbying our Gp's would work, perhaps we could start a petition on Facebook or Twitter, look how public the " No Make-up Selfie " became, it's amazing what a bit of media can do !! smile

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    • Posted

      Without an xray or scan how does anybody know anything for certain about your knees!! They don't want to spend money. You should at least get some physio advice and the usual strengthening exercises.
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  • Posted

    Hi Dawn

    Sorry I haven't been on this site for ages as this year I am looking after my elderly mother who has many illnesses. I can imagine somewhat what it must be for you as you are looking a disabled husband full time. I am living with my mum at present but do at least get home for a few hours most days. My poor husband is having to fend for himself and I think my cat has the right hump with me for not being there!!!

    Anyway, to get back to knees. I did ask my surgeon about the lesser operation and he said that in my case I would need a full knee replacement. He is old school though so at the moment until my husband retires I am holding off. I am waiting for another steroid injection in my knee which I can have every six months. My right knee always hurts but fluctuates in just how bad. At the moment getting on and off of my mum's sofa is aggravating the pain as it is lower that mine at home. The knee seems to be constantly swollen and I'm having problems getting in my bath now and also I wake up with it hurting so it is gradually getting worse as it wasn't like that last year.

    Although I am 61 I sometimes feel like an old woman. On top of the arthritis in my knees I also have it in the tops of my shoulders, base of thumb/wrists (again aggravated by making my mum's hot water bottles I think. All the twisting movements not good for me.) Feet too, and I fractured a vertebrae in my spine last year through coughing so probably there too. I know I am also Osteopenic (the stage before Osteoporosis)

    I can't understand why your doctor hasn't arranged for x-rays, that is the first thing he should do as it will show how bad your arthritis is. In my case I have a vastly reduced space on the inner compartment of my knee and at times if I move in the wrong way it's like someone is sticking a knife in. It doesn't matter how old you are, if you already have osteo arthritis then it needs dealing with and the least he can do is to try steroid injections. I was speaking with a woman at my local bank and she was only in her 50's and had already had both knees replaced and is fine now. Do you have anyone else in your family with early arthritis or do you think yours has been made worse with looking after your husband? In my case my arthritis is genetic as my maternal grandfather was disabled with his knees in his 40's and my mum has osteo arthritis everywhere. She had a knee replacement around five years ago and she is 88 now, and recently she couldn't bear any weight on her left knee and we were going to arrange for an mri as the x-rays looked pretty good. However, it has improved and she is managing to walk with her frame. She wouldn't be able to go under a general because of her other illnesses so I am hoping this was just an odd problem that won't occur again as she really couldn't move and I had to buy a wheelchair for her.

    If your doctor is unsympathetic can you try a different doctor? With regards to medications I can't take ibuprofen as it affects my stomach but when my mum was on anti-inflammatories for years her arthritis was kept in check, although it did end up damaging her kidneys. My niece is on a medication called Naproxen as she has bad knees, and she feels it really helps. We are also both taking co-codamol 30/500, although it's not a miracle drug by any means. Helps if my knees are aching but I think wheb you have pain caused by a mechanical problem nothing really helps much although anti-inflammatories obviously help with the inflammation.

    I wish you luck and I hope by now you have got somewhere with your doctor. Getting back to the Makoplasty procedure, at your age and if the arthritis isn't too bad then I think you will stand more of a chance of getting it done, but you might have to pay privately or move to Scotland!!!

    All the best.

    Sandie

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  • Posted

    sandie59  Yes you are too young for these operations. Why, in the first instance, don't you start hyaluronic acid injections? This comprises injections of a substance that acts as a cushion in the knee joint. I have had it many times and it helps but I think anything is preferable to an operation especially at your age. You can look it up via google  HYALURONIC ACID FOR KNEE JOINTS.  I had many but now am on stem cell therapy. But you can start first with the hyaluronic injections which are totally natural. Hyaluronic acid is even found in our eyes, so no chemicals involved. Do ask about it. I have refused an operation on my knee and have a friend who had both knees done and who pleads with me not to have the same thing done. I know the hip operations are usually 100% successful. However the knees are much more complicated. I lost weight purposely so the knee carries less weight.  I also use Fentanyl patches for the pain and am getting results.  I wish you less pain and don't lose hope. Research is moving towards helping us all.  Best wishes.
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    • Posted

      Which hospital is giving you the hyaluronic injections? No mention of any such treatment in Tyne and Wear! We can request any hospital nowadays (one good bit of progress!).
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    • Posted

      Hi again

      I first saw the Consultant a couple of years ago now and discussed alternatives to full blown knee replacement. He said no to everything including the injections you are suggesting. I have had steroid injections in both knees three times now. Sometimes they seem to help a little but nothing miraculous. My right knee is the worse and is hurting when I wake up now which it wasn't doing a year ago. Both knees generally hurt to some degree most of the time and the right knee is swollen. I'll discuss the Hyaluronic acid injections with my doctor but as the inner compartment of my knee has very little space now I don't know if they are an option. I think my consultant is very much old school and I must admit I don't like the idea of full knee replacements although I have spoken to other younger people who have said it changed their lives for the better. I'll certainly do more research on the Hyaluronic acid injections. As already asked, what hospital did them for you?

      Regards.

      Sandie

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    • Posted

      In addition to my posting and previous replies, I have just looked on the NICE website and they do not recommend giving Hyaluronic Acid injections as they say there is no evidence that it works. Also  looked on Arthritis website and they talk about it but not for people with inflammation, just used where bone is roughened rather than smooth. I don't think therefore that this applies to people like me where I have a big reduction in the inner compartment space of my knee meaning that if I twist or move in a particular way it feels like a knife has been pushed into my knee. I guess the bone is perhaps hitting the other bone or squeezing a nerve? Waiting for an appointment for another steroid injection, but this will be my third and I'm not sure if they will continue to give them to me after this.
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