Knee replacement?

Get a consult with a regenerative medicine sports medicine physician. If there is any cartilage left, it's very likely it can be regenerated with simple injections of his own blood components (e.g. platelet-rich plasma or bone marrow aspirate concentrate). I've had PRP done on my hip labrum and my L5-S1 disc in my spine. It's a very common procedure in Europe but not covered yet in the U.S. There is an incredible physician named Dr. David Suarez in Concord, CA. He is Stanford trained and previously did a fellowship under the godfather of this space, Dr. Marko Bodor, who practices up in Napa, CA at Bodor Clinic. Both are incredible and I trust intrinsically (Ive been treated personally by both). I would absolutely explore this before a full replacement. 

Hi, I had a full knee replacement through Kaiser in 2020 and couldn’t be happier. My range of motion did decrease, so that was a bummer, but I do not have pain in that knee anymore and I’m able to do lots of things that I couldn’t before: mainly waking and hiking for decent distances. I was 50 when I had the replacement. 
For full disclosure, it was the most painful recovery I’ve ever had and it took a long time to really be happy with my choice. Kaiser released me from PT after about 3 months and I was not satisfied with my outcome at that time. I was really dedicated to doing my exercises for a full year and that made a huge difference, especially when it came to be able to fully straighten my leg and bend it enough for a standard quad stretch. 

While I cannot speak for knee replacement directly, I am a Kaiser member, and have experienced having to advocate for treatments to maintain quality of life and highly recommend you get a second opinion from another Kaiser doctor.  It is a little work, but read profiles, and then select a doctor that seems more in tune with your needs for the 2nd opinion. 

Almost two decades ago in my early 20's, I tore my ACL playing basketball.  The first Ortho doctor I met with suggested that it was not worthwhile having surgery and that I could live perfectly fine not doing the surgery because even if I had it there was no guarantee that I would be the same and that it might not help with pain.  At the time I played sports 3-5 times a week and explained I could not imagine trying to do so with constant fear that my knee would buckle and I'd suffer a worse injury. He was totally dismissive, potentially because he could not imagine that a 5'3'' female could continue to enjoy competitive basketball...I quote, "it's not like you play in the NBA."

I read through all the Ortho surgeon profiles and found a doctor that mentioned in his profile that he was a runner and asked for a second opinion with him.  I again explained my needs and goals and this doctor was phenomenal. He explained the potential benefits and risks, was reassuring that this was a personal choice and that outcomes really depended on how hard I would work on physical therapy afterwards.  I had the surgery and while it was hard work to get the knee strong again, I got back on the basketball court, tennis court, and on skates.  While true that the knee was never quite the same as pre-injury, I cannot even imagine having spent the last 20 year on the courts, in skates, or even walking a distance, had it not been for the ACL replacement surgery that I was initially advised against having.

Wishing your husband best of luck on the research to get the right second opinion and, if he decides to go for it, the strength and discipline to follow through with all the required PT to enjoy 20+ years of a solid working knee.

Hi, 

I had a knee replacement (TKR) 9 years ago at age 54. I had the other knee replaced two years ago at age 62. Both have been great successes. I had lots of cartilage removed from my first knee by arthroscopic surgery after a ski injury when I was 22. So after 25 years the degeneration in the joint was severe and I was in lots of pain and using a lot of Advil. I had more and more difficulty walking and my physicality was limited. Yet, doctors said I was too young. Finally I had the surgery performed by Dr. Dearborn in the South Bay. He only does knee and hip replacements. His PA’s are A+. The recovery pain was intense. I took hard-core pain killers for months. Perhaps “younger” patients have more nerve sensitivity, one of the PA’s remarked, acknowledging that the younger patients had more pain. Perhaps my Advil use made me more sensitive to pain.
 The most important part is physical therapy!!! And you must stretch and bend the joint every day. After I timed out of PT I continued to work privately with a personal trainer to maintain/increase my agility and mobility.
For the second knee, going into it had much less pain and was certainly stronger. The recovery was much much easier. After PT I have continued to work weekly with my awesome personal trainer, at great expense, but look at me now! I can do squats and have very good range of motion (which I continue to work on every day). I walk 8000 steps every day, swim 3x per week, take a weekly dance class (low-impact, ofc) and a weekly yoga class. I go on an annual ski trip and ski, though extremely moderately and not for that long each day. I listen to my body. I have rheumatoid arthritis and other autoimmune disorders so being healthy requires a constant awareness and intent. 
If your husband wants surgery in order to return to a type A lifestyle, I don’t think that can work. But having self-compassion, looking inward with acceptance and having an intention for a long and healthy life go well with knee replacements. This has worked for me. 
It is NOT a normal knee and I have large numb areas on both knees. Knee replacements done 20 years ago lasted about 20 years. The technology is better now so I’m hoping mine last a lifetime. No tennis or competitive sports like that. Careful at the dog park! No skiing, either, unless you can be happy with green runs and slow speeds. I switched to telemark to slow me down. And cross-country. 
I recommend a second opinion! And a surgeon that does TKR’s regularly. I think I know folks with Kaiser that have had successful knee replacements. I believe that poor results are due to not doing the first 8 weeks of PT daily. That is where the range of motion comes in before the scar tissue sets in.  Be clear on what outcomes you want and commit to those goals. NOT the minimums. 
Good Luck! Im happy to talk more. 


 

Umm... why anecdotal evidence? I don't know about knee replacements specifically, but I do have experience weighing the risks/benefits of orthopedic surgery, and I found the following steps helpful in making my decision...

--consulting with a trusted physical therapist. They see patients for a much longer span of time than doctors and surgeons do and have a much clearer sense of how well patients progress (or not). Don't underestimate the value of their clinical experiences.

--Truly diving into the medical research and disaggregating the data to discover likely outcomes for *your exact set of circumstances.* I spent a ton of time on google scholar getting to know the jargon and then zeroing in on whether the surgery would be likely to be successful for someone of my age, gender and specific condition. This is incredibly time-consuming but was so, so worth it, IMO. My experience was that the devil is in the details and some patients/types of cases are clearly better candidates for surgery than others. But not all physicians have the latest research at the front of their minds. For example, in my case, gender was a very strong predictor of surgical outcomes. Of the three Kaiser docs I saw, only one of them was aware of that.

My overall advice... do your own research. Don't just listen to strangers on BPN.

I am sorry I have no advice to give, but would love to hear answers to this question.  My 62 year old husband has diagnosed issues and significant pain in both knees.  His Kaiser doctor is saying physical therapy and ibuprofen. 

My elderly father had back surgery that made everything worse so I appreciate their caution, but I'm wondering if they're over doing it.

I don't have personal experience, but one of my oldest friends had both knees replaced, one at a time, about 9 years ago at age 53.   She's very glad she did it.  No more pain, and her range of motion is good.  She had severe pain from arthritis before the operations.