So much fun. Earlier this year, my range of motion with my knees started to get much worse pretty rapidly. They've been "bad" for a long, long time, but this was a new level. I got with my doc, and she checked me over and said "yep, sending you to ortho."

That was a few months ago. Met with an ortho who does knee replacements. Got x-rayed and I have arthritis, bone spurs, and lax ligaments in both. That explains it. He laid out some options, and I opted for the cortisone shots and trying to strengthen them in the interim. Those lasted me about two weeks of real, solid relief, and then I started getting the sharp stabbing pain again. By the tail end of three weeks, I was back to normal.

A followup a few weeks ago involved a conversation about gel injections and whether my insurance would cover them. Turns out, they do, and they will every six months. So that's what I had done yesterday. I'm pretty sore. Couldn't climb into bed last night, and today they're more tender than they were yesterday. Got the calendar marked, if these work the way they're supposed to, I should be feeling pretty good by January 15th. The guy who did the injections said he's had some patients tell him they only get a few months out of them, six months is about the median, and he had one patient tell him they got a year and a half. The wait is going to suck, but I'm hoping for some extended relief. It would be great to build up some strength and get in shape.

Doc says given what's going on with my knees, surgery isn't a long-term fix and I want to put it off as long as I can. I've had lax ligaments all my life, and apparently when they go in to fix those, it's his experience that they just stretch back out. When I was younger, it made for some circus act type flexibility, but now it's just problems. As for the arthritis and bone spurs, that's just life I guess. I don't/can't/won't take pain meds unless I cannot function, so I've just been living with pain. Ice only does so much.

Any advice? What's your experience with this stuff? I could use some hope here, but if you got horror stories, I'd rather know more than less at this point.

I about figured your age. You are too young for a knee replacement. Injections and PT help a lot of people. BTW figure out what physical activites aggravate the condtion.

quote:

Originally posted by P220 Smudge:
A followup a few weeks ago involved a conversation about gel injections and whether my insurance would cover them. Turns out, they do, and they will every six months.

That's cool. My insurance didn't cover gel, nor did it cover hyaluronic acid. My knee doc says most insurances don't. Mine only covered either cortisone shots (up to 4x per year) or knee replacement, and I'm not bad enough for replacement yet (and only ~40, so too young to start down that road). Luckily, I still get 6+ months of relief from each cortisone shot, now that I've fully cut out all high impact activity.

quote:

Doc says given what's going on with my knees, surgery isn't a long-term fix and I want to put it off as long as I can.

You want to put it off as long as you can, regardless. Knee replacements have to themselves be replaced every ~10 years, so you don't want to start that timer unless there's no other option.

Plus, they're constantly coming out with newer and better knee treatments. So in another 5-10 years, there may be some new intermediate option besides just a replacement, or a better replacement knee design that works better or doesn't wear out as quickly.

I blew out the meniscus in my left knee when I was like 19 years old. I'm 65 now and over the years it has deteriorated to the point that I can't run anymore. I finally saw an orthopedic surgeon about 15 years ago. He did x-rays and said I have no cartilage left (bone-on-bone) and also some osteoarthritis. He said that a full replacement is inevitable, but so far I've put that off. I did get hyaluronic acid shots, a series of three about a week apart. Painful just while they were being administered, and they helped a lot the first time. I think it lasted several months. I did a 2nd series but the effect only lasted a few weeks the 2nd time. I never went back for any more shots. He did fit me with an aluminum/velcro brace that helps a lot. I wear it whenever I'm going to have to be my feet for longer than about an hour, or when I'm going to have to walk on rough or slippery ground. It cost a little over $900 then, probably at least $1200 now, but my insurance covered it. The shots I had to pay for myself, they were not cheap IIRC.

The other thing the guy told me (15 years ago) was that replacement joints don't last forever and have to be re-replaced after 10-15 years. They're working on improving them so they last longer, but at the time that was about the longest a replacement joint would last. The whole surgery / rehab thing scares me, so I elected to just go with the brace and revisit the replacement option later, hoping they'll get them to the point that one replacement will last me for the duration. For now the brace is still doing the job. I had to replace all the straps on it 4 years ago, that was about $140.

quote:

Originally posted by ZSMICHAEL:
I about figured your age. You are too young for a knee replacement.

I'm 40. I know, my doctor said they weren't going to want to do one on me.

quote:

Originally posted by ZSMICHAEL:
BTW figure out what physical activites aggravate the condtion.

I'm not being cute when I say absolutely everything. It used to be squatting, lifting and running, now it's walking. Standing from a sitting position will do it if I don't use my hands to brace and help lift myself up off chairs.

When I was young, I wrestled, ran track and cross country, and lifted weights. I had huge quads. I maxed out at 825lb leg extensions when I was 20, and could've likely gone heavier if I hadn't discovered alcohol. I had no real guidance and probably pushed too hard, too fast and did some real damage back in the highschool and college days.

quote:

Originally posted by RogueJSK:
That's cool. My insurance didn't cover gel, nor did it cover hyaluronic acid.

He mentioned the acid and also stem cell therapy. I believe he said insurance would cover neither one. I guess we'll see how this gel stuff works out and go from there.

quote:

Originally posted by RogueJSK:
Luckily, I still get 6+ months of relief from each cortisone shot, now that I've fully cut out all high impact activity.

You're lucky, I was really hoping the cortisone would work for a lot longer than they did. I actually choked up a little in the parking lot walking back to the truck after I got the shots, the pain was just not there. It reminded me of how I felt after heart ablation, you go so long dealing with something as normal and then the instant it's gone, it throws everything into sharp contrast. I have cut out all high impact anything for years. I tried jogging this past spring just to see. A couple hundred yard moderate trial runs told me everything I needed to know about that never happening again. The house we bought has a pool, and I tried swimming laps. The third day of ten minutes at a moderate pace left me nearly unable to walk for two days.

quote:

Originally posted by RogueJSK:
You want to put it off as long as you can, regardless.

I know the recovery on anything to do with knee surgery is protracted. For sure at least this whole coming next year, I didn't want to be recovering from any kind of surgery that would limit my mobility. I have a hernia repair that was either botched or didn't heal right, and I'm seriously weighing if I want to get that looked at and possibly re-done or if I can just live with it hurting.


Expert308, that's rough about the shots not working for you. I wear some OTC knee braces on occasion, but it gets so damn hot here that I honestly hate wearing them. Depending on how these shots work out, I'll ask him about a brace.

quote:

Originally posted by P220 Smudge:
Expert308, that's rough about the shots not working for you. I wear some OTC knee braces on occasion, but it gets so damn hot here that I honestly hate wearing them. Depending on how these shots work out, I'll ask him about a brace.

Yeah, in the summer it gets pretty uncomfortable after a few hours. I can't wait to get back home and take it off.

Sounds just like me... Almost 40 years old, with a bad knee from being a big weightlifter type who was too physically active for such a big guy in my teens and 20s, constantly pounding around on my poor knees, and doing irreparable damage for which I'm now reaping the whirlwind.

And I know exactly what you mean about being so used to constant dull pain that you forget what not being in pain feels like. Although mine tends to take ~2 days after injection before I get full (temporary) relief.

At my first knee surgery ~15 years ago, the doctor told me that I might need a replacement by the time I was 40. Luckily, I'll be 40 in less than a year, and I'm not there yet. Now they're estimating 50ish, but I'm doing what I can to forestall that too, in hopes of some big breakthrough in the next decade or so.

I’m about 20 years older than you, been through cortisone, gel injections, etc.. I’ve gone years with knee pain and tried about everything.

The gel injections for me, only lasted a couple of weeks, nerve blocks lasted months. I did get one knee replaced at the end of May in 22, need to have the other done at some point. It seemed to me, everything tried just masked the pain and really didn’t do anything for the problem until the replacement. With that said, do all you can to put that off as long as you can. The replacement does eliminate the bone on bone pain, but seems to give some other issues. I still have little feeling on the outside portion of my knee and kneeling on that knee is not very comfortable.

Just had a toe joint replacement last week, so the other knee is on hold for a while.

I think it depends on the knee problem. I go to the Nashville VA & was initially referred to a Vanderbilt Ortho clinic. The doc said I was bone on bone. I had gel injections & they lasted about a year. The second gel injections lasted about 18 months. I then had different gel injections at the VA & they have lasted for over 3 years.
My sister had knee surgery & came out worse. Another Ortho Doc said her hips were causing her knee problem. Her hips were replaced & the knee problem went away.

quote:

Originally posted by Anush:
Another Ortho Doc said her hips were causing her knee problem. Her hips were replaced & the knee problem went away.

Similarly, some of my knee issues were undoubtedly exacerbated by untreated flat feet. Eventually getting orthotics and wearing motion-control running shoes helped, but previous years of running around on flat feet certainly didn't help the undue wear and tear on my knees.

It's too late for foot replacements anyway.