Aging is never fun. Today I learned that both knees are bone-on-bone. The well-respected ortho doctor outlined a few options.

For an active 57-year old, who desires to run and cycle and work out, how would you approach this situation?

I suspect that I have been bone-on-bone for several years. I have exercised in very intense workouts for about three years. I want to continue to maintain some physical fitness.

Shots? Cortisone? PRP? Partial knee? Don't fix what ain't broke?

I'm thinking I can handle pain. X-Team proud (fitness program). But, what is optimum?

Bone on bone would probably require knee surgery. Go see a specialist and follow their recommendations. Dr. Randy Peyton is an excellent knee surgeon in Northern, Virginia. One of the top knee surgeons in the country, that flies around the country teaching other DR's how to do knee surgeries. He is one of my customers and very passionate about his career. Here is his website.

https://www.arthritisandsports.com/randall-peyton-md

I too suffered with bone-on-bone in both knees for 10+ years. Went through shots and pain pills; eventually had total knee replacement in both (spaced out over 10 months). I ask myself, why did I wait so long before having surgery?

You have to keep ahead of the pain after surgery by taking the pain pills prescribed; don’t wait until you feel the pain going on. The pain from surgery (soft tissue healing) is totally different from the bone-on-bone pain you are experiencing now.

Physical rehab was about 3-4 months each time, now keeping active at “Y” 3 times per week. I asked rehab folks what’s the difference between Physical Therapy (PT) versus Occupational Therapy (OT); answer: PT helps you get to the bathroom, OT helps you do the paperwork.

Good luck.

This message has been edited. Last edited by: 2BobTanner,

My understanding is bone-on-bone only get worse, not better.
Agree with finding a good knee surgeon, getting a good evaluation and discussion of risk vs benefit for the treatment options.
At your age I would go for surgery; hell, even at my age—18 more than you—-I’d go for it. Don’t let that disability stop you from keeping yourself in the best shape you can be.

Bone on bone will only get worse..pain wise. I have had both knees total Knee replacement and surprise, no more pain. I bike and row every day now but stay away from impact activity just to keep the knees lasting longer.

Cortisone works for about a month and then the pain and funny walking/gait return.

Find a good Ortho and get er done!

You won't regret it.

My buddy did a very painful stem cell procedure multiple times to regrow the cartlidge. It produced negligible results and the miniscule day to day improvements weren't worth the short-term pain and expense of the treatment.

I don't know any more than what I've posted.

I had bone on bone. I took pain pills (diclofenac) for a while. But the Dr. said they wanted to monitor my kidneys to be sure they were not damaged. I figured with my luck, I would destroy my kidneys and still need a knee replacement. Dr. recommended a partial knee replacement in both knees. I had it done about 5 years ago. My knees are still stiff, but much better then they were. Dr. said I was never going to feel like I was 18 again. I have no pain in my hips or ankles or wrists or elbows or shoulder. But I am aware of my knees. Two different DRs have said this is about as good as it gets. I went to the Anderson Clinic at INOVA Mount Vernon Hospital. Joint replacement is all they do. I hope this helps.

I highly recommend stem cell therapy! I’m not sure where the one guy found it painful. That is not my experience. My mother is 70 and did it. Saved her from a knee replacement. She didn’t complain about it being painful. There was some pain, but nothing she would say was an issue.

It is expensive though. I tore both knees (meniscus) when I was 18. I’m 41 now and I’m starting to feel it. I will be starting stem cells relatively soon.

I was bone on bone for ~30 years. Despite that fact I've stayed active and the primary activity that really hurt thereafter was snow skiing.

Afterwards my knee required draining (that really hurt) and then cortisone.

The doctors told me to push off total knee replacement as far as I could. The rationale was the surgical options would get better over time.

I had my knee replaced in 2016, and like others have posted, don't regret it.

If replacement is your only option, make damn sure you take the pain meds, do the home rehab, do the outpatient PT, etc. Don't "be tough" and skip the meds because once it start to hurts, you will be behind the 8-ball in getting comfortable again and continue the rehab.

My bro had JRA and has his knees replaced, and both hips and both shoulders. Basically all his joints are or were bone to bone.

Get them replaced, follow the docs rules, don’t try and gut it out w/o taking the pain meds, but don’t get crazy and take too much, remember the pills will back you up and you will need some Physical therapy, but don’t push it.

Good luck, get thee to a ortho and get them replaced sooner rather than later. Chuck, after having the first knee replaced said, “ I can’t believe I waited so long, I should done this a decade ago”

I had a partial knee replacement done in June after 3 years of terrible pain. 8 weeks later was able to go back to work. The first week of therapy was the hardest for me. I did push myself hard with the therapy and it paid off. I would do it again if ever needed.

I'm fiftynine and have osteoarthritis in both knees, what you call bone on bone. Left knee has had both ACL and MCL reconstructions about 35 years ago. Currently the ACL is severed, and the MCL is calcified. Doc won't repair the ligaments, he says I need new knees and pain will tell me when.

In the meantime he prescribed a knee brace that stabilizes and unloads the outer part of my left knee where the cartilage is gone. Not really convinced it does any good, but I use it religiously when engaging in sports, limited primarily to walking while playing golf. I've gone several years longer than he thought I would, and without what I consider a lot of pain. They bark periodically, and Ibuprofen a couple times a week helps quite a bit.

Recently the pain has increased, particularly suddenly in my right knee, as a result of playing in a softball league. My knees simply hate the impact from running. A couple playoff games left and my softball career is over for now. I also need to lose the 25 lbs I picked up over the past 3 years. I lost 44 lbs about 10 years ago and that helped a ton.

I am delaying surgery to not only allow procedures and replacement knees to improve, but also because the younger and more active you are, the greater the possibility you'll wear the replacement out. Very active people can wear a knee out in 12-15 years. Revision surgery for joint replacements is no picnic as success rates drop from the low nineties to about 70%. That assumes you trust their definition of success, and I don't. Revision surgery is much more invasive, they have to cut significantly above the prior graft because the bone is weakened there by your body attacking a foreign body. It doesn't help that you're usually a decade or more older for the revision either.

I'd like to make it to my mid 60's before replacements, but I'll go earlier if I feel my quality of life is being impacted by the pain. It varies, but I usually don't notice it much during the day. It's there if I think about it, but at night that same pain can keep me awake.

One last thing to consider. When you choose a doctor, you are also choosing a knee. Orthopods generally stick to a single brand. They choose that product for many reasons, but keep in mind some of those reasons may be non-medical, or not be aligned with your needs.

I would perhaps also think about replacing the running with a swimming component. Running is incredibly hard on the knees. I used to be a hell of a runner, but that constant pounding has taken it's toll. Swimming is arguably a better workout, yet much lower impact and that would let you maintain your fitness while being a little easier on Brother Ass.

My 74 year old accountant just had a full knee rebuild 3 months ago. He's been a lifetime long distance runner, and was able recently to complete a short exercise run, in addition to now-longer daily walks, with zero pain issues.

He had completed the 100 mile 24 hour run in California numerous times. Lately he was too crippled from bone-on-bone knee to make it out to the mail box without brace & cane.

Several steps:
Steroid injections
Viscosupplementation injections
Total knee
Each step might buy you time.
Some people can get away with a steroid or visco injection every 6 months before finally needing surgery.
You have to balance the consideration that as you age your chances of surgical complications increase and how much you are willing to change activity to minimize pain.
Realistically takes about a full year to maximally recover from total
Knee surgery.

I tore the meniscus in my left knee playing pickup football when I was about 19. Just stupid, playing in street shoes on wet grass. Didn't do anything about it because I hated doctors. Fast forward to about 8 years ago, and my knee had deteriorated due to osteoarthritis to the bone-on-bone condition. I finally went and saw an orthopedic specialist. He said that at some point I'm looking at a total knee replacement. He also said that replacement joints don't last forever, and that the artificial knees available at the time would only last between 10 and 15 years and then have to be replaced again. I was in my early 50's at the time, and couldn't imagine having to go through the surgery and rehab multiple times. So we did a series of injections that helped some, and they fitted me with an aluminum brace that helps a lot. I'm still using that brace, although it's now in need of a new set of velcro straps. At some point I'll go ahead and get the replacement done, but I'm trying to put it off until the longevity of the artificial joint combined with my age and life expectancy will be such that I'll only have to do it once.

My ortho told me in 1995 I was bone-on-bone in one knee and very close to it in the other. I pretty much stopped running then and switched to swimming. Minimized high impact activities and know that some days will be worse than others.

But I've been lucky, no meds and pain is nominal at best.

Consider replacements sooner rather than later, if a specialist recommends replacements.
You will heal quicker and better now as opposed to 15 years from now, along with having 15 years of functioning knees to enjoy. Choose the right equipment and ask about the lifespan of it. On most, wearing them out is less of a concern as they have improved. Compare different models and ask about the revision techniques. How they attach is a factor in that.
If you do manage to live long enough and hard enough to wear them out, good for you!

Luck!

Bruce

There are foods that can prevent and/or slow down bone on bone with bone broth being one. I use Dr. Axe's bone broth:

https://store.draxe.com/products/collagen-protein


https://articles.mercola.com/s...broth-superfood.aspx

I also use the bone broth sold at Walmart:

https://www.walmart.com/ip/2-p...cken-32-oz/916700806

Dr. Randy Peyton is your man.

https://www.arthritisandsports.com/randall-peyton-md

As a person who lived 20 years with bone-on-bone contact bilaterally, don't yutz around trying to be stoic WRT to pain. It doesn't work long-term.