knee replacement surgery

[Clhammy]

I used to run and hike a lot before my PC diagnosis in 2011. I am bone on bone and considering knee replacement to get back to somewhat of a normal life. I am very active with my work but it becoming harder to function. I had been on lupron but now use orgovyx to control my PC. My question is are there negative side effects that I should be concerned about? Also my PC has not been detected on scans. Thanks

[London441]

ADT (including Lupron and Orgovyx) waste muscle from the testosterone suppression. Returning to hiking is great and reasonable, but you will want to strengthen your lower half as much as possible through resistance training.

The stronger you are, the less wear on the new knee, and the less need for a revision later on, which you don’t want.

If you’ve already been on ADT for some time you have undoubtedly experienced some accelerated muscle loss.

Your running days are probably over, but that risk is up to you. The combination of ADT and a knee replacement will be challenging to recover fully from, and needs to be managed wisely.

[leebeth]

My brother, now 81, has had Stage IV PC for 14 years. He has had both hips replaced while on ADT, one in 2014 and one in 2019. He did great; very smooth recovery, even when he was 78. His oncologist referred him to an orthopedist who has a sub specialty in orthopedic oncology.

[Quambygreg]

Hi Clhammy, I had a full knee replacement 12 months after Prostrate surgery and 6 months after radiation still on ADT. My knee is reasonable, the pain I had previous to surgery has disappeared. I have maintained my gym work 2 days a week to try and maintain muscle. Sadly I still can not run as I would like to but I would say the operation was a success.Happy to chat further if necessary.

Greg

[MateoBeach]

Testosterone powerfully supports healing and restoring bone, nerve and muscle. If you have been stable on your Orgovyx for some time, perhaps you could discuss an ADT vacation, and even short term SPT (high testosterone as used in BAT) to support healing and recovery from knee replacement.I needed spine decompression surgery in 2020. First one failed, but second was very successful when I added testosterone replacement to support healing. Worth considering.

[lewicki in reply to MateoBeach]

That is very interesting. Great.

[Hidden]

You know the answer lies with your Orthopedic Surgeon and your Medical Omcologist...... however, since you asked; started Lupron in May 2004. Had a total knee replacement in 2009. Zero problems. Best est thing I ever did as the constant bone to bone pain was gone. Good luck.

GD

[Clhammy in reply to Hidden]

Thanks you for the information. I have talked to both of my physicians and they say that I will be ok.

[RCOG2000]

Dr Kevin Stone. In San francisco bay area has a blog you can access if you google Stone Clinic where he goes into great detail with regard to knee replacement types procedures and decision making. Also has a book out on Amazon for those desiring continuation of active lifestyle post surgery

I just had a hip replaced locally ( Arizona) ten days ago. On Bicalutemide.for six months prior but without lupron or other meds No problems thus far and surgeon noted good bone quality.

[billyboy3]

Go for the replacement! It will give you freedom back !! You will not be able to run again but you will be more stable and pain free!! Good luck

[Teacherdude72]

I had both knee replaced while on Lupron for my G9 ogolio pca. No issues or problems. Last was done 4 yrs ago.

[Clhammy]

Thanks for all the positive info about knee replacement. 🙂

[Pwjpp55]

I'm 67 and been fighting PC for 11 years. I now have 5 successful joint replacements! I had 4 of them while I was on ADT and Zytiga. Get it done! Don't wait! But be certain to pick a good surgeon!

[jfoesq]

Had my knee replaced about 4 years after starting ADT. My MO had no problems with me having the surgery nor did the orthopedic surgeon. My result has been just OK- could’ve been better- could’ve been worse, but I don’t think ADT had anything- or anything much to do with that. Perhaps the muscle loss made things a bit more difficult but overallI think the impact of the ADT was minimal to none at all.

[FRTHBST]

You might look into stem cell treatments. I talked to a guy on a ski lift last winter who said that it worked wonders for his knee- without it he wouldn't have been able to ski. He did say it was expensive and not covered by insurance. Needless to say $$'s were not his limiting factor, he was on his second treatment the first lasted about 4 years. He was only in his '50's, said that he had developed arthritis as a result of a car accident decades ago.