What to do for the best?

[Maggsie]

I've had RA for 35 years, the last 2 years has been uncontrolled and has caused secondary OA in knees, feet, wrists etc. I saw the knee surgeon last March and put on the list for a replacement. In June I was started on Truxima. It wasn't a great success but I agreed with my consultant that we'd try for another round before trying something else.

Letter arrived yesterday confirming the dates for my next 2 infusions in Feb/March and then, bugger me, letter arrived today for my knee pre-op on 29th Jan!

My dilemma is.... do I put off the truxima infusions and go for the op or stick with the infusions and put back the op. I'm leaning toward having the infusions and trying to get the RA back under control so that at least the rest of my joints might be in better shape post op, otherwise I won't be able to have my next infusions until June (need to be at least 3 month gap between infusions and surgery).

Any insight would be appreciated.

[Hidden]

Which is the most painful, the OA or the RA? You have to decide what is more important to you, there are no guarantees on Truxima working and meanwhile the OA will only get worse. Even if Truxima does work, it won't control the OA. I can only speak for myself. RA for 32 years hip OA for5 . I can say my choice would be surgery first, then Truxima later. But this decision must be yours of course.

[Maggsie in reply to Hidden]

Thanks. I'm getting by with a steroid into my knee every 3 months but know I would have to give that up 3 months before op. I could possibly have a couple of depo injections to get me through to June.

Other complications are that I would struggle on crutches in the winter months. It's quite rural and I have to manage open fires, steps and steep hills

[Pippy25]

What a dilema for you. I too have both RD and OA, but medication wise don't have this situation to contend with. What about spending a quiet moment with a bit of paper and write down what you feel the pro's and con's are for having the surgery or taking the Truxima. I know it sounds old fashioned but it may just help in making a decision seeing it visually on paper. Only you can make that choice and there is no right or wrong. Sending my best wishes to you,

[helixhelix]

My BIL had pre-op for his knee at the beginning of november. The actual operation probably won’t be until February! Go to the pre-op and say you can't have op until June and see what they say. A bit wicked perhaps, but if you cancel pre-op you might be waiting another 6 months to get a new appointment for a pre-op and another couple of months for the op.

[Maggsie in reply to helixhelix]

What a great idea! You're right, if I put off the pre-op I might not get another one when I want one.

[CarolyneJA]

Are you bone on bone re knees? Has the surgeon expressed any concern re healing post op due to RA? Similar boat here in Canada, watching this post. ☺️

[Maggsie in reply to CarolyneJA]

Bone on bone in right knee, not quite so bad in left. Most other joints are painful, especially right wrist (seeing the hand surgeon in early Feb). I'm 99% sure that I'm going to the pre-op but sticking out for a June op., otherwise I'll just be chasing one bad joint after another. Just hoping the Rtx starts working after the next infusion. I'll keep you informed.

[Hidden]

I agree with Helix that you should go for your pre-op as it may be a long time after that that the operation is confirmed and you can tell the nurse doing the pre-op about the timing etc.

I had a similar thing happen to me last year and was so glad I went for the pre-op etc as I went for that in August, but the op wasn't until November, by which time I needed to have another pre-op. I also have both RA and OA and it is very difficult to know which one is causing pain and so on isn't it. I hope all goes well for you.

[Maggsie in reply to Hidden]

Thanks, I'm 99% sure now that I'm going for the pre-op and going for a June op. Here's hoping that things go to plan

[NicolaP]

I had my pre-op for TKR yesterday as OP date is currently 1 April but could be brought forward if a cancellation occurs. I'm pretty sure it said the pre-op has to be done at most 12 weeks before the OP.