why do they insist on a knee replacement without trying to repair it first?

seeing an orthopaedic specialist in Jan about constant knee pain, i know exactly what he is going to say ,i need a replacement.

i want to know ,as i have been told, why they no longer go in and repair it first ,i don't think i need a replacement as it is ok when i don't have a flare up, i have the fluid removed often and a steroid injection which really helps. i am self employed and the type of work i do a replacement will finish my working life and probably me.

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  • Can you just say this exactly as you have said it to us to the orthopaedic surgeon? I can't answer but I imagine, as with so many things nowadays, its often cheaper and easier to replace than to try and fix. And if its going to affect your work and life so adversely I think its very important that you make this clear to all involved in your medical treatment. Good luck. Tilda

  • Can only echo what tilda says, it's your knee! I know people whose knee replacements have been a godsend & have heard about those who regret it so seems to be luck of the draw. I think this is on the cards for me too aat some point but the way I feel at the moment the doc will have to present me with a damn good argument for me to agree to it.

    Something I wonder about is whether it is harder to recover from joint operations when you have a disease that attacks the joints! If it's osteoarthritis and only osteoarthritis that has caused the problem then that's possibly a different matter??

    You know these consultants sometimes seem to be more proactive towards younger patients or those who are breadwinners etc. (not all, of course) but at least it shows they are capable of taking account of the whole person and their particular needs not just their bony bits. So definitely feel justified in explaining your circumstances very thoroughly to your doc.

    Luce x

  • It is your knee & you know how it is. It sounds as though you are able to cope with it for most of the time.

    I had a knee replacement a few years a go - it got rid of most of the pain however it does still hurt & that is probably due to the inflammatory aspect of the disease. The new joint will still have the cartilage & capsule around it which is the bit that causes the fluid so you will still get inflammation & fluid.

    It also depends on whether your damaged knee has "bone on bone" which will cause pain.

    My other knee is now damaged & will need replacing in the future but I will put it off for as long as I can. I've had an arthroscopy on it which showed what was damaged but it hasn't resolved the pain or swelling even though he repaired damaged cartilage.

    You need to talk to the orthopod AND your rheumy drs to find out.

    I had my first replacement when I was 56 so quite young but I did have bone on bone in 3 places.

    Good luck!

  • ii wish they would do a replacement on mine i,ve had 2 clean outs on my right one and it still locks and is painful, you should be ok after replacement work wise as they have good success rates xx

  • Its definitely your choice, but I'm a bit puzzled as to why you think that a knee replacement will stop you working? Most folk I know who have had knee replacements have been able to do far more than before, and they have been highly successful.

    But, if it isn't something that is a problem all the time, I can't quite understand why you are being offered a replacement anyway?

    Seems like you might need to do some more talking with your surgeon, and ask exactly why they want to do the replacement, why they don't think other treatment will work, and what the likelihood of success in your case is. Just bear in mind though that a surgeon's job is surgery - so that is what they are most likely to recommend. You might also want to get a second opinion from a rheumatologist (whose job isn't surgery).

  • It might help if you listed out all your questions before you see the surgeon so you know what the most important questions are that you need answered. There are quite a few options for knees, depending on what the problem is and it may be that you only need a partial replacement not a complete one anyway. I agree with earthwitch that surgeons tend to think of surgical solutions first, but full knee replacements are one of the ops that are often on the low priority list for many NHS trusts so it may not be as automatic a response as you fear. Polly

  • Thank you all so m,uch for your help and replies i will have a talk with my ra specialist and surgeon ,i work in the forestry industry and having a knee replacement would effectively be the end of that.

  • Okay, just thinking that if you currently undertake your presumably very physical work without too much pain or difficulty then it does seem that there is not pressing need for surgery. And also wondering whether you might be able to adjust the tasks you undertake just enough to keep working at it longer by putting fewer demands on the knees? Eg employing someone else to do certain jobs?

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