Knee Replacement at 50

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Susan is a really lovely 50-year old lady who was very unlucky and had a nasty road traffic accident aged 19 - so back in 1986 - fracturing both femurs, her pelvis, her back and a dislocation of her left hip.

She soldiered on for many years but in the end the hip became so severely arthritic and painful that she underwent a total hip replacement on the left side in 2006 and had a very good result from this.

The right knee had always been a problem following the accident but she slowly got to the point where she could only walk for 10 minutes before she had to take a break because of pain, swelling and instability, and she had significant night symptoms. This deterioration took place over a ten-year period. 

On examination she had a very arthritic right knee with significant varus and a fixed flexion of 15 degrees as well as limited flexion. The X-rays were very impressive.

The only real option here was a total knee replacement.

Knee replacement in the younger patient

These are not entered into lightly in individuals as young as Susan but they do show that in a young individual it is possible to get an excellent result to the point that people do feel that they have got their lives back - which is where Susan feels she is today. One year out she is measuring her steps every day and is comfortably walking 10,000 steps on a daily basis and climbs steps without any issue. She says her life has been pretty much on hold for ten years and was quite emotional about the fact that she is now doing so well. I am delighted that she has got such an excellent result from a total knee replacement - although as I say we need to be cautious about carrying out joint replacement in young individuals it can be life-changing.

Testimonial from Sue - 

I had a very bad car accident when I was 19 years old (1985), breaking multiple bones etc. One of which was an undisplaced fracture or my right tibial condyle (which wasn’t found until a couple of weeks after the accident – the other breaks – spine, both legs, pelvis and left arm were more serious so they didn’t bother x-raying further down my body at that time). Once I’d learnt to walk again the knee didn’t give me any trouble although there was a section of it that I couldn’t feel, but in the scheme of things it was a very minor break. Then approximately 4-5 years ago walking started to become a problem. It started just being an annoyance, which I just accepted, then I started not doing things, eg not going out for walks, not going out for a day of clothes shopping, chaging where I parked the car (so I didn’t have to walk up a small hill). When I realised there was a problem my GP arranged and x-ray which showed that I had bone rubbing against bone and osteoarthritis of the knee.

I actually researched Professor Wilson online as the original surgeon I was interested in had just retired. I wanted someone who only did knees so they saw lots of knee issues and were an expert in their field. I liked what I found online and when I met him I liked him too – he looked at other less invasive options – injections etc prior to just going for surgery.

I had very little in the way of expectations. I could hardly walk (maybe 100 metres max), couldn’t do stairs and found hills very difficult, I was just existing as every step was painful – even with prescription drugs. I was hoping for an osteotomy but in the end that wasn’t an option so I had to have a total knee replacement. I hoped that after the surgery I would be able to walk without pain, I wasn’t looking to be able to walk miles just to be able to carry on living.


My expectations have been exceeded. Within 6 weeks I was off regular pain medication, only took the occassional paracetamol when I did physio. A year following surgery I take no pain medication whatsoever. I now regularly walk over 10,000 steps per day, I do a 55-58 minute walk Monday – Friday and a 1 ½ hour walk on most Saturday’s and Sunday’s. I never believed I’d ever be able to do this following the surgery.

For others with similar problems I would advise - "Talk to a professional – I thought that I was far too young for the surgery (49 at the time), I am not the average age for a total knee replacement but hopefully this knee will last me 15 years and it’s totally changed my life." Prior to the surgery I just existed, the surgery has given me my life back. Do the exercises they recommend prior to surgery, do the exercises post surgery, even if you don’t think they are doing any good. The Game Ready ice machine was wonderful for swelling (once I got used to the freezing cold). For a couple of weeks I thought I’d never get my knee to bend more than 15 degrees, I kept perservering with the exercises and at my last physio appointment I got 122 degress bend. Professor Wilson only managed to get 115 degrees under anaestetic. I also made a record of my achievements so when I was having a bad day I looked back at what I was doing a couple of weeks ago and what I was doing at that time so I could see that I was getting better.

Professor Wilson didn’t straight away push for knee replacement he looked to see what he could do that was less invasive although in my case a total knee replacement was the only option. He explained all the options and outcomes and answered all my questions. I was in some pain following the surgery but that was managed very well. I took his advice and hired the ice machine which reduced swelling and pain. Initially I thought I’d never be able to walk properly but I did my exercises and little by little it worked, the knee bent and I’ve now got my life back. As I wanted to get back to a full life it was hard but the effort has really paid off.


Professor Wilson had done his bit successfully (the operation) – now it was down to me to put in the hard work to get the results. If I need another knee replacement which I’m likely to due to my age the only person I’d consider would be Professor Wilson, hopefully he’ll still be operating!"

Sue

Patient