Osteoarthritis of the knees, – any tips?

Hi all, thanks again for your experiences and responses to this – most appreciated! Here’s to some better knees all round..

For anyone who is interested, I met with a reputable knee consultant yesterday and I think this (IMO) highlights why scans can be important for accurate diagnosis.

Just to reiterate up to now I have had: 2 x GP appointments, 2 x MSKs look at the knee and 3 different physios (multiple sessions & programmes with each).

The consultant identified that I have Patella Alta, which is a high positioned patella. Due to this position of the patella it causes irritation, inflammation and pain behind on the femur. I also have a minor split in the knee cap itself (on the edge) but this doesn’t cause any issue.

The good news is that this can be corrected surgically (tibial tubercle osteotomy), and the minor split also can be repaired at the same time. It would be a long lay off (6-8 weeks), but the advice is to get it done when young (er) when recovery is quicker.

Osteoarthritis wasn’t mentioned either, in fact he said the cartilage was almost perfect! odd hey…

So cumulative cost, time, visits, programmes, etc Vs one appointment with an expert and there I have it, an actual course (should I proceed) of action to rectify it. FWIW, he said if I was a fell runner (I don’t run, but walk a fair bit, inc in the hils) I would have been there meeting him years ago…

Cheers all!

Well that’s slightly better news.  Though an op is still an op and a couple of months recovery, it’s hopefully less dramatic than a replacement.

Hoping to hear about my knee x-rays this week from the GP. It’s essentially no better, and despite paracetamol, naproxen and rest keeping me awake at night. Being on my feet enough to someone upper body stuff at the gym leaves it needing some time to decompress.

Well I saw the consultant yesterday to go over my MRI results and, as expected, the options are partial knee replacement or osteotomy. Basically, I only have cartilage in one half of the knee joint and the other half is f_____d. Eventually I will need a full knee replacement, the partial/osteotomy both only having a lifespan of ten years max apparently.

So, I need to decide what to do, whether to eek it out another few years with exercises and painkillers or bite the bullet.

Honestly, I’m really, really f____d off with the whole thing. I’ve had a shit knee since before I even got into my twenties, thanks to an over zealous surgeon, and now it’s officially shagged. I can look forward to welcoming in my retirement with a f____g knee replacement. Great.

IHN, my right partial knee replacement will be 6 years old this summer and I’ve not regretted it one bit. It also straightened out that leg as it had become bowed with the collapse of the inner knee cartilage.

I can’t remember if I was told a specific lifespan of it, but I know from my wife who’s an OT that knees and hips are regularly lasting well in advance of the  10 years you stated, and they’ll be ones that were put in a long time ago.

@longdog – best of luck with the xray results. At least then you’ll get a better idea of what is happening (if you don’t already).

When I got into a bit of a downward spiral about TKR I read this.. Very positive stuff:

https://trainright.com/knee-replacement-training-plan-return-to-cycling/

Thanks for all the replies too. Just on a personal note when my knee has got me down I found swimming (front crawl mainly) was a joy to turn to (in fact 8 months ago I could barely manage a length, now am at ease swimming for 30/40mins without stopping) – a very physical movement but without the worry of thinking about knees, or am I damaging them, etc. Nice and supported in the water too.

Definitely recommend if you’ve a pool nearby.

Good luck to all those deciding on any next steps and what to do. If anything I’ve learned in this that persistence is key, even if that means a bit of ££ for some private opinion – after all these can them be used in conversations with your GP/others

Okay, I’ve calmed down from my hissy fit now. Thanks both for the stuff you posted, it’s helped to assuage my fears/gripes about the surgery.

@longdog – you mentioned previously about prehab and rehab exercises that you did, could you give a bit more detail please?

Pre-hab/re-hab…. It depends on your personal situation and GP/consultant advice, IANAD, but this was me…

Pre-hab…

I tried to keep as active as I could, mainly road/gravel cycling as that was largely fine, especially when I’d had cortisone injections, but I put low gearing on my bikes to allow spinning up hills.

Walking, which unfortunately was a major part of my job, was not at all good, tbh standing was no fun. I really struggled and was in a lot of pain from it and spent most time when i wasn’t working with legs upon the sofa, cushion under my knee.

I did daily stretching of hams, quads and hips, as well as sitting in a squat from time to time. I never had a range of motion issues, it just bloody hurt.

I did wall sits, but also went to the gym to do leg presses, leg extensions and ham curls. Not heavy weights but emphasising a slow  eccentric.  Bar squats were just  too painful, but leg presses were ok.

I just tried to strengthen and keep flexible all my legs as I was having to spend most of my time off my feet.

Rehab…

You get a book of standard physio exercises to regain ROM after the op.  Foot pumps, knee bends, leg extensions and raises to get the quads working again and the joint moving. I did these like a full time job, taking my pain meds as instructed to allow me to get knee bend and straightening back despite the pain/discomfort. Getting the bend and straightening the leg is very important. I also got my wife massage my quad as it was totally switched off and knotted up from the op.

Once things had settled enough to hobble to the shed  I used the turbo trainer with my seat set higher than usual to just get my knee to turn over on the pedals. I found pedalling backwards easiest at first, though it was very slow and not fun at the top of the stroke, but it eased off the joint and helped the ROM. Eventually I started pedalling forwards with very little load and then built up from there. It was quite e a while before I could stand up on the pedals and a good bit longer before I could stand and pedal.

I think by the end of the first week I was managing short walks out side the house with sticks and built that up over time to places I could sit, or get a cafe and then walk back.

Basically do my physio exercises, short walks, then rest and ice and repeat…

Further down the road I started doing the wall sits again and slant board body weight squats, and single leg balances,  and had some sport physio massage.

I did over do it as I was too keen, so go carefully.

I tried swimming which was fine front crawl until I pushed off the wall too hard and had a massive flare up of my knee which was scary, but I’ll settled , but delayed my return to work another month. I actually found swimming tricky for a while as you don’t realise the water pressure that your fighting against when moving about in the water, but my knee let me know.

All the best.

Knee x-rays back and show OA on my left knee, but no details from receptionist. I’ll see if I can get in to see GP tomorrow and see what options are, even if just injection in the short term.

Sods law I could have got to see the GP today, even in 10mins! But I can’t get there with my knee as it is and no car 🙄

MrsLD is WFH tomorrow, so I can have the car. So it’s redial fun from 8am for me 🤣  I think my record is 116 redials before I got through, no guarantee of and appointment though….

Duplicate post…

Having a nightmare with this site the last two days

I’ve just started knee physio with NHS. The just given expected exercises and given a **** walking stick. Confirmed as moderate medial OA, all the ligaments are fine.

Also just carrying on with the naproxen and paracetamol. Ultrasound helps a bit. Creams have done nothing. I did get a steroid injection at the GP, but it only lasted around 3 weeks.

Currently waiting to see orthopedics after getting re-referred in June. My wrist orthopedic guy told me the other day his waiting list is about 9 months :s