Knee cartilage - what's my outlook?

[JR 137]

I often wonder why, in 2019 there aren't sythetic substitutes for these situations- nylon discs for spines, a gel type lubricant for hips/knees/rotator cuffs.

Knee, shoulder and hip replacements work quite well. The artificial surfaces are Teflon. Like everything, they wear out because the body has no way of healing the artificial surfaces.

The replacement parts aren’t the problem; the recovery from surgery is long and not fun.

I’ve heard they’re working on 3D printed hip, knee and shoulder replacement parts. That’ll revolutionize the surgery because it’s allegedly minimally invasive. The current surgeries are quite traumatic. I’ve sat in on a few. Picture sawzalls, drills and brass hammers. Seriously. They have to wear face shields and nurses have to wipe them off from all the “sawdust” aka bone fragments flying around.

 

[Dirty Dog]

Knee, shoulder and hip replacements work quite well. The artificial surfaces are Teflon. Like everything, they wear out because the body has no way of healing the artificial surfaces.

The replacement parts aren’t the problem; the recovery from surgery is long and not fun.

I’ve heard they’re working on 3D printed hip, knee and shoulder replacement parts. That’ll revolutionize the surgery because it’s allegedly minimally invasive. The current surgeries are quite traumatic. I’ve sat in on a few. Picture sawzalls, drills and brass hammers. Seriously. They have to wear face shields and nurses have to wipe them off from all the “sawdust” aka bone fragments flying around.

There are reasons why the archetype orthopedist looks like a linebacker. Ortho surgery is... brutal...

 

[JR 137]

There are reasons why the archetype orthopedist looks like a linebacker. Ortho surgery is... brutal...

A lot of them played sports before med school as well.

After sitting in on my first surgery, the ortho asked me what I thought. I jokingly told him I lost some respect for ortho surgeons because it reminded me more of what my father does (mechanic) than what I thought surgeons do. He laughed and said “I’m pretty much a carpenter, not a mechanic.” That was pretty accurate.

 

[dvcochran]

A lot of them played sports before med school as well.

After sitting in on my first surgery, the ortho asked me what I thought. I jokingly told him I lost some respect for ortho surgeons because it reminded me more of what my father does (mechanic) than what I thought surgeons do. He laughed and said “I’m pretty much a carpenter, not a mechanic.” That was pretty accurate.

I am scheduled for knee replacements in soon. The recent comments have me wondering.

 

[Orion Nebula]

I’ve used the kinesio tape on athletes for patellar femoral syndrome too. Works very well. It’s a bit tricky to get it right, but even trickier to get it to stay on. You can try the spray skin glue (Tuff Skin by I think Cramer is what I used). Just a quick and a bit distant shot of it over the area. Definitely don’t saturate your knee like spray paint. It’s a pain in the a$$ if you’re not used to using it. If you use it, don’t rip the tape off like a band-aid; your skin will come off with it. I’ve seen it done by many a rookie. Roll the tape off, preferably in the shower.
Just a thought.

Ah, so that's what the spray was in a few videos. Honestly, taking just the tape off by itself is exceptionally painful if I rip it off. I found a really sticky brand on Amazon that will stay for a few days if I get it on right. I can only imagine it with the spray adhesive.

I tried taping again last night, but used a longer piece. It definitely worked a lot better, and my knees were very happy with me. It also occured to me that I've been slacking off on my quad and IT band rolling. I spent a good hour on Tuesday with a rolling pin working out all the tight spots... it continues to amaze me how massaging those areas can relieve a lot of pain and stiffness in my knees.

I am scheduled for knee replacements in soon. The recent comments have me wondering.

My mom had both her knees replaced several years ago and recently her hip as well. The incisions for the knees were about what I would expect, but I was really surprised by the how small the incision for the hip was. It can't be much more than 3 inches, and they managed to use that tiny hole to cut off the end of the femur, hammer in a new ball, and line the socket.

 

[JR 137]

I am scheduled for knee replacements in soon. The recent comments have me wondering.

You won’t see any of that stuff. You’ll be out

 

[JowGaWolf]

Knee, shoulder and hip replacements work quite well. The artificial surfaces are Teflon. Like everything, they wear out because the body has no way of healing the artificial surfaces.

Hopefully stem cell research will fix this. If things in the medical field advance like the computer field then many of us will see it in our life time as the norm. Repairing with something that can repair itself and maintain itself is definitely a better option than removing it and placing artificial parts.
Novel stem cell therapy for repair of knee cartilage - Mayo Clinic

The same is being done with hip replacement. While it's still new, it seems like a option with potential especially as stem cell research is improving.
Stem Cells Get Hip

 

[dvcochran]

You won’t see any of that stuff. You’ll be out

I suppose not but I am scared as hell that I will feel it.
Seriously though, I am more concerned with the rehab than the actual surgery.

 

[Xue Sheng]

I suppose not but I am scared as hell that I will feel it.
Seriously though, I am more concerned with the rehab than the actual surgery.

Coworker going through that right now. Not going to sugar coat it, lots of swelling and pain afterwards, but he had medication to deal with the pain. He thought he'd be back to work in a week, I doubted that, I had arthroscopic surgery and came back in a week and I now know I should have taken two. He is looking at 3 weeks, at least, until the Doc says he can return, and that all depends on the Physical Therapist reports. However he is rather happy he had it done, no more constant knee pain, like he had prior to surgery.

A good friend of mine, who was a pro-soccer player, had both knees done a few years back and he is absolutely thrilled he did it. He can walk normal, which he could not do before. He is able to sleep, which he could not do before due to knee pain.

And neither of them felt the surgery at all.

When I had the arthroscopic surgery, when I came to in the recovery room, I asked them when were they going to start. I was told; "Its already done". So I felt absolutely nothing.

 

[Orion Nebula]

Following up on this!

I've had a really lousy time since around US Thanksgiving (end of November). My knee swelled up so much that I could barely bend it or even fully extend it. Plus there was some pain putting weight on it (and occasionally lots of pain), making walking difficult. I even couldn't do a lot of my physical therapy exercises. So that definitely took me out of the dojo, and I actually haven't been doing a whole lot since then, and my knee has significantly improved, although it's certainly not perfect. We also got all of the paperwork in order for the MRI and the insurance company approved it.

I did the MRI this past weekend and we went over the images today. No meniscus tear or injured ligaments, not that we were expecting any. As @JR 137 suggested, there is some degraded cartilage on the underside of the kneecap. There was also some mild bursitis, which makes sense to me given that I had a bout of bursitis back in June. However, the big surprise was that I have arthritis in my knee. My x-rays showed the beginnings of bone spurs, but not really anything that should be affecting me yet. However, the MRI showed some significant degradation on the inner half of the knee. It's not worn down so that there's bone on bone contact, but it's apparently enough to cause inflammation and pain.

The doc was actually pretty thrilled with the results since there's no surgery required, but I almost feel like an injury would have been preferable since you can fix that. Arthritis is kind of forever. The next step recommended is an unloader brace to take off pressure from the inner knee when I'm active. Unfortunately, this is another game with the insurance company. The guy who is taking care of running the insurance authorization and doing the actual measurements and ordering warned me that my insurance company doesn't have a good record for this, and another grad student actually had a lot of trouble getting the insurance company to pay for their brace. But we'll see how it goes.

I'm continuing the CH alpha supplement. Not sure if it's helping or not. My knee certainly feels better than it did two months ago, but I also spent the past month doing zero karate and nothing that would irritate my knee. My sister recommended Ostarplex, as it significantly helped her arthritis. It's a bit cheaper than CH alpha, but I can't find a ton of information on it. She also has a very different type of arthritis (psoriatic). I'm hesitant to try both at the same time (how do you figure out which one works?), plus that's even more money spent each month. Guess I'll probably stick with the CH alpha for now since it's recommended by my doc. Although my mom decided to try the Ostarplex, too, so if she has good results, then maybe that's a good sign that it would be helpful for me. Speaking of Mom, this arthritis is a gift from her. Her knees deteriorated in the same way. Guess my hips are next, too.

The doc also suggested that I give up karate. Specifically, he said that stomping around during karate will irritate my knee, even with the brace on. I suppose he doesn't know a lot about karate - I wouldn't call it a stomping art. Although I am guilty of stomping around quite often, which my instructor continuously tells me not to do (and since having knee problems, has pointed out that it's going to cause more knee issues). It has been getting better over time. Anyone have any thoughts on that? There are a bunch of old guys in our organization who still train with arthritis and various joint replacements, but they've also been doing this for decades and probably aren't inclined to switch to something gentler on the joints. Should I really think about calling it quits and find an art that's a bit lower impact on the knees? There's not an incredible amount of different martial arts in my immediate area. Mostly Kenpo, Taekwondo, and BJJ. I doubt the Kenpo would be dramatically different in terms of impact level, Taekwondo is a no, but perhaps the BJJ would be kinder. There's also a Pukulan school, but I don't know much about that art. There's a Danzan Ryu place about 35 minutes away, but I'm not sure I really want to go that far, especially since traffic can easily increase that to 45 minutes or longer.