Another Knee issue - Looking for other experience
 

Those who don't know me - I am 44 - 6'3" - 300 Lbs and very active. Wakeboarding is my passion and been riding since 1995 which includes inverts and spins (so not real easy on my joints. I had both knees scoped in '95 and pretty much had left knee pain most of my life.

It has really bothered me last 6 months or so and I can not really do any exercise. Yard work, playing with kids and such leaves me in pain and swelling. Now the pain is riding up into the quad and burning as well. Been to (2) doctors and (2) surgeons in the last month. Did MRI and Xrays and PT. They have had me ton of anti-infalms and than Vicodin for days of bad pain.

The consensus:

The structure and ligaments of the knee are all pretty sound and do not require work.
The issue is the lack of cartilage and bone rubbing on bone in some areas. Also The cartilage that is there is frayed which causing the popping, grinding and inflammation.

There are two options at this point (knee replacement is not an likely option at my age and activity)

1.Get an Synvisc injection to help lubricate the joint. This is kind of like super thick motor oil and just helps the knee moving better. This might help the overall pain, but it is a temporary solution that may last from a month to two years. She said it will likely help, but it may not have any affect. I read lots of mixed reviews.

2. Arthoscopy. Go in there and take out the shreds and lose cartilage and check out everything else to make sure there is nothing that the MRI did not show. It is a out patient surgery like I did in '95. I would be on crutches for about a week and than resume sports in about a month. She believe she can get me in the next two weeks. Once again this is a temporary solution, but should reduce much of the pain and the grinding and such. She though that it would likely buy me about 5 years until I would be in a similar situation. Who knows where medicine might be in 5 more years.

If I do the shots and they only last a month or two, than I am going to be smack in the middle of my summer season. if they buy me 4-6 months than I will be right in the middle of many big plans we have. Possibly that would not happen and it would get me through to winter.

If I do the surgery now, I would be off exercise until roughly middle of may or so. That would give me enough time to get my butt in shape and also be ready for summer and my travels.

So I am leading towards the surgery. I am needing to do some more research of course on both methods and talk to guys that have been through it for sure.

I look to my WW'ers for thoughts or advice. Getting old sux! Oh and save the lose weight you fat ass and stop wakeboarding cause you sound like my doctors :)

What position are your bindings in? Try toeing them out more. I am in a very similar position as you age and history wise. I am almost completely ducked out now and no longer feel any pain in my knees. Are you 300 pounds of pure athlete or are you carrying around a lot of extra weight? If you are over weight then you should really think about losing the pounds, it does nothing but wear on your joints. You will feel and wakeboard better. I know you didn't want to hear that, but tough, deal with it.

I dont think you can go wrong either way. Neither guarantee pain relief.

IMO, if the joint is sound, focus on pain mgmt to get you to winter, and if it still bothers you then try the scope. They can do alot of great things with the lube and some cort shots.

The fact is, they are all temporary solutions for those who are that active in our demographic. It is my experience that the biggest problem for guys like us (Im 6'6" 230lbs 39yrs old) is strength around the joint. Basically our joints take alot of the hit because we arent as strong as we used to be even though we dont necessarily feel weaker. We subtly allow our body weight to push against the limit of the joint, rather than the muscles hold.

If it were me, I would get the lube and cort, and start strengthening the structure around that joint.

Oh man, we are in exactly the same position. I have been fighting with my right knee and pain for many years. I had a wreck riding MX last June that really aggravated it. I had my ACL reconstruct in 1991 and it is still tight but I have massive arthritis issues. At 41 they say I am too young for a TKR so I have been trying to buy 5-10 years. I tried Synvisc a couple years ago and it helped a little but not as much as i had hoped. Wednesday I had scoped and had it flexed to break the scar tissue to help get my full ROM back (hopefully) I am walking pretty good today and will be back in physical therapy next week as that was helping a bunch prior to the surgery. I'll keep you posted or feel free to email me at gmrebholz@gmail.com............Giles

Ice skate ... a lot ... and get to where you can skate crossover on the turns. It is miraculous knee therapy.

If you read where skating is hard on knees of figure skaters, well, they're doing twisting landings from jumps, which you won't. I had my cartilage taken out of my right knee at 15 (wrestling injury). I've known of some people claiming to get good results from cycling. But I think the movement is too constrained. Ice skating will also wake up the inner ear in your inner ankle (ie., improve your over all balance).

Jason - Search out Dr. Kenneth Venos; he has offices in Pleasanton and San Ramon. Just as you describe in #2, I had my right knee done in 1995; remove foreign bodies under knee cap, filed meniscus horns flat, general scope stuff. Rehab was several weeks with full recovery. I have little pain anymore and some swelling after big activities, but no real pain. This is 15+ years post surgery, so I say if it is done right, you will get much more than 5 years of pain free service out of your monkey knuckles. Best of luck,
Mike

Sounds like it may be time to start surfing...

But anyways my advice would be NOT to do surgery if you don't have to. Anytime surgery can be avoided, avoid it. Try the shot/shots though the summer before deciding on further action. I won't get All science-y (I'm a senior pre med student) on you but joints, synovial fluid, cartilage and bone can be troublesome.

It's your body and always make the decision that you feel is correct but I would personally hold off a bit.

My wife was having bad pain issues with her knee. They thought she had some torn cartilage. They ended up going in and the cartilage was fine and everything was strong and intact but they found she had thickened ligaments in part of her knee. They ended up scraping that down. She went to her PT which broke down scar tissue and her knee is great now. Big thing was the PT afterward. They had to yank her leg because it was starting to scar after surgery and would have limited her mobility.

IMO the best thing you can do for your knee joints is to loose weight. I'm not saying you are a fatty or whatever but 300 pounds is a lot and the reality is that much mass causes a lot of stress and as you age your joints resist it less well. Its also a lot better for your heart as you age. Again it doesn't matter if its 300 pounds of muscle or 300 pounds of blubber, mass is mass. JMO.