Hi need advice

[gcoe]

Hi wrg1405

This is a normal later sequel to the injuries and subsequent surgery you had - and 20 years ago the surgery was not as good as now. You are too young for joint replacements and anyway from what you describe your symptoms would be too mild to even get a look in.

Personally I don't think a knee brace would do a lot for your knees - some patients swear by them but that might be more a placebo effect. A brace aims to either a) reduce instability or b) control the amount of normal excursion your knee moves through The former is probably unrealistic - an external knee brace is too puny to control such forces; the later is not what you need and in the long term would do more harm than good.

However there is a lot of negativity about osteo-arthritis which is a pity. In fact OA is basically a remodelling disease rather than a primarily a degenerative disease. It is probably the abnormal forces exerted on the joints over a very extended period of time that leads to abnormal remodelling of the joints and on to a cascade of joint changes that are causing the problems you are having. A course of active physiotherapy to rehabilitate the knee can improve the protection to the joint that the muscles around the knee should provide and exert more beneficial remodelling forces on the knee than your knees currently receive. Such beneficial remodelling actually reverses the OA process to some extent, provided the disease isn't too advanced. Even in advanced cases there can be some benefit. Such a course of physiotherapy should include a controlled programme of progressive resistance training (weights), exercises to improve the function of the muscles that stabilise the knee and graded increase in demanding activities on the knee (eg improving tolerance to walking then maybe jogging) There is evidence that such programmes really do help both pain and function. Sometimes the addition of manual therapy (joint mobilisation by the therapist) can also be good but shouldn't be done without including rehabilitative exercise. One final component to consider: are you overweight? - great if you are not but even carrying a bit more weight than you should be greatly increases the damaging forces exerted on the knee when you walk. so your programme should include strategies to reduce weight that is a problem.

I suggest you find a good orthopaedic physio who can devise a gym based program for you. It won't change overnight - takes time and discipline - but give it a go. It could keep you fit and on your feet, thereby promoting good future health!

[wrg1405]

gcoe

Many thanks for taking the time to reply. I do not think I am overweight. I am 5ft 8 and weigh approx 10st 10lbs. You describe my symptoms as being mild I would hate to see what non mild symptoms are like. After plyaing golf I can barely walk, I cannot straighten my legs and the pain lasts for a couple of days. After my first 2 knee reconstruction operations I did undertake the programme you described but after a couple of years in which I had 5 cartliadge op's and another reconstruction op I more or less gave up. The fear for me is going through that again. All this just to spend 4 or so hours hitting a white hard ball and spending most of my time in the woods looking for. Once again many thanks for your input I really do appreciate it.

Bill

[gcoe]

Hi Bill

Sorry if I sounded like I was triviallising your symptoms. I didn't mean to. It is just that to meet the requirements for Total knee replacements you have to be pretty highly disabled. And as you are 42 surgery would be something to try to avoid for a good long while

[wrg1405]

Did I say I was 42? Oh dear ageing myself early. I am 42 in May. Did not mean to make you think that I thought you were trivialising my condition as I know you were not and as stated much appreciative for your input. The surgeon who operated did state at sometime I would need to have my knees replaced. This was after my 3rd ligament recon op. I have had 2 Anterior/Posterior Ligament repairs on my left knee (and this is the one that is really giving me trouble). This is why I am reluctant to go to the Doc's just incase they say its time to do something. Have a great day