I’m looking at having a knee replacement this Fall. My docs have asked why now, the knee has been “terrible” for years, “bone in bone, not bone on bone” was the quote. My reason is simple, I can’t ride. I sustained an injury to the other knee which has impacted the worse one by making it VERY painful to ride. I’m not going to the Olympics or anything but my aspiration for the Summer was to get back to the A/A’s. Long story short, I’ve tried many treatments with little positive effect and it’s making my riding sub par and my poor, forgiving horse uncomfortable and crooked. I am on 200 Mg Celebrex twice daily, have tried CBD (both on and in me), multiple topicals, including human form of Surpass and a BOT knee wrap . Looking for any suggestions that might help me to ride this Summer and not break my horse!
I’ve not had a knee replacement so not speaking from that experience but I have had major orthopedic surgery.
IMO, having a knee replaced such as you are considering is an elective surgery. You can choose to have it and deal with any subsequent risk or you can choose to not and live with having a problematic and painful knee.
I’d look at it as a quality of life issue. From how you describe the joint, it’s not in the best of shape. It is impacting your quality of life.
Not sure why I get why the docs are asking ‘why now’. Now because you’ve had it with your quality of life and now you are willing to accept the risk of the surgery and subsequent therapy needed to get the most out of your new knee.
Perhaps someone else has another non-surgical suggestion but I’m thinking this sounds like a road you should be seriously considering. Yes, you’ll have to take time off from riding. Yes, you will need to be diligent with therapy post-replacement. Might you be able to ride (maybe not early summer but later summer) and have a happy horse? Seems like serious consideration to me.
Let us know what you decide!
My husband had partial knee replacement on 12/31/2018. He’s still a little gimpy, but the pain is so much better for him. The most important thing is doing the therapy. Not sure he could get on a horse (but he doesn’t ride anymore so that isn’t an issue), and he’s just starting to pepper a little bit on the volleyball court with friends. That seems to be going pretty good, but he’s just not pushing himself. He actually had to stop doing his PT after about 6 weeks as he had to have surgery for diverticulitis the middle of March and they couldn’t do the PT while he was healing from that. But his range of motion had been almost normal before that.
He was to the point where he could barely walk before his surgery and did put it off longer than he should have. He is only 50 and a lot of ortho docs wanted him to wait since he was so young. And he had tried just about everything under the sun - PRP, stem cell therapy, braces, TENS machines, drugs, you name it, I think he tried it.
They scheduled my for knee replacement last May, but I pushed it back to October so I could get a season showing in. Well I completed the season, but to be honest the last couple of shows really took it out of me, and the final scores at the last show were horrible, I probably should do sucked it up, got it replaced and been fit for this year.
Back on Track brace, heavy duty pain pills, being diligent about pre op exercises kept it going, but I’m not sure my horse appreciated having a passenger rather than a partner.
Thanks all. I was just hoping someone would say something I haven’t tried yet. Yes, I know I need to do the surgery. It is so frustrating that riding at this point is literally the only thing I cannot accomplish with any sort of comfort. I will be waiting until the Fall because I am self employed as an equine massage therapist and it is coming into my busiest season. I feel selfish (and possibly foolish) leaving my clients during show season. It has been hard to wrap my head around not doing anything competitive with my boy, I’m not getting any younger. He however, does not deserve trying to cart me around a course like this. I am planning on bringing him home for the Summer and just putzing around bareback until next year.
I haven’t had a knee replacement but can share a story of remarkably quick recovery. A woman who attends the same gym as me has had bone on bone arthritis in her knees for years and been on various pain killers to keep up her active lifestyle that includes hiking and sculpting (big marbles sculptures). In January she had one knee replaced. She was home, looking after herself by day 3, walking without a limp by day 5, back at work in a week and back at the gym at 3 weeks. . all of this just weeks before her 80th birthday. It may be worth looking at having the replacement sooner rather than later , if the surgeon considers you have good prospects of a quick recovery
I knew someone that limped along with bad knees forever and at 88 it was surgery or a wheelchair for the rest of her life.
She had the surgery, did so well she had the other knee fixed a year later and after healing went dancing again!
She always said she should have done the surgery decades ago.
An orthopedic surgeon said that knees and hips are joints that tend to impact quality of life more than others because getting around depends on those joints working well.
Those surgeries tend to be some that most have great results.
Patients, if all goes well, always comment they wish they had done it sooner.
I am also “bone on bone” in my left knee, and have been unable to ride for the last two years, it was just too painful. Last week I had Radiofrequency Nerve Ablation (Coolief), and so far it has been very helpful. It burns the genicular sensory nerves, although they are supposed to regenerate in a year, but they said they are finding it can last for 24 months in some cases.
They first temporarily numb the nerves to see whether it should work, if it reduces pain by 80%, you are a candidate. My insurance paid for it.
It can buy you time before scheduling a total knee replacement, which I will probably eventually have, and can give you a chance to exercise and build some muscle before the surgery. My doctor said that about 60% of the Coolief procedures he does are on people who have had a knee replacement, but still have pain.
I am entered in dog shows this weekend, showing my own dogs so running is involved, I haven’t been able to do that, and I’m feeling ready to start riding again.
So far, I am really encouraged. They said the full benefits might take a week or two to be felt. There was no anesthesia, just local lidocaine, and to be honest there was some pain involved with the procedure, but they just needed to give me more lidocaine and when they did, I was fine.
I have had both knees done, and wish I had both done sooner. The first they were reluctant to do when I was ready because I was considered young for the procedure, having just turned 50. (I was walking with a cane and miserable) The second one I tried to delay because I had just started a new job. The surgeon told me that my knee was collapsing inward (varus angular limb deformity) and that if I delayed the replacement I was at risk for tearing all the soft tissue if I tripped and fell, making the eventual replacement much more complicated.
I was back on a horse in 30 days after each replacement. YMMV.
As far as what else to try, I did cortisone injections for a period of time on both. I got a lot of relief from them but the effective period got shorter and shorter. I tried something called a lateral release on one, and had arthroscopy to clean up the cartilage at some point before replacement.
The joint fluid injections were no help to me; I think the knees were too far gone.
If you truly want to delay the replacement, I would recommend trying the cortisone injections. But if you’re already bone in bone (which I totally get, my surgeon told my spouse that I had been bone on bone so long that my femur had worn a depression in the head of my tibia.) I’m not sure how much relief you’re get.
I did do cortisone injection actually as well, forgot to mention it, no change in the knee. That Coolief procedure that HoundHill mentioned sounds interesting. I will look into it!
