I love you guys, not many surgeons are as honest and straight forward as you, this is coming from a retired orthopedic nurse. I appreciate what you do and for your educational videos for lay people.
Great video! I was dealing with bone on bone pain. I went 10 years in moderate pain,, and had meniscus trim in both knees. All my friends noticed I was walking with a limp and in pain. My surgeon and I decided this was a viable option. No regrets with the TKR. I can walk, bike, and ski (easy trails, mostly) with no pain.
Another great video! I like the way you are mixing it up to keep it fresh. Walking through the hall with natural light rather than just sitting one location- it gives a good sense of working doctors in context. Branching out with guest hosts is also very interesting but it is your complementary personalities and style of delivery that is making this channel a success. Two thumbs ( one for each Doc) up!
Excellent. I was given all the other options as “only kicking the bucket down the road” passive yet assertively ... I’m 67. Active. Fit. Teaching fitness classes 4x a week. Acute injury from poorly stretching after a 2.5mile walk resulted in pain. X-rays taken. Bone on bone revealed. Osteoarthritis. But after four weeks of PT and carrying through with pt at home, I’m walking and functioning without pain. I’ve forgotten why I even considered TKR 12 weeks ago. Very limited conversation time with my surgeon. Then Covid spiked and elective surgery cancelled. Phew. I’m glad this pause took place. I found your videos and some others that helped me clarify the timing is off for this surgery.
I am so grateful for this video and so many more you have posted. I’ve had multiple knee surgeries and an acl reconstruction 25 yrs ago. I was told in 09 I had 80 yr old knees. I just went in a little over a week ago and told both knees need tkr. I only went in on hubby’s suggestion to see how they are. I have occasional aches but truly no pain. To hear that I needed that was devastating. I couldn’t wrap my head around this advice with my symptoms. Has anyone of your patients with little pain or effect had it done and glad they did? It makes sense to me if you’re in so much pain or can’t do daily life you would have a comparison. Anyway thanks for being so honest, caring, with a bit of a sense of humor to educate all of us wanting to learn.
Docs, you do a great job with your videos. I had a partial knee replacement ten weeks ago - I'm coming along well and I know that I benefited from your advice regarding issues such as the decision for surgery, prehab, rehab, drug use (I was reluctant to take opiod tablets) and the key point that I'm responsible for looking after myself (oughta be obvious I know, but reminders are good). You are providing a great public service - thank you.
Well thank you so much paul! Very glad we could help in any way. All the best going forward. Thanks for watching, subscribing and sharing with someone if you did.
I have just had a knee replacement operation and must admit it is the most painful thing I have ever had. I had bone on bone and also have mild MS so wanted to improve the amount to distance I can walk to. My other knee also has arthritis but not as bad but I can’t contemplate having this operation again so was glad to hear that it was not essential
Hi tuzanne. So it is very painful for sure. It will get better. Hang in there and thanks for sharing your story. Thanks for watching and subscribing if you did.
Good answer. Getting to TKR is a step-wise process rather than a single decision. There are a lot of solutions that have the potential to really help that don't involve surgery. Also the patient may only need a partial knee replacement rather than a TKR. You guy ROCK!
Thank you! From my X-rays, my doctor said I am “ready” for both knees to be replaced. Also one of my hips needs replaced as well. My knees don’t really hurt much. I am going to put it off for a while. My hip needs done sooner than later. I’ve had both rotator cuffs surgically repaired so I am familiar with painful post operative situations. Everyone says hip recovery is a snap comparatively. I needed this video to help me decide that I was making the right decisions.
@@TalkingWithDocs finally went to orthopedic this week. After x-ray, it was immediately recommended i have a total knee replacement .surgery scheduled for October (Surgeons are booked solid after Covid restrictions)
I have a bone on bone left knee now. I have arthritis and no ACL. I have been told no because of my age which is 52. I am tired of hurting when I walk. Now me left knee is giving out. What would be your suggestion please. Thank you Jodi
2/2023 I’m 67 and in Sept ‘23 had major pain back of knee, xray showed bone on bone, Dr. suggested “gel” injections or TkR, chose TKR. Now 41/2mos later, very minimal pain (lost 20lb). I walk 45-1hr every other day, water exercises other days. Minimal pain. Surgery scheduled end of Feb. Having major doubts now, I can’t mentally justify having TKR as scheduled. Any advice would be appreciated
Well it can be difficult to decide. It is an operation to reduce your pain so if you don't have a lot you need to reassess the goals of the surgery. We always tell patients if you think you can wait you should. Best of luck
Are you familiar with the Iovera procedure? My surgeon recommended I have it done a couple of weeks before my second knee replacement to help with pain management after surgery. Thank you.
Three weeks off from TKR! Yes I know I am ready. The Doc and I made the decision. I've tried everything including fat stem cells. Very good video that traces my history and Doc exactly!
Hi Jay G. Congratulations on your decision. You have done a lot of research to get to this point. Just work on getting as strong as you can before surgery. Good luck and keep us posted.
For sure. That’s the joy of Canadian practice in socialized medicine. We don’t need the work. There is lots of it so we spend just as much time talking people out of surgery. Thanks for watching and subscribing
This REALLY gave me pause for (second) thought. I am scheduled in 3 weeks, and after watching this and another of your videos, I am reconsidering. If there are days that I don't need pain meds, then maybe I should hold off.
Hi Laine. The goal of our videos is to provide information about all of the risks and benefits and to help patients decide whether or not their quality of lives have been compromised enough to consider total knee replacement. It is often a difficult decision. It is best to discuss all of it with your treating surgeon prior to surgery. Hope that helps and thanks for watching.
I need 2 knee replacements due to bone on bone. The last time, 4+years ago, I talked with my doctor, after he looked at latest x-rays he asked me how the hell I was I still walking. I have terribly bowed legs but NO pain. I can't stand on them comfortably for more than ten minutes. I can walk but not for terribly long. I am 72 and really worry I would be one of those people not satisfied with the results as I would most likely have pain that I don't experience now. My family continually bug me to get it done. I am not feeling like I miss out on much. I just traveled from NYC to London by plane by myself to see my first grandchild. I used a wheelchair to make long trip between planes. This was wonderful. I did sightseeing to the best of my ability and had a great time. I am enjoying the videos on physio to strengthen knees so will try that. Does my thinking make sense? I am very leary of surgery and live alone on second floor with 15 steps. I manage those well. Limited range of motion and stiffness/achiness are my issues.
Question for you please. I’m 75 and had a hard fall on ceramic tile about 10 years ago. My inner knee turned purple and was extremely sore. When I had it x-rayed, I was told I have a meniscus tear. I have no problem walking. However, sometimes, if I suddenly turn, my inner knee hurts and suddenly drops, although it doesn’t happen often. I sometimes feel a bit of pain and discomfort going up the stairs. Do you feel I need a knee replacement? Thanks.
Hi Mary J. If you have a torn meniscus the treatment would be arthroscopy not a knee replacement. Knee replacement is for constant knee pain secondary to arthritis. Hope that helps. Thanks for watching and subscribing if you did
Thank you so much for the awesome and informative videos. Could you address osteotomy and knee replacement surgery to correct a knock knee in an upcoming video? What would recovery look like? Does an osteotomy buy a patient some time before he/she would need a knee replacement? Why wouldn't a knee replacement fix an alignment issue and why would an osteotomy even be required? Thank you!
Hi Carole. So typically the options are either an osteotomy or knee replacement but very rarely both. The goal of an osteotomy is to correct - or even over correct - the malalignment in an effort to delay a knee replacement. Our goal is 8-10 years. We have done a video on high tibial osteotomy which is for bow legged deformity. For knock kneed or valgus deformity, it would be a distal varus producing osteotomy. Thanks for the suggestion and we will definitely add it to our list of future topics. Good luck and thanks for watching our channel.
My patellas dislocated a lot as a child and at the age of 15 and 17 surgery was done to fix it. That was now over 40 years ago. Over the years I had frequent pain and cannot do any impact exercises on my knees. To use stairs is one at a time up and down. My pain is not constant. It depends on the type of movement. Squatting, running and bending is completely out. To get up from a chair, I need to push myself up with my arms as I cannot use my knees. I also cannot stand on my knees. When lying on my stomach, I cannot keep my knee straight as my knee hurts from the pressure below. X-rays was done. Inflamation is visible. Bone on bone. The patella is worn with no cartlidge anymore and is also not aligned. The Dr said that there are 2 options available. Patella replacement or full replacement but this will be determined once he opens the knee. Operation is planned for end of Feb23 but I am not sure about it. Some days I feel no pain. The next day I wake up at night from a throbbing pain. Some nights I sleep with a knee sleeves to alleviate that pain especially days that I walked or use stairs a lot. Currently I am taking Bio-Naproxen as all the joints in my body aches and now the pain in my knee feels better. Blood tests results for gout and rheumatoid arthritis are negative. What would be your advice? I do not want to make the wrong decision and regret it in future.
So where do I fit in? When I go grocery shopping, waking around downtown, or standing for 15 minutes being initiated into the Elk’s Club, I felt a lot of discomfort. But as for skiing? I feel a lot of discomfort walking to my hotel room in ski boots, upwards 1/4 a mile to the chair lift, but once I start skiing, little to no pain, just my back. And as a final note, I’m on my feet all day working as a chef, but I can get by. Cortisone injections worked great for maybe a week. I received a hyaluronic acid injection for my knees last September and it did little to no good that I’m aware of. I’m only 53 and had these problems since I was around 44-45. I’ve taken Celebrex on a daily basis since I was about 47. So yes or no for the surgery!
Hi Jon. It is still always up to the patient. If you can live with it and function reasonably well we would always tell you to wait. If you can't take it anymore, then maybe its time for surgery. it is a complicated decision. Best of luck to you. Thanks for watching, subscribing and sharing it if you did.
Great video You guys are Awsome. I had many broken bones from motorcycle accidents later years hip bone on bone couldnt stand the pain. Had a THR. And Now it is so much better. I am glad I had it done. Also same with my knee. And had a. Total knee replacement and I can do things with hardily any pain. Highly recommend if its bone on bone
I'm 62 yrs old, have been putting off the surgery for 5 yrs now, bone on bone both knees, I have good ROM in both knees, hurts when I go up and down stairs, stiffness, extended walking, no problem sleeping, I used to play softball for years had to quit, the pain and stiffness was too much, I have been doing gel injections for a couple years, I get relief for a few months and the pain comes back, I take Meloxicam for relief, helps a lot, my problem is trying to decide if I should do it NOW while I'm relatively healthy or keep putting it off until I can't take the pain anymore?? My brother just had his Rt Knee done on Feb 8, 2024 and he was crying his 2nd day home from the post op pain, that didn't make my decision any better 😆he's a week from surgery as I type and he says that pain was the worst he's ever felt, but he's sore and stiff now, pain at night trying to sleep, but nothing like his 2nd day home. I'm monitoring his progress to make my decision, I'm supposed to have mine done in May 2024. I know we all are different, but I'm seeing results from my brother 1st hand, not reading comments 😀
I need to move to Canada. I have seen 3 different ortho docs in Jupiter Florida in past 15 months. All 3 recommend TKR. Meniscus was cleaned on small posterior side 8 years ago...jogged regularly for past 8 years until swelling on front where incision from the Meniscus tunnel. Yet, I climb up and down 74 steps daily with absolutely no pain. No problem doing long walks, getting up and down from sitting position. Not bone on bone yet, there is still space between. I do knee bends with no problem. Some osteo arthritis in one compartment, not all three. And I am 57. WHY do they keep saying do knee replacement???? I miss my running days, but even after TKR still shouldn't run...so why surgery now????
Hi Laura. Come on up! But you should only get a TKR once you have unbearable pain. Keep running until then because yes no running after your TKR. Thanks for watching and subscribing
I started having problems with both knees 10 years ago with minimal pain. I was 300 pounds. I ballooned up to 350 pounds with type two diabetes. 4 years ago I started needing shots for the pain a year and a half ago when he did x-rays again, both knees completely burn and burn digging in each other. To make a long story not so short how long is 150 pounds reversed my type two diabetes and I’m scheduled for total knee replacement in my right knee on June 6, 2023. I had the go on Social Security disability because I could have very little walking without being in great pain quality of life really bites when you can’t move. That’s how I knew I needed my knees replaced.
I realize I am commenting on an old video, but this is a new thing for me, so giving this a shot. In less than one year (9 months), I have gone from no knee pain to needing a TKR. X-rays showed in both knees: osteoarthritis and kneecaps out of their channel and tilted. MRI showed medial meniscus tear in one knee. Had arthroscopy: trimmed torn meniscus, lateral patella release, and some osteoarthritis scraped away. I am 4 months out from the arthroscopy and still have unbearable pain. I am barely progressing in PT. How is it possible for this to happen in 9 months? Should I get a second opinion?
Sorry to hear this LY. Yes it can deteriorate quickly. A second opinion is not unreasonable. It is all about your pain. Best of luck. Thanks for watching and subscribing
Ntuce video. I'm bone on bone in one knee so am going for a TKR. Pain isn't as bad as it has been, but limited movement and side effects elsewhere points to it being the right thing. (Exercise has helped and I can atill do 10-15,000 steps on l vel ground. Just can't turn.) Once done, we'll see about the other kneel.
I LOVE these videos, binge watching trying to absorb all info. 2 years ago I asked an orthopedic Dr. after he looked at my xrays and told me I needed both knees TKR because I had bone on bone, "how will I know when I need it?"I asked, and he said "oh, you'll know"....I thought that was NUTS, I thought you are the Dr., you are suppose to tell me based on my xrays...HA HA...now I can't walk my dogs anymore, I bought a scooter to get from parking lot to my desk (358 steps), can't stand more than 5 minutes, had to have my brother fly 2000 miles to help me put up Christmas decorations, can't clean my house because I'm sore from the waist down, Christmas shopping was 10 minute intervals with 2 days in between.....yup, I KNOW its time....Wish I hadn't wasted 2 years of my life getting worse when PT and cortisone shots in the joints did NOTHING. Definitely a personal choice. I just hope I didn't compromise my hips, which hurt now as well.
Another great Video..I recognize that hallway that you were walking down at least I think I do. Those doors on the side lead to where you do the surgery correct because it looks like the hallway I went down for my surgery in October as a matter of fact that surgery was done by one your guest speakers in an earlier video for my umbilical hernia surgery. Anyways as always a definite Thumbs up to both of you for another informative and wonderful video. Have a stress free rest of the week.
I'm 76 with bone-on-bone osteoarthritis in both knees left knee is bowed and my right knee is bowing not as bad yet, when walking around the block it's painful but bearable but that's all I can walk anymore. after walking that block I often get cramps in my calves and feet, Will a tkr help ? I've always been a walker and hiking but not much anymore because of pain and leg cramps. Doctor advised me not to wait til I'm 86.
Question. My x ray shows normal joint space and minimal bone spurs. MRI shows severe chrondomlacia on medial side of knee and mild on lateral. Also some bone marrow edema. Whats up with that. Love your videos thank you very much.
Hi G Nohn. You are very welcome. An MRI is a more sensitive test and may identify an area where the cartilage is completely worn out. If the surround area is normal however it will look normal on an xray. Just like when you look at a doughnut from the front you cannot appreciate that there is a hole in the middle. Hope that helps. Thanks for watching and subscribing if you did.
My mother is 53 and she is suffering with it for last 23 years.And we are from India.Would like to know more about knee replacement surgery please guide us
Hi Naela. We are in Ontario. You would have to have a referral from your family doctor. Thanks for watching, subscribing and sharing with someone if you did.
Hi Ann. We actually do have a video on stem cell therapy and PRP. The main takeaway at this point is that the evidence is not there for its routine use in the setting of arthritis. There are many ongoing trials that will hopefully help us determine its exact role as well its inherent potential risks and benefits. Having said that, there are many centers that are currently offering these services while the evidence is still coming in. Hope that helps. Good luck and keep us posted. Thanks for watching.
@@TalkingWithDocs Thanks so much for your reply. I know I probably am headed for a tkr because I am bone on bone but really am not comfortable making that decision right now. I am trying to lose weight and have found that a routine of icing and heat help with the pain. I also am trying to walk as much as I can and maintain a good quality of life. Have a great night and keep those informative videos coming!!
I don't want to seem selfish for wanting to run after a total knee but would like to ask the running Dr, what medical advancement has to happen before running is possible? Is it the materials used? Making an artificial ACL? If I wait 10 years, will there then be a sports total knee option?
Hi Victor. Not selfish. But the advancement would have to be the bearing surface itself to withstand the repetitive pounding. Power walking or cycling for now. Thanks for watching, subscribing and sharing with someone if you did.
Hi you two..love your video as always..I will take this moment to wish you both a very peaceful and loving Christmas that includes Patricia too..from both myself and David too..as well as a fabulous New Year to you all..much hugs for sure🤗🤗😊😊
I have a question if you can answer it. Question:y right knee is pretty much bone on bone, when I'm walking my knee seems like it wants to bend sideways when I make the step and put my weight on it, that's when it changes my life as I don't want to walk. Should I think about looking into surgery
Surgery is an option. Sometimes a custom unloaded brace can help. Worth a consultation to discuss options Liz. Good luck. Thanks for watching and subscribing
I have a unique knee pain....... I can walk ok, get up and down...... no bone on bone pain But when I drive the knee pops and causes extreme pain. Is this a good reason for knee replacement
Hi Brian. Hard to say. It may be related to a torn meniscus. Need to get an X-ray first. If minimal arthritis then an MRI. Best of luck to you. Thanks for watching and subscribing
Hi, Docs I love your videos & I need your advice! I am 62 yrs old w psoriatic & osteoarthritis and miserable in pain since Sept 2020. So i just had a consult w my ortho surgeon. He is saying not sure i would get pain relief w TKR because most of my problem is severe cartilage wear in the patellofemoral compartments!? MRI's show Both knees have complex meniscus tears, i have a sprain in the medial collateral ligament, which i think i tore since the MRI. So new pain and using a cane. Moderate cartilage loss in central trochlear groove, et etc Throw in the Bakers cyst and multiple intra-articular bodies. So, im hearing arthoscopy no good, now Depressed at my prospects. Do you feel i would get enough relief from TKR to have the surgery? Thank you so much for your advice! Ready to move to Ontario☹️
Hi Ellie P. So it is difficult to say without examining you or reviewing your imaging. Having said that we have many patients who have primarily degeneration in the patellofemoral compartment who go on to have a total knee and do well. There are also some surgeons who do specific patellofemoral replacements. If you are in agony, it does sound like replacement is the only viable option. Best to get a second opinion if you are unsure. We wish you all the best. Keep us posted. Thanks for watching, subscribing and sharing if you did.
@@TalkingWithDocs Thank you so much for your reply! I started thinking I was asking for something unreasonable but knowing others have the same problem and get a TKR and do well makes me feel better! since Im being offered nothing else I got a referral to sports medicine and see if they'll scope it, clean it up or hyaluronic acid injections. which we all know is "kicking the can down the road" while more time lost in pain and not living my life. Take care and thank you both for great videos!!
I recently had a knee X Ray done on my right knee. In the written report is was reported that "Joint effusion is seen". What is this about? Would it affect my chances of having a TKR or a successful outcome following a TKR. Thank you.
Hi maginot2u. This simply means there is fluid in the joint and would be very typical of an arthritic knee. It would typically not have any impact on your outcome. If you are uncertain you can always ask your surgeon. Good luck and thanks for watching.
How come knee replacement wouldn't relieve the pain from even smaller cartilage damage? I doubt having artificial joint is painful. I mean isn't any improvement in the quality of life worth it?
I feel my knee pain/problems is from damages sustained in an accident rather than arthritis.. I wonder if knee surgery will help in my case to the same effect as someone with "bad knees"
Hi Steve. Post traumatic arthritis is also a problem that may be solved with total knee replacement. Best place to start is a weightbearing xray and go from there. Good luck and thanks for watching.
IDK. I think enough was answered here. I think my meniscus is toast. I also have trouble with knee stability. Just re-injured it for about the 4th time in almost 20 years. Each time it's a bit worse. About to have an X-Ray. Will know after that, I guess. But.. yeah, I just want a stable knee, so maybe my ligaments need work. Not sure yet.
Hi Peggy. It is always had to know what other surgeons are thinking. We always encourage people to wait as long as they can within the limits of their pain control and function. It is a very personal decision. Thanks for the question.
Hi Reza. That was not our goal! We are simply trying to empower people with information to make informed decisions about their own health. Thanks for watching.
And remember, you are in charge of your own health. Ahhh yes, the world of elective surgery. Research, ask questions, weigh pros and cons to avoid REGRET. Lesson learned.
Yup. And unfortunately a lot of doctors give us bad information. The first doctor gave me some shots not the steroids it was a series of is there a good chance three shots and it was supposed to help the tissue in between sort of clean out and hydrate I guess but it did little or nothing for me and they told me eventually I would need new replacements because I was Near bone on bone with osteoarthritis so another doctor said it was inevitable end almost tried to push me in the surgery the next doctor said it will be an evitable and those tissues don’t ever grow back and you’re pretty much bone on bone now so it’s just a matter of waiting till the pain gets appointment you can’t stand it and need a replacement. Then I started studying on my own and learning about nutrition options and optimizing for the ability to regenerate some of that tissue and read some studies where is actually happening and some people are showing regeneration of that tissue when giving it what it needs the crack collagen‘s end eating appropriately eliminating the lectin‘s and the chemicals and toxins that cause inflammation. It’s not guaranteed and the chances aren’t real high but a lot of doctors have told me it’s impossible it will never grow back, I currently have a Doctor Who tells me it’s possible but unlikely and it’s worth trying and I used to have a Lotta problem when I would try to walk and exercise with swelling and pain and inflammation and use a lot of ice packs, and recently I’ve started the corticosteroid shots and they work amazingly well and I walk once or twice a day now and I don’t have water on the knee or the swelling or the inflammation issues I used to have. I’ve optimize my diet to allow it the option to heal which also helps with a lot of other things like heart disease and some problems with liver function and thyroid and the more I study the more it looks like the same diet that’s going to heal your knee or give it the optimal chance is just eating correctly which is also good for weight loss and everything else I’ve gotten rid of my heart disease and throwing away my medication to long ago my blood pressure is awesome my liver works perfectly and I never have low blood sugar or high blood sugar issues my thyroid works great all my organs are functioning I have no nutritional deficiencies and I’ve gotten much healthier, it will probably take time to see if my knees improve come on my left knee has pretty much bone on bone at this point already so I don’t know that there’s much tissue to regrow but at least my daughters giving it an option and not just telling me that that’s physically impossible and will never happen and I’ve read the research myself, some people regenerate that tissue by eating and exercising properly and reverse osteoarthritis and it’s not highly likely but it’s possible so I’m giving it a shot but more than half the doctors I talk to you told me it’s inevitable you will need a knee replacement where are you will not be able to walk anymore and it’s just a matter of time some tried to push me towards doing it now which is a little ridiculous. I have limitations but I’m still able to walk and function if I don’t overdo it and with the steroids the pain and inflammation is tolerable enough to where I can give it a few more years and give it a chance to try and heal naturally. That’s better than jumping into an operation that will make some temporary improvements but isn’t an optimal solution and isn’t great when you’re young because they don’t last forever and though the technology is getting better it’s not perfect so it should be a last resort and there are a lot of people out there now with some research behind it proving that you can improve it I don’t think you’ll be running marathons but you’re not gonna be running marathons with knee replacements either. I don’t know I think a lot of doctors are a little too gung ho to throw out surgery recommendations and prescriptions without even trying to get people to eat correctly and give their bodies a chance to heal themselves. I found with my heart disease that was almost universal and the advice they gave me was horrible and over 10 years it made me fatter made me sicker and all they did was at my meds And tell me I was eating a good healthy diet pounding down bananas and apples and yogurt and oatmeal not eating salt or red meat and I had a whole Lotta tilapia with my doctor said was good we need to eat fish but Palapa has nothing in it because it’s farm raised on grain and has basically zero nutritional value why don’t they tell you you have to eat wild caught seafood. So even that advice was a joke. After 10 years and being almost dead I stop listening to my doctors and studied myself because they don’t get much nutritional training and even that it’s just being told what to think and tell people it doesn’t actually teach them nutrition and most doctors can’t answer my questions after spending about a year studying because they really don’t know what they’re talking about they keep telling me crap like eat beans for protein and avoid red meat and salt, I fixed it by eating grass fed beef and salt I’m getting rid of the oatmeal and the fruit and toxic vegetables. Coincidentally that’s exactly the type of nutrients and avoiding the type of foods that cause damage to your knee as well so instead of jumping into a surgery I’m gonna give it a few years and see if I can actually get some improvement or at least put it off for as long as possible. :/
