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Partial knee operation

 Poster: A snowHead
Poster: A snowHead
Following daily knee pain in November ,on a 12 day ski course in Kaprun ,I was diagnosed with some Patella maltracking and early patellofemoral crepitus (grinding sound in knee) and xrays show a complete loss of the medial joint space and early lateral patellofemoral wear (i.e. no cartilige left and wear to knee joint). I also have medial compartmental arthritis and I was advised by my knee surgeon that if the pain continued I would need either a 1 ) High Tibial Osteotomy (HTO) or 2)minimally invasive unicompartmental knee replacement ( Following physio and daily exercises I was able to ski for 1-2 hours for 5 days in a row in December.)

Originally I was hoping to delay an operation for as long as possible as I understand that after 8 years the artificial parts wear and I will need a further op ( I am 53) but am now beginning to think that ,unless there is a big improvement from physio exercises in the coming months (that will enable me to ski for longer) I might just as well get the surgery done sooner rather than later.

My questions are :

1) With the HTO or partial knee replacement will I be able to ski like I did before my knee problem (of course after proper rehab training etc) ?

2) I assume either procedure will remove any pain that I currently suffer in my knee when skiing?

3) If the knee replacement or HTO wears out after 8-10 years can it just be replaced with further surgery ?

Any other points ,views very welcome.

Thanks
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
brnttptr wrote:

My questions are :

1) With the HTO or partial knee replacement will I be able to ski like I did before my knee problem (of course after proper rehab training etc) ?

2) I assume either procedure will remove any pain that I currently suffer in my knee when skiing?

3) If the knee replacement or HTO wears out after 8-10 years can it just be replaced with further surgery ?

Any other points ,views very welcome.

Thanks


1) After HTO the angle of leg is altered, this may make it more difficult to flatten ski on snow and get on one of the edges.

2) success at removing pain is not universal with somewhere in region of 80 - 85 % reporting good to excellent outcomes. A small,percentage still have significant pain. I tell all skiers to expect a bit of an ache after skiing , playing tennis, any other fairly vigorous activity. That way they aren't disappointed if they do ache a bit and delighted if they don't.

3) HTO generally accepted can " buy you 8 - 10 yrs" but knee replacement post HTO is less good than if done in a knee that has not had major surgery previously.
UKR : some studies show very high ( 90% and more) survival for the replacement at 15 yrs. it's an urban myth that knee replacements only last ten years. Generally, 90% or more will last ten years. They don't all fail in year 11, but a few will fail each year. Knee replacements that fail can be redone .

If you want some help on deciding if knee bad enough to have surgery email me and I'll send you a scoring system that can be helpful.

Jonathan Bell
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Jonathan Bell Thanks .

1) So from a purely skiing point of view Partial Knee Replacement( PKR )would be better ?

2) I understand the 15-20% who still suffer pain ,post PKR , tend to be the ones who have very acute pain pre-op . In any case its seems a small risk if 80-85% have less pain .

3) So if we are only talking about PKR 10-15 years seems very good to me BUT what happens when it eventually wears out ??? Can it be replaced ??? and are there any other
downsides to a PKR at age 54 ?

I guess part of my current thinking is that if a PKR allows me to continue the life I currently lead in the mountains (where I live and work for 6 moths a year) and am able to regularly ski and hike for another 10 years that's better than limiting the skiing and hiking I love because life is far too short !
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Anyone now skiing after a partial knee op ???????????????
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
I had a partial knee replacement on my left knee on 30th Oct 2013 when I was 51.
My wife and daughter still wanted to go skiing for New Year so we had booked and I was just planning to take a good book and use the lifts to meet them for lunch and drinks but by late November I was getting about so well with no pain in the joint I started to think maybe I may be able to ski just a little to get to restaurants and back.
I went to see the consultant for my 6 week check in mid-December and he said that he could not say to go skiing but if it was his knee he would be going but taking it easy.
So December 29th I was back on skis just over 8 weeks after the operation.
I took the first run very carefully but it felt fine and each run just felt better and better even did a couple of reds during the week and on the final day we skied 20 mile and my knee did not feel sore at all.

I have now had my right knee done on 22 January and the physio has already got me back on my exercise bike and this one feels even better than the first.
We are planning to go back to La Tania the first week of the Easter holidays and I have every intention of skiing again then.

My replacement knee is called an Oxford and as you can probably tell I am thrilled with them both.

I was in a lot of pain with them and walking was very painful and the left one was also giving me pain at night. The operation cured the pain instantly. I have had no pain since lying on the operating table. None at all through the healing process.

My consultant was Mr Hahn who works from several Hospitals around Nottingham.
If anybody is a suitable candidate for a partial knee I would not hesitate to have it done and if you are within travelling distance of Nottingham I would recommend Mr Hahn.
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Farmboy , Wow that's amazing ! Thanks very much for explaining that and congratulations .

I am off to my knee surgeon,in Sussex, this Friday to book my op and am very encouraged by your story and very impressed by such a speedy recovery time . I was under the impression it was 4-6 months recovery but I guess
it depends how motivated and fit you are to start with.
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
brnttptr,

If the Unicompartment Knee Replacement( UKR)wears out or loosens it can be revised to a total knee replacement.

In most cases where I have revised them I largely just use a standard Total Knee with only minimal modification.

The results of a Total knee that follows a UKR are usually not quite as good as a TKR carried out as the primary operation, but they can still be

good.

Jonathan Bell
ski holidays
 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
My mate lived in agony and could no longer ski and needed big painkillers to get through any day.

He had both knees partially replaced and skis like a pain free god now
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