Doctor my knee is bone on bone, and I can barely stand up let alone walk, I’m in mid 70s and my health won’t allow a big surgery to replace my knee, can you help?
Doctor my knee is bone on bone, and I can barely stand up let alone walk, I’m in mid 70s and my health won’t allow a big surgery to replace my knee, can you help?
Doctor my knee is bone on bone, and I can barely stand up let alone walk, I’m in mid 70s and my health won’t allow a big surgery to replace my knee, can you help?
Very common complaint that we get from elderly patients who missed the boat to be able to have safe knee replacement surgery. My conversation with them is always based on staying positive.
-Having wear and tear is naturally built in our nature as humans so we shouldn’t be hard on ourselves, and we should always focus on how to embrace a margin of quality of life and function this is why engaging in a tailored rehab program to maintain muscle strength remains very important.
-When wear and tear is too advanced the only solution is surgery when it’s safe and most of those patients can’t have safe surgery and as pain physician, I can’t reverse the structural wear and tear, but we can work together to control pain and allow a margin of reasonable functioning.
-This is one of the few situations where I’m relatively relaxed with Morphine prescription starting by weaker members such as Tramadol to stronger members in patch form especially Buprenorphine because of its better characters compared to other Morphines along with simple pain killers.
-Most patients by this stage would have had cortisone-based injection in the joint more than once and it ceased to help and what’s called regenerative medicine with the controversial evidence supporting its use is too late to try in this situation. The procedure that I offer my patients here is denervation of the nerve supply of the knee joint through a minimally invasive day case procedure usually under sedation after a successful test injection and this usually can give them up to 6 months of pain relief and it can be repeated.
-Realistic expectations, staying positive, rehabilitation, weight management all remain very important elements in this situation.