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Sallubrious

Artificial joints

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I've had an ongoing knee problem for years -all of my adult life.

It originally started with an injury I inflicted on myself in a motorbike accident when I tore a few ligaments and did a bit of cartilage damage. I've had six operations on it and none of them could be considered a success. The last time they operated on it was going to be my third reconstruction but when I woke from the operation I was handed what was left of my cartilage in a jar and informed that I would never walk again.

I told the doctor to get fucked and got up and walked out, it was possibly the most painful thing I've ever done but there was no way I was going to let a quack point his bone me.

I managed to keep it functional with a rather intense physio program of my own design. I was referred to the hospital physio, but they didn't understand the mechanics of the problem and suggested I do heaps of quadriceps work to strengthen the joint. I told them I already had much stronger quadriceps than most because of my cycling history (I was doing up to 1000 kms a week at that stage on a pushbike. This didn't fit with their dogma , the good books must all recommend the same (wrong) treatment for my type of condition and I had many arguments with firstly the physiotherapist in charge of my case and then head of the physio dept. and finally with almost the entire panel of orthopedic surgeons from my local hospital.

I challenged them to a 50 dollar bet that I could prove they were wrong if they'd put me on the Kin-com dynamometer that was gathering dust in the physio room. They finally relented (they wouldn't take the bet though) and put me on the machine and tested my quadriceps and hamstring strength and it showed that my quadriceps strength was almost 15 % higher over the entire functional range than it was in good knee. This had them puzzled and they just couldn't comprehend how my knee could have such instability with strength levels they witnessed via the Kin-com. It wasn't rocket science so I told them to test my functional strength on hamstring contraction and it showed that my hamstrings had less than 30% of the of the output in watts than my good knee - as I'd insisted all along.

After a conference of educated idiots, they decided to redesign a program to increase my hamstring strength, but I told them to get fucked too. Many of these people don't even have the slightest mechanical aptitude at all and that's all it comes down to - mechanics, not this elusive bullshit they call medicine and use to put themselves on a pedestal above the common man.

I've managed to live with it all these years fairly well but recently it's come to a head. I injured it again a few weeks back and now it's unstable to the point where walking has become a luxury. It's been dislocating almost every day and each night when I try to sleep. When I roll over in bed just the weight of the sheet is enough to stop my foot from rolling over with me and it completely dislocates my knee. I'm not talking about a kneecap dislocation, this a complete dislocation where the tib and fib move sideways about 90 mm and get stuck there.

It's done a bit of nerve damage and chipped a few chunks of bone off inside the joint, so basically it's fucked.

It looks like I have two options - Joint replacement or amputation. I really don't want to let anyone put crap like that in my body and I had a crazy idea that if I hold out long enough biotech/stem cell technology might be able to help re-grow the cartilage and ligaments/tendons ect.

Even if biotech methods are available, I can't see the public health system shelling out for anything like. So the first two options are what I'm left with.

So after that long boring rant.

I want to know if anyone here has or knows of anyone with a replacement knee.

I really don't like the idea of letting someone chop a large part of my anatomy away and replace it with metal and plastic shit, but it looks I don't have much choice.

I'm particularly interested experiences with the public hospital system, I know there are some brilliant surgeons out there, it's the amateurs that work for the public health system that have me worried.

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I don't really have any help to offer except to say -- be careful with the public hospital system, but you knew that already.

When I was around 11, I broke my leg jumping into a swimming pool (yes, it was filled with water). It turns out I had a rare bone cyst that made the bone hollow. Luckily it was benign.

Apparently the story ended up going into a medical journal because it's quite rare for someone that age to have a bone cyst.

Anyway, I went to a public hospital. The doctor put a splint on my leg with two rods going through the leg to hold the splint in place. Quite painful to say the least. The splint was way too long

and dug up into my groin causing a massive wound (like an 1 - 1.5 inches deep) that scarred up badly. The splint didn't do anything and the bone failed to heal.

So, I ended up having to go into surgery again -- this time they elected to put in a plate and screws which luckily worked. They left that in for around 2 years (from memory) before it was removed.

But yea, the Doctor was very negligent and looking back, both my parents and I have said how he should have been sued.

At one stage I was told I might not walk again (wtf?) but that I should at least try physio. I tried physio for a while, but found it unbearable and instead elected to heal in my own time.

Eventually, I learnt to walk on my leg again in my own time.

Of course, your situation is very different and I'm sure because it's the knee, it just adds that much more complexity to the situation..

I don't think this Doctor was classified as an 'amateur', either. He was an older guy and had a lot of experience as a Doctor.. But I guess that just goes to show you should (where possible) stick to specialists..

He was definitely an amateur and negligent when it came to my case, though.

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I want to know if anyone here has or knows of anyone with a replacement knee.

I know a local bloke who has two, spoke to him about it after the first and he said he was happy he'd done it. We're not in regular contact, and haven't seen him since. Like you and me it was a motorcycle thing

I really don't like the idea of letting someone chop a large part of my anatomy away and replace it with metal and plastic shit, but it looks I don't have much choice.

My knees prolly aren't as bad as yours ( fingers crossed ) but there are three things I'd say on this

i) Losing a truckload of weight has made an incredible difference for my ability to carry the injury

ii) Sports science really has improved in leaps and bounds and if you can get advice from people you trust who have experience in this area you might ( MIGHT ) find other alternatives. These are really the people to talk to about fucked knees, it's one of the most common sports injuries and the injured are usually really motivated to get back on the field

iii) Thymosin beta, TB500 or thymocrin is a peptide I've just heard about which apparently has good regenerative qualities, whether you get the surgery or not. I'm not far into the research on this, so check it yourself or ask around here

I was told I'd not walk again years ago ( wasn't overweight then ) after a few bike accidents of the kangaroo/ gravel kind and followup visits several GPs expressed astonishment etc. And the gym had given me strong hammys but I was as unstable as fuck over normal country inclines, and a few overly enthusiastic personal trainers caused a few more probs til I learned how to tell them to fuck off without them cancelling the session

Replacement knees were suggested a few times, or were portended for my future, but I was young enough back then to not be planning for it. I did physio in the 80s and 90s for it but I was told that was as good as it got until I had replacement surgery

Turned out it was the medial ligaments on either side of each knee which were really weak. Until then I'd never been told they were any kind of consideration for my recovery and they hadn't been worked on. No point in having strong hamstrings if you can't use them to stay stable. Was also causing overly tight quads. And the lack of stability was progressively pulling out muscle groups up to my hips in a few places. This was diagnosed by my physio below and confirmed by a couple of gym bods with sport science training who took me th

Got lucky and found an excellent physio at the local gym, he gave me some exercises, I took up stretching on the fit ball in all directions til I felt the tension. Now it only twinges in the rain, and all the extra work I've put in means my knees are in better shape than a lot of women my age, despite the damage. They're not perfect, but they're certainly OK

I don't know if this will work for you, I hope you've got good access ( private health cover? ) to a lot of professionals in different fields to help you make your choise. Knees are a poor design

Good luck, let us know what happens

Edited by Darklight

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Fuck that sucks SYNeR, it never ceases to amaze me how common sense seems to be an elusive quality in surgeons in general.

Once they gain the respect of their piers no amount of common sense coming from a layman seems to get through to some of them. The fact that they used splints too long for your anatomy seems to optimise this. Surely the nurses or surgical assistants would have noticed - but they aren't really permitted to question the decisions made by the surgeon doing the job.

Keeping your mouth shut is a good career move in the medical field for the "subservients"

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Thanks for the input Darklight - sound advice for sure.

My knee is a bit past that stage though. All my ligaments are severed and basically useless, That's why they told me I'd never walk again. A healthy knee has two main hamstring tendons on each side which can take the load in the case of ligament instability but three of mine are severed (at least they were 10 years ago) now I strongly suspect all four are gone.

When they do a "total knee reconstruction" which I've had two, all they do is fix the ACL and clean up any cartilage damage while they are in there. There is also a tendon stripping method where the ligaments function is replaced by stripping tendons from the quadriceps and folding them down under skin to attach them to the lower leg. In the tendon stripping method the load bearing structures are located outside the knee joint instead of inside like a ligament replacement. I believe the tendon stripping method is much less invasive and would have been indicated in my case, but the surgeons wouldn't listen my opinions and proceeded to do the old style patella tendon graft to replace the ACL. Without medial and lateral ligaments to add support the new ACL was all but useless and severed again in months both times.

My daily routine includes a physio program of my own design. If I don't do it, after about a month or so I just can't walk at all.

& no I don't have private insurance so I'm stuck with incompetence of the public health system.

As for knees being a poor design, I think they an amazing structure that can bear an insane load under normal circumstances. When a healthy knee joint is locked at anything more than a snails pace the ligaments bear an almost unfathomable load, throw in a bit of twist and that loading is amplified to a massive extent. When people start wearing shoes that grip very well like a netballer or a footballer wearing studs the natural mechanics of the knee are changed and the loading of the ligaments is amplified sometimes to the point of failure.

Edited by SallyD

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Sally I'm sorry to hear it and knee injury can make you feel fucked for sure. I'd still try a sports scientist if you can get your hands on one, just for a rounder evaluation, but apart from that I'd be looking at the thymosin beta option- ask on Pharma forum here

God that all sounds painful. Good luck

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Hi SallyD,

my mother and my uncle both had knee replacements last year. Both are very happy with the results, both said it was the most pain they had been in, in their lives.

My mother is not allowed to kneel on the new knee.

I think both of them went private, but I will ask next time I see them.

Swiper.

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Thanks Darklight I'll look into it anything that might keep me off the operating table is definitely an option.

This will sound quite butcherous to most, but I've developed my own prolotherapy technique which has kept me walking all these years.

I make a pressed juice extract of Symphytum and PC it for 15 minutes and then inject it into the joint. The idea is to create an irritation that your body has to heal and it's been suggested ligaments can be regrown (if not completely severed) with prolotherapy. It hurts like hell for a day or two but after that it comes back better than it was. There's been no medical supervision during this treatment, so I'm not recommending anyone try it themselves.

I've used this method the last two times they told me I'd never walk again and it got me back on my feet both times.

There is an Aussie doctor doing prolotherapy now but I can't think of any way I could get there to see him. I don't know if he'd treat me without health insurance anyway.

On a side note the only person to ever give me an accurate diagnosis was a vet and he didn't need any C/T scans or Xrays. No ortho has ever come close to his level of expertise.

Edited by SallyD

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Thanks Swiper

I'd love hear their opinions and maybe what type of device was used.

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Sounds like a pretty traumatic experience.
I have a friend who is an orthopedic surgeon who does hips but knows alot about knees. I will ask him and get back to you.

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Thanks stjimi.

It will be good to know if there have been any advances in recent times. I know they align the replacement joint with a computer these days but I don't think much has changed involving the design of the device for a while.

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