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Q&A with Australian Health Practitioners
What other options are there for knee replacement at age 45?
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I had a bad car accident 22 years and the knee has continued to deteriorate. Despite multiple operations including a Maquet Procedure, nothing has helped. I now have grade 4 chondromalacia and have been told it is bone on bone. My Specialist has advised there is nothing more that can be done surgically other than a knee replacement.
I have concerns that I am too young and how long do they typically last. Quality of life is poor as I am in constant pain and cannot play sports or run around anymore. Options, suggestions? -
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Thanks
Dr Chien-Wen Liew
Orthopaedic Surgeon
Adelaide Orthopaedic HIP, KNEE and SHOULDER Surgeon specialising in Sports Injury and Joint Replacement. View Profile
Unfortunately post traumatic arthritis often deteriorates rapidly, and although you are young, a total knee replacement may be the best option at keeping you mobile and pain free.
The current research shows that patients under 55 have a much higher rate of revision - but as you can imagine, this is a bit of a line in the sand, and each patient's specific situation needs to be assessed on its merits.
For all total knee replacements performed, about 7.5% of them are revised by 14 years (The extent of our literature in Australia).
A Maquet is used to offload the patellofemoral joint. Without knowing what pathology is in your knee, the options can vary. It sounds like most of your issues are with your patellofemoral joint. There are options here, such as a patellofemoral joint replacement. These have a much higher rate of revision, but may give you some years before needing a total knee replacement.
Depending on what the pathology in your knee is will depend on the options. Partial knee replacements are an option if you are a suitable candidate. A high tibial osteotomy is used to offload areas of your affected knee, but has limitations as to its use, depending on where the arthritis is.
The last resort is a fusion. This stiffens the knee, and prevents pain, gives you strength, but you can't move the knee after. This is not a great option as it stops any knee flexibility which can start to affect other surrounding joints.
I hope this answers your question.
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