I am in almost the identical situation as the OP - 66 years old with 7 previous knee surgeries, chronic low to mid-level knee pain, and occasional locking of one or both knees. I still ride a great deal, walk a lot, and single hand a 40-foot sailboat in the open ocean.
Last Monday I spent two hours with a TKR fellowship trained surgeon who is a serious athlete, a Naval reserve officer, and manages knee rehabilitation for many of the nations special operations guys. He has been doing TKR work for over 15 years.
He provided very clear criteria for partial knee replacement and spelled out the circumstances under which it might work. The criteria for a partial replacement are very clear cut and, as I understand it, all physicians will reach the same conclusion given a set of X-Rays and exam. Each knee has three compartments and at least ONE must still be in good shape for further consideration of a partial replacement.
There was no question my knees were of no value except as a location to do bi-lateral TKR.
We talked about my life style (physically active and able to ignore much of the pain) and my goals (ride 100 to 150 miles a week and continue to sail my boat).
the doctors conclusions were:
- my knees are a mess and no additional treatment will make them better
- I am still enjoying a lot of good quality exercise
- I am not making the bad knees any worse
- Waiting to do the TKR will not make it any harder for him to do a good job in the future
- Orthopedic medicine is still learning a lot about the medical and mechanical aspects of TKR and waiting might provide some benefit as techniques and medicine improve.
- the bad knees are not causing much loss to my quality of life
- Once I have TKR I will be ecstatic with the results and I will be able to ride, walk, hike just like 20 years ago
- I have grave reservations about the CURRENT NEED for the TKR
- He will never do a TKR if the patient is at all hesitant - it takes 100% total comittment by the patient.
Someday I will seriously demand, maybe even BEG, for the TKR and at that time he will be glad to do it. He also said he is very confident that a year after the TKR I will tell him I wished I had done it years earlier.
He does both knees in the same week if they both need to be replaced.
The first knee on Monday morning and the other knee on Thursday or Friday depending on how the first recovery is going.
PS - had a shot of cortisone in each knee and now, five days later, they feel great. He wants to try cortisone shots every five or six months to see if they will give me three or five years more use with the natural knees.
My plan is keep using the knees as much as possible and NOT replace them until I can't ride another pedal turn.