Total Knee Replacement (TKR)

Some background, I am a 36 year old, 6ft 7in male in the US. I have been a big boy my entire life, currently hovering around 380lbs. Around 2015 I started having some knee pain in both my RT and LT knee. I have had multiple rounds of steroids in both knees and after one injection in my LT knee I started having intense pain. They did a few visits of PT and an MRI and found that I had a horizontal cleavage tear of the lateral meniscus tear in my LT knee. In June 2018 they repaired the tear and removed bone fraying due to arthritis. That solved some of the pain and after recovery I was good for a few weeks but the pain stayed albeit a bit milder. My ortho recommended a round of Orthovisc in my LT knee, and upon the first injection the pain increased, and did so for the remaining 3 injections. There is still some pain and popping in my LT knee, and when it pops it POPS, but the pain is mild as compared to my RT knee.

While the arthritis has always been worse in my RT knee the pain has not been, until about 3 months ago. The pain has become unbearable. Sitting with my knees bent, my knee stretched for an extended period of time, walking for extended periods, standing for extended periods, getting out of chairs or cars, all cause pain in my RT knee. I had an MRI done in October 2019 and they found:

1. Tri-zonal horizontal cleavage tear of the anterior horn and anterior midbody of the lateral meniscus.
2. Slight free edge fraying and fibrillation of the posterior horn and posterior midbody of the medial meniscus.
3. Tricompartmental osteoarthritis with moderate in the patellofemoral and the lateral femorotibial
compartments with intermediate to high-grade chondromalacia.

I have been to two orthos since then (not the same as the one who did my LT knee as he is just too far for me to get to after work) and both have flat out refused to even consider a TKR now, while both have said “it is my future.” The first told me “lose weight and then we will talk,” as he closed my folder and walked out the door. The most recent one I went to was a little more open to discussing my issue and not just dismissing me due to my size. He has a sports medicine background and we talked about a knee arthroscopy with medial and lateral partial meniscectomy and tricompartmental chondroplasties.

My biggest issue at this point is this, I don’t want to keep putting a bandaid on a gunshot. I also don’t want to live in pain, as the RT knee pain right now is causing other issues. I just need to find a doctor who is willing and able to go through the process of getting me approved for a TKR in my 30s.

PS. Yes I know my weight plays a big part in all of this, and I am actively working to lose weight. Actually down 15lbs in the past 4 months.

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