I am a 72 year old female, who has been to a doctor that sugested that I have a total knee replacement. I am hopeing that there is a alternative precejure that you may relay to me that does not involve a general anesthetic.

-- Dorothy Elizabeth Ruble (speedy@hereintown.net), September 27, 1999

Answers

I am not sure if all your concern is only about the general anesthesia involved with the surgery that has been suggested to you or if there are more concerns then that alone. But, if your only concern is not wanting to be "put out" for health or psycological reasons, it maybe comforting to know that a total knee can often be done under an epidural type of anesthesia. You can be put into a mild "twilight" sleep, so you will not remember anything if that is acceptable to your health considerations. The drug of choice for this is similar to a Valium type drug. The epidural is often considered very useful in total knees, as it can aid in pain management the first 24 hrs or so post op. Once blood thinners have commenced to avoid thrombosis post surgically however, the epidural has to be removed, and other forms of pain mgt. begun.

I encourage you to discuss alternatives to anesthsia with both your surgeon and the anesthesia team that will be working at the facility where the surgery would be done.

As far as alternatives to total knees, it really depends on what the knee looks like in terms of ability to do partial knee surgery, or grafting etc. It also depends what your need for the total knee is going to be for as well. Generally a total knee is thought to be an elective surgery. That would mean it can be up to you in terms of what sort of lifestyle and pain levels you are willing to endure vs getting a prothesis.

Definitely investigate all and any alternatives if you have reservations about anything to do with the procedure being suggested. Your succcess in any joint replacement is often tied strongly to your confidence in the surgeon and your ability to come back from it rehabilitation wise.

-- (Msmorro@aol.com), October 03, 1999.

Check search engine google under 'alternatives to knee replacement'. You will see several posting about uni-spacer, a relatively new procedure. Also there are injections of a fatty substance that lubricate instead of cartilage between knee joints. Note that in some cases, knee replacement may be an elective procedure, so get insurance approval first. I will certainly investigate more than just having this nasty surgery.

-- Paul W. Preston (paulwpreston@aol.com), December 07, 2002.

I have 86 year old mother who is not able to have any radical surgeries because of chronic anemia,autoimmune problems,Sjogern Disease/Syndrome,and she had since childhood a very bad knee from fall and blood poisoning which almost lost her the leg at 6-7 years of age---she show allergic reactions to so many medications needed to accompany any and all surgeries that even getting her mouth ready for knee is almost impossible so is there anything else beyond the world of the knife for someone in this situation--external appliances to bolster her knee which are not so heavy she cannot lift them? she is only 120lbs herself and although it would not ease pain totally maybe it could still keep her mobile enough in the house and short trips out of the house --to car and so on---thank you

-- janice l baker (jlbaker@qx.net), August 03, 2003.

I recently[Feb.,'04] read in the inflight magazine of United Airlines of a procedure that was an alternative to knee replacement. This procedure(actually it is a series of injections) is pointed toward bone on bone problems. The clinic is based in Miami. Sorry I can't be more specific.

-- timothy delaney (tdelaney@kw.com), February 18, 2004.

This is in reference to the article in an in-flight magazine mentioned by another contributor. I think it referenced the Center for Regenerative Medicine, www.arthritisusa.net, (305) 866-8384. From what I read, this does not involve general anesthesia. I am also a younger candidate for total knee replacement and have serious reservations about doing so. I am still investigating alternatives, so I would love to hear from anyone regarding alternatives as well.

-- Amy Ruddick (aruddick@pencorp.com), December 30, 2004.