Is joint replacement necessary?

[flower4]

Two years ago I had MRI of knee. Impression 1.Small radial type tear in the body of the lateral meniscus with no displaced meniscal fragments.2.Isolated bone marrow edema in the most anteromedial aspect of the medial femoral condyle with no associated fracture.3.Mild tricompartmental osteoarthritis manifested by loss of joint space,marginal osteophytes and mild cartilage loss. No full thickness cartilage defects.4.Knee joint effusion with no osteochondral intraaticular bodies. 5. Bilobed popliteal cyst.Cortison injections were given
I have had problems since I had syvinal injections which worked for 7 months. Pain in knee and the gel injections a second time in April. Knee pain has returned. I also have RA and have been on Plaqunil for a few months.I also have thinning of the bones.I am a 52 year old female. My Dr said I should go ahead with knee replacement. I trust my Dr. but am a little afraid of such a major surgery.Dr. took x-rays last office visit.

[Dr Vinod]

Beg your pardon for not completeing the treatment part.

Total knee replacement at your age after all the problems and conservative treatment failing is the best option.
You can follow the advice of your orthopaedician but he has to explain all the pros and cons to you.
You would need physiotherapy to recover after the surgery and it would be intense till 6 months and you have to continue some form of exercise lifelong.
If you understand the whole procedure you can go ahead!
Take care..

[flower4]

My main question is about knee replacement since I have been disgnosed with RA.My biggest concern is in your opinion is knee replacement necesssary?

[Dr Vinod]

When RA is clinically suspected, immunological studies are required, such as testing for the presence of rheumatoid factor (RF, a specific antibody).
Because of this low specificity, a new serological test has been developed, which tests for the presence of so called anti-citrullinated protein antibodies (ACPAs). Like RF, this test is positive in only a proportion (67%) of all RA cases, but is rarely positive if RA is not present, giving it a specificity of around 95%

The American College of Rheumatology has defined (1987) the following criteria for the classification of rheumatoid arthritis:

Morning stiffness of >1 hour most mornings for at least 6 weeks.
Arthritis and soft-tissue swelling of >3 of 14 joints/joint groups, present for at least 6 weeks
Arthritis of hand joints, present for at least 6 weeks
Symmetric arthritis, present for at least 6 weeks
Subcutaneous nodules in specific places
Rheumatoid factor at a level above the 95th percentile
Radiological changes suggestive of joint erosion
At least four criteria have to be met for classification as RA.


Take care!

[flower4]

Do you start at top of questions and work your way down? I am awaiting your reply from 7/29. Thank you very much. Flower4

[flower4]

I went searching on systemic bone disease. I found lupus. I tested postive for RA.and am being treated for RA. Would all the tests my rhumatologist ran find this? I have not had any skin rashes and seem to always have symtoms of bladder infection or over active bladder.I have had a lot of bladder infections in the past with blood in my urine. I had a cystoscope years ago to make sure I did not have bladder cancer since I smoked when I was younger. I have swollen joints and run fever at times.

[flower4]

Thank you.I am so nevous about this surgery.My rhumatologist has said he does not want me to keep having cortison as I may need it for my RA. during flairups.What is systemic bone disease?

[flower4]

One fact I forget to mention before. I also have bone island in the distal femoral diaphysis. Could you please tell me what my mri means. My surgery is in 3 weeks.I realize you can not tell me if I need surgery or not but I would like you thought on this.Thank You so much Dr. Gratefully yours flower4