Are my meaningful ski days coming to an end?

[schindlerpiste]

Stem cells or my cbd cream. The cream is cheap in comparison so you might try that first.

The doctor who did my stem cell injections uses my cbd cream daily.

Just sayin...

I'll try some of your cream. PM details/invoice

Thanks

[bodywhomper]

Have you consulted with a Physical Medicine and Rehabilitation physician? They may have some viable ideas that differ from an orthopedic surgeon.

[schindlerpiste]

I did. I was told that another arthroscopy would probably do no good, and that I should do strengthening exercises (rubber band, wall squats, etc.) and see how that goes.

[bodywhomper]

I know at least some PMR’s dabble with injections, too.

[Orthoski]

A lot of wisdom in this post, also a lot of approaches that worked for some people but have less support in the literature.

From an anatomic point of view, you have wear and tear to your knee and the cartilage has been worn down and damaged. Nothing will change that - cartilage has very poor regenerative capacity and by necessity so (if it had a robust and healthy blood supply we'd bleed every time we jumped). Given that humans lived an average of 25-30 years in prehistoric ages, a huge proportion of us on this forum have exceeded our powertrain warranty.

Physical therapy can maybe help by strengthening the muscles around the knee, stretching the hamstring can decrease stress across the front, etc. Low risk, potential reward

Many traditional injections have minimal support in the literature and especially hyaluronic acid is no longer recommended by the American Academy of Orthopaedic Surgeons and is not covered or rarely covered by insurance. Steroid injections can afford temporary relief for some people.

Multiple scopes for arthritis (or even one scope for that matter) has not been well supported in the literature. At the end of the day, surgery is like a marriage. And not only in the commitment between patient and surgeon. If the first two didn't work, there's an inherent true leap of faith that the third one will somehow be different.

Stem cells and all the biologic injections (platelet enriched plasma, etc) have limited support and there's such huge variability in what is actually in the injection that you have to be very careful. I think we'll find in the long run that they're good in very specific situations, but I worry that it's the new kid on the block and we'll try and use it for everything, obscuring their actual role.

On the other hand, the ability to draw joy simply by being in the mountains. Well, if you can figure that one out, works every time.

[Bunion 2020]

^^^ Not what most of us here wanted to read but honest. Thx.

[schindlerpiste]

Thanks for the bleak, if not hard truth of it. Woe is me.

The Iceman and exercise with a bit of cream mixed in for good measure.

[JayPowHound]

Honest and very informative post, with the assumption that your references to "the research" are accurate.. and I have to reason to assume they're not.

Big takeaway for me: Enjoy time in the mountains whenever and however you can.

[spanghew]

Given that humans lived an average of 25-30 years in prehistoric ages, a huge proportion of us on this forum have exceeded our powertrain warranty. can afford temporary relief for some people.

People say this all the time, but it hasn't been my experience. I recently dug up over 200 people, all buried 3000 - 5000 years ago. Most of these folks had lived well into their 50s and 60s, and this is a common demographic observation on multiple prehistoric burial sites. The point that is correct, though, is the pain: many people had broken bones that had healed, badly, in their 30s, and they had lived with giant bone growths fusing broken femurs, for example, and suppurating wounds and TB and all kinds of other ailments that most of us today would whine about constantly and have treated with fancy chemicals. What these old-time people used to treat their pain is pretty much unknown, but they lived plenty long enough to enjoy it for quite some time.

[schindlerpiste]

I bet they were smoking/eating peyote that grew on Dino shit
...and sucking on coca leaves

[Orthoski]

People say this all the time, but it hasn't been my experience. I recently dug up over 200 people, all buried 3000 - 5000 years ago. Most of these folks had lived well into their 50s and 60s, and this is a common demographic observation on multiple prehistoric burial sites. The point that is correct, though, is the pain: many people had broken bones that had healed, badly, in their 30s, and they had lived with giant bone growths fusing broken femurs, for example, and suppurating wounds and TB and all kinds of other ailments that most of us today would whine about constantly and have treated with fancy chemicals. What these old-time people used to treat their pain is pretty much unknown, but they lived plenty long enough to enjoy it for quite some time.

It's funny that you mention this. I've looked it up and it matters if you look take into account infant mortality or not. If you take average life span of all people, it comes to about 30 years plus or minus. But if you made it to 15, then you had a likelihood of living longer, perhaps 50-60 years or even beyond that. Childhood was tough in the old days...though you didn't have to deal with social media.

[PB]

Yep; infant/child mortality was brutal back then. Once over the hurdle chances improved, although the medical challenges faced by adults back then were pretty daunting. Most of us would have been killed or committed suicide due to pain and/or incapacitation given our activities. My ruptured intestines would have been a death sentence 100 years ago. Hell, people died from tooth cavities/extractions. Wasn't much fun being a baby factory either. Turns out, the good old days ....... not so much.

[Mr C]

My 17 year old tells me I lived in the “good ‘ol Days”.

[Dantheman]

I recently dug up over 200 people, all buried 3000 - 5000 years ago.

Whoa, cool. Life Expectancy At Birth is definitely a misleading statistic when maternal/infant/childhood mortality is high. However, IIRC, evidence of osteoarthritis is common among the people who were lucky enough to make it to 50-60+.

[old goat]

IME as a not particularly zen personality the difficulty in accepting physical limitations as you age is realizing that you cannot do what you used to do. Your brains remembers what it felt like even if your muscles don't. Skiing at a level that would have made you ecstatic when you were learning can leave you disappointed as you decline. That's not to say it's not enjoyable but it might require a reordering of the psyche.

That's not to say the OP will never ski at or near his peak, at least for now. But it is something all of us have to deal with if we don't die young.

[Mr C]

Well said. Turning 60 in Jan…do what you can while you can. Just grin and bear it!

[Obstruction]

Jaysus! Not to be harsh but if being able to perform at peak level is the definition of meaningful .... and if we have to choose between meaningful or nothing I guess a lot of us geezers are going to be closing the books on our sex lives too.

[spanghew]

However, IIRC, evidence of osteoarthritis is common among the people who were lucky enough to make it to 50-60+.

Having had my hands xrayed a few times recently for relatively benign reasons, it was depressing to hear the young doctors cheerfully diagnose my finger joints as pre-arthritic and the inevitable reward for having lived this long. Doctors in general seem to think that geezers should just sit around passively observing their approaching demise to avoid answering "did you have any falls this week?" in the positive. Many nurses, too, seem disappointed to find a reasonable blood pressure and low pulse rate. I'm thinking of memorizing that Dylan Thomas poem to write on the obligatory questionnaires.

[PB]

I remember being super annoyed/insulted the first time I got the "any falls" question ....... then I fell. Now I'm annoyed if they don't ask.

[Core Shot]

Jaysus! Not to be harsh but if being able to perform at peak level is the definition of meaningful .... and if we have to choose between meaningful or nothing I guess a lot of us geezers are going to be closing the books on our sex lives too.

Heh
Banging three times or more per day ain’t happening anymore
I guess I could
But meh

[Shredhead]

Still haven’t said why TKR isn’t an option?

Tons of people here are still crushing it, with aftermarket parts.

[schindlerpiste]

Shread: Not interested, right now. I have had too many people (more than 5) come into my office who have suffered either infections, replacement failure and DVT (which have resulted in repeat procedure and even death) only to advise that these are "risks inherent in the procedure". I would have to be in really bad shape (unable to ambulate) before considering that type of misery.

[PB]

Jeezo, were they done in the slums of Calcutta??

Seriously, those are the first instances I've heard of with serious fails. I'm sure there are such occurrences, but to have encountered that many seems unusual. If there's a reverse lottery ticket, you should buy several.

[schindlerpiste]

Practice professional negligence lawn NY/NJ for 20 years and you see all kinds of things

[Dantheman]

Practice professional negligence lawn NY/NJ for 20 years and you see all kinds of things

Well, you have been retired for almost 15 years. There have been significant advancements in the field in that time. The best joint replacement surgeons in the country are right up the road at the PC hospital. There's no harm in going in for a consult. Dr. Davis is great guy. He won't recommend the carpentry solution unless it's truly justified, and most insurance won't approve it unless you're all the way at Stage 4.

The other thing to consider is that it's common to develop problems in other joints as a result of the poor mechanics your body adopts to compensate for the bad joint. AC was developing problems in her other knee and hips and those went away following her TKR.