Knee Replacement Surgery

[JohnS]

Hi everyone. I was diagnosed at the end of last year. I am scheduled for a partial knee replacement in May. Does anyone have experience of a knee replacement in someone with MND? My neurologist is concerned that being off my legs a lot during rehab may really accelerate the MND weakness in my legs. But I am keen to get the knee done because at the moment, with my wife helping with all the hand dexterity problems, the main QOL problem for me is inability to walk far because of my knee!

[Tabbycat]

I worked on an orthopaedic rehab ward for 6 years. They will get you up and weightbearing/walking a few steps with a frame the day after surgery.

The most important thing is to take regular pain relief as prescribed (four hourly through the day) so you can comfortably do the exercises and walking, to get the best out of your new knee.

I don't recall treating any patients with a diagnosis of MND but I would say your biggest issue would be muscle fatigued.
Are you using any walking aids at the moment?

If gripping a rollator frame (walking frame with 2 wheels at the front and 2 ferrules at the back) is a problem they can use a gutter frame which you lean your forearms on. This will be temporary until you build it the strength in your quadriceps muscle.

[Ellie]

A warm welcome to the forum JohnS

My neurologist is concerned that being off my legs a lot during rehab may really accelerate the MND weakness in my legs ... the main QOL problem for me is inability to walk far because of my knee!

You both have compelling arguements John and the final decision should be yours to make.

You don't say if your legs are affected by ALS - your muscle mass before the op is important but if it's already less because you can't walk far, then how much, if any, ALS is affecting you legs becomes more relevant for rehab.

I have known a few people who had their ankles/lower legs immobilised for weeks because of fractures, so no weight bearing at all and when the plaster came off, those with the best function before the break more or less regained it.

In my mind, QOL is the driver in any situation. Plus, you'll have to answer to Tabbycat if you're not doing your exercise regimen 😉😘

[TinyLady]

JohnS - I had a total hip replacement long before my MND diagnosis (15 years ago) so not able to comment specifically. But what I do remember is how quickly you are encouraged to keep mobile and regular moving and physio really helped recovery.

I think if I had it done now (with MND), the inactivity from the pain before surgery would probably make me less mobile than the reduced movement immediately afterwards. But everyone is different. Good luck if you go ahead. I love my new hip and the life it gave me.

[JohnS]

I worked on an orthopaedic rehab ward for 6 years. They will get you up and weightbearing/walking a few steps with a frame the day after surgery.

The most important thing is to take regular pain relief as prescribed (four hourly through the day) so you can comfortably do the exercises and walking, to get the best out of your new knee.

I don't recall treating any patients with a diagnosis of MND but I would say your biggest issue would be muscle fatigued.
Are you using any walking aids at the moment?

If gripping a rollator frame (walking frame with 2 wheels at the front and 2 ferrules at the back) is a problem they can use a gutter frame which you lean your forearms on. This will be temporary until you build it the strength in your quadriceps muscle.

Thanks Tabbycat. I don't use any walking aids except poles so far. I have lost a lot of mass from my quads but there was a lot on there previously; so lucky in that regard I guess! My physio thinks i have enough to be OK... The problem in judging my situation is that my legs do get fatigued but I can't be sure that's the MND or the strange gait adopted to walk with the knee. My wife says I look like Baptiste (BBC series)

[JohnS]

A warm welcome to the forum JohnS



You both have compelling arguements John and the final decision should be yours to make.

You don't say if your legs are affected by ALS - your muscle mass before the op is important but if it's already less because you can't walk far, then how much, if any, ALS is affecting you legs becomes more relevant for rehab.

I have known a few people who had their ankles/lower legs immobilised for weeks because of fractures, so no weight bearing at all and when the plaster came off, those with the best function before the break more or less regained it.

In my mind, QOL is the driver in any situation. Plus, you'll have to answer to Tabbycat if you're not doing your exercise regimen 😉😘

Thanks Ellie. I feel a bit more empowered now xx

[JohnS]

JohnS - I had a total hip replacement long before my MND diagnosis (15 years ago) so not able to comment specifically. But what I do remember is how quickly you are encouraged to keep mobile and regular moving and physio really helped recovery.

I think if I had it done now (with MND), the inactivity from the pain before surgery would probably make me less mobile than the reduced movement immediately afterwards. But everyone is different. Good luck if you go ahead. I love my new hip and the life it gave me.

Thank you TinyLady!