Knee surgery question

[Turbobalaclava]

I have a somewhat vague question regarding knee surgery and enlisting. I had knee surgery in 1998 to repair a fractured and dislocated knee cap I recieved while playing soccer in collge. I went through around 8-9 months of rehab and was cleared to play again. Fast foward to 2006, I am now 27 and looking closely at the 18x enlistment option. My question is this.

What are the chances of someone with that kind of injury getting cleared to enlist or at least getting a wavier? I realize this question has no black and white answer but I am hoping to get at least a little piece of mind.

I have not had any problems with the knee since the surgery and can do all that is asked at the MEPS physical(or at least all that I know of). I am currently rucking with around 60lbs, running, lifting, doing pt, and trying to learn to land nav and once again have no problems. My fear is that when the Doctors look at my knee and the scar on it, they are going to balk. If anyone has experience or knowledge that may be helpful or increase my chances of passing the physical I would be very thankful.

Thanks in advance for any insight and for putting such a informative site together.

More importantly, THANK YOU all for your service and sacrifice.

[The Reaper]

Do some reading. Do some searching here.

AR 40-501 is all you need to know.

TR

[Turbobalaclava]

Thank you The Reaper. I have looked through that document before, but once you mentioned it again, I noticed several parts that I missed. This does not bode well to my "paying attention to detail".

Regardless, question pretty much answered.

[The Reaper]

I think you will need a waiver, which may be difficult to obtain.

Best of luck.

TR

[Doc]

Turbobalaclava,

I like your ability to be respectful and straightforward. Go to MEPS, show them everything you've got and request a waiver.

I did 24 years after I showed them my situation and got a waiver. Hopefully, you will too.

Go for it.

Good luck.

[greenberetTFS]

I've been postponing replacement knee surgery,both knees,for several years now and when I did a search I came up with this post. I've been getting cortisone shots every 3 months at the VA,it's the most they will allow now. However they don't last more than a couple of weeks and than the pain is back again. They said I definitely need surgery because it's "bone on bone" now. They claim it's a 6 to 8 week recovery period and of course they will only do one knee at a time. I'm an old codger and I think it may take longer than that. Any one out out there have a recent knee replacement they can tell me about thier actual recuperation period? :(

GB TFS

[Red Flag 1]

see below

[greenberetTFS]

My involvement with joint replacement surgery has been limited to providing surgical anesthesia. Given that, most folks just seem to know that surgery is the solution for mobility without pain. If the articular surfaces have been destroyed, it is hard to see a solution without surgery.

The bulk of my cases were done with regional anesthesia. Physical Therapy began in the Recovery Room within the first hour after surgery. I would expect that your post operative experience would see more mobility with less pain, on a daily basis. Your surgeon knows you best, he/she should be able to give you a pretty good idea of how long your recovery should take.

RF 1

RF1,

Thanks for the quick responce....They told me 6 to 8 weeks, but at my age I find that hard to believe...:rolleyes:

GB TFS

[JJ_BPK]

I've been postponing replacement knee surgery,both knees,for several years now

GB TFS

I've had friends with knees & hips,, and the doc keeps threatening me about my hips.

The only consistent point(s) I ever heard:

1)don't wait to long.. If the old bones are losing calcium, you can get on the back side of the curve, to the point where they don't want to do the procedure.

2)the longer you wait the Doc's will find a way to make it an out-patient drive-thru procedure at Micky D's. :D

And you can quote this non-professional FOG that doesn't like a lot of pain,, anymore....

Good Luck...

[Dad]

TFS
For what it is worth, my father had it done7 years ago when he was 80 and was playing golf 8 weeks later. Is 87 now, no longer plays golf but has been pain free since the surgery-minus the rehab

[PSM]

My grandmother had hers replaced in her early eighties and was up and about pretty quickly. Then again, she left the hospital several days sooner than a man who had his done the same day and he was 25 years younger than her. It could depend on your genes.

Good luck.

Pat

[AF Doc]

TFS --

First I should say that this is not my area of expertise. Given that though, the usual course is to start physical therapy shortly after the operation--think hours not days. A reasonable goal is to be up using a walker or crutches in 4-6 weeks or sooner. Moving under your own steam or with a cane in 6-8 weeks. You won't be at 100% yet, but return to modest activity is not out of the question.

Here's the fine print though: "your mileage may vary." Different factors can affect your recovery time. Most important is your will and discipline to do the assigned physical therapy. Somewhere I heard an old adage about the surgeon being only as good as the patient's physical therapy. Not entirely true, but not entirely wrong. As you are a QP, I don't see a problem here.

Most patients are warned that recovery can take up to 6 months. So hold off on booking that skiing holiday in Switzerland just yet. The key is to do the physical therapy--there are no short cuts. Just like life, eh?

Remember, once your new hinges are installed, you can expect to get 10-15 years service out of them. But ask your surgeon what you can realistically expect given your overall health.

Here's wishing you good health and a quick recovery!

[tom kelly]

I've been postponing replacement knee surgery,both knees,for several years now and when I did a search I came up with this post. I've been getting cortisone shots every 3 months at the VA,it's the most they will allow now. However they don't last more than a couple of weeks and than the pain is back again. They said I definitely need surgery because it's "bone on bone" now. They claim it's a 6 to 8 week recovery period and of course they will only do one knee at a time. I'm an old codger and I think it may take longer than that. Any one out out there have a recent knee replacement they can tell me about thier actual recuperation period? :(

GB TFS
After going to The Phila.VAMC Orthopedic Clinic for 9 years and NEVER seeing the same Doctor MD, PA or nurse practioner twice and the fact that I never saw a Board Certified Orthopedic Surgeon at the VA, I was given the procaine and steroid injections 4 times per year for the last 4 years along with Naproxen 500mg. Tablets 2x per day for pain. After 3 years of this treatment A 4th year surgical resident switched me to physical thearpy and Acetaminophen 500 mg every 6 hours for pain as needed. On June 25,2008 I went to the Phila. VAMC and saw my Primary Care Provider because of the severe pain in my L/ knee, she refered me to X-Ray for an MRI which showed "Marked degenerative changes involving the left knee. I believe there is displaced medial meniscal fragment/ tear as described. But also believe there is a remote ACL tear with relocation of the distal tendon now adjacent to the medial condyle in the intercondylar notch. Primary Diagnostic Code: Major Abnormality." Primary Interpreting Staff: Joseph R Perno, MD, PhD ( Verifier). This report was sent to the Primary Care Provider who in turn refered me to Ortho for a consult. She said I was supposed to see the Chief Resident and let him decide the best approach. Turns out I saw a 3 year resident with an intern who gave me another injection and a perscription for Acetaminophen 325 mg 1 tablet every 6 hrs. for pain. Three days later the left knee gave in and I could not support any weight on it nor could I climb stairs using the L/knee for support. I went to Penn Orthopedics at Pennsylvania Hospital and saw Robert E. Booth MD of Booth, Bartolozzi, and Balderston who are rated the Top Knee Replacement Surgeons in the country. Dr. Booth looked at the X-Rays and the MRI and examined both knees and told me I needed a Total knee replacement for both knees. He also said he does 1700 knees per year has 33 years experience and that it takes him 25 minutes to do each knee. After surgery you go to Recovery for 12 hrs. and you are placed on a CPM (continuous passive motion) machine to gently bend the knees to keep them from getting stiff. The hospital stay is 3 or 4 days and then you go to a rehab facility for 5 days and you are sent home with instructions to go for physical therapy for 4 to 6 weeks to build strength before returning to normal activity. Regard's, tom kelly

[JJ_BPK]

I went to Penn Orthopedics at Pennsylvania Hospital and saw Robert E. Booth MD of Booth, Bartolozzi, and Balderston who are rated the Top Knee Replacement Surgeons in the country. Dr. Booth looked at the X-Rays and the MRI and examined both knees and told me I needed a Total knee replacement for both knees. He also said he does 1700 knees per year has 33 years experience and that it takes him 25 minutes to do each knee. After surgery you go to Recovery for 12 hrs. and you are placed on a CPM (continuous passive motion) machine to gently bend the knees to keep them from getting stiff. The hospital stay is 3 or 4 days and then you go to a rehab facility for 5 days and you are sent home with instructions to go for physical therapy for 4 to 6 weeks to build strength before returning to normal activity. Regard's, tom kelly


Tom,,

Sorry to hear that the VA treated you so bad. I hope Dr Booth has you up & golfing shortly. :lifter:cool::D

Per chance, did you ask the Doc if he had any relatives that worked at the Ford Theater in D.C. ??? :eek:

Best of Luck,,,

[cszakolczai]

I've been postponing replacement knee surgery,both knees,for several years now and when I did a search I came up with this post. I've been getting cortisone shots every 3 months at the VA,it's the most they will allow now. However they don't last more than a couple of weeks and than the pain is back again. They said I definitely need surgery because it's "bone on bone" now. They claim it's a 6 to 8 week recovery period and of course they will only do one knee at a time. I'm an old codger and I think it may take longer than that. Any one out out there have a recent knee replacement they can tell me about thier actual recuperation period? :(

GB TFS

If I may... look into a company called Carticel. I had bone on bone in both of my knee's. They take a biopsy of your cartilage, grow it in a lab in Massachusetts, then implant the cartilage back into your knee. I'm not sure if they actually have an age limit (no offence) I just know that my doctor said in younger patients the cartilage usually always grows. May be of interest for you though.

[mac117]

Turbobalacava.....if you have full range of motion, can squat, jump, walk, and your knee presents a stable presence when put through a knee exam you should have no problem with enlisting. You may require a waiver, but that should not be a problem....you may have to be persistant with your desire to enlist. If one DR tells you no, don't stop there. (Remember, there is a war going on! You shouldn't have too much difficulty)

I had my right meniscus repaired in 92 and continued jumping, rucking, running, and deploying for 9 more years, and we won't go into the other injuries. You would be hard-pressed to find a professional soldier who hasn't had something repaired, replaced, or removed and is still performing.

Good luck....and be persistant!

[greenberetTFS]

After going to The Phila.VAMC Orthopedic Clinic for 9 years and NEVER seeing the same Doctor MD, PA or nurse practioner twice and the fact that I never saw a Board Certified Orthopedic Surgeon at the VA, I was given the procaine and steroid injections 4 times per year for the last 4 years along with Naproxen 500mg. Tablets 2x per day for pain. After 3 years of this treatment A 4th year surgical resident switched me to physical thearpy and Acetaminophen 500 mg every 6 hours for pain as needed. On June 25,2008 I went to the Phila. VAMC and saw my Primary Care Provider because of the severe pain in my L/ knee, she refered me to X-Ray for an MRI which showed "Marked degenerative changes involving the left knee. I believe there is displaced medial meniscal fragment/ tear as described. But also believe there is a remote ACL tear with relocation of the distal tendon now adjacent to the medial condyle in the intercondylar notch. Primary Diagnostic Code: Major Abnormality." Primary Interpreting Staff: Joseph R Perno, MD, PhD ( Verifier). This report was sent to the Primary Care Provider who in turn refered me to Ortho for a consult. She said I was supposed to see the Chief Resident and let him decide the best approach. Turns out I saw a 3 year resident with an intern who gave me another injection and a perscription for Acetaminophen 325 mg 1 tablet every 6 hrs. for pain. Three days later the left knee gave in and I could not support any weight on it nor could I climb stairs using the L/knee for support. I went to Penn Orthopedics at Pennsylvania Hospital and saw Robert E. Booth MD of Booth, Bartolozzi, and Balderston who are rated the Top Knee Replacement Surgeons in the country. Dr. Booth looked at the X-Rays and the MRI and examined both knees and told me I needed a Total knee replacement for both knees. He also said he does 1700 knees per year has 33 years experience and that it takes him 25 minutes to do each knee. After surgery you go to Recovery for 12 hrs. and you are placed on a CPM (continuous passive motion) machine to gently bend the knees to keep them from getting stiff. The hospital stay is 3 or 4 days and then you go to a rehab facility for 5 days and you are sent home with instructions to go for physical therapy for 4 to 6 weeks to build strength before returning to normal activity. Regard's, tom kelly

Tom,

Thanks for the feedback, however I haven't decided that I'm going to get the operations yet. My surgeon's name is Dudley S. Burwell Jr. He's an independent, operating out of Biloxi,Ms. His practice is Advanced Orthopedics, they are contracted by the VA because the VA doesn't have the capabilities for this at their Biloxi facilities. I've had only one bad experience with the VA when they gave me,what was later termed a "false-positive" on a head scan. But in general they have taken good care of me for quite a few years. Again,thank you for the info.

GB TFS

[greenberetTFS]

Don't have to concern myself any longer about getting my cortisone shots. The doctor told me not to come in for the appointment, since he recommended surgery, the VA said I'm no longer allowed to receive the shots! Unless I have the surgery my appointments with orthopedics is over. Didn't I just say the VA has been pretty good to me over the past years. Well, this is the 2nd time they've screwed me......:boohoo

GB TFS :(

[Red Flag 1]

worthless.

[Boomer-61]

Regarding the original post of the young man with the fractured patella. I had a fractured femur healed, had the rod removed and enlisted without issues. I would assume if you've been asymptomatic with this for many years, you have a well healed fracture. You should be good to go. But, I'm not the gate keeper. Good luck.
Regarding the questions about knee replacement, I've been subspecialized in hip and knee reconstruction for 18 years. At our facility the general protocol is: The surgery takes about an hour, you are in recovery for about an hour, in the hospital for about three days. You will leave the hosp when you can get in and out of bed on your own, walk up and down the hall and do steps with PT. You will be discharged home with home health if needed, PT 3 times a week for a month either in home or at a facility. You will protect your gait with crutches or a walker for about a month and a cane for about a month after that. You will improve rapidly for the first several weeks and then progress will slow to the point of a complete recovery in about 6-9 months. During that recovery period you will be able to return to activities of daily living and could go back to work in 6-8 weeks depending on the type of work you do.
The weak link in total knee replacement is the bearing surface ie the polyethelyne plastic. The wear properties have imporved dramatically in the past ten years. There is no way to predict how long they will last, it varies with lifestyle, age body habitis etc. For our average 74 year old lady it should last a life time. Things that decrease life span of the device are: impact loading, obesity and abuse. For the average male at his ideal body weight, he could expect a 1% per year rate of failure, meaning at ten years there is about a 90% chance that you're still going strong.
Complications include: deep vein thrombosis, pulmonary embolis, infection and any host of issues involving allergic reactions or anasthetic complications.
Total knees are not normal knees. There are many things you can do with them but you should not do any impact loading sports, ie running, tennis, basketball etc. Things to do are: swimming, golf, cycling etc. It's a great operation, our patients get up and walk that afternoon. When you look at the national statistics on either knee or hip replacement surgery it has the highest patient satisfaction rating. It is the most predictable life enhancing, cost effective surgery.

[greenberetTFS]

Guys,

This is should be my last post regarding knee surgery...Due to financial reasons,I need to work in order to supplement my social security.So I've decided to go with visco supplement since the VA approved it over cortisone shots. They told me it should last at least 6 months and maybe longer. Thanks for all the feedback......:D

GB TFS :munchin

[Red Flag 1]

q

[Boomer-61]

I hope they are effective for you. Drive on.
Boomer