Does anyone have experience with options other than surgery, such as SynVisc-1?
I googled a bit but found 90% was just propaganda, etc., and no real feedback from patients.
Several years ago
Knee1.com - Comprehensive Knee Information,Blogs,Forums,Treatment,Care Tools,Articles and Videos was a great place to ask questions about ACL injuries/surgery/rehab. You could try the knee-replacement portion of the forum... I can't tell whether it's as good as the ACL forum was a while back.
Thanks for the feedback, it's reassuring to hear that the Total Knee can be done at advanced ages. And gosh, at 92 that is quite an accomplishment. This lady is really worried about the major surgery because of "horror" stories from her acquaintances.
I also wonder if knee replacement is covered by Tricare?
IIRC Douglas Fairbanks also had a pair of knee replacements in his 90s. Of course he didn't get referred back to Tripler Army Medical Center.
But Tricare will pay for it.
Thanks for the posts, this is very helpful. I think the DW's aunt can do the rehab but everything I read says that is key.
I am really wondering if Synvisc-1 is a route to go, the results seem so short term.
Here's a wacky thought. Do the physical therapy now. Do it with a real physical therapist using the same exercises as if she'd just had the total knee replacement. If she's not feeling an order of magnitude better after 6-8 weeks then do the surgery. Or give it another six weeks. She can always change her mind and do the surgery next month. Changing her mind after the surgery... not so much.
A few years ago in a small controlled study, patients with damage to their meniscii were told that they were going to have arthroscopic surgery. On half of them, the surgery was actually performed. On the other half, the incision was made but nothing else was done. The only people who knew which patient got what were the surgeons.
After completing rehab, the doctors interviewed their patients. (The doctors didn't know who'd actually received the surgery, either.) The results between the two groups were not statistically different.
When athletes tear their ACLs, they start physical therapy as soon as the swelling is brought under control (48-72 hours, continuing with lots of NSAIDs) before having the surgery. Building up their quads & hamstrings helps stabilize the joint and control the relative motion between the bones. When this same treatment was done with "civilians", many of them improved so much that they elected not to have the surgery.
After I tore my ACLs (and then re-injured the knees a couple years later before finally getting a diagnosis), I was nervous about the surgery. After talking to a taekwondo physical-conditioning coach, we elected physical therapy. It took me two years to get back to full strength & flexibility, and I can still feel that hopping on my left leg is weaker than on my right, but today I can do everything in taekwondo that I need to do. I also do full squats (using a 100-pound weight) & full lunges. I can even run a couple miles if I'm feeling particularly testosterone-poisoned. Maybe someday I'll have the surgery in conjunction with whatever miracle goop replaces human cartilage, but until then I'm going to stay ACL-free unless I absolutely have to have the surgery.
It's been over a decade now; so far so good. I'll never play basketball or ski a downhill slalom ever again, but I suspect that your spouse's aunt has retired from those sports too...