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Suggest Treatment For Stiffness And Pain In Knee While Having Heart Disease
Question: im having stiffness and pain in my ten year old knee replacement im scared because i read i may need a knee revision done i cannot do this im 75 years old with congestive heart failure will i be able to continue to keep walking and be independent without any more surgeries
I have serious heart problems I cannot have anymore surgeries on knee
I have serious heart problems I cannot have anymore surgeries on knee
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I understand your concern, and would like to explain that before drawing a conclusion about knee revision, it is necessary a careful physical exam and additional imagine tests (knee X ray study, MRI, arthroscopy) in order to decide the level of a possible impairment.
Currently, even if a new knee revision or replacement is necessary, the actual level of anesthesia practice (spinal, epidural and even general) is such to permit a safe intervention with minimal risks for complication.
A conservative approach for the knee would be preferable if possible. Nevertheless, it remains on your attending orthopedist's decision whether to preserve or intervene.
In this latter case, it is necessary to review your actual cardiac status.
It is important you have a compensated state of your congestive heart failure (no dyspnea on daily activity, no overt edema, no uncontrolled arrhythmia).
Please, could you upload your last cardiac ECHO report, resting ECG and any other possible medical data for a direct review?
I remain at your disposal for further discussion in case of any other uncertainties.
Hope to have been helpful.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I understand your concern, and would like to explain that before drawing a conclusion about knee revision, it is necessary a careful physical exam and additional imagine tests (knee X ray study, MRI, arthroscopy) in order to decide the level of a possible impairment.
Currently, even if a new knee revision or replacement is necessary, the actual level of anesthesia practice (spinal, epidural and even general) is such to permit a safe intervention with minimal risks for complication.
A conservative approach for the knee would be preferable if possible. Nevertheless, it remains on your attending orthopedist's decision whether to preserve or intervene.
In this latter case, it is necessary to review your actual cardiac status.
It is important you have a compensated state of your congestive heart failure (no dyspnea on daily activity, no overt edema, no uncontrolled arrhythmia).
Please, could you upload your last cardiac ECHO report, resting ECG and any other possible medical data for a direct review?
I remain at your disposal for further discussion in case of any other uncertainties.
Hope to have been helpful.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
im still walking and all i want to know if im over reacting to needing a rivision also the knee replacement is a very painful journey that only a healthy heart can take on in fact it was so painful my healthy heart at the time was erratic and giving concern so when you said an epidural is safe that is not what im talking about im talking about living through the pain afterwards that could kill an old person with a weak heart, it seems your answer has nothing to do with my question...
goodbye
goodbye
Brief Answer:
My opinion:
Detailed Answer:
Dear Madam,
Living with pain is very exhaustive even in a healthy heart, so you are quite right on that topic.
What I meant with my answer is that a conservative approach (THAT IS NO SURGERY) to your problem is preferable unless the pain is as unbearable as you need to take very frequent pain killer drugs (anti-inflammatory drugs).
Remember that having too much anti-inflammatory drugs (like Advil) may have an adverse effect on your heart failure condition.
You asked me exactly” I have serious heart problems I cannot have anymore surgeries on knee” and I think that two main issues when dealing with this problem are:
(a) intra-operative risks (where anesthesia is crucial),
(b) peri-procedural period which is largely linked with CHF status.
But, if you are meaning how a person could live with a chronic persistent pain, I would say that this is more disastrous for your heart than just a painful surgery (or even more than one).
If you provide me with what I asked you above, I could give my professional opinion on the matter.
But, if you don’t prefer to continue our discussion, I respect your choice.
Have a nice day!
Dr. Iliri
My opinion:
Detailed Answer:
Dear Madam,
Living with pain is very exhaustive even in a healthy heart, so you are quite right on that topic.
What I meant with my answer is that a conservative approach (THAT IS NO SURGERY) to your problem is preferable unless the pain is as unbearable as you need to take very frequent pain killer drugs (anti-inflammatory drugs).
Remember that having too much anti-inflammatory drugs (like Advil) may have an adverse effect on your heart failure condition.
You asked me exactly” I have serious heart problems I cannot have anymore surgeries on knee” and I think that two main issues when dealing with this problem are:
(a) intra-operative risks (where anesthesia is crucial),
(b) peri-procedural period which is largely linked with CHF status.
But, if you are meaning how a person could live with a chronic persistent pain, I would say that this is more disastrous for your heart than just a painful surgery (or even more than one).
If you provide me with what I asked you above, I could give my professional opinion on the matter.
But, if you don’t prefer to continue our discussion, I respect your choice.
Have a nice day!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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