Knee replacement with psoriasis

** Originally posted by sjreis **

My PA is quite bad and even though I a only 42, I am needing both of my knees replaced. I can no longer walk more than a block at a time and cannot even go to the grocery store for my family. My ortho has agreed that the damage to my knee joints is very extensive and I need to have total knee replacements.

Here's the problem.....I have pretty bad psoriasis on my knees and the dr. does not want to cut through it. He says it puts me at a great risk for infection. Has anyone on here has this problem or had the surgery even though there is psoriasis on the knees? Please help.....I really can't wait much longer and I'm at a breaking point. I currently take Enbrel and do light treatments which helps the psoriasis, but does not eliviate it altogether.

ANYONE?

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** Originally posted by jagfangirl27 **

I think he says that it would put you at greater risk for infection because any surgical scar is going to itch, and by itching you risk getting germs into the surgical wound. I had a hysterectomy last year and the cut was in a place where I previously had P. Now I have P there worse than I ever had it, and I know I made it worse by itching the cut.

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** Originally posted by viwilkes **

sjreis,

How awful for you. The only think I can think of is that if you are on embrel, and you have psoriasis on your knees, it may be harder to heal under those conditions. There is micro surgery now for the hip but I am not sure about the knees. I have know several people who had knee replacements and they say that they should have had it done years ago because the new knee joints are so wonderful. I need new knuckle and finger joints but so far have not investigated. When it gets bad enough, I will. I hope the best for you.

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** Originally posted by RichJ **

hi viwilkes,
welcome to the p family. you will meet some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

try and have a good day all

richard

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** Originally posted by tetons **

What are your knee symptoms? I have just started having pain in my knees on the inside of both knees same location and then a little on the left outside part. I have been really exercising and hope I am just sore and that it is not my PsA progressing to my knees but it is going on two weeks now. It just burns at times and then I feel some pressure whenever walking or just sitting. It also really hurts at night to the point I can't get comfortable and if I go to sleep, it is not for long. I too am in my 40's. So far PsA is in my hips (burns, aches) and two fingers (sausage fingers, burning) with some shoulder, back invovlement (SI area) as well. I just wanted it stay in those places and not progress. Of course I am still in denial that I actually have this. I am still new to all of this. I don't know that much about psoriasis. It is evidently only mild on my elbows and with the Enbrel it is basically mild. I was put on medicaiton more for the PsA

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** Originally posted by saiyedfz **

Glucosamine/Chondroitin is supposed to help in knee arthritis. I have hip arthritis and been taking Glucosamine for a while now and it does seem to help. If you are not already taking it, please try if you can to see if it works before going for surgery.

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** Originally posted by jbattista **

I would definitely put off having the knee replacement until your psoriasis heals. If you would get an infection in the joint, they treat it by removing the implants and iv antibiotics. Then you would have to go through the whole process again after living a while without a knee. Sounds terrifying if you ask me.

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** Originally posted by DEBAK **

I don't know that it would increase your infection risk more likely is the potential for the koebner effect which causes P to be worse in that area that has been traumatized ie where the incision is. Pre and post op antibiotics will cover the infection risk. I think you will have to go off the enbrel before surgery so that you are not as immune compromised which could cause more infection risk but the cutting thru the P in and of itself should not be an infection risk.

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** Originally posted by ericw10 **

My PA is quite bad and even though I a only 42, I am needing both of my knees replaced. I can no longer walk more than a block at a time and cannot even go to the grocery store for my family. My ortho has agreed that the damage to my knee joints is very extensive and I need to have total knee replacements.

Here's the problem.....I have pretty bad psoriasis on my knees and the dr. does not want to cut through it. He says it puts me at a great risk for infection. Has anyone on here has this problem or had the surgery even though there is psoriasis on the knees? Please help.....I really can't wait much longer and I'm at a breaking point. I currently take Enbrel and do light treatments which helps the psoriasis, but does not eliviate it altogether.

ANYONE?

Im also 42 and probably will need a hip replacement soon. Luckily the knees are nowhere near as bad and hopefully the treatments have arrested further damage. But I think you may want to get a 2nd opinion from another orthopedic surgeon. His concern is valid, but it should not stop him from treating you. He is scared of litigation. I would contact your derm and explain the situation and he can possibly refer you to a "P friendly" ortho. Either that or he gets you on some potent 'roids to get you cleared up long enough for the surgery.

And I dont know your particular knee situation, but if not a total replacement, they have minimally invasive techniques that dramatically reduce the size of the incision.
http://nyp.org/masc/unicom_knee_repl.htm


My wife had torn meniscus in both knees from going at it too hard in her Zumba class. They did laporoscopic surgery and all she had was 3 tiny incisions. Was up and around in a few days. They did the same thing for my Inguinal hernia operation. Just a few 1/2" long cuts and I was discharged an hour after recovery and outside washing the car that evening. Amazing what they can do these days. My Dad had the same surgery 25 years ago and he was wiped out for a week with a huge incision across his belly.


So get a few different opinions. Will be some extra co-pays, but worth it to know you are getting the best option for you. Best of luck.

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** Originally posted by Since1966 **

I have been on Enbrel for 5 years and have p on both knees. I had an ACL replacement on my R knee and have had meniscus repair on my L knee in that time frame with no complications due to p. My ortho DR wasn't concerned about infections or the p conditon. You may need to get another opinion. I also have a NB UV light unit for home use that keeps the p reasonably flat and scale free.
Hope this helps.

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