UKC

Both my knees severely restrict me when descending steep uneven ground after climbing.I am very unstable and even with poles i struggle to get down without either falling over and struggling on the easiest of paths.I am waiting on various scans to happen and have seen a consultant who says my ligaments are okay.So anyone who has had similar issues or knee replacements your thoughts and advice will be much appreciated. Climbing up is fine as i load the joints differently.

John

I find myself in a similar position, uphill OK, downhill painful - especially with a sack full of climbing gear. I've seen various doctors/physios and received contradictory replies. 

The best advise that I've followed is to strengthen the quads. Lunges, squats, single leg squats and cycling are my new friends - three times a week. I also do single leg balance exercises regularly.

My physio tells me that knee replacement surgery will not give me the range of movement that I have now. I'm still 5yrs away from that. I intend to spend that 5 yrs getting my legs stronger - it's working for me now

Good luck.....Jeff

As far as the knee replacement and range of movement issue goes, it may well depend to some extent on your priorities with climbing and walking. Some people get the range to climb as before, some are compromised (proper rehab obviously essential). I am in a similar position to you (assuming you have osteoarthritis - imaging will confirm). My hillwalking is gradually becoming more affected and if I didn't climb I would probably be getting on with replacement, but I have been holding off for a couple of years because of the risk of messing up my climbing. At some point, possibly quite soon, the loss of hillwalking and, of course, mountain rock climbing will swing the balance the other way and make me take the plunge.

There is no perfect timing. Surgery has its risks and replacements don't last forever* but, on the other hand you don't want to end up after surgery wishing you had gone for it five years earlier and had been able to do a lot more in that time.

My advice would be to see a good, recommended, knee surgeon so that you know where you stand and definitely keep up the knee strengthening (physio will advise) - it will make your knees last longer and when you do have surgery rehab will be better with strong knees (don't end up inactive and weak before surgery by delaying too long).

*My surgeon said that 90% of replacements work well after 15 years and can last up to 30, so factor in your age!

I had a problem with my right knee. After having an MRI scan it turned out that my patella was misaligned and it was grating on my patella. The operation involved cutting my tibia, realigning it and scraping out some stuff from my kneecap. This has been very successful. I would wait until your consultant has looked at your scans and you might not need a complete knee replacement. 

Sounds like OA...my best advice  is to get some private medical insurance now and/or start saving. As for strengthening your legs before surgery...in an ideal world, great idea. In NHS world...you won't get onto a list for knee replacement until you can't walk and are in 24/7 pain. In the ensuing 2-3 years you spend on a waiting list, your muscles will have wasted away..along with all the other things you value in life...