MDA Q & A Knee replacement surgery (CMT)

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>>>>I found this interesting about knee replacement surgery and CMT

http://www.mdausa.org/experts/ask_cmt.html

SUBJ (2/01): KNEE REPLACEMENT SURGERY

I was diagnosed with Charcot-Marie-Tooth (CMT) disease at age 20; I'm now

58. I have mild symptoms and have been relatively active in the past 40 years,

doing almost anything I desired with some limitations. I have osteoarthritis in

my knees. At age 44, I had my right knee scoped and cleaned out. Everything went

well. However, for the past seven years, my knees have bothered me enough to

consider more help. Almost one year ago, both knees were scoped and cleaned out

and microfractures were done to try to regenerate more cartilage. Nonetheless,

my right knee is still very painful and my doctor wants to do a knee

replacement. I'm concerned about this surgical procedure and its effects as

relates to my CMT. I am a stable patient, meaning no braces, no turning feet or

other problems that might interfere with recovery; however, I cannot use

crutches due to lack of strength in my shoulders and back. After my last

arthroscopy, I noticed my balance is not quite as good and walking in the dark

is more difficult. I am eager to walk with no pain, but I am concerned about the

effects of repeated surgery and, particularly, a knee replacement with CMT. Any

thoughts on this issue would be greatly appreciated.

REPLY from MDA: Irwin M. Siegel, M.D., MDA Clinic Director, Rush

Presbyterian-St. Luke's Medical Center, Chicago, IL

I would proceed very cautiously with a total knee replacement in a patient

with CMT. CMT is a progressive disease and has apparently already affected your

knees. What little normal sense of balance remains in the affected knee may be

lost with a total knee replacement. Other treatments, which are not as radical,

such as the injection of Synvisc or a similar product, as well as appropriate

bracing, should be tried before resorting to further surgery.

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