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I’ve finally made the decision to have a total knee replacement. After years of pain and limited function it is time to improve my quality of life.
The decision has been a long time coming and didn’t occur overnight. In this article I will share my knee experience from beginning to end with others who may be considering a total knee replacement.
I’ll share experiences from my youth, “my Injury” and I’ll share how I’ve been able to cope (cope isn’t the right word because I still did most of the things I enjoyed) with a bad knee throughout my adult life.
When I began searching for information about knee replacement surgery, I found plenty of advice on the from doctors and hospitals, but I found little when it came to personal experience.
As with any big decision, I not only wanted to hear from the experts, but also peers who had similar experiences, doubts, and questions like myself. I hope this article quenches some of your thirst for information.
An Active Childhood
I’ve always been very active and quite athletic since I was a child.
I grew up in the 1950’s and 1960’s. My dad spent thirty years in the Navy so every two to three years we would move to a new location.
Most of my time was spent outdoors with my two brothers and the neighborhood kids. We spent very little time watching television. I played baseball, basketball, football and many other sports and activities.
Many of the activities took place on hard surfaces, in the street or on concrete courts. Other activities took place in the woods or near the ocean depending on where we lived. During the summer and weekends, we would leave the house after breakfast and chores and meet up with the neighborhood kids.
During the school year, after a snack we were out the door. We would pick teams and start playing whatever sport was in season. We would only stop for meals. In the summer we didn’t come back inside until it got too dark to play.
When we lived in Rhode Island, time was spent building tree forts, running around the woods. In the winter we went sledding, ice-skating and had snowball fights.
From the age of seven to eighteen I played organized baseball, Little League, Pony league and American Legion in the summers.
I never had any serious injuries except a broken arm sustained when I fell out of a tree playing tree tag at age 10.
In high school I played basketball and baseball for four years.
My older brother tore ligaments in his knee playing high school football and was unable to play baseball his senior year in high school. My dad strongly suggested that I not play high school football. I was injury free during my high school years.
The summer that I graduated I broke my arm playing American Legion Baseball. My arm healed and I was able to play 3 years of College baseball until I broke my leg playing in a summer league between my Junior and Senior year of college.
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A Torn Meniscus: The Cause of My Total Knee Replacement
During the summer of 1972, I slid into third base and sustained a spiral fracture of my right tibia. I had a pin inserted below the knee and another through the ankle. After eight months the pins and the cast were removed.
A great deal of atrophy takes place when you have a cast above the knee for eight months. Unfortunately, I broke my leg playing baseball in a summer league back home. I then returned to college three hundred miles away.
In order to attend class with a cast above the knee, I carried a car jack stand around to prop my leg up in class. I returned home every month to see my doctor. When the cast was removed, my doctor assumed that I would get therapy through the baseball team at my college.
My college baseball career was essentially over, the season had started and I would not be able to play again before my eligibility ended. So, I did not have any formal therapy. I had a leg press in my garage and a bench press that I worked out with.
After eight months in a cast I was itching to get back on the field or on the court and I did not pay enough attention to rehabilitating my knee. I began to play pick-up basketball, then seven months after getting the cast off I played City League basketball.
In the first game, I stole a pass and went in for an uncontested layup. I jumped off my left leg, landed on my right leg and felt my knee buckle. I knew something was wrong and limped out to my car. The next day it was swollen with fluid. I had my knee drained for the first of several times.
An orthopedic doctor confirmed that the cartilage in my right knee was torn and that I would need an operation to repair the knee. This was before arthroscopic surgery. I had a spinal, watched the doctor remove torn fragments and thought it was all repaired as good as new.
I did receive therapy and built up the muscles around my knee. Two years later at the age of 24, l was playing basketball and the knee buckled again.
After a trip back to the doctor I had my second old-fashioned knee operation to remove more of the cartilage. Again I rehabbed with extensive therapy.
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After rehab, I was able to play basketball 2 nights a week, ran a mile 3 times a week and played competitive softball into my fifties when the knee no longer functioned well enough to perform on the court or on the field. I had an occasional cortisone shot that relieved the pain for short periods. I always wore a neoprene compression brace and took anti-inflammatory pills on a regular basis.
In my mid-fifties I visited an orthopedic surgeon who scheduled an MRI. After reading the results, he told me I was a candidate for a knee replacement and when the pain became unbearable I should come back to make an appointment for a knee replacement.
In the meantime, he suggested that I receive a series of hyaluronic injections in the knee and go to therapy. At that time, he said that 60% of patients had a positive reaction to the injections. Unfortunately, I was not one of the 60%.
He also prescribed six weeks of physical therapy and the doctor gave me a prescription for a high tech custom knee brace. I was able to resume the same activities for about two years until I began to feel like I could no longer perform at a competitive level.
I quit running, playing basketball and softball. I began to swim every day and ride my bicycle to and from work. I didn’t and still don’t enjoy swimming but it was one of the few cardio exercises I could do and not feel any pain.
Bicycle riding for me was seasonable but definitely built up the muscles around my knee and increased my range of motion. In my late 50’s and 60’s, I became very involved in hiking. I hike 8 miles twice a week.
Living with a Painful Knee
I began to use anti-inflammatory pills before and after activity. I also began to wear a compression brace to keep my knee warm hoping it would increase blood flow.
I began to take glucosamine supplements daily. They didn’t seem to make any difference but it’s hard to tell with supplements because they work overtime, not immediately.
I tried to eliminate walking on concrete, asphalt and other hard surfaces. I looked for dirt paths to do my walking on. I began to ice my knee more often after activity and began to find the knee to be painful and throbbing when I was in bed.
So I took more anti-inflammatory pills. When I hiked and walked around the neighborhood I began to use walking sticks or a cane.
Anytime I had to stand and wait, I found myself putting the majority of my weight on my good leg. I began to feel pain in my left hip if I stood too much. The same hip pain occurred if I walked long distances especially on concrete and uneven surfaces at the beach.
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Knee Pain As A Senior
After retirement, I moved to the Coast. I enjoyed hiking, walking on the beach and I began to play pickleball. I was able to ride my bike year around.
At age 65 I really began to notice that the knee was progressively getting worse. Walking on the beach and walking down hills when hiking began to be very painful. Even walks with my wife around the neighborhood on asphalt or concrete became very painful.
I really enjoyed the introduction to doubles pickleball but my mobility was very limited, plus I was playing on a hard surface pounding the knee joint. During this time, my family and friends began to make comments about my limping.
They also noticed that my leg was beginning to bow out. I knew it was time to see an orthopedic surgeon. Still, I continued to put it off.
My Knee Replacement Diagnosis; Meeting with Doctors; Advances In Knee Replacement Surgery
My wife and I travel to Australia every year to spend a month with our grandchildren. My son-in-law works in medicine. During our visit, he noticed that I was limping more that he’d ever seen me limp. He suggested I go to Sydney, stay a few nights and he would arrange a visit with an orthopedic surgeon he was friends with from Medical School.
The surgeon took X-rays of both knees. The good news was that my left knee was extremely fit for someone my age. After looking at the right knee, his first question was “how are you walking”.
You have no cartilage and your knee joint is bone on bone. He told me that if he showed the X-rays to 100 orthopedic surgeons they would all agree that I needed a total knee replacement as soon as possible. He spent twenty minutes with me, explained the operation, the importance of preparing my knee for the operation and the importance of rehabbing the knee after surgery.
He emphasized something very important that day. He said, “the procedure was not as important as the surgeon I chose to do to the operation“. He advised me to consult my primary physician, read, and ask the advice of others who have had TKR for their suggestions on the right surgeon.
Find a surgeon with a great reputation and one who is busy. Another thing I learned is if a surgeon can fit you in his/her schedule immediately, that’s not a good sign for the demand of his/her work.
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My Knee Replacement Expectations
The primary reason for putting the knee replacement surgery off for so long was that I was afraid that something would happen and that I would not be able to hike, swim and play pickleball at all. Even though those activities were painful, at least I was able to do those activities on a regular basis and maintain a degree of fitness.
The secondary reason that caused me concern was the rapid pace of medical advances. In the 1970’s when I had my two knee surgeries, it was before arthroscopic surgery. I have what is called two “zipper scars” from my “old school” surgeries.
After the surgeries, I was put in a half cast for six weeks with no mobility. A few years later, patients were having arthroscopic surgery and were moving their knee the day after surgery.
As I told one doctor, I don’t want my bone cut off and two years later a new procedure is used that eliminates the cutting of the bone. Once the tibia is cut, it will not grow back.
Conclusion
I’ve always been an active person. I believe the activity has kept me fit and in good shape. I know I need to have my knee replaced and I am willing to go through the pain and rehabilitation to improve my quality of life.
Even though activity can be painful for me I can still do many things people my age and others are unable to do. After considerable research which included many conversations with friends and acquaintances who’ve had knee replacement, I am convinced that the surgery will allow me not only to participate in the activities I enjoy but it will allow me to enjoy those activities with much less pain.