What you need to know before that joint replacement

Steve Perkin takes you along for the ride on his joint replacement journey.

What you need to know before that joint replacement

Five years ago, I went to my GP complaining of pain in my right knee.

He sent me away for X-rays, told me my knee wasn’t great – osteoarthritis – but advised me to put off surgery for as long as I could.

Five years later, aged 65, I hobbled back. I told the same GP that my much-loved weekly game of golf was agony by the time I got to the 18th – and not because of my dodgy putting.

Golf aside, there were other reasons I was back in the doc’s surgery. My wife loves walking and wanted to travel the world seeing things on foot. She wanted me to share this with her, but I couldn’t.

“But the worst thing,” I said to my GP, “is that a throbbing pain is keeping me awake at night.”

I’d tried various brands of painkillers and anti-inflammatories, but this wasn’t something I could do for the next 10 or 20 years.

The following week I was off to see an orthopedic surgeon and was booked in for a knee replacement (TKR) two weeks after that.

I knew a bit about what to expect. I had two good mates who’d had knee replacements and they were enjoying life again after years of complaining.

For me, it was a no-brainer – a couple of uncomfortable months in return for freedom of movement.

My research determined that, while this was major surgery, it had a very high success rate – in excess of 90 per cent. In 2014–15, there were 52,039 hospitalisations for knee replacements in Australia – 600,000 last year in the US.

According to US figures, 90 per cent of people who have a knee replacement experience a lot less pain. Most are able to perform daily activities and stay active, and this was certainly the case with some of my golfing mates who’d had knee and hip replacements.

So off to hospital I went. Surgery was booked for a Wednesday afternoon and I was home on the Saturday, armed with boxes of drugs to help with pain, blood thinning, constipation and nausea. I was a walking pharmacy.

My leg was wrapped in a compression stocking to help prevent clots and ease the swelling, while the actual wound was bandaged with a simple adhesive strip running the vertical length of the cut.

I’d been given some advice by a physio on exercises to aid recovery, and I’ve been reasonably diligent with this.

As I write this, I’m three weeks post surgery. I can walk without crutches, but I’m wobbly. I’ve been told the knee is strong, yet I can’t help but feel vulnerable and weak and I regularly feel that I’m hyper-extending the knee.

There’s some numbness in my upper thigh and occasional stabs of pain in and around the knee, but at no time could I say that the pain has been extreme.  

Every day has seen slight improvement. For example, on day six I managed to get out of bed fairly normally.

I can get in and out of the car, albeit with some difficulty, but I’ve been told I can’t drive until I’m totally off medication and can walk without aid. I’ve achieved the latter, but I’m still taking mild painkillers at night to ensure a comfortable night’s sleep.

And I’m already concerned about the other leg and wondering whether it will require a knee replacement, because I’m not sure I can go through this again, certainly not for a while.

It’s giving me some discomfort, perhaps because it’s doing extra work.

Cost-wise, I’m about $1500 out of pocket, despite having top-level private health insurance. But that’s another story.

Whether I’ve made the right decision to replace my hard-working knee with a prosthetic only time will tell. The experience of others says yes, but it’s not easy.

If you’re in the market, be mentally prepared for discomfort, numerous mental and physical challenges, boredom, some pain and an inability to do so many simple things without extreme care. But keep the focus on the long-term view – a pain-free round of golf, a long walk with friends …

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    COMMENTS

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    Star Trekker
    12th Dec 2019
    11:36am
    I had my knee replacement 2.5 years ago and a revision 2 weeks ago, due to knee slipping out of joint. Hopefully this has fixed it.
    Star Trekker
    12th Dec 2019
    11:37am
    Mine was through the public hospital system with no out of pocket expenses.
    Scott
    12th Dec 2019
    11:42am
    Steve recounts the common route to total knee replacement: (1) restricted motion & pain, (2) medication, (3) surgery.
    It leaves out weight loss and exercise programs, before deciding on surgery.
    These steps are proven to very substantially delay, or even prevent, need for knee replacement for a significant proportion of people with osteoarthritis.
    Why could it be that they are so commonly overlooked?
    GeorgeM
    12th Dec 2019
    9:58pm
    Yes, a few things are left out, although Steve seems to have written a fairly informative piece. Of course medical professionals, especially surgeons (who profit) encourage doing it - no surprise! It is not mentioned that most prostheses last only 15-20 yrs (and you can't repeat the surgery), although there is some discussion about how long some new prostheses in USA will last. Steve suggests a success rate "in excess of 90%" - that is blatantly wrong - I was told by a top researcher (Professor) in the field that the success rate is around 70% - NOT good enough in my opinion to rush for it, given also the limited life span, extreme discomfort post operation, impact of painkillers on your stomach, etc, etc.

    Exercise programs as you have indicated are recommended and can prolong the decision for very long, although I can't say how long, and it is also in the hope that some new cure will come up, such as Stem Cells being actively researched in Israel, etc.
    Arisaid
    12th Dec 2019
    11:52am
    I am 12 years post knee replacement. Keep up the exercises. Walk, walk, walk. Still can't kneel and if I get down on the floor it's pretty difficult getting up again! Have a tiny spur that gives me a bit of gip every now and then BUT nothing like the pre-surgery pain. It takes a while to really get going again but it is a marvellous operation as it gives you mobility.
    Jenny
    12th Dec 2019
    12:00pm
    Several of my friends have had this surgery done, a couple have had both knee joints replaced. One even had both knees done at the same time! All have had positive results, although none enjoyed the experience. Patience and attention to physio is what is needed for the process to be optimal.
    KB
    12th Dec 2019
    2:02pm
    It does take longer to get over aknee replacement than over a hip replacement
    KB
    12th Dec 2019
    2:02pm
    It does take longer to get over aknee replacement than over a hip replacement
    Tanker
    13th Dec 2019
    2:02pm
    It is best to try to hang out before have a knee replacement but when the time comes go for it in the knowledge it will not be pleasant. I have two partials with one being replaced by a full one after about 9 years. The best thing I did was to go to rehab where a proper exercise regime really helped plus pain management was sorted out.
    Accept that even with strong pain management it will hurt when exercising but stick with it as it will be the best in the long run.
    DELboy
    15th Dec 2019
    5:17pm
    I agree, go to rehab for the reasons above. I had mine in 2015. One thing I would recommend is thigh strengthening by lifting ankle weight straps, every morning and night. This allows you to straighten your leg quicker,after the operation, and therefore recover quicker. I was told to resist kneeling if possible, but I can, and use a soft base if possible. Hip next?


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