Continuing My Journey to Knee Replacement

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Last month, I offered the first of what will be a series of pre- and post-knee replacement operation articles that will cover my experiences through double knee replacement surgery in June by the skilled surgeons at Mid State Orthopaedic and Sports Medicine Center. In preparing for the big day, I have recently completed a series of pre-op visits and consultations.

I’m fascinated by what X-rays allow you to see—in this case front, back and side views of my left and right knees. It was a historic look inside too, because the next time the film will reveal something alien, something man-made, and not God-made. This look-see was part of a thorough pre-surgery examination a few weeks ago. It demonstrated what the doctors thought it would; mainly a pair of degenerated, arthritic joints whose time has reluctantly come for a mechanical refitting.

After a long medical history conversation, Dr. Chris Rich had measured, twisted, pulled, bent and eyeballed both knees before the X-rays, explaining that hands-on examination is still very valuable even in this day of cutting edge (I find the pun a little distasteful) technology. The physical exam and X-rays confirmed for the surgeons what type of artificial joint would be best suited to make me whole again.

Still, it gets your attention when the surgeons, with some fanfare, call you over to point out a few things. The first thing I noticed was what resembled a poached egg protruding from the inside of my left knee. It turned out to be a whopper of a bone spur. For a moment I was pleased to have impressed Dr. Rich and Dr. Terry Texada, the surgical “double team” that will perform the simultaneous bilateral replacement.

“It’s pretty much what we expected, and it’s easy to see why you’re ready to have these knees replaced,” said Rich. Physically ready, yes. Mentally ready, well, that’s a work in progress. “The joints we use are excellent, the best that are available, with a long history of success,” said Rich. “What we do as surgeons is not only putting a new surface on in place of the arthritis, but we also make sure that the alignment of the leg and the new joint and its relationship with the soft tissue and the natural contour is precise. We redirect the weight bearing angle back to the center of the knee. In layman’s terms, it’s a little like a front-end alignment on a car; you not only get a new set of tires, but a balancing and an alignment as well. Our goal is to make the knee stable, flexible and pain-free again.” I have a one-word reaction to that: “Yes!”

I knew there would be more to do before the surgery, such as a pre-operative appointment with my family medicine physician for a general physical analysis and blood testing. There also needs to be a discussion about the options available for anesthesia. However, I thought I was finished for the day at Mid State Orthopaedic. Not quite.

Rich’s long-time nurse practitioner directed me into a private waiting room and quite starkly told me what to expect. “This is major surgery, especially since we’re replacing both knees. There is a very small chance of a blood clot or infection. We will aggressively use blood thinners and pressure pumps. We will be making bone cuts into your knees, and you may need blood. It will take 60 to 90 minutes from incision to close. You will have a significant amount of pain after surgery. It can be excruciating. We can take the edge off the pain, but we can’t eliminate it. You may be nauseous and dizzy the first time you stand up, and we will make you stand up and walk a few steps the morning after surgery.”

“You may experience some depression during your recovery, and you may seriously question your decision to have had this done. You must make a commitment to rehabilitate, no matter how much it hurts. It will hurt a lot for several days, and you need to know that now. We don’t want you to be surprised. The surgery is only the beginning in bringing your knees back to full function. The rest is up to you, and it’s not easy. But you will slowly get better as you go through your therapy and rehab. It may take a few weeks. It may take several weeks. Everyone is different. You will return to normal only to the extent that you work hard. If you are motivated to make this work, it will. And there will come a time when you’ll be glad you went through this.”

Ad so, I had the facts of life regarding knee surgery. Between now and my operation, I’m going to make several copies of her last few sentences and place them where I’ll see them everyday.

If you suffer from osteoarthritis of the knee and experience pain and decreased function, call (318) 473-9556 for an appointment. Talking to an orthopaedic surgeon from Mid State Orthopaedic & Sports Medicine could be the first step towards getting your life back.