New knee will be worth the bother

For what it's worth

Posted: Friday, February 11, 2000

The entire caper went just as planned. I met the other three guys in a dimly lit room at the end of a long corridor, well before dawn. The morning was cold and clear.

I was a little nervous and felt a little chilly, but that might have been due to the flimsy, backless gown I was wearing. We had been planning this operation for several months.

My friends were ready, all wearing their masks. One approached me, holding a small needle in one hand and a gas mask in the other.

``Is it time for me to go nighty-night?'' I asked. We all laughed and he said ``Yep. Time for your nap.''

When I awoke a couple hours later I was a proud new owner of a brand new knee joint. All three of my pals came to check on me during the afternoon and all agreed the procedure had gone perfectly.

The trio was comprised of two orthopedic surgeons, Dr. John Matthew's and Dr. Ladd Rutherford and a super smooth anesthesiologist, Dr. Reveley. The procedure was done at Deaconess Hospital in Bozeman, Mont., where there are more fine doctors specializing in this type surgery than you might believe. I had researched various places around the country to have the work done and concluded that, in this instance and given the expertise of the doctors involved, it was best to do it close to home.

Be assured sharing this information with you is not an effort to garner any special sympathy. Many of you have far more serious medical problems than I and I'm sure other readers have already undergone either a hip or knee replacement.

While I hesitated to write about it I finally concluded I might be able to provide information of value to those are contemplating a total knee replacement in the near future or for those who may face this situation in years ahead.

You will know you are ready when (a) you can't walk or stand without pain in your knees and, (b) when the x-rays show there is direct bone-to-bone contact. Obviously your surgeon will be evaluating the situation - it isn't something you decide on your own.

In my case both knees are totally shot, the result of prior trauma, abuse and wear and tear. We chose to do the left knee first.

To show you just how far joint replacement technology has come, there are now more than half a dozen firms manufacturing replacement joints, parts and pieces. In my case we used a Zimmer Nexgen Size G (don't ya just love it!) Dr. Matthews, who in addition to being highly recommended as a surgeon had also helped develop several devises used in post-operative recovery, chose the Zimmer.

Without getting too clinical on you, the procedure is fairly straight-forward. The ``bad'' parts of the knee are removed and the new pieces installed. Hammers, saws and physical strength are required to do the job, which, in my case, also required a great deal of trying and fitting to make sure everything fit perfectly.

The replacement was also an opportunity to repair and straighten several other aspects of the leg which had deteriorated through the years.

The surgery took less than two hours and I spend six days in the hospital. Total recovery takes several months, and I am told many people are not back to ``normal'' for up to a year. But 30 days after I left the hospital I was moving around well on crutches, could drive the truck although it took me a few minutes to get in the seat, and had regained about 80 percent motion in the knee.

There has been pain. There will be days when it will hurt. On the other hand, I put about half my weight on the new knee a couple days ago and there was no pain at all. Dr. Matthews tells me that most people will end up with little or no pain when recovery is complete. With normal commonsense use of the knee and barring an accident, the knee should last at least 10 years - probably longer, but no one can fairly predict it's longevity since each case is different.

Through my research and several lengthy conversations with Dr. Matthews, I learned of the rapid progress in this field. The surgical techniques are well developed and the devices are improving about as fast as computer upgrades do.

I learned that knee replacements are more complex and problematic than hip replacement. I learned that a major cause of post-operative trouble is the simple fact patients will not follow prescribed physical therapy.

Believe me, the physical therapy part of this process is no fun, but the alternative is a less than total recovery of use of your knee. As far as the physical therapy goes, it only took a couple of sessions with my new found friend before I began referring to him as a Physical Terrorist rather than a Physical Therapist. It hurts.

This process has been made easier by the frank and open approach of Dr. Matthews and the others involved. No one minimized or avoided discussing potential problems, every detail was discussed if I asked about it - in fact I was encouraged to continue my research and ask more.

By the time I met the other fellas that chilly December morning we were old pals who knew what was on the schedule and we went about getting it done. Next year we'll do the other one.

If you are facing a knee replacement don't put it off. It really is a far different procedure today than five years ago and monumentally improved from ten years back. It's too late for some of us, but if you are having trouble now with your knees, hips, or back, talk to a specialist soon. There is much that can be done short of a total replacement and at the minimum you might be able to extend the use of what you have.

Warren W. Wiley a former Juneau resident, political observer and radio personality, now lives in Montana. He can be reached by e-mail at wwiley@mcn.net.



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