Haims: Total knee replacement, for many, is a new lease on life (column)
January 1, 2018
Technology and procedures in knee replacement surgery have changed dramatically over the past decade. For those who have been on the fence because you have been told to wait until the knee completely fails or until the knee pain significantly impairs activities of daily living, I have some optimistic information and stories to share with you.
Opting for a total knee replacement is a very personal matter, and there are various considerations to be made before committing to undergo surgery. For those who have already consulted an orthopedic specialist and found that they may be candidates, a total knee replacement may be the Holy Grail, as it may provide a more active lifestyle and ease of motion.
However, just because a knee is achy or has mild to moderate arthritis doesn't necessarily make a person a candidate. While this is not a comprehensive list, here are some factors to consider when determining your candidacy for a total knee replacement:
• Everyday activities are limited by severe knee pain, stiffness.
• The knee has become so unstable that it "gives out."
• Rest and/or medications have little effect on inflammation and swelling.
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• Weight loss, medications and injections have not proven helpful.
I have been mountain biking for more than 30 years and skiing/snowboarding for almost 20. I have had three ACL replacements and multiple orthoscopic procedures. Daily, my right knee is achy. Long walks exacerbate existing chronic inflammation. Mountain bike rides that occur on back-to-back days leave me taking too many Aleve or ibuprofen.
Over the past seven years, I've met with knee specialists from coast to coast. After each appointment, I've walked away a bit disappointed. Outside of injections, which only provide short-term solutions, each medical provider recommended that I wait until either my knee "failed." As well, each had cautioned that because the life expectancy of knee replacements was about 15-ish years, receiving a second replacement in my mid-50s or early 60s was not advisable.
Left with few if any options, I have endured the discomfort of my knee. I've been in a hold-and-wait pattern that has left me despondent and frustrated.
Over the past few years, my interest in a knee replacement has been rekindled. Not only have I had a couple of local friends undergo a replacement procedure, but my office has been hired by about a dozen clients from Steamboat, Summit/Frisco, Aspen and Vail to help with their knee replacement recovery.
Hearing the stories from local friends and clients of how they arrived at the decision to undergo surgery has been extremely educational. Their stories varied so differently from friends and family friends who have undergone knee surgeries.
What does "one of the best" mean?
Earlier this year, my brother's wife shared with me how her father's recovery from a knee replacement was going. He had the procedure done in Miami from "one of the best." He spent three days in the hospital recovering, two weeks on two crutches and then another week on one crutch. It's been four months since his surgery, and he is still not comfortable with walks on the beach and is dismayed that he has no time frame of when he will start to play tennis again.
In November, a 53-year-old friend who is an avid mountain bike racer went to "one of the best" in Chicago for his knee replacement. He, too, spent a couple of days in the hospital. However, within three weeks, he was off crutches completely. Now, almost two months later, he is training on a spin bike and hopes to be ready for spring biking season.
Does "one of the best" mean the surgeon helped you achieve a better quality of activity in the least amount of time? Does it mean that your recovery was somewhat painless or there were few, if any, complications? Could it mean that surgeon's technique and skills may lead to faster healing or to a knee lasting longer?
Please read next week's follow-up article for insight about researching a surgeon, questions to ask, setting expectations and understanding rehabilitation.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. Contact him at 970-328-5526 or visit http://www.visitingangels.com/comtns.