Jane’s custom-made knee replacement
Custom-made knee replacement surgery
I was 63, active, fit and well… apart from one ‘bad knee’, and in my opinion too young to have a total knee replacement. My knee had been a problem for 30+ years, with three previous arthroscopic procedures and numerous injections. With the knowledge that no more could be done to ease the horrible constant pain, it was time to accept the inevitability of a new knee and to say goodbye to the old one.
It is a pretty monumental decision to go ahead with such big surgery, and the timing of this surgery weighed heavily on my mind. I didn’t want to leave it until my fitness levels became non-existent and my life determined and dictated by my dodgy knee. If I were to have this surgery, I was determined to find out as much information as possible and take time to consider all the options open to me with the benefits of private health insurance.
I knew I wanted a Conformis knee replacement, as it makes sense to me to have a knee that fits my anatomy rather than make my knee fit the prothesis. So, I had found the knee I wanted, and that just left the surgeon! Mr McDermott was the man of choice, and after the initial consultation he confirmed a new knee was the only surgical option.
Ahead of the surgery
How do you prepare for such surgery? You need a surgeon who is honest, informative, and prepares you for the hard rehabilitation you will need to undertake to make your knee a success post-op. I was lucky enough to be well-informed, and although at times the information was scary, I wanted to regain elements of my life that had diminished over several years because of debilitating knee pain. There is also another side of you that just wants to do it without knowing too much, which I think is a sort of self-protection against what is to come – a head-in-the-sand approach! Not a good way to go. This is surgery that you need to buy into, and there is no room for passivity.
My surgery and the early post-op period
My surgery went ahead in-between Covid lockdowns, and went well, with no complications, and I was home within 4 days. It’s then the work starts! Whether you feel tired (and boy do you feel tired), you cannot sit back and think ‘I will start my rehab when I feel better.’ Initially, the new knee felt weird, stiff, tight and swollen, and there was an element of altered sensation, but I really didn’t care as I felt totally elated by the fact that the surgery was done, my pre-op pain had gone and it was the start of my road to knee recovery.
Every day is different with the intensive rehabilitation. There is a fine balance between exercising, stretching and trying to get the knee as flexible as possible versus overdoing it – so by the time you try to rest, it’s impossible because the knee is sore and hot from the bending and stretching. It’s a balance that you really can’t win, as you just have to work that knee and know that the pain and discomfort is ultimately your friend, as its a sign that you’re doing what’s required.
There are up days and undeniable down days, where the frustration and tiredness of the slog of rehab gets you down. This is where a good physio is totally necessary, to keep you on the right track and to motivate you to carry on, and to help you stretch and bend when it feels like you just want to be left alone and be happy to have a knee that ‘will do’!
The rehab following TKR is a slow-burn. The frustration comes from feeling like you are not progressing fast enough, and you start to wonder if it will ever improve. The knee does improve, just a little bit each day, and sometimes it’s such a small improvement that you can easily miss it in the eagerness to move forward. Its important to take time to reflect and celebrate the small improvements, and know that in time these will add up to a knee that is the best that it can be.
I feel that the recovery from knee replacement surgery is both physical and psychological in equal parts, as one effects the other. It is a daily learning process, and each day is different. I cannot deny that it is a slog and I can see why so many people struggle to overcome the post-op issues. I have been fortunate as I was well informed, had a Conformis knee, a brilliant surgeon, dogged determination and everything in place to make this work.
8 weeks post-op!
Eight weeks down the line, and there is till a long way to go in my recovery process, and I know that I will get there, even if there are blips along the way. This is a steep learning curve that will continue for a while yet! I look forward to the coming months and the changes and improvements in my new knee, which in turn will allow me to return to activities that I had missed for a very long time. It’s exciting, and the slog of rehab is worth it with knobs on. I have purchased a Peleton exercise bike, which has been brilliant. I cycle everyday and stream into classes I can’t quite manage yet, but which inspire me to keep going.
I am grateful to Ian McDermott for his straightforward honesty in what can only be described as a trusting partnership of replacement and recovery.
If you are considering knee replacement, take time to explore your options, find the right surgeon for you, read the information you are given, cogitate and digest it, and then go for it with positive determination. You will succeed….
9 months post-op!
It is now 9 months since my surgery, and my knee continues to improve and reshape itself. It now feels and looks very much part of me, whereas for a while I was very aware of my new knee and its movement. I find myself running to do something and it then occurs to me that my knee doesn’t hurt, but should I do this? My knee doesn’t stop me doing anything, but sometimes my brain tries to go into default mode and tries to trick me back into old knee times and habits.
How thankful I am to be able to go to bed without an ice pack for company and pills at the ready. Sleep deprivation due to knee pain is exhausting and debilitating, and has a very detrimental effect on overall well-being and the people around you. My knee is shiny (I know, I’ve seen it) and new, and allows me to function at a high level during the day and sleep at night.
I continue to use my Peleton cycle as it not only helps with the physical aspects of rebuilding muscle mass, but is a real boost psychologically as you improve from hardly being able to turn the pedal to cycling 6 miles up hill and down dale in 20 minutes. Of course, the bonus is that I am now fitter than I was before my surgery.
On reflection, I think that I should have had my surgery earlier, as in trying to carry on regardless it caused buttock pain and secondary hip pain problems, mainly from the inability to use my knee and the serious wastage of my quads muscles. The deterioration of my knee was slow and gradual, but it produced harmful side effects. I’m not sure I was really aware of the damage being done along the way. It took me a while though to find the right surgeon, as I was not easily impressed, and I was certainly not going to have such a big operation without careful consideration, research and feeling that I had total trust in that person.
My Conformis knee is strong, feels good, looks good and has been life-changing. I find it hard to to understand why anyone would have anything less, when able to have the choice. I reiterate my earlier comments that this surgery is a partnership between surgeon and patient: get that right first, and then just work like stink on the rehabilitation, which will help you achieve the best from your new knee, to take you into the future. I cannot stress enough how important the rehab process is: don’t take it lightly, and do as you’re told, even when you think you can’t, you can!
It is tough surgery: be realistic, expect to falter along the way but don’t throw in the towel. Keep positive and focused, and that new, shiny knee will serve you well.
I would like to thank Ian McDermott for his skill, care and honesty, and I’d also like to thank the fabulous team who looked after me at London Bridge Hospital, and Conformis for their superior custom-made technology. I must also thank my husband and my dogs for bearing with me!
Mrs Jane Valentine
26th September 2021