Let us now praise titanium. And we shall not forget cobalt and chrome alloy. Then, of course, we shall also give thanks to ultra-high molecular weight polyethylene.
For these are the materials that new knees are made of and new knees can mean a new life. Knee replacements typically release people from pain (think bone-on-bone crunching) and from restricted mobility (think limping and cane.) It’s as if patients have had a successful trip to Lourdes without ever getting on a plane. About 95% of patients with a first knee operation have no pain anymore or very little of it.
Now it’s one thing to know the stats, but even more dramatic to see older people saved from a life of limping and too many pain pills. Most cheering of all is watching older people swing dance as they did at a recent local concert featuring the bright beat of Glenn Miller. Yes, some mid-life people took to the dance floor, but they were outnumbered by us swinging geezers. My mate, Cranky Pants, took to the dance floor just 18 days post-op with his new knee. (He has not yet named it, but I am lobbying for the name Fred---as in Astaire.)
OK, so my man didn’t swing me over his head, but he was dancing to celebrate his titanium and polyethylene and maybe even the substance that held the knee together and that would be methacrylate, a bone glue that is well worth dancing about. And I, his partner, a woman who had to go through airports in a wheelchair 10 years ago, was out there dancing with him. My dancing days are not over, but starting again. That’s due to my titanium hips, which get me searched, wanded and patted down at airports now, but a wanding is better than a wheelchair.
The Downside
You already know there are risks to any surgery---risks associated with anesthesia and blood loss, plus the possibility of blood clots, infection and other bugaboos. But one way to ensure the best possible outcome is to find the most accomplished and experienced joint replacement surgeons. Our surgeon did 11 replacements in that one day.
Another is to do everything you are told to do---everything. Take the anti-clotting meds. Wear the anti-clotting stockings after surgery. This is no time to resist authority. “They” know more than you do.
Still another way to ensure success is to go to a hospital or ward that specializes in joint replacement. Cranky Pants was at a center that did nothing but joint replacements. The post-op care was highly specialized and knowledgeable. Also, post-op classes and group rehab were done each day so the client and the designated family coach---think designated nagger---could not only meet and greet other patients, they were in a class that educated all there about fast recoveries and post-operative success.
Age seemed no barrier to surgery. In class, we met a 96-year-old woman with a new knee. She was tired of limping around her house and wanted to get out more. Volunteers even provided a buffet meal to encourage everybody to walk the corridors to the lunch room with their brand new replacements. All nice treatment, of course, but it was great to be out of there by the third day having just spent two nights in a hospital setting.
Pain. Alas, some pain is part of post-op life, especially with knee replacements. As for the op itself, it’s always some form of la-la land, but the trick is to be smart enough to switch over to the post-op pain meds as the anesthesia wears off. So pay attention. Nobody knows your pain level better than you do. Speak up about it. Macho does not work as a pain reliever.
Worry about getting “addicted” to pain meds seems to have subsided in the medical community we encountered and the new thrust is---take what you need to get by without pain. Just be sure you are pain-medicated before those first tentative walks and before beginning those physical therapy exercise sessions.
Rehab
Every joint replacement procedure has five stages: 1. Worry and pain. 2. More worry and pain. 3. The op itself. 4. The hospital/center stay. 5. Rehab, which means doing all the exercises recommended, overseen by a home-visiting therapist and later, by an out-patient therapist. If you don’t do these, you may not get sufficient range of motion in the new joint. So move it.
Words to the Wise
Read more about knee and hip replacements at www.johntdearbornmd.com. Click on Patient Education and Research to get your questions answered and to find out more about less invasive surgery and the Washington Center for Joint Replacement. They also offer a good set of links to other sources of information. For specialty centers in your area, google: joint replacement clinic or orthopedic clinic. Also, local hospitals often offer education classes to the public about joint replacement options.
