Things to Know Before Opting for Knee Replacement

Another Way for week of July 3, 2020

Things to Know Before Opting for Knee Replacement

After I first wrote about my husband’s knee replacement (which took place four days before most of the country shut down because of the pandemic), things got dicey with Stuart’s recovery. He started having inflamed IT bands—the part of your upper leg that runs from the outside of the hips to the knee and connects to your shinbone.

IT stands for “iliotibial” and WebMD.com explains the problem like this: “If your IT band gets too tight, it can lead to swelling and pain around your knee.”

If you’ve never heard of it, you’re lucky. Most of the time it keeps the leg hanging together and functioning, but when it gets painful, it can be miserable and the sting can strike any time. It’s a common overuse injury from repetitive movements.

Overall, Stuart’s therapy, although he did his at-home exercises faithfully (often taking three to four hours a day in two sessions, including warm up and icing down afterwards), he felt like he was hitting a wall. It appeared the inflamed band along the side was firing the pain and halting progress.

At his two-month check-up, the doctor said he felt a manipulation was called for, because of how progress seemed to have stalled. In a manipulation, they put you under anesthesia (or opt for a spinal block), and the doctor pushes your leg back to the maximum bend he or she can get. Yes, that would be excruciating pain if you were conscious. The object is to break up scar tissue, which Stuart had plenty of as mentioned in my previous column on this topic. The scar tissue not only made it difficult to get a proper bend in his knee, but together with the IT band, caused a lot of inflammation and pain.

A manipulation doesn’t always work, and sometimes, in very rare situations, a bone breaks. So we were uncertain regarding the risks but Stuart definitely felt stuck, unable to make progress.

After the manipulation, he would have to use a continuous passive motion (CPM) machine at home for at least a week, to keep his knee moving slowly and gently. These are very common to use on various parts of the body. He would need to be strapped in 16-20 hours a day. How would he even sleep?

He did manage to sleep some in the contraption, and overall, averaged being literally tied down 15-18 hours each day using it. Both of us were ecstatic when the week was over.

So what was the outcome? Overall, he achieved much more bend in his knee, found walking easier—especially when needing to go down slopes. Generally, his pain level went down. Now the trick is to keep that agility and bend thriving, which is not easy.

At some point Stuart gloomily told his therapist* he would be doing his stretching and prescribed exercises for a year. To which the therapist responded, “No, you will need to continue to do some exercises for your knee the rest of your life.”

Let us hasten to add: everyone’s experience with this type of surgery is somewhat different; our pain thresholds are different, each body make up is different in terms of the afflictions it has faced (high blood pressure, prior injuries, diabetes, heart surgery), and all these health issues can complicate outcomes. Stuart is allowing me to write with this much detail about his experiences in the interest of helping others know what they may be in for when deciding on knee replacement. We were both quite anxious about the manipulation but at this point, 3.5 months after surgery, Stuart is happy he decided to accept the manipulation ordeal.

The recovery has been depressing, exhausting, and difficult, but it’s not chemo, it’s not dialysis, and it’s not Covid with isolation from your mate/family. There have been moments of celebration, such as when the therapist finally got Stuart’s knee to the degree of bend stipulated by the surgeon. He is still working to gain another five degrees or so. We’ll continue leaning on each other and on the good Lord.

I would welcome stories of your own experiences, good or bad.

What have you learned?

Share here, or write to anotherwaymedia@yahoo.com or Another Way Media, P.O. Box 363, Singers Glen, VA 22834, or comment on the blog.

Another Way is a column by Melodie Davis, in syndication since 1987. She is the author of nine books. Another Way columns are posted at FindingHarmonyBlog.com a week after newspaper publication.  

* Stuart received the bulk of his therapy from Center for Hand and Physical Therapy and received great professional care.