Anyway, both surgeries seemed to have gone quite well, and I worked hard at the physical therapy part of the program. The bottom line is that my wife and I have been able to do a lot since the surgeries that would have been otherwise impossible before. Activities have included:
Okay, so this is knee replacement #3 for me! Both knees had been replaced in 2017, one in August and the other in October. The operations seemed to have both been a success. My surgeon had been a missionary companion in Paris 50 years ago (“missionary companion”: missionaries for our church are always assigned in teams of two). He had an excellent, international reputation with the clinic that bears his name: Rosenberg Cooley Metcalf Orthopedic Clinic of Park City, Utah. He is the Rosenberg part of the name. Their clinic has treated lots of professional and Olympic athletes, with Tiger Woods having been one of those. Tom’s specialty was knees.
- A six-month mission for our church at the Visitors’
Center at the new Paris Temple in 2018, - Eight weeks in France last year. We went for the
celebration of the 75th Anniversary of D-Day and stayed on until the wedding of
a friend on 26 July, with a wonderful 10 days in Italy coming towards the end,
and - Lots of activities with our 21 grandkids, who
work hard to keep us young!
It is important to recognize that we never would have been able to do all we have without the surgeries.
Nevertheless, the situation with the left knee (second replacement) has never been quite right, and we don’t really know what has caused the problems. I began seeing the surgeon again following our trip to France last year. Rosenberg’s replacement (a really young guy!) determined that there was a great deal more play in the left knee than in the right. He suggested as a first step more physical therapy to try to compensate for the looseness. As I learned about what helped, I added new exercises to the exercises and stretches I had been doing since the first surgeries. Specifically, the thing that seemed to help the most were strengthening exercises with an exercise ball between my back and the wall for partial, squats. As time passed, however, it became clear that something more had to be done.
The surgeon was hopeful that the simple replacement of the polyethylene spacer between the tibial and femoral components would do the trick. To have a better idea as to what to expect when he got in there, he ordered up a bone scan (skeletal scintigraphy with intravenous radioactive tracers). This revealed inflammation below the tibial components in each knee, but there was much more inflammation present in the left knee than the right. Combining that evidence with X-Rays, he told me that we needed to anticipate the possibility of a Plan B (replacement of the tibial component as well as the spacer) or even Plan C (a changeout of the whole shooting match and adding a posterior stabilized prosthesis by Stryker. When I explained these various possibilities to our kids, our oldest son said, “Pops, if none of those three works, there is always Plan D: A peg leg and a parrot!” ?
When the doc got in there, however, he discovered that things were in some ways worse than he had anticipated. The metal protection added to the back of the patella was attached by only one of the three connective elements to the point that it could be spun in place. The polyethylene spacer was worn on one side, so bad as “it could have come from a knee where it had been in place for 20 years.” Was this uneven wear due to errors in the angles of bone cuts and placement upon initial replacement? Was it caused by an unfortunate occurrence just after I returned home, the CPM machine had fallen over in bed, twisting my knee something fierce? The surgeon and his PA were adamant back then that this would not be a problem. The new surgeon told me that he could not assert that the CPM machine tipping over was not the cause!
So, here I am recovering from TKA #3! My wife just said a few minutes ago, “I cannot get over how much easier this one is compared with the first two.” No doubt some of the difference has to do with changes in anesthesia: a spinal block and then a femoral block that lasted several days. This gets the patient past the early pain. The anesthesiologist said I could stay awake and watch if I wanted. I am not sure he was serious, but I declined and was happy when they squirted the sleep-inducing drug into my IV and then woke up in the recovery room, totally oblivious to the fact that four hours had passed.
Another possibility to explain how comparatively easy this one was is the fact that the muscles in my leg were already accustomed to dealing with a prosthesis. Of course there is the trauma of opening up the knee, pulling out the old, and inserting the new and then putting it all back together again and sewing it up (They used internal, dissolvable sutures this time rather than the gruesome looking staples from the first time around.). That said, things are going so much better this time around that the difference is rather astounding.
So, I know that you are not excited about having to go through the experience again, but I can assure you that there is every reason to believe that things will be better for you this time around! It is amazing the miracles these surgeons can pull off and they keep getting better at it!
