Total knee replacement

A handy guide for the lame

Photo by John Cameron on Unsplash

The NHS will be playing no part whatsoever in this article

Background or “Why should anyone care about your bloody knee?”

A few weeks ago I asked the question on GP whether anyone had any good knee operation tips, expecting to be flooded with advice from the bunch of elderly and creaking folks who hang out round these parts. I received many warm words of encouragement, but mainly based on other relatives /acquaintances who had been repaired. Being a very kind and generous person, I have therefore decided to share my knee replacement experience with you.

Just to provide a little background: I am 6’6” and weigh in at around 18.5 stones, so think of the actor Alan Ritchson in his role on Amazon Prime as Jack Reacher. Except you need to think of a 64 year old Reacher with a penchant for real ale who last visited a gym in 2005. For those of you who can do BMI calculations, I may be technically obese, but then so are most of the England rugby team.

I had both my hips replaced in 2021 which worked out very well and then suddenly last year my knees began to hurt, with the left one claiming pole position. My experience with arthritic joints is that for a long time they don’t hurt too much. But then, all of a sudden, they do.

Having done careful research into the cause of my aching knees, I can now point a resentful finger at the short arses of this world who appear to have decreed that all chairs and toilets should be just inches off the ground. This does not matter so much when one is young and sprightly, but as the years pass, the wear and tear becomes noticeable and eventually unbearable.

This would also probably be the appropriate time to point out that, as someone who has:

  • Paid large tax bills every year for the last 45 years,
  • Barely troubled (fortunately) the NHS for anything,
  • Never been in a police station, court of law or a prison or have called the Fire Brigade,
  • Funded the secondary and tertiary education of our children,

I am [thinks of appropriate polite phrase] rather angry that when I finally need something back from the state – such as medical treatment – I can either suffer several painful months – or more likely years – on a long waiting list or dip yet again into my post-tax income.

So I dipped. After a final meeting with my consultant, a date was set four weeks hence.

Fortunately the hospital accepted American Express, so my future new knee was already paying me back in the form of air miles.

After this introductory paragraph, I hope you are now starting to care about my knee.

Preparation – get match fit

From my hip operation experience I knew that the first and most important item on the agenda was to choose my Jack Reacher book. You will need this to get you through the first sleepless night. It will be sleepless, because (at least in the private sector) you will be attached to an anti-clotting machine which squeezes your leg every few minutes. Normally, I am not adverse to having my leg squeezed, but this machine and the annoying noise it makes will effectively prevent you from falling asleep.
No one has ever said that Reacher is great literature, but Child’s books usually provide a decent yarn and story line which can be followed when a) extremely tired and wired and b) full of morphine and other drugs.

Item 2: find out what exercises you will be doing post op and start doing them straight away. Not only does this build up your leg muscles in advance, but you have also established an important part of your routine. Muscle memory established.

Item 3: plan for post op life: – adjust your crutches / practise using them again (everybody should be given a set a crutches for their 60th birthday – you are bound to need them at some point over the coming decades) / put grab handles in the shower / raise up your chairs / buy some industrial strength laxative – the pain killers will, ahem, slow your digestion / buy a gadget for picking things up off the floor – everything always ends up on the floor / be kind to your wife /partner as you will be heavily reliant on them for the first few days with your new joint.

Item 4: stop drinking. They advise you to stop a few days before the op, but I have always found it easier to get the stopping over with a couple of weeks in advance so that you can concentrate fully on what lies ahead and the wave of medication coming your way.

The operation

As with the hips, this was very straightforward: modern anaesthetics work so fast, you can barely count back to 8. They knock you out and two hours later you slowly wake up with a new body part and a system full of drugs.

Post operation – this is where the fun starts

Normally, they want you out of the door on day two after the operation. That was perfectly fine after both my hip replacements, but this time (for various reasons I need not dwell on here) I needed another day. They didn’t think this was necessary. I disagreed.

Normally I am a placid fellow and used to getting what I want through reasoned argument and if required, a slightly raised voice. However, when the physiotherapist got his role mixed up with that of a consultant and as part of her argument for sending me home immediately, a nurse starts telling me how they are planning a trip to an NHS hospital to see how they manage to discharge patients on the day of surgery, I suffered a catastrophic sense of humour failure.

Anyway, the paying patient won his case….

Mrs H picked me up the following morning: I have had good care and three nights in hospital, but there is no doubt that this is a major surgical intervention. I am light headed from the cocktail of drugs inside me, but it still hurts a lot squeezing in and out of the car. Same day discharge you say NHS?

For the first two days you really are quite vulnerable and weak as the proverbial small cat. This is when having someone by your side is rather important. However, the body’s ability to recover is quite extraordinary. One week post op and I could move around – albeit with crutches – quite freely.

Other top tips: lots of ice packs and raised legs / take advantage of all physio sessions you are offered and do your exercises religiously, but don’t overdo it. I made the mistake of walking too much simply because I could and it felt fine. However, at the four week check up with the consultant who was very impressed with my progress – shoots cuffs, straightens tie – he told me to cut back on my steps and spend more time with my leg raised and encased in frozen peas.

Everyone tells you that having a knee replaced is a lot more painful than a hip. This is indeed true, but not as bad as I had imagined from the stories that I had heard.

However, because the knee is a more complicated joint and various tendons etc have to be pulled to one side during the op, seven weeks after the event I still have a degree of stiffness and discomfort, though – with the exception of one anti-inflammatory per day – all medication has stopped.

Now that I am fully mobile, I eagerly await the phone call from the Amazon Prime studios to audition for the sequel “Reacher – The Twilight Years at Spoons”.

Episode 1 is provisionally entitled: “Where did I put my Glock 32? And my glasses?”

© Jacques Hughes 2024