Before Surgery

Describe the progression of your knee issues leading up to surgery. How long did you wait to decide on the surgery? Whose advice did you consider in making your decision? 

I have been overweight since childhood, and had several knee injuries during my lifetime, which caused severe loss of cartilage in both of my knees. Around 2008, I experienced a lot of pain in my right knee and was told by an orthopedic doctor that I should “lose 100 pounds, take glucosamine, chondroitin, and Celadrin, and come back when I was in my 60’s because I needed a knee replacement.” 

I took the recommended supplements and began a walking program, and the knee pain lessened for a while. In 2010, the pain came back and did not subside, so I went to another orthopod and was treated with three injections of Synvisc in each knee. The injections relieved the pain, but only for three months—not the six to twelve months for which I had hoped. A cortisone injection only relieved the pain for two months.

Tell us your age, describe your health, and talk about any feelings you had as the date of your surgery approached. What were your top two fears?

At the time I underwent surgery I was 52 years old, weighed about 269 lbs., had type 2 diabetes, and had slight hypertension. My ability to walk and use stairs was compromised by my knee pain, which then caused me to be more sedentary and gain weight.

My greatest fears were complications during surgery from anesthesia, pain, and rejection of the knee by my body. All of these fears were alleviated by my surgeon during our first consultation.

How did you select the surgeon who performed your surgery? What made the experience with your surgeon positive or negative? Did you have a role in selecting the hospital where your surgery was performed?

I discovered my doctor after searching the internet for knee surgeons in Delaware; I was impressed by patient ratings that I found online and the information posted on Dr. Cassells’ website about his hands-on personal treatment of patients and being able to shower immediately after surgery (due to [the use of] plastic stitches rather than staples).

My doctor looked at my x-rays, told me that my right knee was severely damaged, and that I was a good candidate for total knee replacement. He answered all of my questions, was not at all rushed, and made me feel very comfortable with my decision to have the surgery. My doctor informed me that he only performed the procedure at the Wilmington Hospital Center for Joint Replacement; that was fine with me because I had already heard wonderful things about the center from people who had been treated there.

Were you interested in learning about, or did you research, the type of knee implant your doctor selected for you?

My doctor told me about the replacement knee that he was using. When he told me that this latest knee replacement could last for up to thirty years, due to vitamin E infused polyethylene, and that I was not too young to have my knee replaced, I was convinced that I should have the surgery and that he was the right doctor to perform my surgery.

After the Surgery

Describe the post-surgical pain and/or any complications you experienced and how you managed them. What was most effective in helping you with your recovery? 

My doctor assured me that I would have very little pain after my surgery, as he stated, “on a scale of zero to 10, most of my patients experience about a two or less.” I never had any pain that I would have rated above a two throughout my surgery, recovery, and therapy. The anesthesia and pain medication administered before, during, and after my surgery prevented almost all discomfort; I did not experience any pain throughout the first 24 hours, and during physical therapy sessions I experienced only minimal discomfort from the stretching of the incision and muscles above the knee.

The nursing staff at the hospital was extremely vigilant about pain management and made sure I received my medication at least 30 minutes before any physical therapy so that I would be able to complete my sessions relatively pain-free. My doctor prescribed Celebrex and pain medication throughout my recovery period to prevent discomfort and promote mobility. I was able to use stairs and take showers as soon as I went home, which really helped the recovery process and made me feel normal.

Describe the most challenging part of your rehabilitation. What was your experience with physical therapy like, and how critical did you find it to be? What role did you have in selecting your physical therapist or therapy clinic?

The most challenging part about recovery was regaining the flexibility in my knee. I had two weeks of in-house therapy and then eight weeks of outpatient physical therapy. I chose Pro Physical Therapy because the center was relatively close to my home and it provided free transportation if needed; the therapists were friendly and helped me to heal quickly.

The only real discomfort that I experienced was during therapy because the therapists worked on my leg to increase the flexion that I had lost from both the surgery and years of lessened use. Taking pain medication before therapy greatly lessened the discomfort and enabled freer movement.

How long did it take you to become fully active again? How long has it been since your surgery and are you happy with your current activity level?

My surgery was at 8:00 a.m. on Monday, June 13, 2011, I was walking with a walker by that afternoon, and was released from the hospital by Wednesday evening, June 15, 2011. By July 25, 2011 I was able to go on a cruise with my husband, walking up and down the stairs on the cruise ship as well as walking along a rocky beach in Peggy’s Cove, Nova Scotia. I was cleared to return to my full time teaching job by the end of August 2011.

I am now able to navigate stairs without pain, without clinging to the railing, and while carrying items such as a basket of clothes. I have resumed all my normal activities, including walking 1.5-2 miles each morning on my treadmill and being on my feet all day at school. On June 13, 2012 it will be one year since my surgery.

What does it feel like to have an artificial knee? Compare how you feel now with how you felt before your knee replacement.

Life after knee replacement was a bit strange at first; it was extraordinary to look at my knee and imagine titanium supporting me instead of bone and to not feel the pain that I had experienced for so long before my surgery. I was quite amazed that I could support my weight on the knee just hours after surgery. My knee remains numb on the surface, but does not ache.

The relief from constant pain and the increased mobility that I received from having my knee replaced was well worth the brief amount of time and energy I spent recovering from the surgery and in physical therapy.

If you offered advice to someone else considering knee replacement, what would it be? 

If you are experiencing knee pain, go to an orthopedic surgeon and explore your options. Do not let your age, weight, physical condition, or fear keep you from getting relief or from being active. I was very upset when my first physician told me I was too young and too heavy to have the surgery, so I lived with the pain for several years.

Replacement knees have improved tremendously, hospitals with joint centers have knee replacement down to a science, and there is no reason not to live your life to the fullest by regaining your mobility and eliminating your pain.