I am a 58 year old overweight female. I had a partial, called a unicompartment,
knee replacement in March
of this year. I only had damage to the medial (inside) portion
of my rt
knee, not the lateral and the ortho had done 12 other uni's and liked them and I was in favor
of maximizing me and minimizing titanium, so there you have it. Surgery went well but it is not what I expected so will give you my findings so you have ore questions to ask your doc. A partial does not straighten your leg like a total would. That might not affect folks with a sudden injury, but mine was osteoarthritis that I had for several years. gradually, from favoring the
knee, I had twisted my leg almost imperceptibly. It was apparent on the x-ray
of both my legs facing forward - it was evident that the tibia and fibula were not aligned or straight. I saw it. I remarked on it. I was shocked by it. I know I asked the ortho doc about it. It just never occurred to me to force a complete answer from him, how important it would prove later, how much pain I have now with each and every step I take and that titanium meets that bone -- that portion
of my
knee straight, but everything else in
knee and leg still crooked. My physical therapist was able to explain it to me -- but that was two months after surgery. It is now 6 months later and pain is still like a bone break. Would I have done a total had I know? I don't know. But I would have kept asking - or changing doctors - until I got one who understood and acknowledged the problem.
My surgeon used no staples or big sutures so I have a relatively-speaking beautiful scar. What else I did not know: The
knee is larger than my other and always will be because the replacements (partial or total) are larger than normal knees. I do not know if the knees that are made-to-order by computer scribing to your personal CT scan are the same as I did not have extra thousands
of dollars lying around to purchase one
of the high end replacements. But there are several websites that show you what is out there and available and I strongly advise you look at all the various brands and types
of knees before you decide. Most surgeons have their favorite prothetics and that's that -- and often it is not because they are the best ones for you but because the physician has some kind
of relationship with that manufacturer or was trained on that model. I was glad I knew what else was out there so I could decide to what extent i was willing to go, look, change doctors, etc. And i was able to ask pointed questions like, "But I read that I would not be able to kneel ever again with that model and kneeling is important to me."
And
knee prosthetics, including partials, are only built to 125 degrees
of range
of motion since that is average. I was able to get up to 124 degrees without much trouble (how much I could bend my
knee). But I still cannot straighten it completely flat (which is actually measured at a minus degrees). After six months, I still have numbness and swelling and there are days I can't get past 110 degrees (what you need to ride a bicycle), but I know it isn't lost permanently, I just need rest and ice or gentle exercises and it will bend more tomorrow. But my problem is that I now know that I am more flexible than average - my left
knee has 147 degrees
of range
of motion. My new right
knee can never even get close - I will always have 20 degrees difference between my knees. Look on a compass to see how very much that is. That's 15%
of my total range. So that makes it very confusing to walk straight - my left
knee is at 147 degrees and my right at 125. And while most folks don't have 147 degrees, most people don't make it to 125 degrees with their replacements, either. And nobody ever mentioned anything about degrees and differences or re-learning how to walk. When you add the ROM difference between my knees with the fact that with any type
of replacement
knee you can no longer turn you body the same way because your
knee won't twist - you have to take small steps with your whole body to turn - there is a lot
of relearning to do. Only insurance only pays 25 visits for therapy, most
of which (if not all) are spent getting you up, moving, flexing, building back strength. No one teaches you how to walk, they just get you up and walking. There's a big difference. You may not have that problem - i live in Alaska, gravel road, like to walk outdoors, have steps and pets and
an active life - but good to know in advance what to ask, beforehand. Get your ortho to send you to a therapist beforehand to measure your knees, observe your walk, tell you exactly what it will take to get to the activity level and type you expect. A good therapist will tell you. And do NOT just go to the therapist your surgeon sends you to - again, every ortho surgeon has his/her "own" therapy agency or therapist that they prefer for many reasons (one surgeon wanted me to go to a therapist who turned out to be his live-in girlfriend: she might be a great therapist, but that was too uncomfortable for me, especially since he was not forthcoming with that info!). Ask friends for therapist recommendations, go see and interview them BEFORE your surgery, find one you are comfortable with and trust and tell your surgeon who you want. It's acceptable to do that.
Anyway, after all this, I'll give you some
of the up side. Last week i walked up a flight
of steps like everyone else - one foot, one step, alternating - for the first time in 2 or 3 years. I just finished picking wild blueberries out on the tundra which I had been unable to do at all last year - while the
knee still didn't like to squat at all, I was able to walk up and down the hills to find the berries. My dog and i are once again traipsing the moose trails together for 1-2 hours at a time. Before the surgery, I was only able to walk flat, flat, flat, and then not for too long without a
knee brace on. I still have to be careful, I wear high top hiking boots to support my ankle so I won't twist my
knee with a misstep, but I don't have to use a walking stick at all! My leg still won't kick properly when I swim but i can swim for 40 mins - a far cry from the 2-3 laps I could swim a year ago.
What would I do if I knew then what i know now? I don't know, no one does. You pay your money, you take your chances. BUT I would not have waited, not one minute. i would have had something replaced - whole or partial - when it first started hurting or decreasing my life. No one welcomes surgery, but if I could go back, I would have saved all those injections and braces and Synvisc and whatever and had the surgery. All the walks I missed! Plan to snowshoe this winter and maybe by next spring, will be able to get the golf pro to help me swing without torquing my
knee. I hate the pain, but I hated the disability much more. read, ask, read some more -- but then decide and do it and get on with your life. And good luck to you.
