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The Knee and Me

Millions of people have had total knee replacements. I didn't know I'd be next

During the next three years my knee dictated my lifestyle. I'd start each day with over-the-counter pain relievers—I eventually shied away from prescription drugs because of bad reactions and because I didn't want to become too dependent on them. I measured my simplest activities by how much pain they would cause.

I'd never cared much for going to the supermarket. Now I hated it. I started having my groceries delivered. I convinced myself that it wasn't because it was agony to walk up and down the aisles, but because it took so much time. I stopped going to museums, which had become one of my favorite things to do since moving to the Washington, D.C., area. I stopped going to the theater and concerts because it was increasingly painful to sit for long periods without being able to straighten my leg. Exercise? Forget it. I had always been a walker—two to three miles a day. But those days were long gone. Now, walking more than a block became an excruciating excursion.

I continued to live this way because I was terrified of the unknown. I knew that eventually I would have to make a choice between replacement surgery and living the rest of my life in constant and constraining pain. But I kept telling myself that I would make that decision in the future. Always in the future.

I limped on.

But then came London. As soon as I got back home, I began my search for an orthopedic surgeon. Other hurdles also loomed. Would my medical insurance cover the procedure? How would I manage the time off from work? And, most important, who would take care of me after the surgery? I had no relatives nearby. My adult children live on the West Coast, and my siblings are scattered all over the United States. All of these questions used to be excuses; reasons for my procrastination. No more.

During my search, I discovered that Johns Hopkins Bayview Medical Center in Baltimore had an impressive list of highly rated surgeons. The hospital is an almost two-hour drive from my home, but I figured this would be a minor inconvenience in order to get the treatment I wanted. I called the patient information center and requested a list of doctors who specialized in knee replacements. I then researched the individuals on the list and compared backgrounds, educations, and board certifications. I chose Carl A. Johnson, MD, who had performed more than 2,000 knee replacements and also teaches the procedure. And yes, the hospital accepted my insurance. I had no more excuses.

My first visit with Dr. Johnson was a revelation. I'd never had a doctor spend so much time listening and explaining. After sending me off for a round of x-rays and studying the sorry state of my right knee (and the comparatively good state of my left knee), he spent almost an hour reviewing my options and carefully outlining the risks as well as the rewards of surgery. He showed me x-rays of a repaired knee so I could see how mine would look post-operation. He let me hold the prosthesis, a sample of which he always carried around in the pocket of his lab coat, and he demonstrated how the parts would work together. The artificial joint had two metal components—one that fit on the bottom of the thigh bone (femur) and the other on the top of the leg bone (tibia). A hard plastic disc separates the two and is designed to facilitate the knee's motion by reducing friction. If this part wears out in the future, Dr. Johnson explained, it could be removed and a new one slipped in without disturbing the metal parts, which would have already bonded to the bone; a much easier procedure than doing a complete knee revision.

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