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The Knee and Me

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

He answered every question I had. How long would the incision be? (On average they're five to seven inches, more in larger patients.) How long would I have to stay in the hospital? (Three to four days, but some patients need additional inpatient hospitalization in a rehab facility.) How long would it be before I could drive again? (When my knee had sufficiently healed so I could comfortably bend it.) Then he asked me about the non-surgical measures I had used, such as physical therapy and nutritional supplements. I told him I had used them all and more. He advised me that only I could decide when the time was right for an operation, and said he wanted to see me again in three months.

That gave me plenty of time to do some serious research on knee-replacement surgery. I read books and articles, and scoured the Internet for any useful information I could gather. On the American Academy of Orthopaedic Surgeons site, I learned that there have been nearly three million total knee replacements performed between 2002 and 2007 (the last year for which they have statistics). I confirmed these encouraging statistics by talking to anyone I knew who'd had the surgery: friends, coworkers, friends of friends, even the owner of my favorite gas station. Each and every one of them told me they had only one regret: that they hadn't had the surgery sooner.

I also discovered that there had been many attempts to design an effective artificial knee during the last century. The first, in the 1940s, involved a prosthesis that was hardly more than a hinge held in place by stems that extended into the hollow marrow cavities of the bones. Other attempts included metal spacers placed between the worn joints and molds placed over the femoral halves of the knee bones. None were very successful. Then, in 1968, Frank Gunston, a Canadian orthopedist, performed the first replacement operation using metal and plastic secured by surgical cement, a technique that has been perfected and is still the standard today.

In the early days of knee surgery, patients were encouraged to wait as long as they could before undergoing the procedure because the replacements would often wear out in a matter of months and cause complications. Now, advanced technology and tools ensure much more predictable and safer outcomes. And while many variables, including the patient's age, general health, bone mass, surgeon skill, recovery, and patient activity, make it hard to pinpoint an exact average, doctors agree that it's safe to assume that a replacement today could last anywhere from ten to 20 years. Even if a revision is needed, in many cases the newer prostheses are designed so the work can be done using minimally invasive surgeries.

Buoyed by the promising statistics and positive testimonials I'd gathered, I drove to my next appointment with Dr. Johnson. I wasted no time telling him that I was ready. As it happened, his surgery schedule was full for the next several months, which was fine with me. I'd waited this long, and I could use the time to make plans with my family and employer.

I'm a very independent person and it was difficult for me to ask my family for help. But it was more than heartwarming for me to see how eager they were to be there for me. My sister and my daughters arranged time off from their full-time jobs to come and help me during the first weeks of recovery, which are the most difficult. They would arrive in shifts—one week each. My older brother, who is retired, would finish off the duty, staying with me until I was able to drive and return to work.

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