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[QUOTE=Tbear;1377536]When I realized I needed a knee replacement, I began searching the web to find out as much as I could about the process but never really found an account that answered so many small but significant ( to me ) questions that could help me understand and get through the process. So my way of giving back to all those that find themselves in a similar situation is to share my experience. This is likely to be a bit long winded and only of interest to those getting ready to have knee surgery. I'd be happy to answer questions as I can for anyone who asks. I am 70 years old and very active in Pickleball. The medial side ( inner side ) of my left knee was bone on bone form osteoarthritis.
My Surgery was March 21. It began with a search for a reputable doctor and although I'm sure there are many, two names kept popping up in conversations with friends as well as posts on the internet. The two doctors were Dr. Duke who practices in Ocala, and Dr. Ngyuen ( pronounced ' Win " ) who practice down towards Orlando.
Dr. Ngyuen is noted for non-conventional type of knee replacement in as much as he enters the knee from the lateral side as opposed to across the top of the knee cap. His method alleges less pain and faster recovery times.
Dr. Duke is a more traditional surgeon having done over 5000 knee and hip replacements. I chose Dr. Duke mainly because of his long standing success in knee replacement and his ability to do the surgery within two months of my first visit.
I have nothing negative to say about Dr. Ngyuen. He is very popular and from what I understand it takes 4-6 months or longer to get on his schedule. I had planned to visit him but cancelled because I was so impressed with Dr. Duke.
My first visit to Dr. Duke's office was to be assessed by his Assistant. She took X-rays of my knee, put me through some range of motion tests, and told me that I had bone-on-bone on the medial side of my left knee and was a candidate for surgery. However here came my first surprise. She said that the rest of my knee, the patella and lateral side were absolutely fine. Also, since I was relatively fit and not significantly overweight ( I'm 5'7 and 176 lbs ) that the doctor might suggest a partial knee replacement ( also called resurfacing ) of just the damaged area. ( I wondered if Dr. Ngyuen would have suggested the same but will never know. )
In anticipation of surgery, his assistant gave me exercises to do to strengthen my quads and hamstring which I faithfully did for about two months prior to the surgery.
She made an appointment for me to see Dr. Duke about 3 weeks later and asked that I see my primary doctor to get clearance for surgery. ( Blood work, EKG, chest X-ray )
Dr. Duke's bedside manner is second to none. He explains everything fully, gives you various options, and treats you with the kindness and respect as if he were talking to his father. I was extremely impressed with his professionalism.
He confirmed his assistants notion that I would be a good candidate for a partial replacement. He said that two thirds of my knee was fine and that two thirds of your own knee is better than a totally artificial one. He suggested putting an Oxford partial knee on my medial side. He told me if I wanted a full replacement that he would certainly do it but his recommendation was to go partial. If someday for some reason I needed more work, a full replacement could still be done. I went with his recommendation for a partial.
The surgery was done at Marion Community Hospital. Five days prior to surgery, I visited the hospital to pre-register where they took the usual information from you such as insurance, next of kin, etc.; they also took one last draw of blood and said I would be called the day before the surgery to be told the exact time. The pre-registration staff was kind, professional, and overall excellent in their interface with me and my wife.


Sure enough, I was called the day before my surgery and was told to be at the hospital at 6:30 AM. When I arrived, I was immediately taken into my prep area with my wife to put on a hospital gown. I was given a mild sedative to calm my nerves, had an IV put in my arm and heart monitor patches applied to my chest. I had a visit from Dr. Duke who marked and initialed the correct knee to perform surgery on; I was also visited by the nurse anesthetist who said I would be given a spinal block as well as general anesthesia. Shortly afterwards I was being wheeled into the operating room. They transferred me to the operating table and I remember absolutely nothing from that moment until I was in the recovery room with a nurse by my side. I felt no pain or discomfort whatsoever. Shortly afterward I was taken to my private room for my overnight stay. I did realize I had a catheter in me which would be removed the next day. If all went well, I was schedule to be released the day after surgery.
Three hours after the surgery, a physical therapist came in and had me get out of bed and with the assistance of a walker, walk from the bed to the door and back. I still felt no discomfort or pain. I was constantly being given various kinds of pills; I'm not even sure what they all were...
The hospital room was clean, bright, and equipped with a central heart and Oxygen monitoring center and of course a call bell if I needed the nurse. My oxygen level dropped lower than it should at one point and they administered oxygen to bring the level back up. Apparently a side effect of the anesthesia. There was a TV and meals served at dinner and the following day for breakfast and lunch. The staff, through all the shift changes, were excellent. Professional, caring, and attentive to your needs. Hats off to the staff of Marion Community Hospital.
The second day the therapist returned and this time I walked all the way down the hall and back. I also went to a physical therapy class where they explained some exercises to do as well as how to climb steps as your knee begins to heal. I was still in no pain and beginning to think this wasn't so bad after all ... stay tuned!
I was set to be released except I had to prove I could pee before they would let me go. Seemed sort of odd that they remove the catheter and then want you to pee ( nothing left in the bladder ! ). So I drank a whole bunch of water but much to my dismay I still couldn't pee. They became concerned and did a bladder scan to determine how much fluid was in my bladder. They were concerned it was too full so they did another catheterization to remove the fluid. ( Creepy procedure for me, slight discomfort but not my favorite experience. ) A few hours later I was able to pee and they could then discharge me. They said that my experience with this was not an uncommon one after surgery and catheterization.
I was sent home with an ice machine that looks like a cooler with a leg wrap that pumps ice water around your leg. They also gave me some things to help me to get dressed and perform every day activities like putting your socks on.
I still had little to no pain but was warned that the anesthesia and spinal block actually take several days to fully leave your system and that the third day was often a difficult one with pain. - They were right -
Although I was on several pain medications including a double dose of oxicodone, the first night was a tough one for me. My knee became very swollen, stiff, and painful to move. Since I had drunk so much water during the day, I had to get out of bed and pee several times the first night and it was very, very difficult. Had I known, I would have just kept a urinal bedside so I didn't have to flex my leg to get out of bed. We bought one to have handy for the second night.
The first day home I had a therapist and nurse come to the house from Greystone. My knee movement was a mere 70 degrees. ( if your knee is at a right angle it is at 90 degrees; full range of motion is close to 130 degrees ). The therapist assessed me and performed some exercises with me to begin to get range of motion back. I was still in considerable discomfort trying to bend and straighten the knee. She also asked the doctor to give me a regiment of anti-inflammatory pills to help reduce the pain.

RESPONSE

Hi and thanks for your summary of the knee event.
I will submit this to you, trying to be helpful. After my total left knee replacement, at Physical Therapy, the major effort was to bend the knee,,,,,,,,,,,,, bend the knee a lot.
This will stretch the ligaments and get all the items involved, lined up and working again. So, OK then I had to press the PT for some facts, like how far is enough. It took some pushing to find out that the magic number is 120 degrees. This way you will have the normal travel of the knee in daily use. So, then I chose to stop therapy and I made up a strap, it is a piece of webbing with a loop on the end. I lay down on the bed, have my wife hook up the loop to my foot and then I pull and pull and pull and I even scream. 120 degrees means the full ninety degrees down and then 30 more degrees. I MADE UP A CARDBOARD OR FOAM CORE PIECE, A TEMPLATE OF THE 120 DEGREES AND MY WIFE HOLDS IT IN PLACE TO CHECK THE ACTUAL ANGLE. Why?
Because I read a story in a medical journal that if you do not get the right angle OF BEND , they may have to put you under with anesthesia and a very big medical person forces your leg to the 120!!!!!!!!!!!!!!!!!!!!!!!!! OUCH
So keep it in mind and call me if you like and I can send you a picture of the strap, over a year now, I still use it.
This bend is very important for sure. Some people do not do the therapy and do not get the bend and they really are in for some hard times with the leg.
Good luck,,,,,,,,,,,,,,,, bbbbbb 352 775 9228