[Tbear]

Well its been six weeks since the surgery and I must admit that a bit of confusion is setting in...

The knee is still slightly swollen and as a result my flexion is staying about the same - around 115 degrees with no discomfort at that position. My PT person does not want me doing further flexion stretches, only extension stretches.

I've been reading various sources on the internet about swelling and its treatment ( always dangerous to read stuff on the internet ) and there seems to be several schools of thought.

One suggests that swelling ( within reason ) is good in the sense that it is the body's way of handling the healing process of the trauma to the knee. As such, trying to reduce the swelling too much or too soon with frequent ice sessions can actually slow down the healing process.

The classical school of thought - RICE - Rest, ice, compression, and elevation, suggests that is the best course of action and anything you do to increase swelling should be avoided. Do not exceed your threshold of discomfort by either exercise or daily activities because that leads to more tissue irritation and swelling which you want to avoid.

There is a web site called bonesmart.org that essentially says leave your knee alone and it will heal just fine. Your range of motion is there and will come back as the remainder of the swelling subsides. It strongly believes that the expression 'no pain, no gain' is a total myth.

So what the heck do you believe?

At the moment my knee feels great when walking and doing daily activities. I still can't put full weight on it in the sense of climbing stairs but it seems clear that for at least several more weeks not putting excessive stress on the joint is the right thing to do to allow the bone to grow into the implant (remodel).

My current physical therapist seems to be of the school that only extension stretching is needed at this point. He also has me taking 20 minute walks in a pool as well as 10 minute sessions on a horizontal stepper machine with increasing resistance each week.

So perhaps I'm no longer obsessed with the rest of the swelling rapidly subsiding if in fact physiologically it is needed to complete the healing process. Let me be clear, the swelling that occurred right after surgery is long gone and I'm referring to some residual swelling that is impeding my flexion from continuing to improve towards my goal of the 120-130 range.

I'm in that frustrating phase where I feel good and want to do more athletic related things but I know that I can't for another six weeks or so.

I need to stop whining though; I met an individual the other day that had his knee replaced in November and he can't move it past 60 degrees of flexion and is still in PT 5 months later. He said his knee also 'slides' side to side slightly. He showed me pictures of his leg after surgery and it looked like a truck ran over it - severely bruised from his hip to his ankle - couldn't believe what I was looking at... His surgeon plans to go back in to figure out what's wrong.

I'll continue to count my blessings.

Tbear

[Tbear]

When researching information about my partial knee replacement, one piece of the puzzle I could not wrap my arms around was how much it might cost me personally.

I have the Villages United Health Care Advantage insurance policy and all I could find out was that I wouldn't have to pay more than the maximum $1900 which was my out-of-pocket deductible.

For the benefit of those following this thread, I can now share with you what the hospital and doctor sent to the insurance company, what they paid and what I paid.

The largest bill was from the hospital - $84,828 of which insurance allowed and paid $8,595. I was in the hospital technically for 1 day with an overnight stay as required by Medicare and I paid a hospital copay of $150.

My doctor billed $2,800 for the surgery of which insurance allowed and paid $1,196. I paid nothing.

There were also some smaller charges from labs and another physician which I think was the anesthesiologist who charged $475 and was paid $142. None of which I had to pay.

The home physical therapy I had ( 13 sessions at $90 /session ) was paid in full by insurance and nothing out of my pocket.

The physical therapy I am now taking externally charges $180 per session but insurance allows and pays only $35 per session. I also pay $15 copay per session.

So all in all, my out of pocket for this entire ordeal has been very little. Adding in some copays for pain meds and the rest of my PT ( which ends the end of May ) I will have paid about $350 out of my pocket.

Someone opened up a scary thread in this forum called Medicare to allow Balanced Billing.

Tom Price who is the new director of HHS ( Health and Human Services ) is a former physician and as a congressman has been trying to pass legislation that would allow doctors and hospitals to charge their patients the difference between what Medicare allows and what they submitted. He is now in a position with a Republican house and Senate to try push something like this thru.

It would be disastrous for seniors. I haven't seen any actual action yet by Price to do this since he took his new position.

Imagine if I had to pay the difference or even some percentage of the difference between $84,828 and $8,595! I couldn't have had this procedure done on my knee.

We seniors need to keep an eye on this one, no matter which political party we favor!

[Tbear]

Its been 8 weeks and 2 days since my surgery. Today was my last PT session with Florida Rehabilitation Specialists ( I highly recommend ).

The final readings say my knee can flex to 128 degrees ( measured to the point of mild discomfort ) and the straightness reading is minus 3 degrees ( meaning my knee straightens past straight by 3 degrees which is perfect ).

I've begun to ride my bike and continue to do pool walking as well as hamstring stretches. I see the doc on Monday for my last checkup before heading to our summer home in MA.

I am expecting to be cleared to phase back into pickleball in about 4 weeks. Physically I feel like I could play now, but I'm sure the inside of the knee still needs some additional time to heal.

Unless there is some type of dramatic news, I'm likely not going to provide any more updates on a weekly basis. I'll probably give a heads up several months down the road to provide closure....

I hope sharing my experience has helped or will help those of you that are considering whether or not to have your own knee fixed. I'm so glad I took the plunge. My advice is - don't wait too long, it will just make it worse...

I can't speak highly enough of Dr. Duke and his staff.

I strongly suggest doing your homework when selecting a surgeon. Consider the experience of your doctor and be sure to research whether or not his methods are conventional. if they are not, research whether his methods have been peer reviewed and published in medical journals and are being adopted by other surgeons in the country. Consider whether there are long term statistics about your potential procedure and resulting implant.

Make sure you ask around. Its amazing how many people in The Villages have had knees replaced. I've learned an awful lot just talking with people about their experiences and whether or not they were happy with their selection of a surgeon.

I'll still be checking the forum so if anyone every has any questions feel free to ask...

Tbear

[Chi-Town]

128 and -3. That says it all. Good for you.

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