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Once upon a time I participated in an aerobics class three times a week.
The exercise was good for me and I particularly enjoyed this activity.

In about the year 1999, I noticed some pain in my right knee while
performing the aerobics; I thought it was probably a sore muscle
or tendon.   However over the next few months the pain persisted
and became increasingly worse.   I had a difficult time walking
and could hardly use stairs (up or down) because sometimes
the knee would buckle.

An MRI showed that the cartilage was very worn and damaged so
I had bone rubbing against bone. Both my knees had quite a bit
of damage, however the left knee exhibited pain only infrequently.

The arthroscopic surgeon I saw at that time (not Dr. Walsh)
had me try some physical therapy but the pain grew worse
with every movement. I quit going to therapy and called
the doctor and told him I had to have something done
immediately because the pain was unbearable.

He put me on anti-inflammatory drugs and made arrangements to
do an arthroscopic procedure where three small incisions were
made and the bone scraped to give me some scar tissue
in place of the cartilage.

That was in August of 2001 and this gave me several years of relatively
pain-free walking, however as time went along the pain necessitated
my use of anti-inflammatory drugs.

When I first saw Dr. Walsh about my frozen shoulder, I also mentioned
my knee.   He told me that when the Celebrex now longer kept me
free from pain, then I would need a knee replacement.   I thought that
time had come in 2005, but the doctor told me I could take Celebrex
twice a day so that bought me a little more time.

No matter what your age, a problem with the knee joint may keep you from activities you enjoy. Pain and
stiffness may even limit the daily tasks you can do. Problems with the knee joint tend to build up over time.
Knee pain may be caused by: a) a bad injury that did not heal properly, b) a chronic illness such as diabetes,
or c) wear and tear from years of constant use.

Total knee replacement surgery almost always reduces joint pain. During this surgery your damaged knee
joint is replaced with an artificial joint. After a total knee replacement you can look forward to moving more
easily. Benefits of knee replacement surgery include 1) stops or greatly reduces joint pain, 2) increases
leg strength, 3) improves your quality of life by allowing you to do daily tasks and low-impact activities in
greater comfort, and 4) provides years of easier movement.

The Procedure
An incision of about 8 to 10 inches is made on the front of the knee. All the bone surfaces of the joint are
shaped to hold the prosthesis, then the parts of the prosthesis are put in place. At this point the surgeon
tests the fit and alignment of the prosthesis. If it fits correctly, its parts are secured to the thighbone,
kneecap, and shinbone. Then these parts are joined. Together they form the new joint.

In 2006 I started making plans for my knee replacement surgery. I could not allow myself to get to the
position I was in just prior to my arthroscopic surgery, unable to walk and unable to control the pain.
Prior to the surgery, the doctor arranged for me to attend a very helpful class at the hospital where the
hospital staff explained exactly what would happen every step of the way. They also gave us tips on
how to prepare our homes for our recovery period.

My surgery was done on July 19, 2006 by Dr. Kevin Walsh at Edward Hospital.   The anesthesiologist
gave me the choice of a spinal block or general anesthesia. I chose the spinal block but the sedative
they gave me pretty much knocked me out anyway. I did not want the breathing tube down my throat;
they use that with the general anesthesia. They also used a nerve block in my leg that lasted about
twenty-four hours. The surgery took approximately one hour; a drain was put in the leg to
remove excess fluid and reduce swelling.

After the surgery, I spent several hours in the recovery room before being transferred to a hospital
room on the orthopaedic floor.   I was not in any pain at all.   I was given a general IV and also a
patient-controlled analgesia which allows you to control your own pain medication.   When you push
a button, pain medication is pumped through the IV line. This can provide a steady level of pain
relief once the feeling comes back. There are built-in safety features which assure that you will
not get too much medication.

I could not get up to go to the bathroom so I had to use a bedpan.
I suppose you do what you have to do.

That evening they sat me up for a while in a cardiac chair.   It looks like a stretcher; I just slid over from
the bed onto this thing then they folded it up into a sitting position.   I felt very nauseated when I sat
up, in fact I had to vomit; they told me that is normal.   It did feel good to sit for a while.

The next day a therapist showed me how to do some exercises in the bed and also got
me up and walked me around a little in the room; I was still attached to the IV.

On Friday the nurses started giving me pain medication in pill form; they told me not to use the
PCA unless I absolutely needed it.    I did not use it so the IV came out later that day.   I was
finally able to eat normal foods instead of liquids but did not have much of an appetite and
felt kind of nauseated.

The therapist helped me to walk in the hallway with the aid of a walker.

On Saturday when I got up, I put on my regular clothes in anticipation of being discharged.
A therapist came and showed me how to go up and down stairs and had me practice a little.
Arrangements were made for me to be in the care of home health care nurses and therapists
for the next three weeks. I left the hospital on Saturday afternoon.

Soon after my arrival at home, the hospital had arranged to have delivered a
CPM (continuous passive motion) machine.   You just lie in bed and put your leg
in the machine.   When turned on it flexes the knee to help make it work better.

A home health care nurse came out early the next morning to check on me and
to assess my condition.   A home physical therapist also came out to do her
initial assessment and to arrange further visits over the next three weeks.

The next week went OK with visits from the nurse and the therapist.   I was doing
well and becoming more mobile.   I was taking my pain medication every four
hours as I had been told.   They want you to be proactive in pain management so
you can become more mobile as soon as possible.

I did not feel well and often felt nauseated but I had just been through major surgery
and was also taking some extra medications so I did not think there was anything
unusual.   However one week after my discharge from the hospital I started running
a high fever and vomiting.   By Sunday afternoon I went to the emergency room for
treatment and was admitted to the hospital where I stayed until the following Friday.
You can read about this on the next page which I have entitled "The Great Escape."

After returning home for the second time and getting back into home therapy again,
by the end of the third week, I was doing well and was dismissed.    The fourth
week involved me driving and going to outpatient therapy.    I can walk unassisted
and with the help of therapy expect to soon have a normally-functioning right knee.

I have learned that if you take care of your new knee, it can last many years, possibly the rest of your
life.   Some people mistakenly think they can do anything they once did.    However the knee can be
damaged by high impact activities such as running, aerobics, or tennis.   Better activities would be
walking, golf. or swimming.   Why take the chance of having to go through this or possibly worse
again.    You have to use some common sense but otherwise can enjoy a normal life of lower
impact activities.

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My Knee Replacement

This is the surgeon who successfully
took care of my frozen shoulder, my
trigger finger, and most recently
replaced my right knee. I jokingly told
him that I was going to keep going
until he operated on all my body parts.
He is a very good surgeon; if he has
among his patients the president of
Edward Hospital, that's a pretty good
stamp of approval.

Dr. Kevin Walsh specializes in the
diagnosis and treatment of
musculoskeletal disorders. He has
particular interest in arthroscopy, joint
replacement and sports medicine. Dr.
Walsh is a Phi Beta Kappa graduate of
the University of Notre Dame. He
received his medical degree in 1983
from the University of Chicago. He
completed his Internship at the Rush
Presbyterian-St. Luke's Medical Center
in Chicago, IL, and completed his
Residency at the Michael Reese
Hospital in Chicago, IL. Dr. Walsh was
Chief Orthopaedic Resident in
1987-1988. Dr. Walsh is a member of
the Illinois Orthopaedic Society,
American Academy of Orthopaedic
Surgery and Notre Dame Orthopaedic
Society.