The knee replacement has given me a normal life again

Photo of an elderly couple riding bikes

Hilda, 81 years old

“I now totally forget that I have an artificial knee in daily life. I'm only reminded of it if I knock it hard. Also because I'm worried that something might break.”

I have hip dysplasia and a pelvic misalignment on the left. That puts particular strain on my left knee, and it was obvious for quite some time that it would cause problems sooner or later. But I didn’t let it get me down. I've always been a very happily active person. I used to go walking, swimming and cycling a lot.

I thought I had twisted my knee

I had a hip replacement in 2002. Around 2005, I started to notice that my knee was hurting more and more often. At first I thought I might have twisted my knee or overdone it with the cycling. I used a cream and didn’t go to see the doctor at the time.

But the pain got worse and worse, so eventually I did go to the doctor. He examined my knee and did an x-ray. The result was that my knee was totally damaged due to wear and tear. There was no cartilage left.

We started with conservative treatment, physical therapy and exercises at home. I did that for about three quarters of a year. But it didn’t get better. My knee kept buckling out of the blue and I often almost fell.

It was clear to me that I couldn't carry on like that

I couldn’t stabilize my knee; it was always wobbly when I walked, and very painful. I was able to ignore it for a while, but that didn't last long. I became increasingly anxious about leaving the house. I also really struggled to go up or down stairs, or walk on uneven surfaces like gravel or sand.

My knee was restricting me more and more. My decision to have a knee replacement was sealed when my husband at one point said, “Why do you keep torturing yourself? Just get it done!” I then said, “Okay, I’ll do it” and stuck to that decision. It's up to each individual to decide how long they can put up with symptoms like that. It varies from person to person.

I went back to the doctor to tell him about my decision. I wanted it to be done straight away. An orthopedic clinic was the only option in my opinion. They have the most experience. I also looked into how many of these operations the hospitals performed each year.

I then had the surgery in a hospital of my choice and got my new knee in 2008.

I was shocked at first after the operation

I got a huge shock when I came round after the anesthetic and took the first few steps. Everything felt strange and it was like there was a foreign body in my leg. It took me some time to get used to it. But over time I slowly “forgot” about the artificial joint and I no longer think of it as a foreign body. It's a part of my body now, part of my “scaffolding.”

After getting my new knee, the main pain was gone at first. But the wound was painful and it hurt to move after the operation. That was relieved with good treatment, though.

Everything had to grow back together again and the muscles had to be built back up.

As soon as you wake up from the anesthetic: Exercise!

I had to start doing exercises as soon as I came round from the anesthetic. My knee had to be mobilized again with stretching exercises. I found that quite painful as well.

I was given a kind of dynamic splint in hospital to move my knee in a controlled way. The extent of bending was adjusted depending on my progress. They tried to restore a 90-degree bend in hospital. We didn't quite manage that, but it wasn’t a problem.

Rehabilitation: More exercises and preparing for everyday life

I went to stay at a rehabilitation center after about ten days. I carried on with the exercises there, at first with two crutches, then with just one.

You can never stop doing the exercises, and if you don't move about enough, you’re done for. But you have to be careful about how you move. Because my other knee is also already damaged, I'm not allowed to carry anything too heavy, and too many stairs aren't good, either.

I was shown exercises to do at home. Some of them were hard to do in my daily life. But there are many others that I can do well! It's important to me that I can do the exercises easily. Otherwise, they're no fun and I eventually stop doing them.

I often do my exercises while doing my daily chores. For instance, if I'm taking something out of a cupboard, I go onto tiptoes and stretch out. If I have to go up or down stairs, I place my feet very consciously. I also make sure I roll my feet when I'm walking, and have certain techniques for carrying things. I learned all of that at physical therapy.

And I generally exercise a lot. I went swimming every day before the Covid pandemic hit us. I loved that!

Not easy to find your own limits

Even before the operation, I had to try and find my own pain threshold, my own limits. You shouldn’t overstrain your knee, with or without an artificial joint. That's sometimes not as easy as it sounds. You think it will be no problem. But then you realize that it was too much strain.

There's a certain amount of in your knees. You have to know the upper limit of strain you can put on them. If your knee hurts, you have to take a day off and rest completely.

I do sometimes use creams in those situations. They relieve the pain a little. If that doesn’t help, I take painkillers. But you should discuss that with your doctor and find out which ones are okay for you. There are two types of painkillers that make me feel unwell. I told them that before the operation and wasn’t given those kinds.

I gained trust in the knee over time

Some people worry even though everything is in the right position. You then have to build up trust gradually. It took about six months for my knee replacement to heal and work properly. But that will vary, depending on things like your age. It goes faster in some people.

I now totally forget I have an artificial knee in daily life. I'm only reminded of it if I knock it hard. Also because I'm worried that something might break. But I've gained more trust in my new knee over time.

My new knee can put up with quite a lot

My knee replacement can really take some strain. I once fell on it pretty hard and had a large bruise. I was worried that something might have broken. My knee was fine, though. The prosthesis was still going strong. The bruise was quite nasty, though, and it took months for it to go away.

You should avoid falling if possible, but some things can't be avoided. These things happen sometimes. Then it's often nowhere near as bad as you feared.

I'm still holding off on the second knee

I don't necessarily want to have a new joint in my other knee. I'm already quite old. Although I've heard from other elderly patients that the operation was fine for them.

I think it can be a problem when doctors say to patients, “Once you have the new joint, you'll be able to do everything again.” Patients then think they'll come round from the anesthetic and waltz off as if there had never been a problem. They're often not told that they'll have to do exercises and generally be careful. That can raise false expectations.

Physical therapy and exercise such as swimming and cycling are a good idea if you have osteoarthritis, whether you have a prosthesis or not.

Always with me: a note with information about the prosthesis

I don't always have my official patient ID card with me, but I do carry a little note with the main information in my purse. I always have the patient ID card with me if I'm flying, though. Sometimes my artificial knee sets off the scanners at the airport. That doesn't happen as much nowadays, but I prefer to be on the safe side.

I always took my list of medications with me when traveling too. That way, if I were to have an accident I would have all the documents with me. It's easy to forget things like that in the heat of the moment.

If you're considering surgery

It's a good idea to get a second opinion before having this kind of surgery. I wanted to have the operation in an orthopedic clinic because they often have more experience than normal hospitals do. You can also check the hospital’s statistics online, to find out how many operations they perform and how many corrective procedures they do, for instance. It also doesn't have to be the hospital closest to where you live.

I think it's important to be well-informed in advance... about the illness too, of course... by checking reliable sources online, for instance. There's so much poor information on the internet. You have to be careful what websites you look at.

I would always discuss things in detail with your doctor before this kind of surgery, and ask to see the different implant models that can be fitted. So that you have an idea of what's going to happen with your body. Talking to other people who have had a knee replacement is very important, too.

This kind of operation isn’t just done overnight, and you have time to prepare.

A normal life again

The joint replacements have given me a normal life again. I also have a hip replacement. After the operation, I was able to do things like go on longer bike rides with my husband again. That was lovely! It truly is a blessing that we have these treatment options!

Acknowledgment

Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.

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Created on January 13, 2022

Next planned update: 2025

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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