Work Out - A bouquet of grateful thanks

By Nancy Leasman

I did it. I had knee replacement surgery and am on the mend. And, I am grateful to all those who daily help people with dysfunctional joints regain their mobility.

I’m grateful to the surgical team, the nurses and staff in the hospital, and my spouse for offering help with all those things one cannot manage alone after joint replacement. The physical therapy team which provides consistent assessment and encouragement cannot be thanked enough.

My gratitude goes much further, too. To both the brave doctors and the brave patients who over the decades dreamed that somehow a worn out, or damaged, joint could be replaced.

Knee replacements were attempted as early as the 1860s, though they generally didn’t result in a functional knee. Early implant materials included ivory, which wasn’t durable enough, and hinged iron which had its own issues. Infection was a difficult-to-manage complication. Other materials used included stainless steel, titanium, other alloys, and plastic.

All of the advancements from pain control to robotic-assisted surgery have resulted from research, meticulous record-keeping, and analysis of results.

The first successful total knee replacement was in 1968. My dad had knee replacement surgery in the early 1980s, which I now realize wasn’t really that long after the procedure had been perfected for common use. My grandparents both suffered from degenerative joint conditions and both the fact that the procedure wasn’t available to them, and lack of health insurance to share the cost, meant they dealt with increasing physical limitations as they aged.

Infection control is still a major concern with prevention being the most successful method. Patients are instructed to wash the surgical sites with a special antiseptic soap daily for four days prior to surgery. Surgical scrubs and sterile techniques are followed during surgery, and administration of intravenous antibiotics during the hospital stay improves outcomes. Research has even produced advanced antimicrobial bandages that seal completely around the incision. The bandages allow for showering the day after surgery if desired.

Blood clots can be a serious complication following surgery. Oral blood-thinning medication, a quick return to physical activity, and elevation of the affected limb help reduce the incidence of clots. Elevation and ice also reduce swelling and pain. Anti-embolism stockings, from toe to hip, are also prescribed.

Pain control is another medical advancement. Options in anesthesia from being awake (with a spinal block) to full anesthesia are possible, though full anesthesia has its own risks. Nerve blocks injected prior to surgery last several days and give the patient a chance to get moving while an oral pain control regimen is established. All of the advancements from pain control to robotic-assisted surgery have resulted from research, meticulous record-keeping, and analysis of results. They’ve resulted from the dreams of surgeons, anesthesiologists, nurses and other medical staff making both the process and result better.

Two weeks out from surgery, I’m walking with a cane. I can do light household chores, climb stairs, and write. I’ve crocheted half a dozen hats, read some books, let the family handle the details of the annual deer hunt, and am gradually getting back to social activities. Above all, I am extremely grateful to progressive medicine.