The following text is based on my experience in getting a new knee installed. I tried to write about the event as it occurred so as not to miss some details. The reading of it might be a bit wonky but the information is accurate. as it happened to me.
I had the new knee installed a bit over 1.5 weeks ago on a Wednesday, the 3rd of January, 2024.
I had the second knee installed May 14, 2024.
(I am putting the data in (for the left knee install) at the end of the right knee data.)
This narrative is for anyone who might be considering getting a new knee. It is just a hodge podge of my own slightly odd observations.
Where to go for a new knee:
The operation was done by EBJ, Everett Bone and Joint's Dr Bill Huang (Wong) and his staff. There have been so many positive testimonies from former patients and his count on knee installation is over 5000 apparently. High marks also from me for his entire team.
Care giver: I cannot say enough good things about my beautiful wife who made this transition possible and painless. She drove me around, kept track of my meds, got me food, etc... The list goes on a LONG WAYS.
Narrative begins:
An example of the bruising caused by the surgery. My entire leg was bruised but no pain was noted. The baby aspirin regimen thinned my blood enough to lose the bruising in 4 weeks. |
The knee with the 16 staples removed. Approximately 2 weeks post surgery? |
Physical
Therapy for knee surgery:
Surgery January 3, 2024
Preoperative
Exercises:
Ankle Pumps: Gently pull toes up towards your knee then
point towards the floor. Both ankles
together or alternating. 30xs every
hour.
Quad Sets: Press the back of your knees down into the
surface as if you were trying to lock your knees. Hold for 3 seconds, relax. 2 x 10, 2xs a day. Advanced: use pillow under heel
Glut sets: Squeeze buttocks together as tightly as
possible. Hold for 3 seconds. 2 x 10,
2xs a day
Side Leg Slide
(Hip abduction) Lie on your back, Slied
your operated leg out to the side keeping your kneecap and toes up. Keep your leg straight by tightening your
thigh muscles; do not lift your leg.
Gently return to the middle.
Heel Slides: Slide operative leg heel towards buttocks,
keeping heel on the surface. Slowly
return to starting position. Once you
have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day.
Straight Leg Raises: Keep your non operative leg bent for
support. Slowly lift operative leg off
the bed, keeping the knee straight throughout the entire motion. Lift no higher than the height of the
bent knee. Slowly lower.
Long Arc Quads: (Knee Extension) Sit your back against a chair. Slowly straighten your leg and hold for 5
seconds. Use non surgical leg
assist your surgical leg into
extension. Hold for 20-30 seconds, then
relax
Post surgery
: Pretty much the same as presurgery.
Quad Sets: Press the back of your knees down into the
surface as if you were trying to lock your knees. Hold for 3 seconds, relax. 2 x 10, 2xs a day.
Glut sets: Squeeze buttocks together as tightly as
possible. Hold for 3 seconds. 2 x 10,
2xs a day
Side Leg Slide
(Hip abduction) Lie on your back, Slied
your operated leg out to the side keeping your kneecap and toes up. Keep your leg straight by tightening your
thigh muscles; do not lift your leg.
Gently return to the middle.
Heel Slides: Slide operative leg heel towards buttocks,
keeping heel on the surface. Slowly
return to starting position. Once you
have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day.
Straight Leg Raises: Keep your non operative leg bent for
support. Slowly lift operative leg off
the bed, keeping the knee straight throughout the entire motion. Lift no higher than the height of the
bent knee. Slowly lower.
Long Arc Quads: (Knee Extension) Sit your back against a chair. Slowly straighten your leg and hold for 5
seconds. Use non surgical leg
assist your surgical leg into
extension. Hold for 20-30 seconds, then
relax
Advanced PT
from home visits: (Sean)
Double leg Heel rises
with support, calf raises:
While standing next to a chair or countertop for support,
raise up on your toes as you lift your heels off the ground. Return heels to ground and repeat. 10 xs, 2 sets, 2xs a day, hold for 5 seconds.
Walker Marching: While standing with a walker, lift up one
knee allowing it to bend as your raise your foot off the floor. Set the foot back down and perform same on
the other leg. 10 times, 2 sets, 2xs a
day.
Walker squats: Stand in a walker with feet shoulder width
apart. Begin by bending knees and
lowering your body into a squat, as if you would be sitting into a chair. Don’t sit, your body weight should be directed mostly touching the chair
with your buttocks, straighten your
knees and rise back up to a fully standing position. Knees should bend in line with the 2 toe and
not pass in front of the foot.
10 times, 2 sets, 2 xs a day.
Walker Hip Abduction: While standing up using a walker, raise your
leg out to the side. Keep your knee
straight an maintain your toes pointed forward to the entire time. 10 times, 2 sets, hold 2 seconds, 2 xs a day.
Walker Hip Extension: While standing up using a walker, extend
your leg behind you. Do not allow your
back or chest to move. Also, keep your
knee straight the entire time Lower your
leg back down and repeat. 10 times, hold
2 seconds, 2 sets, 2 xs a day.
Quad Sets: Press the back of your knees down into the
surface as if you were trying to lock your knees. Hold for 3 seconds, relax. 2 x 10, 2xs a day. Advanced:
use 5 “ pillow under heel.
Heel Slides: Slide operative leg heel towards buttocks,
keeping heel on the surface. Slowly
return to starting position. Once you
have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day.
Heel slides advanced : Attach a strap to operative foot and pull the
heel as far as you can. Count to 5 then
release. 10 times, hold for 5 seconds, 2
sets, 2 xs a day.
Out Patient Physical
Therapy: Joel Anderson (Anderson
Physical Therapy , Arlington WA)
Double leg Heel rises
with support, calf raises:
While standing next to a chair or countertop for support,
raise up on your toes as you lift your heels off the ground. Return heels to ground and repeat. 15 xs, 2 sets, 2xs a day, hold for 5 seconds.
Walker Marching: While standing with a walker, lift up one
knee allowing it to bend as your raise your foot off the floor. Set the foot back down and perform same on
the other leg. 15 times, 2 sets, 2xs a
day.
Walker squats: Stand in a walker with feet shoulder width
apart. Begin by bending knees and
lowering your body into a squat, as if you would be sitting into a chair. Don’t sit, your body weight should be directed mostly touching the chair
with your buttocks, straighten your
knees and rise back up to a fully standing position. Knees should bend in line with the 2 toe and
not pass in front of the foot.
15 times, 2 sets, 2 xs a day. Lower to bed with out siting.
Single leg balance: While standing up using a walker, raise your
non-operative leg out to the side. Keep your knee straight and maintain your
toes pointed forward to the entire time. Raise leg forward, then raise leg
back. 15 times, 3 sets each leg, hold 2 seconds, 2
xs a day.
Standing Balance: Stand on operative leg, balance for 30
seconds. 5 times, 2 sets, 2xs a day.
Step downs: 4”
step, Step down with your non operative
leg until the heel touches, then come back up.
10 times, 3 sets, 2 xs a day.
Standing Knee Extension: Straighten operative leg while standing, step
your weight on to the non operative lege keeping it straight. 20 times, 2 xs a day.
Quad Sets: Press the back of your knees down into the
surface as if you were trying to lock your knees. Hold for 3 seconds, relax. 2 x 10, 2xs a day. Advanced:
use 5 “ pillow under heel.
Heel Slides: Slide operative leg heel towards buttocks,
keeping heel on the surface. Slowly
return to starting position. Once you
have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day.
Heel slides advanced : Attach a strap to operative foot and pull the
heel as far as you can. Count to 5 then
release. 10 times, hold for 5 seconds, 2
sets, 2 xs a day.
Out Patient
Physical Therapy Version 3 (assigned March 9, 2024): Joel Anderson (Anderson Physical Therapy ,
Arlington WA)
Heel Slides: Slide operative leg heel towards
buttocks, keeping heel on the surface. Slowly
return to starting position. Once you
have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day.
Heel slides advanced : Attach a strap to operative foot and pull the
heel as far as you can. Count to 5 then
release. 10 times, hold for 5 seconds, 2
sets, 2 xs a day
Standing Balance: Stand on operative leg, balance for 30
seconds. 5 times, 2 sets, 2xs a
day. JUMP TO THE LEG AND CATCH BALANCE
Walker Marching: While standing with a walker, lift up one
knee allowing it to bend as your raise your foot off the floor. Set the foot back down and perform same on
the other leg. 15 times, 2 sets, 2xs a
day. FLEX KNEE FULLY
Walker squats: Stand in a walker with feet shoulder width
apart. Begin by bending knees and
lowering your body into a squat, as if you would be sitting into a chair. Don’t sit, your body weight should be directed mostly touching the chair
with your buttocks, straighten your
knees and rise back up to a fully standing position. Knees should bend in line with the 2 toe and
not pass in front of the foot.
15 times, 2 sets, 2 xs a day. Lower to bed without sitting.
Jump Balance: Jump from foot to foot and balance on each
side as much as possilble.
Kettle Ball Squats: Right leg forward, left leg
straightish. Reach down and bend the
front leg to pick up kettle ball. 10xs, 2 sets
Partial Lunge to 14”: right leg forward and back leg bending,
working the front leg most. 10xs, 2 sets
Out Patient Physical Therapy V. 4.0 and at the three month mark: Joel Anderson (Anderson Physical Therapy , Arlington WA)
My flex was 130 degrees without effort. My extension is staying at zero.
Probably as good as it going to get. Need to build strength and balance!
Double leg Heel rises with support, calf raises:
While standing next to a chair or countertop for support, raise up on your toes as you lift your heels off the ground. Return heels to ground and repeat. 15 xs, 2 sets, 2xs a day, hold for 5 seconds.
Marching: While standing balanced lift up one knee allowing it to bend as your raise your foot off the floor. Set the foot back down and perform same on the other leg. 15 times, 2 sets, 2xs a day. FLEX KNEE FULLY
Lunge lifts: Use the new knee forward (right in my case) and kneel on the left knee. Then lift to standing on the right leg. Left hand can go to a steady support and even help lift until it is not needed. 2-3 sets of 10-15, 2xs a day. This is new and very tough to do but it is seemingly effective. I like it.
Squats: Stand next to bed or chair with feet shoulder width apart. Begin by bending knees and lowering your body into a squat, as if you would be sitting into a chair. Don’t sit, your body weight should be directed mostly touching the chair with your buttocks, straighten your knees and rise back up to a fully standing position. Knees should bend in line with the 2 toe and not pass in front of the foot. 15 times, 2 sets, twice a day. These are getting easier but are still making me breath hard.
Snap Heel Slides: Slide operative leg heel towards buttocks in a snapping motion, keeping heel on the surface. Slowly return to starting position. Once you have gone as far as your leg will go, slowly straighten leg. 2 x10, 2xs a day. This exercise is very effective in stretching the bits.
Strapped Heel slides, advanced : Attach a strap to operated foot and pull the heel as far as you can. Count to 5 then release. 10 times, hold for 5 seconds, 2 sets, 2 xs a day This exercise is losing it's effectiveness seemingly but it took a while to stretch (one of my favorite exercises) as much as it did. I suspect I would be much less stretched if I hadn't used the straps to pull as hard as I could.
Standing on one leg for 30 seconds: I use my electric toothbrush to time this and get two balances on each leg per brushing session. Do as many balances as one can.... I do 2 twice a day.
The three month mark: Balance and daily living observations.
Getting dressed: Inserting my left leg into a pant leg or brief first occasionally requires a steady hand on the part of the closet. Putting the right leg in nearly always needs support.
Stairs: Going down stairs with my hands full is slow but getting a bit better each day. Going up with hands full is slower and a bit wearing, energy wise.
I have concerns that 10,000+ steps a day is a bit wearing on the unoperated knee. I have been averaging over that for weeks now and am cutting back a bit to conserve it's use. The right leg is stronger each day.
Balance is a big deal and I need to try and get it back.
My disc throw is not any longer. Starting my chainsaw is getting harder but with a bit more workout maybe I can get past that for this season.
Had the CT scan of my left knee yesterday (4/5/24) the data is sent to the firm that makes the new part so the process is started. May 1 has the interview with the team at Providence Hospital. Then the date for my surgery can be scheduled.
The four month mark:
I am looking forward to getting the second knee installed as my left leg gets real sore after 4-5,000 steps now. Sitting is the killer. Getting up from a chair is a slow process and painful. The right leg (new knee) is doing all the work but the pain from the left side hampers my scampers.
I was doing my ballroom dancing after 7 weeks, excluding a couple of the more active dances, eg... Quick Step, Viennese Waltz, and Salsa. Now after 12 weeks I still have not done Viennese and Salsa is just for the young anyway.
I was getting up off the throne but now the left side is not helping so I have to push off with my arms again.
THE LEFT KNEE visited:
I had the left knee installed on May 14 and now, as I am typing this, 3 weeks after that. I am doing this separately so not to make reading about the experience confusing between the two events.
This is two weeks after surgery and before the nurse removed the 20 staples in the top. Lori took out the 4-5 stitches in the lower cut. |
All in all this knee is probably more typical. I had no complications sending me to the hospital post surgery.
Drugs:
I had morphine pills for 3 days, Movastin (sp) for 5 days (this blocks the gut from the opiod drugs and kept my bowels active. It worked!)
Now on baby aspirin for a month and Tylenol (1000 mg) every 4-5 hours with an extra one for sleeping.
Following surgery, I had a week where I was barely able to get a couple hundred steps a day. Then a week at about 2.000 steps a day, then a week at 3500 steps a day..
THEN: I had a big ouch as I thought to go for a stroll and get the mail. OUCH happened on what I am thinking is the weight bearing bit of the knee. I took the next day off and stayed under 1.000 steps.
Digestion:
It took 5 days for the constipation to release but by taking some OTC drugs it finally worked. Stool softener seems to get the job done for me.
After 3 weeks, mostly all is normal. Occasional one day hold up but make up the next day.
Physical Therapy:
Since I had no complications post surgery I was able to start up with my home PT dude, Shaun right away. He is a good cheerleader and tells me I am doing well. Last week (just after week 2) I had a zero extension number (zero is perfect). I had a 102 flex which is good but the final number should be 130ish. Still, after this short period, doing well.
He is coming in twice this week and expects to graduate me from the program. I would then go to Outpatient PT.
OUT PATIENT PT:
My first outpatient PT report on the left knee. A day short of 5 weeks for the second knee. 118 flex 3 exercises: Heel slides with strap, hold 10 seconds, 10 reps Glut set and then raise the leg straight up as many times as possible. Attempt to hug left knee to right shoulder, 10 reps, hold for 10 seconds.
There is hope on stopping the glut lock up at night. The last exercise might do it. Sleeping the entire night would be a HUGE improvement.
Regular MD:
I went to the regular Medical Doc for drugs as PT cannot prescribe them. I got Gabapentin (sp) which is for sleeping, anxiety and something else. I asked for a muscle relaxer. Apparently those are more difficult to get now a days. Anyway the drug worked or the stretches worked. Each day the muscle spasm (on the piriformis) lessened, the third night it was not there at all. Huge improvement!
OUT PATIENT PT: second visit
I got the new PT at my wellness center this time, Connor vs Joel. He is just out of PT training in San Diego and has a lot of experience with post operations of installed parts. I am going in every week now until?
1. Hamstring Stretch. 3xs a day 30 seconds to one minute. Use a strap to hold leg in air.
2.. Squat: Hold on to the kitchen sink and lean back to squat. 12 x
3. Piriformis stretch: Knee to opposite shoulder, 3 xs, 30 seconds. Use strap
4. Straight leg raise: On back, straighten leg with quad set, lift to height of opposite knee. Hold 1 second. 20xs 2 sets
5. Heel slide: Slide up with muscles first, then pull with strap. 20x
PT for July
1, 2024
1. Hamstring Stretch. Sitting, do both legs, one at a time,
straight out with heel on the ground.
3xs a day 30 seconds to one minute.
2.. Squat:
Hold on to the kitchen sink and lean back to squat. Try and get thighs
horizontal. When getting up squeeze
glutes and quads. 12 x
3. Piriformis
stretch: Knee to opposite shoulder, 3 xs, 30 seconds. Use strap (do
as needed)
4. Quad Knee
kickout (edge of bed) 20x, 2 sets
5. Heel
slide: Slide up with muscles first, then pull with strap. 20x
6. Calf stretch, leaning against wall with leg
back and stretched. (runner stretch),
both legs. 3xs, 30s
PT for July
8, 2024
1. Hamstring Stretch. Sitting, do both legs, one at a time,
straight out with heel on the ground.
3xs a day 30 seconds to one minute.
2.. Squat:
Hold on to the kitchen sink and lean back to squat. Try and get thighs
horizontal. When getting up squeeze
glutes and quads. 12 x
4. Quad Knee
kickout (edge of bed) 20x, 2 sets hold each kick for 5 seconds but not too high
up. Keep leg straight.
5. Keep thigh on floor, 4 seconds (glut
set). Rise straight leg to opposite knee
height. 10@
6. Calf stretch, leaning against wall with leg
back and stretched. (runner stretch),
both legs. 3xs, 30s
7.. Heel
slide: Slide up with muscles first, then pull with strap. Hold for
5 seconds, 20x
8. Ankle pumps, 20x
9. Walking:
Straighten knee when it is behind you to bring through. 2 sets of 15 steps.
PT for July
22, 2024
1. Hamstring Stretch. Sitting, do both legs, one at a time,
straight out with heel on the ground.
3xs a day 30 seconds to one minute.
2.. Squat:
Hold on to the kitchen sink and lean back to squat. Try and get thighs
horizontal. When getting up squeeze
glutes and quads. 12 x
4. Quad Knee
kickout (edge of bed) 20x, 2 sets hold each kick for 5 seconds but not too high
up. Keep leg straight.
5. Keep thigh on floor, 4 seconds (glut
set). Rise straight leg to opposite knee
height. 10@
6. Calf stretch, leaning against wall with leg
back and stretched. (runner stretch),
both legs. 3xs, 30s
7.. Heel
slide: Slide up with muscles first, then pull with strap. Hold for
5 seconds, 20x
8. Ankle pumps, 20x
9. Walking:
Straighten knee when it is behind you to bring through. 2 sets of 15 steps.
10. Calf/Toe rises, 2xs 12
11. Hamstring curls, 2x 15x, both legs
12. Intentional walking with left leg straighten
on back location.
PT for July
29, 2024
1. Hamstring Stretch. Sitting, do both legs, one at a time,
straight out with heel on the ground.
3xs a day 30 seconds to one minute.
2.. Squat:
Hold on to the kitchen sink and lean back to squat. Try and get thighs
horizontal. When getting up squeeze
glutes and quads. 12 x
3. Calf stretch, leaning against wall with leg
back and stretched. (runner stretch),
both legs. OR Toes up on wall or step… 3xs, 30s
4. Heel
slide: Slide up with muscles first, then pull with strap. Hold for
5 seconds, 20x
5. Walking:
Straighten knee when it is behind you to bring through. 2 sets of 15 steps.
6. Hamstring curls, 2x 15x, both legs
7. Marching, thigh up and then straighten leg on
lowering, 3xs, 12 reps.
8. Knee
Extension with weight and hamstring curl with weight. Have Skylar set me up.
Note the steri strips holding the cut together. The right leg is in the thigh high compression sock. |
Driving:
I was able to climb into my F-150 and get the door shut yesterday, so before the 3 week anniversary. Good thing that leg just has to sit there. No clutch!
I take my cane with me during the day but the walker waits where I sleep.
Sleeping:
This seems to be the worst thing. I only get one hour before having to pee. That really sucks as I don't feel real rested for the day. Lots of naps, particularly after each meal! Not the worst thing.
I am sleeping on the recliner as I cannot seem to get comfy in my bed. Might be due to the body capture of the recliner, not allowing me to move much. I try the bed periodically but not much sleep there.
I had similar issues on the first knee install so figure I will get through this. Last night I had a couple of two hour consectutive sleeps.
AFter one month, I am now staying in my bed instead of the recliner. Bit by bit my sleep is getting a more complete.
Compression Socks:
This things are to be worn for a month post surgery. My caregiver, Lori, is real good and strong from moving horse manure. Good thing, as the socks take some grunt to get them over my size 13 EEEE feet! Only a week left on them. Once on they are not bad to wear. I was able to get them off on my own about a week ago.
Showering:
I had to wait 5 days before taking my first shower and had to make do with spit baths and a washcloth. UGH.
I placed stool from my shop in the shower for me to sit on and it works a treat! What a fantastic invention! Love the shower.
I took the shop stool out after 3.5 weeks.