A Patient's Story of Artificial Knee Replacement

Dr. Randale Sechrest: Hello, I'm Dr. Randale Sechrest, your host for eOrthopod.TV. Today we'll be talking remotely with a patient who has undergone a total knee replacement. Mr. Will Netelenbos. Thanks for joining us Mr. Netelenbos.

Will Netelenbos: Thank you so much, appreciate the opportunity.

Dr. Randale Sechrest: Well, what I'd like to do is sort of explore your experience in having knee pain and then making the decision to have an artificial knee replacement and the look at your experience around the artificial knee replacement and now, as you've recovered from the artificial knee replacement, really talk a little bit so we can give other patients an idea of what to expect through this whole process. So, let's begin by talking a little bit about the problem that led you to consider an artificial knee replacement. Can you give me a little bit of a history about your knee problem?

Will Netelenbos: Yes, certainly I can. For years, you know I played several sports, I played soccer, I played volleyball and all of these types of sports and slowly and surely I found that my leg was actually beginning to twist a little bit and actually turned to the outside, to my right side. And what happened was that I began to start actually having problems getting up on the stairs and going down the stairs. And not only that, I had a problem with getting out of a chair – that was probably the most difficult thing. After about 4-5 years walking around like that. It really got so bad that I almost needed a cane to move around.

Dr. Randale Sechrest: Now, during all that time that you had a played those sports, have you ever had any serious injuries to the knee?

Will Netelenbos: Well, I did once I had a problem with the meniscus, and so they supposedly that was taken care of. But it really never healed, it never gave me the kind of mobility that I had before. You know so, I did have a couple of injuries, but you know at the time, I didn't think that they were of a long-term nature basically.

Dr. Randale Sechrest: And when you're talking about your meniscal tear or meniscal injury, did you actually have surgery for that problem?

Will Netelenbos: Yes, I had. I had surgery, as a matter of fact, I don't know if it was the same or if it was anything else, but I had at least two surgeries on my right knee.

Dr. Randale Sechrest: And were those arthroscopic procedures, where they just put the scope in or were they formal operations?

Will Netelenbos: One was arthroscopic and the first one I believe, yes, was years ago, was an actual fact you know, cutting into the knee and I don't think at the time, that was 20 years ago, it wasn't too common for arthroscopic procedure.

Dr. Randale Sechrest: I'm curious, when you had the arthroscopic procedure before you ended up having artificial knee replacement, how long before the artificial knee replacement was the arthroscopic surgery?

Will Netelenbos: Well, I would think it was probably it got me through for a couple of years, but it was never really doing what I thought it would do. Which is that I would have really good mobility again. I think it was more of a bandage type of a thing than actually a good result, being able to walk again the way I used to walk.

Dr. Randale Sechrest: But you do feel that the arthroscopic procedure gave you some benefit for a temporary period of time.

Will Netelenbos: Yep, it certainly did, Absolutely.

Dr. Randale Sechrest: Now how long has it been since you've had your artificial knee replacement done?

Will Netelenbos: Well, it's been quite a while and I'm just guessing now, but I think it's been at least 7 or 8 years – seven years maybe, roughly.

Dr. Randale Sechrest: And you haven't had anything else done to that knee since you had your artificial knee replacement?

Will Netelenbos: No. Not anything at all whatsoever.

Dr. Randale Sechrest: Well, tell me a little about your experience in terms of making the decision for an artificial knee. It sounds like you had that arthroscopic procedure hoping that that would solve the problem, obviously. And at least by you more time, as it became clear to you that that artificial knee was going to need to be done, what prompted you to finally make the decision to move forward?

Will Netelenbos: Well I think one of the worst things was the pain. I had pain radiating in my legs, probably in combination with a bad right hip which I had replaced you know a couple of years ago. But I had this radiation going through my legs and it would be hard to sleep at times at night. And, again my leg started to sort of move towards, my foot was actually you know, turning slightly over the years to the right. So, I was sort of, you know, not walking balanced at all. It was a very unbalanced walk. But the pain was certainly one of them, and that was the decision where I got to a point, I say listen if I don't do, you know if I don't start doing something different here, I will be totally immobile. And so, that was the real reason it was a physical endurance that I could no longer deal with – it was hard on me. So, and it effected me not just physically, but it effects you in other areas too. You know it can be not only sleeping, but just your attitude towards day-to-day functioning in you know in a work place or wherever you are.

Dr. Randale Sechrest: You mention some of your recreational activities, and you mention that this does have an effect in the workplace, I'm just curious, what type of activities did you do in addition to the recreational activities?

Will Netelenbos: Now, is this in the past or currently?

Dr. Randale Sechrest: Well, while you had the knee pain.

Will Netelenbos: Oh, the knee pain, yes, I would think that it could have been a couple of things, it could have been, umm, you know I was interned as a kid, in WWII prison camp and so the first three and a half years that I was there, you know, we didn't have type of diet that you would have available to you now. So there were a lot of deficiencies probably there right from the beginning. But I think that most of it was also because I've always enjoyed sports, and I was maybe too aggressive, or not aggressive to the point where I started to be getting injuries and the injuries continued and they expanded and got worse. And so that was probably the biggest thing I would say. I did several sports, 3 or 4 different kinds. And um, I think that was probably the biggest contribution.

Dr. Randale Sechrest: Well, lets talk a little bit about the pre-op and how you prepared to have your artificial knee replacement. Did you have to visit your regular physician? Did you have any other medical problems that needed to be stabilized before you went and had your artificial knee replacement done?

Will Netelenbos: Not really, I have to say that my approach to it was basically, that since there were no real other issues to, and I would say this any time for any operation, if that I you know, I did umm, spent more time in the gym so to speak. I still go about 3-4 times a week. But I made a special effort to really prepare myself for the operation, mentally as well as physically. I would recommend to anybody you know, and it's not hard to do, you just you don't have to be the world's greatest athlete, but you just spend a little time. And I did this for about a month and a half, and this was you know, in addition to my regular workout, but just giving it a little extra so I wold be better prepared for the operation.

Dr. Randale Sechrest: You know I think a lot of patients have a fear of having a major operation, and especially an artificial joint operation, whether it's a knee or a hop or any other joint. I think one of the things in talking to patients over years, faced with this decision, is that fear of the pain that is going to come after the surgery. Did you experience any of those misgivings, or any sort of concern about pain during this operation or immediately after the operation?

Will Netelenbos: I have to say, and I don't know if it's because I did prepare myself for this physical portion of it, I have to say that I had maybe pain for a day or so, just the normal pain after you have the operation - a day and a half – it's been the most amazing thing – my worst pain was my digestive system and being, you know because of probably the anesthetics and what have you, you know I had some problems there with, what do you call it, uh, stomach acid and stuff like that. You know, but that was the worst – constipation - I couldn't think of the word. Constipation – was the only big problem during that period, and I was out of the hospital the first time – well that was for the knee operation, I was out of the hospital after the second day or so. And that was about 6 years ago. And so there was no pain for me after I quit taking the pain killers about the 3rd day after I got home and then never looked back, I mean it was unbelievable, It was just unbelievable I felt so good.

Dr. Randale Sechrest: Well, lets talk a little bit about the rehab that you went through artificial knee replacement. When did you start physical therapy after you left the hospital?

Will Netelenbos: I believe it was about – and like I say it's been a number of years – but about 4 or 5 weeks after.

Dr. Randale Sechrest: And when were you able to drive a car after your surgery?

Will Netelenbos: I think about, it was very quick, it was even before I got into what do you call it – you just mentioned it -

Dr. Randale Sechrest: physical therapy?

Will Netelenbos: the physical therapy..I'm sorry. Ya, I had actually started driving before I went into physical therapy, you know very carefully, but I knew what my limitations were, which were very few in actual fact. So, it was just getting into the car was a little bit challenging, slightly, one leg first and then the other, but once I was in there I had complete control. So, ya, it was amazing. I was quite surprised about it myself.

Dr. Randale Sechrest: Now, after surgery, I'm assuming you were either on crutches or a walker or some sort of support – how long did you need to use either crutches or a cane before you could discard them completely?

Will Netelenbos: Well, the crutches incidentally, I wasn't using one of those when I got home, they were suggesting I use a little walk, what do you call them, a walker, a little walker. I tried that for a couple of minutes and I knew that wasn't for me, so I used the crutches the first period and uh, I would say it was probably about oh, a month and a half or so, or two months. And then after that period I changed to using the cane, I don't even think it was even a month and a half, it may have been just a month, and the cane worked out really good for me. And I used that for 4-5 months or 6 months.

Dr. Randale Sechrest: And at the time, were you working at the time that you had your artificial knee replacement?

Will Netelenbos: Yes, yes.

Dr. Randale Sechrest: And how long did it take you to get back to work after your artificial knee replacement?

Will Netelenbos: Well, you know I did, I was able to, the kind of work I did was not, wasn't physical, it was more managerial, more administrative type, but I was able to get back after about 3-4 weeks. Three weeks I think I was ready to go.

Dr. Randale Sechrest: And how long do you think it took before you really had this behind you and you could pretty much assume that you were completely well, and you sort of just went about your business and didn't think about the artificial knee anymore?

Will Netelenbos: I would think it was about maybe 7 – 8 months, somewhere around that period, and I, you know I have to say that actually, you know the process right, the early process, didn't even cause any pain, it was more of a mental thing to begin to slowly realize that I had a great new right knee and no longer after 6-7 months was I thinking about that knee anymore, like you know it was just second nature. I never thought of it after that anymore, it was just so good, unbelievable.

Dr. Randale Sechrest: And talk a little bit about your activities now. I mean you've had this artificial knee for several years now. Do you find that it limits you in any way, or do you do anything you want to do?

Will Netelenbos: It doesn't limit me at all, I have to say again, it's the best thing I even did in my life, besides a few other things, but I can now go up the stairs, I can go down the stairs, I don't really need to use the hand rail. The other thing is, the most wonderful thing is, that when I had my knee problem it was so hard for me to get out of a chair – so what I was doing was every time like at home or at work, to compensate for that by trying to avoid getting out of the chair as much as possible and undertake tasks all at the same time – be it at home or be it at work. And wait till the right moment and I'd say ok, now it's time for me to go, because I didn't want to – it was painful, it was you know, so I wanted to minimize the amount of activity, which in itself of course is not good for you anyway. So, yes, it has given me complete mobility. And not only that but I play tennis, as a matter of fact I have a tennis game later on today. So, it's a great blessing.

Dr. Randale Sechrest: Well, I think this has been an excellent sort of history of your experience with artificial knee replacement and I'm sure patients are going to appreciate hearing your experience. Is their anything as we close that you feel that patients should know that we haven't discussed up to this point, if they're either considering the knee for an artificial knee replacement, or perhaps if they've already had one and are looking for encouragement during the rehabilitation program, what would you tell those patients?

Will Netelenbos: Well, the biggest thing is that you know that if you make the decision, and I would recommend that if it impairs you, if you are not yourself because you can't do all the things that you need to do, because of a bad knee or a bad hip, I would suggest that you definitely make a decision on this, and it of course depends on where your are, how old you are. But you know I'm right now 69, so, I went under the knife about when I was 63, or 62 on the knee, and for me it was ideal. So my recommendation is that if you still feel like you're not young enough to enjoy life, and you want to enjoy life, proceed with it, it's the best thing you'll ever do. And prepare yourself. Again the best advice I can give you is to prepare yourself about a month and a half, two months before the operation, if you do exercise, do more exercise at the time and get a great mental as well as a physical stimulation as a result of that which will get you through an operation easily. Because that's what it really is.

Dr. Randale Sechrest: Well, I want to thank you for all your comments, and I want to thank you for sharing your experience with patients, so thank you very much for joining us today.

Will Netelenbos: Thank you so much, it was a pleasure.