On the Other Side of Knee Pain.
I’ve had medical issues since I was 41 – asthma, breast cancer, congestive heart failure, lupus, and rheumatoid arthritis – yet I’ve never let these issues define who I am or what I do,” said 57-year-old Claire C. of Creve Coeur, Mo. “I’m not going to let anything stop me from doing the things I enjoy – and that includes my knees.”
Claire, a master gardener, volunteers with her gardening friends. They tend to the flowerbeds in some of St. Louis’ most beautiful gardens: Longview Farm House in Town and County, the historic Jewel Box in the City of St. Louis and Tappmeyer House in Creve Coeur.
Four years ago, Claire felt a burning sensation in her right knee at the end of the day. “I’d walk up a hill while gardening and my knee joints didn’t feel totally tight,” she recalled. “On level ground, I felt as if I was going to fall. I wasn’t sure-footed anymore. It was an unstable feeling – like walking on sand.”
Her symptoms continued to develop. “On a trip to Rome and Venice, Italy with my husband, I suddenly went down on a garden path,” Claire sadly recalled. “It was a bad fall – my pants ripped and my leg was bleeding. For seven days, we walked everywhere on cobblestone streets because there were no sidewalks. I was in pain and feared falling again. I felt as if I left pieces of my right knee all over Italy.”
"When I came home, that was it! I knew I needed to see an orthopedist, so I made an appointment with Dr. Richard Johnston. The X-rays showed that I had no remaining cartilage in my right knee. Dr. Johnston answered all my questions and made me feel as if I was the only patient in his office.”
Dr. Richard Johnston, an orthopedic surgeon on staff at Missouri Baptist Medical Center said, “There’s an upcoming epidemic of baby boomers who fall into two categories – they’re either athletic or physically large. Many, in both of these categories of boomers, are headed toward knee replacements due to their lifestyles.”
TOTAL AND PARTIAL KNEE REPLACEMENT.
“The knee consists of three sections – the medial, lateral and patellofemoral,” explained Dr. Johnston. “In total knee replacement surgery, damaged bone is resurfaced and worn parts are replaced. Most patients will need a complete knee replacement where damaged bone and joint surfaces are replaced with metal and polyethylene components.
Some patients with isolated severe arthritis may be a candidate for a partial knee replacement, which targets only those sections that are affected, rather than replacing all three sections. This procedure is less invasive, with less blood loss and usually a faster recovery.”
Dr. Johnston said, “We believe that 90 percent of people with knee implants will be doing well in 20 years. In most cases, the implant outlasts the patient. Longevity depends on whether a patient is in good physical condition, their activity level, weight, and the accuracy of implant placement during surgery.”
Around Valentine’s Day in 2007, Claire underwent a full knee replacement on her right knee. “A visiting nurse assisted me for two weeks and a physical therapist helped me use a continuous passive motion machine to reduce pain and swelling, increase range of motion and assist with exercise. I gradually regained knee strength with weight training, stretch resistance bands and exercise on a stationary bicycle.”
“Physical therapy and continued exercise are important after surgery to improve the range of motion in the knee to a full extension,” Dr. Johnston explained. “Some of the greatest benefits patients may see are walking unassisted, rising from a seated position, squatting and sitting in a cross-legged position.”
After her recovery, Claire couldn’t wait to get back to gardening with her friends. But her joy was short-lived. “In December, my left knee was killing me. I was nervous going down stairs – I already fell once and skinned my knee. I was so tired of feeling unstable when I walked. That was scary to me. I went back to see Dr. Johnston.”
Once again, the X-ray revealed there was no cartilage in her left knee. So with no qualms, a full knee replacement was scheduled on her left knee in January 2008.
“After a successful surgery, and because I did everything I was supposed to do during my recovery, by spring I was able to return to my absolute passion – gardening with my friends. I’ve enjoyed sharing gardening tips with Dr. Johnston as well.”
“For 10 years, I’ve loved providing the community with something beautiful. And, now, with my brand new knees, I can continue this work without fear of falling.”
Richard Johnston, MD, is board-certified in orthopedic surgery and on staff at Missouri Baptist Medical Center. He received his medical degree from Vanderbilt University School of Medicine in Nashville, Tennessee, and completed his residency in orthopedic surgery at Washington University School of Medicine.