What can I say? Fate caught up to my knee. I have always had a certain amount of knee pain but at 59 I am scheduled to have a left total knee replacement this coming Monday, August 22, 2016. I am writing this for my patients and for everyone having a knee replacement that is someone else’s patient. This time I am someone else’s patient.
Since venturing from my fellowship in joint replacement surgery at The Rothman Institute in Philadelphia in 1991, I believe that I have performed well over 3500 knee replacements without a sense that one day this would be my fate. Performing a knee replacement is a surgical religious experience. It is the perfect storm of thoughtful, elegant surgery coupled with a massively positive intervention on the quality of life of the patient. In good hands, a knee replacement takes about 45 minutes to an hour to perform. The results are so good that when a less than optimal result happens we, as surgeons, have great sadness for the patients because we feel we do the operation the same way each time.
The frustrating part about knee replacement surgery, from the surgeon’s point of view, is that there are times when the results are just not good. Even if this was 3% of the time all you have to do is crunch the numbers. If a surgeon does 200 knee replacements a year and 3% of patients are not happy with the result, that means 6 people a year (a lot of humans) are not pleased with your attempt to make them feel better. This makes for a tough job sometimes.
I am at the other end of the scalpel now. I think I have two fears- one small, one big. The small one is the pain after surgery. That will be temporary. Considering my surgeon uses what is referred to as a multimodal approach to pain with many medications and modalities as well as the use of a long acting local anesthetic (like Novocaine) called Exparel, I think the pain will be manageable enough. Check back to this blog in a week or two for the truth about the pain! The big concern is actually whether or not, despite the skill of my surgeon, Dr. Craig McAllister of Seattle, Washington, what if I am in that 3%? The group where everything went well in the operating room, the x-rays look great, and by all accounts my result should be a home run. I have seen too many patients, over the past 25 years in practice, who were in that 3% of less optimal results to know that it is impossible to predict this group. We will find out soon enough how well I do.
I will try to keep you abreast of my progress and my thoughts about my surgery from the perspective of a surgeon-patient. In a way I will be curious to see how accurate my own perceptions of a patient’s perceptions of the surgery are. Buyer beware, though, because this blog, in the end, is the experience of one patient and one operation.
I hope everyone who has the opportunity to read this gets something out of it!