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Various treatment options
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Risk of arthrofibrosis is least if knee has good function before surgery, with limited swelling and adequate gait pattern
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Tertiary referral center for the Netherlands
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Knee osteoarthritis causes invalidating pain and limitations in daily living. A total knee prosthesis (arthroplasty) can solve these limitations. The KNee Active Program (KNAP) at the Máxima Medical Center in Eindhoven (The Netherlands) allows rapid recovery and return home after 3-4 days. This case describes the experiences of a 59 year old lady after total knee arthroplasty (MIS Knee).
The pain increased gradually in the years prior to the surgery: pain started in the morning and my walking distance decreased. I had to climb stairs foot by foot, and woke up frequently at night due to knee pain. Both dr RPA Janssen and I wanted to review all treatment options available before doing an operation (specialized physiotherapy, injections in the knee).
After some time, the operation became necessary. The intake (all appointments with the anaesthesiologist, orthopaedic assistants, blood examinations) took place on a single afternoon. That's nice, no hassle. Specific information brochures were provided and an afternoon information session was organised. During this information meeting, all aspects of the surgery, rehabilitation and procedures were well explained and questions may be asked freely.
The hospital stay as well as the operation went according to the descriptions in the information brochures. The orthopaedic ward is fully adapted to patients with total knee and hip replacements including special chairs and highly trained personel. They are often present and extremely helpful. I did not notice much of the operation: I felt no pain and often fell asleep thanks to the medication. In my moments of being awake, I was well informed on the surgical developments by the anaesthesiological assistant. She was very comforting and gave me a feeling of security. After surgery, the feeling that I experienced was much different from the pain of the osteoarthritis; my leg did not hurt but felt very heavy. Exercises started on the first day after the operation. This is a very pleasant experience: your knee bends without the osteoarthritic pain. First time out of bed (second day after the operation) is scary at first, but you adapt rapidly.
It is surprising to see how fast you can get back on your feet and walk with 2 crutches. Once you leave the hospital, exercises need to be continued with a physiotherapist as well as a home exercise program. Leg extension is very important: I frequently put my foot on a footrest and put a bag of magazines on top of my knee. In the beginning, you sense a feeling of slight giving way of the knee. This feeling dissapears gradually. I planned a vacation 3 months after the operation and was able to walk decent distances without crutches. I had a feeling of having my normal life back again. At this time- 6 months after the operation- I feel great, just like 5 years ago. I am no longer dependent on anything nor anyone and am really enjoying life. Long live the knee prosthesis and dr Janssen!!!