When the knee surgeon becomes the patient: my knee replacement recovery diary

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My knee replacement recovery diary

Leading London and Bristol knee surgeon Mr Jonathan Webb found himself in the unique position of becoming the patient when he recently decided to undergo knee replacement surgery. After injury his knee playing rugby for England in the early 90s, he underwent a meniscectomy and for many years remained pain-free and very active.

However, in the last five to seven years, Jonathan experienced increasing pain and lack of mobility as he developed knee osteoarthritis. So, he decided to undergo a robotic total knee replacement at the Fortius Clinic in London. Here he details his road to recovery.

Day 0:
Have been able to sit with the knee resting into extension most of the time. Occasional rest slightly flexed and generally has been bearable with just a strong sense of tightness. Never realised how effective IV paracetamol was!

Midnight – Spinal finally wore off. Pain now 4/10 with some stinging around the incision and just a sense of tightness but still able to do a straight leg raise.

Unable to pass urine. Been 8 times to bathroom between 2am and 6am before finally managing. Really didn’t want a catheter!

Day 1:
Swelling increased steadily and ability to do straight leg raise disappeared.

Practiced walking with crutches, feels very uncontrolled, especially the ability to straighten knee. Not been able to do that for years.

Pain pretty strong, helped by regular pain killers and ice. Trying hard to rest with knee in extension, stretching posterior capsule. Walked around ward and did stairs.

Night better but difficult to find comfortable place to rest knee. Fine if you lie on my back but who sleeps like that ?

Day 2:
Better sleep so able to do a few static quads and straight leg raises today.

Have to remind myself to stand on 2 legs with knee extended. Clearly been relying on left for long time. Much more secure when quads engaged.

Did stairs independently so went home at 11am, 46 hours after surgery.

Slept better in 2 hour bursts.

Day 3:
Icing 8x 30 mins

Trying to do exercises as often as possible. Swelling means flexion only 60 degrees.

Able to walk around house without crutches.

2 weeks:
Whole leg swollen and bruised, from top of thigh down to ankles.

Using the Game Ready knee wrap, which combines Intermittent Compression with Cold Therapy, 3-4 times a day, very helpful. Cannot imagine what it would be like without one!

Flexion still only 60 degrees but extension becoming more comfortable. The lack of bend is worrying me but Andrea, my very experienced Physiotherapy colleague, keeps reassuring me it will be fine, and then goes and ‘assists’ my flexion to excruciation!

Able to walk without crutches but tends to swell more so have continued to use them.

Still requiring strong painkillers most of the time.

3 weeks:
Able to do short flat walks of around 20-30 minutes. Not much in the way of painkillers during the day, started driving short distances. This was on the basis that I could stamp my right foot on the ground hard and I had a practice drive in a car park doing an emergency stop without pain.

Night pain causes me to wake between 2-4 times. I try and store as many painkillers for the night as I can out of my 24-hour quota.

Hands on deep tissue massage very beneficial to stiffness, swelling and flexibility. Highly recommended!

4 weeks:
Still getting moderate swelling by mid morning. Gone overnight.

No painkillers during day, back to work half time. Knee swollen and stiff after operating lists.

Stopped using the Game Ready.

5 weeks:
Full working week.

Knee fine during day but has started being very sore up, and especially down, stairs. Probably related to less time doing my exercises as back at work.

6 weeks:
Overall I’m struck by the variety, unpredictability and at times, severity of the different pains the knee has had throughout recovery. Quite often not related to what I do and often I, the supposed expert, have no idea what causes them.

Pain on stairs miraculously helped by very old school 60 minute soft tissue work done by Physiotherapist.

8 weeks:
Real transition to minimal pain on walking, even up stairs.

Flexion now 120 degrees.

No night pain at all. Still getting a sciatica type pain when driving for more than 30 minutes.

Knee still very stiff if I’ve been standing operating for more than a couple of hours.

10 weeks:
Played 3 rounds of golf in 2 days. In buggies but still walking around 4K per round. No pain. Golf unaffected. Won 2, lost 1!

4 months:
Minimal pain.

Still a limit to how much strengthening I can do but walking pretty unrestricted ie 2-3 hours wouldn’t be a problem albeit with an ache afterwards.

5 months:
Started road cycling during lockdown and as principle means of cardio fitness. Knee really responds well. If a little stiff at start then it frees up with the movements by end of a ride, managing up to 30K+. Getting my heart rate up to max for first time for maybe 18 months.

6 months:
Still some clicking with certain manoeuvres especially coming up stairs as I lift my right knee up from a lower step to put it on a higher step. Suspect this will be permanent

9 months:
Virtually never experiencing any pain. Would have to really push the knee hard on uneven ground, long day standing or heavy weights to get a reaction. Bend is only about 15 degrees less than the other side. Leg press 10% down compared to left knee.
Still tender to kneel on it but not that different to other knee.

12 months:
Near normal. Very occasional twinge from the outer top of shin bone if I twist awkwardly getting out of the driver’s seat of the car.
However I can push leg weights in gym with impunity, flexion still improving bit by bit. Hiking and cycling unlimited by the knee, just my lungs/stamina.

In summary: Life changing.