Myron Gets a new Knee ... Again...

 It's been coming on for about a year and a half. I started having pain in my left knee in about January 2021.  I finally went to a local orthopedic surgeon in Florida.  At that time he diagnosed an "arthritic flare-up". He recommended one or the other of two injection therapies: The first was a visco-supplement, which involves a series of 3 injections, each one week apart.  This therapy provides a lubricating coating of high molecular weight hyaluronic acid (HA) injection to relieve knee pain caused by osteoarthritis.  The therapy lasts about 6 months and then must be repeated.  I know at least one other pickleball buddy who swears by this therapy.  Visco therapy would be covered by my insurance.  The second therapy he recommended was A2M Therapy. Alpha-2-Macroglobulin (A2M) is a naturally-occurring molecule found in your blood.  A2M Therapy isolates and concentrates A2M from your own blood for reinjection at the injury site. The concentration helps boost natural healing and support tissue restoration. This therapy has apparently not been proven clinically effective.  Furthermore, it is fairly expensive ($2700 for one knee, but a discount for both knees!) and not covered by insurance.  The alternative to these 2 therapies are rest after a flare-up.  In the end I chose to do nothing and see how it went.  This doctor did not see anything in x-rays to suggest surgery at this point.

Fast forward to November 2021.  Pickleball is my life, and I would play every day if I was able.  We have very nice facilities and a great group of players at our resort in Florida.  However, my left knee pain continued to worsen.  I found that I must rest a day or two before playing again.  As the winter progressed my pain worsened.  I would have a flare-up and be forced to quit playing for a week or two.  Then I would play again, but try to be gentle.  Not easy given my competitive nature. Then something would give, and I would repeat the cycle. It was unbearable, and I was miserable. 

I went to another local orthopedic surgeon in Titusville.  He extracted 3.5 vials of fluid (a world record!) and ordered an MRI.  The MRI revealed bone on bone osteoarthritis and major soft tissue damage, which apparently had not existed a year ago.  Surgery was warranted, but he suggested we do a round of visco-supplement therapy first.  That was fine, since I knew I would not have any surgery in Florida, particularly performed by this surgeon, who locals warned was a hack.  The visco-supplement therapy seemed to have minimal effect, but I was able to continue to play pickleball, at a reduced level, and hobble down the street to happy hour each night.

I made an appointment with my home town surgeon, Dr. William Ward, for April 25, a few days after returning home from Florida.  Consequently, surgery was scheduled for May 17.  This would be a total knee replacement (total knee arthroplasty or TKA) vs. a partial replacement (unicompartmental knee arthroplasty), which I had on my right knee in September 2018.  You can read about that experience HERE.  I thought the partial replacement was hard, but they said the total replacement would be much more significant, with a much more difficult recovery and rehabilitation.  They were right.

As with my previous surgery, Dr. Ward used the Mako™ Robotic-Arm, affectionately known as R2 KNEE 2.

R2 KNEE 2

All dressed and prepped

Dr. Ward autographs his sketches

My new incission scar is about twice the length of the scar from the previous surgery on my right knee. I don't know the number of stitches, but there were 38 staples. 

Kinda like Frankenstein

This image shows the difference in the relative sizes of the implants.

I spent two nights in the hospital vs. one night for my previous surgery. The following Monday I started twice-a-week physical therapy (aka "Pain and Torture") sessions for the next six weeks.  During that time flexibility and strength gradually increased, to the point that I had 115 degrees of flex.  I began playing a little gentle pickleball at about week five.  By week six I was playing a little harder, sometimes forgetting that I was still in recovery.  

It will still be many weeks before I am fully recovered.  There is still significant swelling which may last up to a year. Ice is good!  Strength and flexibility are not yet optimal.  I had the final follow-up with Dr. Ward's PA on July 8 and was essentially released to do whatever I wished.  All-in-all I am happy and life is getting back to normal.  Pickleball: here I come!