How do I determine how competent the doctor is? I have scheduled surgery on one knee in October however during the summer, the other knee has become more painful than the one to be replaced. What do you think of bi'lateral surgery?

-- paul boardway (pbinc@superior.net), August 22, 2000

Answers

To answer your question....if needed, I am VERY MUCH in favor of bi- lateral knee replacement surgery. I had my surgery done 13 months ago and have not regretted my decision to have both knees done at one. If you have to have two knees done...why prolong the proceedure. Doing one knee at a time almost takes 2 years out of your life. NOt that it's that horrible....it isn't. But, why would you want to experience 2 recoveries when you can have it all done and overwith at once? The longest part of the recovery is the physical therapy that follows. I was lucky enough to be transferred to a rehab hospital for 2 weeks following surgery. There you learn all there is to learn about self care and mobility during the recouperative period. Following rehab....I had a physical therapist come to the home...3 times a week....for about 2 weeks. He showed me exercises to do at home. After my yearly check with my orthopedic surgeon...I was given another perscription for another 4 weeks of physical therapy at an outside facility. They had a pool and I was given water exercises to do....as well as the usual bike and treadmill exercises. Personally, I felt that the warm water exercises was the most beneficial. Even heals at a different rate. I was very discouraged because I was not able to walk up or down steps without holding on to a bannister for 10 months. One day...it just magically happened....I walked down the stairs before I realized I wasn't hanging on. Don't fear this operation....they have it down to a science!!! If I can answer any more questions for you....just ask.

-- Janet Miller (Needils@aol.com), July 15, 2001.

Please see previous comments on bilateral versus unilateral total knee replacement. Secondly, how do you determine the competence of your physician? I think it is important to know how many total joint replacements the surgeon does in a typical year. Some surgeons focusing their practice primarily on total joint replacements are more likely to have reliable outcomes since this is the focus of their practice, also the experience of the the surgeon in general, whether the surgeon is a member of the American Academy of Orthopaedic Surgeons, whether the surgeon has completed a fellowship in joint replacement can all be indicators, but are not guarantees of competence. Finally, word of mouth should never be underestimated. Surgeons with good results tend to establish good reputations in the community. I hope this helps.

-- Marc W. Hungerford, M.D. (mhunger@jhmi.edu), August 14, 2001.

I am 70 yrs. old and had both knees replaced in July of '03. Went to a re hab hosp. for 4 days only as I did remarkably well. Although getting around was initially difficult I coped and forced myself to do home exercises as well as working hard at an out patient facility. The pool exercises were the most beneficial. I now have 120 degrees range of motion in both knees and hardly know the new knees are there any more. There is absolutely no pain and I expect to bet better and better everyday. Attitude is very important and a strong will to succeed is necessary. Toughness helps enormously. Good luck.

-- Geraldine Guidal (garagefish@optonline.net), April 04, 2004.

I am 53 years old and tore both knees up from running in my younger years. I had both knees done 11 months apart. I have no regrets. I learned alot from the first that I was able to take into the second total knee. I took general anesthesia on the first and due to the morphine drip I was not able to help myself in the hospital. The second total knee I elected to take a spinal with twilight. This was the way to go. I was in total control of no only myself but my pain meds. When I needed them I took them. It allowed me to participate in my physical thereapy while in the hospital. Also I highly recommend going to a rehab center after surgery if it is a good one. Check them out before your surgery. I found one that worked you 3 hours a day and then the rest of the time I spent on the CPM machine. Great machine. It allowed me to get to a point so that after 10 days I was at 90 degrees of bend. Other than that phyical therapy is important but so is doing the exercises on the days that you don't attend physical therapy. Recover is in your hands. Endure the discomfort and you will get through it fine.

-- Bruce Barney (ibbarney@comcast.com), July 12, 2004.