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Messages to others about knee replacement

The men and women we talked to offered lots of different advice based on their experiences of partial knee replacement surgery. Everyone is different and what works for one person may not work for someone else. Here are some of their suggestions.

Many people recommended a partial knee replacement to those who are eligible and might be considering it. The benefits included being pain-free again and mobile enough to do the activities participants had had to give up because of pain and swelling. This included going for walks, gardening, golf and playing with grandchildren. Some wished they’d had surgery sooner rather than putting up with severe pain. Jennifer, for example, was pleased she’d had surgery to both knees and couldn’t think of any negatives:
 
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It’s ‘wonderful’ to go for walks and sleep properly at night. Jennifer advises people not to put up with knee pain because something can be done about it.

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Age at interview: 64
Sex: Female
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What's the positives if someone is thinking about having the operation?  

Go of it because it's just wonderful to go for a walk and not feel that you’ve got to keep sitting down because you’ve got so much pain. And it doesn’t wake you up at night – I mean at night I used to… before I had the operation I'd turn over and my knees were so painful it used to just wake me up. 

And walking, how much could you walk beforehand, or you were hardly…? 

Hardly any distance, yeah very, very little really. 

So it sounds like both times you’ve recovered really well. 

Yeah... I would say don’t put up with the pain because there is something that can be done and, when you’ve had the operation, just make sure you do the exercises, that’s really, that’s it.
 
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Nancy could hardly walk before her first knee operation and the pain was getting unbearable. She’s had both knees done now and said ‘it’s been brilliant’.

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Age at interview: 81
Sex: Female
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It about ten years ago, you know, something terrible. I could hardly walk in the end. And it was so painful. It was almost letting me down, you know. And that’s when I went and had the first knee done. And that was great. And then the other one, a few years, two years later, I’ve had the other one done. Because, you know, and it’s been brilliant ever since. I can walk, go walking and do shopping and all that, that I couldn’t do before.

So when you were having the pain, did you say that was about ten years ago?

Yes, it was. And then I used to go to the doctor’s. I mean it first started off where he used to give me these injections. But then that just lasted for a while. And, you know, then this pain come back again. And so he decided that, you know, to have the, go for the knees.

So over the years the pain was just getting worse and worse?

Yes, that’s right, yes.

And the steroids had no effect?

It was getting unbearable really, you know.
Having knee replacement surgery was ‘one of the best things’ that David had done. He said he now has a normal life again in which he can walk and garden without pain. He advises talking to the physio for longer before leaving the hospital to fully understand the exercises. Several people talked about the improvement to their quality of life and a few were now considering having the second knee done.
 

Before surgery Phillip couldn’t walk the dogs, play golf or kick the ball with his grandson. Surgery is painful but the ‘transformation is unbelievable’.

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Age at interview: 62
Sex: Male
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Can you tell me the difference between before you had the, your knees done and now?

Oh, now I’ve been, I mean it’s only been, what, six weeks. I’m out there taking the dogs for a walk, kicking a football lightly with my grandson. Started my golf again, only slowly, but not too much. Because I haven’t been able to play golf for three or four years or walk the dogs or even kick the ball with my grandson. So . . .

So was that painful?

Yes, yes. And the transformation is unbelievable, unbelievable.

So first you had the right knee done?

Yes, correct, yes, yes.

Is there anything else you would say to somebody who’s thinking about having --

Don’t wait. Have it done. Anything, hip, knees, anything. I would, if I was anybody. Like I was advised by my wife to go and get it done. I should have done. But being pig-headed, I didn’t, but yeah. Yes, if anybody has, mind people have asked me what it’s like. I’ve said, “Well, it’s not without pain. But looking at the longer picture, it’s going to give you more freedom of life.” You know, it’ll give you a healthier life, where you can actually move and actually walk, go shopping for two or three hours and not have to sit down. And, you know, just the simple things in life really. What we take for granted.

And you’ve mentioned it’s those simple things. But it’s, it’s changed your life?

Yes, it’s made me feel more happy. I used to be so grumpy. I used to be in so much pain.

Because of the pain?

Yeah. And I couldn’t do what I wanted to do. Frustration as well. Which did strain us a little bit. Not to the point of, but you know. So much better. 

So you’d definitely recommend it?

I would recommend it to anybody, yes.
Several participants cautioned that everyone is different and while some people recover straightforwardly from operations, others may not. Jacky advised people to talk it over with their family as well as the GP. Many advised others to see the GP and ask for a referral if they consistently had knee pain that was getting worse over time, pointing out that knee arthritis is quite common. Once referred, Lesley suggested people take someone with them to the pre-operative assessment as it can be a long day with lots of tests. Having someone there to fetch some lunch or a drink can be helpful. 

Helene, who lives alone, made practical arrangements before going into hospital to make things easier while she was recovering. This included buying soups and other food that was easy to prepare.
 

Helene stocked up on food and filled the freezer before surgery. She also recommends doing the exercises as often as possible and sticking with them.

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Age at interview: 66
Sex: Female
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Are there any tips you would give to somebody from your own experience?

I think you listen… you do listen to sort of what they tell you like making sure you don’t have to do shopping. I know one can shop online these days, it's so, it is easy, but that’s one of the things I do remember taking on board was to fill a freezer up, have packet soups and yeah that sort of thing. Can you repeat the question now sorry?

The message that you…and tips you would give to somebody.

Oh right. Recovering, as they're recovering – you just to have to have the courage to do all the exercises as much as you can, otherwise you're not going to recover. You just have to stick with it and know that it's you and that’s all there is.
Jacky advised others not to be afraid of asking questions if they’re unsure about anything, and Geoff to set goals during recovery.
 

Jacky couldn’t fault the professionals who cared for her. They were encouraging and helpful. She advises people to ask them questions.

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Age at interview: 57
Sex: Female
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Is there any message you would want to give to health professionals there at all?

No, because I can't fault them. They're encouraging everybody to do what they need to do. They're there if you need the extra painkillers or extra advice; they're there for you and I'd just say, "Don’t be frightened to ask. Make sure you ask – if you're not sure, ask them because if they can't find out for you, or if they don’t know the answer, they’ll go and find it out for you. And then they’ll encourage you to do what you're supposed to do."
 

You need to increase the exercises gradually. Geoff recommends setting small goals and building up to doing more. He felt much better within ten weeks.

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Age at interview: 64
Sex: Male
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I would think don’t really rush it the first six weeks, take your time. Don’t try and walk up the stairs three times a day if you don’t need to, once is enough. If you’ve got a downstairs toilet, use it; don’t just go upstairs because you think it's going to make you better. It really does need to build up but I think personally, you know, I think you need to do the exercises; you need to build it and then gradually do all these things but not all in one week.

But do you think people will have a tendency to want to do everything as quickly as possible?

Mm most people I know would say, "Well I'm going to do that today." Set little goals and think, 'Well I've done it today, I'll do twice as much tomorrow.' And then when you sit in the chair and you think, 'Oh that hurts a bit,' you know and you cause yourself a lot of pain I think.

And if someone was told they had arthritis and they were suitable for the half knee replacement, and they're thinking about having it, what would you say to them?

I'd say have it every time. Yeah, I've got a friend now who's got the same problem that I've got and he said he's going to have to have it done – so go and have it done. Within ten weeks you're going to be fine.
Some people suggested wearing comfortable clothing and footwear during recovery and whilst exercising. Keith and Alice recommended having sports shoes that are easy to slip on and off:
 

Keith bought some sports shorts, a lightweight tracksuit bottom and slip-on shoes that were easy and comfortable to wear when exercising and icing his knee.

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Age at interview: 71
Sex: Male
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Funnily enough I’ve been asked by now friends or a friend who’s about to have the same operation for any advice I can give. And things I found really helpful were, I had a, I went and bought a, I made sure I had some sports shorts and a really lightweight tracksuit bottom. And I wore that more or less continuously for five weeks. So when I was doing exercises, you know, it was easy. When I wanted to ice my knee, I could take the tracksuit bottom off, do it. And I actually found that very helpful and was pleased that I, you know, did that. 

Another thing was I got some open-backed shoes, slip-on shoes, which actually I had already, but I got a new pair. And of course one’s knee swells up, you know, and the leg swells up and I couldn’t get shoes on. I mean so having that open-backed thing, shoes, was very helpful.
Many people stressed the importance of doing the exercises recommended by the physiotherapist. Some who’d had both knees replaced strongly recommended doing the exercises even when recovery felt slow.
 

It’s important not to get disheartened if recovery feels slow. Penelope had both knees replaced and it’s been ‘very good’ both times.

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Age at interview: 65
Sex: Female
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Don’t get disheartened that you don’t think it's going fast enough – this was my problem this time. I've done really well but I had to keep telling myself I am doing well because I kept feeling…I think the thing is once you get back, the days are so long that you feel longer time has gone than has really gone on. So after a couple of days it's like it's been a week and you're thinking, 'Why aren’t I getting better quicker?' but not to be despairing, you will get better. So long as you do your exercises it'll gradually work, it has for me, yeah.

And you said that you would recommend anybody who's thinking about it [partial knee replacement] to go and have it done?

Yes, yes, well from my experiences, I don’t know about anybody else but my experiences have been very good.

And both of them it's been like a half knee, partial knee?

Yes, yes.
 
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Surgery is painful and recovery takes time, but it’s important to listen to the doctors. Joan wished someone had told her this beforehand.

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Age at interview: 68
Sex: Female
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So if somebody was thinking about having this operation and they're not sure, what would you say to them? 

I would say it is painful but give it time and it'll be alright… Just go by what the doctors tell you. Don’t be stupid, just do what the doctors tell you, or the hospital, and then just go with what they say. Don’t expect a miracle straight away; it just takes time...

So if someone was thinking about having this operation, they’ve got very painful knees, what would you say to them? 

Well, go ahead with it. If everybody said it to me I would have felt better.
Other practical tips during recovery included using a raised toilet seat in the first few weeks because bending the knees could be painful. Useful aids that some participants were given by medical staff included bath seats and hand rails.

Lesley was pleased she had knee replacement surgery and, ten weeks after the operation, had a scar that was barely visible. She advised rubbing cream into the knee:
 

After the staples and dressing were removed, Lesley had dry skin. She massaged her knee and the top of the thigh with body lotion.

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Age at interview: 58
Sex: Female
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You mentioned that you used a cream on the actual wound?

Yes, when the clips were out and the dressing was removed, I’d got like dead, dry skin on my knee. So I used some body lotion and just massaged. And I massaged the scar as well because I didn’t want any tightness or anything. And then at the top of the thigh I’ve got like a little knobbly bit. And it’s stretch, the, I don’t know, it’s a bit, it looks a bit tight. So I just massage some hand cream or moisturiser cream in there and just keep it moist and just keep massaging it.
The people we interviewed also had messages for health professionals. Some advised them to think about offering physiotherapy to partial knee replacement patients after surgery. Others felt it was important for professionals to see patients as individuals and to look at the whole person and their history as they may be living with other conditions.
 

Peter recommends listening to the doctor’s advice. If exercising feels painful, try it again later. Professionals should make sure patients leave with the correct medications.

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Age at interview: 66
Sex: Male
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If somebody has had the operation, is there any advice or tips you would give in terms of recovery?

Yeah. “Do as you’re told. Absolutely, do as you’re told. If you have been told to do certain exercises at certain times, do ‘em.” If you don’t, you’ll finish up with a seized-up knee and… If you do as you’re told, you can move at the right time, you can move your knee, you know. Most of the time the exercises, they state quite clearly, “If it starts to hurt, stop.” Fine, fine. Do the exercises. If it starts to hurt, stop. Leave it for tomorrow. But at least you would have done some. The more you do, the better it’s gonna be.

And is there any message that you would like to give to health professionals at all?

Possibly the only thing I would say would be, “Make sure that when that patient leaves hospital that patient has got quite clearly and categorically all the necessary pills and information that they need written down. Not just ‘take once’ on the side of a box.” But they’ve got to have, they’ve got to know exactly ’cos their mind is possibly elsewhere, wanting to get out to see somebody or to do something. “Make sure that they’ve got the information that they need.” And, you know, other than that, that’s it. Because I’m really, really happy with the way I was treated in hospital. More than happy. You know, they really looked after me.
Many praised the care they were given and said they were grateful that their experience had been positive.
 

The health professionals were ‘tremendous’ and the hospital felt like a hotel. Lesley shared a room with 4 other people and they supported each other.

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Age at interview: 58
Sex: Female
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Is there any message that you’d like to give to the health professionals at all?

Well, I think they’re tremendous, I really do, at the Nuffield [NHS hospital]. From start to finish really I’ve not been that worried. I’ve been reassured. Everybody’s been friendly. The hospital, the three days, nights that I had in hospital, it were like being in a hotel [laughs]. Having meals, and being attentive. And being in a room with four people was very helpful. Because four of us had different things. One had a back problem. I had my knee. And the other had hip replacements. And that was good because everybody was supporting each other. 

And the staff were marvellous. They were friendly, sociable, attentive, did whatever you asked them to do. They, nothing were too much trouble for them, yes. I couldn’t praise them enough. And the doctor’s marvellous. Coming checking, making sure. Come several times just to make sure that everything were okay and there were no problems. And any questions. And you didn’t really have many because, you know, it was all planned out for you. So a success, yes.
Last reviewed August 2018.

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