Golf is many things to many people — and rarely, if ever, is it referred to as “torture.” But that’s exactly how Malcolm Riley, 79, started feeling about his favorite sport when his knee pain from arthritis was at its worst. First, he started avoiding playing, then he hung up his cleats altogether. In addition to the physical pain, it bothered Malcolm to give up the active lifestyle he loved. “I had a few years that were very painful, but then I kept putting off surgery because I thought it would get better. Sadly, it only got worse,” says Malcolm. “The pain finally motivated me to get knee replacement surgery.”
Finding the right orthopedic specialist
Last year, Malcolm decided to find a doctor to perform a knee replacement. Hours of online research and a recommendation from a friend brought him to Dr. Steven F. Harwin, Chief of Adult Reconstruction and Total Hip and Knee Replacement in the Department of Orthopedic Surgery at Beth Israel Medical Center.
Malcolm’s process is precisely what Dr. Harwin encourages patients to do: “Patients with arthritis should seek out surgeons who specialize in total joint replacement. Even more important, it’s been shown that surgeons who perform higher yearly volumes of joint replacements have better outcomes than those who perform fewer yearly volumes,” explains Dr. Harwin, who performs about 600 knee and hip replacements each year.
Pain management before, during and after surgery
The first step for Malcolm was to seek out pre-operative education, which gave him an idea of what to expect, starting with the surgery, taking him all the way through the rehabilitation process. Most patients worry about post-surgical pain, Dr. Harwin says. Thanks to a multi-modal approach, pain management can be quite effective and includes: pre-surgical anti-inflammatory medication; injections in and/or around the knee to control localized pain prior to closing the incision; and self-administered patient-controlled analgesia (PCA) after the surgery.
After total hip or knee replacement, patients transition to oral medications within one or two days, and are ready to go home within 2 to 3 days. “Patients are up and walking the day after surgery. They usually transition from a walker to crutches or a cane quite rapidly,” Dr. Harwin says. That was true for Malcolm, who graduated from a walker to a cane on the second day after surgery.
Rehabilitation is key
The rehabilitation process is different for each patient, but generally, they can drive and travel by 3 to 4 weeks, and are functioning normally by 6 weeks. Most are fully recovered in 12 weeks. “We encourage people to have a formal physical therapy program to ensure they are on the right road to recovery,” says Dr. Harwin.
Malcolm stayed in Beth Israel’s rehab unit for four days to start his physical therapy. He was given a list of exercises to stretch and move his knee, and the physical therapist worked with him daily, to stretch it even further. “Therapy and rehab are the most important things you can do after surgery. You have to work hard and stay motivated,” Malcolm says. After Malcolm went home, he continued to work with a physical therapist, nurse and occupational therapist for weeks.
Little pain, big gains
Knee replacement is the best thing he’s ever done to conquer his knee pain, Malcolm says — and he encourages others not to be afraid of the temporary pain that’s part of recovery and rehab. “That pain will eventually go away. You just have to commit to the therapy and push yourself through those bouts of pain. I’m sure you will not regret it,” he says.
If you think it may be time for knee replacement, call 1-855-411-LWNY (5969) or visit BethIsraelOrtho.org for more information.