Archive | Medicine RSS feed for this section

The Knee, One Year Later

knee_7weeks_dual.JPG
Tomorrow  is the one-year anniversary of the rebuilding of my right knee by Dr. Andrew J. Feldman. The surgery involved a high tibial osteotomy, an ACL recision, and a microfracture. When I saw Dr. Feldman three months ago, he was very pleased with the result. The tibia, into which a wedge of cadaver tissue had been inserted, had healed perfectly; the ACL reconstruction was stable and strong; and the alignment was just what he wanted. He believes that we have staved off a knee replacement for a good long time. Unless I abuse it. (Apparently, Steve Yzerman, the former captain of the Detroit Red Wings hockey team who had the same operation, went back to playing hockey, knowing the the knee would only buy him a couple of years. Given the salary he was being paid, it was worth it to him, but now he will need the knee replacement sooner rather than later.)

So I’m going to wear a knee brace whenever I do sports activities that are likely to put rotational stress on the knee. That includes ice skating, rollerblading, kicking around a soccer ball, and playing tennis. The brace is way cool, by the way. It’s the official brace of the U.S. Ski Team, and it’s manufactured by Donjoy and was custom-fitted for me by Gotham Surgical and Brace on 39th Street. I had my choice of colors, but chose a respectable dark blue.

knee_brace_1.JPGknee_brace_2.JPG

I know it’s hard to believe seeing just the pictures, but the brace is actually remarkably comfortable, indeed, much more so than the smaller fabric covered brace I was wearing a couple of months after the surgery. What’s great about the brace is that there’s no fabric on it, so it’s cool and there’s nothing to rub against the area where the plate was screwed onto the bone.

The knee feels strong. Here’s what I can do now that I couldn’t do before the surgery: run for the bus. I can go from standing still to running without a second thought and without pain afterward. The arthritis is still there on the medial side of the knee, but with the weight shifted to the outside of the knee, I’m rarely aware of it. Oh, there’s a minor twinge every now and then just to keep me honest, but it’s night and day from a year ago.

And the area where the plate was inserted has almost all of the feeling back. In fact, I think there’s less numbness than there was after the first surgery twenty years ago.

To celebrate the anniversary, I bought myself a new set of CCM hockey skates, my first new pair in about fifteen years. My first time on the ice after the surgery was last weekend at Wollman Rink, though it was so crowded that it was hard to really get in good skating rhythm. So tomorrow morning, weather permitting, I’m off to the “The Pond at Bryant Park” first thing in the morning to put the knee through its paces. Bryant Park on a weekday generally has the advantage of being less crowded than Wollman and — even better — much less expensive: in fact, it’s free.

Don’t worry, Dr. Feldman, I’ll be conservative!

Posted in Medicine, Sports | Comments { 0 }

The Knee, Six Months Later

knees_june_2008.jpgToday marks the six-month anniversary of my knee surgery. All in all, things are going very well.

I had my last visit with my surgeon, Andrew Feldman, two months ago. At that time, he was very pleased with my progress, saying that I was ahead of where most patients would be after four months. He told me that there were four areas in which things might go wrong: the healing of the tibia, the stability of the ACL repair, the flexibility of the knee and joint, and the overall alignment of the leg. In my case, everything was working out perfectly.

He was particularly pleased with the alignment of the leg.The picture at right shows a recent picture of my knees. You can see that my “good knee” (the one at the right of the picture) is naturally a little bow-legged. The repaired knee, at left, is much straighter. In fact, Dr. Feldman over-corrected just a little, meaning that my right leg is actually a little knock-kneed. This assures that the weight is borne through the outer part of the knee, away from the damaged medial area.

For the last two months, I’ve been working out steadily on the elliptical trainer in the gym, trying to build up strength in my quad and hamstring. Last month, I began rollerblading again, which also gives those muscles a nice workout. I’m currently wearing a brace whale blading, to avoid wrenching the knee in the event of a collision or fall.

I’m still not supposed to be subjecting the knee to any significant impact, but I have been experimenting with a few minutes on a treadmill a couple of times a week, just to see what it feels like to run. It’s feeling better and better. Clearly, I’m not going to be running a marathon at any point in the future, but I do hope to return to tennis and squash and to be able to play soccer and baseball with my sons. That seems like it’ll be possible. Right now, I can kick a soccer ball pretty well, but I have more work to do before I can run after it gracefully.

The last four months have been a process of learning how to walk comfortably on the realigned knee. I still walk a little stiffly, and I limp a little if I’ve given the knee a real work out. My flexibility is good, though I can’t yet bend my right leg all the way up to my buttock. The knee is a little stiff when I get up after sitting for a while. And there is a little numbness and an occasionally prickly sensation around the area where the plate has been attached to my bone (beneath the diagonal scar in the picture) and in the muscle lining my tibia (tibialis anterior). From my experience after my previous ACL-repair, I expect that I’ll always have some odd sensations below the knee.

On rare occasions, I’ll feel an arthritic twinge from the medial side of the knee, but it’s nothing like the nearly constant pain I had before the operation. Indeed, for the most part I don’t experience the knee as “painful.”

So I’m pleased with my progress thus far, though I realize I still have a a lot more work ahead. Progress now occurs at a slower rate than it did during my intial rehabilitation. But all the time spent at the gym for the past four months is paying dividends beyond a stronger knee. My next visit with Dr. Feldman is sometime in September. I’m hoping for an equally positive evaluation then.

Now if only I could finish writing that book manuscript …

Posted in Medicine, Sports | Comments { 0 }