I had the replacement on my left knee on Oct. 25. It has been a magnificent experience. The doctor is the DaVinci of surgeons IMOP. Here it is only a little less than one month and the scar is healing down smooth.
Can walk bend knee to about 110 deg. and feels so good to not have that grinding in the joint any more.
Now the right knee will be done in March I hope.
Guys, if you have this grinding in your knees go see a doctor and have the xrays to show how bad they are, but having the replacements is going to be good for you.
That is great news for you! I can tell you that having had both hips replaced I can concur with your feelings about joint replacement. I still plan hockey and remain active. Take care, Jim
I have two daughters in life sciences at Uni at the moment, and I can't believe the dedication of so many people who make this kind of career their choice. That said, on repeat operations, I would say that the surgeons probably fall under a distribution of skill, but none the less they do so many of these operations the results are excellent. My mother had here hip fracture, the bad one, done this summer, and she was walking the next day. It is incredible what they crank out.
My body seems to smooth out scar tissue really quickly, dueling scars would have been pointless on me. On my heart operation, they did a million tiny sutures, and you could hardly see it. Then after half a year it welled up like a new red mountain range, seems to be settling back down again. The whole process was surprising at most stages.
My neighbor has a different story. He had a knee replacement last year right before Christmas. The knee is still swollen. It still hurts all the time and he can't walk without a cane and can't bend the knee much. He goes in next week for a scan in prep for repeating the surgery. He said the dr thinks some piece of plastic is out of place.
Agree, one friend is bouncing back so quickly, another took months to be pain free. Research different doctors' results and the hardware, but don't get a replacement before necessary, in my opinion. I hope to be at least 75 (another 10 years) before I have to have one.
Technically speaking, there is more variability in people than doctors. I'm not saying there is no variability in doctors. Just that they are heroes if you feel good after, and bums if you don't. When I was in hospital recovering from a crash, people would ask me who did my operation, and then they said it was a good thing it wasn't the other guy. But on the other hand, when both of your feet are sheared off by the seat in front of you, for starters, there is more variability in the wound than anything else. I had 80% cartilage in my right ankle after the surgery, and zero in 3 months. Could have been 20 years, oh well. I guess he was a quack.
The only problem with lionizing the doctors is it undermines the generally competent work that most of them do, and undermines competence in the system. If you get a top 5% guy, good for you, but is that all you can hope for and expect to recover from. My guy pulled a 3 inch screw out of my ankle after a period of time. It could have been done by pretty much any carpenter.
When Norman Bethune was working at a hospital in Canada, he pioneered a lot of surgeries. He was disliked even in that age, because he brought down surgical success rates. He saved a lot of lives that would otherwise not have received any treatment at all, but on the metrics, you didn't want to know him at all.
In the mid 90's both of my hips went out. I was told I had to have both replaced. I was around 55 at the time. I did a LOT of research on the Internet and found that almost every study proved that the surgeons that preformed several surgeries a year were almost always successful, and that those that only did 3 or 4 a year accounted for almost all the failures and problems.
I questioned the doctor that I had been referred to extensively and determined he was doing many every year and had been doing so for at least 5 years. At first I think he was somewhat annoyed with me for the questioning, but later calmed down as I explained what I had found.
Doctors are no different than any other skilled, trained person. I wouldn't have a home built without checking references and talking to a builder ~ why would I entrust my body to someone without doing the same?
As it turned out after the discussions, he proceeded to replace both hips in one summer. As I was having the replacements done at a fairly young age he recommended I have replacements that had a rough surface installed (like a sintered material) that had no glue. It required that I be off the leg for 6~8 weeks after surgery to allow the bone to attach to the surface. It is stronger and if necessary for a second surgery later in life allows for a glued replacement without any old glue contamination. I am still on the first set after more than 20 years. At 76, I am keeping my fingers crossed!
"every study proved that the surgeons that preformed several surgeries a year were almost always successful, and that those that only did 3 or 4 a year accounted for almost all the failures and problems."
I think I am missing the first numbers in your example?
But assuming you mean guys who do a lot, as in your example, makes sense to me. But take cardiac surgeons, where I had mine done, it was an assembly line. Those guys probably do hundreds a year, and would do more if there wasn't some kind of billing cap. I'm not having mine done in some camp in the outback. I loved my surgeon, though I barely met him. In fact they switched mine out on me as I was going in. But some of that is modern times. They create specialty hospitals up here where people do a ton of hernias, or hips. If your guy is an unparalleled genius, other than normal distribution factors, there is probably something wrong with your hospital. Think about it. When Franz K did his dovetail video, he was a genius, most people had never done anything like it. But over time, almost everyone with a hand saw can cut decent joints. While there was no real management involved, the whole area got a serious going over.
If a hospital is doing a lot of monday morning heart operations, then need to work it out. If you depend on someone's hyper skill, then you aren't doing something right. If you have hacks, move them into something they are good at; get people the equipment then need; analyze results, whatver. The prima dona mentality can be part of the problem.
Now it is different if there is some kind of cutting edge option, and there often is. Then you need people on the edge, rare creative people. But it is a shot in the dark. New stuff is unproven, and where there is proven stuff that works, you have to choose what approach you want to take.
Not to burst anyones' bubble about the special abilities of any particular orthopedist, I believe at this point that it is more about the quality of the wood than the woodworker. Having seen many many many joint replacements during my career as an anesthesiologist I can tell you that these days with all the jigs and fixtures used to do this joint work they are done with precision no matter who is manning the saws, drills and hammers. First year residents can do as perfect a job as a surgeon with thousands under his belt.
Now if you are talking about surgeries that require the precision of an unguided hand, and the experience of a staff that has guided patients through complicated pre, peri, and post operative courses, such as coronary artery bypass grafting, then I agree that quality results are affected more by numbers.
Now back to the wood and the woodworker analogy: the patient has much more to do with results than the technique where the technique is guided. For examples: patients with good positive attitudes do better and have better recoveries (got no studies, just my own observation), patients who smoke, have diabetes or some other impediment to blood flow don't heal as well, choice of anesthetic technique may affect outcome, discipline in following a proven and well defined post operative routine such as conscientiously performing physical therpy, etc.
By the way, most of the orthopedic surgeons I knew who were considered better were also good woodworkers.
Tom, I don't know where you are located, so don't know how your surgeon was selected. but here in Indiana most times when a specialist is needed for joint replacement, heart treatment etc., a referral is made by your primary doctor.
The primary doctor is usually an MD that has a general practice. How they determine who they refer you to when a specialist is called for is black magic to me.
In many areas around here the MD is associated with a particular hospital and the specialist may also be a part of that hospital's group. My comments were made due to my research on the internet.
A specialist in orthopedic surgery associated with the hospital may specialize in treating sporting related injuries and be darned good at that, but in fact may do very few hip surgeries.
The fact he does so few may result in inexperience in that surgery, and the results may result in a less than successful result. That is the information I obtained from the internet.
Other Orthopedic Surgeons may specialize in joint replacement and have vast experience in that field. (As a comparison a woodworker that installs thousands of feet of crown molding vs one who specializes in window door trim and has only installed a few feet of crown in his career).
The surgeon that preformed my surgery did tell me of his experience and also said if I didn't feel confident with him that he would refer me to one of the two hospitals within about 50 to 100 miles of my home that were solely joint replacement surgery specialists. I then explained my research and told him that he had all the qualifications I wanted. After the surgeries, I was able to continue to work until my retirement at 65 so have no complaints.
As an Engineer that worked a lot in the automation of small assemblies for about 40 years, both in design of the machines, writing up the purchase specs., purchasing and/or building machines, programming and debugging the machines, I can attest to the variations in skill level of engineers in that field. I have no reservations in saying that many Doctors have the same issues.
I agree, frequency and specialization all go to hand in hand to give confidence the process will go well. My surgeon also aside from 10 hips a week is a teaching MD at McMaster Univ in Hamilton Ont. He not only was performing 10 a week but had two interns working with him for both of my surgeries. The hospital I went to performs 2500 hip replacements a year so the staff is well versed in this process.
I am 10 years on my first hip and 7 on my second, I was given 20 years on them before they would need to be revisited for potential of replacement but on my last visit the Dr said I was doing so well that the hips may last easily another 20 years...a combination of his technique and newer materials he used have given me confidence I could still playing hockey till my mid 60's.....
Joint Replacement technology is always getting better but physio was my key to getting back to normal... now if I could drop about 25 pounds I might get the hips to last longer!
Maybe if I could drop about 25 pounds I won't need new hips or knees at all. I did it before, and I could do it again, but I am having a hard time convincing myself.
I have a friend who weighs about 400 pounds. He broke his foot. His explanation was that it just failed. I'm sure he knows he needs to lose 200 pounds, but I haven't mentioned it to him.
I'm certainly not suggesting that one should disregard specialization. Of course I would get a hip surgery done by someone who had done many before, though my first major surgery was required because the specialist was giving the student a chance to land the airliner in freezing rain. So you never really know who is holding the knife, well not always. My point is more in line with DocJim, in that I don't particularly believe that a supernatural doctor is required to do what are these days routine procedures.
My 91 year old mom just had a fracture to her hip, in the bad place where the muscles attach outboard, near the right angle. They fix this by fixing a rod perp to the flank, and another rod down into the main bone. These thread the needle in that one of these rods goes though the other like a mortise and tenon and that is what creates a rigid fixture so that the load path is restored to the hip. Think about that? All the variables, and the required structure. Genius or Jig? Probably some flexible adjustment in the intersection also.
My daughter is studying to be a psychiatric nurse at Mac, at the moment. She wants a Psych degree first, and then onwards. I think Mac has a good program in post modern complaint therapy, or something.
DocJim. In the movies it mostly seems the anesthesiologist is sorta a spare wheel character. Shows up slaps the mask on, done. I think it is a pretty amazing specialty. When I took my first hit, one of the other guys got a bad deal, and was screaming a fair bit for the month we were in hospital. Their anesthesiologist was the pain guy, which is pretty amazing. My mom who has been in near perfect health her whole life, is about to have her third operation this year. The anesthesia is the part she has the greatest difficulty coming back from. Seems to really hammer old people. I suppose they have software and microchips for a lot of it, but it is still a hands on thing from what I hear.
Don't know if they do this in Canada, but here in the US it is not unusual for an Orthopedics company to do both the surgery and the follow up PT. I thought it seemed to be a good idea.
The surgery went fine, but I was disappointed in the results of the PT, which I did religiously. My GP then referred me to a different PT provider and the results were night and day. Increased my mobility dramatically. She cautioned me against the bundled services, saying that the surgery rightly got most of the attention and funding, but the PT was just a half hearted sideline. There's a saying in the US that doctors "Don't like to leave money on the table."
Disclaimers - this is just one personal anecdote, I don't know whether it is common or a fluke and it was a hand operation, not a hip replacement.
