Pickleball Points — thinking about a knee replacement?


So many folks have told me they are considering knee surgery that I thought it might be helpful to share some of my recent knee-replacement experiences.

I normally try to incorporate humor in my articles, but knee replacement is absolutely serious. It certainly isn’t something you should do unless you absolutely need it, but if you need it, get it done sooner, rather than later.

The one thing you will hear often in the world of knee replacements is that no two patients respond the same to the surgery. In my case, recovery on my first knee was totally different than my second knee, despite everything else being the same. One knee recovery was textbook, the other long and laborious.

Dr. Clay Wellborn of Nirschl Orthopaedic replaced my right knee last October, and it is now doing great. There is no pain. I can walk the beach without stumbling, and I can drive long distances without pain.

I had hoped that after I recovered from my right knee replacement, I would be able to play some summer pickleball before I had my left knee replaced. It was not to be. My left knee became even worse because my corrected knee was now applying a new and very painful pressure on it. Every time I stepped down on my left leg, it felt like the injection of a large hot needle into multiple spots in and around my left knee. Therefore, I was forced to have my left knee done as soon as possible.

Knee-replacement procedures in general are becoming routine. As some indication of the surgical advancement, had I not lived so far from the hospital in Arlington, Va., I could have been released from the hospital on the same day as my surgery.

But it isn’t a walk in the park. According to the American Academy of Orthopaedic Surgeons, 2 percent of replacements result in serious complications. There are slightly higher odds that something else, such as reaction to the meds or pneumonia, might flare up. I ended up in the ER with pneumonia, so be sure to use any post-surgery breathing apparatus.

Mike Smith, the Ocean View Crew’s coach, had a partial knee replacement, and he is recovering well and expected to return to the pickleball courts much sooner than if he had a full replacement. Based on his example, I would suggest that you ask your physician if you might be a candidate for partial knee replacement.

The best tip I can offer is not to think of any knee surgery as an event, but as a journey. If you view it this way, one morning in the recovery process, you will suddenly get a big smile after you realize that, after many years, you managed to sleep a full night without pain in your twisted and gnarled knee waking you.

Here are eight more tips for those headed on the knee-replacement journey:

(1) Get as fit as you can beforehand, and get your weight under control. Follow your doctor’s instructions regarding pre-operation exercises, because you are going to be doing plenty of exercises after the surgery. For two months before surgery, I worked out every other day for 90 minutes, pushing my pain limits to improve strength and lose weight, to reduce stress on my new knees as my body adapted to them. For those two months, I remained on a diet strong in protein and iron.

(2) Follow instructions. Much of what they tell you is common-sense, but it’s when you decide you know better than the doc that you get in trouble. You will be in enough pain that it is difficult to think clearly, so just do what you are told. However, if something isn’t quite right, call your doctor’s office immediately.

(3) You have two enemies after surgery. The first is infection. We went to great lengths to clean and disinfect my home. I followed instructions about washing and cleaning the wound, and stayed away from situations that might introduce me to a possible infection. A friend who picked up an infection in his hospital had to have five operations on that same knee in one year.

The second enemy is swelling. Swelling leaves scar tissue that you and your physical therapist are going to have to overcome. Ice and elevation can dramatically reduce swelling, and likely will improve your recovery. If you don’t like ice, I can guarantee you will not like the manipulations the doctor might be forced to use at 90 days after surgery if your knee hasn’t responded to physical therapy.

(4) Pain meds will in most cases be required, and they can be very constipating. Take them on time, in the quantity suggested, and eat something small if they stipulate not to take them on an empty stomach. Talk to your doctor and the nurses, and stay on top of that.

(5) Work with your physical therapist. Therapists deal with knee-recovery patients every day, and can compare your recovery to all other patients. They will know when to challenge you and when to have you rest. In my case, I decided not to use a home therapist on my second knee replacement, but go directly to Bob Cairo, my physical therapist in Ocean View.

(6) Plan on not driving. Without knee flexibility, and while on painkillers, plan on putting away your car keys, because it just isn’t safe for the rest of us. Be sure to have a patient person do your driving, because there is a lot of therapy, and a lot of waiting.

(7) Talk frequently with someone who has recently been through the process. Over such a long period, there are days and periods when you get very depressed. A friend from tennis who had traveled this road called every three or four days just to check in and discuss the recovery process. It meant a great deal to me and helped keep me on track.

(8) I’ve found balance to be an issue with new knees, and have incorporated balance and core training into my routines. Nearly a third of all adults 65 or older have serious falls, and it is the seventh most common reason for death in those older than 65. So, work with your therapist and consider a personal trainer.

Improved core strength will help you resist nasty falls. Less weight and good muscle tone will help expedite the acceptance of new joints to your body. I view my new knees as an opportunity to get and stay in good physical shape to help defend against the rigors of old age… when I finally get old.

In a recent New York Times article, reporter Gretchen Reynolds cited a 25-year study of 8,600 Danes, in which they concluded that racket-sport participants lived longer than sedentary participants, and longer than those participants in jogging, swimming and cycling.

Cycling — their national sport — added 3.7 years of life over sedentary participants; jogging added 3.2; soccer 5 years; but tennis added 9.7 years.

When asked for his opinion on the results, study co-author Dr. James O’Keefe speculated that games requiring a partner “probably has unique psychological and physiological effects.” Hey, Doc — our pickleball community already knew that!

Speaking of a healthy lifestyle, please join me in welcoming Bay Colony, Bayside, Savannahs Landing and Sea Colony to the Fun league — the Coastal Community Pickleball League. I dropped by Savannahs Landing and Sea Colony this past week, and the folks there were having a great time.

One lady at Sea Colony complained that she made too many errors, so I asked her if her laughs exceeded her errors. “Absolutely!” she exclaimed.

Vaughn “The Baron” Baker is a Senior Olympics gold-medalist in pickleball, and is public relations director for the First State Pickleball Club (FSPC) and captain of the Ocean View Crew pickleball community. He spent his career working with top tennis professionals while working for Wilson Sporting Goods and introducing the Prince Tennis Racket and Wimbledon Tennis Lines. For more information, visit PickleballCoast.com.

 

By Vaughn Baker

Special to the Coastal Point