Central  South  Dakota  Medical News
The Clinical View
by Phillip Hoffsten,M.D.
10 July 04

KNEE SURGERY:  REVIEW FROM THE PATIENT’S SIDE

     In September of 1958, there was a 19-year-old naïve young man who enjoyed playing football.  He had all the classical delusions of self-indestructibility.  One day there was one wrong step and he tore the anterior cruciate ligament, which is the main structure that holds the knee together.  In 1957 there was no way to diagnose the torn ligament so it was treated with crutches and time. Four months later in December, he was playing basketball.

     Fifteen years later in 1972, the knee “locked up” and knee surgery was done to remove a damaged cartilage that had been exposed to an unprotected fifteen years of wear and tear due to the torn ligament from the past.  At that point, the major stabilizing ligament for the knee was gone and now a major cushion in the knee was gone.  There was to come another twenty years of basketball and racquetball with that adaptation to a “slight disability”.

     By 1993, thirty-six years after the original injury, the pain became enough of a message that it was time to quit those games.  So then there was walking, bicycle riding, swimming and those wonderful exercise machines in the gym.  But it was obvious at this time, that the injured leg was getting deformed.  The knee was chronically swollen and it didn’t straighten out all the way.  A squat knee bend was impossible and the calf muscle on the injured side was getting smaller.

     After ten years of that, the calf muscle was starting to get really small.  Exercise it and work on it as I would, the calf got smaller and smaller because I just wouldn’t walk on it normally.  Then came pheasant season and I couldn’t walk the fields normally to go pheasant hunting.  The situation had deteriorated to serious crisis considerations.  It was time to get a new knee.

     I had talked to enough people who had had prosthetic knees placed.  They all seemed very happy. They said the pain just stopped.  That would be really nice.  They said that they sure could do at least as much as they could before the knee was operated on.  Some patient’s indicated that their back quit hurting because their walk could become normal again.  That was welcome news.

     So then I talked to the orthopedic surgeon, Dr. Stout who I had worked with for 20 years.

He said that he could stop the pain, pretty much make both knees look alike again, fix it so that I could walk straight and rebuild the muscles in my left leg.  He said that it was very clear that this knee wasn’t going to get any better no matter what I did by myself but he could stop the deterioration if we got it fixed.  By the way, the sooner the better.  It is easier to fix things that aren’t quite so broken.  But then he got real negative and said that I probably wouldn’t make the tryouts with the Timberwolves next fall.  Oh well.

     So for the last two months, I have been working very hard at weight lifting to build the muscles up in my left leg and get ready for this surgery.  I stopped taking aspirin a week before the procedure.  I have been promised that I will walk the day after surgery whether I want to or not.  Dr. Stout has promised that no matter what negative memories he has in the past, he will stop my pain in the postoperative period. There will be an intense restorative and rehabilitation effort postoperatively but that I can get back to work in about three weeks.

     So surgery is scheduled for June 8th, and I am scheduled for an emergency room rotation duty three weeks later. Next week I will tell you what really happened.