 Poster: A snowHead
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Just over a month ago I had my three month check up at Wimbledon Clinics after my Partial Knee Op in April and wanted to post my experience in the hope it may be of interest to others.
Background : On my last day of the ski season in March 2013 I did a short easy ski tour and half way up started to experience pain in my left knee (until this day I had
never experienced any knee pain) .The next day I did a two hour hike up a mountain with friends and still had the pain . Hoping it would go away I did nothing for six weeks and then went to see a physio Bill Potts . I worked with Bill for six months to strengthen the knee with various exercises and mountain biking three times a week on the South Downs where I live. The pain reduced and the knee improved but when I went skiing for the first time in November the pain returned and got worse making it impossible for me to ski for more than an hour.
I saw a local knee surgeon who advised me that I needed a partial knee op but would not be able to ski after it . I then contacted Jonathan Bell at Wimbledon clinics for a second opinion who advised me that I needed a partial knee op and that
I WOULD be able to ski after it provided I did the six months post op rehab exercises.
The op was booked for April 7th 2014.
Pre-op
I had further physio from December with Bill who wanted to strengthen the muscles that support my knee as much as possible as he said that would make
post op recovery much easier . I did the exercises 6 days a week from December until the op in April.
One week prior to the op I had to visit Wimbledon Hospital to attend a pre-assessment clinic with a nurse who specialises in knees . This involved various tests and questions on health and allergies and giving blood and urine samples. In addition the nurse ran through what would happen from arrival to departure and showed me a model of the knee and the replacement that would be fitted . It was a very useful meeting and answered all the questions I had had about the op . I was also relieved to find out that my overall health was good and apart from the knee I had nothing to worry about.
The op was booked for Monday 7th April pm with the expectation that I would be staying in for three nights leaving on Thursday afternoon.
Day of Op
My wife drove me up to Wimbledon and I checked in just after lunch . As I was having a late afternoon op I was able to have breakfast but then only water pre-op.
The afternoon passed quickly with short visits from Jonathan Bell ,the anaetthetist Dr Bernadette Ratnayake and various nurses taking blood samples or doing various
tests. Then finally the big moment came and I was wheeled down to the operating
theatre at about 7.00pm which I found very amusing and sureal as reminded me of the TV series M.A.S.H. Then after some talk with Dr Ratnayake ,about the celebratory glass of wine I was going to have after the op I was out ! The next thing I knew (2-3 hours later) I saw Jonathans smiling face hovering over me saying it went well . At this moment I was very happy as I knew the worst was over and things could only get better.
A catheter had been fitted whilst I was out!
I was then wheeled back my room and was given the first of my tablets I had to take at various intervals (I think they Pregablin and Tapentadol for pain and
to prevent blood clots) . I then had a some sandwiches as I was quite hungry and discovered that wine was off the menu for at least two weeks whilst I was on the various painkillers etc. (Not quite sure how I ever thought I would be drinking wine straight after the op?)
I dosed a bit later but was visited regularly during the night by the nurses to check my blood pressure etc and to provide me with regular pills and check on my general well being. At this stage ,as with the rest of my experience in the Hospital ,
I was not in any pain but had no feeling in my legs due to the effect of the anesthetic . I also had a movement machine (not sure what its called) fitted under my leg to gently move my knee during the night . White stockings were also fitted which are I believe to stop a blood clot developing in the legs.
Day 2
After a full English breakfast (appetite back to normal ) I was visited by Tracy from the Wimbledon Physio team who outlined some basic exercises to do e.g. moving toes when the anesthetic wore off and feeling returned to my legs.
This happened gradually by lunchtime and I started to move my toes as much as much as possible. Tracey also outlined other exercises to do when home an explained that
I would be going down to Hydrotherapy the next day.Later in the afternoon the Catheter was removed and I was able to get out of bed with the aid of crutches.
Tracy returned and showed me how to use them going up and down stairs and I practiced walking up and down the ward .
Less visits by the nurses during the night (every two hours I think.)
Day 3
I was wheeled down to Hydrotherepy where I did a 30 minute session in the water walking around the pool doing various exercises which was great . My knee bend was measured at 90' . Continued to move my toes and walk up and down the ward a few times with the crutches.
Day 4
Hydrotherepy in the morning which went well and got a knee
bend of 100' and given the all clear to go home in the afternoon. The nurses were all excellent and I was told that I would have to take medication at home for two weeks and
was shown how to self inject in the tummy. This was not
as bad as I had thought and is only once a day for 14 days.
Home in the evening.
Day 5-7
Great to be back home and tried to move about as much as
possible in addition to doing the exercises 3-4 times a day.
The knee was still swollen and I had to use a Cryocuff which
ices the knee as well as putting pressure on it 3 times a day.
Sleeping was difficult as I found it very difficult to find a
comfortable position to sleep in .
Week 2 -3
My wife drove me up to Wimbledon for my last Hydrotherepy
session at the start of week 2 and knee bend was up to 105.
Carried on doing the daily exercises to bend and stretch the
knee . Was able to stop using the crutches at start of
week 2 and do some light gardening.
The difficult sleeping at night and the effect of the drugs made me feel very tired at times and I tended to have a nap most afternoons.
At start of week 3 my wife drove me to my Physio Bill Potts
who gave me some additional exercises to help increase the knee bend.
At end of week 3 I injected myself for the last time and had no more pills to take !
Week 4
Still doing the daily exercises and using the Cryocuff
and feeling very positive.
Week 5
Had one month check up with Johnathan Bell in Wimbledon
who said it was all looking good. He was able to manipulate my leg to achieve a 115' bend and was very happy with that. I explained that I felt the scar on my knee from the op
was preventing me bending it further so he showed me some
stretching exercises which were very useful in making the
scar more flexible. Next meeting was scheduled for 3 months
post op and he said I was ok to drive and fly at this stage. I drove to the Physio the next day and felt fine .( I have an automatic so much easier than a manual).
Week 6 to 12
As the weeks went on I continued to do the exercises
on a daily basis 3 times a day taking Sundays off.
I had Physio with Bill every two weeks and he was able to
modify the exercises I was doing to improve flexibility and strengthen muscles supporting the knee as well as starting to incorporate light work on my spin bike I was able to gradually increase the distance I walked from about 30 minutes in week 6 to an hour by week 12 .
Sleeping gradually improved and my energy levels started to
rise and I would say that by week 10 I was feeling almost
back to normal . In week 12 I went to the Tyrol and was able
to do a two hour mountain walk . Coming down was harder than going up and I felt a bit tired after . A few days later
I did a 3 hour walk and felt fine and at the end of the week
did a very steep 3.5 hour walk and felt great after.
Week 13
I had my 3 month post op meeting with Johnathan Bell who was very pleased with my progress and said would not need to go back for the 6 month check up so he would see me 12 moths post op when they take an xray of the knee. He also said he
was happy for me to start skiing again this season as long as I
kept up the exercises.
On the same day I had an hour session with James Vickers
at Wimbledon who is a ski specialist physiotherapist who has
worked with Olympic skiers. James did various movement tests
and gave me four sets of exercises to really strengthen my
legs and muscles that support my knee. At first I thought he
had confused me with a Royal Marine recruit rather than the
54 year old who has never been a fan of exercise and rather
enjoys nice red wine far too much . Anyway these new exercise were very important and I was determined to do them .
The exercise are :
4 x 25 wall squats normal feet position
4 x 25 wall squats feet slightly wider than above
4 x 25 wall squats feet sumo width apart.
4 x25 Hamstring chair bridges ( not moving chair)
3 x 10 split squats on each leg holding for 10 secs at end of each 10
4 x25 calf raises on each leg.
Bike : 4 minute warm up level 10 (25-30mph)
1 minute level 30 (hill)
1 minute level 10
1 minute level 30
1 minute level 10
1 minute level 30
1 minute level 10
1 minute level 30
4 minutes level 10 (25 -30mph)
I have now been doing this programme for 4 weeks . I try to do it very early in the morning two days on and one day off .It was hard in the beginning but is now much easier and in a strange way something I actually enjoy and feel much better for doing.
Key points
. If you have a knee problem or expect you need a knee
replacement or other surgery and want to ski afterwards try to
see a knee surgeon who is also sports specialist . I cannot
recommend Johnathan Bell and the team at Wimbledon Clinics
highly enough. http://www.wimbledonclinics.co.uk/consultants/mr-jonathan-bell/
. Pre-op do as much exercise as possible to strengthen the
knee as guided by a Physio. I cannot recommend
Bill Potts from Lindy Griffiths Physio highly enough.
http://lindygriffiths.co.uk/
Bill also has his own practice called Perfect Motion Physio
http://www.perfectmotionphysio.com/
The work that Bill did with me pre-op definately made my
post op recovery much easier.
. Stay positive ! Once you have had the op things will just
get better and better each day .Every day that passes is one day nearer to getting back to the slopes.
Next report will be from the slopes! 
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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brnttptr, Fantastic report, and a great advert for Wimbledon Clinics care...hydrotherapy, passive movement, cryo cuff...I could have only dreamed of such stuff with the NHS.
I see you've got the measure of James Vickers, I felt exactly the same as a 54 year woman who never exercised before injury...but let me tell you , that's not the worst he can do  ..he is fantastic though!
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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brnttptr, It was great to meet you at your follow up & it looked like you were doing really well. You & holidayloverxx, are scaring me a bit, as I have yet to have my hour long session with James Vickers - think that is happening next month. I look forward to your report from the slopes
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You need to Login to know who's really who.
You need to Login to know who's really who.
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brnttptr, great report - well done with keeping up the physio. so many people don't. 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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brnttptr, thanks for report. Do you mind if I ask: how old were you when you suddenly developed knee symptoms, and what was diagnosis mandating partial knee replacement (osteoarthritis? )
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You'll need to Register first of course.
You'll need to Register first of course.
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brnttptr, thanks for the report as well. It is very reassuring, as after my last knee operation I was told next time I wreck my knee I will need a knee replacement. I am obviously doing all I can to minimize that including giving up hockey (but refused to give up skiing).
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peanuthead , I was 53 when I first developed the pain out of nowhere .Never had any problems with my knees before. As I mentioned I ignored it for 6 weeks hoping it would go away and then went to physio with Bill Potts for 6 months which helped alot . I was able to cycle the South Downs Way a few months after but when I skied the pressure it put on the knee was too much . (Admittedly I was skiing in terrible conditions : ice ,moguls , low viz on a glacier which is not ideal but the point is that if you don't ski ,do squash or other high impact sports you can get away without the op ) . The diagnosis , when I finally went to a knee surgeon after skiing in pain was that I had completely worn out all of my cartilage around the knee and would need a knee replacement.
When I contacted Jonathan Bell he sent me an Oxford Score questionnaire and it showed very clearly I needed a knee replacement . So would recommend getting one done to assess how bad a knee problem is.
genepi , Nice to meet you too at Wimbledon .(Amazing coincidence!) Don't worry about James .Bill Potts ,my physio in Sussex knows him very well and rates him very highly .Whatever he gives you will help achieve your goals and even though it may seem hard at first
it gets easier. I remember after the first week telling Bill I ached all over and he said "Don't worry its just the weakness in your body coming out!)
Holidayloverxx ,Thanks . I am sure it will get worse .I think the next step is to do the same with weights !!!!!!
PamW : Thanks.
NickyJ : Thanks .Unfortunately skiing does place huge pressure on the knee .In my case Bill tried to get me to strengthen the knee muscles for 6 months but it did not work because my knee was too far gone . Have you tried the Oxford Score Test yet ? Might be worth doing just to see how bad it is now and if necessary getting in done sooner rather than later.
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brnttptr, I am too young to have a knee replacement (38!) I am trying to keep my muscles as strong as I can, and skiing went very well in April (with the brace recommended by my Physio), thankfully my Physio felt I was able to ski and was happy with my rehab.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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NickyJ : Perfect ! That's great! If you can ski pain free now and continue to strengthen the muscles you may never need a knee replacement .
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| brnttptr wrote: |
| NickyJ : Perfect ! That's great! If you can ski pain free now and continue to strengthen the muscles you may never need a knee replacement . |
My Fingers crossed! There is a lot now missing from my knee.... I have half my reconstructed ACL remaining and 1/3 my cartilage left.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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brnttptr, weights...I am up to 20kg on my shoulders doing split squats and step ups...enjoy!
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