George
George has arthritis in both knees, which has been painful and caused him to trip in the past. He had emergency surgery for a shoulder injury when his left knee locked and he fell through a window. After a consultation with a surgeon, it was confirmed that George needed a total replacement in both knees. George went ahead with surgery on both of his knees, which he thinks were “really successful”. He is currently in the queue to have his right knee operated on.
George is married, and has three adult children and grandchildren. He is a retired sales manager. His ethnicity is White English.
More about me...
George’s knee pain became an issue shortly after retiring at age 64. In his left knee, the pain began with a “savage stab” when he was piling logs of wood. He felt as though his knee was saying “that’s it, I’ve had enough” when the pain didn’t go away. In addition to being painful, George could hear the left knee “crunch” and feel the bone “rock” in the socket as he walked. His knee problems also caused him to trip. On one occasion, George’s left knee locked and he tripped through a shed window, which tore his rotator cuff and required emergency surgery. In other health concerns, George worried about the effect of his weight gain on future risk for diabetes and heart disease. He was concerned that he may need to be put on a statin. George also had surgery for a retinal problem with one of his eyes.
In his everyday life, George struggled with going down stairs and bending over. He had enjoyed cycling, running, and sport his whole life and expected to be able to devote more time to these in retirement. George felt “exercise envy” towards his friends who were still able to be active. He was very disappointed to not be able to play football with his grandsons. Looking back, George thinks his knee issues could have been prevented with earlier intervention. He believes that his knee issues stemmed from “gradual deterioration” with being slightly bowlegged and the impact on his walk. George also developed plantar fasciitis (also known as policeman’s heel). He saw a podiatrist but didn’t return when his insoles wore out.
Shortly after the pain increased in his left knee, George went to the GP and was sent for x-rays. The scans showed that George has mild arthritis; this diagnosis made George wonder if he was “being a blooming wimp”, but he was also told that there isn’t a clear relationship between severity of arthritis and pain levels experienced.
George had physiotherapy for his knees and his shoulder injury. The physiotherapist was confident that the exercises could ‘fix’ his knee problems and was “adamant that it was down to me”. However, George found that the exercises “just seemed to wreck my knee” and caused him more pain. Nevertheless, he continued to do physiotherapy exercises at home for his knee whilst waiting for an appointment with a specialist. George also had two cortisone injections into the left knee but found these only offered relief for a very short period of time; they were “a panacea” for a day, but then it was “back to square one”.
George was “delighted” when his appointment with an orthopedic surgeon was moved forward because of a cancellation. After further x-rays and a consultation with the surgeon, it was agreed that he needed total replacements in both of his knees. The surgeon went through a full risk assessment, but George says he was focused on the benefits and willing to “take any risk” for “the last years of my life to be mobile”. George received a booklet containing the information he and his surgeon had discussed, and his surgery was scheduled.
Following medical checks and a home visit to install bath and toilet modifications for his recovery, George had a total replacement of his left knee. Of the care at hospital, he says: “The facilities were first class. The staff were first class. The care was first class. The surgeon was a genius, and the operation went as sweet as a nut”. George was required to stay in hospital overnight due to excess bleeding after tearing open a staple by stretching his knee too far back. Once back home, George had to wear a special bandage on his knee. Otherwise, George feels his recovery went extremely well. He had a visit from the physiotherapist in hospital and once more at home, at which point they told him that they were pleased with his progress. George spoke to his surgeon only once after surgery over the phone to confirm that his knee was working as it should.
George only used a crutch for the initial days after his surgery, and was back to activities like cutting the grass within a few weeks. He was given codeine, liquid morphine, and paracetamol for pain relief after the surgery, but didn’t end up using any of these in the end. George feels he is back to “absolute mobility” in his left knee and cannot believe how much surgery has benefitted him: “Tremendous, absolutely couldn’t speak more highly of it, really successful. [...] It’s just transformed my life”. George has since received a total knee replacement on his right knee, which he feels went “even better than the left”.
With regards to his other health concerns, George has since also received new insoles for his plantar fasciitis and feels his shoulder is “as good as it is going to get”. Now that he is able to be more active again, he is less concerned about the potential for weight gain and other health issues.
Reflecting on his experience as a whole, George wishes that he could have been offered surgery earlier, as it was almost a five-year process from when he first had pain to having the knee replacement. He feels that surgery should have been done at the first sign of arthritis, rather than having to go through physiotherapy and steroid injections. When asked if he had advice for others considering knee replacement surgery, George says “don’t hesitate”. He looks forward to hopefully leading an active lifestyle and staying healthy now that both of his knee replacements are complete.
George had been extremely active his whole life and felt envy when he saw other people running down stairs or up a hill.
George had been extremely active his whole life and felt envy when he saw other people running down stairs or up a hill.
I’d been extremely active, yeah, that is this thing that I’m stressing on, really active the whole life, cycling, running and then of course the beating, you know, I used to do a massive amount of driving on a Saturday, that was every Saturday. Out, no problem, you know pheasant beating, you’re over undulating terrain, no problem whatsoever, and then this is just like “aargh.”
So, it’s just a switch in your life, like you- You know I used to be able to kick a football with the grandkids and that, and that’s what I was, that’s what I really - you know I can’t even kick the ball now? So, they’re the things that, that get you, you know?
That’s what I want to get back to, is just being able to do, to be mobile and- Everything else is, well, apart from my arm - but everything else is working, you know? Touch wood.
And that’s what I want - to keep it working, you know, that’s the sort of thing.
So, if it’s just, if that’s the sort of thing that you’re looking for, the mental aspects of it, you know are just like that’s, it’s just like envy of people. You watch the telly and you envy somebody running down the stairs, going up the stairs, up a hill, or something like that, you know? You just - like I just want me knees to let me go down the stairs.
George was used to having an active lifestyle. While waiting for knee surgery he began cutting other people’s grass as a way to exercise, but wondered about the impact on his knee.
George was used to having an active lifestyle. While waiting for knee surgery he began cutting other people’s grass as a way to exercise, but wondered about the impact on his knee.
Since retirement what I’ve been doing is grass cutting, you know, and that’s been, like grass cutting round the village.
People kept saying, you know, 'would you, would you cut me grass?' And I’ve limped round, you know. That’s, just to try and keep some exercise going, just to go and cut a couple of little lawns and things, just to try and get some sort of exercise.
Cos you can cut a stretch, and then sit down on a seat or something. That, helps you know? Just rest it rather than just say, “Oh I’m gonna sit in a heap.”
I’ve tried to, to keep it going you know? And I keep thinking ‘am I just making it worse here?”
George felt physiotherapy made his knee pain worse and decided it would not help his knee to get better.
George felt physiotherapy made his knee pain worse and decided it would not help his knee to get better.
The GP then sent me back for another physio referral, cos I kind of lost the plot with it.
So it’s maybe about two years ago that the GP referred me back, and that started the process of physio again. Cos as soon as they send you back, they put you back in the physio loop, which is just, “Try these exercises, try more exercises,” you know? You get rubber band, “Stretch your knee, stretch your knee,” you know? And I’m just thinking “Why? [laugh] It’s the exercise that’s killing me knee."
Well that again was a referral. And they then gave me a set of exercises which I did, and then let it lapse. Well not let it lapse, it just sort of expired, and then I just said, “No, it’s not getting any better.”
And I thought, you know like it ran its course and then just said, “Okay that’s it.” And it felt like I was, like I’d made a little bit of progress, and then it’s just rapidly got worse, you know, so I went back again.
And then it was more physio. They were absolutely adamant that it was down to me to make it, that you should not, the lady I saw, “You can definitely fix this, it’s- you’ve only got mild arthritis, you’ve only got mild arthritis, if you do all these exercises it’ll be fixed.”
So, I did the exercises and it just seemed to wreck me knee. Seriously.
Oh well, the physio now has been, sorry I’m saying the physio- I’m saying still doing physio, I’m still, you know making sure that I do the exercises just to keep the knee mobile, but obviously, we’ve decided now that it’s not going to get any better with physiotherapy.
Having knee surgery is “a no brainer” for George. He wants to spend his last years mobile and not be sitting in a wheelchair with additional health problems.
Having knee surgery is “a no brainer” for George. He wants to spend his last years mobile and not be sitting in a wheelchair with additional health problems.
Well, you have to weigh it up, that’s why I’ve, you sort of deliberate it. Yeah, I could have been more vociferous potentially, thinking. So I’ve maybe kicked the can down the road as well, you know? Reluctantly, because the physios did say - you know there’s no guarantees, you know - you’d be better off if you just keep doing this. They are insistent that, if I just kept going with the exercises, I would be alright.
And for you at the moment the balance of the benefits that you hope a surgery or a treatment could have versus the risks - what’s the balance for you? What’s your thinking about that at the moment?
No, I’m - if he says I can have a knee replacement, any surgery, I’ll do any surgery now cos I’m just heading for sitting in a wheelchair now. That’s, that’s it. If I don’t do it, I’m- me mobility’s reduced, or I’ll just fall over and have a heart attack.
Or I’ll get diabetes and then I’ll be, there'll be something else, so whatever the outcome is I’m hoping he’s gonna get a knife inside me knee and do something, fix something. Whether it’s just the ligaments or something like that, or to clean the joint out, or to do something with the cartilage, whatever it is.
But I’m at the point now like, even if I got septicaemia or Covid, I don’t care. I want my knee fixed.
It’s like a risk that you’re - worth taking?
Yeah aye. Yeah, it’s yeah. It’s a no brainer. I’ll just - I’m doing it now cos I am heading for sitting in a wheelchair.
No, just fix my knee. That’s the one, what I want him to do. I’m not worried about anything else, just, even if he tells us all the associated risks, I’m not bothered. I just want my knee fixed.
George’s wound took longer to heal after he snagged one of the staples while bending his knee after his operation. He felt he had been a bit “hasty to want to be up and about.”
George’s wound took longer to heal after he snagged one of the staples while bending his knee after his operation. He felt he had been a bit “hasty to want to be up and about.”
The facilities were first class. The staff were first class. The care was first class. The surgeon was a genius, and the operation went as sweet as a nut. One little issue was I had snagged one of the staples, in the knee, because of the-, you have to perform immediate exercises, and the exercises opened up the wound.
And they couldn’t have been more meticulous with regards to the application of these-, a specific type of bandage which withdrew impurities from any of the wounds, and I needed three of those, and each time it was applied with meticulous precision and care, and, you know, basically the health service was fantastic.
It took a little bit longer to heal the wound because of that-, the rest-, you know, there’s a great significant scar across your knee, and it was just this one little area that kept bleeding. But apart from that, the whole thing went as sweet as a nut. I was up and about grass cutting almost within-, you know, within a matter of weeks.
Tremendous, absolutely couldn’t-, couldn’t speak more highly of it, really successful. And it’s given me absolute, you know, mobility in the knee, it’s just transformed my life, and I just wish it could have happened sooner.
And it was your left knee, and it was a total knee replacement, is that right?
That’s it. A total knee replacement. Absolutely brilliant health service; first class.
Brilliant, brilliant. And the bandages that you explained about when the sort of wound opened up, is that mostly-, that was to kind of avoid infection, but there was-?
It’s to avoid infection, yeah. That’s exactly what it was, because they're really concerned about sepsis and stuff like that. And seriously, it couldn’t have been-, and they're pretty expensive these bandages as well, you know.
It’s like a massive long, extended bandage which applies on with adhesive round the wound, and there’s a tube attached to it, and that tube is attached to a pump, which you carry round strapped to your waist, and that works constantly to withdraw any potential air from the wound. It just pumps out all the time, you know?
It’s a phenomenal piece of kit.
Yeah. And how soon did that happen, was it sort of quite immediately that-?
Oh, I did-, it was my fault: I bent the knee. I was getting back into bed, you-, [chuckles] like, they give you these paper underpants to wear, and it was removing those - I bent my knee too far to actually get the old underpants off and my own ones on, and I think I did it then.
So next time when I get it done, I'm going to be more careful in not stretching the knee initially. But it was just one-, they're metal staples you see, and it was just one metal staple, and I just couldn’t get it to stop bleeding. It was just one area, the rest healed up dead quick, you know?
But-, other than that, you know, fantastic, absolutely fantastic. And it didn't take long after that for it to heal, you know. It was-, but it did extend the period of being able to get up and about, which was a little bit of a frustration. But never mind, we're up and done. Fantastic.
And I will not be so hasty to just want to be up and about: I'll do-, I'll be a little bit more pragmatic about the process, because now I know how long it really will take, I won’t want to think I can do it all in five minutes.
I just wanted to be up and about and doing things too quickly, so I'll do-, I'll be a little bit more, as I say, pragmatic about the process, because I know that I'll be able to do it within the six weeks; I wanted to do it in three. And six is adequate, you know? So I'll be working my way through the process properly as opposed to trying to do it in 20 minutes flat.
George recalls how painful his knee problems had been and how they affected his mobility. He says his quality of life has transformed since having knee replacement.
George recalls how painful his knee problems had been and how they affected his mobility. He says his quality of life has transformed since having knee replacement.
You go over in your head anytime you go somewhere, and you remember the last time you went down the staircase.
We’ve just been-, for example: this weekend we went down for Christmas to a place in [England], and we stayed in the same house. And I remember the Christmas visit - I think it was two, three year ago - and the staircase, it was-, it’s an old house with a huge staircase. It was like a dread to get up and down those stairs, you know? I had to sort of lever myself, heave myself up, lever myself down.
I can remember coming down the stairs - this is what you do, you go over here - ‘oh the last time I did this, I couldn’t do this, I couldn’t do that.’
Even the little local bookshop was still there, you know - that’s got an upstairs: up the stairs.
It’s just-, I cannot tell you what-, how-, what it does to your life to get your knee changed. It’s just everything-, and it comes back to you every time what you couldn’t do and what you now can do; it’s just incredible.
It was just that painful and that restrictive, you know it really was. You know, instead of being 70, I was 90, that’s-, that’s what you go to. I want the last years of my life to be mobile, you know and now, it’s just-, it’s-, I cannot stop expressing the transformation in my life, of this, and being pain-free, and regaining mobility.
My own personal wellbeing, you know - mentally I've improved. Every-, everything, it just-, it-, it’s just-, I-, Yeah, I just cannot describe how different my life is.
Every morning you sling your leg out of bed and stand up, and you don't have to go through 10 minutes warmup, frightened to put your knee down. You know, honestly, it’s just- I'm repeating myself, and I just can't tell you how-, what it’s done to my life.
George was about 65 when he started having knee problems. He feels people should be put on the waiting list as soon as osteoarthritis is discovered in the knee.
George was about 65 when he started having knee problems. He feels people should be put on the waiting list as soon as osteoarthritis is discovered in the knee.
After the first X-ray.
As soon as you've got rheumatoid arthritis in your knee, it’s only degeneration that follows, it’s not- it doesn't recover.
You-, all they do is-, they're kicking the can down the road. And that’s exactly what’s happening.
So as soon as anybody gets spotted, get them in the queue, and give them a knee, and you could save a whole load of hassle, because they're not getting older. I guess it’s the fact that they-, what they want to do is time it, so they love giving 70-year-olds a knee because they know that they're going to last the duration. They're not going to need two knees, because you-, [chuckles] because you're at the end of the branch.
So 70’s about the right time if you're going to give somebody a knee, I think that’s what they think about it. Because they're so expensive, man - that’s the problem; it’s a massive amount of money.
I hope the outcome is something that you know clinicians can look at it and say something. And that is the point I want to make: an earlier prognosis would’ve benefited me immensely, just to say, “Now this guy will be goofed by the time he gets to 70, so we can fix him when he’s 65.” And I would’ve had five years of, you know, being able to participate in cycling and other things.
That’s what I really regret, that I've just had to limp on and take all these tablets, get fat, drink too much, and put, and now sit thinking.
Cos I get out of breath more easily than I ever did, you know? Just I’m, even just noticing just walking around in the garden, I feel like I’m out of breath, it’s my heart not working as it used to. And that’s a major concern.