Hermione
Hermione has pain in both knees. She previously had both hips replaced, which went well. Hermione expected to be offered joint replacement surgery or steroid injections at her appointment about her knees. In her appointment, the surgeon recommended a total knee replacement for her left knee. Hermione feels optimistic that this will help, but wishes the wait time was shorter.
Hermione is widowed, and has two adult children and one child who died. She is a retired NHS nurse. Her ethnicity is White British.
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Hermione currently has pain in both of her knees. She was diagnosed with arthritis a few years ago, but had known that her knees were “not quite right for quite a long time”. Though both of her knees are affected, the left one is worse than the other and it feels like something is “catching in it”. Her knees sometimes give way on uneven ground and she has had occasional falls. Hermione now has handles installed in parts of her home, and uses a walking stick or crutches when she goes out. She is disappointed that she is less able to garden or go for walks, and sometimes finds it difficult to get enough exercise because of her knee problems.
Hermione had her hips replaced in 2017 and 2020, and is pleased with the outcomes. She was told that she had ‘marginal osteoporosis’ after breaking her wrist a few years ago; she took medication for bone strength for a few years and it hasn’t been a problem since. Hermione currently takes blood pressure tablets daily, along with paracetamol for her knee pain. On days where her knees are especially painful, she also uses Voltarol gel and hot or cold compresses. She has been offered co-codamol for pain relief but avoids it because of the side-effects. Hermione also has carpal tunnel in her hands, which can make it difficult to support herself up the stairs.
About three years ago, Hermione saw her GP about her knee problems. She went to some group physiotherapy sessions which “kept my knees moving but it didn’t do anything very beneficial”. She was due to have a steroid injection in one of her knees but this was cancelled because of Covid-19 restrictions. Hermione went back to her GP about 18 months ago, as the condition of her knees had worsened. Her referral was delayed because it turned out that the referral letter had not been sent, but this was set right after she followed this up with her GP.
Before the appointment coming up with a knee surgeon, Hermione had expected that scans would be taken and that she would be presented with either replacement surgery or steroid injections as her treatment options. In past appointments with physiotherapists, she felt discouraged from having knee surgery, though she thinks this may overlook the severity of her pain levels. At the appointment with a knee surgeon, Hermione planned to ask about the risks, recovery process, and timeline associated with having surgery. If the surgeon suggested she should have knee replacement but the delays for surgery were over six months, Hermione thought that she might consider going private with the surgeon who did her hip replacements.
Hermione’s openness to knee surgery is partly due to the success of her hip replacements. She is hopeful that having knee surgery will reduce the pain and allow her to get back to enjoying more activities in life. However, she had heard from other people that knee replacement is often more difficult to recover from than a hip replacement. Hermione’s sister also had a bad experience with a knee replacement, which resulted in developing sepsis and needing another operation. Hermione found this “a bit worrying, but [I] just hope that that doesn’t happen again”.
At her knee surgery consultation, Hermione’s surgeon told her that her knee would qualify for joint replacement. The surgeon talked her through some possible risks and complications, though she thinks these were more related to surgery in general rather than her specific health concerns. Upon being offered surgery, Hermione had made up her mind “straightaway” to go through with it. It was “disappointing” for Hermione to hear that the wait would be 6-12 months. She offered to take a last-minute cancellation appointment if one comes up, to get the knee replacement surgery sooner. Thinking ahead to recovery, Hermione is considering looking into hiring an independent local carer for the first few days, but doesn’t expect she will need much more help beyond this.
Eventually, Hermione hopes to have surgery on both of her knees. For now, she is on the list for her left side and is continuing with physiotherapy. The surgeon also mentioned about the possibility of steroid injections, but didn’t seem to think that her knees would benefit from these. Hermione has considered seeing a surgeon privately, but was put off by the cost. She has also tried buying some supplements she saw advertised for knee pain online, though feels these haven’t had much of an effect. Hermione continues to rely on Voltarol and paracetamol for pain relief. She is currently recovering from a recent carpal tunnel decompression operation and may have another on her other hand soon.
Hermione feels “hopeful that that [knee surgery] will have a good result when eventually it happens”. Though she recognises that she may have “overoptimistic faith in surgery” to fix her pain, she plains to “stick with that” rather than over-thinking it. Hermione reflected that there’s “always a risk” but that she remains “hopeful that it’s not going to happen”. Hermione considers herself to be in good health overall, and is doing her best to stay active within her limits. She is trying to keep her leg muscles in shape to help with recovery, and advises others in similar situations to do the same.
Hermione’s knees were painful when walking and on stairs. One knee occasionally became painful when standing.
Hermione’s knees were painful when walking and on stairs. One knee occasionally became painful when standing.
Yeah, walking like, they become painful after walking for ten or fifteen minutes, and they are painful sort of stepping up and stepping down stairs and steps. And just occasionally I’m getting one feeling a lot worse, it feels as if something’s sort of catching in it and then it’s very painful to stand on it or straighten it. But that sort of goes off again after resting it.
Have you had any sense of the joint being unstable or sort of falling, because of your knee?
I have fallen, usually sort of on uneven ground and sort of find one gives way a bit on uneven ground.
And do you find that your knee problems and the pain you experienced affects sleep for you?
Affects sleep? Yes, it can do, it can do. It depends sort of what position I’ve got them in.
Hermione had NHS group physiotherapy sessions and private physiotherapy over time. Her knee pain worsened and she was waiting to see the orthopaedic surgeon.
Hermione had NHS group physiotherapy sessions and private physiotherapy over time. Her knee pain worsened and she was waiting to see the orthopaedic surgeon.
About two years before that I saw the GP and was recommended for some physiotherapy, so that goes back a bit, probably two or three years now.
Can I ask more about what was that physiotherapy like for you?
Well, it was it was a group physiotherapy session, so it was a little bit helpful, I think it sort of kept my knees moving but it didn’t do anything very beneficial. And in fact, it got as far as them recommending to have a steroid injection in one of my knees, but that was cancelled because Covid came along. And they weren’t doing that sort of thing.
It came about because I was aware of having to wait a long time to see anybody and I just felt I needed to be doing something about my knees, so I booked to go to a physiotherapist, that was a private one as well. Just to keep something going before I had the orthopaedic appointment.
And do you still see that physiotherapist or stay in touch with them as you’re doing the exercises at home?
I’m now just doing the exercises at home. I have an option to go back if I feel I want to, but at the moment I’m just continuing to do the exercises.