James
James has had several surgeries on his knees, with two partial replacements and a total knee replacement on his right knee. Recently, he felt something dislodge in his left knee and he’s been having difficulties with walking. He feels that his knee has improved since his GP made the referral, but he expects he might eventually need a total knee replacement.
James is married, and has two adult sons. He is a retired vehicle design manager. His ethnicity is White British.
More about me...
Besides problems with his knees and wrists, James considers himself to be in pretty good health. James’ knee issues started after a tear to his cartilage while playing football. Since then, he has had problems with both knees. Both of his wrists have been broken, one of which needed to be re-set afterwards. He has tried steroid injections on one of his wrists which is arthritic, but didn’t find them very effective. James now considers his wrist something to “put up with” as it’s “not too bad”. He currently takes codeine for pain relief in both his knees and wrist. James was diagnosed with high blood pressure after it was identified to be a bit high before a knee surgery. Tests also showed some issues with his with his heart and built up cholesterol, but this wasn’t considered bad enough to need a stent. He takes blood pressure tablets and blood thinners to manage this.
In the early 1990s, pain in James’ knees prompted him to see a knee specialist under the private insurance provided by his job. He had surgery to clean out his right knee joint. The surgeon also noticed a torn ligament during the operation, which required a further procedure to install a plastic ligament. James’ pain and gait did not improve after the surgeries though. He had issues with the plastic ligament and, when James returned to the surgeon, he was told that his knee was out of alignment.
A partial knee replacement on his left knee was done in 1995, which improved his pain levels. However, soon afterwards, James started having problems with the knee dislocating and swelling. He saw the doctor again who said that the right knee had collapsed from being unable to bear his weight. The surgeon suggested that he should have a partial knee replacement on his right knee first, and then they could revisit his left knee. He had the second partial knee replacement “without much discussion”. James went to see a different specialist under the NHS upon leaving his job with private insurance. He found it “quite hard for me to convince everybody that there was something wrong” with his knees, despite being knock-kneed and in pain.
At the encouragement of his son, James paid to see a new private consultant. James got the impression that his new doctor disapproved of how his previous doctor had handled things. Looking back, James can’t remember being told much about the risks or any less invasive options. He suspects he may have been treated like a “cash cow” since it would be more profitable to operate. James’ partial knee on his right side was ultimately removed and replaced with a total knee in 2015. He can now walk more easily and painlessly, but continues to have some mobility problems.
James has been having issues with walking on his left knee recently, and he also felt like a piece of the bone had broken off, so his GP made a referral. He has had challenges with getting X-rays booked in and done correctly. Seeing a physiotherapist also felt like a “waste of time”, though James admits he “didn’t give them a chance”. James was given an appointment to see a surgeon about total knee replacement but, whilst in the waiting room, he was told that the appointment had been cancelled. When he asked further, he was told that the hospital wouldn’t do revision surgery on knees with existing prosthesis. Frustratingly, this meant that James had to go back to his GP and go through the referral process again. He is now waiting on a consultation at another hospital.
Going into his appointment about knee replacement, James hopes to find out if the surgeon can identify what went wrong and stop his knee from collapsing. James feels “slightly a fraud at the moment ‘cos it isn’t that bad” currently, and his knee seems to have healed. He plans to tell the consultant about this. Ideally, James would like to be offered a total replacement as he thinks this would “give me another sort of ten years without worrying about it”. James says he is also be open to other treatments for his knee, but expects that he would still need surgery later on.
The hospital did not do revision surgery, James’s appointment was cancelled whilst in the waiting room. He went back to his GP and the referral process again.
The hospital did not do revision surgery, James’s appointment was cancelled whilst in the waiting room. He went back to his GP and the referral process again.
I think you have to wait two or three weeks for the results, and then I got a phone call from my GP at home saying he’s just been looking at the x-rays and he- I don’t know whether he understood what they said or not, but he asked me was it interfering with my way of life?
And at the time it did, cos I couldn’t move hardly. So, he said, “I’ll put you on the list, the referral list.”
So, they referred me to whoever they refer you to, and I got a form to fill in to say what hospital and when I would like it done. So I filled that up and said I’d have it done, have an investigation at the [hospital] as soon as possible.
I then got an appointment at the [hospital] in about two months I think. Then when I got there the woman was very cagey and said, “Do you mind sitting down?” So I sat down, and then another woman come over and said, “I’m sorry Mister, [name] but your appointment’s been cancelled.”
And I said, “Oh when was it cancelled?” And she said, “Oh today.” So I went, “Well, no-one told me.”
So, and the reason they gave me was that they didn’t do revisions, I think the word they used. They don’t do repairs I suppose. The fact that I’d already had half a knee they wouldn’t look at repairing it, yeah.
So that meant I had to go back to my GP, who said to me. Well the receptionist said, “Oh it’s nothing to do with us, we’ve referred you so that’s all we can do.”
So, I offered to go and buy a pop-up tent and sit outside the doctor’s reception and go on a hunger strike until someone gives me an appointment for me knee.
With that she then I think she rung around and got me eventually - I didn’t get it on the day, but I eventually got this appointment which I think is next Wednesday at the orthopaedic hospital in [city].
And how long was it between? So you basically got to the appointment at the other hospital, - how long had that process taken to get from your-
Well. it was about, it must’ve been at least three months, because it was well - it was during the last summer’s cart racing team and I didn’t get the appointment till just before Christmas.
So, and then, can you imagine, I’d waited all that time and I was, I was crippled really. I was just sitting watching the grass grow, that’s all I could do. And then when I get the appointment I stumbled to the hospital and I’m then told it’s been cancelled.
And no-one told me or they told, they told me they’d told the surgery but the surgery said no-one told them. As it was actually on the day of the appointment, I can understand that, but when I got back to the GP no-one knew what to do once a referral wouldn’t, been cancelled, yeah?
And it was, you know it wasn’t - I can understand if there’s a seven-year waiting list but it’s just that, there’s that, there was, no-one seemed to care about me.
James hoped that having his partial knee replaced with a total knee replacement would give him five-ten years without worrying about his knee.
James hoped that having his partial knee replaced with a total knee replacement would give him five-ten years without worrying about his knee.
I would like them to say, I think, at my age and I’m still quite mobile - to say that we can put a full knee replacement in. Mm, cos I think that would give me another sort of ten years without worrying about it, you know.
Anything else they might suggest yeah, I will be grateful of, but it may be temporary or still leave me with a joint that’s going to go. It’s about twenty-five years old I think, my left knee, half knee, so.
And although it’s always fallen apart from new, you know, it’s, it must, I don’t know whether they wear out or not but.
Because the actual, when [the doctor] swapped me half knee to me full knee that didn’t really hurt that much in recovery, you know? So I would put up with that to have a, another sort of five, ten years of knee free problems.
But I can understand if that’s, you know, with the present situation a bit of an issue, and I would take whatever you’re offering. That’ll go from nothing and just keep an eye on it, or we might be able to do something.
So, you think total knee replacement is sort of inevitable at some point it will be required, even if other measures happen first?
Yes, I suppose yeah. It’s just that I never feel secure with it, you know, if I’m gonna go walking somewhere, even if it’s around a country house, there’s always the chance that my knee will fall apart and I may not be able to get it back together again.