John
John is waiting to have joint replacements on his left hip and right knee. He previously had joint replacements surgeries in his left knee and shoulder, which were both successful. At his recent knee consultation, John had an x-ray taken of his lower body and he is waiting to hear from his surgeons about which joint replacement will be done first.
John is married and has one adult daughter. He is a retired farmer. His ethnicity is White English.
More about me...
John is currently waiting for knee replacement surgery on his right side, as well as a hip replacement on the left. Six years ago, he had a partial joint replacement on his left knee. He has also had a joint replacement on one of his shoulders three years ago. At the moment, he lives with daily pain from his hip and knee. John started applying buprenorphine patches for pain relief about six months but he is not sure if they are helping. He takes amitriptyline for additional pain relief, which was originally prescribed for suspected sciatica. He also takes lisinopril for high blood pressure, metformin for blood sugar regulation, and simvastatin to prevent cholesterol issues in the future. John sometimes uses a heat compress to soothe his knee or hip joints when they are painful, especially at night. He finds it helpful to use Nordic poles, for example when he is walking along cliffs.
An x-ray scan before John’s first operation for his left knee showed that both knees had a similar level of damage. For this reason, John has known for a long time that he will probably need a similar surgery for his right knee. He thinks that being a farmer and working with sheep, who are at knee level and “don’t worry too much about how they knock you about”, is why he’s had problems with his knees. He thinks that a skiing accident decades earlier led to his left knee developing problems sooner. After an arthroscopy to remove cartilage and when physiotherapy didn’t relieve his discomfort, John had a partial knee replacement on his left side. The operation was painful, but John feels he has “benefited greatly” from it. He was also pleased that he recovered in time for lambing. The only problem John has experienced from the partial knee replacement is some loss of sensation when he kneels down.
It has been a few years since John’s left knee surgery and the pain in his right knee has gradually increased. John had been unsure about when to speak to his GP about his knee. Knowing the situation with long waiting lists, John decided “maybe I ought to get myself on a waiting list, I can always make a decision later down the line”. He was unable to see his GP in person because of the Covid-19 pandemic, but managed to get a phone appointment.
John requested a referral for his knee through his GP and then, four months later, he was referred for his hip by a physiotherapist. He had an assessment appointment about his hip and knew that he would need to decide which operation to have first. He explains that “we’ve got to balance the two somehow” to sort out the pain. Almost a year after first asking for a knee surgery referral, John had an appointment with a specialist where it was agreed he was also eligible for knee surgery, but the question remaining was which joint first.
John isn’t sure which joint he would prefer to have replaced first, as the pain levels in each vary at different times and he thinks that sometimes one joint puts more pressure on the other. At the moment, the pain in his knee is worse than his hip and he fears that the knee is getting “progressively worse”. He has been having issues with falling recently and worries about being able to get back up when he is alone. John had more x-rays at his recent knee consultation, which he thinks will help with the decision. He expects surgeons will decide which joint to replace first, and then the next one would be around six months after that.
John was struck by how quick the knee appointment was, but didn’t feel like anything was left out. The knee surgeon told him that he would likely get a partial knee replacement with the possibility of a total knee if needed during the surgery. The surgeon also talked through the risks of the surgery. John’s outlook is that: “you have to take some risks in life, otherwise you get nowhere”. As he had gone in expecting to be offered surgery, John felt a “bit sort of blasé” when it was confirmed he was eligible. Based on the success of his first knee replacement on the left side, John had hoped to have his right knee done at the same hospital and by the same surgeon. This wasn’t possible as the surgeon had retired, but John still feels it’s worth traveling further as he trusts the hospital has “the best people to do the job”
The surgeon told John the wait for knee surgery would be one to two years, which was a bit of a relief as John had heard rumours that it could be a wait of three or four years. He advises others with joint problems to start the process of being considered for surgery sooner rather than later as the pain “creeps up on you”. As he is waiting to hear about surgery, John is considering self-referring to see a physiotherapist to get a knee support.
John accepts that he will likely need to wait for a while before having either surgery. He feels relieved that things are in motion as he found it worrying to be on the waiting list for an assessment for so long without hearing anything. John suggests that patients should be sent some reassurance that they are on the list and that they have not slipped through the cracks. Thinking ahead to having knee surgery, he expects that the first four weeks will likely be “blooming painful”, but hopes the short-term pain will be worth the long-term benefit. He hopes he won’t be discharged from hospital too quickly afterwards, as he has felt rushed out after some previous surgeries.
Getting access to his own GP is difficult so John talked about his knees and hips at the same time. They are both affecting his quality of life.
Getting access to his own GP is difficult so John talked about his knees and hips at the same time. They are both affecting his quality of life.
Well, it literally, when I wake up in the morning, I don’t know whether it’s gonna be my right knee or my left hip giving me trouble, both together, one or the other or sometimes neither, it really is as random as that.
And I know that it’s been difficult to speak to your GP and you sort of saw them separately about both the hip and then the knee at different points. Is your GP aware that you’ve got both ongoing?
Oh, probably yes, yes because the last, you’re normally only allowed to discuss one problem.
And so, you know, like I say - you make an appointment with your doctor, you get a ten minute slot - and you’re lucky if you get one within four weeks.
So, what I did when I was talking to him about the hip, I sort of slipped the problem with the knee in at the same time really, which you’re not supposed to do but how else can you get to talk to anybody about it really?
I mean it, I don’t blame my doctor it’s just the system at the moment.
As I say, you go on and you’re sort of thinking ‘well it’s a bit like the other one’ but then you think you tolerate it and think ‘maybe I’ll get away with it?’ But I think as I was talking to the doctor, I felt I ought to mention it especially with the way things are and waiting lists. I thought, well maybe I ought to get myself on a waiting list? I can always make a decision later down the line.
John asked to be referred to the same surgeon, who had a good reputation, that did his left knee replacement.
John asked to be referred to the same surgeon, who had a good reputation, that did his left knee replacement.
When I said to my doctor “I think I need to be referred for my right knee” he gave me, well he didn’t really give me a choice - I said “ I wish-, I have a preference for such and such hospital.”
And I have a - it seems sensible to me that because this particular consultant dealt with the left knee it seemed sensible for me to be going on the same team to have the right knee done. So that if I ever have any problems I have, not gonna be referred to two consultants - I can have the same consultant for both knees.
Which seemed sensible to me. And I told my doctor the name of this surgeon who is supposed to be top dog, they say, he‘s the one that does all the children’s joints, and things like that. He’s, so he’s very good, top of the tree I’ve been told by the various nurses and junior doctors that I’ve spoken to.
So obviously I wanted to have the same - to go to the same chap really. So that’s what I was, I know that my doctor did write to this hospital and request that I be put on this chap’s waiting list.
And how did you first start going to that hospital? Or when you had your first operation, was that just the one it was referred to?
No I, because of all - the hospital that I’m going to is, I mean, [laughs] you must already know which hospital I’m talking about - it’s just known for - it’s one of the leading hospitals in orthopaedics as far as I know.
And purely on the reputation of people like my surgeon who dealt with my first knee who, as I said the medical staff, they told me he was top of the shop. And the same with my shoulder - I had the surgeon who was top of his game, you know? And so, if I go in, I only want to go in once.
Yeah so, I said I didn’t want to go to the local hospital which was the first thing the doctor said to me, you know, “I can get you booked into so and so.” And I said, “I’d rather go to the other one”.
Because initially, years ago, I believe you had to go to the hospital you were sent to, whereas I think they changed that in more recent years, where you could elect to go to the hospital you wanted to.
John had X-rays of his hips as well as his knees at his referral appointment. He was advised that he needed both knee and hip replacement.
John had X-rays of his hips as well as his knees at his referral appointment. He was advised that he needed both knee and hip replacement.
And I had consultation about the hip, back in the first of December. And then the first meeting I had with anybody about my knee was yesterday. The 7th, 6th of July.
And they looked at the whole of my lower body and they said that really one of the problems is affected by the other, and vice versa. So they try-, when they put you through these operations they try to straighten you up a bit, so if I have my knee done it will affect how my hip is, and if I have my hip done first it will fix how the knee is - so we've got to balance the two somehow.
He reckoned that they would be probably six months apart, and they would make the decision which one was done first.
Well, I mentioned about the X-ray and they were literally-, I was there about quarter of an hour or 20 minutes early, and they literally picked me up as soon as I came inside the door and sent me straight down to X-ray.
And they X-rayed the whole of my lower body, because of what I mentioned earlier about the hip affecting your knee-, your left hip affecting your right knee, and right knee affecting my left hip. So he really took a picture of the whole thing.
And then I went back and changed, and we sat down then in the interview for about, oh, I don't know? 20 minutes. And he just explained to me about-, I was in, certainly- He said that, you know, the normal warnings about death and strokes and stuff and generally informing me about the procedure, you know what they do?
Because at the moment it’s the inside of my knee that’s causing the problem, same as the other one.
So what they're going to do is put me up for-, when I go under the knife, they will have a half knee to give me, and then with a whole knee on standby if it’s needed. Which is the same as last time. And the-, a half knee is less risks, apparently.
John says if you’ve got any knee problems at all, don’t delay, go to see your doctor.
John says if you’ve got any knee problems at all, don’t delay, go to see your doctor.
Well, I have given advice to other patients, or people I know who are waiting or they've got the same problem
I've told them, “If you start getting a problem with your knee or your hip-” and this is what I did, I mean with this knee now, because I knew how painful the operation is for four to six weeks afterwards and it is painful, I've sort of been pretending to myself that I didn't need it on my right knee and I probably should have booked in two years ago, in all honesty.
So, I've said to them "don't-," these are people who are obviously younger than me - I said to them, “As soon as you think you've got problems,” I said, “don't delay.” I said, “get booked in with your doctor and get it seen because, you know, especially with the waiting lists as it is now, for goodness sake, don't delay.”
John says it was very painful after knee surgery but worth it.
John says it was very painful after knee surgery but worth it.
I know when people have said to me that knee ops, they ask me what it was like and I don’t tell them it’s easy.
I tell them how it is, and I always say to them the first four weeks it’s blooming painful.
But I said it - having seen how the knee feels since it’s - I said it’s worth doing it for four weeks of pain. When I talk- I’m talking 9 out of 10 stuff.
After the four weeks you start getting better, and it’s paid off really, so those last six years have left me pretty good really.