Joint Camp

Part of the presurgery at Guthrie is a session called Joint Camp. My camp took place March 22. My wife and I walked in the hospital at 7:45am to begin. One of the main goals of the session was to gather all the background needed for surgery ahead of time. The nurse who I am likely to see after surgery taped on EKG leads and ran a tape. She did an intake of my medical history.

After that we were taken to a conference room where we met the other "campers." Four of us are facing joint repair. The first camper I met is 6 years older and will have both knees resurfaced the day before my single surgery. The next camper was a mid-sixties woman and the last a late 50s gentleman who will get his hip replaced.

The two facts I gained from the physical therapist were one, the cutting of the ends of my leg bones will mean the loss of the pressure receptor feedback. This could make the joint feel strange until my brain releans. The second regards a nerve block. For recent shoulder surgery I had a nerve injection. Not fun. In this case an IV would be inserted to drip anesthesia on the femoral nerve until its time for me to be discharged. This will allow me to do PT with less pain.

Paperwork

Yesterday I went in to fill out my presurgery paperwork with Christine Doak P,A, She mentioned a nerve block possibility during the operation. I had one for my left shoulder and it was not a pleasant experience. She explained that leg blocks work different. For the arm block the nerve in my neck was pierced with a needle and a novacaine like chemical injected. As it wore off, my arm buzzed and my neck throbbed for a solid day. Hard to sleep when that's going on!

When the leg nerve is blocked, they put in a tiny catheter which drips number on the nerve. This sounded better than the needle.

A deeper understanding of knee replacement

I recently emailed Dr McClurg some questions. On 3/14 I went on to talk with him abut the upcoming surgery. I asked about .ligament retaining surgery. In his opinion the jury is still out on its value. Dr. McClurg elated that leaving the ACL and PCL add complexity to rebalancing the joint. During surgery, he will make adjustments on the two outside tendons of the joint to keep even tension throughout the bending and straightening of the knee, thereby realigning my upper and lower leg. If the two inside ligaments are left in, they also would need to be accounted for. Years of damage have thrown them all off. Now the complexity of realignment has increased 16x!

He also bright up a patient who came to him who had retained the PCL. This person had fallen on some stairs and torn the ligament. The joint was rolling because it was designed to have a who,e PCL for support.

I also asked him about my high riding patella, or Patella Alta. cpuld he repair that during surgery?

"To a limited degree." He replied. "The length of the patellar tendon is already set. We canut in more material to raise the joint line a bit so that the patella is more likely to rest in the groove. However if we have to do a revision, which at your age is likely, we would have less to work with the next time."

I asked if I would be shorter.

"No."

I'm having the Smith and Nephew Visionaire one off cutting guides done. They were not able to fashion the guide for the tibia. The screw in their from the Hauser Procedure decades before through too much of a shadow on the MRI. I will be able to keep the screw after surgery.

Dr. Joel McClurg answered my questions patiently and from a solid knowledge base. I feel as confident and informed as I can.