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The Hindu
The Hindu
Vijaya Bharat

On your knees

While gently massaging my aching knee, I told my husband that Homo sapiens had paid a heavy price for evolving into two-legged animals. Wear and tear of the knees often leads to degenerative changes in the bone ends and the cushioning cartilage in between.

In the past three decades, there has been a hundred-fold rise in the reported cases of osteoarthritis of the knees more so in women; with China, India and the USA in the top three positions. The contributing factors could be longevity, obesity, sedentary habits and possibly heredity. Despite being physically active and agile and not obese at the age of 70, osteoarthritis had crept into my knees five years ago and progressed steadily. Though my speed had slowed, I continued to walk but steps and stairs would make me anxious. The aching right knee occupied my mind all day and disturbed me at night as well. I did learn some tricks to minimise pain by keeping the knee stretched, climbing steps slowly and accepting gladly any helping hand.

A friend, an orthopaedic surgeon, was clear in his advice, “Do knee-strengthening exercises, take calcium and vitamin D supplements and if needed, painkillers. It’s a degenerative disease and will not reverse. Since you do not have any co-morbidities, if the knee is interfering with your lifestyle, get it replaced by surgery.” The ball was in my court. Gastritis made me avoid strong painkillers. I remembered the toll osteoarthritis had taken on my late mother. The ailment that started in her fifties curtailed her mobility over the next four decades. Immobility led to loss of muscle mass and would make her slump. My mother was afraid of joint replacement and chose to slow down in tandem with the slowly progressive joint degeneration. Despite her longevity and mental clarity, my mother’s quality of life was adversely affected by the state of her knees and leg muscles.

Over the years, biomedical technology has evolved to provide sturdy metallic joints and surgical techniques have become refined and high-volume centres have perfected the art and science of patient care. All these factors influenced me to consider surgery at an appropriate time. My family discussed the pros and cons and opined, “If the knee is not going to become normal, why do you want to wait and suffer the pain?” I told them about the caveat in knee replacement. Even a well-performed surgery will not yield the desired results unless it is followed up with physiotherapy for a few months. My daughters said, “Then take a break. If the new knee can keep you active in the long run, go for it. It is a lifestyle-preserving surgery, mom”.

I told my daughters, who are in their early forties, to take care of their knees by swimming, cycling and doing yoga, in addition to walking. I advised them to watch their weight and consume a nutritious diet with nuts and vegetables. Dealing positively with the inevitable stresses in life and getting adequate sleep should do well for them. Should clicks and pain ever occur, they should avoid extreme flexion of the knees. With all our doubts cleared, I underwent a total knee replacement and it was reassuring to have the support of the family all through the recovery process. There would not have been so much discussion in the family if it were a life-saving or a limb-saving surgery. We chose an option that would preserve my desired lifestyle in the long term. The new knee is expected to last for more than 20 years and my bucket list has become longer.

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