This was another full week for medical appointments, with a total of five appointments in four days. I have an orthotic crafted by my podiatrist now; it's sort of fine-tuned at present with strategically placed felt pads, and I have extra felt pads should they be needed. I don't know whether it's getting pressure off the ball of my foot or not, but it os rotating my foot inward a bit closer to vertical, which helps my balance with shoes on, and it cuts the number of additional shoe inserts needed to get enough lift under my heel to walk from three down to one. On the other hand (other foot?), it hurts my toes.
My followup with the orthopedist was brief. Basically it can be summarized in two sections: care and recovery, and how the surgery went. The care and recovery section is pretty much "Keep wearing the brace whenever you're up and about, keep up the physical therapy, use a little neosporin on that suture that's being slow to heal." The answer to the "how did things look in there" question was that there's a lot of deterioration in my knees, the kneecaps are a lot worse than anything else, he cleaned up what he could, and there is definitely bilateral knee replacement in my future. It's just not certain when yet.
Total knee replacement basically includes three elements:
- Cutting back the bottom end of the femur and replacing it with a metal (titanium or stainless steel) prosthetic close in shape to the original bone;
- Cutting back the top end of the tibia and replacing it with a flat-topped metal prosthetic capped with a high-lubricity plastic (teflon or delrin, for instance) bearing surface;
- And lastly, planing off the back of the kneecap and refacing it with a high-lubricity plastic bearing surface.
Out of more than idle curiosity, having studied this somewhat, I asked whether anyone had tried just refacing the kneecap if the rest of the bone surfaces and cartilage were fairly sound, to try and put off (or avoid) the need for total knee replacement. The orthopedist's reply was that while it has been tried, it has a very poor success rate (60% to 65% at best, compared to 98% for total knee replacement), and nobody does it any more because of the low success rate.
Well, it was a thought, anyway ....