A physician’s thoughts and tips for patients needing knee replacement surgery

So, a lot of times we’ll refer patients
to physical therapy before the surgery so they can work on strengthening and conditioning
and flexibility of the knee joints in anticipation of their upcoming surgery. The better condition the patient is in heading
into the surgery is only going to play well in terms of how they can recover. A lot of people talk about factors that go
into a speedy recovery, but the reality is how fit the patient is going into it really
is one of the key determining factors for that. On the day of the surgery, I’ll be actually
signing and putting a “yes” on it to confirm the site of the surgery. The surgery itself will last anywhere from
90 to 120 minutes. Most knees are made of a type of metal, a
cobalt chromium, on either the top or the bottom portion, maybe of titanium. Then there’s actually some other brands
that have oxinium, which is a specialized coating. The key about the knee replacement is that
we try to recreate the shape at the end of the femur, and most knees are of this similar
design. A lot of people think we’re going to come
in and just chop off the ends of the bones and stick something in that makes the knee
replacement. This is actually what the end of the femur
looks like when we finish or finalize our preparations. So it’s one shave there, two, three, four,
and five cuts on the end of the bone to reshape that knuckle joint so that it’ll accept
the implant when we cement it into place. And then on the shin bone, or the tibia, we
make a single cut, a transverse cut straight across. In the middle of the joint, we use a polyethylene
shim, so this is the plastic component and this part can actually be replaced. On the back table we actually have implants,
that aren’t the ones for implanting, that we can put the cap on the femur bone and on
the shin bone, and then we have different plastic thicknesses to make sure we have good
dynamic tension to the joint because you want to get good soft tissue balancing to the knee. So that you’re dynamic tension is restored
so you do not have too much play, that you have a fairly snug knee that is equally balanced
in extension and flexion and everywhere in between. The typical recovery period for a patient
undergoing a routine knee replacement is anywhere from, on average, two to six weeks. So after surgery, there is pain and there’s
swelling, that’s typical. You’re independent within a few weeks – most
people are off crutches within a few weeks after surgery. There’s really very, very few limitations
– the only one I request my patients not to do is to run for sport. I much prefer a patient hop on a stationary
cycle or a bike. So, biking is unlimited; hiking, unlimited;
walking, no problem; swimming, outstanding. One of the myths I frequently run into in
terms of patients coming in to see me is that they’ve been told by someone, “Well, you
can only have one operation, or maybe two, and then you’re in a wheel chair.” Well, I can tell you that’s just not the
case – patients can have both knees done at the same setting. There’s no real restrictions to doing it
from the surgical standpoint or with the surgical team, provided the patient has adequate medical
clearance. People ask me all the time, “Am I going
to get taller from my knee replacement?” It’s not so much the patient’s going to
get taller, if they had a significant angle to the knee, they’re bow-legged or knock-kneed,
we correct that or realign it back towards straight, which may seem like the leg is getting
longer but it’s really not – it’s resetting back to where it was once before.

3 comments

  1. This is my Dr and I can confirm everything he has said.  I am 37 and just got my knee replaced.  I am also making a documentary that will be out next fall showing that my limitations after surgery are minor and I am able to return as an active snowboarder.

    If you want to follow my journey follow me on:
    Instagram @tedore.
    I can 100% give my full support for Dr Toomey.

  2. I had my right Knee Replaced here May 31, 2011 and was told 6 weeks to recover.

    Developed Pneumonia while in recovery and then released. Got double Pneumonia and hospitalized for a week. I was in a great deal of pain and was told by Dr. Toomey that I had an over abundance of scar tissue. Several Procedures later, still no healing and several Physical therapy sessions. I was told By the Doctor that the surgery was successful and that some patients are just to weak to recover in six weeks. He was making sarcastic remarks about me being a man. This Guy screwed up my knee so bad I could not walk. I could not straighten my knee or bend it. My physical therapist was baffled too. I reached out to one of Dr Toomey's staff,  and there had been other questionable cases like mine he had seen.

    Rudest Doctor I have ever dealt with. Dr Toomey was very rude to me and my wife during our initial consultation and we should of left. He is good at taking advantage of people during their desperation. <br/>After several surgeries and stress and being financially bankrupt.

    8 months later I saw a new Surgeon here in Skagit Valley who told me that Dr Toomey had Botched the Surgery and that he could correct it with a revision surgery.  He showed us and explained what Dr. Toomey had done wrong that resulted in me not being able to bend or straighten  my knee. We asked the Doctor, Did he screw up on the surgery and he said yes, But we can fix it.
    After the revision I was able to walk in 3 weeks.

    Dr Toomey was anything but Pleasant or professional.

    Stay away from this place and this surgeon !!!

  3. I'm getting ready to schedule Dr. Hormel for arthroscopic knee surgery. Have ripped up meniscus and accompanied arthritis/cyst problems. Have been told that this will provide relief for a time, but will probably require knee replacement eventually. Thank you so much for alleviating my trepidation at having this procedure!

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