MS and Knee Surgery: My Total Knee Replacement Adventure, Part 2

My 22-year journey with multiple sclerosis has overlapped with other conditions. Two of my comorbidities include rheumatoid arthritis and osteoarthritis. Because of moderate to severe damage to my knee joints due to osteoarthritis, I had two total knee replacements (TKRs) last year.

Deciding on and planning for surgery

In Part 1 of my story on this surgical adventure, I shared that I worried MS symptoms were causing increased knee pain. I shared a bit about how I decided when to schedule TKR surgery. And I discussed a few things I did before surgery to make it easier at home after surgery.

Since my knees were equally damaged, I could choose which one to have replaced first. I chose my right knee, so in July I experienced my first total knee replacement. I was very nervous ahead of time because the only surgeries I had ever experienced involved my tonsils and my wisdom teeth.

My surgery experience

The knee surgery itself went well, although it did take longer than my surgeon had anticipated. There was more bone damage than x-rays had revealed. As part of installing the new prothesis, my surgeon straightened my leg during surgery so that my tibia and femur were better aligned.

Realignment pains

My lower right leg no longer aimed towards 11:00 from the knee when I laid it straight in front of me on the couch. After surgery, a straight line drawn from hip to knee to ankle could ring the chimes of high noon on my imaginary leg clock. For my left leg, extra work needed to be done to correct a flexion contracture of the knee where I couldn’t straighten it fully prior to surgery. It was the straightening of the joints that I believe caused the most difficulty during recovery after surgery. Realigning the bones meant that certain muscles needed to be lengthened to accommodate their new positions.

In the case of my right leg, it was the shin muscles that complained the most, and I had a hard time bending my knee to the desired range of motion for some time. With extra swelling after surgery, I also experienced increased numbness in my foot and weakness during ankle flexion. These were overlapping post-surgical symptoms and infrequent MS symptoms. Thankfully both symptoms decreased as swelling in my leg went down and I got stronger during physical therapy.

And then the left knee

In October, I underwent a left total knee replacement. This time a joint contracture was present which prevented my knee from fully extending straight prior to surgery. The straightest I could go was about 5 degrees bent.

It took a full 9 weeks after surgery to be able to reach 0 degrees fully extended straight leg. The hamstring muscles and tendons have been particularly persnickety during recovery, but things are much better now. But even another 6 weeks later, I’m still working on that range of motion every day to reduce the pain I feel when keeping the knee straight or bent for any extended periods of time.

Surgery recovery and MS spasticity

You may recall at the beginning of this story, I was most concerned with how my MS spasticity might interfere with recovery from surgery. After physical therapy helped me strengthen my hamstring, quadricep, and calf muscles on each leg and after I could comfortably straighten both legs to their full extension, I finally realized that my spasticity hadn’t made me cry since before surgery.

I’m still taking daily oral medication for spasticity, but I think that the consistent and intense practice of strengthening and stretching during physical therapy and home exercises prescribed during recovery has made a huge difference. Not only are my knees improved after surgery, but my MS symptoms have also been reduced as well.

Post-knee surgery reflections

It’s now been 6.5 and 3.5 months since my knee surgeries and I couldn’t be happier. Now. I can stand long enough to cook dinner. I can walk 1.5 miles. I can ride the indoor exercise bike for 40 minutes and not be in pain. Early in the summer, I was worried that surgery would exacerbate my MS, but fortunately, it did not. In fact, my MS politely took a backseat and enjoyed the physical therapy ride.

The work of recovery isn’t done and I’ve still got a lot of strengthening and conditioning to do. Most importantly is that I must maintain the motivation to continue the exercises every day at home. If I do so honorably, I anticipate that I might be strong enough and healed enough to try riding my bike outdoors once again in the summer.

If you are considering surgery, I do encourage you to discuss aspects of preparation, procedure, and recovery with each of your doctors and healthcare providers. Combine their perspectives to develop a plan that is best suited to your needs.

Have you had a surgery experience?

Now, I’d like to hear your stories. Have you had major surgery while living with MS? What were your concerns and how did you manage those with your doctors? How are you doing?

Please share your stories. This is one of my favorite parts of being a member of this community. We can learn so much from each other.

Be well,

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