Dr Rosemary

MEDICAL ADVICE COLUMNIST OF THE YEAR

After the operation the surgeon said the joint kept flipping out so they had to cement one side.

At my yearly check-up last week, the doctor said the reason I was getting pain was because the joint was at an angle, thus stretching the ligaments and said I should take painkillers. Isn’t there another solution? I am 77.

aA TOTAL knee replacement involves removal of the end of the thigh bone (femur) and top of the shin bone (tibia). The end of the femur is replaced by a curved piece of metal and the end of the tibia with a flat metal plate. These are both fixed using special “bone cement”. A small piece of plastic is placed between them, which acts like cartilage, reducing friction between the metal as the joint moves.

It sounds as if your operation may have been technically difficult. This can happen unexpectedly but people who are overweight or who have had severe arthritis for many years, with subsequent changes to the structure of the muscles around the joint, are more at risk. Even after straightforward surgery it can take three months or more for the pain and swelling to settle. In some cases it can take much longer – up to a year for the final swelling to go.

Any new knee joint will continue to recover for two years after the operation. During this time the scar tissue heals and you need to work on restoring the muscles with exercises from your physiotherapist.

If your joint is at an angle the exercises may be more difficult and painful but the more you can do them, the greater the chance of your knee recovering. If you haven’t seen a physiotherapist recently you would probably find it helpful to have a few more appointments, so ask your GP or your specialist for a new referral.

I HAVE had a pacemaker fitted for a leaking mitral valve. Does this mean I have heart failure?

aTHE mitral valve lies on the left of the heart, between the