Treatments

Peter Wieneke's testimonial I developed knee pain aged 60 in 2019 when training for an ultra-run the length of New Zealand. After six weeks of rest, I was no better and had to stop running altogether. By 2023 even the daily dog walk was a torture. 

An MRI showed osteoarthritis with full thickness cartilage loss, a potential indication for a knee replacement. As waiting lists for public patients in Ireland are long and I don't have private insurance, I looked at my options and, through my GP, was made aware of the treatment abroad facility in Amsterdam. Internet-research confirmed that the surgeon running the program, Dr. Michiel van Trommel, is very experienced. As a doctor myself I know how important the operator's experience is with regard to a good outcome.

After posting my history and knee-images (MRI and x-rays) to his team, I had a phone consultation with Dr. van Trommel, who confirmed that there was an indication for a partial knee replacement and explained the implications to me in detail. He arranged a face-to-face consultation with a provisional booking for hospital admission and knee replacement to go ahead that same afternoon, provided there were no unexpected findings.

In the days running up to the appointment I filled in health questionnaires on-line and had a detailed telephone consultation with the anaesthetist with the opportunity to decide whether I would have a spinal or a general anaesthetic.

I booked the flight to Amsterdam myself, but collection from the airport, transport in Holland and hotel accommodation were arranged for me on the other side. Consultation and procedure went ahead the next day. Everyone in the hospital had excellent English,  was friendly and professional. The spinal anaesthetic with some sedation was entirely painless. During the procedure I was barely aware that there was some drilling going on, but I couldn't have cared less.

That first night after surgery I spent in hospital, as surgery was late in the afternoon, and then spent another night in a nearby very comfortable hotel, with a trained nurse in the room next door, all arranged by the orthopaedic team. Next morning, 36 hours after surgery, the surgeon reviewed me at the hotel and removed the pressure dressing. At lunch time I was delivered to the airport to fly home to Cork. The only negative experience was a flight delay by four hours, me sitting in the departure lounge, unable to raise the legs due to the setup of the benches, and even unable to get myself a coffee. Have you ever tried to carry a cup of coffee when walking on crutches? It is probably a good idea to have a companion traveling with you.

The speed and extend of recovery depend a lot on pre-operative fitness. I got nearly full flexibility within a fortnight. After 3 weeks I was back to work in clinic and theatre, and after four weeks I took my first outdoors bike ride, 12 kms on the flat. Exactly 9 months after surgery I was able to participate in an unsupported cycling challenge, 4000 kms from Italy to northern Norway, cycling over 200 kms per day and sleeping in my tent.

The knee doesn't entirely feel the same as the original before osteoarthritis kicked in, but I have no pain, can cycle and swim unlimited, and can go for short runs. I recommend a knee replacement highly for people with advanced osteoarthritis of the knee who are limited in their activities of daily living due to pain. The old advice to delay as long as possible holds no longer true. Go for it early, well before you are deconditioned.