The Book of the Knee - common sense and help for patients by a patient

By Jayne Warren - 03/11/2007

After having two knees replaced, Paula May had many questions in her mind that she needed answers to - and many people who had questions for her. So, after four months convalescing, she decided to compile "The Book of the Knee" , a practical, sensible booklet to help others in her situation. It covers just about everything from describing basic knee problems and hospital admission to care of the knees during convalescence.

Her booklet may be timely as well, given that scientists have predicted that the number of knee replacement operations carried out on the NHS is set to increase from 32,942 in 2000 to 53,712 in 2010. Revision surgery - carried out due to complications or natural wear and tear after the first operation - has already soared by 300%, and accounts for one in five knee operations done on the NHS.

Writes Paula: "It was after extreme difficulties, years waiting for pain relief and periods of operations and convalescence that made me decide to write this booklet from my own experience. Before my knees got the better of me I had been very active - a vet's assistant, receptionist, mother of three, a horse-rifer and counsellor.

"Then suddenly my life was about whether I could climb the stairs, drive my car or use a swimming pool. Not to mention the minefield of modern gadgets like support pillows, chairs and beds. Some I found to be useful but the best was the simply old-fashioned walking stick. I've noticed that many older people use this and manage very well, saving money at the same time."

And of course, it's only when our knees wear out that we realise just how much they do for us. But "wear and tear" disorders are often brought on early if people play sports that cause knee trauma - like football of skiing. Minor knee trouble can be handled quite easily with physiotherapy and the use of various painkillers designed for arthritic conditions, such as Ibuprofen. But if the condition becomes more serious, the variety of treatments available can be confusing.

Dr John Cormack, a GP, who provided Paula with advice and guidance for the booklet writes: "Some GPs can inject steroids diirectly into the knee joint, which can have a powerful effect. But there is a limit to how often this can be done. At which point, a patient needs a specialist.

"The knee-joint is highly complex, its design allowing movement and stability. One of the key elements is the cartilage covering of the bones. This is a soft substance containing cells, matrix and fluid which, more than anything, allows the smooth movement of the various components of the joint. The trouble is, when cartilage is damaged (either by disease or trauma), it is not very efficient at repairing itself, although the knee-joint will, to some extent, compensate by producing more fluid."

The most common way of dealing with a knee that is so damaged that it is beyond repair, is to perform a knee replacement. Although techniques have improved, it is still a major operation and therefore reserved for those whose symptoms are severe and where the alternatives have been eliminated.


The Book of the Knee is available from Paula May by sending a cheque for £3 (which includes P&P) payable to Paula May to: Paula May, 42 Dowdeswell Close, London SW15 5RL. Please remember to include your name and postal address, and say you read it in the Mature Times!