The Knees are New, But the Walk is Weird!
The unexpected challenge of learning to walk again
I’ve always loved to travel, but the common experience in exploring any place in the world is … lots of walking! Walking has never been my favorite mode of exercise, though the daily tasks of getting from here to there have been unavoidable. But as I approached 60 years old, the pain in my knees became more than an annoyance. On my first visit to the orthopedist, he advised that the meniscus in my left knee was pretty well shredded, and an arthroscopic procedure to remove it would make me more comfortable (though leaving my femur and tibia to grind against each other with each motion at the knee joint). Someday, he advised, those knees will likely have to be replaced.
Following that minor surgery, the knee experience was indeed improved, though the feel (and sound) of those grinding bones over the following 10 years told me that “someday” was now. So at age 72, and still hoping for many years to travel the world, I studied up on the modern techniques for total knee replacement (“TKR”), found an orthopedic surgeon with a great reputation, secured authorization from my Medicare Advantage plan, and went under the knife.
The surgery itself and the immediate aftermath were amazingly quick and painless. The robot-assisted procedure lasted about an hour; three hours in the recovery room until I could demonstrate walking and a modest stair-step; and then released to my partner for low-level activity at home with immediate in-home physical therapy. Full range of motion and flat extension came about quickly, and apart from some swelling and stiffness, I felt that walking could become my new favorite activity!
However, one fact I have failed to mention is that my legs have never been straight. From birth, and probably exaggerated through wear as the years have gone by, I have suffered from a condition known as knee valgus . . . commonly called “knock knees”. As a result, when standing with my knees together my feet would actually be two or three inches apart. I had obviously adapted to the misalignment through my life, but now I was able to thoroughly enjoy the prospect of having my legs become perfectly straight as a result of TKR. All I needed to do for this wish to come true was to have the other knee replaced as well!
So, six months following my left knee TKR, I went under the knife again to do the right one. The surgery and immediate aftermath were pleasingly similar to the first operation, but after just a few weeks into physical therapy, I knew that something was very different. The new knee joints were functioning perfectly, but the straightening of both legs had now put my feet in an entirely different alignment.
The truth was that my brain’s signal to my leg muscles anticipated that my steps would land my feet where they had always been. But such was no longer the case. In fact, the sensory perception of my legs was that I was now bow-legged, and my feet tended to run into each other frequently as I walked. To counter this, as I worked with my physical therapist and personal trainer at the gym, I developed an awkward exaggerated stride that resembled Frankenstein’s.
The retraining of my leg muscles to try for a natural gait has been a considerable effort. I am now six-months post-surgery on my second TKR, and the walking gets a bit better just about every day. But there is a lesson to be learned: the body, as directed by the brain, has learned through a lifetime to do things a certain way. Retraining is more than simply saying “We are going to do it a little differently now”!
