Try Oxford:  It Isn’t Just for Scholars

On August 13, 2008, I didn’t win an Olympic medal, but I did celebrate a year of being pretty much pain free in my left knee—better than a gold medal to me.  Before August 13, 2007, I couldn’t have made that statement.  The cartilage in the medial (inner) part of the knee joint had worn away, and I had been walking bone on bone for a long time.   Though I could still ride a bike without too much discomfort, walking gradually became extremely difficult.

My only relief came from steroid shots, which I got three times a year, but they gave me only three weeks to a month of partial respite. My stomach can’t tolerate NSAIDs, and Tylenol was useless.  I was running out of options.

In May 2007, I made an appointment with Dr. Eugene Wolf, one of the best knee specialists in the area (he has offices in San Francisco and Greenbrae, California).  I asked him to prescribe a knee brace.  Dr. Wolf wanted x-rays of the knee, but he wasn’t encouraging about the benefits of such a support.  By the time the x-ray technician brought in the film, I felt I’d run out of options.

Dr. Wolf put the images on a screen, comparing them with others taken a few years earlier.  He finally spoke, confirming what I already knew:  I had no cartilage remaining in the medial joint.  I also had many loose bodies swirling around under the kneecap and elsewhere, creating potential problems for the remaining good cartilage and the patella because of the grating action.

He said, “You need an operation.”  I, of course, thought he meant a total knee replacement, having assumed that was my only alternative.  Then I heard him saying, “You’ll walk out a few hours after the one-hour surgery.”

That’s when he told me I was a good candidate for the Oxford Unicompartmental Knee System, a knee implant that duplicates the original knee joint and is used in situations like mine where I still have stable cartilage in one section.  I didn’t need a total knee replacement.

Dr. Wolf pointed out there’s a major difference between the Oxford knee implant and other unicompartmental devices:  it is mobile bearing.  An artificial meniscal bearing glidea freely throughout the knee’s range of motion, replicating normal movement.  The free-floating nature of the device also improves durability of the implant because the wear and tear is distributed evenly over the surface.  Most will last the lifetime of the patient.  Also, the incision is less invasive than for other mechanisms, especially total knee replacements, and the overall trauma to the knee is far less.

The device has been available in England and Europe for over fifteen years and in Canada since 2000.  But the U.S. didn’t approve its use until three years ago.  In an article on Today’s Surgicenter, Dr. Wolf says,

‘Up to 40 percent of the 500,000 patients that now undergo total knee arthroplasty in the U.S. could benefit from this new knee prosthesis now done on an outpatient basis.’

After discussing it with my husband, I made a date for outpatient surgery on August 13, 2007.   I walked out of St. Mary’s Hospital a few hours after the operation—six hours to be exact.  I used crutches for support, but my left leg bore my full weight.  I had a few days of pain that Oxycontin controlled successfully.  After three days, I switched to Advil, used mainly at night for pain management, along with ice packs.  I never felt overwhelmed with pain.  I could move about with one crutch.  After about a week, I didn’t need any painkillers, for the most part.  I started bending and straightening my leg immediately and began physical therapy at two weeks.  A month after surgery, I was back to my usual routine at the gym, upper and lower body strength training, and riding a stationary bike.

Today, a year and a half later, I’m not only walking without a limp and free of arthritis pain, but my knee feels normal.  Except for the scar and some loss of feeling around it, I wouldn’t know I’d had surgery, and the implant feels like a natural part of my anatomy, not like a foreign object.

Clearly, I’ve become an enthusiastic advocate for the Oxford implant.  It can be a miracle for many people.  So if your doctor has told you a total knee replacement is in your future, think again.  You may have more choices than you thought, and you don’t have to go to Oxford.  It will come to you.