David Simpson

David, 62, is a retired, former army officer and civil servant who enjoys golf, skiing, dancing, gardening, travel, sailing, reading and languages.

Man on skis "I retired from the army in 2000 and spent the next four years as chief executive of a military charity. I have always been a fit and active person, having spent almost six years in the parachute forces and the rest of my career in a cavalry (tank) regiment.

"I play golf once or twice a week and until the problem with my knees, used to go sequence dancing at least once a week with my wife. I do not do inactivity! When not out golfing, etc, I am in the garden, which is over a third of an acre and needs constant attention. In addition, I am health and safety secretary for our local show, the biggest village show in the country.

"Up until July 2007 I had been fully active in every sense. I had had a few minor twinges in my right knee and taken painkillers on an irregular basis, mainly for night pain. During the Heckington show, I noticed that due to having to walk around the site in the mud (the summer of 2007!), my right knee was becoming more and more painful. At the end of the show, after three days, I could hardly walk and had to seek medical help.

"I was diagnosed as being in need of a unicompartmental knee replacement (where only part of the knee is replaced) but due to my age it was not going to happen quickly. As my daughter was due to get married in Nassau, I had to do something and had an arthroscopy with just enough time to recover and walk her down the aisle. I had tried a number of alternative medicines, both to relieve pain and to prevent degeneration - glucosamine, etc, but nothing helped as my cartilage had totally disappeared on the medial side.

"In December 2007 I went to see Professor Cobb at King Edward VII Hospital, London, who confirmed that I would need surgery, but suggested I try to last a bit longer on painkillers. By about January 2008 my right knee was causing me a lot of pain and, due to the limping, my left knee was almost as bad. I was unable to walk the length of our drive - 80 metres - and had been classified as ‘disabled’.

"I spoke to Professor Cobb and asked whether it would make sense to have both knees done at once as it would minimise the time I was ‘out of action’. He said that it seemed a sensible idea and that he would use ‘navigation’. We agreed to proceed with an operation date of 19 June 2008.

"Set out below is a post-op résumé of my recovery:

MONTH 1/Week 1
Operation on both knees at 3pm 19 June. Lasted 3+ hours and was carried out using navigation. Prof Cobb later told me that he had used a slightly different method of incision to minimise scar length. Uneventful first night. Pain control was excellent, I was given intra-venous Voltarol and the option of a morphine pump.

Day 2: I was out of bed and used two crutches to move around the ward under supervision. No pain from knees at all but some discomfort due to drips, etc.
Day 3: First real session of physio. Walked along the corridor and really came to terms with the crutches. Managed stairs under supervision. Still no pain. Able to stand and to move to bathroom unaided but sat on a high stool to shave, etc.
Day 4: Full physio session plus hydrotherapy. Reduced to one crutch for walking on the flat. Nurse took us round the block of the hospital 500+ metres. Still no pain and apart from nights, no discomfort. Dressings changed and the wound (sealed with Dermanbond) seemed neat and dry.
Day 5: Morning physio session, plus hydrotherapy. Discharged 11 am. Still no pain and did not use the morphine pump at all to manage pain whilst in hospital.

Week 2
At home. Pain managed by combination of Voltarol and Cocodamo when needed. No pain during the day but some discomfort at night when turning over in bed. The pain was not in my knees but my hips. Occasional dull ache in the knees but not ‘painful’. District nurse came to check wounds and said they were excellent and did not merit further visits. Visited my GP (ex-orthopaedic surgeon) as instructed with X-rays and CT scans, he commented that all seemed in order and that the surgery was most precise. Paracetemol prescribed for pain management. Began to increase daily walks but still no pain other than dull ache at night. Still doing static indoor exercises as directed.

Week 3
Steady progression. Still no pain in the day but discomfort at night, mainly when changing position. Some spasms in the knees but able to increase daily activity. Still no gardening, etc, but able to use 'sit-on' mower. Cleared to drive after 14 days post-op. Knees ached at the end of the day but not sufficient to be described as painful. Not able to push back on the joints fully. Aware of the need to 'progress slowly' as directed by Prof Cobb – beware of trying to do too much so as to induce pain.

Week 4
Good progression during the day with longer walks and some light gardening. Still no pain during the day but nights continue to be uncomfortable due to pain in hips and when moving the legs beyond the usual range. (I suspect that this is caused by subconsciously raising the knees whilst asleep, thus causing a sharp pain which woke me). Only medication is Paracetemol at night, max. four per night. The skin around the wounds is tender, possibly where the nerves have been cut, but it is an irritation rather than a pain as they are healing well. By the end of the week I felt able to walk almost anywhere, but still conscious of the need for care.

MONTH 2
Steady progression and able to walk the fairways at the golf club – without playing until I had seen Prof Cobb. Wary of uneven ground and the need to strengthen the lateral muscles. Daily life now more or less back to normal but not overdoing things. No pain during the day and nights still a little uncomfortable. Visited Prof Cobb at Week 6 who was content and did not wish to see me for a further year. He said that one reason for the pain in my hips could be due to the ‘re-orientation’ (fixed my bow legs) of my joints which was putting pressure on unusual spots on my hips, etc. He said that all pain should have gone by the end of August (Week 10). It had!

MONTH 3
Essentially things are back to normal, in that I can do most things without worry. I still take care on uneven ground and have begun to play golf, not a full round yet but almost. The night aches have now stopped and only occasionally is there any pain when I turn over. My wounds are fully healed and look very healthy. I have no problems whatsoever with steps or even step ladders although I try and avoid the latter. Since leaving hospital I have not needed crutches at all and have not used a stick. I only used a walking aide for five days in hospital. The most difficult action is standing from low chairs or sofas. Prof Cobb warned me to be careful with this movement and I see why, as the strain on the joint is considerable. My gait is best described as cautious. Although I have full movement I still tend to walk 'gingerly' as excess pressure on the joint when I force it back is uncomfortable. I am now concentrating on improving this aspect to get back to normal.

ONE YEAR ON
After only seven months, after having been cleared to do so by Professor Cobb, I was back skiing in Austria, slowly and gracefully but skiing! Now as this years Heckington Show approaches I am totally back to normal and whilst many people I know who have had similar operations limp quit badly, I have no limp or side effects at all.

"So what has the operation meant to me? It has given me my life back. As an active and fit 62 year old who, prior to the operation could not walk the length of our drive, the Corin knees and the skill of the surgeon have literally given me my life back and brought me back from the abyss of depression. Pity the golf swing is not as good as the new knees!"