What my knees need

TOMORROW marks the first anniversary of my knee operation. This is the fifth time I am writing about my knees, and hopefully it will be the last. Or at least for a very long time.

A quick recap: I underwent a meniscus root tear surgery for my left knee on May 28 last year. It affected me so deeply, I decided to write about it.

As it turned out, quite a few readers found it useful. I found this out when my orthopaedic surgeon – who didn’t know I was the famous Aunty June – told me many patients came for consultation after reading my columns on my experience.

“You saved a lot of knees,” was her comment.

I am quite encouraged that readers found my column helpful, so here is my latest update exactly one year on.

When I first wrote about my injured knee, which I titled “A pain that brought me to my knees”, I was still debating between choosing a conservative treatment approach comprising physiotherapy with anti-inflammatory drugs and surgery to suture back the torn meniscus.

I opted for surgery because meniscus root repair success rates are generally good – reportedly between 80% and 85% – although I knew my success rate could be affected by my age and whether I had osteoarthritis and how severe it was.

After I decided on surgery, I braced myself for a long road to recovery that could take up to a year. Four months after the op, I did say I wasn’t sure I had made the right decision because I was undergoing arduous, exhausting sessions of physiotherapy.

I was so determined and consumed about getting better that I even bought a pulsed electromagnetic field (PEMF) machine that supposedly could reduce inflammation and accelerate tissue healing and bone strengthening, as well as ridiculously expensive supplements like deer placenta.

The surgery certainly cured the pain, but there was the possibility that the repair could fail with the knee remaining unstable and making popping or crunching sounds when bent.

However, after two follow-up consultations, the doctors deemed the surgery was a success. Yes, I would rate my knee as being back to about 85% of what it was before the tear. There is some instability and it creaks like a rusty door. There is also slight stiffness and tightness that eases when I flex it.

Still, I am quite happy that I managed to achieve this result. I can walk and stand for long periods, even do a bit of careful dancing, and my knee – actually both knees – survived my acid test: my China trip last month covering six mountains and lots of squatting toilets.

All that physiotherapy and hours in the gym really paid off. I am quite fit and lighter by 6kg, which is very good for my joints, especially after my bone scan showed I have osteoarthritis in my hip.

For the sake of my health, bones and joints, I must continue with my gym sessions to maintain muscle strength. I don’t particularly enjoy them, but I do what I must, together with controlling what I eat, which is such a sad thing to do in old age.

Despite all my efforts, I know my body parts will continue to wear out and possibly more surgery, like a total knee replacement, in the future.

My meniscus root tear was termed a “silent epidemic” that affects many people and it was only 15 years ago that doctors finally figured out what was the cause of the pain and developed the surgery to fix it.

It is estimated that by the age of 80, the onset of painful arthritis will result in one in 10 people requiring a hip replacement and one in 20 needing a knee replaced. These are invasive treatments that have limited lifespans. Luckily, with amazing medical breakthroughs and discoveries, alternatives are being developed.

Already, scientists have come up with cutting edge technologies to regenerate cartilage and to prevent the development of bone-removing cells. The latter is what I am taking for my osteoarthritis in the form of an injection every six months.

What I am quite curious and hopeful about are exoskeletons that I have mentioned in a previous column. These are defined as “wearable robotic devices” that provide battery-powered mecha­ni­cal assistance to the hips, knees or ankles, so that less physical exertion is needed to walk.

There are models that are of medical or rehabilitation grade designed to assist people paralysed by stroke or spinal cord injuries to stand and walk again. These are more cumbersome and usually strapped from the chest to the feet.

What I am interested in are exoskeleton legs that will benefit older folk. These are battery-powered devices that are strapped on at the waist with the “legs” going down to either above the knee or the calf. They are engineered to support lower-limb joints that offset the body weight, thus relieving joint pressure. The result is seniors are able to walk longer distances and climb stairs with a lot less effort.

There are several brands in the market – you can find them on online shopping sites priced from a few hundred to thousands of ringgit – and the more established ones include Hypershell, Milebot, Exo Bionics, Keeogo and Rewalk. Most of us have never heard of them, but industry leaders are already predicting that these devices will be as ubiquitous as mobile phones once lighter, sleeker and more affordable models are developed for people with mobility issues.

China has wowed tourists with such devices being available for rent at several mountainous tourist spots like Tai Shan and one of the mountains I visited in Jiangxi Province. I wanted to try it out but the model that was strapped on my body felt heavy and uncomfortable, so I didn’t rent it.

The brand that is making headlines is the US-based Vastnaut One model that is touted as the world’s first AI-powered “4x4” consumer-focused wearable exoskeleton, meaning it has four joints and four motors to power both hips and knees. Reviews of the product have been overwhelmingly positive.

The device, however, is not available for general retail as yet. What the company did was to launch a pre-order and crowdfunding campaign on Kickstarter in April that allows a buyer to lock in a pre-order discount with a deposit on its website.

My very tech-savvy nephew in Sydney has pre-ordered one for his mum, my oldest sister. Lucky thing. Delivery is expected to be in July and I will definitely be getting her to share her user experience. I would seriously consider investing in one if it can help me avoid future invasive knee surgery and keep me on my feet.

The views expressed here are the writer’s own.