More Knees Please – a long one for the weekend

I’ve decided it’s time I wrote about my knee operation. Why in the name of all that’s holy? You ask. Well…

It’s an esoteric op, it was first carried out in 1996 and since then, only about 1,600 have taken place. I could find very little information about what it entailed online when I was about to have it done and I thought it might be helpful to anyone else about to experience it if I could give them an idea of what to expect. So here I am.

However, before I start the knitty gritty of the op I’m going to explain how I buggered my knee up in the first place, for no other reason than that it’s an excuse to bang on about nothing in particular.

Right. Here we go…

Once upon a time, when they were dealing out the legs, I was issued with a pair of quality seconds. Well no that’s not strictly fair – as Peter Cook so memorably said – my right leg… my right leg I like but I fall down on my left leg. True, unlike Mr Spigot, I do actually have a left leg and for the most part it’s perfectly functional. It’s just the knee which is a complete lemon. In fact if I could I’d send it back and get it replaced under warranty. At the very least I think a stiff letter to the relevant board of ombudsmen would be in order, were they to exist.

My left leg is particularly in my consciousness at the moment because I’ve undergone a surgical procedure called an osteochondral transplant on its knee. This, to those of us who do not have the planet-sized brain required to obtain a medical qualification of any description, is basically a bit like having a hair transplant, only instead of taking hair from where you have some and planting it in a spot where you’d like to but you don’t, an osteochondral transplant entails taking something a bit like a geological core sample from a part of the joint where there is some cartilage and transplanting it into a spot where you’d like to have some but don’t. I guess it’s a kind of shocks and springs job…..

WHY?
Shocks and springs are usually associated with high mileage – surely I’m far too young for bits of me to be wearing out? Well yes, I am, hence my desire to contact the, sadly, non existent knee ombudsmen but then, in mitigation, the rot got started earlier than normal, to be precise, as early as the tender age of 8 the time I started having “growing pains” in my left knee.

I have long held a theory that the robust nature of my play, as a child, might be partially responsible… in particular a favourite game for my brother and I known as “Cresta Run”. Mmm.

Cresta Run involves a flight of stairs a cardboard grocery box and two children. Here’s how it works – The children need to be between 8 and 12 years old to play for two reasons, first because at that age, they know no fear and second because any larger and they won’t fit into the grocery box er hem… sorry “bob sleigh”. Child One climbs into the “vehicle” at the top of the stairs, kneels down and leans backwards while Child Two pushes the box slowly forwards – knee end teetering out over the void. When correctly positioned, the only thing stopping the vehicle from beginning it’s descent will be the firm hold of Child Two who is finishing setting up the stopwatch and waiting for confirmation of readiness from Child One. Once both children are ready and the stopwatch is set Child Two shouts “Go-Go-Go!” starts the stopwatch and lets go of the box. Child One, the pilot, pushes their knees downwards while, at the same time, keeping the body weight mostly to the back to avoid unpleasant somersaulting and launches itself into the void….

It’s very exciting! We lived in a 3 storey house with two sets of 9 stairs between each floor. That’s one hell of a rush if you make it down all six sets which, as you can imagine, we regarded as the ultimate extreme sports challenge. It’s very difficult to corner and take in the next flight before the carpet neutralises your momentum but it is possible if you can grab the bannisters and swing yourself round with your arms, lowering the amount of weight and therefore friction on the bottom of the box. We spent a happy couple of weeks playing “Cresta Run” in our plastic Jim Clark style crash helmets, before my Mum caught us and banned us from doing it ever again. Naturally, we spent many a happy hour repeating the experience over the next year or two whenever she went out – I should point out here that we lived in a school so somebody else was always in – they just didn’t know – and wouldn’t have believed, anyway – what we were doing. It is also living proof, should you ever require it that all children are a) horribly devious b) absolutely convinced they are indestructible and c) probably are…. almost.

The stairs were carpeted but they were concrete underneath. All that bouncing over thinly disguised concrete might explain why a small area of my knee bone died. This, medical spuds, is called osteochondritis desicans. It dies, drys out and you end up with a dead spot with no cartilage on it…. Two things can happen. It falls off and you need surgery to have it removed, not quite as easy then as now or… you avoid any impact sports – you take a year off games (Stephen Fry would be soooo jealous)… and then even though Bob’s not my Uncle’s real name… it grows back – or at least, the dead bit of bone re-animates and doesn’t fall off and bob around in your joint. You can also have surgery during which they put a small screw in, fixing the piece of bone back onto your leg. Surgery is quicker and, I suspect, what I should have done but surgery for the same thing had proved a monumental disaster for my Mum – she spent from the age of 18 to 21 walking with a stick although on the up side, she dines out on the story of how the enormous crack her knee made as she curtseyed at some do or other got her a wink and a big smile from the Duke of Edinburgh…. but I’m going off at a tangent again.

By the time I was referred to the specialist who signed my year and a half no games chitty I was 10 – and the first thing my mother asked, obliquely, was whether the Cresta Run was responsible.

“Could it have been caused by a severe knock?” She asked.

“Weeeeell….. I doubt it very much.” Said the specialist. “It’d have to be a very severe knock.”

“What about a series of smaller knocks or jarring? We have a concrete yard.” She asked, probably going about as close as she could get to “My children think it’s fun to toboggan down our 36 concrete stairs in cardboard boxes would that be the trouble?” without stimulating unwelcome interest from Social Services.

Again, a firm no. So it was no games for a year which meant that the only sports I’ve ever been any good at are the ones everyone else started with me when we were all aged about 12…. um… hocky. Oh yes, and roller skating. I was allowed to roller skate, it’s low impact – except when you fall down – and because I couldn’t do anything else my parents actually encouraged me. It was also the most practical sport since our house was in a large school comprising two quadrangles of smooth concrete and an equally splendid tarmac drive to glide over! By the end of the year I could out skate anyone in my school, even the fifth years, hell I could out skate fifth year BOYS from other schools… I was good, I was BC Torville only my specialism was what I think these days is called “aggressive skating”. Skating over things, under things, launching myself off things, backwards down stairs – the right kind of stairs (now that was cool!) and of course the horizontal cornering wall of death thing where the right kind of wall and the right kind of corner presented themselves in tandem…. I can’t do any of that now, of course, because you have to have a knee which actually works – even if it hurts – and these days, I don’t. The year off games more or less did the trick in that the desiccated bit of bone reanimated itself. They made me stop for another 6 months just to be sure and there I was. Cured.

SO WHAT’S THAT GOT TO DO WITH MY CURRENT PREDICAMENT THEN?

I think it’s the origin of the bald spot. Despite the fact the bone was alive I suspect the cartilage didn’t re-grow – I didn’t ask at the time so I’ll never know for sure. It should have done at that age but since the bone had regrafted and there was no operation available to mend the cartilage they would have regarded me as cured anyway. I assume that if the cartilage had grown back my knee would have stopped hurting, which it didn’t. Ever. And that meant I limped and unbeknown to me, over the next 8 years or so my left leg got weaker and weaker and weaker. It also meant that after 5 years or so, although there wasn’t anything actually getting caught in the joint and making it lock straight or bent it did sort of… stick. Driving was tricky unless I drove the kind of car where you are sitting on the floor with your legs straight – hence my choice of a Triumph Spitfire the moment I could afford one and my subsequent graduation to a Lotus in the belief that it’s a practical car… well, for me it is.

STAGE TWO IN THE JOURNEY FROM LEG TO PEG

This took place a few years later in London in about 1994. Picture the scene…..

I’m in London, I’ve been to an evening class in “wine appreciation” and on to a pub for some beers with a couple of friends. I’m a bit merry – actually I’m completely and utterly rat arsed and I’m heading back to Victoria, which is taking me ages and ages because there’s some monumentally irritating building site in the middle of everything which means the path I usually use is blocked and I’m going to have to go all the way down Buckingham Palace Road and round. As a Londoner, I walk everywhere but since it hurts, I try not to walk further than I have to. I’ve already walked from Farringdon to Victoria that day so I don’t want to walk all the way down Buckingham Palace Road and round unless I absolutely have to.

“I’ll take the path, anyway.” I think. And so I do…. and there at the end is a four foot wall, barring my way. No matter, there, the other side of it I can see the junction with Victoria Street. This is exactly where I want to be and this is a piddley little wall – I used to jump three times my height out of trees when I was a nipper so, unafraid and I climb happily over. I’m sitting on top carefully holding my bag of wine tasting iso glasses – I don’t want to break them – and find the height hard to judge in the sodium lights. “Ah what the heck?” I think and off I drop. After a very short time, only a millisecond or two but a millisecond too long, you understand, a thought wanders into my head. “Shouldn’t you have landed by now….?” It says… and then I do. Badly. All wrong. My knee started to bend sideways. Now, even in the state I was in I knew that knees bend one way and one way only, towards the front. Backwards and sideways is not the way God or nature intended. It was accompanied by an unpleasant feeling that something was popping out of line. I threw myself in the other direction and to my relief, whatever felt like it was popping out popped back, my knee joint ceased bending out-leftwards and I crashed to the pavement. I was delighted to discover that I hadn’t broken my iso wine glasses and of course, I wasn’t dead – a bonus I appreciated more fully when I took in the height of the wall this side – I’d guess about 12, maybe 15, feet.

So, nothing was hurting, I was relatively unscathed and it was time to go home, to tell my flat mates about my intriguing adventure. I stood up but my left leg didn’t. If I put any weight on it, it crumpled under me and I fell over again. Hmm…. what to do next. I could William Shatner/Kirk roll the 100 yards or so to the tube but the pavements round that part of Victoria were one huge lavatory for the homeless and the night air was filled with a weedy miasma of pathetic drizzle. If you think back, you’ll remember that while Captain Kirk rolling when he is travelling with the Away Team is as ubiquitous as his losing his shirt he only rolls when he is on a nice clean star ship or a dry and dusty planet. Dry, people, this is the key here, dry. There is no rolling about in marshy swamps, especially not when there is a high probability that the greater part of any “water” involved is tramp’s wee… So, Kirk fans, I didn’t fancy rolling 100 yards along a damp smeggy London pavement and subsequently down about 200 stairs onto a even damper and smeggier London Underground covered in Special Brew after it’s been through some old weegie guy. Especially not as I would then have to roll further from the Victoria line to the Jubilee Line at Green Park than I would if I cut my losses, climbed back over the wall and headed there direct.

I hummed and haad and decided that maybe it’d be a good idea to go to casualty… this was in the days before mobile phones so I simply hopped into the middle of the road and stuck my hand out until the right kind of taxi stopped. A sympathetic one. It didn’t hurt at that point, it just didn’t work. But I had no cash so I had to pay him the £1.50 fare with a cheque. By the time I’d got to the hospital I could stand on it again and I felt a bit stupid, they gave me a big elastic bandage, x-rayed it and my husband, who was then my boyfriend, came and collected me. I never really found out what I did at the time but odds are I tore or ruptured my anterior cruciate ligament. You have two big ligaments holding your knee together, which cross over from the front of your thigh to the back of your lower leg and another goes from the front of your lower leg to the back of your thigh. The anterior one is the one that goes from front thigh to back leg… I think. Later examinations revealed movement which was there because the ligament had been stretched or torn and, like elderly nicker elastic, it had gone soggy. Less of a pop I felt at the time, then, and more of a twang, perhaps. Mmm.

Before you tell me I couldn’t possibly tear or rupture a ligament and not notice I should point out two things… one, I was very, very drunk. Two my knee had hurt day in, day out, for 8 years so unless the pain was startling I wasn’t going to notice. Oh yes and a third thing, Three, I was in shock. The next morning the pain was impressive enough to make me actually whimper. I’m not a screamer, pain makes me swear under my breath, any uncontrolled noise is a sure sign of extreme agony – yes, I know wait until I have kids.

It was 6 months before I could walk without a stick, a year before I could walk without limping and after that, if I gave up my morning knee exercises for more than a month or so I would twist it again.

A couple of years later, after I’d moved to Cambridgeshire and married Mr BC I found a nice clear road and started to in line skate. It was painful to start but I finally built up my left leg enough to hold my knee together properly. The fact some kind soul left their crutches on the bus and didn’t claim them – meaning I could – also helped to ensure a much speedier recovery from further twistings.

So it was that so long as I had legs like Charles Atlas, my knees would work… for a while.

Tune in, when I next get round to it, for another exciting instalment of BC’s Dodgy Knees..