Sarah, a dedicated physiotherapist with decades of experience helping others recover from injury, recently found herself in an unusual and challenging position – becoming the patient.
Following years of knee troubles, a surprising diagnosis, and a series of setbacks, Sarah underwent partial knee replacement surgery earlier this month. Here, she shares her story of persistence, preparation, and recovery.
A long road to surgery
Sarah’s knee problems began more than two years ago, following what seemed like an ordinary run after dropping her daughter off at nursery. However, the stiffness and pain she experienced afterward didn’t resolve as expected. “I was really struggling to bend my knee, and it just didn’t settle down,” Sarah recalls.
An appointment with Consultant Orthopaedic Knee Surgeon, Jonathan Webb, confirmed a small lateral meniscal cartilage tear. While significant discomfort ensued, surgery wasn’t deemed necessary. Instead, a steroid injection brought much-needed relief, allowing Sarah to resume her active lifestyle – temporarily.
Sarah’s troubles compounded when (unrelated) surgery on veins in her legs triggered an unexpected and severe post-operative reaction. “I had lots of nerve pain, my ankles and knees were swelling, and I couldn’t even get off the sofa without help,” she explains. “Severe fatigue was also a big problem,” she adds.
After extensive testing and meetings with her Rheumatology Consultant Dr Jon Houghton, Sarah was diagnosed with reactive arthritis, an autoimmune condition linked to the HLA-B27 gene. Though treatment helped alleviate many symptoms, her right knee remained problematic.
Time for knee surgery
Despite ongoing strength and conditioning exercises, alongside refraining from impact sport and running for a year, Sarah’s knee pain escalated by late 2024. “By Christmas, I could barely walk for longer than 10 minutes before becoming sore,” she says. It was at this point that Sarah’s injury was impacting her everyday lifestyle. “I couldn’t even take my daughter to the park.”
An MRI revealed that the lateral side of her knee had deteriorated to bone-on-bone contact. The damage was so severe that Mr Webb advised knee replacement surgery as her only viable option.
Sarah’s MRI above - far left was in 2022 and then (centre) most recently with red circles to highlight the change in her lining and then far right after her surgery with the half knee in place.
Preparing for knee surgery
With a surgery date set for 7th January, Sarah shifted her focus to ensuring her knee was in optimal condition for the procedure. Contrary to what some might assume, she avoided any pre-operative strengthening. “From my experience and advice from orthopedic surgeons, you want a quiet knee before surgery,” she explains. “I stopped all exercises that made my knee sore, put my feet up, and focused on relaxing and enjoying Christmas with my family.”
The days leading up to surgery were a mix of practicality and preparation. A pre-operative assessment included blood tests, swabs for infections, and discussions about the procedure. When the day arrived, Sarah was first on the surgical list. “Being the first meant I didn’t have time to sit around and get nervous,” she jokes.
The immediate aftermath
Sarah’s knee dressings being removed
The knee replacement surgery went smoothly, and Sarah’s medical team ensured her pain was well-managed post-operatively. “I woke up with some pain, but the nursing staff were incredible.” However, her recovery wasn’t without its challenges. “Getting up the first time was daunting,” Sarah admits. “You’re nervous about moving your leg, and it doesn’t want to cooperate due to the anaesthetic.”
Despite the initial hesitation, Sarah’s physiotherapy background proved invaluable. “I’ve been teaching people how to crutch-walk for 33 years, but doing it myself was a different story,” she says with a smile. With assistance from the nursing staff, she quickly regained confidence, managing to walk with crutches just hours after surgery.
Sarah opted to stay in the hospital for two nights, appreciating the quiet time to focus on her recovery. “I have a six-year-old daughter, so I fully intended to make the most of uninterrupted rest!”
Life as the patient
Transitioning from physio to patient has given Sarah a unique perspective. “I’ve always told my patients to stay on top of their pain management, and now I can confirm how vital that is,” she says. Following her own advice, Sarah is adhering strictly to her post-op care plan.
Although her recovery is progressing well, Sarah acknowledges the mental and physical hurdles involved. “It’s strange to experience the fear and uncertainty my patients often describe. Even with my knowledge, I had moments of doubt – like, can I trust this knee?”
She’s also mindful of not rushing her recovery. “I’m taking it slow and letting my body guide me,” she says. “I want to ensure I heal properly so I can get back to doing the things I love.”
Early days
Sarah doing her daily rehab
Sarah’s trusty wattbike
While it’s still early days, Sarah is optimistic about her long-term prognosis. She hopes the surgery will not only resolve her knee pain but also reduce her reliance on medication for reactive arthritis - in Sarah’s case, Suphasalazine.
“As my knee improves, I might be able to start tapering off some of the drugs. But it’s a wait-and-see situation, and I’ll work closely with my rheumatologist to monitor progress.”
“Often the immune system can right itself over a long period of time,” explains Dr Houghton. “The long-term aim is to review Sarah’s medication in three to four months time and, if all is going well, to start reducing the dosage that she's currently on with the long-term aim of not having to take it at all.”
Now, Sarah's at two weeks post-op, she really feels that she can add so much more to the rehab programme given to patients. Reflecting on her journey, Sarah admits it’s been a humbling experience. “As a physio, I’ve always been the one guiding others through recovery. Being on the other side has given me a deeper empathy and understanding of my patients’ needs.”
“It was a pleasure to help Sarah get her active lifestyle back on track. We’ve worked together for more years than either of us would care to mention but she has been such an amazing inspirational therapist for my patients,”
“I knew she would tackle her own rehabilitation with that same dedication. Having been through knee replacement surgery myself I also was well aware of how tough it can be at times during the recovery,” added Mr Webb.
For now, Sarah is focused on her gradual return to normal activities, taking ‘one step at a time’! With her determination and a wealth of professional experience to draw upon, it’s clear she’s well on her way to getting back to her active lifestyle.
