I opened my eyes and nothing had changed. Or so I thought.
Part 2 ended with the plan in motion. Part 3 begins with the work that made the surgery possible and the moment everything changed.
Why I Wanted the Surgery
I didn’t pursue the fusion takedown out of vanity. In fact, Dr. Salter had done a remarkable job with the original fusion. My gait was smooth, my pain was minimal, and for many years, that fused knee allowed me to live my life with a kind of stability I desperately needed at the time.
But four years after the fusion, the juvenile arthritis made itself at home in my right knee. What followed were years of surgeries and procedures. Each one a reminder that a right knee replacement was waiting for me somewhere down the line. And as that reality came closer, I began to think about what recovery would look like with a fused left knee. How would I manage rehab? How would I bear weight? How would I regain strength on a leg that had been compensating for so long?
I didn’t want the takedown because something was “wrong” with the fusion. I wanted it because I was trying to protect my future. I hoped that restoring movement in my left knee might buy me time before the inevitable replacement on the right. I hoped it would give me a better chance at a successful recovery when that day came. And beneath all of that was a deeper truth: I wanted options. I wanted to feel like I had some say in what happened to my body, instead of waiting for the next crisis to decide for me.
That desire to stretch out time, to give myself the best possible chance, was what kept me searching for a surgeon who would listen.
The Tissue Expander Phase
Dr. Gross explained that the first step wouldn’t be his alone. Another surgeon, the head of Plastics, would place the tissue expanders under my quadriceps, and Dr. Gross would be in the operating room so he could see everything inside my knee for himself. It was a team effort, the kind of collaboration that made the whole possibility feel more real.
The plan was simple in theory, but daunting in practice. After the expanders were placed, I would spend the next three months returning to the hospital once a week. Each visit, saline would be injected into the expanders to slowly “blow them up,” stretching the tissue millimetre by millimetre. It was a strange process. It was science mixed with patience and trust. Every week, I could feel the pressure building, a reminder that my body was being prepared for something entirely new.
It wasn’t glamorous and definitely not easy. But it was progress. And after fifteen years of closed doors, progress felt like hope.
A Change in the Plan
When I woke up from the tissue expander placement surgery, Dr. Gross was standing at my bedside. He had that calm, steady presence I had already come to trust. He told me the expanders had gone in smoothly, but once he’d seen inside, he realized something else needed to be done. He had decided to release my patella (knee cap) from the fusion and encase it in a gel-like casing to protect it. It was the right call, but it came with a consequence: there was now a scooped‑out section in my bone, which meant I had to remain completely non‑weight bearing for the next three months. If not, I might break the fusion.
It was a lot to take in. But strangely, I wasn’t overwhelmed. By that point, I had already been through two hip replacements, four years apart, and I had lived through the evolution of post‑surgical rules. When I had my left hip replaced in 1991, the protocol was strict: non‑weight bearing, then toe‑touch weight bearing, and only then a slow progression. By the time I had my right hip done in 1995, everything had changed. They sent me straight to toe‑touch weight bearing because research had shown that small amounts of weight stimulated the bone to heal faster.
So when Dr. Gross told me I’d be non‑weight bearing for three months, I explained what I’d learned from those earlier surgeries. He listened, smiled, and said, “You know too much.”
It was a moment of levity in the middle of something daunting. A reminder that even in the most technical, clinical situations, there was room for humour, and the kind of mutual respect that makes self‑advocacy possible.
A Little Freedom Before the Hard Work
Once the tissue expanders were in and the weeks of careful stretching began, I slowly graduated from toe‑touch weight bearing to using a cane. And the moment I had even that small bit of mobility back, a friend and I decided to do something a little bold: we booked a long weekend in Las Vegas.
It wasn’t reckless. It was intentional. I knew what was coming. The months ahead would be all about relearning, rehab, and recovery. My world was about to shrink into appointments, exercises, and the slow, disciplined work of rebuilding a knee that hadn’t bent in years. Before stepping into that chapter, I wanted one last breath of freedom. A little fun. A reminder that life was still bigger than surgeries and protocols.
And, as a side note, thank goodness long skirts were in style. I had a very strange, very noticeable lump of fluid sitting above my knee from the expanders, and pants were, let’s just say, not an option. The skirts hid everything, and honestly, they made the whole situation feel a little less clinical and a little more manageable. Sometimes fashion really does save the day.
Waking Up to a New Reality
When I woke up in recovery after the takedown surgery, the first thing I saw was Dr. Gross standing beside my bed. Instinctively, I lifted my head, hoping to see something I hadn’t seen in twenty‑two years. A bending knee.
But that’s not what I saw.
My leg was stretched straight out on the bed, wrapped in layers of bandages, looking exactly as it always had.
My heart dropped. I looked at Dr. Gross and asked, “You couldn’t do it?”
He shook his head gently, with a big smile. “Yes, we did it.”
I blinked at him, confused. “Then why am I not on a CPM machine?”
(Continuous Passive Motion – a device that slowly bends and straightens the knee after surgery.)
He said, “We don’t use those anymore after replacements.”
And I answered, “Yes, that makes sense for people who could bend before the surgery.”
He paused, thought about it, and said, “You’re right.” Then he turned and went to get one.
When Pain Met Possibility
What happened next was both excruciating and unforgettable. He had to get my straight, hasn’t‑bent‑in‑22‑years leg, onto the machine. As he lifted and guided it into place, the pain was blinding and I screamed. Not a dramatic movie scream, but a raw, involuntary sound pulled straight from the deepest part of me. A nurse came running.
Before she could panic, Dr. Gross said, “Don’t worry. This is one of the happiest days of her life!”
And he was right. Through the tears and the pain, I smiled, nodded, and then screamed some more.
Because beneath the agony was something bigger: my knee was bending. For the first time since childhood, it was bending.
And that alone made every sound that came out of me worth it.
Seeing My Knee Bend Again
The first time the CPM machine began to move, I felt a kind of anticipation I can still remember in my chest. It wasn’t excitement exactly, it was something deeper, something closer to awe mixed with fear. For twenty‑two years, my knee had been a fixed point in my body, a constant, unchanging line. I had learned to live around it and to accept it. And now, here it was, about to move.
As the machine slowly lifted my lower leg, I watched with a kind of disbelief. The bend was tiny. Barely a suggestion of movement. But to me, it felt monumental. It was like watching a part of myself wake up after decades of silence. I didn’t know whether to laugh or cry, so I did a bit of both, all while still screaming from the pain. OMG, the PAIN!
But underneath the pain was something else: wonder.
I had forgotten what it looked like for that joint to move. I had forgotten the shape of that bending knee, the way the skin folds and the muscles shift, the way a straight line becomes something alive. It felt like witnessing a small miracle. Not dramatic or cinematic, but deeply personal. A quiet miracle. One that belonged only to me.
In that moment, I wasn’t thinking about the months of rehab ahead or the uncertainty of how much movement I would eventually regain. I wasn’t thinking about the years of searching or the surgeons who told me no. I was thinking about this: My knee was bending. After twenty‑two years, it was bending.
And for the first time in a very long time, I felt the future open just a little wider.
That first bend was only the beginning. In Part 4, I’ll take you into the early days of rehab, when every movement felt new and every small gain felt like a step toward a life I had almost stopped imagining.
–––––––– ✧ ––––––––
FAQ
Why does this part of the story matter?
Because this is where preparation becomes reality. Part 3 is the chapter where the expanders, the stretching, the waiting, and the uncertainty all lead to the moment everything changes. The first bend, the proof that the surgery was possible, and the beginning of a future I had almost given up on.
What were tissue expanders like in real life?
They were small balloons tucked under my quadriceps, filled a little more each week through a tiny port under the skin. As the saline went in, a small bump would rise on my thigh. This was unsettling and impossible to ignore. My leg began to feel heavy and full, like it was carrying a quiet pressure from the inside out. It wasn’t painful, but it was strange, and it reminded me every week that my body was being stretched toward a future it hadn’t had in years.
Why did the head of Plastics place the tissue expanders instead of Dr. Gross?
Tissue expanders were originally developed for reconstructive surgery, not orthopedic surgery. They’re most commonly used by plastic surgeons to gradually stretch skin and soft tissue before procedures like breast reconstruction or scar revision. Because of that, the Plastics team are the specialists trained to place them safely and correctly.
In my case, this surgery was a hybrid procedure: part orthopedic, part reconstructive. It required both teams working together. Dr. Gross handled the orthopedic side of the plan, and the head of Plastics placed the expanders because that’s their area of expertise. It wasn’t a handoff or a delegation; it was a coordinated, team‑based approach to a very unusual situation.
Are the tissue expanders permanent?
No. Tissue expanders are temporary. Their only job is to stretch the surrounding tissue so there’s enough room to safely undo the fusion and place the new hardware. Once they’ve done their job, they’re removed during the takedown/replacement surgery.
They’re not implants, and they’re not meant to stay in your body long‑term. They’re simply a short‑term tool to prepare the area for the next stage of surgery.
What made the first bend so significant?
Because it was the moment that proved the surgery had worked. After decades of being fused straight, my knee finally moved. Painfully, yes, but unmistakably. That first bend wasn’t a test to decide anything; it was the first real sign that my leg had a future it hadn’t had in twenty‑two years.
Did I know what the first bend would feel like?
I thought I did. I knew it would hurt, and after everything I’d been through, I assumed my high pain tolerance would carry me through. Silly me. Nothing prepares you for waking up muscles, tendons, and ligaments that haven’t moved in this way for twenty‑two years. It wasn’t just pain. It was the shock of an entire system coming back online after decades of silence.