Question: After having a knee replacement on one of my knees, I can’t bend my knee completely, and this stops me riding a bike. Is there anything I can do?
It’s delightful to hear that someone who has had a knee replacement wants to ride a bike, as most people who have this operation are well over 60.
Unfortunately, a replacement knee is never as good as the young original, but most people can eventually bend their knee to a right angle. If this is not possible within six months of the operation, it is unlikely that any significantly greater movement will be achieved. Regular physiotherapy in the first few months after the operation is essential to gain the maximum mobility in the new knee.
Considering the fact that the old knee would have been very painful and had limited strength and movement before the operation, most patients find a replacement knee a marked improvement. I trust that you have adjusted the bicycle seat to give the knees the least possible necessary flexion, but other than this I regret that I cannot offer any further advice for your problem.

Question: I am 76 years old and two years ago I had a knee replacement operation. It was not a success, and after two years of pain and not being able to walk any distance, my surgeon wants to open it up again and cement it. I am very apprehensive about this operation, and would like your opinion on how necessary it is.
Unfortunately, not all operations turn out the way that the surgeon (or patient) would wish. Knee replacement operations have a very high success rate, and often give dramatic relief from chronic, severe arthritis. People who have been barely able to walk find themselves to walk freely for long distances within a few months of the operation.
You have been one of the unfortunate failures. This is probably a matter of bad luck, not incompetence on the part of the surgeon, nurses or hospital. After two years, your knee is not going to improve, and it is reasonable to let the surgeon try to correct the problem that has developed. Loosening of the joint, so that the artificial joint is not firmly cemented to the bone, is one of the commonest complications, and can usually be corrected without too much trouble.
Without further surgery you will continue to suffer constant knee pain. With surgery, you have a chance of significantly improving the knee discomfort, and possibly recovering completely. At worst, the operation cannot make your knee more painful than it is now.

Question: I have severe pain at the back of my heel that flares up whenever I start running. I am young, and trying to keep fit, and this constantly prevents my running.
Running puts a great deal of stress on the attachment of the large Achilles tendon into the back of the heel bone. With the constant jarring and pushing on this point, th§ tendon may tear and separate slightly from the bone, leading to acute pain and tenderness at the site. Treatment is by rest, and anti-inflammatory tablets. Occasionally, an injection is given into the sore point to settle the inflammation, and very rarely surgery is required. If you do not rest for long enough, or start running too hard too soon, the problem rapidly recurs.
Running is not the best form of exercise to keep fit because of the excess stress it places on feet, ankles and knees. Swimming and cycling are far more effective, and it is probably better to keep fit with these for a season until the heel has completely healed rather than run.

Question: What can cause pain in the front half of the foot? I cannot recall injuring it in anyway.
Gout is a severe and obvious cause of foot pain, but there are several other common causes.
Metatarsalgia is a condition common in athletes. It is an inflammation of the bones that form the ball of the foot, and is due to prolonged running, jumping or walking, usually on hard surfaces. Soldiers on route marches may develop the condition. Severe pain may develop in the ball of the foot, and the treatment is primarily rest, and anti-inflammatory medications. A ‘march fracture’ of the fore foot bones, due to the stress of continued walking or running on the foot may be another cause. There are minimal changes on x-ray, but excruciating pain on attempting to walk. Six weeks rest heals these fractures. In the elderly, foot pain may be the first sign of poor circulation, diabetes, rheumatoid arthritis or neuralgia.
Because these conditions can be serious, the cause of the pain must be investigated by a doctor and the correct treatment started.