Knees and kneed

Context: my right knee has decided that with its more distal neighbours the tibia and fibula being “cabrioletted” since they commenced weightbearing, it can only take so much of being genu varum and it’s time to let the brain know

Sixty five years of service delivery seems pretty good for something designed by chance and environment. To those who reckon it's intelligent design, perhaps you are right.

But why, after going to all that trouble to create, in all its perfection, the human body, then build in planned obsolescence? Maybe marketing and intelligent design go hand in hand.

Context: my right knee has decided that with its more distal neighbours the tibia and fibula being “cabrioletted” since they commenced weight-bearing, it can only take so much of being genu varum and it’s time to let the brain know.

Quite why it decided to do so just when I was about to start a two-week hike around Iceland, is anyone's guess, but if ACC listens nicely to my fascinating anecdote of downhill antics in the Pyrenees, then I might be able to get a return on all that money I have paid into their investment funds over the past four decades.

Thirteen Kiwis hiking around Iceland might sound a little Roger Hallish, but we have a lot in common, particularly knees.

They're an interesting lot, these knees. None are encumbered by an excess of adiposity and most support reasonably well-off mountain hiking bodies that average 65 years of age. Some of these joints are well known to bone doctors in New Zealand while others are destined for their TLC in the near future, judging from the dinner table discussions.

However, the demographics of this group highlights a clinical dilemma that troubles me as a GP. Namely, should I provide patients seeking publicly funded, joint replacements with the information on the surgical criteria and scoring process?

The HDC code has pretty clear advice on what I should do.

The problem is that patient comprehension and use of the thus acquired information causes great inequity, for the persons who gain the most from my information provision, as poorly informed as it is, are not the disadvantaged and the health illiterate.