Move Beyond Pain: Read Don's Story
Don has always been active.
Splitting time between a home in Hamilton and in Port Saint Lucie, Florida, in good weather Don can usually be found out riding his bike or swinging his clubs on the golf course.
“All of the things I like to do require a certain level of physical activity,” says Beach, a retired Mercer County College administrator.
An active lifestyle is generally a great thing for the body, but it can prove to be hard on the joints. And Don soon found that his knees were experiencing significant wear and tear.
“I was having difficulty doing the things I normally did,” Beach says. “Stairs became difficult - doable but painful. Same with golf and bike riding.”
Don began working with orthopedic surgeon Michael Duch, MD to find the best way to treat his knee pain. After attempting to manage the pain with regular cortisone and lubrication injections, the two decided together that a double knee replacement was the best course of action to help return Don to his regular active lifestyle.
“I leave it up to the patient to tell me when they are ready,” Duch says. “I like to work with them to keep up their lifestyle as much as possible, but when their quality of life decreases, that’s usually when they want to have (surgery) done.”
To perform the dual knee replacement at RWJ Hamilton, Duch used a technique called patient-specific instrumentation, which has been known to provide great accuracy and reduce the amount of time a patient must spend in the operating room.
The patient has a CT scan done of the knee to create customized surgical guides that are designed to match the individual patient’s knee anatomy. The procedure helps the surgeon achieve consistency in the placement and positioning of the knee replacement and can cut down on the amount of time spent in the operating room.
“It’s more accurate,” says Duch. “And I already know what size I’m going to use prosthetic wise.”
Dr. Duch also used a quad-sparing technique, where the surgery is performed without cutting through the quadriceps muscle and the tendon of the thigh. This allows patients like Don to regain their mobility much faster following their surgery.
“I think most patients are surprised when you tell them they’ll be up and moving the day of their surgery,” Duch says. “But in reality they do very well.”
Up and Moving
Don was up and about the same day of his surgery and went home the next day. During his brief stay, he began his rehabilitation in the Joshua Harr Shane Rehabilitation Room at RWJ Hamilton’s Center for Orthopedic & Spine Surgery. He worked with inpatient rehabilitation specialists on range of motion and even on accomplishing everyday tasks during his recovery.
“They even had a fake car that I practiced getting in and out of,” Don recalls. “Since I was going home the next day it was important for me to know how to get in and out of a car properly.”
After about eight weeks of outpatient rehabilitation, Don had returned to the gym on his own three days a week. Today, the father of two and recent grandfather of one is back on the bike and the golf course.
“I’m back to doing all the things I had been doing before pain started,” Don says.
Age is Everything
Age plays an important role when it comes to planning a joint replacement. While joint replacement surgery can provide relief and help patients return to their normal life, it is important not to have a procedure done too early. Technology has come a long way in joint prosthetics, but most still only last about 15 to 20 years before they have to be replaced again.
“If you have to go in and do a revision of a joint replacement, it’s a much bigger procedure with a higher complication rate and the outcomes aren’t as satisfactory,” Duch says. “So we would like patients to only have to have the procedure done once.”
Patients can also help their joint replacements last longer by adjusting their daily activities.
“I think patients can do the things they enjoy, just in moderation,” Duch says. “If a person goes skiing 20 times per year, if they instead go twice a year, that would be fine. Despite those realisms you want people to enjoy a good quality of life and not shut them down.”