Second Opinion Leads to Right Treatment

After being treated at an orthopedic practice near his home, Kevin Ply still had severe knee pain. David Huxtable and Kendall Thompson still had pain and instability long after knee surgery at other orthopedic practices. None of these patients was satisfied with what they were told about their knees or the treatments they had received.

For a second opinion, Ply, Huxtable and Thompson all turned to Shelbourne Knee Center, where each found the right treatment to get back to their daily activities.

Avoiding Early Retirement

Ply had been diagnosed with a meniscus tear and arthritic changes in his right knee. The orthopedic surgeon performed arthroscopic surgery on the meniscus tear and gave Ply cortisone shots for his osteoarthritis (OA).

But Ply’s pain continued to worsen. It got so bad that Ply, who was 54 years old, was considering early retirement from his career as a firefighter.

“I started thinking about another option,” says Ply. Based on the recommendation of several firefighters, he went to Shelbourne Knee Center for a second opinion.

Ply’s first appointment included a detailed medical history, X-rays on both knees, which the other practice hadn’t done, and an exam by Orthopedic Surgeon Rodney Benner, MD. “I was impressed at how thorough they were,” says Ply.

Dr. Benner recommended that Ply try Shelbourne Knee Center’s research-based Knee Rehabilitation Program for OA before considering total knee arthroplasty (TKA). Even though the physical therapy didn’t help Ply enough to avoid surgery, it did facilitate a better surgical outcome and a faster, easier recovery. “The rehab before surgery prepared Kevin to do well after surgery by maximizing his function and letting him get comfortable with the physical therapy regimen,” says Dr. Benner.

In June 2018 Dr. Benner performed the procedure. Six weeks later, Ply returned to work.

Shelbourne Knee Center is about 65 miles away from Ply but he didn’t mind traveling to Indianapolis. “I was disappointed that I did not have that level of care locally,” he says. “I would recommend Shelbourne Knee Center to anybody.”

Getting Back to Everyday Activities

David Huxtable had TKA on his left knee four years after TKA on his right knee. So when his left leg started collapsing every time he stood and his pain was worse than before the procedure, the retired aerospace engineer knew that something was wrong.

Huxtable’s surgeon told him that nothing was wrong, and he needed to build up his muscle strength through physical therapy. But more physical therapy didn’t provide more strength or stability.

“I needed to go see somebody else. I decided to get a second, third and fourth opinion,” says Huxtable. First, he went to see Dr. Benner. “The new knee didn’t fit well, and David’s ligaments were too loose. This made David’s knee unstable and painful,” says Dr. Benner. Revision TKA was the only solution.

With one doctor saying everything was fine and another that he needed another surgery, Huxtable got two more opinions. Both orthopedic surgeons agreed with Dr. Benner about the need for revision surgery. “I decided I would entrust Dr. Benner with doing the revision to my knee,” says Huxtable. Dr. Benner performed the revision TKA in August 2017.

Huxtable’s quality of life rose from 6 (on a scale of 1–100) before surgery to 100 and he was able to return to his everyday activities.

Healing an Unusual Injury

Kendall Thompson injured her left knee during a bike ride. A local orthopedic surgeon diagnosed a tibial plateau fracture and a tibial spine avulsion. A week later, he implanted a plate and 10 screws to reduce the fracture and sutured the tibial spine avulsion.

Thompson regained range of motion and some strength through physical therapy and working out on her own. But she was still in a lot of pain and her knee didn’t feel stable. “I resumed life in my new normal,” she says. “I didn’t do a lot of the physical activities I used to do because I didn’t trust my knee.”

Nearly two years after the injury, Thompson’s knee pain got worse. She went back to the local orthopedics practice where another doctor gave her a cortisone shot without doing a physical exam or reviewing her medical record.  “I was in pain again two days later,” she says.

“A thorough knee exam on both knees is necessary to evaluate any knee problem or injury,” says K. Donald Shelbourne, MD, orthopedic surgeon at Shelbourne Knee Center.

When Thompson went back again, the doctor did a cursory exam and without any imaging told her that she had a torn anterior cruciate ligament (ACL) and needed surgery. He also said that she needed to have the hardware from her first surgery removed.

Thompson decided she needed a second opinion. Several people recommended Shelbourne Knee Center to her.

At her first appointment at Shelbourne knee Center, Thompson discussed her injury and her treatment options with Dr. Benner. “Kendall’s case was unusual,” says Dr. Benner. “We were honest about this, and worked with her to take care of her injury without overtreating her.” 

Dr. Benner recommended physical therapy to improve Thompson’s range of motion and strengthen her knee, followed by surgery to remove the hardware. Thompson started physical therapy that day. In January 2019, Dr. Benner performed the procedure.  
   
“At every step I felt certain that the next step was required,” says Kendall. 

Seeking Second Opinions Before or After Treatment

Shelbourne Knee Center provides many second opinions about TKA, ACL tears, and other knee problems. Some patients, like Ply, Huxtable and Thompson, come after they have issues with treatment provided elsewhere. Others come before scheduling knee surgery.

For patients with knee OA, having TKA or living with pain aren’t the only options. Dr. Benner recommends that patients try Shelbourne Knee Center’s Knee Rehabilitation Program for OA before considering TKA. “We have a system in place, including a team approach and physical therapists in our office, to facilitate non-surgical treatment of knee arthritis,” he says.

Most patients—76%— improve enough that they no longer need TKA1.

Evaluating Options After an ACL Tear

A second opinion is even more important for athletes with ACL tears. Nationally, only about 50% of athletes return to sport at the same level after ACL reconstruction.

Athletes and their parents should take the time to find a knee expert who performs a high-volume of ACL reconstruction procedures. Dr. Shelbourne, for example, has performed more than 7,000 ACL reconstructions. This is one of the reasons why 85–90% of athletes treated at Shelbourne Knee Center return to sport at the same level within a year2.

“When it comes to your knees you don’t get a second chance,” says Dr. Shelbourne. “It’s common sense to get a second opinion.”

For more information about second opinions at Shelbourne Knee Center, call 888-FIX-KNEE.


References

  1. Shelbourne DK. Nonoperative Treatment of Knee Osteoarthritis, presentation at the Herodicus Society Meeting, June 2018.
  2. Unpublished data, 2018.