Three weeks after total knee arthroplasty (TKA), Susan Simpson traveled from Crown Point, Indiana, to Chicago to see the musical Rent.This was the fourth knee surgery in 13 years for the 66-year-old grandmother, all performed by orthopedic surgeons at Shelbourne Knee Center.
Surgery Relieves Horrendous Knee Pain
Simpson’s knee problems started in 2006 when her left knee began to get stuck sometimes when she bent down. “I could not move it until the horrendous pain let up. Sometimes this would take 30 minutes,” she says. Simpson went to see K. Donald Shelbourne, MD, an orthopedic surgeon at Shelbourne Knee Center whom a family member recommended. Dr. Shelbourne diagnosed the problem as iliotibial band (IT band) syndrome, an injury to the strong, thick band of fibrous tissue that runs from the hip along the outer thigh to just below the knee joint.
While most cases of IT band syndrome are treated conservatively, Simpson’s IT band had tightened too much for this. In August 2006, Dr. Shelbourne performed arthroscopic IT band lengthening and Simpson’s knee problem resolved.
More Problems in Both Knees
Then, in October 2008, Simpson fell from a ladder and re-injured her left knee. “I remember crying out in excruciating pain,” she says. The next morning, Simpson could barely walk. She made the 2.5-hour drive to Indianapolis to see Dr. Shelbourne again.
“No one was going to touch my leg other than Dr. Shelbourne,” she says. “He’s amazing.” Dr. Shelbourne diagnosed an anterior cruciate ligament (ACL) tear and a meniscus tear. Since Simpson isn’t athletic, Dr. Shelbourne recommended physical therapy instead of surgery.
Simpson’s right knee became painful in 2011. Dr. Shelbourne performed diagnostic arthroscopy and found a partially torn meniscus and mild-to-moderate cartilage wear. Dr. Shelbourne performed a partial medial meniscectomy and chondroplasty to remove the loose cartilage flaps and debris within the right knee in April 2011.
Less Pain than Expected
Meanwhile, Simpson’s left knee had become painful again. This time, Dr. Shelbourne suggested ACL reconstruction. “I was really scared. I am not good with pain and I knew it was a long recovery for young athletes,” she says.
“I told Mrs. Simpson that if she did what we told her to do, she would be fine,” says Dr. Shelbourne. In July 2011, Dr. Shelbourne performed ACL reconstruction, using a patellar tendon graft to facilitate recovery, and a partial medial meniscectomy.
A week later, Simpson walked into her first follow-up visit without crutches or a cane. “I was so proud of myself. I did exactly what they told me to do.”
Those instructions included pre- and post-op physical therapy and bedrest for the first week post-op to minimize swelling and pain. During the first week, a continuous passive motion machine gently flexed and extended her knee joint and a knee cryo-cuff provided cold and compression. For pain, Simpson took only Tramedol, a non-narcotic drug, and Tylenol. “I recovered quite well and have not had a problem with that leg since,” she says.
Surgery Relieves Severe Knee Osteoarthritis
By the summer of 2018, Simpson couldn’t walk in the park, play with her seven grandchildren, or even finish grocery shopping due to severe osteoarthritis in her right knee. Getting in and out of the car was excruciating. “My life wasn’t enjoyable,” she says.
In April 2019, Simpson returned to Shelbourne Knee Center, hoping that the Knee Rehabilitation Program for osteoarthritis (OA) would solve her problem. She had read about this program and knew that only 24% of patients went on to have a TKA after completing it1.
But X-rays showed that Simpson had no cartilage left and surgery was the only way to relieve her pain. In April 2019, Rodney Benner, MD, an orthopedic surgeon at Shelbourne Knee Center, performed Simpson’s TKA. While Simpson was initially nervous about not having Dr. Shelbourne perform the procedure, by the time it was over she “had complete faith in Dr. Benner.”
The TKA post-op procedure was similar to that for the ACL reconstruction and meniscus repair. While the pain was worse after TKA, Simpson took only Tramedol and Tylenol.
Better than Other TKAs
Simpson says that her TKA recovery was easier than that of friends who also had the procedure. She went home the day after her surgery and rested her knee for the first week, while her friends were in the hospital for up to three days and were told to walk the day of surgery. Simpson also regained her range of motion faster than her friends.
Four weeks after surgery, Simpson says she’s doing “fabulously good. The doctors and physical therapists at Shelbourne Knee Center have got this down to a science.”
For more information about ACL reconstruction, TKA, and other knee procedures, call 888-FIX-KNEE.
References
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Shelbourne DK. Nonoperative Treatment of Knee Osteoarthritis, presentation at the Herodicus Society Meeting, June 2018.