When David Huxtable’s left leg started collapsing every time he stood after total knee arthroplasty (TKA), he knew that something was wrong. “Every time I took a step on my left leg in physical therapy, my leg would pop out sideways,” says Huxtable, who is 70 years old and lives in Lafayette, Ind. Huxtable’s pain was more severe than it had been before the procedure.
Four years earlier, the retired aerospace engineer had his right knee replaced, so he knew that what he was experiencing wasn’t normal. The surgeon who performed the procedure told Huxtable that nothing was wrong, and he needed to build up his muscle strength through physical therapy. But more physical therapy didn’t make Huxtable’s knee stronger or more stable.
Huxtable decided to get other opinions on his case. His made an appointment with Rodney Benner, MD, an orthopaedic surgeon at Shelbourne Knee Center. “Mr. Huxtable’s ligaments were too loose and the implant components were tipped inward and toward the back in a way that wasn’t properly aligned with his knee,” says Dr. Benner. “He needed revision TKA.”
Orthopedic Surgeons Agree
Huxtable now had one opinion that everything was fine and another that he needed revision TKA. He went to see two more surgeons, who both agreed with Dr. Benner about the need for revision surgery. “I decided I would entrust Dr. Benner with the task of doing the revision to my knee,” says Huxtable.
Experience and Meticulous Surgical Technique
Unlike many orthopedic surgeons who perform primary TKA, Dr. Benner regularly also performs revision surgery. He has extensive expertise in the technically challenging procedure, which requires meticulous preoperative planning and the use of specialized tools and patience during the procedure to preserve as much of the bone as possible.
Dr. Benner is also co-author of “Tibial Tubercle Osteotomy in Revision Total Knee Arthroplasty,” published in Techniques in Revision Hip and Knee Arthroplasty, (Giles R Scuderi MD, author, 1st edition, 2014).
A Smooth Recovery
Dr. Benner performed the revision surgery on Huxtable on August 14, 2017. “I woke up afterward and everything was fine,” says Mr. Huxtable. “The job Dr. Benner did was remarkable. I did not need to take a single pain killer.” Huxtable had needed pain medications after his other knee replacements.
Shelbourne Knee Center’s process for primary and revision TKAs includes precautions and interventions to minimize pain and swelling and facilitate healing. These include:
- A Continuous Passive Motion machine that keeps the knee elevated and continuously moving at a small degree of flexion
- A compression stocking
- A Cyro-Cuff, to provide cold and compression. K. Donald Shelbourne, MD, orthopedic surgeon, invented the Cyro-Cuff
- Lying down with the leg elevated for the first week after surgery
- A post-op knee TKA rehab program that focuses on restoring range of motion before strengthening
Huxtable’s post-op rehab began one week after surgery and continued for about six months. He had no problems.
“Dr. Benner and the staff at Shelbourne Knee Center know what they’re doing,” says Huxtable. “Dr. Benner was honest with me, and he’s easy to talk to.”
David Huxtable’s Outcome
At 12 months post-op, objective testing and Huxtable’s self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS) survey showed considerable improvement:
- ROM:
- New knee:
- 2 degree of hyperextension to 135 degrees of flexion
- Normal knee:
- 2 degrees of hyperextension to 135 degrees of flexion
- Quadriceps muscle strength:
- 116% compared to normal knee
- KOOS survey (higher scores are better):
- Pain score:
- Pre-op: 69
- Post-op: 100
- Symptoms score:
- Pre-op: 46
- Post-op: 96
- Activities of daily living:
- Pre-op: 78
- Post-op: 100
- Sport:
- Pre-op: 50
- Post-op: 100
- Quality of Life:
- Pre-op: 6
- Post-op: 100
- Pain score:
- New knee:
Return to Normal Life
Since his revision TKA, Huxtable has been able to travel again and enjoy life. He and his wife, Darlene, have made several trips to Florida, where they plan to move soon. They’ve also visited San Diego, where they lived before moving back home to Indiana.
“Recently, I spent six hours walking around at the Indiana County Fair, with no problem whatsoever,” says Huxtable.
To schedule an initial appointment or second opinion, please call 888-FIX-KNEE. To refer a patient for a consultation, visit https://fixknee.com/for-physicians.