Bouncing back after knee replacement surgery
Machine shop owner Kim Smith has spent most of his career working on unforgiving concrete floors, so he wasn’t surprised when his knees started acting up a few years ago.
The Harvest resident tried steroid injections to stay mobile and keep his chronic joint pain at bay, but it wasn’t a permanent fix. By 2011, walking had become such a chore that Smith decided to try knee replacement surgery.
“I had this stabbing pain that was with me all the time,” he said. “That sort of pain will change your personality and turn you into someone who no one else wants to be around. It also takes away your desire to be active.”
Smith made an appointment with Howard Miller, MD, at The Orthopaedic Center (TOC) on Huntsville Hospital’s campus. Dr. Miller is one of the area’s most experienced orthopedic surgeons and specializes in joint replacement.
In October 2011, Smith had his right knee partially replaced by Dr. Miller at Madison Hospital. During a partial knee resurfacing, only the damaged portion of the knee is replaced; healthy bone and ligaments are preserved.
Smith worked hard in physical therapy and bounced back quickly, returning to work just three days after leaving the hospital.
While his surgically-repaired right knee continued to get stronger, Smith’s left knee got worse. Earlier this year he called Dr. Miller again and scheduled partial replacement surgery for mid-April, this time at Huntsville Hospital.
Smith completed the hospital’s Joint Camp program to help regain strength and flexibility in his left knee. He recently began walking at the Monrovia Community Center near his home. Once the knee is fully healed, Smith, 61, said he looks forward to playing basketball with his grandchildren again in the driveway.
‘GET IT DONE’
“If I could do it over again, I would have had replacement surgery a lot sooner,” he said. “I’d advise anyone who was in my situation to just go ahead and get it done. There’s no point living with the pain.”
Smith isn’t alone. Thousands of North Alabama residents suffer from osteoarthritis or joint trauma that limits their daily activities. Many of them turn to TOC and Huntsville Hospital or Madison Hospital for help. In 2015, orthopedic surgeons performed 1,249 knee replacements, 685 hip replacements and 88 shoulder replacements at the hospitals.
Dr. Miller said joint replacement surgery has made remarkable strides during his career. As recently as the late 1970s, they were performed infrequently, carried a high risk of complications and confined patients to a hospital bed for 10 days or more.
But continual advances in surgical techniques and artificial joints have convinced Dr. Miller that knee and hip replacements will eventually become outpatient procedures.
“We’re getting pathways together for that to happen in Huntsville,” he said. “Our current length of stay in the hospital is three days at the most, and some patients are going home after a night or two. It’s become a more predictable operation, and the risk of infection is now less than one half of 1 percent.”
Patients are also getting serious mileage – often 25 years or more – from today’s artificial joints, which are crafted from durable metals such as titanium, cobalt and chromium.
At Huntsville Hospital, the vast majority of joint replacement patients go to Joint Camp within hours of surgery.
Started in 1998 and housed on the hospital’s fifth-floor Orthopedic Unit, Joint Camp specializes in post-surgical physical therapy. More than 1,600 patients graduated from the program in 2015.
Joint Camp nurses and physical therapists get all patients up and moving on the morning after their surgery – if not sooner. Twice a day, patients have hour-long group physical therapy sessions where they support and encourage each other. The therapy includes bending and flexing surgically-repaired knees or hips, moving with the aid of a walker and climbing steps.
Between Joint Camp sessions, patients are strongly encouraged to walk the halls of the Orthopedic Unit. The more movement, the better.
“Our therapy is the key to every patient’s recovery,” said Joint Camp Director Catherine Brown, board-certified Adult Clinical Nurse Specialist. “We’re working toward getting everyone up and moving on the day of their surgery. Patients who start moving sooner tend to recover more quickly and don’t need to stay in the hospital as long.”
Joint Camp patients gave the program high marks on the most recent federal Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Ninety-one percent said they would always recommend Joint Camp, while 85 percent rated the overall quality of care a 9 or 10 on a 10-point scale. Those patient survey responses placed Joint Camp in the 95th percentile or better of similar programs nationwide.
Huntsville Hospital has also been a Blue Cross and Blue Shield of Alabama Blue Distinction Center for both knee and hip replacement surgery since 2013.
“I believe we have a stellar team,” said Brown.