MY VERO: Joining the knee-replacement crowd

By Friday afternoon, as long as there are no physical setbacks beforehand, I will have become one of thousands of Vero Beach-area residents to have undergone knee-replacement surgery.

It will be the first of the two knee arthroplasties I have planned across the next two months. The right one gets replaced this week. The left one is scheduled for mid-July.

If all goes well, I’ll be back on the tennis court by Halloween … I hope.

There’s no way to know going in. Not everyone progresses through the post-operative rehab process at the same rate, with the same results. But even if everything goes as well as expected, this will be a lost summer, at least when it comes to playing tennis and golf.

And for those wondering: The summer would’ve been lost even if I had both knees replaced at the same time.

Unfortunately, I didn’t have that option. While some orthopedic surgeons do perform bilateral knee replacements – and mine had agreed to do so, though he prefers to put at least six weeks between operations – the folks at Indian River Medical Center no longer allow it.

The reason?

No answer was readily available from IRMC. According to several knowledgeable sources, however, one local orthopedist experienced complications while performing double knee-replacement surgery on at least two occasions and hospital administrators decided to suspend the procedures to further reduce the risks.

“It’s not like it’s not done,” said Vero Beach’s David Griffin, who was considered among Florida’s top orthopedic surgeons before he retired two years ago. “It’s just more risky.”

Those patients who opt for bilateral knee-replacement surgery are under anesthesia for up to four hours, more than twice as long as needed for single-knee procedures. In most cases, they also require blood transfusions.

There’s a higher risk of potentially dangerous blood clots developing. Same goes for infection, which, if one occurs, could require both prostheses to be removed until the problem is treated. Also, the rehab following double knee-replacement surgery is considerably more difficult, because the patient doesn’t have a good leg to stand on.

Still, Sebastian River Medical Center spokeswoman Angela Dickens said she knew of no policy prohibiting bilateral knee-replacement surgery at that hospital.

Some local orthopedic surgeons will stagger the procedures, replacing the knees only days apart, a process that requires only one hospital stay, one trip to the operating room and one rehab period. There’s additional risk in that, too, but even for those with health insurance, out-of-pocket costs are reduced by thousands of dollars.

My guy is Chris Talley of Pro Sports and Pro Spine in Vero Beach. I like him and trust him. I’m confident he’ll do a terrific job on my knees, which he has been treating for the past three years. And I’m not heaping praise merely because we’re both Washington & Lee University alums.

When I moved back to Vero Beach in 2011, I did my homework. I asked around. I talked to friends and acquaintances, and especially tennis players, who were seeing local orthopedists, then made my choice.

I did the same when selecting a surgeon for this life-altering operation, though I never seriously considered anyone else. Talley knows me, knows my knees, knows what I want from all this.

That matters to me.

“Probably 50 percent of knee-replacement patients just have such severe pain that they can’t function in their daily lives,” said Griffin, who arrived here in 1980 and performed knee-replacement surgeries throughout his 33-year career. “The other 50 percent want to maintain an active lifestyle.”

For those who don’t know: Knee-replacement surgery dates back to the late 1960s, grew in numbers through the 1980s and began to boom in the 1990s – a surge that continued into the new millennium. The procedure now has become popular among many in the 65 to 75 age group.

Baby boomers, Griffin said, are proving to be more active, more athletic and more concerned with physical fitness in their retirement years than seniors from previous generations. Some years, he added, 1,000 to 1,200 knee-replacement surgeries were performed at IRMC.

“When I was really going,” he said, “I’d do 250 to 300 a year.”

The numbers recently aren’t nearly as high, at least partly because Griffin, whose specialty was knees, has retired and Dr. Omar Hussamy now operates at SRMC. Also, many local seniors already have undergone the surgery.

In fact, Dickens said 268 total knee replacement surgeries were performed at SRMC in 2013, and 107 have been done already this year.

IRMC’s numbers weren’t readily available. But according to FloridaHealthFinder.gov, website for the Agency for Health Care Administration, 412 total knee-replacement surgeries were performed at the Vero Beach hospital between October 2013 and September 2013.

Of those 412, a total of 305 involved patients ages 65 and up.

“In the ’80s, we would tell patients to wait, because a good result was knee that lasted seven to 10 years,” Griffin said. “Now, if the surgeon does a good job and the patient doesn’t abuse it, you’re looking at a 20-year knee. So for someone like you – 55, active, quality of life severely hampered by knee pain – there’s no reason to put it off.

“You’re going to need it eventually,” he added. “You might as well do it now and enjoy being active for the next 20 years.”

That’s exactly what I was thinking.

Which brings me to this: How did I get here? How did I beat up my knees to the degree where I need new ones? What finally pushed me to the point where I decided I had enough?

Truth is, I’m younger than most people needing this kind of surgery. But years of running and playing numerous sports and carrying furniture upstairs while helping people move destroyed the cartilage in my knees.

Running was especially harmful, considering that when I started jogging in the 1970s, running shoes offered little cushioning and no real support. They were little more than light sneakers. And when I played lacrosse in college, our offseason training consisted of running many miles up and down the hills of western Virginia.

I continued to run until 10 years ago, when I tore cartilage in my left knee while playing tennis. From then on, my running days were done. But I was able to play tennis.

Eventually, though, even tennis hurt. There was surgery to clean up a torn meniscus in my right knee, deterioration of the cartilage in both knees and a couple of cortisone shots. But they were just temporary fixes.

The pain just kept getting worse, and not only on the tennis court. There is no cure for advanced osteoarthritis. There’s only knee-replacement surgery.

“Everyone’s different,” I remember Talley telling me not too long ago. “Everyone has their own pain tolerance. When the time comes, you’ll know. Your knees will tell you.”

They have.

Although I continue to read about the advances being made in orthopedic science and the new materials being developed and tested, I’m ready now. I’m eager to put all this pain behind me. I’m not going to wait.

Besides, Griffin said it’s better to go with both a surgeon and product that have proven records of success.

“A lot of people who are thinking about knee replacement will research it first – go online, look at doctors’ websites and read about the latest technology,” Griffin said. “But the latest technology doesn’t have any track record. So you’re probably better off going with a doctor and prosthesis that has been around for five or 10 years.”

That’s what I’m doing. I’m going with Doc Talley and Stryker’s “Triathlon Knee System,” which debuted in 2005. I know the rehab will be rough and that I’ll be doing this all again this summer.

But I’m excited about Friday morning and getting my new knees and, more than anything else, significantly improving my quality of life… and, maybe, my tennis game.

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