In Need of Knee Replacement?
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Rapid Recovery and Restored Mobility at Towson Orthopaedic Associates
Imagine being a natural born athlete who played Division I lacrosse and field hockey in college, only to reach your middle years and feel the excruciating pain of bone on bone and arthritis in your knee. For anyone — star or everyday athlete — the crippling sensation of knee pain can ruin the quality of life.
Knee pain is common as people age, often caused by an old injury or the gradual wearing away of knee cartilage. Former college athlete Lynn Verity Flynn, of Baltimore County, went from participating in lacrosse, field hockey, horseback riding and gymnastics in her teens and 20s to having her athletic life come to a painful halt in recent years. "I got into my 40s, and my knee just went out on me!" recalls Flynn, age 56, who is executive national vice president at Arbonne. "I had a national conference in Las Vegas and could hardly walk through the hotel, my knee swelled so badly." Her inactivity also caused her to gain weight for the first time in her life. The culprit was an old gymnastics injury that had caused the knee cartilage to deteriorate.
A Life Changer — From Pain to Gain
At first, Flynn tried intermediate therapies such as inflammatories and cortisone shots, but when they stopped working and she couldn't take the pain and weight gain anymore, she did her research to find the best possible orthopedic practice for her knee replacement.
"I had learned a lesson from watching my mother go through a hip replacement. She didn't do her research before choosing her surgeon and didn't get the result she wanted," says Flynn.
As Flynn searched for an orthopedic surgeon, "the same name kept coming up again and again — Towson Orthopaedic Associates," she recalls. She chose to have her knee replacement performed by board-certified orthopedic surgeon David F. Dalury, MD, one of a group of experienced joint replacement specialists in the practice. "The result has been life changing," says Flynn.
The expert orthopedists at Towson Orthopaedic Associates (TOA) — including Brian D. Mulliken, MD, David Schroder, MD, and Scott J. Tarantino, MD — specialize in a unique approach they created called "rapid recovery". "The concept of rapid recovery from knee replacement is that patients now experience much less pain in the period after surgery, are able to be more mobile, and return home safely from the hospital much earlier than in the past," says Dr. Mulliken. "As a result, patients experience a much quicker recovery over time."
Unique Post-Op Pain Formula
"University of Maryland St. Joseph Medical Center deserves a lot of credit for adopting rapid recovery for joint replacement," says Dr. Dalury, who explains that the expert anesthesiologists and surgeons at UM St. Joseph Medical Center teamed up to create a formula for pain relief that is so effective that scientific papers have been published about it nationally and world-wide. "We were one of the earliest practices in the country to do this," says Dr. Dalury, who humorously refers to the formula as a "cocktail we created here locally."
The "cocktail" is a series of medications that are delivered into the area surrounding the newly implanted knee at the end of the operation, while the patient is still in the operating room. This form of delivery is called local infiltrative analgesia.
"The main reason that patients didn't opt for knee replacement in the past was fear of pain," says Dr. Dalury. "Our pain relief formula minimizes opioids by using several different types of medications that affect the cycle of pain. These low doses of medications work in tandem without the side effects of opioids. Rapid recovery is a very different approach that combines excellent patient education, enhanced pain management and focused physical therapy," he adds.
Flynn remembers waking up from her knee replacement surgery and thinking, "This is amazing. I feel so good. I had no pain. The analgesia lasted for 36 hours. I could get up, go to the bathroom and do a little bit of physical therapy there in the hospital." Although an accomplished athlete, she calls herself "a wimp about surgery," because she was afraid there would be pain. "I had never had surgery before," Flynn says, "but it was the best decision I ever made. If I can do it, anyone can do it. The nurses made me very comfortable. I was definitely taken very good care of at St. Joe's."
Good Reasons for Knee Replacement
According to Dr. Mulliken, a candidate for knee replacement is someone who has advanced arthritis, significant pain and functional limitations. "Most patients have exhausted all the non-operative measures for treating arthritis and usually benefit tremendously from having their knee replaced," he adds.
"Knee replacements are very predictable, durable and reliable. They provide 90 to 95 percent pain relief and the complication rate is very low, just one to two percent," says Dr. Dalury. "At four to six weeks after surgery, patients are feeling comfortable and confident, and the knee is working very well technically."
Most patients go home the day of surgery or the following morning. "They receive home physical therapy and nursing for the first week to ten days so they do not have to leave the house. Pain is generally very low and can be well controlled with oral medication," says Dr. Mulliken. Physical therapy continues for approximately six weeks, with progressive increased activity. Full recovery takes about two to two and a half months.
"Eight weeks after surgery, I was driving," says Flynn. A year later, she was back to her athletic life. "My new knee has zero pain ever. I work out at twice a week at a cross-fit type fitness center. There was no way I could have done that before surgery." In addition, Flynn's weight gain has come off. "My business is health and wellness. It was very challenging for me not to be able to be the person I usually am. Now because of the knee replacement, I look and feel authentically my best self."
"The typical feedback I get from patients after knee replacement is tremendous satisfaction, much less pain, much greater functional activity and many patients state that they are grateful for getting their life back," says Dr. Mulliken.
Knee replacements also provide longevity. "Most knee replacements are doing very well at 20 years out," says Dr. Dalury.
Made of chrome cobalt and surgical steel, knee replacements come in different shapes and sizes, so that the surgeon can achieve an individualized replacement. Technically the operation is much less invasive than it was previously, is performed in less than an hour in the hands of experts, and can be done without placing the patient under general anesthesia, explains Dr. Mulliken.
"They function very much like normal knees for routine daily activities," adds Dr. Mulliken. "They also work well for light recreational activities and exercise, such as riding a bike, swimming, rowing machines, elliptical and sports such as doubles tennis or playing golf on a regular basis."
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