Back on Track
Kim Piper, RN, was in pain. Kim oversees the genetics program for the Iowa Department of Health, but as a former labor and delivery nurse, she spent years on her feet in a hospital setting, which had taken a toll on her knees.
When knee pain put her plans to walk a marathon on hold, Kim sought the help of her family physician. She was diagnosed with arthritis in both knees, which significantly reduced her ability to function without pain.
After a year of treatment, Kim's knee pain required the intervention of an orthopaedist. Kim was referred to Des Moines Orthopaedic Surgeons' David A. Vittetoe, MD, practicing at Methodist West Hospital.
"We started with steroid injections in both knees," says Kim. "When that no longer worked, we tried injections of synthetic viscosity medications that I called 'joint lube.' When the pain still kept me up at night, we discussed the option of total knee replacement."
Kim and Dr. Vittetoe decided to replace her left knee joint because it was causing more pain than her right knee. She was educated about the procedure in the Total Joint Class at Methodist West.
In the past, knee replacement surgeries were delayed until patients were older to reduce the likelihood of needing more than one joint replacement surgery on the same joint. With time, man-made joints can loosen and deteriorate, but new data shows today's prostheses are lasting longer.
"Contemporary hip and knee replacements are more durable than they have been historically, making them viable options for patients Kim's age," says Dr. Vittetoe. "We felt her functional status had declined to an unacceptable level, and joint replacement surgery was warranted. Our goal for each patient is to reconstruct the joint to be as close to 'normal' as possible."
In Good Hands
Kim was prepped for surgery and given a spinal block, which numbed her lower extremities. The joint replacement surgery took about 45 minutes, and Kim was walking later that evening with the aid of a walker.
Requiring only oral pain medication, Kim was able to move around her room, walk down the hall and practice climbing stairs the first day after surgery. On the second day after surgery, she could walk with crutches.
"My care after the surgery was excellent," says Kim. "The nursing staff was very attentive, the support staff on the orthopaedic floor was knowledgeable and the physical therapy staff was very encouraging."
A Healing Environment
Joint replacement surgery is becoming a more common procedure. Outcomes for the vast majority of patients are good in terms of pain relief and return to former levels of functioning.
Total Joint and Spine Services at Methodist West include a 34-bed orthopaedic unit that specializes in total joint replacement. Each room is designed with patients recovering from joint replacement surgeries in mind.
Kim was able to walk into the shower and sit on the second day of her hospital stay. Each private room also features hotel-like accommodations for family members.
"It was a unique experience to be a part of the planning for a new hospital," says Dr. Vittetoe. "Working together with referring physicians, anesthesiologists, nurses and therapists, we have taken a team approach to the care of joint replacement patients."
Because of the ice and snow in mid-December, Kim was thankful she had been prescribed in-home physical therapy for the first two weeks. She knew an injury in the first six months after surgery might result in revision surgery to repair the joint.
Later, better able to navigate icy sidewalks, Kim attended three weeks of outpatient therapy. She returned to work four weeks after her knee replacement surgery, feeling it had been well worth it.
"I'd like to thank all the staff at Methodist West and my orthopaedic surgeon for giving me the opportunity to walk without pain," says Kim. "I feel fortunate to have been referred to Dr. Vittetoe. I credit his expertise and the excellent care I received at Methodist West and at physical therapy for my quick recovery."