Total Right Knee Arthroplasty
A 64-year-old construction company superintendent and wrestling coach is back to work following total knee arthroplasty at Sacred Heart's Joint Replacement Center.
The revamped joint replacement program embraces a model of wellness and early mobility designed to get patients back on their feet and moving faster than traditional programs. The track and field themed "Back on Track" program is a collaboration between PeaceHealth and the Slocum Center for Orthopedics.
New protocols designed for shorter length of stay, faster recovery and superior outcomes include minimal use of nerve blocks, elimination of continuous passive motion (CPM) machines, group exercise and physical therapy classes, strong encouragement to discharge directly home, emphasis on direct referral to outpatient therapy when possible.
David Krull, the subject of the following case study, had his right knee replaced several years before the Back on Track program was implemented, and his left knee replaced under the new program.
Subject: David Krull, 64, a construction company superintendent and wrestling coach, complained of severe pain in his right knee that limited function and caused sleep problems. His medical history included left total knee arthroplasty in 2009, before Sacred Heart implemented the Back on Track Joint Replacement Program.
Diagnosis: Mr. Krull was diagnosed with severe right knee osteoarthritis. Nonoperative modalities such as activity modification, ambulatory aids, injections, ibuprofen and Tylenol had failed to ease his discomfort. He was scheduled for right total knee arthroplasty at Sacred Heart with orthopedic surgeon Steven Shah, MD, of Slocum Orthopedics.
Treatment: Following total knee replacement, the patient was transported to the Joint Replacement Center within an hour. He progressd well with the rapid recovery physical therapy progam, and had excellent range of motion and walking ability by the second postoperative day. The multimodal pain protocol kept his pain scores very low, and his narcotic pain medicine use was minimal.
Outcome: After two nights in the hospital, the patient was discharged home with outpatient physical therapy, and continued to progress with his recovery over the subsequent months. Mr. Krull praised the care he received at thr Joint Replacement Center. "The care I had at the hospital was incredible," he said. "My whole way of life has changed. I can go hunting again, I can go fishing again. I can play with my grandson. Before, I could barely walk." The patient was happy with his experience following left total knee in 2009, but did state that the Back on Track Joint Replacement Program took things to "another level."
Post-Operative Images of Total Knee Arthroplasty
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