The following article is sponsored by University of Utah Health Care.
By Natalie Dicou
Mateo Jimenez was living a retiree’s dream. An avid skier, he headed up to the slopes every chance he could get. But a lifetime of kayaking, running and skydiving was catching up to him, and the osteoarthritis in his right knee began to throw a wrench into the fast-paced plans he had for his golden years.
Over the years, Jimenez had his knee scoped, received injections for the pain, and popped a lot of ibuprofen, and each treatment worked for a while to a varying degree, but by the time he was in his early 60s, he’d exhausted all of his minimally invasive options. A man who would ski every day if not for the pain was sidelined from the activity that gave him the most joy. His physician, Christopher Peters, M.D., an orthopedic surgeon with University of Utah Health Care, recommended knee replacement.
“We do knee replacements for people who are very, very sick and really need it so they can walk around the block to maintain their health,” Peters said. “We also do knee replacement on a recreational tennis player who was able to get by previously but now finds he can only play tennis for 10 minutes, and that’s his passion in life. More and more we are finding that knee replacement works well for more active patients who want to get back to activities like skiing.”
Peters stresses that one should never rush into a decision about knee replacement. He says the surgery yields its best results when patients exhaust every possible nonoperative option, including activity modification, weight loss, anti-inflammatory medicines and, in some cases, physical therapy. But when an individual remains functionally limited, and ideally is over age 60, the surgery can be a life-changer.
“I wanted to ski so bad, so I’d go and try to just baby my knee,” Jimenez said. “I used those rubber knee braces, but my knee would swell up.”
Eventually, he had to stay home – even on the best powder days.
But was knee replacement the answer?
Knee replacement — which comes in total and partial varieties — has made substantial headway in just the past decade. For starters, the quality of artificial joints has improved, and they now last for 15-20 years. Perhaps even more significant progress has been made thanks to new protocols that surround the surgery, including better pain relief, early mobility, early rehab and new anesthetic techniques.
“Some of these advancements in the past 5-10 years are making the process of undergoing knee replacement a much more comfortable experience and have largely ended the days when patients were writhing in bed after knee replacement,” Peters said.
In the old days, patients were told to stay in bed. Today, they are up and walking with the help of a physical therapist 4-6 hours after surgery. Staying mobile speeds recovery and helps to minimize the risk of blood clots, heart attack and stroke.
Because the knee is a much more complicated joint than the ball-and-socket hip, the surgery is trickier, and 80-85% of patients who undergo knee surgery are ultimately satisfied with the results. Satisfaction for hip replacement reaches into the mid 90s. Part of these numbers may be due to the increased popularity of knee replacement surgery among people who aren’t ideal candidates.
“We find that people who have really tried to live with their impairment for a period of time tend to do better than someone who may have had pain for a week and then gets a knee replacement,” Peters said.
Picking an optimum time for surgery is a fine balance, Peters said. When people reach the point where they need the surgery, it can work wonders. Peters frequently receives photos and videos of his patients skiing or cycling up Emigration Canyon.
“Those types of stories where people are basically returning to activities that they thought they wouldn’t be able to do again are pretty much the norm these days,” Peters said.
Returning to the slopes
Jimenez underwent knee replacement just as the ski season was ramping up — and he worried he’d miss the entire season. It’s common for patients to be able to go back to work within six weeks of surgery and to be golfing, skiing and playing tennis within three months. Sure enough, by March, Jimenez was skiing again, and for the first time in years, his knee felt great.
“He’s my fountain of youth,” Jimenez said of Peters who also performed hip replacement surgery on him. “I’ll be 72 in March, and I’m skiing over 100 days a year. That guy walks on water as far as I’m concerned.”
At first, Jimenez was afraid to ski because he wasn’t sure his knee was strong enough.
“I’m pretty smart when it comes to my body, so I started out just skiing for a couple of hours,” he said. “After I went 2-3 times, I thought ‘this thing is solid,’ and I started skiing harder.”
He said he owes his rapid recovery to the work he put in after surgery, especially activities like water aerobics — even if he was the only man in the class.
“You can’t get discouraged and go home and sit on your tail,” said Jimenez, who says he’s looking forward to the upcoming ski season and that, even years after his knee replacement, he’s feeling like he’s 45 again.
Do you think you or a family member might be a good candidate for knee replacement? Contact the University Orthopaedic Center at 801-587-7109.