BACK ON THE TRAILS
How A Knee Replacement Kept This Ultramarathoner Running
When intense pain forced ultramarathoner Jeff Gleason to drop out halfway through a 135-mile race, he knew he could no longer rely on ice, heat, stretches and medication to keep running. Gleason’s doctor told him the knee replacement he desperately needed would end his running days. After 40 years and more than 80,000 miles logged, Gleason wasn’t ready to switch to biking. Less than three months after a knee replacement with Dr. Richard A. Berger, a pioneer in tissue-sparing knee and hip replacement surgery, Gleason ran a half-marathon with ease. Eighteen months after surgery, Gleason ran a 100-miler.
After the ultramarathon—the Harbison 100 in Columbia, South Carolina—Gleason’s new knee felt like the rest of his body, sore but not incredibly painful.
“After any ultra, you feel like somebody beat you with a baseball bat,” Gleason, who hails from Pittsburgh, said. “Your thighs are sore from the pounding you take for 20 hours. My knee hurt, but it hurt just like everything else. It didn’t hurt like I have a bad knee.”
That’s Dr. Berger’s goal: to get patients’ joints back to their old days before arthritis added pain and subtracted function in their hips and knees. Since 2001, Dr. Berger, an assistant professor at Rush University Medical Center in Chicago, has performed more than 20,000 knee and hip replacements, including 12,000 as outpatient surgeries.
What sets these surgeries apart is Dr. Berger’s tissue-sparing technique. Traditional knee replacements involve cutting muscles, ligaments and tendons, which then heal with scar tissue that decreases function. This traumatized soft tissue also poses a conflict during recovery and physical therapy, Dr. Berger explained. The patient’s new knee must bend to gain function and range of motion, but the damaged muscles, ligaments and
tendons are painful and need to rest and recover. Since he hasn’t cut the patient’s soft tissue, Dr. Berger can test the new knee to determine its original, pre-arthritis position—another advantage over traditional techniques, he said.
“I restore the joint’s location to where it was before, which makes the joint function more normally,” Dr. Berger said. “The knee is a fine-tuned machine. If you’re off by even just a little, it doesn’t function right. When you put the knee in the right spot, the knee functions very smoothly with no gaps, no bounces and no clicks.”
When they come to him, some patients need accessible parking permits for people with disabilities because walking across a parking lot is too painful. Others are forced to wait for an elevator even for one flight of stairs.
Dr. Berger’s goal for his patients extends beyond eliminating their pain; he enables them to resume the activities they love, such as running marathons, skydiving, skiing or playing with children and grandchildren.
“We think of arthritis as grandma’s disease,” Dr. Berger said. “It’s not. The average age of the patients I operate on is 52. They’re younger. They’re active. They’re working. They’re taking care of their households, supporting their households.”
Gleason, who turns 63 on Oct. 27, started running at Texas A&M in the 1970s and ran his first ultramarathon, a 50-miler, in 2002. He averages about 70 miles a week, ramping that number up to about 100 miles per week during peak training for an ultramarathon. His ultramarathons are measured in both miles and days.
Gleason’s knee pain increased gradually. He took two months off from running after dropping out of the 135-mile race. He tried running again and couldn’t make it even a quarter of a mile.
Then, he accompanied a friend to a post-surgery appointment with Dr. Berger.
“Dr. Berger looked at my swollen knee and said, ‘What’s your story?’” Gleason recalled. The doctor sent Gleason for an X-ray that d ay and confirmed he could replace Gleason’s knee—and, yes, Gleason could resume running afterward.
Gleason had knee replacement surgery Jan. 30, 2018, started biking the next week, started a mix of running and walking by the end of February and ran five miles on March 8.
“I have to admit I was a little skeptical,” Gleason said of his return to running. “Because running had been such a large part of my life, I was willing to give [knee replacement] a try. I am putting as many miles on it as I did before the onset of the injury. On my final visit, I asked Dr. Berger if I could start training for ultras, and his answer was he would never recommend running 100+ mile races but if I was crazy enough to do it, the knee would not be a limiting factor.”