Less Pain, More Gain
Muscle-sparing Knee Replacement Surgery Empowers Faster Recovery
Penny Pitou has repeatedly made history by overcoming obstacles. No girls were allowed on her high school ski team, so Penny skied as “Tommy.”
When, at 16, she began having issues with her left knee, necessitating the removal of some cartilage, the surgeon told her she’d never ski in the Olympics. Despite that prediction, she went on to become the first american to medal in downhill skiing, winning two silvers in the 1960 Olympics. Now nearly 80 years old, Pitou owns Penny Pitou travel and leads skiing and hiking tours in the alps.
last year, she realized it was time to address the left knee that had been troubling her for years, and she knew she needed to find a doctor who could get her back on her feet in the short window between skiing and hiking seasons.
Leaving Pain In The Dust
Pitou’s friend — a fellow skier and former joint replacement patient himself — strongly recommended Dr. richard a. Berger of rush University Medical center in chicago. Pitou decided that traveling to chicago from her home in New Hampshire would be worth it to get the results she sought. “I was a little nervous about the whole thing,” Pitou says. “But it was very easy. Once I made the first phone call, all I had to do was follow the instructions of Dr. Berger and his staff. they are very organized.”
Pitou up walking just a few hours after surgery and climbing steps soon after. Friends had warned her about excruciating pain, but the discomfort was considerably less than she had anticipated. In fact, she was back to work part time just six days after surgery.
In only 12 days, she was walking on local trails. after three weeks, she regularly walked along cross-country trails and up lower hills. Dr. Berger’s staff had told her that at six weeks she’d be at 90 percent, and she took them at their word. Six weeks post-surgery, she went cross-country skiing and started hiking regularly — first for 90 minutes to three hours, and then for up to five hours.
“the first time I did a major hike after surgery, I thought I’d forgotten something or something was missing,” Pitou says. “It occurred to me that what was missing was my knee pain. after being on the mountain for four or five hours, I was pain free.
It was unbelievable. even when I got in and out of the car, I could do it without feeling any pain.”
the prospect of excruciating pain and a long recovery is what prevents many patients from getting a bad knee replaced as soon as they should, according to Dr. Berger. “People are afraid of pain from surgery,” he says. “So they endure their arthritic pain for months or years. For my patients, there’s only a little discomfort involved. Once your motion comes back, your pain goes away. My patients get their motion back extremely quickly, and therefore their pain goes away extremely quickly.”
Innovative Surgery Speeds recovery
the key differentiating factor is the way in which Dr. Berger performs knee replacement surgery. the traditional surgery is performed with the knee bent and involves tearing or cutting the quadriceps muscle. this creates a conflict after surgery: the muscle needs to heal and therefore doesn’t want to move, but the new knee needs to move so it doesn’t become stiff.
“In traditional knee replacement, the physical therapist is telling you, ‘Move your knee or it’s never going to move again,’” Dr. Berger says. “Meantime the muscle is saying, ‘I don’t want to move.’ that’s why traditional knee replacement is so painful. With traditional surgery, patients struggle for months with their physical therapy because their muscle doesn’t want to move.”
Dr. Berger’s technique goes beyond minimally invasive to a true muscle-sparing procedure. Dr. Berger, who also earned a mechanical engineering degree from MIT, designed special tools to enable the surgery to be done with the knee extended so that the quadriceps muscle is relaxed and can be pushed aside without tearing or cutting. He is one of only a few surgeons in the world who does the surgery this way. Since 2002, he has performed about 1,000 knee replacements per year, and a majority of these patients leave the hospital the same day.
Less Downtime makes A Difference
Post-surgery results reveal the biggest benefits of Dr. Berger’s method. the other difference is his special high-flex designed knee engineered to provide more range of motion after surgery.
after months of pain and physical therapy following traditional surgery, patients
eventually regain range of motion. “a lot of them will fall short and end up with a knee that doesn’t bend and perform the way they want,” Dr. Berger says. “It’s still hard to get up and down out of a low chair or low toilet seat. they still take stairs one step at a time. they have to use the armrests to get off a chair.”
In comparison, Dr. Berger’s patients breeze through physical therapy in two or three weeks. they ultimately regain 95 percent of range of motion, compared to about 80 percent for traditional knee replacements.
Besides pain, the other issue that worries patients is the need to take weeks or months away from work, Dr. Berger says. “they worry about the downtime,” he says. “they just can’t take the time off. Many people can’t afford to take three or four months off from work.”
With Dr. Berger’s approach, people can return to a desk job in a week or two, and return to a more active job in three or four weeks, he says. He does knee replacements on people of all ages — some in their 20s and 30s. “this isn’t just ‘Grandma’s Disease,’” he says.
Pitou And other Patients Get Their Lives Back
For years, Pitou had babied her left leg but put off doing anything about it. “When hiking uphill and downhill, I’d always favor my left leg,” she says. “When skiing, I could ski on one leg just fine. So I ignored it.”
By the time they have surgery, most patients have made numerous concessions — giving up the activities they love because they’re in pain, Dr. Berger says. “they don’t go for long walks. they don’t play golf. Gradually, they pull away from the life they’ve enjoyed. Normal life is slowly taken away from them. Some of them are housebound, imprisoned sitting in an easy chair or even in bed,” he says.
after surgery, most patients tell him: “‘thank you for giving me my life back.’”
Five months after surgery, Pitou led eight days of hiking in europe with huge ascents and descents of up to 4,600 feet in one day. “I thought, ‘I will die,’” she recalls. “and you know what? I was fine. the knee was terrific.”
Seven months later, her knee is great, and she’s looking forward to ski season. “I don’t even know I have a new knee,” she says. “It’s fabulous. I feel like I have a different body from the waist down. I’m ready to ski.”
Getting your life back will require about the same time investment as a vacation. “Instead of going to Disney World this year, have your knee replaced,” Dr. Berger says. “Get your life back.”
then when you take the next vacation, you’ll be ready for golfing, chasing grandkids — even skiing or hiking with an Olympic champion.
For more information and additional patient stories, visit outpatienthipandknee.com.
“For my patients, there’s only a little discomfort involved. once your motion comes back, your pain goes away. my patients get their motion back extremely quickly, and therefore their pain goes away extremely quickly.” Dr. Richard A. Berger Rush University Medical Center, Chicago