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After several joint replacement surgeries, Lorry Graham jokingly calls herself a “bionic woman.” Friendly and optimistic, the 75-year-old Delaware resident always enjoyed an active lifestyle. And she always felt younger than her chronological age. Therefore, when arthritis caused by wear and tear began to cause an unpleasant weight on the knees and hips, she refused to take it sitting. Over the past six years, she has had four joint replacements at New York City’s Special Surgery Hospital (HSS), both her knees and her two hips, so she can enjoy life without pain.
“The pain was very, very limiting. It was affecting my quality of life and I didn’t want to live like that, ” she says. She decided to do something about it and researched a lot. “There were three main factors I considered before surgery,” she explains. “The first was the best hospital I could find, which was HSS. The second was the best surgeon I could find. And the third component was my mental attitude and my willingness to do the work after surgery to get the best result. ”
For each joint replacement surgery, Ms. Graham, a former high school teacher and advisor, made the trip from her home in Delaware to HSS in New York City. “I always knew I had to do it. I love walking, I love shopping, I love playing with my grandchildren, ” she explains. “And arthritis made me limp, it hurt, it affected my sleep. This type of pain is shown on the face. You are not a happy person. I didn’t want to delay the surgery any longer than I had to. ”
Her doctor, Geoffrey Westrich, MD, who specializes in knee and hip replacements in HSS, says it’s not uncommon for patients to have advanced arthritis in two joints. Having four joint substitutions is less common, but it does happen. He recommends that patients considering various joint replacement surgeries do their research to find a high-volume joint replacement center and an experienced orthopedic surgeon who takes the time to answer all their questions and who they are comfortable with. .
“When someone has more than one joint replacement, timing and recovery are important and no two patients are alike,” says Dr. Westrich. “If someone has painful arthritis in both knees, for example, and conservative treatments like physiotherapy and over-the-counter medications offer no relief, we usually wait about three months between surgeries. It’s the time it takes the body to heal. and the time it takes to do physical therapy and make the muscles strong again. Patients will support their weight with the side that underwent the first surgery. ”
Dr. Westrich adds that a critical factor is the surgeon’s experience in knowing when it is safe to proceed with the next joint replacement. That’s why, after the first postoperative visits, Dr. Westrich sees the patients again after six weeks to make sure they are doing well, and sometimes after three months, before proceeding with a second joint replacement.
These days, on the same day, double replacements of the joints are performed less frequently, as Dr. Westrich and other HSS researchers have found that it is best for most patients to have “in-phase” procedures, that is, to have the surgeries performed at least months apart. “In studies, we have found that bilateral knee replacement surgery on the same day can present more challenges for the patient from a medical point of view, more pain medications are needed after surgery and physiotherapy is much more difficult because they don’t have a good standing leg, so to speak, ”he says.
Dr. Westrich points out that sometimes there is a good reason to perform a bilateral joint replacement on the same day. For example, both arthritic knees may have a severe flexion contracture, meaning they are in a bent position and the patient cannot straighten them. “In these cases, it may be appropriate to do a double joint replacement, as physiotherapy can be much more difficult if the unoperated knee is bent.” He adds that if the contracture is not too severe, a shoe lift can equalize the length of the legs and allow the patient to do physical therapy after two different procedures.
Mrs. Graham had four different surgeries and, less than two months after her final hip replacement in May, said she was feeling very well. “I am shaking this, I am totally shaking it. I went to play mahjong with my friends and when I came in, they couldn’t believe how good I looked and how good I was doing.”
She believes her mental attitude and willingness to work hard in rehabilitation after surgery played an important role in optimizing the outcome of each joint replacement. Dr. Westrich agrees that going in with a positive attitude and dedicating yourself to work can improve outcomes.
“Clearly, Lorry Graham was very interested in his recovery and worked very hard after the surgery to get a good result,” he notes. “There is no doubt that patients who work hard and spend a lot of time on physiotherapy tend to progress faster and have a better overall recovery.”
Just two months after her last hip replacement, Mrs. Graham visited a new New York City park with her friend and walked for more than an hour without pain. “I walk everywhere,” she says. “I am doing better than in the last six years. It feels great. ”