Eddie's new knees
Knee replacement surgery gives Higbee man
a chance to walk without pain
|His legs wrapped
in iodine-impregnated film, Eddie Edwards undergoes double knee
replacement at Columbia Regional Hospital. Hockman uses a number
of specially designed tools for knee surgery. His procedure is
less invasive than knee replacement surgeries done in the past
few years. The entire operation is done through a 4- to 5-inch
incision. He also cuts less muscle tissue which leads to speedier
recovery by his patients. Eddie was able to walk again the day
after his surgery.
Last fall Eddie Edwards
did something he truly enjoys. He loaded his horses in a trailer and
headed to Eminence for the Cross Country Trail Ride. Unfortunately
for Eddie, a member of Howard Electric Cooperative who lives near Higbee,
the experience was not pleasant this time.
in his knees left him unable to walk more than a few steps and mounting
a horse was sheer agony. “Usually I walk to the mess hall,” Eddie
says. “This year I drove.”
For 10 years the
pain in Eddie’s
knees had gotten steadily worse. Doctors advised him to wait until the pain
became too great to tolerate. In October Eddie, 62, was at that point.
pain was 40 and the scale only goes to 10,” he says. Getting
up hurt. Sitting down hurt. He felt pain with every step. The time had
come to seek some relief.
Paula, works as a nurse in the rehab unit at Columbia Regional Hospital.
Over the years she had seen a number of patients undergo knee replacement
surgery. She learned of a new technique performed by Dr. David Hockman,
a surgeon with the Columbia Orthopaedic Group.
“So many of
his patients do so well,” Paula says. “They get
moving so quick. So that’s where we headed.”
been replacing knees for about 30 years. Nearly 250,000 Americans
get new knees each year, with the number increasing as the population
ages. But in the past knee surgery involved huge incisions and cut
muscles that left patients with a long, painful recovery.
Eddie waits patiently for the surgery to begin. If anyone could
look forward to an operation it was Eddie, whose knees caused him
doing the new procedure in August 2003. He was told to expect about
100 patients his first year. Instead he had more than 300 in his
first full year of practice. His patients have come from all over Missouri
and as far away as Arizona.
have to have this done,” he says. “They can
do less activities or use a walker. But that’s not a healthy
Hockman uses a new
technique called “minimally
invasive knee replacement.” The
procedure is done through an incision that is 4 to 5 inches
long using miniature tools and high-tech replacement joints.
old way was to cut, twist and stretch,” says. Hockman. “People
re-covered but it took them a long time.”
He says doctors
used to cut all the way through the patient’s quadriceps
tendon, which surrounds and supports the knee joint. Then
they would rotate the knee cap out of the way to get at
the joint surface that needs to be replaced.The new technique
spares most of the quadriceps. The small incision is moved
around when the doctor needs access to a different part
of the knee. New tools, including guides resembling woodworking
jigs, let the surgeon cut away damaged knee parts and drill
holes to attach new material to the leg bones.
|Dr. David Hockman, a surgeon with the Columbia Orthopaedic Group,
holds a model of the replacement knee.
Eddie made an appointment with Hockman, who cleared him
to have both knee joints replaced.
was caused by bone spurs and worn cartilage that allowed his bones
to rub together. Because of the pain Eddie quit exercising.
This caused him to gain weight, which only made the problem
He says the rigors
of working on the railroad, jumping to the ground and grabbing on to
moving train cars, took its toll on his body.
Over the years doctors
tried just about every form of treatment to ease his pain. He had
cortisone injections, used arthritis medications and even had arthroscopic
surgery. Knee replacement seemed to be his best option, but doctors
wanted him to wait as long as possible because the replacement joints
also wear out.
On a cold, dreary
morning in January, Eddie checked into Columbia Regional Hospital and
prepared for surgery. Eddie would have both knees replaced during the
Paula kissed him
goodbye and nurses wheeled him into a brightly lit operating room.While
Hockman and his team listened to songs like “Old
Time Rock and Roll” and “Don’t
Worry, Be Happy” on the operating room
stereo, Eddie blissfully snored through the
an X-ray of Eddie Edward’s knee the new material installed
by Dr. David Hockman stands out from the gray bone. Com-posed of
oxinium, polyethylene and a titanium base, the new knee material
is cemented onto the bone. The doctor compares the procedure
to a dentist putting crowns on teeth.
The procedure took
most of the morning, one to two hours per knee. Hockman likens it
to a dentist resurfacing a diseased tooth
with a crown. The damaged pieces of bone, pockmarked
like the skin of an orange, were sawn away.
Holes were drilled into the bone using a precision
guide that wrapped around the knee bones.
Then a replacement
joint was glued into the holes. In the past (and still today) cobalt
chrome was used for the three knee replacement parts. Eddie’s
new knees are made from oxinium, a new material
made by allowing oxygen to absorb into zirconium metal. In the process
its surface changes from a metal to a ceramic combining the best
advantages of both materials.
By 1 p.m. Eddie was
out of the operating room. He could walk that same day but Hockman
prefers to let patients recover fully so
they don’t lose their
balance and fall. The pain is intense,
much worse than Eddie expected.
“I had no idea
what I was getting into pain-wise,” Eddie admits a
few days after surgery. “Most
operations I’ve had I was back
up right away. I’m a man, man.
But with this one it didn’t work
His first steps with
the new knees were baby ones, just
four steps to a chair with a lot
of assistance. A few days later, however,
the pain eased enough that he was
able to walk by himself using a walker.
|Six days after surgery, Eddie still feels pain but can move with
the aid of a walker. While the road back will be a long one, Eddie
believes his new knees will improve his quality of life.
The walker is standard
issue for a month to six weeks. But most patients
make their six-week checkup without it, Hockman
In time Eddie will
be able to return to most of the activities he once did. “There’s
a lot of dos and don’ts
and the first thing is, ‘don’t
take a chance,’ ” Eddie
High impact activities
like running or tennis are off-limits
for life. He will have to avoid
rough ground and slippery surfaces.
But studies show with proper
care the knee has an 85 percent
chance of lasting 15 to 20
Still the new knee
won’t be the same as the one Eddie was
born with. “What
God gives you is a lot better
than anything man can make,” Hockman says. “This
will take care of the pain
but there will be some limitations. It won’t
pivot and he will be limited
to low-impact activities.”
As the pain gets
better Eddie is looking forward to returning
to his old activities. “This
is going to make a difference,” he
says of the surgery.
doctor, he told me it’s
going to hurt. But if
I keep doing the exercises,
it’s going to get
future Hockman says
gene therapy might replace
the surgery he now
performs. He says if the technique
can be perfected patients
will receive injections
of their own genes that
will instruct the knee
to repair itself.
“I’ll be an antique then,” Hockman
For more information about knee replacement surgery call (573) 876-8662
or on the Internet visit www.ortho.smith-nephew.com/us.