Revising the replacement

Archive, December, Month

Encountering an “exceedingly rare” complication, a McLaren Macomb orthopedic surgeon strove to return his patient to her pain-free life.

Sherry always loved to cook.

Over a 40-year career in the restaurant industry, she ran the kitchens of longtime local favorites, satisfying countless diners over her many years.

But the years of hustle in the kitchen eventually took their toll.

“On my feet, on hard floors all day,” Sherry said, “bending, twisting, turning, carrying 40-pound bags of meat, the cartilage had worn out in my knee. It was bone on bone.”

Recalling the pain in her right knee as excruciating, she had to step away from her life in a professional kitchen. It was just too much.

Aiming to fix the issue, an orthopedic surgeon recommended a full knee replacement.

Thinking her problem was solved and her pain resolved, she returned to the life she knew. But new issues would arise that would again require skilled hands and an experienced, compassionate mind.

Health challenges & complications

Sherry first realized something might be amiss when she experienced the sensation that her knee and implant “felt loose.”

A few years after the replacement surgery, Sherry had experienced a number of significant health conditions, the most serious of which was her diagnosis of breast and lung cancer. Unrelated shooting and throbbing pain had also returned to her repaired knee.

It got so bad that she could not even cross her legs while sitting.

“And steps — I could not go up the stairs more than one at a time,” she said, “and I couldn’t go up if I was holding anything.”

During an appointment with her oncologist at the Karmanos Cancer Institute at McLaren Macomb, she detailed the pain and many difficulties she was having with her knee.

Oncologist Dr. Salman Fateh referred her to McLaren Macomb orthopedic surgeon Dr. Michael Wagner.

Meeting Dr. Wagner

“He cares,” Sherry said. “I would recommend him to anyone.”

Though Dr. Wagner didn’t do Sherry’s knee replacement, he had the experience and expertise to go about fixing it and relieve her pain for good.

“Joint replacement implants are designed to return people to a pain-free, active lifestyle —what they were used to before their pain limited that activity — and it can gain some wear and tear over time,” Dr. Wagner said. “In Sherry’s particular case, it was too soon for that implant to degrade. With her, the first step was to find what was causing her complication.”

Examining the knee and taking blood and fluid tests, Dr. Wagner quickly determined that her knee was infected, leading to these new, painful symptoms.

Sherry had previously been treated for a routine infection unrelated to her surgery or hospital care. Having taken a prescribed medication, she thought she had beaten it, ridding it from her body. Instead, she found herself with this new, debilitating pain after the infection spread to her knee.

“I’m hoping just to be able to walk up and down the stairs again,” she said. “To be able to stand for more than 10 minutes and cross my legs again.”

Revision

“This sort of complication is exceedingly rare and should not deter anyone who’s considering a joint replacement,” said Dr. Wagner, who added that it affects less than half of one percent of joint replacement patients. “First step was to treat the infection, and to do that, we had to remove the implant.”

During the same procedure, he irrigated the knee and put in a temporary antibiotic spacer. Though it limited her mobility, this new implant delivered antibiotics to the surrounding tissue while also preserving the joint.

For about eight weeks, Sherry also underwent daily IV treatments to fully and thoroughly clear her body of the infection.

And when treatments were complete, Dr. Wagner was able to replace the temporary spacers with permanent knee implants on Oct. 18, completing Sherry’s knee revision.

“He called me the night before surgery, making sure I was OK and if I had any questions,” she said. “He’s great, so thorough.”

Three sessions every week with a physical therapist followed, but progress also followed. Every day, Sherry is able to walk farther and farther with less and less pain.

And although she was still able to host holidays and grace the table with a meal, the upcoming holiday meals won’t come at a painful expense.

“I love to cook and always did,” she said. “It’ll definitely be easier now that I can be on my feet for more than 10 minutes.”