New Knees For Lucy And Me

Jerry Coffee
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Wednesday - September 02, 2009
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It was a football Friday-kind of afternoon in the northern Florida fall of 1962, and our squadron flag-football team had enjoyed a successful season. We were looking forward to a fun-filled game and one final victory before beer and barbecue with the opposing team.

I called our first play from scrimmage: “Sweep left, option pass deep.” I took the direct snap from center, moved left, pumping the nose of the ball into my left hand as if intending to pass but my target was covered. As my blocking back moved the defensive end toward the sideline I tucked the ball into the crook of my arm, planted my left foot to quickly turn up field, and ... the lights went out!

Through the crackling sound of cartilage and ligament I saw lightning-colored stars on a liquid black sky. Suddenly, I was on the ground clutching my knee tightly to my chest while rolling from side to side in pain.


 

That was the beginning! Whirlpool therapy, followed by simple surgery to trim away torn cartilage was standard procedure in those days. Non-standard was reserved for a celebrity quarterback like Joe Namath, who sustained a similar knee injury a short time later. But after trimming torn cartilage, his doctor literally took tucks in his stretched lateral ligaments, cinching up the joint as tight as ever.

But not being a million-dollar QB, the integrity of my knee remained compromised, leading to a lifetime of always stepping off curbs carefully, awkward manipulations to unlock my knee to the extended (usable) position, and three arthroscopic surgeries to suck up the “joint mice” - pieces of floating cartilage throughout the joint. Decades of skiing and tennis were neutralized by several rounds of cortisone shots along the way.

Of course, another severe “sprain” from a high-speed ejection from my Navy jet over Vietnam didn’t help.

The ultimate result of 50 years of cumulative trauma caused one examining orthopedic surgeon to exclaim as he looked over my X-ray, “My God, Coffee, this is the worst knee I’ve ever seen. How did you even walk in here?”

So, anyway, two weeks ago, Dr. Cass Nakasone, Straub Hospital’s knee and hip specialist, removed what was left of my tired, raggedy knee and installed a new, state-of-the-art stainless and Teflon (or Teflon-like) model. Actually, a resurface job might be more accurate. I use to visualize a “knee replacement” as removing the lower part of the thigh bone (femur) and the upper part of the shin bone (tibia) and inserting a manufactured duplicate knee “joint” in between.


In actuality, it is more of a thorough resurfacing, i.e., the end of the femur is reshaped to fit inside a stainless steel jacket that resembles the end of the old femur but with new, smooth and rounded surfaces. A button-like device reattaches the patella (knee cap) in the same place. The top of the tibia is removed to leave a flat surface, into which a shallow, curved Teflon “socket” is driven. The concave curves of this lower piece match the convex curves on the stainless jacket surrounding the end of the femur for a smooth steel-to-Teflon contact - no more bone-to-bone, no need for cartilage.

Dr. Nakasone is known for his “minimally invasive” surgical technique, which involves less actual cutting of muscle and tendon thereby accelerating the rehabilitation process. Assuming a successful surgery, rehab is considered the real key to a successful outcome.

Unlike only a few years ago, joint-replacement surgery has become fairly routine. Almost everyone knows someone who has had it. In responding to friends inquiries of how I’m doing, I mention I’m recovering from knee-replacement surgery, and the answer is frequently: “Oh yeah, I had both of mine done, ya know!” or, “Hey, good for you. They’re gonna do my hip next month!”

It was only a few weeks ago I wrote about our sweet dog Lucy having her torn ACL fixed with what was essentially a knee reconstruction. Man these days, it’s even hard to get a leg up on the dog.

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