Sometimes A Bigger Surgery Scar’s Better

Jerry Coffee
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Wednesday - April 21, 2010
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The year was 1962, Naval Air Station Cecil Field, near Jacksonville, Fla. It was early fall - football season. As a 28-year-old “Red Hot!” wearing borrowed cleats, I quarterbacked the squadron intramural flag football team in the first game of the season. I called a pass-run option around left end, got the snap from center and drifted left, looking for my receiver up field, but he was covered so I tucked the ball away and planted my left foot to cut sharply up field.

But the cleats grabbed the grass, holding my left foot firm while my body pivoted right. I heard and felt the sharp “snap” in my left knee, saw silver-white stars on a black canvas, and crumpled to the ground like a sledge-hammered sheep before slaughter. Clutching my knee tightly to contain the pain, I somehow knew at that moment it was a life-altering injury.

I nursed the joint back to a semblance of normalcy, just in time to make the squadron’s deployment to Key West to stage low-altitude recon flights over Russian missile sites in Cuba.

Between my fifth and sixth flights I reinjured my knee playing volleyball on the flight line; same snap, stars and searing pain. Manning up for my sixth flight the next day, I gingerly coaxed my left leg over the side rail and into the cockpit.

Next day: “Doc, my knee’s a little wobbly, can you give me a knee brace to fly in?” After a quick exam: “You don’t need a brace, you need an operation. Your meniscus - the cartilage pad between your femur and the tibia - is torn. You’re ‘down’ as of now.”

Forty-eight years, a high-speed ejection over North Vietnam that broke my arm and sprained both knees, several “pretzel treatments” at the Hanoi Hilton and three more operations later: “This is the worst knee I’ve ever seen! I dunno how you’re walking on it,” exclaimed the Tripler orthopedic surgeon, attaching the X-ray to the light box. I’m thinking, “OK, even though I can still hike, bike and ski, it is getting more painful. Maybe it’s time to think seriously about a knee replacement. Almost everyone I know who has had one is pain-free.”

So I shop around and settle on the “minimally invasive” technique touted by a local surgeon with high credentials, and endorsed by Hawaii’s Olympic Decathlon champion Bryan Clay. My thought process: “Minimally invasive means less cut muscle and tissue, therefore faster rehabilitation.”

So I had the full knee replacement surgery last August, and eight months later my knee is still swollen, and I still can’t hike, bike or ski. On a pain scale of one to 10, I’m holding around three - give or take - peaking at nine when I try to walk down stairs normally. The surgeon referred me to his associate, an arthroscopic specialist, who last February scoped my knee and cut out significant scar tissue that was impeding the natural movement of my patella (knee cap). It did reduce the pain and my limp initially, but the overall improvement is marginal. “Be patient,” I was told. “This was major surgery, and may take months to heal.”

Two weeks ago I sought a third opinion from a highly recommended orthopedic surgeon from another local hospital, who confirmed what I was coming around to on my own: “minimally invasive” may not be the best approach on a knee with a history of trauma. Yes, my six-inch scar is nifty, but a 10-inch incision would have allowed the surgeon to expose more-internal scar tissue from previous injuries and surgeries, which then could have been removed. And, at this point in my life, what’s another four inches of scar!

So for those of you who may be considering a joint replacement or know someone who is, I hope my saga might be helpful in the decision process.

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