Patient of the Month

A native of London, England, Valerie Houseman spent her entire career as a ballroom dancer. Her talent, hard work and devotion made her a world champion, but not without a price.

"Ballroom dancincing is extremely wearing on the knees," admits Valerie, "and for the ladies it is particularly hard on the right knee and especially with the high heeled shoes we wear.

"After all those years on the dance floor my knee began aching constantly, and I even had jabbing pains. I started walking with a limp but didn't realize just how bad it was until my daughter, Abigail, pointed it out.Your leg hurts you today doesn't it? she would say. You are limping much more today then you were yesterday."
 Valerie's condition was debilitating. "I walked as little as possible," she remembered. "Standing up was difficult because of the work it took to push up through my knee, and sitting down was hard because then I was pushing down through the knee."
 Valerie finally turned to her personal physician, who in turn reffered her to Mark J. Davis, MD, a board-certified orthopedic surgeon with extensive and prestigious additional Fellowship training in knee and hip replacement from Anderson Clinic in Arlington, Virginia.
 "I went to see Dr Davis," remembers Valerie, "and I liked his attitude.
I appreciated the way he spoke and listened, and when he learned that I was a dancer he understood how important my hips and knees were to me. I told him that I wanted to be active again, and for me that meant I would have to be pain free. "I felt confident Dr. Davis would be able to make me as mobile as was physically possible, which was important because I still consult for and judge competitions in the United States and abroad."

The Evaluation

According to Dr. Davis, a thorough history and a clinical examination focused on determining levels and location of pain and stiffness are essential before making any recommendations. "Dr. Davis showed me my x-rays," recounts Valerie, "and I could see on the inside of my right knee there was bone rubbing bone, which is why I was in so much pain. There was no cartilage left there at all."
 The doctor explains that x-rays are used to determine if arthritis is apparent only in the inside part of the knee, an important prerequisite in determining the best intervention. In a normal knee, the condyles, two rounded, knob-like protuberances at the bottom of the femur or thigh bone, fit and move in the hollows of the tibia or shin bone, forming the actual knee joint. when one condyle is damaged due to wear, injury or arthritis, the resulting pain and impaired motion of the knee can become incapacitating.
 "I recommended that Valerie have a partial or unicondylar knee replacement,(UKA), also known as the Repicci Unicompartmental Knee Replacement," explaine the surgeon.A UKA relieves the patient's pain and restores both the correct alignment and motion of the knee joint."

UKA benefits

  Dr. Davis is an expert in UKA. He hosts one of the only few physician training centers in the entire United States where surgeons can come to study, learn the UKA procedure and then go home to offer it to their own qualified patients. Also, four times a year, Dr. Davis travels to Chicago to teach the surgical technique alongside its developer, Dr. John Repicci of Buffalo, New York.
 "We consider the UKA procedure to be minimally invasive for several reasons," explains Dr. Davis. "First, the incision is typically only about three inchs long. Second, only the damaged portion of the knee joint is replaced. Basically, we are preserving the natural knee joint and replacing only the portions that are bad, much like a dentist would repair a single bad tooth, rather than pulling all your healthy teeth and giving you dentures.
 "Third, unlike with a total knee replacement [TKA], where a patient may remain in the hospital or rehab facility for up to two weeks after surgery, a partial knee replacement patient typically goes home a day after the surgery."
 Dr. Davis notes that, in most cases, the recovery from a partial knee replacement is faster than that for a total knee replacement: "Typically, patients are not able to drive until approximately six weeks after a total knee replacement, but most of my partial knee replacement patients are able to drive at two weeks following surgery. They become independent again much faster
 "Partial knee replacement is an early treatment option," stresses Dr. Davis. "People don't need to suffer for years and years, waiting until they're candidates for a total knee replacement; they can opt for a partial replacement and get back to a pain-free lifestyle much quicker.
 If, down the road, additional osteoarthritis warrants a total knee replacement, that option is still open to UKA patients; the have not burned that bridge.

Positive outcome

 The recommendations of Dr. Davis provided the ideal solutions to enable Valerie to return to her normal activities.
 "Dr. Davis knew I was motivated," reflects Valerie, "so he got me up and running. Ten days after my surgery I was getting up and walking across the room without my cane or walker."
 "I was appointed a physical therapist for rehabilitation and we worked hard, but I didn't have a problem doing the exercises because I wanted to return to my career".
 "It is important to me that my patients know our relationship doesn't stop when their surgery is complete," says Dr. Davis."I reassure my patients that we have the resourses and community connections to make sure that their rehabilitation and well-being are supervised after they leave the hospital".
 Valerie has returned to her busy career, and also spends afternoons with her two-and-a-half year old granddaughter Michaela Simone, who she describes as the joy of her life.
 "I don't even have to think anymore about getting up and walking.,"describes Valerie, "I just do it. It's amazing how quickly you forget about how much pain you were in once it's gone."

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