Patient Story - Knee Replacement
A crashed motorcycle — a crushed knee
Whoever said “no good deed goes unpunished” may well have had Natalie Anderson in mind. In May 2002, while working — ironically enough — at a Seattle hospital, Natalie bought a motorcycle to make her daily commute a little easier on the gas tank. She chose a quiet, traffic-free Saturday morning for her trial run from home to work. Natalie was about to declare the venture a success when, just a block from her destination, she took a corner a bit too fast and flipped over the curb. The motorcycle was still in good shape — the same could hardly be said of Natalie's knee.
A disheartening prognosis
Although she crashed right in front of the hospital's emergency room, the medics took one look at Natalie's knee and headed straight for the local trauma center. After her initial exam, the doctors there reported some very bad news: her knee appeared beyond repair and she would likely lose her leg.
This, of course, would be devastating to anyone. But given that Natalie was only 27 years old and a sports enthusiast of the highest order — she loved running, hiking, surfing, cycling, horseback riding and most anything that kept her moving — this was, in a word, unacceptable.
Heroic efforts to save a leg
Fortunately, a doctor at the trauma center agreed with Natalie and did everything possible to mend her knee. Over the next five years, Natalie underwent no fewer than five surgeries and countless painful and rigorous physical therapy sessions. The good news was that she did indeed keep her leg. The bad news was that her mobility was severely limited — she could hardly walk down a flight of stairs without hanging onto the railing — and any attempt at normal activity caused excruciating pain.
In search of a better solution
While Natalie was indeed grateful to the doctor who repaired her knee and saved her leg, the constant pain — and the fact that she was forced to watch all her favorite activities from the sidelines — sent her on a search for a new and better answer.
She went to see several orthopedic surgeons who all offered the same advice: “You're too young for a knee replacement, so you'll just have to live with it until you're 50.” The surgeons' option to waiting was even less desirable: amputation. When Natalie found herself actually considering this — anything to reclaim her young and active life — she knew it was time to do something different.
At long last — good news for Natalie
“Knee replacement is something I approach very cautiously,” explains Dr. Toomey. “While our joint replacements today are extremely good and the technology continues to improve, we can't claim that they'll last forever. All joints — just like any bearings — are subject to wear. Whenever we replace a joint in a young person, there's always the chance that 20 or 30 years down the road, the joint will need to be replaced again. A re-replacement is a riskier, more challenging and technically demanding surgery, so we usually encourage our patients to wait as long as possible.
“In Natalie's case, it became very clear to me that she was in severe pain most of the time. Her quality of life had deteriorated to the extent that even considering her youth, surgery was the best option.”
More surgery for Natalie — not once, but twice
Dr. Toomey planned Natalie's knee replacement surgery in two stages. The first was to remove all the hardware — three metal plates and nearly 20 pins — that remained from the previous five surgeries. A particularly stubborn piece of that hardware was in the back of her knee and quite difficult to access; a stripped screw head in Natalie's tibia (a bone in her lower leg) was another complication. “Fortunately, we have all the right equipment to handle all these occurrences, so although her first surgery was a challenging one, it was a success,” recalls Dr. Toomey.
Out with the old
Natalie recovered beautifully from her first surgery in April 2007. Six months later, she returned to Swedish where Dr. Toomey performed the second surgery — a total knee replacement. Although he performs hundreds of knee replacements a year, this one was anything but routine. Natalie's previous surgeries had left her bone unusually dense and coarse; a great deal of scar tissue limited the knee's flexibility; the original fracture created an uneven joint; and a small piece of the tibia — to which Dr. Toomey was planning to attach the artificial knee — was missing.
Once again Dr. Toomey was up to the challenge, and five-plus years after her accident, Natalie at last had a new knee that would — with a rigorous schedule of physical therapy — give her the pain-free mobility she longed for.
Heroic efforts from Natalie
While the major part of Dr. Toomey's job was now complete, Natalie's was just beginning. She was up and walking the very next day. She was fanatical about doing her prescribed exercises and physical therapy – she was so gung-ho, in fact, that Dr. Toomey had to tell her to take it easy. By then a substitute teacher, she added weights to her pile of teaching supplies and did leg lifts during her planning periods. Every evening, she worked incredibly hard to flex her knee, and after years of bending to only 85 degrees, she didn't rest until she achieved a full 120 degrees.
Off and running — literally
Now that Natalie's knee can keep up with the rest of her, she is constantly on the go. She hikes, rides her horse, takes spinning classes several times a week, and rides her bicycle all over town.
Go ahead and ask her if she's glad she chose total knee replacement surgery at Swedish — but you'll have to catch up with her first.