The pain in Etta Ruth Fruits’ knee was becoming increasingly worse. Her knee had been deteriorating over the past couple years, and she knew total knee replacement was the next step. But it was a big decision and not one she took lightly.
With the help of a friend, Etta Ruth researched different orthopedic surgeons and chose Terrence Devlin, M.D. Before her first appointment, she ran into another friend who’d recently had Dr. Devlin perform total joint replacement. “All she could do was compliment him so I felt pretty good going into my appointment with him,” she shares.
Right away at the appointment, she knew she’d made the right choice in her surgeon. “When I met him, I felt like I already knew him,” she says.
Etta Ruth, of Waynetown, appreciated the time Dr. Devlin took with her. “He explained everything so well and spent an hour with me and my husband. He didn’t act like he was in a hurry at all,” she recalls.
She says Dr. Devlin educated her on her particular situation but left the final decision up to her: “I was really bow-legged and he told me, ‘It will only get worse, but it’s your decision when and if to do this.’ I really liked that he wasn’t pushy about making a decision.”
In fact, it has such an impact on her that she ended up scheduling surgery before she even left his office. “I turned right around and made the appointment. I knew this was the right way to go,” she shares.
Guiding patient decisions Dr. Devlin, who primarily performs total hip and knee replacement, believes patients should have two symptoms to benefit from surgery. First, the pain from the arthritic condition should be progressed to a point where it is affecting the quality of a patient’s life. Secondly, the joint pain must be a result of arthritis or a tear in the cartilage.
“I’ve had people come in with horrible painful knee, but their x-rays show nothing. I don’t perform surgery in those cases. We need to look for the cause of pain and then determine the appropriate treatment option,” he explains. However, when Dr. Devlin determines that a patient is a candidate for total knee or hip replacement, he asks them a series of questions to help them decide if surgery is the route they want to take.
“This is still considered an elective surgery so I share with my patient the benefits of surgery, and I go over the risks involved. Then I ask questions to help them assess their quality of life. These help them as they make the decision with their family,” he says.
Questions may include:
- How far can you walk, and can you walk without assistance?
- Can you get up and down the stairs?
- Can you get up from a chair without using your hands?
- Do you wake up at night?
- What can’t you do that you used to do?
Taking that first step again The goal with surgery, Dr. Devlin says, is to relieve the pain in the joint. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint.
Orthopedic surgeons encourage patients to use their “new” joint soon after surgery. In most cases of hip or knee replacements, patients are asked to stand and begin walking – using a walker, crutches or cane – the day after surgery. “It’s important to begin working on regaining range of motion and muscle strength soon after surgery,” Dr. Devlin says. “The sooner that happens, the better.”
Those who undergo hip replacement almost always gain back even more motion than prior to surgery. With knee replacement, most patients gain back the movement they had—but without the pain. Some even gain back greater motion and strength than before.
Dr. Devlin says a significant part of the recovery involves the patient: “I tell my patients that 50 percent of a good result has to do with my performance as a surgeon. But the other half is their ability and willingness to participate in therapy and regain their motion and strength.”
That couldn’t have been truer with Etta Ruth. She had surgery on Tuesday and was home three days later. By Sunday, she’d walked the 40-foot walkway at her house with a cane—and then again without it. Before she knew it, she’d walked a couple blocks to the local grocery store.
“I was determined,” she exclaims. While not everyone moves along as quickly as Etta Ruth, Dr. Devlin says he has seen such results when patients are dedicated to post-surgery therapy and exercise.
In general, Dr. Devlin says it takes about six to 12 weeks for a full recovery and restored level of physical activity. “It can be sooner,” he says. “It depends on a patient’s age, weight and willingness to exercise their leg.”
Etta Ruth knew when she’d reached the point of full recovery. “I’ve always been a fast walker. But by spring, after a winter of exercising, I’d gotten rhythm and speed back again. Everyone who sees me is just amazed.”
And Etta Ruth uses these encounters to tell people about Dr. Devlin: “You wouldn’t believe how many people I’ve sent to Dr. Devlin. I pass out his cards. He is just the best—the best!