Joint-replacement surgeries are giving more Oklahomans freedom to move again

By Jim Killackey

Published: September 2, 2007

Gaylene Turner traded an excruciating battle with arthritis in her right knee for three hours in an Oklahoma City operating room that sounded a bit like a construction site.

If the 72-year-old educator had not been sedated for her knee-replacement surgery at Bone and Joint Hospital, she'd have heard the jarring thwomp of a surgical mallet, the whir of drills and the buzz of spinning saw blades.

The smoke and odor of cauterizing tissue beneath the skin permeated the air, along with the distinctive smell of a surgical cement used to bond metal to bone.

Such a scene represents a burgeoning medical trend in Oklahoma: joint-replacement surgery, also known as arthoplasties.

Orthopedic surgeons are changing lives as they replace worn down or injured knees, hips, shoulders, elbows, ankles, wrists and even finger joints.

Arthritis is the main culprit. Hip replacements can be caused by rheumatoid arthritis, malformations of the hip joint caused by dysplastic hips and other diseases.

Oklahomans from their teens to age 101 had joints replaced this year with the latest implants made of cobalt chrome, titanium alloys, ceramics and hardened plastic.

The demand for joint replacements will only increase as aging baby boomers hope to rejuvenate their mobility in years to come, doctors said.

An estimated 11,000 joint-replacement and joint-revision procedures will be performed in Oklahoma this year, according to the state Health Department.

About 6,800 will be knee replacements.

Most of the surgeries are done in Oklahoma City and Tulsa hospitals. The surgery costs about $30,000.

Bone and Joint in Oklahoma City and St. John's in Tulsa have started joint-replacement surgery centers, where all procedures are performed on Mondays and grouped-together patients recover throughout the week.

"I had a 43-year-old patient who just had a hip replacement. He had a motor-vehicle accident 20 years ago and had traumatic arthritis in his hip,” said orthopedic surgeon Dr. Warren G. Low with the McBride Clinic in Oklahoma City. "He said it made his mother cry because she hadn't seen him walk normally in 20 years.”

Yet "many individuals can be restored to active lifestyles by undergoing total-knee replacements,” Dunitz said.

Dr. Robert Steves, an Oklahoma City orthopedic surgeon, often does three knee-replacement surgeries on a Monday. He said he could "never duplicate what God created” for normal joints in the body, but current techniques and tools do a pretty thorough job.

Turner decided on a total knee replacement because the crunching of bone on bone in her arthritis-damaged knee "kept getting louder and louder,” and she no longer could climb to her choir seat at Council Road Baptist Church.

"Art is in charge,” she would often say of the painful arthritis in her knee. "But I wanted to stay active the rest of my life.”

Before her surgery, the computer literacy teacher at Metro Tech underwent extensive physical therapy covered by Medicare.

During her knee procedure, the joint was surgically exposed. Diseased bone and joint surfaces were removed. Remaining bone was prepared to receive the prosthesis. It was then sized and fit onto the bone. Bone cement was used to help secure the prosthesis. The wound was closed.

Within 24 hours of her surgery, her pain was less than it had been in years.

"The Lord took care of me,” she said.

Results were similar for car dealer Hubert "Ward” Grisham, 46, who has had two hip-replacement surgeries because of arthritis. Dr. Timothy Puckett, an OU Physicians orthopedic surgeon, performed the surgery.

"It started to get ugly. I could hardly walk,” recalled Grisham, a 6-foot, 6-inch former basketball player.

Grisham once "chickened out” and cancelled a scheduled surgery. But the pain became so horrible he had his first procedure in October and the second in May.

Grisham figured he'd be "cut on and beat on” during the surgeries, but the result would be well worth it.

He was correct.

"Now, I can move around and talk to people, and that's so important in my business,” Grisham said.

Another thing he can do is lift up and throw daughters Madison, 9, and Lauren, 10, over his shoulder.

"The kids deserved their dad back,” Grisham said.

Dr. Sheila Algan, an OU Physicians orthopedic surgeon, is doing a less-invasive joint replacement of the knee known as "unicompartmental knee arthroplasty.” The computer-assisted surgery involves smaller incisions and replacing only a small amount of the injured knee. Ligaments aren't touched, and recovery is quicker.

The new procedure is not for all knee-replacement candidates, Algan said.

Related developments:

•Oklahoma City neurosurgeon Dr. Michael Hahn last week used a "cervical artificial disc” to repair a woman's spine.

Instead of fusing the woman's herniated disc, Hahn used a newly approved metal implant, which he said should give the woman a greater range of motion and alleviate the weakness and pain the woman had in her left arm.

The physician said he expects the artificial disc to last the remainder of the woman's life.

•A Cushing orthopedic surgeon has been trained in an alternative procedure to hip-replacement surgery.

Dr. Joel Tupper is using the "Birmingham Hip Resurfacing” technique.

The bone-conserving approach preserves more of the patient's natural bone structure and stability, covering the joint's surface with an all-metal implant that more closely resembles a tooth cap than a hip implant, he said.

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