Running around after a group of second-graders is hard work.
This was especially true for elementary teacher Lonna Martinez, who
recently had patient-specific knee implant surgery.
Running around after a group of second-graders is hard work. This was especially true for elementary teacher Lonna Martinez.
Martinez, 55, suffered osteoarthritis in both knees, and the discomfort made her need to rest often. But finding time to sit is hard to do for a second grade teacher.
“I was out on the playground with the kids everyday during P.E. and as a yard duty, I was on my feet all the time. I was in constant pain,” said Martinez, who has taught for 31 years with two of those in the Gilroy Unified School District.
“I’d stand up and there would be pressure, and I knew I was going to have pain. I was exasperated.”
The Rod Kelley Elementary School teacher suffered with joint pain for 10 years. Somehow she got through the school days.
“You just do it. Yes, I was taking a lot of Advil. I was putting my feet up when could. You get tired of it.”
Martinez said she ran the gamut of treatments from physical therapy, cortisone and joint fluid injections to having her meniscus surgically removed.
Dr. Maury Harwood, a Morgan Hill orthopedic surgeon who specializes in sports medicine and joint replacements, gave Martinez different treatments for eight years.
Still, nothing worked. Martinez had no cushioning left in her knees: all the cartilage was gone, and her knees rested bone on bone.
Harwood told Martinez she was a candidate for partial knee replacement surgery in both knees. Martinez’s missing cartilage would be replaced by a metal and plastic implant.
Harwood is one of nine surgeons in Northern California who uses a new knee replacement technology – patient-specific implants, commercially known as the iUni G2 and the iDuo G2 by Conformis.
From a CT scan of the patient’s knee, the company uses computer software to create an individualized implant for each patient’s knee.
“It’s so far superior. I wouldn’t use anything but a patient-specific implant,” Harwood said.
The individualized sizing makes all the difference. Before patient-specific implants were commercially available, surgeons used traditional implants that came in standard premade sizes. During the operation, the surgeon had to cut it to fit using a standard cutting guide.
“If you can imagine, that’s less than perfect. That’s like using a one size spare tire for all cars. It makes no sense, it absolutely makes no sense.”
Harwood said having an improperly fitting implant can cause a new implant to fail.
“The No. 1 problem that causes implants to fail is poor alignment. What happens is the implant gets a lot more stress than it should. The stress makes the cement break down, the implant gets loose and then the patient gets pain.”
Martinez had surgery on both knees in June 2010, and it has been so far, so good. She was back to work the first day of school in August, seven weeks post-surgery.
“It’s so much easier to get through the day. I told my students I had surgery, showed them the scar. They were very understanding. They said I had a cool scar.”
She said her healing process is going naturally – her knees feels stronger and she is enjoying the added freedom. She still has some residual pain and tendinitis – inflammation of the tendons – as she heals from her surgery, but said she feels much better and teaching is easier.
Harwood said knee replacement surgeries in the United States are increasing as people play harder and are more active than in previous generations. Adolescents, for instance, play sports year round.
“Unfortunately, the body is made of mechanical joints, and the harder you push it the faster it’s going to wear down, that’s just the way it is,” he said.
Harwood said it used to be that doctors would tell their patients they needed a knee replacement but they should wait until they were 70.
“It was because of surgery risks and the technology not being up to snuff. Partial or full replacements would fail. And each time you do a replacement, it becomes harder and harder and more difficult. The consensus was ‘Let’s not do it until then, so they don’t have to get so many. ‘ ”
Not anymore. As people have become more active, they also now expect to be active later in life.
“People want to be able to do things,” Harwood said.
He said knee replacement patients are getting younger and their knee replacements often last 20 years.
“People expect to live an active lifestyle, with as little pain as possible. If that means buying another surgery, I think people are much more willing to do that then they were 20 years ago. It’s a relatively recent change in philosophy.”
Martinez is about to get more active herself. She’s planning a trip to Peru this year to see the Inca ruins at Machu Picchu. The ruins sit between two mountains and Martinez will enjoy climbing up lots of stairs.
“I’ll enjoy walking to get there and getting around, not having to worry about where to sit down.”
