Setting more Goals Thanks to Knee replacement – a Patient Success Story

Ronald Millet didn’t dread knee replacement surgery; it was the period of required inactivity afterward that had him worried. The Lancaster resident, 65, wanted to get back to his active lifestyle, which includes cycling 7,500 miles, on average, each year. He tried a variety of treatments to delay the inevitable, but once he started limping and couldn’t straighten his leg, he began research that led him to Emerson Hospital.

A serious bike crash several years ago slowed Mr. Millet down, but only temporarily. “I was riding my bike at top speed when the handlebars snapped off in my hands,” he recalls. “After rolling several times, I smashed my right knee on the pavement. It blew up to four times the normal size.”

His knee was never quite right after the crash, but he kept riding, playing hockey, hiking, snow-shoeing and cross-country skiing. “Three years ago, I noticed that my knee hurt if I skated, but only after skating,” says Mr. Millet. An orthopedic surgeon diagnosed a meniscus tear and performed minimally invasive surgery to repair it.

“That was when I heard the words ‘no cartilage.’ He told me I would require a knee replacement at some point. I thought I could plow through it, so I kept doing whatever I wanted to do.”

That doesn’t include sitting down too often. Since retiring from his job as a corrections program officer, Mr. Millet has two active part-time jobs—at a local bike shop and an orchard, where he does seasonal work. During fall cleanup at the orchard, all it took was one misstep to remind him that his knee was vulnerable.

“I stepped into a hole, and my knee blew up again,” he says. “I had it drained a couple of times and did physical therapy, but I knew I was in trouble. I was limping, and I couldn’t straighten my leg.” He began asking friends, neighbors and his sister—a nurse—about orthopedic surgeons who specialize in joint replacement surgery. “Everyone endorsed Dr. McInnis at Emerson.”

Mr. Millet made an appointment with John McInnis, MD, a Massachusetts General Hospital fellowship-trained hip and knee replacement surgeon. He hoped he could delay the surgery.

He was pleased when Dr. McInnis suggested buying some time before scheduling the procedure. “There’s a right time to perform this operation,” says Dr. McInnis. “We expect patients to get 25 years from today’s knee implants. Ron already paid his dues by trying a number of different treatments and wearing a brace, but I thought cortisone injections could get him a few months of relief.”

They did, and Mr. Millet kept going. “I would limp to my bike, cycle pain-free, and then get off my bike and limp away,” he says. “Dr. McInnis told me I’d reach the point where I was begging to have the surgery done, and he was right. But first, I enjoyed the fall cycling season and working at the orchard.” His knee replacement was scheduled for just after Christmas 2018.

Heading into surgery, Dr. McInnis knew that Mr. Millet was physically fit. “The strength

was there, so we didn’t worry about getting Ron teed up ahead of time,” Dr. McInnis explains. “Some patients need to regain motion and build back muscle before their surgery. This helps them handle their physical therapy [PT] later.”

John McInnis, MD

“The surgery went well,” says Mr. Millet. “I was uncomfortable the first day, but I was ready to walk that afternoon, when the physical therapist came into my room with crutches.” After one overnight at Emerson, he headed home with plenty of motivation.

“One overnight is fine for younger and healthier individuals,” Dr. McInnis notes. “Our multi-modal approach to pain helps patients get moving and go home sooner, and getting out of bed the day of surgery helps prevent the potential development of blood clots.”

Staff from Emerson Home Care paid regular visits to monitor Mr. Millet’s vital signs and begin his PT. “They were all outstanding; I learned a lot from them,” he says. “By my first follow-up visit with Dr. McInnis, I was steadily increasing sessions on my lifecycle. Dr. McInnis examined my knee and said ‘you’re doing everything right.’ That was music to my ears.”

“Ron’s motion was excellent,” says Dr. McInnis. “He couldn’t straighten his leg before his knee replacement, but just a few weeks afterwards, it was almost completely straight. I knew that, after his surgery, Ron would do everything I asked him to do.”

From there, Mr. Millet was soon walking a couple of miles a day with his eye on the spring, when he will be cycling outdoors again. “I’ll stay mostly seated on my bike during climbs,” he says—a way to keep the strain off his knee. But his goals don’t stop there.

“I plan to hike all the 4,000-footers in New England,” Mr. Millet says. “There are 28 in New Hampshire alone, and I’ve hiked some of them already. I’ve been training in one way or another since I was a teenager. It doesn’t matter much what you do, but I believe you have to do something physical every day.”

His knee replacement will keep him going. “It was the right decision at the right time,” he says.