Hitting Her Stride
Retiree Gets Her Groove Back After Knee Replacement



Dianne Allison doesn't give in easily. When her osteoarthritis limited participation in one activity, she'd replace it with another and move on. But knee pain nearly stopped Dianne in her tracks.

The first sign of serious knee trouble sprang up after a lot of walking during a 2010 European summer vacation. Cobblestone streets and lots of stairs put wear and tear on her arthritic knees. A large cyst developed behind her left knee. By September, she was hardly walking at all. "My gait had slowed and my husband noticed I was walking a little bent over," she says. Dianne is tall, and her stride had shortened significantly. Water aerobics, an exercise she enjoys because it takes weight and pressure off arthritic joints, became increasingly uncomfortable.

When she consulted with her orthopedist, the verdict was total knee replacement. The cyst turned out to be a Baker's cyst, which can accompany severely arthritic joints. She had large bone spurs in the knee and the knee joint was reduced to bone-on-bone. "It wasn't possible to do arthroscopic surgery to clean that out," she says.

That's when she was referred to joint specialist Nauman Akhtar, MD, MBA. Dr. Akhtar is fellowship-trained in total joint replacement (see sidebar), and is focused on keeping Loudoun at the forefront in the field. Dianne's surgery was right up his alley.

	Nauman Akhtar, MD, MBA Is your knee pain becoming too much to bear? Nauman Akhtar, MD, MBA, will present a FREE seminar on advancements in knee joint replacement Sept.  14 at 2 p.m. at Inova Loudoun Hospital. Call 855-My-Inova (694-6682) or register here.

Less Pain, Quicker Recovery

Loudoun is keeping in step with exciting new developments in total joint replacement, says Dr. Akhtar. New methods, including computer-navigated surgery and individualized pain control, mean shorter surgeries, shorter hospital stays and quicker recovery. Knee replacement surgery has dropped from three hours to 90 minutes. And what was once a four-to-five-day hospital stay is now typically two to three days at Loudoun, he says.

Excellent pain control is the key to these improvements. Dr. Akhtar uses intra-operative, multimodal pain management techniques, which reduce the amount of each painkilling drug given by spreading out their use before, during and after surgery.

This leads to greater postoperative mobility and faster recovery. "With multimodal pain therapy, our patients don't have as much disorientation and can tolerate physical therapy in the hospital," Akhtar says. "After total knee replacement, I have them walking the same day."

Back in Step

Dianne and her husband were well prepared for what to expect before, during and after surgery at Inova's informative "Pre-Operative Joint Camp" session. She then did physical therapy to strengthen muscles around her knee to help with later recovery.
During the one-and-a-half-hour surgery, Dr. Akhtar cleaned out the Baker's cyst and removed bone spurs. He then replaced her knee with a high-performance cobalt-chrome-and-plastic joint. With the help of attentive, expert Loudoun staff, Dianne was able to walk, climb a few stairs and get in and out of a chair using a walker before returning home in just two days. Once home, she immediately began a three-day-per-week, in-home therapy.

In May, just three months after her surgery, Dianne was "90 percent better." She was walking faster with a longer stride and was back at her gym doing muscle-strengthening exercises, including presses, curls and squats. She also has started back to water aerobics three times a week. Her experience at Loudoun was positive, she says. "It's major surgery, but I'd tell others to check out total joint replacement. When pain starts affecting your daily life, it's time to do something about it. This surgery can make a big difference in your life."