From inside the lodge, nurse and competitive skier Nancy Riley-Jones looked out on an achingly beautiful day at Silver Star Mountain in Canada. Sunny skies and fresh powder made for perfect skiing.
But severe knee pain had sent her inside before noon. As her friends hit the slopes, she realized it was time to do something.
“I really felt like I had come to a place where my life was not the way I wanted it,” said Nancy. “A change was needed.”
Nancy has always been an athlete. She did ballet and tap dancing throughout her childhood and discovered competitive skiing in college. She also enjoyed dancing with her husband. After taking time off from competition to raise her children, she began masters ski racing in 2004, a sport she found fun and challenging.
Giving up her active lifestyle was not an option.
She had gone through three arthroscopic knee surgeries already because of her history of knee arthritis. Arthritis of the knee causes pain, stiffness and swelling, and simple daily activities, such as getting up from a chair, can be affected. After trying alternatives to avoid another knee surgery, such as activity modification, anti-inflammatory medications and knee join injections, she was still experiencing pain and knew a knee replacement was in her future.
For patients with severe knee arthritis like Nancy, knee replacement surgery can decrease pain and improve quality of life.
“I had good orthopedic care with my past knee surgeries,” she said. “But when it came time to do the knee replacement, I really looked around to find someone who could do a minimally invasive approach.”
A colleague recommended orthopedic surgeon Dr. Seth Leopold, who specializes in hip and knee surgery and has been performing minimally invasive knee replacements for 12 years.
Minimally invasive total knee replacement, also called quadriceps-sparing knee replacement, is a surgical technique that allows surgeons to replace the joint without cutting the important quadriceps tendon or everting (rotating) the kneecap out of position during the operation. The procedure uses the same implants (made of cobalt chrome or titanium) as traditional knee replacement surgery, but the incision is smaller and there may be a decrease in post-operative pain. In addition, the recovery time is faster – patients often can walk without a cane within a couple of weeks of surgery.
“The minimally invasive approach is a gentler surgery compared to traditional knee replacement,” said Leopold. “Patients are getting better noticeably quicker with this approach. However, not all surgeons are doing it, perhaps because it has not been around as long as the traditional approaches; we can’t give 20-year follow-up on an operation we’ve been doing for 12 years, but we have published our results to this point.”
Leopold recommends that patients educate themselves on the different methods and come with questions to ask their surgeon. This helps create a better visit.
“In the life of a patient, this type of surgery will always be a big event. It is a heroic journey,” he said. “I try to be the patient’s mentor, coach and cheerleader, but I’m on the sideline and they’re in the game.”
Nancy Riley Jones shows her gold medal to Dr. Seth Leopold.
And the game isn’t the surgery; it is the recovery and rehabilitation time. The hardest part is getting back the knee’s range of motion.
Dr. Leopold did the first knee replacement on Nancy in August 2013, and nearly a year later performed the surgery on her other knee. Nancy said that the rehabilitation with a physical therapist was harder than she anticipated. She expected to feel better in three to four weeks, but it took longer than that – about nine weeks after her first surgery and five weeks after the second to return to work and almost a year to feel completely recovered.
“Someone who wants to return to an intense sport like skiing really needs to put the time in to recover and regain strength,” said Leopold.
After each surgery, Nancy would try skiing again over the Thanksgiving holiday weekend. She didn’t ski very hard at first, but as she started to gain strength and more confidence, getting back to competition entered her mind.
“I just wanted to live my life again. I wanted to be able to walk around at work and maybe do a little bit of skiing,” she said. “But I felt so good after my surgeries that I kept training.
On March 17, 2016, two years after her last knee surgery, Nancy competed in the United States Ski Association Master’s Super G in Big Sky, Montana, for the women’s national title and won the gold medal.
She had no idea she’d go on to win a national championship after knee replacement surgery. Before her knee replacement, the highest Nancy had placed in national competition was fifth.
“I guess I needed to be a little bionic,” she said. “I can dance and ski again. Life is really good.”