While I would like to pretend that every surgery I perform is perfect, in reality, a small percentage of time, things may not go as well as we would have liked. In fact I would say these cases often occupy 99% of my mind space.
Allow me to introduce you to Mr. Kaminski. This is what you get when you mix unbreakable will power, with determination, and commitment. We performed a total knee replacement for him for severe debilitating arthritis. After surgery unfortunately he developed arthrofibrosis or a significant scar response that restricted his range of motion. I have never met someone so dedicated to his physical therapy. Nonetheless, for inexplicable reasons he would gradually lose his range of motion as scar tissue set in.
We did an extensive diagnostic work up to make sure there were no underlying causes. Ultimately we tried an arthroscopic lysis of adhesions and manipulation under anesthesia to restore his range of motion. Pictured is his knee before and after the procedure demonstrating the amount of knee flexion regained. Unfortunately his scar tissue came back and once again was stuck with a stiff knee.
This did not phase Mr. Kaminiski. He researched extensively on his own and even developed his own medieval like torture device with pulleys to promote knee flexion (see video!). Determined to heal he requested we try the arthroscopic lysis of adhesions and manipulation under anesthesia once more, only this time he was going to use his device and approach his therapy differently.
Admittedly, I had my doubts. However I could see that Mr. Kaminiski was not going to accept no for an answer and that he was ready to accept the associated risks of another procedure. We attempted the procedure again. Once more we were able to restore his range of motion intraoperatively. Immediately postoperatively he went to work. He leveraged his new device and diligently worked with rehabilitation to ensure he did not regress.
Fast forward 5 months later and I am happy to report that Mr. Kaminski’s hard work and persistence has paid off. He has finally restored a functional range of motion and deserves all the credit for it. Experiences like this are humbling and remind me how important it is to engage my patients and individually craft a treatment plan.