A Way Around the Pain

A New Pain-Relief Technique is Helping Knee Replacement Patients Enjoy an Easier Recovery

Now recovered from his knee replacement surgery, Jerry Skidmore can enjoy walks with his wife, Kathie, again.Excruciating pain greeted Jerry Skidmore after his first knee replacement surgery at a hospital in Poplar Bluff, Mo. A morphine pump did little to ease the pain.

The Gideon, Mo., man felt the same sharp pain after a second surgery to fix his replacement knee.

To make matters worse, the anesthesia made him nauseated. Pain pills didn't help. He even suffered hallucinations, he says. "I was sicker than a dog."

By early 2008, the replacement knee - even with surgical repairs - still bothered him. "I had difficulty walking. I couldn't climb the stairs by myself," recalls the 64-year-old Skidmore, a supervisor at Noranda Aluminum's sprawling Bootheel plant. "It kept getting worse and worse." His knee was also extremely swollen.

A frustrated Skidmore decided to look to another physician for medical treatment. He turned to R. August Ritter, M.D., of Orthopaedic Associates in Cape Girardeau and a member of the Southeast Hospital medical staff.

Dr. Ritter concluded that Skidmore would need another total knee replacement. Skidmore worried about having to endure painful surgery again, but was thrilled when Dr. Ritter told him about a new pain relief system available at Southeast Hospital called the On-Q ® C-bloc, which could dramatically reduce Skidmore's postsurgical suffering.

How it Works

First used at Southeast Hospital in May, On-Q ® C-bloc is a small, high-tech balloon that holds a local anesthetic and delivers it through a tiny, specially designed tube or catheter into the surgical incision site. Similar to the way a dentist injects novocaine at the drilling site, the On-Q C-bloc numbs the surgical site, directing medication only to the area of pain. The pain medication is administered through the groin area.

"The result is a quicker recovery and less pain for the patient," Dr. Ritter says. That means the patient is less likely to need narcotics, reducing the incidence of postoperative nausea and vomiting, he says.

"This is not an epidural, but an infusion at the femoral nerve level," says Anesthesiologist Matthew LaValle, M.D., of the Southeast medical staff. "It has no power source, it works off hydrostatic pressure."

Dr. LaValle says he and other board-certified anesthesiologists at Southeast Hospital have embraced this new means of providing pain relief for their patients. Patients typically receive the pain medication for about three days before the device is removed.

A Different Kind of Recovery

Skidmore says he has nothing but praise for the pain relief system, and that he noticed the difference immediately after his surgery on July 9.

"The pain just disappeared," he says. "I could raise that leg right up, and I wasn't sick to my stomach. All I wanted to do was eat."

A day after his surgery, Skidmore told his wife, Kathie, he couldn't believe he wasn't in pain. "He was on cloud nine," she says.

During inpatient therapy sessions in the hospital, the nerve block system is turned off. Still, Skidmore says the medication already in his system made a difference during the very first day of rehabilitation exercises.

"I walked all the way around the room twice," he says. By the end of his first therapy session, however, Skidmore began to feel postsurgery pain. He was relieved when the pain pump was turned back on. "I told Dr. LaValle, ‘I love the pain block,' " Skidmore says.

He spent two nights and three days in the hospital. The nerve block device was removed before he left the hospital. Physical rehabilitation is vital to the success of knee replacement surgery. Thanks to the On-Q ® system, Skidmore was able to be more active during his physical therapy sessions in the days following his surgery.

"The quicker you can begin therapy, the more you will be able to move the knee," says Skidmore.

Skidmore says his mobility has continued to improve as he exercises his new knee, and that he'd recommend the On-Q ® system to anyone having the surgery. Although he admits that it hurt initially to have a needle inserted, he says he quickly forgot about it when the pain relief kicked in.

"It's worth it," he says.