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Joint Replacement Patients Recommend Program 100 Percent

Robert McKnight Jr. photo

Robert McKnight Jr. was able to walk his daughter down the aisle after his joint replacement surgery at Monongahela Valley Hospital's Orthopedic Institute. He is standing near a pavilion he built for his wife and personal coach Lois. Their adopted dog, Luke, helped keep Mr. McKnight active after knee replacement surgery.

Joe Picinotti Jr. photo

Joe Picinotti Jr. had remarkable results after his total knee replacement at Monongahela Valley Hospital's Orthopedic Institute. He is shown with his wife and coach Norma at the quarterly reunion the Orthopedic Institute hosts for total joint replacement patients, where patients and coaches meet with staff and provide feedback on the program.
(June 25, 2014 - Carroll Township, Pa.)

How often can a health care program boast a perfect score of 100 percent? The year-and-a half-old Orthopedic Institute (OI) at Monongahela Valley Hospital's patients report that 100 percent of patients would recommend the hospital's Orthopedic Institute to others who need total joint replacement surgery.

The Orthopedic Institute is one of the only local joint replacement programs that surveys its patients (patient reported outcomes) on pain and functionality of sitting, standing, walking, using steps and more, before and after surgery. Patients are surveyed pre-op and then again at six weeks, three and six months and at one and two years.

The program also boasts a 92 percent patient satisfaction rate, and 90 percent of patients reported little or no pain three months after total joint replacement procedures.

When Robert McKnight Jr. fell at work while unloading milk trucks because the pain in his bowed right knee was so intense, his surgeon said waiting a few years until retirement was not an option. He needed to have the knee replaced.

Mr. McKnight, age 63, decided to go to the Orthopedic Institute at Monongahela Valley Hospital. Orthopedic Surgeon Ari Pressman, M.D., performed Mr. McKnight's knee replacement last October.

Because his knee was so worn out from 38 years of heavy physical work, the recovery and therapy took a bit longer, but Mr. McKnight was able to walk his youngest daughter, Tiffany, down the aisle for her wedding May 9 when she became Mrs. Kenny Foster.

Looking back, the Belle Vernon resident appreciated the intense preparation the "prefab" program provided to joint replacement patients before surgery, including the pre-op testing and the classes and information binder that both were a guide to necessary exercises and a wealth of information about every step of the process he would experience as a patient.

Up and walking the same day as his surgery, Mr. McKnight found extra inspiration in the group therapy sessions he attended after surgery as well.

He said that he had been experiencing some discomfort and felt a little disheartened. That was, until he met a man who had had both knees replaced and was just determined to "get back to it."

"I thought if he could do this with two knees (replaced), I could certainly do it with just one; I thought 'he's got to be in more pain than me,' and I really pushed myself from there on out," he said.

Each patient in the Orthopedic Institute also walks through the process with a personal coach to help him or her recover. Mr. McKnight's wife of ten years, Lois, a nurse since 1971, was his coach and she attended both the pre-surgery classes and helped him after the surgery.

"Being a nurse, I was expecting 110 percent out of him," she said. "He didn't have home therapy, he went straight to outpatient therapy and he used the home-exercise machine six hours a day as prescribed."

Mrs. McKnight said her husband also had another special weapon in his recovery. Right after Mr. McKnight's surgery, they adopted a 10-year old miniature schnauzer, Luke, from a patient at the senior living facility where she works.

"Luke was a Godsend. It was really good for Bob to walk with him. Bob would even get down on the floor and play with Luke - that's tough for someone with a new knee," said Mrs. McKnight.

The McKnights said they both appreciated the extra care they received and were grateful that the staff gave him in a larger room at the end of the hallway to accommodate visits from some of their combined families of seven children, nine grandchildren and four great-grandchildren.

Joe Picinotti Jr., a retired pipe fitter and welder, also had his right knee replaced in March but his experience was slightly different. To help cushion his deteriorating knees, Mr. Picinotti had been receiving injections periodically for about six years from Scott Baron, M.D., an orthopedic surgeon.

A two-week trip to Italy that required intense walking was a clear signal to Mr. Picinotti that he could no longer put off the joint replacement surgery he needed.

"The shots were not lasting. At the end of the day, my knees were just killing me and that was every day, sometimes it didn't wait until the end of the day," he said, adding that he had difficulty sleeping from the pain and steps were especially difficult.

"I had to step up with both feet on one step before I could go to the next step, with both feet; my knee would ache to no end and I couldn't fall asleep," he said.

He was hesitant about the surgery because he watched his wife three years ago receive a double knee replacement at another facility, and although she was satisfied with the procedures, she experienced significant, long-lasting pain.

Mr. Picinotti said that during surgery he had received a new pain medication called Exparel to control pain and expedite mobility. The drug is injected directly into the surgical site before it's closed. He said he also followed the pain management plan his doctor gave him because he didn't want to wait until he was in pain to use the prescribed meds.

"The pain wasn't there at all (after surgery). I had zero pain in the hospital. We went to therapy and I could not believe I had no pain. Talking to others in therapy, they've had pain. Once I got home, the therapists couldn't believe what I could do (at outpatient therapy)," he said. "At the pre-surgery class, they gave us exercises to make our muscles as strong as we could and I think that helped tremendously in my recovery."

The Charleroi resident said a lifetime of heavy lifting and working outside that kept him in top shape could also have contributed to his good post-surgical experience. And now he carries the laundry up and down the steps for his wife, one foot after the other.

"I would like to give all of my nurses a big hug, they were so fantastic, every time a nurse would come in I'd ask her to help me take a lap (around the Orthopedic Institute floor)," he said. "Everyone on the 5th floor was wonderful and we didn't want for anything. If I had four knees, I'd get them all done there."

Mr. Picinotti and his wife, Norma, enjoy traveling, especially to visit their grandchildren in Michigan. He said he can't wait to get his other knee replaced so they can visit their family and head to their next bucket list destinations: Prague, Germany, Holland and Austria.

Both men plan to have their left knees replaced at the Orthopedic Institute at Monongahela Valley Hospital in the coming months. For more information on joint replacement surgery with less discomfort and quicker recovery, call the Orthopedic Institute at 724-258-1218
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