In this episode of the Between the Bones Podcast, Dr. Thomas Fehring talks more about his experience as a knee replacement surgeon and how his procedures have affected the care he provides to his patients.
Dr. Fehring’s interest in knee replacements begins in college
Dr. Fehring played football at Wake Forest. During his time at the university, he underwent four operations when he injured his knees during play. After his undergraduate studies and collegiate football career, Dr. Fehring focused his medical school studies on arthroplasty. Arthroplasty is the study of the replacement of hips and knees. His medical training took him from Vanderbilt for residency to Boston for further studies. In Boston, Dr. Fehring focused on “specialized training and how to re-do a knee replacement or a hip replacement that has either worn out or had some complications.”
Since joining the physician team at OrthoCarolina as a practicing surgeon, Dr. Fehring has been appointed as the Co-Director of the OrthoCarolina Hip and Knee Center and specializes in surgery for arthritis of the hip and knee, primary total knee replacement, revision total knee replacement, and arthroscopic knee surgery.
Knee replacement basics
In Episode 5 of the Between the Bones Podcast, Dr. Fehring explains that knee replacement surgery remedies knee pain when other, less-invasive options have been exhausted. He elaborates by sharing, “You can treat that [knee pain] conservatively with many modalities, like anti-inflammatories Advil, Aleve, and occasional injections. There are a few different types of injections, cortisone, or what we call a Viscosupplementation or a gel injection, which are adequate to delay knee replacement. But at a certain point, all that kind of stops working, and patients are looking for an alternative.”
The knee pain can be caused by either trauma-related to infection but more commonly by the results of degenerative arthritis. With this condition, patients lose some of their articular cartilage, which is the white cartilage on the edge of the bones. As this cartilage degenerates, people experience bone-on-bone scraping, which causes pain. As the pain becomes more severe and conservative and non-invasive options for pain relief are attempted, a knee replacement is a standard next step.
Recovery time for knee replacement surgeries
As Dr. Fehring has been both a knee replacement surgeon and a knee replacement patient, he can speak objectively and personally about the recovery period after surgery. He explains in the podcast that healing “Usually involves a day in the hospital. Some people are doing these outpatient surgeries now if they're very healthy patients, but it's usually an overnight stay. Then you're you get up walking on the day of surgery with a therapist’s help, and then the next day, they teach you how to do exercises at home. And then for three or four weeks, you get physical therapy twice a week, and then you're pretty much on your own with a home program. You use a walker or crutches for the first two or three weeks and then a cane.” Walking and movement soon after surgery, with the help of a physical therapist, are critical in reducing the likelihood of complications such as blood clots or pneumonia.
After Dr. Fehring’s second knee replacement, he was back working part-time in the operating room six weeks after surgery. He expected to be back working full time in the operating room eight weeks post-surgery.
As far as pain reduction, Dr. Fehring shares that immediately after the knee replacement surgery, 80% of the patient’s pain they experienced pre-operatively will go away. The remaining 20% of pain will slowly dissipate a year after the surgery.
Knee replacement surgeries – provider, then the patient
Dr. Fehring underwent a second knee replacement surgery in late 2021. He felt confident being treated by a fellow OrthoCarolina surgeon and shared that his attitude toward his patients changed post-surgery. On the podcast, he said, “my empathy level went up about a hundred percent for what my patients were going through, and I actually wrote a little article about that to my peers in one of our major journals. That until you go through something like this, you really don't understand how it affects your daily life, your family life, your expectations going in as well as your expectations afterward.” The journal article authored by Dr. Thomas Fehring can be found here.
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This information is provided as an educational service and is not intended to serve as medical advice. If you are seeking specific orthopedic advice or assistance, please consult with your OrthoCarolina physician or locate one in your area through OrthoCarolina’s website at www.OrthoCarolina.com.
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