SIOUX FALLS, S.D. (KELO) — A new type of pain management is helping knee surgery patients recover more quickly and without the need for high-dose opioid painkillers.
Julie Becker is the Executive Director of the St. Francis House. It’s a demanding job coordinating staff and volunteers and helping residents get a job and get back on their feet.
Sitting still is not one of Becker’s strong suits.
“People who know me know I’m not in my office all the time. I like to mingle and talk with the guests, I have donors who come in. I like to make sure my staff feels supported and so being able to do that I have the luxury of being able to move around quite a bit,” said Becker.
Becker says she puts in 10,000 steps a day.
All that moving took its toll on her knees.
Becker has a unique perspective when it comes to knee surgery because she’s had two of them, one the traditional way, the other with a procedure before the surgery.
After her first knee replacement, Becker says her recovery was tough.
“I was in so much pain that I remember the first day of physical therapy I sat in the wheelchair and just cried,” said Becker.
Becker is one of the many people who don’t handle opioids well.
So when it came time for her second knee replacement her knee surgeon remembered the challenges she faced and recommended a new procedure to help manage the pain.
“I was supposed to be the first but I think I was like 3rd of 4th,” said Becker.
The procedure involves freezing nerves with a device called the Lovera.
“Pain is the number one limiter of people being able to get back to rehab,” said Buchanan.
Dr. Jonathan Buchanan specializes in sports medicine. He spent 10 years as one of the team physicians with the NBA’s Portland Trailblazers before being lured to Avera’s new Human Performance Center in Sioux Falls.
“If there is a way we can treat patient’s pain before the surgery so that when they come out of surgery they have less pain then they don’t need the narcotics and they are up walking around, seems like a miracle seems like they are walking around that day or the next day,” said Buchanan.
Dr. Buchanan says there are three or four main nerves in the knee that transmit pain to the brain.
“People think of nerves more like wires running through your body, but really they are tubes of water. And if you put something really cold by something filled with water the water expands, kind of like taking a water bottle and throwing it into your freezer, it breaks open. So if you can put a really cold needle next to that water, the nerve then it breaks the nerve open and it kills the nerve. And people get a little nervous and uh oh my nerve is dead now, but they regenerate so,” said Buchanan.
The process works by locating the nerve, inserting a probe, and introducing a very localized freezing effect.
“And then I’ll push the button and you can see the ice forming, it just forms a little ball of ice on the end of the needle. And like I said the nerve is a hair’s breadth or a pencil lead thickness so as long as you are close you can still catch the nerve,” Buchanan said.
Dr. Buchanan says nerves deep in the knee will have no sensation for 3 or 4 months. During that time patients like Becker can get in the bulk of their rehab before the nerve grows back.
“The more you get up and move and walk and do those types of things, it keeps that joint moving. If it lays still for a long period of time it’s kind of like the tin man, you got to get it moving… my recuperation was much easier I did all 32 sessions of physical therapy on both knees but this one was ten times better,” Becker said.
This technology holds a lot of promise. Dr. Buchanan says once ultrasound improvements are made then smaller nerves can be located.
“We are able to catch branches of nerves and treat a wider variety of pain. Now my goal as a sports medicine physician is to restore function right, so I want people getting better, so treating the nerve is like my last-ditch effort to get people better. I’m not a pain doctor, I’m a function doctor,” said Buchanan.
Dr. Buchanan admits there can be side effects, it doesn’t always work, and sometimes he has to repeat the procedure to get the desired effect. But for patients like Becker, it’s been a difference-maker.
“I’m a true testament of the new way is 10 times better than the old way,” Becker said.
The Lovera procedure has been around for a few years now.
Those who don’t tolerate painkillers or who have certain medical conditions are top candidates prior to knee replacement surgery.