Knee Cartilage Damage, Knee Replacement

Christopher Haas is not hardwired to sit still. The 57-year-old from Reading, Pennsylvania, played competitive volleyball for 20-plus years. He was also a runner, a triathlete, a trainer, and has a very physical job as a FedEx courier, which he's been doing for 17 years.

Even a severe car accident in 1984 resulting in a broken femur didn't slow him down. He kept up five days a week of volleyball after his femur healed. But two years later, the severity of the fracture and his regular volleyball schedule took a toll on his knee.

His knee troubles cascaded into a series of surgeries and increasing knee pain. His first was to repair his anterior cruciate ligament, or ACL, and a medial meniscus tear. He was warned to slow down, but he didn't.

"I continued to run with all the things I do, then the knee would get bad again, and then I'd do it all over again," adds Christopher. With that came the second surgery. Then, a third in 2012.

What's age got to do with it?

After the last surgery, doctors said they couldn't do any other procedures. His cartilage was worn so badly that the bones of his knees were grinding against each other. His surgeon said he'd be a candidate for full knee replacement — if he were older.

The best bearing surface in terms of durability is what we're born with — cartilage on cartilage. If someone in their 40s or 50s has a joint replacement or even a partial joint replacement, they may need revision surgery for mechanical loosening or other problems.

A Third Opinion

Christopher had had enough. He had a heart to heart with his wife, Kirsten. Regardless of the age concern, she wanted him to consider the knee replacement. And he wanted to be done with all the pain medication.

When another doctor told him he needed to be older, Christopher went online to Penn Medicine's site, filled out an appointment form, and met with the Penn Orthopaedics team.

At Penn, we offered something that no one else mentioned — a partial knee replacement.

If someone develops end-stage arthritis in one compartment of the knee, and the other compartments are relatively preserved, they're often a potential candidate for replacing just that compartment, or partial knee replacement.

Calculated Risks

Christopher was excited, but he wanted his wife's blessing. Kirsten was concerned about the longevity of an implant at Christopher's young age.

The Penn Orthopaedics team assured the couple that despite his young age and active lifestyle, a well-done partial knee replacement would offer a durable option. Christopher also could get back to his normal pace — at work and at play — whether that meant light jogging and aerobic activity, or climbing a flight of stairs with a heavy package at work.

Christopher had the hour-long surgery in late August 2014. His surgeon made sure the overall alignment was perfect between his hips, his knee, and his ankle, so he would have no problem bearing heavy loads.

The Road To Recovery

Despite the surgery's immediate success, the full rehabilitation process would take a full year.

Running or playing a little volleyball once in a while is a bonus for me. I never thought I'd be able to do any of that ever again. Now, two other guys at work that I recommended to Dr. Kamath have each had partial knee replacements. — Christopher Haas, 57-year-old FedEx courier who got back on the road with a partial knee replacement after years of knee pain.

Christopher was sent home with a list of exercises to build strength and flexibility, but he didn't have any formal physical therapy for the first several weeks, just the exercises. For the remainder of the yearly recovery, Christopher did physical therapy, including work with in-home equipment.

"Back in my 20s, 30s, and 40s, I would listen to what the doctor said and then I would interpret it the way I wanted to," Christopher says. "But at 57, if my doctor says it's gonna take a year, then it's a year."

Christopher went back to work full time in December 2014 — just in time for the Christmas package rush. In September 2015, he completed his first 5K in six years.

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