Of the more than half a million Americans who undergo knee replacement surgery each year, few have cases as complicated as Ken Strawhecker's. In fact, his was one of the most complex knee replacements ever performed at Chester County Hospital, a multi-part procedure that involved two orthopaedic surgeons working together over several months: Chet Simmons, MD, chief of Orthopaedic Surgery at CCH and L. Scott Levin, MD, chair of Orthopaedic Surgery in the Perelman School of Medicine.
Partnerships like this are becoming increasingly common between pairs of Penn Medicine hospitals, in this case Chester County Hospital and the Hospital of the University of Pennsylvania. The goal of this “systemness” is to keep more medically complex patients in their own community instead of having them travel downtown for care. Strawhecker was the beneficiary of this philosophy.
After a car accident caused severe open fractures of Strawhecker’s knee and femur, he underwent multiple surgeries, which ultimately led to severe scarring and bone deformity. “The old injury also led to arthritis in his knee, which caused him severe pain that he was managing with medications and braces,” Simmons said. “A knee replacement was really his only option, but we couldn’t do that safely without first addressing the skin damage and scar tissue in his knee.”
First he needed surgery to create an adequate and stable soft-tissue envelope around the bony structures through which to operate safely and ensure proper healing. Levin, who also is a plastic surgeon and specialist in microsurgical techniques for soft-tissue reconstruction, was just the specialist for the job. He performed a free flap procedure, transplanting living tissue with its blood supply from the patient’s thigh to the knee, connecting small blood vessels using the microscope to assure viability of the tissue.
Three months after recovering from the procedure — which Levin likened to “reupholstering” the knee — Strawhecker was ready for his knee replacement surgery.
On the day of the surgery, Levin joined Simmons in one of Chester County Hospital’s newly opened operating rooms. Levin’s role was to carefully raise the free flap and give Simmons access to the inside of the knee. Because of the existing structural damage in Ken’s knee, Simmons used a specialized implant to help make up for the severe ligament damage and deficiency that was present. Advanced, three-dimensional CT scans taken prior to surgery gave the team a clear roadmap to Ken’s knee and the surgery was a success.
After a successful surgery, Strawhecker has several months of recovery and rehabilitation ahead of him, but after years of exponentially worse pain he’s looking forward to a better quality of life. “I want to be able to throw to my kids in the backyard or walk up and down stairs without pain,” he said. “I’m not trying to be a super athlete, but it’ll be icing on the cake if I can play a pickup game of basketball with the guys at work.”