Gradual knee pain

When Anne Jurenec was in her twenties she tore her left anterior cruciate ligament (ACL) while playing volleyball. Anne knew she needed surgery to repair her knee, but life got in the way. She was busy with a family and a career so she managed the pain and waited several years before getting her ACL reconstructed. The surgery was a success, and for a long time, Anne lived pain-free.

“The pain came on gradually,” Anne said. “I started to feel a dull ache in my knee, and at night, I would wake up with a sharp, shooting pain. It got to a point where I could no longer do the things that I loved, like ride a bike or horseback ride. Eventually, even going up stairs or walking to a meeting became challenging.”

“Bone on bone”

Anne, now in her fifties, is the executive director of the neurosciences and spine service lines for the Froedtert & the Medical College of Wisconsin health network. A colleague recommended she make an appointment with orthopaedic surgeon Edward Nelsen-Freund, MD, to discuss treatment options.

“Anne had developed osteoarthritis in her left knee,” Dr. Nelsen-Freund said. “The wear and tear in the knee joint was most likely related to her ACL injury when she was younger. Anne’s X-rays showed the cartilage had worn away – it was bone on bone. A total knee replacement was the best option to decrease Anne’s pain and increase her mobility.”

Knee replacement surgery is an elective procedure. Some patients choose to manage their pain with conservative treatments and limitations in their activities and never have surgery, but not Anne. She was determined to get back to her active lifestyle.

“I felt so limited not being able to do the things that I enjoyed,” Anne said.

Preparing for surgery

Dr. Nelsen-Freund administered cortisone injections to Anne’s left knee to relieve some of the pain until the date of the surgery. They also discussed Anne’s activity goals to select the appropriate prosthetic for her lifestyle. The bearing they ultimately chose is made of highly wear-resistant plastic, called polyethylene, and has a proven clinical outcome. 

“Newer technologies exist, which are available through the Froedtert & MCW health network,” Dr. Nelsen-Freund said.  “But it is important to recognize that while newer designs may be better than what was historically available, they may also be worse. The knee Anne chose has a proven track record and will last 20 years or more. When the plastic wears, we’ll be able to easily replace it – like changing the tires on a car.”

Finding relief

Anne’s knee replacement was in September 2017 at Froedtert & MCW Community Memorial Hospital in Menomonee Falls. The surgery was on a Monday, and she returned home on Tuesday. By Friday, Anne had begun physical therapy at the Froedtert & MCW West Bend Rehabilitation & Sports Medicine Center. The Froedtert & MCW Mequon Health Center opened shortly after that, and she continued her therapy at the new location because it was closer to home. 

“I worked hard in PT and did all of the exercises,” Anne said. “I was very motivated.”

Dr. Nelsen-Freund said Anne’s commitment to strengthening the muscles around the knee joint helped her recover as quickly as possible. Anne returned to work with no restrictions seven weeks after the procedure.  A few months later, she was back at the barn and horseback riding. 

“I am enjoying my life again,” Anne said. “It is so much fun to be able to be spontaneous. I don’t have to plan around the pain anymore.”

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