First full knee replacement surgery at BMH

The first total knee replacement, performed at Blue Mountain Hospital by Dr. John LeBlanc, D.O, in March, is being called a complete success by hospital officials and the patient.

“I was nervous coming into it,” said Blanding resident Tim Riffey, who had the first knee replacement at BMH. “Most people say knee replacement isn’t bad, but I had a prosthetic too (since 2002), which made it kind of scary. This leg has done everything over the years and now the bad leg is forced to take it all. I felt it would take longer to adjust, but it’s gone very well.”

So well, in fact, that Riffey was out mowing his lawn last Wednesday, just two weeks after his surgery. He said the knee had bothered him for a couple of years, but in the months leading up to the surgery he couldn’t do much on it at all.

“An MRI showed I had large gapping holes in my knee. Surgery went great. They were more professional than any TV surgeons,” Riffey adding grinning. “They gave me some medication that deadened the pain for three days. I looked down at it and wondered why there was no pain. I knew I was on a pain pill but I never took a pill that had that kind of effect. You could touch it and nothing. I moved around the next day in the hospital and used the machine that bends your knee for you. I was surprised at how well it turned out. I saw several knee surgeries on You-Tube and hoped it wouldn’t be like that.”

According to Dr. LeBlanc, Riffey’s knee replacement went well, but the surgery was different from others because not many knee replacements are done on individuals with prosthesis on the other leg.

“Usually with his knee, he would rely on the knee that is degenerative to help stabilize the prosthesis. Then you have to have the confidence to put the full weight on the knee replacement and on the prosthesis both. It was kind of a challenge for him but he did quite well,” LeBlanc explained. “The knee that we do here is personalized or designed for a specific patient. They call it TruMatch® because it uses a cat-scan to identify the irregularities in that knee, and it helps us to provide a knee that is custom fit. You can perform the knee replacement with a robot, but the problem with a robot is that when you are relying on a robot (called a MAKO), it assists the surgeon with the cuts by having a device that helps to guide your hand in how to cut the knee. It’s okay but it takes away a lot of the skill level of the surgeon. Kind of leaves the robot to chance, depending on how much confidence you have in robotics. The problem with that is if there’s something that looks questionable you have to decide is the robot at fault or is the whole system at fault.

“With our system it gives you a plan and a design and you can decide if you agree with it. So I think our system’s better,” LeBlanc continued. “I think it’s a little more hands on and relies on your skills more. The one knee we put in is called a mobile bearing. It allows the knee to pivot and move more realistically like a real knee vs. a knee that just flexes and extends. It allows it to pivot and do more for the more active individual.”

LeBlanc said this procedure is considered to be minimally invasive because he spares the quadriceps. This is the muscle that attaches to the kneecap or patella. So he doesn’t cut into it and the recovery is quicker.

“I release the muscle off the bone and that way when they’re recovering, in the hospital, they’re not getting that pain in the thigh and they’re able to do more and get better quicker. They can get to the stairs quicker because they can use that muscle that doesn’t shut down. The incision is a little smaller than the average incision because of the instrumentation I use,” he added. “I think if I’d violated the quadriceps and cut into the muscle it would have been worse because he wouldn’t have been able to put as much weight on it and he’d have more balance issues.”

Another factor in the surgery and recovery of Dr. LeBlanc’s patients is a medication called Exparel®, a pain relieving injection that lasts three days. So when Mr. Riffey was in the hospital and said he had no knee pains, that was the reason. Which is tremendous. Exparel® is injected into eight different areas of the knee. It attaches to the fat and is held in the knee for 72 hours, which allows the knee to be pain free. It allows the patient to use the machine that helps bend the knee; it allows him to walk on it and allows him to use less narcotics, which is important. It also eliminates the need to use blocks after surgery.

According to Summer Wojcik, BMH Surgical Manager, when a patient first comes to the hospital for a knee replacement, they talk about a total joint replacement.

“We have them get a cat-scan done through TruMatch® to identify what their old joint looks like and makes them a custom joint that only fits them,” she said. “They send Dr. LeBlanc an e-mail with the results and he then verifies the measurements for the tibial plateau. Everything’s on there, so it’s going to match the patient’s joint perfectly. It wouldn’t be usable on anyone else. It basically designs a knee for that one patient.”

“He was really great,” Riffey said of Dr. LeBlanc. “You feel like you have a friend there. He talked about his horses and about my life and lot of stuff. I told him about my music. I’ve played and studied music all my life. Your feet are the most important part of the drums; your foot pedals. You lose your foot pedals you might as well retire your drum set because that’s your drums, your feet.

“The hospital staff at Blue Mountain Hospital is top notch,” Riffey added. “Even the cooks ask what you want and everything tastes home made,” he said. “They all were very attentive all through it. It was nice.”

Riffey also had good things to say about Dr. Paul Macdonald, DDS, who had to do some dental work on Riffey, at the UNHS Blanding Family Dental, to remove infection before his surgery.

“Dr. Macdonald numbed and gassed and numbed and gassed and he had me out in about an hour. In a day I was eating solid foods. He treated me just great,” Riffey said. “I’ve been treated great all around by these people. Blanding, in my opinion, is building a fantastic medical facility at Blue Mountain Hospital and at Utah Navajo Health System, Inc. People come to Blue Mountain Hospital and have shoulder surgery and knee surgery done and other things. I really like Dr. LeBlanc. He’s a really nice fella.”

Dr. LeBlanc has more knee replacements scheduled over the next couple of months. Anyone wishing to consult about knee replacement or shoulder surgery, other orthopedic surgery or general surgery can contact Blue Mountain Hospital at 435-678-3993 or the Surgery Department at 435-678-4812.

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