Andrews surgeon successful with innovative outpatient knee surgery
FROM STAFF REPORTS Gulf Breeze News news@gulfbreezenews.com

Submitted photo Gwen Petet, right, works with a physical therapist at the Andrews Institute in Gulf Breeze to rehabilitate her knee after surgery.

It all started with pain and knee problems as an adolescent. Gwen Petet of Pensacola recalls being a young child, and always having problems that caused years of excruciating pain.

"I had my first surgery at age 14 that consisted of muscle transplantation," says Petet. "I spent eight days in the hospital and wore a cast. I was young, so I brushed it off and didn't think twice about it. But that is when I began wondering if all this time and effort in the hospital would actually make a difference."

As someone who loves spending time outdoors, working in her garden and taking care of her lawn, Petet continued to keep up with her activities, despite ongoing pain. But in the years that passed, Petet's knees became increasingly worse. "I had surgery in 2004 to repair some of the damage, but eventually I still needed to go back in," says Petet.

After assessing Petet's knee, Michael Hartsfield, M.D., an orthopedic surgeon affiliated with the Andrews Institute, concluded that Gwen was a candidate for a more minimally invasive knee surgery. The procedure he recommended is called unicompartmental knee surgery, also known as uni knee surgery.

Submitted photo Gwen Petet, left, works with her physician and prepares for surgery.

"Through Gwen's visits and MRI, I determined that she did not need total knee replacement," said

Dr. Hartsfield. "More importantly, I identified Gwen as a good candidate to conduct this procedure as an outpatient. She was in good physical condition and had the motivation to work hard in rehabilitation to make this procedure a success."

Dr. Hartsfield is an experienced unicompartmental knee surgeon, completing over 1,000 surgeries, and is considered an expert in the field. He is the first surgeon in Northwest Florida as well as the Andrews Institute to perform this as an outpatient procedure.

"Typically, uni knee surgeries are done as an inpatient procedure requiring day or two in the hospital," says Hartsfield"However, with recent advancements and taking into consideration a patients general health, age and drive to get back to their activities of daily living, qualified patients could potentially enter surgery in the morning and leave to go home that same afternoon."

At the age of 48, Petet decided she didn't want to spend another day of her life in pain. She met with Dr. Hartsfield to discuss her condition and how to end the increasing discomfort and dysfunction in her knee. Sometimes, less is best

Cartilage normally found in joints can break down and lead to significant problems. This breakdown removes the buffer between bones and the resulting bone-against-bone friction causes pain and eventual loss of movement. "My knees were causing so much pain that I had a hard time going about my daily activities," says Petet. "I was struggling to keep up."

When this breakdown in the joints occurs in more than one of the knee's three compartments, then total knee replacement might be the solution. The uni knee procedure, on the other hand, works best when only one diseased portion of the knee needs repair. Basically, doctors insert a metal runner and plastic insert to keep the bones in the knee from rubbing together.

"The procedure takes a little over an hour, and if done as an outpatient procedure at the Andrews Institute, the patient goes home that same day usually within five to six hours," says Dr. Hartsfield, who has been performing the uni knee surgery on patients for over 8 years. "In my experience, patients recover much faster from the uni knee surgery versus total knee replacement and can be riding a bike or swimming in about two to four weeks."

A mobile decision

Petet decided to have the surgery at the Andrews Institute Ambulatory Surgery Center (AIASC) and had the first uniknee surgery completed as an outpatient in September 2007. "The Institute made it easy for me to get back to my normal routine," says Petet. "The surgery couldn't have gone any better, I had the perfect experience."

Dr. Hickman, anesthesiologist for the AIASC, utilized an innovative anesthesia block in Petet's knee in order to be pain free for the first 24-48 hours following surgery. "That was the first time I was without any pain in my left leg," says Petet. She was able to rest comfortably at home and began rehabilitation without an intense amount of pain and little to no use of pain killers.

"Rehab was pretty easy, and mostly involved trying to get my knee to bend 90 degrees," says Petet. "I met with my physical therapist the day I had surgery to discuss my rehab protocol and actually began rehab the day after surgery." Only two days after surgery, Petet was nearly full-weight bearing on her left leg.

Gwen's progress was largely due to the fact that she had a fullmedical team available to her at any time. "My experience was terrific," says Petet. "The Andrews Institute and Dr. Hartsfield made my experience world-class. The Institute makes it very convenient because I can receive all of my care, surgery, MRI and rehab, all in one place."

Not only was Petet the first patient to receive the uni knee as an outpatient procedure, she has been the only patient to have the procedure on both of her knees. The surgery for her right knee was completed in January 2008. "It's only been two months since I had the uni knee surgery for my right knee but I have already seen remarkable results," says Petet. "Thanks to the procedure, I can now be outside working in my yard doing what I love, and not even think about my knees."