Working as a bedside nurse requires extensive physical effort – pushing wheelchairs, twisting and lifting, and standing for long periods. Jennifer Thomas, who’s been a nurse at UK HealthCare for six years, can attest to this. In fact, it was while assisting a patient from a wheelchair that she badly injured her knee.
“The pain was excruciating – a sharp, stabbing burn,” Thomas said. “It was constant regardless of sitting or walking. My sleep was interrupted due to the discomfort, stairs were next to impossible to navigate and playing with my newborn grandbabies – be it pushing a stroller or carrying them from room to room – was difficult at best.”
The injury also made it difficult to do her job as a pre-op nurse. Sometimes she’d be walking into a patient’s room when her knee would give out, causing her to fall. She had trouble standing for the long enough to assist with epidurals and nerve blocks, and her knee would swell after long days.
Thomas cycled through the standard treatment options: cortisone shots, physical therapy and two surgeries. These treatments required time off work and extended periods of rest, but they didn’t provide relief. The only way to reduce the pain was to stay off her knee and keep her feet elevated.
Participating in a clinical trial
In November 2015, a year after her original injury, Thomas was referred to Dr. Christian Lattermann, director of UK’s Center for Cartilage Repair and Restoration in UK Orthopaedic Surgery & Sports Medicine. In order to fix Thomas’ injury, Lattermann need to perform a cartilage transplant. Unfortunately, many patients who undergo this type of procedure experience muscle weakness afterward. To combat this problem, Lattermann, along with co-principal investigator Caitlin Whale, are leading a clinical trial to investigate how muscle stimulation using a device called the Phoenix Device could improve muscle strength following surgery.
“Weakness in the thigh musculature after this procedure is a big problem that we have not been able to improve,” Lattermann said. “[The Phoenix Study] is a way to find better techniques to treat this weakness.”
Thomas was eligible to participate in the clinical trial. First, Thomas’ strength and functional performance were measured. She then underwent an osteochondral allograft, a surgical procedure where a living piece of cartilage and bone from a cadaver is implanted in the knee. After surgery, Thomas had nine weeks of rest. Within days of surgery, she began a home treatment program, and a couple of weeks after surgery, she began participating in physical therapy. After completing the 12-week home treatment, Thomas’ strength and function were measured, and then again at six months and one year.
Lattermann’s team is still collecting data for this study, which will help them evaluate post-surgical treatment programs and how muscle stimulation can improve recovery.
“The basis for any clinical treatment has to be evidence-based research, and that’s what we’re doing here,” Lattermann said. “Our goal is for every patient being seen clinically to be enrolled into a research study or register as a research participant.”
Meeting her goals
After 12 months of treatment, Thomas feels she’s achieved the goals set out at her first appointment, even if she’s not exactly where she was before the injury.
“I am not 100 percent, but I understand Dr. Lattermann never promised or expected 100 percent,” she said. “I believe we met the goals he had hoped we would achieve. There are still some things I can’t do and some things I will never be able to do again. Aside from those few downfalls, I can walk, play with my grandchildren, stroll in a park or mall, get around my house, wear normal shoes and boots. I can live my live without falling to the ground, limping and enduring horrid pain.”
This was Thomas’ first time participating in research, an experience she describes as extremely positive. She felt comforted by the fact that she would leave each appointment with a plan of care and established treatment goals.
“I’ve had a lot of experiences with a lot of surgeons, and there’s no one like Dr. Lattermann,” Thomas said. “I can’t begin to express the gratitude I have for him and his team.”
Thomas now works as a nurse case manager, which is less strenuous for her knee. She says her own experience as both a patient and research participant have made her better at her job.
“I’m thrilled to be in the position I am and honored to be able to continue nursing,” she said. “I have yet another experience I can share with my patients. Understanding and personal knowledge are among the best gifts a nurse can share with her patients.”
- Learn more about UK Orthopaedic Surgery & Sports Medicine, which can help those with debilitating injuries or chronic bone problems get back to their normal way of life.
- Dr. Lattermann, along with Dr. Darren Johnson, was ranked as two of the best knee surgeons in North America. Read about their accomplishment.