What to Expect from a Knee Replacement, According to a Surgeon
We caught up with Dr. Keith Berend, who was named one of the top 22 knee surgeons in North America two years in a row, to ask him about knee/hip replacements. And how they affect pickleball play. If you have any additional questions for Dr. Berend after reading our conversation, let us know in the comments and we’ll do a follow up article!
PBU: We have to ask first, do you play pickleball? If so, what got you into it?
DR. BEREND: My 80-year-old stepmother plays pickleball nearly every day. She introduced our family to the sport several years ago. Since then, we have played intermittently until the pandemic basically shut down elective surgeries. At that point, my partner (who lives around the corner) and another one of our associates (who lives up the street) both put pickleball courts in their driveways. We played nearly every evening through the summer of 2020. We also tend to play when we’re on vacation as we enjoy playing as a family.
PBU: Tell us about your medical experience/background.
DR. BEREND: After graduating from Florida Southern College in Lakeland Florida, I attended Duke University for my medical school and stayed at Duke for orthopedic residency training. Following orthopedic residency, I began an adult reconstruction hip and knee replacement fellowship in Columbus, Ohio. I stayed on in Columbus with joint implant surgeons and Dr. Mallory and Dr. Lombardi. I’ve been here practicing hip and knee replacement surgery since 2002. We have subsequently re-branded as JIS Orthopedics to provide overall musculoskeletal care, including: sports medicine, spine, hand, shoulder, and of course hip and knee surgery.
PBU: How has knee replacement surgery changed in your time?
DR. BEREND: When I began in practice in 2002, patients would routinely stay in the hospital for several days. Pain management and mobility has changed significantly over the last 18 years. We now routinely perform nearly all of our knee replacement surgeries as an outpatient with the overwhelming majority being done at a freestanding ambulatory surgery center. This allows the patients to be up and mobile and home the day of surgery. We performed over 11,000 outpatient replacement in the last 7-8 years. And it appears to be safe and quite successful. The implants themselves have not changed dramatically. But the performance of the surgery through less invasive techniques, significantly better pain management, and outpatient surgery are the real remarkable innovations that occurred in the last two decades.
PBU: What’s a common theme that prompts a knee replacement?
DR. BEREND: When a patient has significant arthritis of their knee that is significantly interfering with quality-of-life, it is time to consider knee replacement surgery. Particularly active patients and those that enjoy the game of pickleball will seek out an intervention to improve their quality of life if their ability to play and enjoy the sport is diminished. Of course conservative options are always recommended, but once those conservative measures fail (such as weight loss activity, modification injections, anti-inflammatories, and physical therapy), it’s time to consider joint replacement.
PBU: On average, what can someone who plays pickleball every day/week expect from a knee replacement?
DR. BEREND: Recovery from a joint replacement routinely takes about six weeks to get back to a reasonable level of function. Running and cutting may take up to 12 weeks and a full recovery can take up to a year. I will tell most of my active patients, particularly those who enjoy pickleball, they can return to dinking at 6 to 8 weeks and return to play as they progress their activity to a more normal game.
PBU: What is recovery like? Wil they return to playing like they used to?
DR. BEREND: Because we reserve joint replacement surgery for patients whose arthritis has a significant impact on their quality of life, most of my patients ability to play and enjoy pickleball is diminished and that is one of the reasons that they are pursuing an improvement in their lifestyle. Following recovery, these patients are able to return to the sport they love at an equal or even higher level than prior to their surgery.
PBU: Are there any positive cases that stick out to you about someone returning to the pickleball court after a knee replacement?
DR. BEREND: Off the top of my head, I do not recall any particular one case but as the sport of pickleball has significantly gained attention and enthusiasm, I find more and more of my patients report that this is an important part of their daily activities to participate in. It seems like particularly in the winter months, when some patients go to Florida and they return, they will tell stories of either injury or discomfort or quality of life suffering while playing pickleball. And so it’s a pleasure getting to help them get back to a comfortable level play and life.
PBU: Any parting words of wisdom about staying active in older age?
DR. BEREND: Movement is critical to maintaining a good quality of life. In any age group, activities such as pickleball, being outside, enjoying friends, and playing a sport that can be played by all ages is critically important.
