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Column from Anne Semmes: On my watch – How I became a bionic woman

By Anne W. Semmes

I was intrigued, years back, when my Greenwich friend and community leader Betty Warner, who suffered from rheumatoid arthritis, told me she had bone in a bone bank at New York’s Hospital for Special Surgery (HSS). What? Bone in a bone bank?? Yes, after having had six joint replacements that she called her “ticket to freedom.” As I was then a writer/producer on NBC’s Today Show always in search of a story, Betty said, “Check it out.”

I found that bone bank, that deep freezer where there were bits of bone from operations used for research purposes, and in Betty’s case, used to build her a better foot. But I also discovered a great deal more. I was invited to film for the Today Show the first cementless hip replacement operation!

From seeing the computerized images of what would be installed in that HSS gentleman’s hip interior, I was soon escorted into the operating room with my cameraman to film the pioneering orthopedic surgeon Dr. Allan Inglis cleverly installing those bionic pieces into that gentleman’s hip!

Little did I know then that one day I too would be on an operating table for a similar procedure.

It began with my friends commenting on my limping. And there was that struggle to put my socks and shoes on my left foot and tie my shoelaces. And there I was at the Hospital for Special Surgery offices in Stamford looking at my x-ray with orthopedic surgeon Dr. Alexander McLawhorn telling me, “You’ve got bone on bone in your left hip,” i.e. severe arthritis. “You need a hip replacement.”

Oh my god. Visions of looking deep into that gentleman’s hip with my cameraman came back like a flash. Was there no other alternative? Wasn’t I one of three sisters never to have a hip or knee replacement? I would break the record! The doctor saw my reluctance and offered a cortisone shot in the hip to see if that would help. But no, it did not help my limp or let me put that sock on.
The doctor was wise. He’s a busy guy and wants committed patients. He’s performing this intricate hip replacement surgery nearly 600 times a year! And that doesn’t count knees!

My friends were ecstatic when I told them I had chosen to have a hip replacement. “You’ll be walking in days after the operation,” they assured me.

So, as I had seen that cementless hip replacement all those years ago how has the procedure changed I asked the good doctor. And remind me what that word cementless meant? So, in place of a sort of grout affixing those implanted bionic pieces, he explained, there is “osseointegration, the bone implant growing together with the bone as a living tissue…it’s very specific to the exact surface finish of the implants – as the surface finish of most of these implants is quite rough.”

Regarding those bionic implants, Betty Warner had told me they were made of “miracle metal” titanium, “a once exclusive metal of the Department of Defense.” McLawhorn confirms that those bionic implants consisting of a socket, ball, and stem are made of titanium in the main. And together they weigh one to two pounds.

“We use a semi-automated type of robotic process,” he explained, “which means that the power of the thing is really under my control, in particular preparing the pelvic bone and putting in the socket. That’s under what’s called haptic guidance. So, it’s like a third arm.” (For those who aren’t squeamish the good doctor has an explanatory video of a 72-year-old woman having an anterior hip replacement which I had, at www.youtube.com/watch?v=i_cQM2N9VmU).

So, let’s cut to the chase. It’s May 11. I arrive at Stamford Hospital at 6 a.m. I’m the first to arrive. I’m on the fifth floor and my room overlooks Long Island Sound! The sun is rising below clouds. Suddenly an osprey appears chasing off a bald eagle. I’m astounded. I’m an osprey steward. All is well as my cool, calm Dr. McLawhorn steps into my room. I’m the first of his six joint replacement operations today. But he’s fit, in his 40’s, and asks after my welfare. He departs and now the anesthesia drip begins. At some point in this process, I find he’s painted his name on my left hip. I’m branded.

It’s not long after my one-and-a-half-hour operation when the PT nurses arrive. I’m inundated with them massaging my legs to keep the blood flowing. One gets me to stand up and then walk! with a walker. Before long it’s the morning of May 12 and my good doctor arrives and says I’m doing fine. But no outpatient PT for four weeks. A special van takes me away to Nathaniel Witherell for eight days of rehab.
Nathaniel Witherell in its pastoral setting has welcomed injured WWII heroes, those from the polio epidemic, and now this reporter with a new hip.

One can’t say enough about the extraordinary therapy one gets here. They are constantly on your case. As the workout days pass, I am soon being told I am graduate material. They are proud of my progress, except for the occasional reprimand, “You’re furniture walking again,” meaning I have left the walker behind. And then its departure day, and the near disaster happens. Ready to leave I spy a forgotten hairbrush under the sink and dive for it. My left leg jackknives and I fall flat on my back.

“Help,” I yell, and a nurse arrives, and asks, “Did you hear any snap, crackle, or pop?” “No,” I reply.

“Any trip or fall or stumble particularly within the first couple of months after hip replacement could result in a fracture of the bone around the implant. So that’s a real concern about falls from a hip replacement perspective.” So said my good doctor during my six-week checkup. I had dodged a bullet, a possible redo of my operation.

All in all, I had a good report. “Flexion is good. Abduction and adduction are good. Internal rotation is fine.” But he found my external rotation a bit on the stiff side. “Which is just what you need to put your shoes and socks on and things like that,” he said. “But Doctor,” I said, “I can already lift my leg up and put my shoes and socks on!”

That brought a smile to prize-winning Dr. McLawhorn. It was seeing that improvement as a medical student at the Hospital for Special Surgery that turned him on to orthopedic surgery. “It definitely has a big impact on the quality of life for patients much more than a lot of surgeries that we do,” he shared. “And because of that, there is a really high career satisfaction, job satisfaction rating amongst surgeons who perform joint replacements. So, I think it’s a win win.”

On September 25, a Sunday, Dr. McLawhorn has signed on to his second annual 25-mile Bike HSS ride to benefit the Hospital for Special Surgery. He’ll be riding, “in support of every person who suffers from a musculoskeletal condition because MOVEment, health, and wellness are more important than ever.” Here, here! McLawhorn will actually be traversing our neighborhood, from Riversville Road to Lake Avenue, with the map showing a rest stop on Round Hill Road. If you see him, give him a wave!

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