After Darlene Day’s husband passed away in 2018, she embraced traveling as a way to fill the void in her life.
The retired nurse went to Paris in 2019, and although her arthritic left knee made walking difficult, she enjoyed the trip enough to make plans to travel next to South Africa.
But the COVID-19 pandemic caused that trip to be canceled, and while she waited for the pandemic to subside, her knee pain worsened. Cortisone shots helped her manage the pain for a while but gradually became less effective. “I was having a hard time, especially going up steps,” said Day, who has two adult children and two grandchildren. “I knew I wanted to travel, and in order to travel, I knew I had to get my knee replaced.”
With the help of a friend and fellow nurse, Day connected with Andrew Ehmke, D.O., a board-certified, fellowship-trained orthopedic surgeon specializing in minimally invasive robotic-assisted knee and hip replacement surgery at the Center for Advanced Joint Replacement (CAJR) on the campus of UChicago Medicine AdventHealth La Grange.
After meeting with Day and confirming she needed a knee replacement, Ehmke replaced her knee in August 2022 with the help of a Mako® robotic-arm assisted surgery system. She went home the next day after starting physical therapy at the hospital. She then had physical therapy three days a week for about a month. At that point, “I felt pretty good,” Day said. “The pain was manageable. I didn’t stay on the pain-killing medication long. Tylenol® was good enough.” About six weeks after her surgery, she was walking normally without any pain.
Reaching a peak
Eager to travel again, Day flew to Florida in November 2022 to celebrate a friend’s birthday. “I couldn’t believe I went to the beach, and I was walking in the sand,” she said. When an opportunity to travel to South Africa arose again in 2023, Day signed up without hesitation. “I said, `I’m going to go. I didn’t get this knee fixed just for nothing,’’’ she recalled.
Day, 71, not only took the trip, but also climbed to the top of Table Mountain, which overlooks Cape Town and Table Bay from an elevation of more than 3,500 feet. “They take you in a gondola to a flat part of the mountain, but then you have to hike up farther to get to the top,” she said. “I said to myself, `I don’t believe God let me have this knee not to go.’ So I went and made it to the top. I was very proud of myself.”
Standing at the top of the mountain was an emotional experience. “I said, `My eyes have seen the glory,’’’ she said. “The view was beautiful. I had never seen anything like it. I just thanked God.”
Helping patients get lives back
Day’s case was typical of those that Ehmke routinely handles, although he said hers was particularly inspirational because her surgery enabled her to resume traveling, take the trip to South Africa she had missed, and top it off by ascending Table Mountain. Her experience, he added, exemplifies why he chose to specialize in robotic-assisted knee and hip replacements.
“It’s extremely gratifying to see such big improvements in patients’ quality of life,” said Ehmke, who serves as co-medical director of CAJR. “Patients often tell me they have gotten their life back because of the surgery.”
Ehmke began performing robotic-assisted knee and hip replacement surgeries in 2015. He now has performed more than 1,000 and believes so strongly in their effectiveness that he does not perform traditional open knee and hip replacement surgeries.
Mimicking patient’s natural knee
When compared with open surgeries, robotic-assisted surgeries offer multiple benefits, including a smaller incision, less time in surgery, greater surgical precision, reduced pain, faster recoveries, and joint replacements that fit better and feel more natural, Ehmke said.
His knee-replacement surgeries usually take about an hour, and most of his patients return home the day of their surgery and feel normal again about six weeks later. “Even before six weeks, my patients are highly functional,” Ehmke said. “They’re usually driving again after two to three weeks.” By contrast, traditional open knee replacement surgeries take twice as long and require hospital stays of two to three days, followed by about three months of recovery, he said.
“Where robotic-assisted surgery really shines compared with open surgeries is that once the patient has recovered and returned to their full activities, their new knee mimics their natural knee so much better,” Ehmke said. “It feels more natural and more comfortable and allows the patient to do more rigorous activities on the knee. Because it fits comfortably and smoothly, it’s going to last longer.”
Using robot as surgical tool
Before surgery, Ehmke uses a CT scan of a patient’s knee to create a 3D virtual model of the knee. He studies the model, evaluating the patient’s bone structure, disease severity, joint alignment and surrounding bone and tissue, and creates a customized surgery plan based on the patient’s unique anatomy. “I can plan out exactly what size parts I’ll use to fit them perfectly and how I can position them to recreate their specific anatomy,” he said.
The 3D model and surgical plan are loaded into the robot and displayed during surgery, enabling Ehmke to follow his plan with great precision, making fine-tuning adjustments as necessary. “Using the robot, we can make adjustments in one-millimeter increments, which is impossible to do with the naked eye,” he said. “The precision of the robot allows me to be a much better surgeon because I can fine-tune the knee in ways I never could before. That produces a more comfortable, natural fit for the patient.”
Planning the surgery in advance shortens operating time because “I don’t have to stop and think about what step comes next,” Ehmke said. “I can just execute the plan with robotic precision.” He also credits CAJR’s specially trained surgical staff for the efficiency and success of his surgeries. “Our team is very experienced,” he said, noting that CAJR handles more than 3,000 joint-replacement surgeries a year.
Ehmke emphasized that his surgeries are not automated. “I control them 100 percent,” he said. “The robot is a tool I use in surgery, not something that does the surgery for me.” For example, although a saw is attached to the robotic arm to cut bone during surgery, Ehmke moves the saw himself, making precision cuts based on his surgical plan. “I can stop it whenever I want, and the robot prevents it from going outside our pre-programmed zones, so it only removes the bone we want to remove to make the implants fit perfectly,” he said.
Emphasizing communication
Ehmke believes just as strongly in the importance of the human touch with patients as he does in the benefits of robotic-assisted surgery. Before surgery, he meets with patients to get to know them, understand their lifestyle and goals, and discuss their surgery. They later return for a pre-operative visit with a nurse practitioner who walks them through a guidebook describing their surgery and what to expect during their recovery. The nurse practitioner answers any questions they might have and makes sure they will have everything necessary for a successful recovery, including medications, a walker and a cane.
“When they get home, we want everything to be in place so everything goes smoothly right off the bat,” Ehmke said. “One of the big reasons my patients recover quickly is the very thorough educational program we provide for them before surgery.”
Ehmke and his team also encourage patients to call or email about any questions or concerns after surgery, and he and his team make sure to reply quickly to patients’ inquiries. In addition, he has pre-programmed a texting program to send encouraging messages to patients and to answer questions that commonly arise at specific points during recovery. His emphasis on communication reassures patients and helps them recover faster, Ehmke said.
Caring for others again
While Day’s new knee has enabled her to travel again, her newfound mobility has freed her to enjoy her other favorite activities, including spending time with her children and grandchildren at her camping trailer, socializing with fellow seniors at a local community center, and caring for relatives and friends with medical issues or other needs.
“It has changed my life,” she said. “I’m now able to help take care of people because I don’t have that pain in my knee anymore. I just thank God each and every day that I can get up and out and do something to help somebody.”
She already has referred others with knee pain to Ehmke. “I love Dr. Ehmke,” she said. “He was very knowledgeable and very patient, and he explained the surgery very well. I trust God, but I trust Dr. Ehmke and his team with my knee.”
For more information about knee and hip replacement and the Center for Advanced Joint Replacement, please visit Orthopedic Care | UChicago Medicine AdventHealth. To contact an orthopedic specialist treating patients at our Center for Joint Replacement call 855-206-2538.
