Jeanne Landreth had pain in her knees for close to 20 years. Finally, while
spending the summer of 2014 in Sun Valley, Idaho, at her summer residence,
she concluded that enough was enough.
“I’m a very active person, and I love to hike, so I decided
to evaluate my options, including knee surgery,” she says. “I
went to see a physical therapist, figuring he had no ‘skin in the
game’ when it came to surgical treatments and would be likely to
give me an unbiased opinion on knee surgeries. He said I needed knee replacement
In September of that year, Ms. Landreth made an appointment with Dr. John
Dearborn, who serves as co-medical director with Dr. Alexander Sah at
the Institute for Joint Restoration and Research (IJRR) at Washington Hospital.
“Dr. Dearborn told me that my x-rays showed I only needed partial
knee replacements, so he referred me to Dr. Sah for consultation because
he is regarded as a leading specialist in the procedure,” Ms. Landreth recalls.
One of the most experienced total hip, total knee, and partial knee joint
replacement surgeons in the Bay Area, Dr. Sah has performed more than
300 partial knee replacement surgeries. Few surgeons in the Bay Area perform
partial knee replacements, and particularly patellofemoral (kneecap joint
“A friend of mine had hip replacement surgery performed by Dr. Sah,
and she said she trusted him completely, so I decided to go ahead and
see him,” says Ms. Landreth. “I was very impressed with Dr.
Sah from the get-go. When I met with him, I still thought I wanted total
knee replacements. But he showed me the x-rays and pointed out how the
arthritic area at the top of the kneecaps was bone-on-bone, and that the
rest of the knees were OK. It made sense to me, because 95 percent of
my pain was on the top of the knees.”
Studies have shown that partial knee replacements can be durable up to
15 years and beyond in properly selected patients. In addition, if arthritis
develops elsewhere in the knee, a partial knee replacement can be easily
converted to a first-time total knee replacement.
“Partial knee replacement can be a great option for patients who
have arthritis or damaged cartilage in only one part of the knee,”
Dr. Sah explains.
“When you are deciding between total knee replacement and partial
knee replacement, there are three areas that need to be evaluated –
the inner and outer sides of the knee and under the kneecap,” he
adds. “The advantages of partial knee replacement can be substantial.
Partial knee replacement surgery is less invasive, bone preserving, and
the ligaments in the center of the knee are left intact. Recovery is much
faster than total knee replacement. Because all of the ligaments are preserved,
the joint feels more like a natural knee – because it is. It is
a good option especially for younger patients like Ms. Landreth, who is
in her 60s, with damage to only one part of the knee.”
Ms. Landreth had surgery on her right knee in February 2015, and a second
surgery on her opposite left knee just two months later.
“Dr. Sah and his staff were very thorough in preparing me for the
surgeries, providing me with a large binder of information,” she
says. “Also, since my muscles around the knees had atrophied because
I had been avoiding movements that caused pain, they gave me several exercises
to strengthen the muscles before surgery. Both surgeries were performed
early in the morning, and I walked out of the hospital by 3 p.m. after
Since December 2014, Dr. Sah’s total knee replacement and partial
knee replacement patients at the IJRR have been walking just hours after
surgery. This change is due to his continued improvements in pain management,
blood-preserving techniques, and accelerated rehab protocols. He speaks
to surgeons throughout the state and at national meetings about optimizing
pain control to maximize recovery. For example, Dr. Sah uses a novel local
injectable, long-lasting pain medication in the knee at the time of surgery
to minimize narcotic use. With this injectable pain medication, patients
can experience two to three days of pain relief without the side effects
of pain pills.
“Getting patients to walk the same day as surgery helps speed their
recovery immediately after surgery, and patients also seem to recover
faster overall,” Dr. Sah explains. As Director of the Outpatient
Joint Replacement Program, Dr. Sah recently led a symposium on rapid-recovery
joint replacement at the annual national hip and knee surgeon meeting
in Dallas and also lectured at the California Orthopedic Association annual
meeting this past May.
In 2015 and 2016, nearly every one of Dr. Sah’s partial knee replacement
patients have been able to go home the same day as surgery, and about
85 percent of his total knee replacement patients go home the morning
“Dr. Sah had told me I would be up and walking within hours of surgery,
but I was still surprised,” Ms. Landreth says. “At no time
did I feel the pain was unbearable. I don’t like pain medications,
but I took the prescription ones at night for a few weeks, later switching
to Tylenol. I know people who had total knee replacement surgeries, and
I think my experience was much better.”
After each of her surgeries, Ms. Landreth carefully followed Dr. Sah’s
instructions for elevating and icing the knee and for exercising in moderation,
increasing the exercise gradually. A physical therapist visited her at
home in Carmel for several sessions after each surgery, and then she went
to outpatient physical therapy to work on exercises for strengthening
and improving her range of motion.
“I was very surprised that Dr. Sah called me at home several times
after my surgeries to personally check in with me,” Ms. Landreth
remarks. “If I had any questions or concerns, I could call him or
email his physician’s assistant, Abigail Goetz.”
By mid-June, Ms. Landreth was once again enjoying hiking and golfing, and
she got back on a bicycle at the end of June.
“I did a lot of hiking at our summer home in Sun Valley this year,”
she notes. “I noticed I had better balance and strength because
of the surgeries and physical therapy. I also really noticed the difference
in the level of pain between last summer and this summer. I still have
a little bit of pain when climbing stairs, but it is so much better than
before and keeps getting better.
“Dr. Sah and the entire staff at Washington Hospital were wonderful,”
she adds. “There was not a single person who wasn’t courteous
and helpful, which made it a really good experience. I would absolutely
recommend them to anyone considering total or partial knee replacement
If you need help finding a physician, visit www.whhs.com and click on
the link for “Find Your Physician.” For more information about
the Institute for Joint Restoration and Research at Washington Hospital,
including information about partial knee replacement surgery, visit www.whhs.com/joint-restoration/.