Baker City Herald

Maryalys Urey grimaces, then grins, then grits her teeth against the pain.

andquot;You're doing my homework for me,andquot; she says to Ben Bertrand, who works to loosen the skin around the impressive scar on Urey's left knee.

The homework she has is exercises designed to strengthen her knee that now contains a joint made of cobalt, chromium and nickel.

She underwent total knee replacement surgery Oct. 23 to ease her pain.

andquot;It was really hurting,andquot; says Urey, 85.

And that agony disrupted her life mainly birding trips with Elderhostel, which offers andquot;learning adventuresandquot; for those over the age of 55.

andquot;I couldn't really do the hiking without trekking poles,andquot; she says.

A replacement remedies that pain, says Bertrand, manager of rehabilitation services at St. Elizabeth Health Services.

andquot;The annoying, all-day, constant aching pain is gone,andquot; he says.

Now, with her new knee, Urey is working hard at physical therapy to strengthen her leg muscles, steady her balance and increase the flexibility in her leg.

All that isn't exactly easy.

One of her tasks is do leg presses, and Urey settles in as Bertrand attaches weight to the machine.

Her first few tries look like a breeze.

andquot;Pretty easy?andquot; Bertrand asks.

andquot;Yeah,andquot; she says.

andquot;Let's give you the hard one back then,andquot; Bertrand says.

Urey just smiles and keeps working.

andquot;I shouldn't have said anything.andquot;

In total joint replacements, surgeons remove the damaged or diseased parts of the joint, cap the bones with metal and insert a plastic spacer to replace cartilage.

Jerry Nickell, who worked as a physical therapist prior to becoming the vice president of missions and human resources at St. Elizabeth, remembers his introduction to joint replacements during his internship in 1980.

andquot;I had the opportunity to view a total knee replacement and total hip replacement I was really excited because this was a relatively new thing at that point,andquot; Nickell says.

According to the American Academy of Orthopedic Surgeons (AAOS), the first total knee joint replacement was performed in 1968, and in 2005 there were 534,000 of those surgeries in the U.S.

One of the first hip replacements is credited to a Boston surgeon who, in 1925, molded a piece of glass to fit over the ball of the hip joint. When he discovered that glass couldn't withstand the stress, he worked on a new technique using plastic and stainless steel (

Total hip replacements numbered 235,000 in 2005, according to AAOS.

Baker City's orthopedic surgeon Dr. Eric Sandefur and physician assistant Autumn Swiger-Harrell average two to three total joint replacement surgeries per week 83 total for 2006-2007 at the Eastern Oregon Center for Orthopedics at St. Elizabeth. (Those are in addition to Sandefur's five to seven other types of surgical procedures.)

The Center for Orthopedics was finished last summer and features equipment that allows Sandefur to perform computer-assisted surgery that helps set joints in precisely the right place.

andquot;We're so lucky to have this available,andquot; Urey says as she works on more exercises under Bertrand's watchful eye.

The main reason for joint replacements is pain caused by osteoarthritis and injury.

Bertrand said that 10 years ago joint replacements were expected to last 10 years.

andquot;The newer prosthetics are lasting 20 years,andquot; he says.

Once everything has healed, that knee is practically as good as new. Technological advances have also lead to replacements that mimic a more natural movement.

andquot;It's acting exactly like a normal knee,andquot; said Blake Marlia, a physical therapist at Baker Valley Physical Therapy.

And those titanium replacements are tough.

andquot;They're pretty much indestructible once it heals,andquot; Marlia says.

The post-surgery rehabilitation period lasts two to three months, with three sessions per week to strengthen leg muscles, improve balance and work on rotation.

andquot;It's a grueling, intense two to three months,andquot; Marlia says.

He says it's important for patients to understand that andquot;it's going to be painful, but that pain will go away.andquot;

The result, he says, is a physical state superior to what the patient had before surgery.

andquot;They should get back to doing more than before,andquot; he says.

Take Dixie Driggers, who had both knees replaced in January of this year.

andquot;Oh man, I have a whole new life,andquot; she says.

Driggers, 47, lived with knee pain for 30 years.

andquot;My knees grated and creaked and hurt since I was 16,andquot; she says.

At 26 she shattered the end of her tibia in a horse accident and underwent surgery.

andquot;Hobbling around on that one I ruined the other one,andquot; she says. andquot;They'd hurt so long I'd learned to live with it.andquot;

But living hurt.

andquot;It made everybody cringe any time I moved,andquot; she says. andquot;I couldn't get up off the floor.andquot;

And she wanted to play with her 10-year-old daughter, Elizabeth.

andquot;I couldn't play ball with her, I couldn't go up and down the bleachers.andquot;

Surgery revealed that she had no cartilage left in her knee, and bone spurs covered the surfaces.

She likes her new titanium knees.

andquot;I can skip I haven't been able to skip for 15 years, and skipping is important when you're a preschool teacher,andquot; she says.