Orthopedic Surgery at Mayo Clinic Ends Nurse's Hip and Knee Pain

Orthopedic Surgery at Mayo Clinic Ends Nurse’s Hip and Knee Pain

By
Joel Streed

March 27, 2020

Jesse Stewart couldn't understand why the seven orthopedic surgeries he'd had for pain in one knee and both hips hadn't done anything to improve his quality of life. After coming to Mayo Clinic, however, Jesse found the answer to that question, and he finally received surgery that fixed the problems.

At 26, Jesse Stewart should have been entering the prime of his life. Instead, Jesse's life was hampered by chronic pain. By that point, he'd already endured seven orthopedic surgeries intended to relieve him of knee pain that began during college with an ACL tear and a torn meniscus, as well as pain in both hips.

Jesse's first surgery was with a local provider in Michigan. "It didn't go very well," he says. Although he didn't get much relief from that surgery, or from any of the six surgeries that followed, Jesse persevered through the persistent pain. He managed to finish college, earn a degree in nursing, and land a job at Mayo Clinic in Rochester. At Mayo, he met Aaron Krych, M.D., an orthopedic surgeon. Dr. Krych identified the underlying source of Jesse's continuing knee and hip pain, and after several more surgeries, Jesse finally was freed from the chronic pain.

The experience left a lasting impression on Jesse, both personally and professionally. "My experience at Mayo — from walking in the door before surgery to after surgery — was hands down the best hospital experience I've ever had," he says. "Care providers go out of their way to make you feel important at Mayo Clinic, which is a big deal to patients. It was a big deal to me, so that's what I'm striving to do for my own patients."

A worsening problem

After Jesse's first surgery in Michigan, it quickly became clear during physical therapy that problems still remained. "My hip started hurting a lot during all the exercises and stretches I was doing after surgery," he says. "I ended up being referred to see another surgeon elsewhere in Michigan for hip impingement."

The diagnosis of hip impingement — a condition in which the ball and socket of the hip joint don't fit together correctly — led to four hip surgeries for Jesse. None of them eliminated the pain. "I'd have maybe a month or two of reduced pain, but the pain would come right back. I'd have the same issues I had prior to surgery," Jesse says. "Nothing ever got better."

In addition to his hip issues that were still causing problems, Jesse couldn't seem to get rid of the knee pain either. "I had two more knee surgeries in Michigan for meniscus tears," Jesse says. "That brought me up to three knee and four hip surgeries. After each one, I got little to no relief. The same issues and symptoms kept reappearing. I had a lot of difficulty walking and staying active."

The ongoing stress not only affected Jesse's health, it also had an impact on the future he was trying to build for himself. "I was in nursing school at the time, so I had to work around my nursing school schedule to have all of these surgeries done," he says.

Jesse pushed through and graduated, though. With degree in hand, he accepted his first nursing job in Mayo Clinic's Department of Neurosurgery in Rochester. But his lingering knee and hip pain followed him to Minnesota.

"From a career standpoint, I was like: 'What am I going to do? I can't continue living and working like this.'"
Jesse Stewart

"I'd come home after a shift and be in a ton of pain. I'd take a bunch of ibuprofen so that I could get some sleep without waking up in pain," he says. "I normally try to stay away from that stuff. But in order to keep going and keep working, I felt I had no other choice. I was icing all the time."

Fresh out of college and barely into a career he'd worked so hard to begin, Jesse couldn't help but worry that he'd eventually have to give it all up. "From a career standpoint, I was like: 'What am I going to do? I can't continue living and working like this,'" he says. "I couldn't stay on my feet and care for my patients the way I wanted to without being in worsening amounts of pain. It was affecting my mood and stressing me out, which is also tough on the body."

A revision of a revision

It was at that point Jesse became a Mayo Clinic patient, as well as a staff member. "Initially, I had cortisone shots in my hips and knee, but those didn't help either," Jesse says. "I then went through multiple CT scans, MRIs — all those things — and was ultimately referred to Dr. Krych."

The results of Jesse's imaging revealed a unique cause for his hip pain. "He had impingement in both hips with labral tears. That happened because he'd formed extra bone from being an athlete growing up. That extra bone led to impingement, which then led to secondary damage to his labrum," Dr. Krych says. "He had a challenging case because the impinging bone was in a location of his hip that was difficult to access. The bottom line of why his previous surgeries were not successful is that if you don't eliminate all the locations of impinging bone, then symptoms in the hip will continue."

Fortunately for Jesse, after studying the imaging, Dr. Krych and his team were confident they could access the impinging bone that remained and remove it all. "We went ahead with repeat revision surgery for him, and we did that in a staged fashion," Dr. Krych says. "We performed surgery on his left hip first and then his right hip."

"After surgery, it was a night-and-day difference. I had no clicking or popping in my hips, and no more catching, which is what had caused me pain."
Jesse Stewart

Jesse understood that improvement after surgery wasn't guaranteed. "This was a revision of a revision on both of my hips, and before surgery, Dr. Krych's physician assistant, Bruce DeGrote, said: 'I have to be honest. This might not help you,'" Jesse says. "But after surgery, it was a night-and-day difference. I had no clicking or popping in my hips, and no more catching, which is what had caused me pain."

With the hip problem resolved, Dr. Krych and his surgical team turned their attention to Jesse's right knee. "Even though he'd had a previous ACL reconstruction performed on his right knee in 2014, followed by another knee scope in 2015 and then a meniscus repair in 2017, he continued to have pain and limitations in his right knee," Dr. Krych says. "So we addressed the residual meniscus tear and also cleaned up some other damaged cartilage in his knee."

Just like he did after his hip surgeries at Mayo, Dr. Krych says Jesse breezed through his recovery from knee surgery, as well. "Thankfully, Jesse responded well to all of our surgeries, which is a testament to him," Dr. Krych says. "The aspect I admire most about Jesse is he's incredibly motivated and has a really positive attitude. He's just one of those patients that does well after surgery because he is so positive and diligent about his recovery."

A different kind of care

With recovery now behind him, Jesse says the improvement is remarkable. "I'm still working on getting my strength back up. But from a range-of-motion standpoint, I can squat normally now, which I was never able to do before," he says. "There are so many things that I couldn't do throughout much of my life that I can do now because I'm no longer in chronic pain, and my hips are no longer constantly clicking or popping. I can come to work now and not be in pain."

That's thanks to Dr. Krych, his surgical team, and a patient experience that Jesse says from start to finish was unlike anything he'd experienced before. "At other hospitals, I felt like a number. But at Mayo, Dr. Krych would call me at home to check up on me after my surgeries," he says. "Bruce DeGrote would also send me messages through the patient portal to ask how I was doing. Little things like that made me feel more like a human being and less like a number. Because of that, regardless of where I am in life from here on out, I'll always come to Mayo Clinic for my health care. There's just that much of a difference."

It's the kind of difference that Jesse now is able to make for his own patients without worrying about pain getting in the way. "My experience as a patient at Mayo Clinic has definitely impacted the way I look at and do my own work as a nurse," he says. "Because I've now seen that when you provide care at this high of a level, patient outcomes are going to be so much better. I'm trying to do the best I can for my patients and to treat them the way I would want to be treated if I were in their situation."

As a fellow care provider, helping Jesse continue his work as a nurse was one of Dr. Krych's goals, too. "It's very satisfying for me to take care of other Mayo Clinic employees and help them stay in the game, so they can continue providing care to our patients, as well," he says. "That's doubly rewarding for me as a physician within our Mayo Clinic family."

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