网曝门事件

Karen Mendes loves taking care of her homestead farm in Hanford. 鈥淚 have chickens, sheep, rabbits and pigs,鈥� she says. 鈥淚 love my animals. I鈥檓 very attached to all of them.鈥� But two years ago, while feeding her chickens after a heavy rain, she slipped in the mud and hurt her knee.

鈥淚 was in tremendous pain all the time. I just couldn鈥檛 get comfortable,鈥� she says. Finally, after other providers couldn鈥檛 find a solution, Mendes鈥� primary care provider referred her to 网曝门事件 Health and  a fellowship-trained adult reconstruction orthopedic surgeon in Tulare.

Finding answers

As soon as she saw Dr. Brethouwer, Mendes had a feeling he would be the one to help relieve her pain. 鈥淢y previous doctor had ordered X-rays where I was lying down, but they couldn鈥檛 find anything wrong with my knees,鈥� she says. 鈥淒r. Brethouwer said, 鈥楲et鈥檚 do X-rays while you鈥檙e standing,鈥� and sure enough, it showed that my knees were basically bone rubbing on bone.鈥�

Dr. Brethouwer says that after explaining her options, he and Mendes opted to start with nonsurgical treatments. She had just started a new job, and she didn鈥檛 want to take medical leave right away for surgery.

鈥淲e usually start with rest and activity modification to avoid activities that cause pain,鈥� Dr. Brethouwer says. 鈥淧eople can use over-the-counter pain medications such as ibuprofen, acetaminophen or topical gels, and we can initiate cortisone or gel injections to help the pain, too.鈥� He adds that these options typically work for a time but become less effective as the disease and pathology worsens, which is what happened with Mendes.

Renewing the knee

The knee is like a hinge that bends back and forth, with some rotation. The bones, cartilage, muscles, ligaments and tendons work together to stabilize and support the body. So when the cushioning cartilage wears away, as it did for Mendes, exposed bones rub together and cause pain with motion.

After doing several rounds of cortisone shots, Mendes knew it was time for surgery when her pain was so severe that it made her sick. 鈥淢y pain tolerance is pretty high,鈥� she says, 鈥渟o when it gets that bad, I know it鈥檚 time to do something about it.鈥�

In early 2023, Dr. Brethouwer performed a surgical knee replacement on Mendes. 鈥淒uring the operation, I make a series of cuts on the distal femur (end of the thigh bone), proximal tibia (top of the shin bone) and patella (kneecap), to trim off the portions that are worn out and no longer doing their job,鈥� he explains. Those parts are then replaced by metal caps. 鈥淏etween those caps, we insert a piece of plastic so that when the knee is going through its range of motion, it glides smoothly instead of rubbing.鈥�

Back to activity

Joint replacements are different from most operations, Dr. Brethouwer says, because a successful recovery requires a proactive approach from the patient. 鈥淎 large part of knee replacement is making sure we regain motion,鈥� he says. 鈥淵ou can鈥檛 start to strengthen the knee or improve endurance until the range of motion is back.鈥� That鈥檚 why people who have a knee replacement are usually up and walking, with help from a walker, the same day as the operation.

Mendes says that Dr. Brethouwer educated her on the importance of taking her recovery seriously, which she did. 鈥淗e said, 鈥業鈥檒l do my part, you do your part, and we鈥檒l have you back on your feet.鈥� He sent me to physical therapy, and I鈥檝e been doing everything they say,鈥� she says. 鈥淩ight away, I had almost no pain after my surgery, and I鈥檝e been recovering so well.鈥�

She is looking forward to doing the things she loves again 鈥� walking around town, taking care of her animals and going back to work 鈥� and she credits Dr. Brethouwer with helping her. 鈥淚 can鈥檛 say enough good things about him,鈥� she says. 鈥淗e really cares about each and every person he treats.鈥�