Avoiding Knee Replacement
What follows is a written summary of our Interview with Michelle Stiles PT who discusses strategies to avoid knee replacement. To listen to the full interview from The Bee's Knees Podcast click on the PLAY button above.






I was very fortunate to work with an outstanding orthopedic surgeon early on in my career. He was on the East Coast in Virginia Beach. His name was Dr. Louis C. Jordan. It’s called the Jordan Young Institute.  He was really a pioneer at the time; still early-going in those years. People didn't get their knees done right away. And their range of motion was much more abbreviated. And they had profound weakness in many cases. The rehab was a lot different back then.






Dr. Jordan and His Knee Patients
Dr. Jordan realized that if he didn't make the rehab go smoothly for his patients it didn't matter how good a surgeon he was. If the rehab screwed up his surgery there wasn't going to be a good outcome for his patient. He also knew that an excellent outcome was a walking marketing tool for him. We understood that right away. And he actually came through the home health agency that I worked for and instructed us on what he wanted done with his patients. I'd never had that happen before.






And he would only see a patient who advocated doing the exercises four times a day. And as a young PT I thought ‘boy I think that's a little bit too much. Geez can my 80 year old lady with sugar diabetes do that?’ And as I worked with him longer I was just blown away. Then I added some things of my own. And that's the system that I ended up creating. And that became the book that I ended up publishing.
After I finished working with Dr. Jordan, I worked with another pretty top physical therapy group in New York. Then I went on the road and that’s when I found out that there are a lot of knowledge gaps out here.






The Standard Knee Recovery Protocol
Early on, before I had had those training experiences, rehab was pretty straightforward. There was a basic set of exercises that we gave everybody. And generally speaking if somebody didn’t do well it’s the patient’s fault, lack of compliance. They say they're doing it, but they're not. But what I really found out was that they were actually doing the exercises, but they weren't effective for them.






So I’ve tried to fix that with motivation and measurement. I put different pieces of this puzzle together as I had a lot of time with knee patients in their homes. It allowed me to be one-on-one with people to figure out what didn't work for them and why they didn't succeed. And I did get a system down. And I created kind of a niche in physical therapy particularly for knee surgery recovery.






My Knee Recovery Protocol
When you show somebody two to three degrees on a goniometer, that little tool that you use to measure angles, they see that it’s not very much. But when you when you put two or three degrees together every day for a week, you get 21 degrees range of motion. It's phenomenal for people. So I would track it very closely. I would go into a patient’s home on a Friday and I would predict their progress, and then when it happened just as I said, they would continue to grow in confidence that they truly were in control of their recovery.
“You're at this amount here, let’s get two or three degrees today. You should be here by Monday.” And we'll check that. And they were. So that's what I put it out there.