A Real-Life Recovery
Story By Lindsey Christie
, Knee1 Staff
Steven Rumble was playing a casual game of flag football more than 30 years ago when he seriously injured his knee. Running down the field for a touchdown, Rumble turned to catch the ball. Unfortunately, his right knee remained planted and he heard the dreaded, pop.
For more than five years, Rumble, an avid runner, felt the residual effects of his injury as he struggled with his knee joint popping in and out of place. In 1977, his knee “locked up” and he finally took himself to the doctor. His doctor informed him that he would require surgery to repair the damaged knee. The “state of the art” technique in the seventies was to remove the damaged tissue. Rumble’s doctor did nothing out of the ordinary; he simply removed his meniscus and, unbeknownst to Rumble, his anterior cruciate ligament.
The surgery was a temporary fix though and Rumble soon felt the pain and unsteadiness return to his knee. He managed to exercise and remain quite fit as he worked through the pain year after year. In 1999, at age 52, Steven Rumble sought the help of specialist Jack Farr, M.D. and the Cartilage Restoration Center. Rumble’s goal at that time was to avoid having a total knee replacement and the necessary revision surgery within the next ten years.
Dr. Farr was cautiously optimistic about helping Rumble, but mentioned the possibility of Rumble ultimately needing a joint replacement. Rumble began a series of surgeries on May 20th, with a quick “cleaning out” of knee debris so that he could head to Disney World with his family. He recalls walking all over the place and doing “OK” with his bum knee.
Dr. Farr planned the next surgery, an ACL graft and realignment osteotomy, for October of 1999. Upon examination of the knee, it was clear that he could not move forward with the osteotomy at the same time as the ACL reconstruction. Rumble’s bones were too soft. Rumble tolerated the ACL repair, did rehabilitative exercises, and prepared for his next round of surgeries.
Two months later, on December 16th, Rumble headed back into the hospital for his osteotomy. Two bone grafts, 19 weeks, and a pair of crutches later, the graft took and Rumble’s knee started to heal. Rumble recalled being frustrated as he waited patiently for the bone graft to take. He was vulnerable on his crutches as he hobbled around all winter in his sweatpants waiting for his next round of surgery.
In May 2000, Rumble headed back to the hospital for his sixth operation. This time, Dr. Farr attached a meniscus graft and implanted autologous chondrocytes. Farr implanted the autologous chondrocytes on both the tibial and femoral surfaces of the joint.
Carticel is approved by the FDA for use on the femoral surface of the knee joint only. When asked about this seven-hour surgery, Rumble remembers nothing more than a mild respiratory reaction as a result of the anesthesia. This procedure usually requires a hospital stay, but Rumble, determined as ever, headed home after a 23-hour outpatient stay.
Rumble completed two sessions of physical therapy before striking out on his own with step work and a continuous passive motion machine. He started the machine immediately and spent almost 15 hours a day in it. He even slept in it. Rumble believes it helped him advance his recovery and advises recovering patients, “Make sure you really use the CPM.” When asked if all of the surgeries were worth it, Rumble states, “Definitely. Dr. Farr did a beautiful job.” Rumble had learned to tolerate pain and as a consequence, found the biggest nuisance of all his operations to be the side effects from the pain medications he had to take.
Although optimistic at first, once Dr. Farr got a peek inside Rumble’s knee, he classified his job as a salvage operation. Salvage he did. Rumble will never run again, but he says that his knee is back to 90 percent and he walks regularly for exercise. He is satisfied with his new knee and will remain so if he can stave off a total knee replacement for the next 30 years.