Since 2015, Joplin’s Bobby Smiles has become an expert on the human knee.
Four years ago, the retired state trooper and U.S. Army veteran had extensive surgery on his left knee; he’d been having trouble for some time fully extending it, he said. A Freeman orthopedic surgeon had to clear away scar tissue before rebuilding the entire joint and using surgical staples to close the incision. Common with such procedures, there was the usual swelling and months of physical rehab, he said.
“Lots of pain,” Smiles admitted. “Not so much where I had to (take) medication, but there was pain with the knee.”
When it was time to have surgery on his right knee earlier this year — “Both of my knees had been destroyed,” the 69-year-old said — medical technology had managed, in this case, to expand the playing field. Freeman orthopedic surgeon Derek Miller brought to Smiles’ attention a brand new procedure that would dramatically shorten both the post-surgery physical rehab he would face as well as the pain he felt during recovery.
There was little hesitation on his part, Smiles said: “The doctor offered it, he told me we’re going to try something new, and I said OK. And we did it. Just like that.”
The new procedure Miller was referring to is called iovera, which uses a form of cryoanalgesia, or the application of cold via needles to the sensory nerves and soft tissues surrounding the knee. This, in turn, interrupts the pain impulses traveling between nerves and brain.
“I was going to do it anyway, one way or the other,” Smiles said with a chuckle.
Physical wear and tear over the years had pretty much “destroyed” both knees, Smiles said, a combination of playing high school football — he was a Neosho High School Wildcat — a stint with the U.S. Army during the Vietnam War, a helicopter crash and 22 years serving as a state trooper, climbing in and out of the patrol car.
Smiles came in two weeks prior to his May 6 surgery earlier this year to undergo the iovera treatment. A Freeman anesthesiologist first used ultrasound to locate the peripheral nerves surrounding the knee before targeting those post-surgery pain centers with blasts of freezing cold.
“We think (iovera) is going to be a game changer for knee replacement patients,” Miller said.
On average, the treatment takes about 15 minutes to complete, Miller said. More importantly, pain relief lasts approximately 90 days or longer.
“We’re having just great results with it,” Miller said, “with our patients taking 50% less pain pills than (those patients) who haven’t had the treatment.”
Because the treatment diminishes pain, “patients are requiring fewer pain medications, both narcotic and non-narcotic,” Miller said. “As a result, they just feel better, they do better. ... They’re walking sooner and are able to go home sooner.
“When we see them back in the office they are so much happier and having less pain and doing better with their knee replacement as a result,” he added.
Dozens of Freeman patients have already undergone the treatment, Miller said — it is now an option given to every knee replacement candidate. During Smiles’ May surgery, however, he was one of the first four to undergo the treatment: Freeman began performing the procedure that same month.
The difference between his left knee and the traditional surgery from 2015 and his right knee and the iovera system, Smiles said, “was night and day. I just breezed right through it. There was no pain at all.”
Because of that lack of pain, he would recommend the procedure to others facing knee surgery.
“What I went through this time, it was just a blast,” he said. “I didn’t have to worry about any type of pain ... whatsoever.”
To find out more about this innovative treatment or to schedule an appointment, call the hospital at 417-347-5400.