Knee pain from fall leads to unexpected double hip replacement

Raymond Lerner, a maintenance technician for a property management company, was on the job when he slipped and fell on a patch of ice.

“I was a little sore, but I wrote it off,” says Lerner, 48, of Kent.

Over the course of a few months, however, he started experiencing pain in his right knee.

“One day, my knee kind of gave out, and I almost fell,” he explains.

Lerner’s pain began radiating from his knee up to his hips and back. That’s when he made an appointment with his primary care physician, Stephen Lu, MD, MultiCare Family Medicine – Kent.

“I thought it was my knee, but Dr. Lu X-rayed both of them, and he said they looked great,” says Lerner. “Then, he X-rayed my hips and found they were actually the source of my pain.”

Dr. Lu referred him to Kevin Lawson, MD, orthopedic surgeon with MultiCare Orthopedics & Sports Medicine – Covington.

“Dr. Lawson told me my hips were bone on bone and that I’d need surgery,” Lerner explains.

He found out during the appointment that hip pain can actually start in the knees and work its way up to the hips. He also learned that he had osteonecrosis, a condition that caused the tissue in the head of his femurs (thigh bones) to erode.

Osteonecrosis, or avascular necrosis (AVN), can occur due to trauma to the hip joint. Young children can even get it if they’ve had chronic steroid treatment for certain diseases. However, its most common cause is alcohol abuse. Alcohol can cause fatty deposits in the blood vessels, blocking the flow of blood to bones. When the tissue doesn’t get blood flow, it dies.

This was likely the cause of Lerner’s AVN.

“I’m an alcoholic in recovery,” he says. “Dr. Lu helped me get sober before any of this happened with my hips. He prescribed a medication to help with cravings, and it worked.”

Dr. Lawson says AVN can be very painful and severely limit quality of life and function.

“If the tissue damage isn’t too bad and can be salvaged, there are procedures that help with hip preservation,” adds Dr. Lawson. “In Ray’s case, however, it was past the point of preservation, and he needed replacement.”

“It’s rewarding to see [my patients] go from barely walking to being pain-free.”

Lerner’s first surgery was in December 2020. He took a 12-week leave from work to recover. During that time, he had physical therapy twice a week for eight weeks. And because it was during the COVID-19 pandemic, they came to his home.

“The physical therapy team was really good at working with me knowing my other hip was still bad,” he says.

Lerner needed to use a walker for the first two to three weeks after surgery because he couldn’t bear a lot of weight on the bad hip.

“It was kind of rough getting back to work because I had to deal with the pain in the other hip that still needed surgery,” he explains.

Lerner’s second hip surgery was in January 2022. He only had to take eight weeks off work since he had two good hips, making recovery much faster.

“Dr Lawson is awesome and his bedside manner is great. He had a real understanding of my situation and reassured me through the whole process,” says Lerner. “After both surgeries, I woke up and he was right there to see how I was doing.”

“My goal is to give my patients the best outcome possible,” says Dr. Lawson. “It’s rewarding to see them go from barely walking to being pain-free. Ray’s quality of life had decreased due to his hip pain, but he got back to work and to doing the things he loves.”

Lerner is on his feet all day at work, going up and down stairs.

“But I can do that now, no problem,” he says. “And my wife Trudy and I like to take weekend trips up to mountains and go hiking with our dogs, so I’m happy I can do that again. After my two surgeries, I feel 110 percent better.”

If you’re experiencing joint pain and you think you might be a candidate for joint replacement surgery, schedule an appointment with your doctor or other health care provider and ask for a referral today.