Dwight L Patient Gets Back to Cycling and Active Lifestyle

"The care was superb."

Dwight Lewis exudes youthful joy and zest for life. The 71-yearold Trenton resident isn’t just a manager for a national construction company, a married father of three and a grandfather of two. He also walks, skis, bikes, swims, dances, practices yoga, does weight training and goes on scuba diving expeditions to places like Fiji.

With a fitness regimen that includes workouts six days a week and thousands of cycling miles a year, it’s easy to see how knee pain and surgery to fix it might slow him down.

But a total knee replacement at Robert Wood Johnson University Hospital (RWJUH) Hamilton less than two years ago has helped him become more active than ever. In 2023 alone, he covered 4,700 miles on his bike.

Dwight was so pleased with his surgery’s success that he felt compelled to write a note to his orthopedic care team at RWJUH Hamilton a year after hisjoint replacement. “I felt it was only appropriate…to tell you how fantastic the process has been for me,” he wrote. “It’s life-changing.”

Conservative Measures

Prior to surgery, Dwight had spent decades living with steadily increasing knee pain and limited range of motion that he powered through while living his active life.

It all started with a high school football scrimmage. “This oversized senior dove into my knee,” Dwight recalls. The injury required surgery that included removing cartilage from the inside of his left knee.

Dwight did exercises to regain mobility such as lifting a bag of canned food with his foot while sitting on a table, but his range of motion never went beyond 115 degrees.

Michael R. Duch, MD
Michael R. Duch, MD

Over the next four decades of wear and tear, his bones developed arthritis, formed painful spurs and wore unevenly, with the tibia and femur no longer in proper alignment.

Eventually, he enlisted a critical member of his knee-care team: the doctor who eventually would perform his knee replacement surgery, Michael R. Duch, MD, an orthopedic surgeon with The Orthopedic and Spine Institute at RWJUH Hamilton and a member of RWJBarnabas Health Medical Group. The two met about 12 years ago, before Dr. Duch practiced at RWJUH Hamilton.

“My knee was beginning to bother me significantly, and a friend highly recommended Dr. Duch,” Dwight says.

Dr. Duch recognized that Dwight’s knee might eventually need replacement surgery, but he didn’t start with that. “I always take a conservative approach,” says Dr. Duch.

Dwight had injured his meniscus, a crescent-shaped band of cartilage that serves as a cushion between the tibia (shinbone) and femur (thighbone). Wear was occurring on the inner side of his knee and underneath the kneecap. To address the problems he saw, Dr. Duch first performed an arthroscopy, a minimally invasive joint surgery, to clean up the damaged meniscus.

The procedure helped but couldn’t resolve all issues. Dr. Duch also treated Dwight’s knee with injections of cortisone and hyaluronic acid. Sometimes called gel injections, hyaluronic acid shots were given weekly for three weeks every year. “These worked remarkably well for about seven years,” says Dwight.

When Dr. Duch joined RWJUH Hamilton, Dwight continued receiving injections from another doctor but found that he needed treatments more frequently. Eventually the pain became so bad that Dwight decided he wanted to discuss surgery. And he knew who he wanted to do the procedure. “I looked up Dr. Duch,” he says.

Quick Improvement

When Dwight reconnected with Dr. Duch in April 2022, the doctor ordered an X-ray and showed Dwight his deteriorated joint and misaligned bones. By now the need to do knee replacement surgery was clear.

Dwight already was looking beyond surgery: He wanted to recover in time to go cycling and scuba diving on a trip he had planned to Cozumel, Mexico, in January 2023. He and Dr. Duch scheduled the surgery for September 15, 2022.

Dr. Duch performed Dwight’s total knee replacement with the help of Mako Robotic-Arm Assisted technology. The process started with a CT scan of Dwight’s ravaged knee, which was uploaded into the Mako system’s software. The system then created a 3D model of the knee that helped Dr. Duch pre-plan and assisted with the surgery.

The entire procedure was completed in less than an hour. “The knee prosthetic is actually in place within 17 to 22 minutes,” says Dr. Duch. “I use mesh with glue to close the incision, so there are no sutures.”

Dwight was walking with assistance that afternoon, a Thursday, and was discharged Friday. After some initial pain and weakness, Dwight began making quick progress. “I gave up the walker on Sunday, began driving on Monday and started physical therapy on Wednesday,” he says.

Dwight continued physical therapy three days a week for three months with RWJ Rehabilitation and Physical Therapy in Hamilton. “By the time I finished PT on December 23, my leg was strong, my balance was strong and my range of motion was cresting 135 degrees,” he says.

Although an expected amount of swelling continued into 2023, Dwight’s knee was ready to meet his goal. By January, he was scuba diving and riding his bike 50 miles around Cozumel. By late summer, his persistence with physical therapy exercises increased range of motion in the replaced left knee to 143 degrees—“within a few degrees of my right knee,” he says. “This is amazing to me.”

An Expansion Makes Progress

Construction is more than 75 percent complete on Robert Wood Johnson University Hospital (RWJUH) Somerset’s 76,000-squarefoot vertical expansion project. The two-story addition will include the hospital’s Orthopedic Center of Excellence, a 35-bed inpatient unit featuring all-private rooms and a rehabilitation gym. It will also house a 10-room Rapid Decision Unit for Emergency Department patients who require additional observation.

About 100 hospital community supporters, donors, physicians and employees got a sneak peek at the progress on the project during a recent hard-hat tour and open house coordinated by Somerset Health Care Foundation, the hospital’s fundraising arm.

“Moving our orthopedic unit to this new facility will enable us to make more of our patient rooms throughout the hospital private, which will enhance patient satisfaction and promote healing,” says Patrick Delaney, Chief Administrative Officer, RWJUH Somerset. The facility is expected to open by early 2025.

Learn more about Orthopedics at RWJBarnabas Health.