Getting Hip to Surgery
Total joint replacement relieved Scott Krater’s pain when other therapies couldn’t
Scott Krater of Port Carbon, Pa., first noticed a twinge of right-hip pain in 2014 while out golfing. As director of Schuylkill County’s 911 Communications Center, a member of his borough fire company and its chief for 19 years, the 57-year-old Krater wasn’t a stranger to aches and pains. But the pain didn’t go away. Instead, it steadily grew worse.
By late fall 2015, Krater’s hip truly began to bother him. Hitting the links the following spring, “I realized how bad it had become,” Krater says. “I couldn’t golf without pumping myself with Advil or Tylenol to relieve the pain.”
Worse yet, severe aching had migrated to his right leg and the outside of his left foot. “I was compensating for my hip pain by walking with a noticeable limp,” Krater says. “That put pressure on other parts of my lower body.” During football season, as part of the “chain gang” that moved sideline markers during Pottsville Area High School games, he hobbled up and down the field with difficulty. “The 2016 season was a real struggle,” Krater recalls.
Trying conservative treatments
By then, Krater had consulted with orthopedic surgeon Robert Boran, MD, with Lehigh Valley Physician Group Orthopedics–Schuylkill Manor Road, in Pottsville. “X-rays showed that Scott had moderate-to-severe degenerative arthritis,” says Boran, who recently retired from surgery. “Because he was young, we decided to start by trying conservative, non-operative treatment.”
Physical therapy, including pool-based aquatic therapy at LVHN Rehabilitation Center–Schuylkill, helped make the pain more tolerable but didn’t halt disease progression. In December 2016, Krater had a cortisone injection into the hip joint. “That helped until about February,” Krater says. “We reached the conclusion that conservative treatment had failed,” Boran says. “The next step was to proceed with total joint arthroplasty” – hip replacement surgery.
A necessary surgery
Krater’s progression was typical of people who need total hip replacement. “We consider several factors before surgery,” Boran says. One is that imaging, such as an X-ray, shows arthritis to be severe. Another is that pain significantly affects walking, quality of life or daily activities. A final consideration is that more conservative treatments have not provided relief. “Scott certainly met all those criteria,” Boran says. “He had end-stage osteoarthritis where there is no cartilage visible on the X-ray and you have bone-on-bone, which usually means constant pain.”
On surgery day, Krater felt comforted by familiar faces from the community where he grew up and dedicated himself to public service. “Dr. Boran had done my mother’s hip replacement surgery,” Krater says. “The prep nurse was a high school classmate. The operating room nurse was a neighbor in Port Carbon. We were all on a first-name basis. Whatever my reservations or anxiety, it helped a lot to look at faces I knew.”
Surgery went smoothly, and Krater immediately noticed a difference. “When I woke up, I had pain from the incision but nothing like the pain I had prior to surgery,” he says. “That pain was all gone.”
Physical therapy is critical
Therapy was both immediate and vital. “Rehabilitation is extremely important,” Boran says. “It strengthens muscles weakened not only by surgery but by previous lack of motion due to pain and arthritis.” Activity also helps prevent blood clots in lower extremities. “I was walking the day after surgery,” Krater says.
Krater received physical therapy at home for two weeks. About three weeks after surgery, he attended the Schuylkill Chamber of Commerce’s annual golf outing. “My goal from surgery had been to at least putt at that event,” Krater says. “I fulfilled that goal.”
Krater continued doing physical therapy at LVHN Rehabilitation Center – including leg stretches, knee bends and stepping exercises – three days a week for two more months. “He progressed like gangbusters,” Boran says. After three months, Boran gave Krater the best news of all: “I told him he could start playing golf again.”
“I’m ecstatic and pleased beyond words,” Krater says. “I’m basically doing everything I did before surgery – but without pain.”
– Richard Laliberte