In the summer of 1971, Jerry Linhart was managing the tire department at Big R, a venerable farm and ranch supply retailer in Greeley, Colorado. Selling tires wasn’t a surprise. The location was.

Linhart had come to Greeley from Akron, Ohio, the self-proclaimed “Rubber Capital of the World,” and birthplace of Goodyear, the tire manufacturer whose origins trace to 1898. Linhart had already worked at several rubber companies before he got a job interview at Big R. He was unimpressed by the sleepy northern Colorado town and especially the fragrances from nearby feedlots that wafted on the summer breezes.

Then the owner of Big R, a “wise man,” asked Jerry where he was headed after the interview. “Back to Ohio,” Jerry replied.

“You’re not going to the mountains?” the surprised owner asked. He ultimately extracted a promise from the reluctant Jerry to at least make one high-country trip before he headed back east.

Jerry complied, he got a taste of the majesty of the Rockies, and his life changed.

“I went to the mountains and that was that,” he said, echoing many Colorado transplants before him and since. He headed back to Greeley.

Budding romance at checkout

Now ensconced in the Big R tire department, Jerry met a young woman named Sharon working the checkout line. A Greeley native, Sharon was a student at the University of Wyoming in Laramie, earning some extra money during her summer break. The two went out a few times, part of what Sharon saw as “a summer fling” before she went back to school.

Far from a fling, it turned out. The two married on Valentine’s Day 1974. Forty-seven years later, they are still together. Across the decades, they’ve owned and operated several businesses, from a bottled water distributorship to a gladiola farm to an airport commuter service. They retired comfortably after Sharon sold Linhart Public Relations, which she founded and owned for 25 years.

“We share a lot of values,” Sharon said. “That has served us well and made us closer, but we are still independent. The secret of our success is the support that we’ve given each other during the ups and downs of business.”

Hip pain together

They found after retirement that they would need that mutual support more than ever before. Retirement was supposed to feature plenty of travel, hiking, socializing and, in Jerry’s case, even motorcycle riding. But then the couple found they shared an unwelcome physical problem: severe osteoarthritis in both hips. It made standing, getting in and out of cars, and walking painful ordeals. Sharon’s jaunts around nearby Washington Park in Denver stalled. The yoga exercises they’d done regularly for 30 years slowed considerably. Hip pain stymied Jerry’s recovery from a right knee replacement in August 2020.

Because of that slow recovery, Jerry got a referral to Dr. Ryan Koonce, an adult reconstructive orthopedic surgeon at UCHealth Highlands Ranch Hospital who specializes in knee and hip replacements. After Koonce took X- rays of Jerry’s hips, Sharon spoke up.

“Hey, could you look at mine too while we’re here?” she asked.

Koonce agreed. What he saw startled him, he said during a recent visit at the hospital.

Both Jerry and Sharon needed double hip replacements. It’s not uncommon to replace both hips, Koonce said. He’s also done replacements on both husband and wife.

“But I’ve never had a husband and wife who came in with such severe arthritis in both hips,” Koonce said.

A quadruple success

He’s now successfully replaced all four, starting with Sharon (left hip) in February and ending with Jerry (right hip) in May. During Jerry’s three-month checkup with Koonce in late August, both Linharts were walking easily and said their hips are now pain-free.

Sharon also had her hip-replacement surgeries on an outpatient basis. In May 2020, Highlands Ranch Hospital had become the first in the UCHealth system to develop an outpatient joint replacement program, Koonce said.

Koonce noted that as of September 1, 44% of the hospital’s joint replacement surgery patients go home on the same day. Orthopedic surgeons at UCHealth University of Colorado Hospital on the Anschutz Medical Campus have now begun performing outpatient joint-replacement procedures, he added.

Koonce uses an anterior approach for all his hip-replacement surgeries. This means he enters the hip joint from the front, which requires only separating muscles rather than cutting through them, as is required by an approach from the side or back. The muscle-sparing technique generally allows patients to start moving more quickly, Koonce said.

Writing the book on joint replacement

Advanced technology, surgical technique and patient education are the keys to good patient outcomes for Jerry, Sharon and his other hip replacement patients, Koonce said. For example, a computer navigation system in the operating room assists him with correctly placing the new hip implant, equalizing leg lengths, measuring and matching the distance from the pelvis to the hip, and making sure the hips are properly aligned across the pelvis.

“We need to measure everything accurately to get the hip to function correctly,” Koonce said.

Every patient also gets a Koonce-authored guidebook for patients that explains hip replacement and non-surgical alternatives (he has companion titles for knee replacement and the basics of hip and knee osteoarthritis). The books supplement patient classes that explain joint degeneration, the benefits and risks of surgery and what patients can expect from their procedures.

“People who come in for joint replacement want to be involved in their own care and want to know what is going to happen,” Koonce said. “There is a set of questions that you can predict they are going to ask. The book is an attempt to answer the common questions in a readable format. It’s very important to me that patients know what they’re getting into and that they participate in their own surgery and their own recovery.”

In the near future, Koonce said he and his orthopedic surgery colleagues expect to roll out an interactive online course available to anyone getting joint replacement surgery at UCHealth. He said the 45-minute course will include information from his books, quizzes, 3D videos and printable handouts.

Data-driven care

After Koonce reviewed Jerry’s X-rays and examined him – “everything looks perfect,” he said – certified athletic trainer Fernando Saldana took over. In a short corridor outside the exam room, Saldana timed Jerry on a four-meter walk and an up-and-go test to assess his balance, mobility and fall risk. Saldana also recorded how many times Jerry could rise from a chair to a standing position in 30 seconds.

The tests help Jerry’s team assess his recovery and contribute to other data in PatientIQ, an automated system UCHealth uses to collect patient reported outcomes, or PROs, that help providers assess their patients’ perceptions of pain, ability to perform their normal daily activities and other factors in their recovery. The goal: glean as much information as possible to design systems that consistently deliver high-quality care, supported by evidence.

As Koonce had put it earlier, the overarching goal of the technology, the education, and the tests is “to do the procedures the same way every time so we get consistent results. But we tailor the care to individual patients.”

For both Linharts, the process worked. After finishing his sit-to-stand test, which he completed with relative ease, Jerry walked back to the exam room. “I couldn’t do any of those before my hip replacements,” he said.

Solving the scheduling scramble

Sharon also stressed the close attention she and Jerry received from Koonce’s team. Physician assistant Jordyn Roddy, for example, readily answered any and all clinical questions and concerns. The staff also efficiently handled the scheduling chores, which required staggering the couple’s surgeries so they could care for one another during their respective recoveries.

The surgeries, of course, also occurred during the ongoing COVID-19 pandemic. That meant juggling times for COVID testing and vaccinations.

“The staff had to work hard to get us scheduled for all these procedures,” Sharon said.

A new lease on life

With four surgeries in the rearview mirror, the Linharts look forward to the robust life they earned through years of hard work bolstered by their commitment to one another.

Jerry recalled feeling great at age 70, then taking an abrupt downhill slide. Things are on the upswing again. “Now I feel like I did then,” he said.

Not long ago, Sharon said, her most pressing concern was “figuring out where to sit down instead of standing and talking to people.” Now she and Jerry have happier prospects to consider.

“We’re pretty socially active and enjoy being with friends,” she said. “I want to live a long time yet. We both have plans to travel and do fun things now that we’re retired.”

And Jerry may yet get back on that motorcycle. For now, it’s with a friend, who he admitted might be reluctant to give it back.

“I said I’m not riding it until I get this stuff fixed,” he said. “But I loved going to the mountains. I’m hoping to get back on.”