Having exhausted her options — physical therapy, corticosteroid injections, painkillers and even extreme weight loss — Maria Melendez felt hopeless. The pain in her knees was so bad that she couldn’t even bend down to pick up something off the floor. Dancing at her wedding, she thought, was out of the question.

Then she met UCHealth orthopedic surgeon Dr. Sunil Jani at the Longmont Clinic.

Jani was similar to other doctors Melendez had consulted in that he wasn’t ready to immediately put Melendez under the knife. Typically degenerative arthritis is not a disease of younger people. At 48 years of age, Melendez had a lot of years of life left, many more than a typical knee replacement would likely sustain.

“Knee replacement surgery is a significant treatment that works well,” Jani said. “However, we quote about a 20-year life span for hip and knee replacements, so it is possible that Maria may need revision surgery on one or both knees in her 60s.”
Newlyweds Maria and Domingo Melendez have fun with their own version of “trash the wedding dress” at their recent wedding. Thanks to knee replacement surgery, Maria was able to enjoy her wedding standing up, dancing throughout her three-day celebration.
But Melendez was suffering.

“Nothing was working,” she said. “I still had swollen knees and was still having to work and take care of my mother, and I was still in pain.”

Melendez cares for her 85-year-old handicapped mother and does custodial work for an area school district. Even with her pain, she is used to being a woman on the go and doing things for herself, but her knees started locking up more, and she would sometimes even tumble to the ground.

“By 4 p.m., I had to shut down,” she said. “I could barely stand and had to ice my swollen knees.”

“Maria had no options left,” Jani said. “Historically, the thought process was to wait as long as possible before moving forward with surgery. However, if you are not being active and not doing the things you love to do because of painful arthritis, then your quality of life has already decreased. A joint replacement can help to restore your activity level and improve your quality of life. I try to get my patients back to doing what they love to do, so that they can live life to the fullest, instead of suffering needlessly due to worries of another surgery decades down the road.”

Jani decided it was time to consider surgery — something Melendez had been begging doctors to do for years.

“There are always pros and cons,” he said. “During joint replacement surgery, we remove bone and cartilage and replace it with metal and plastic. Each subsequent surgery grows more challenging.”

But overall, first-time knee replacements are second only to hip replacements in the increase in quality of life over time — less pain and more mobility through the years.

Jani and Melendez discussed all of her options in detail.

“I asked a lot of questions, and he paid so much attention to me,” she said. “He really wanted to make sure I was comfortable with my decision.”

“There were no other good options left to try, and that’s why we agreed to move forward with surgery,” Jani said. “Her X-rays showed bad kneecap arthritis. But I don’t treat X-rays, I treat people. It’s my job to inform patients about the various options for getting them better, and the pros and cons of each. In most instances, the patient tells me, the surgeon, if and when they are ready for surgery. ”

Melendez was ready. She was ready to work again without pain. She was ready to dance at her wedding.

When Melendez woke up from her first knee replacement surgery, her “heart was big,” she said. “There was no more pain, and I was very comfortable — I felt like Superwoman.”

She was up walking within a few hours, and a few days later, went home with a physical therapy and rehab schedule. Jani said they could discuss scheduling the second surgery in a few months. About six weeks later, Melendez was convincing Jani she was strong enough for an operation on her second knee.

“Fifty percent of how well a patient does is my job in the operating room, but the other 50 percent is based on their hard work in rehab —not doing too much too soon, but also not doing too little, either,” Jani said.

Melendez’s second surgery had a slower recovery, and she used a walker for two weeks. But the whole time she could see her wedding party — three days of dancing and eating with her large Mexican-American family — just weeks away.

And then on July 23, with her heels left behind — but a short skirt to show off her new knees, Melendez and her groom whirled around the dance floor to Leonard Cohen’s “Dance Me to the End of Love.”

“I got my life back, and I got to dance at my wedding,” Melendez said. “And I danced a lot!”