The first time I helped a young person walk again

We had to replace the entire joint with an artificial hip, which is pretty routine for 65-year-olds but not for someone in their 20s.
Robert Karsch
Dr. Robert Karsch

Photograph by Ben Rollins

Dr. Robert Karsch
Orthopedic surgery, Premier Orthopaedics & Sports Medicine
The patient
was in her early 20s, and she had severe rheumatoid arthritis in her hips. It had gotten so bad that she had to pull out of college. She had developed what we call hip flexion contracture, which means her hip was stuck in a fixed, bent position. Even if she tried to stand up, her head would nearly touch the ground. She was wheelchair bound and getting very depressed stuck at home.

Seeing a patient in this condition is less common today than it was back then in 1998 because the medications are so much better now. But there are unfortunately a lot of young people who rapidly develop severe rheumatoid arthritis; it’s a crippling disease.

We had to replace the entire joint with an artificial hip, which is pretty routine for 65-year-olds but not for someone her age. I didn’t really have any other choice because the ball and socket were so deformed.

Within days, she started to take steps using a walker. Eventually she got out of the wheelchair permanently and was able to drive, go out with her friends, and importantly reenroll in college. In my head, I expected the surgery to be a success, but seeing the impact it had for her as a human being. . . .I’ve been in practice over 21 years, and it remains one of the top two or three experiences of my career. —As told to Josh Green

This article originally appeared in our July 2017 issue.

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