R5 Steven B. Zelicof, MD, of Sound Shore Medical Center in New Rochelle, NY, Describes a Patient who had Knee, Hip, and Shoulder Replacements

Steven B. Zelicof, MD Sound Shore Medical Center

Orthopedic surgeon Steven Zelicof, MD, often rebuilds damaged joints in pairs—two hips or two knees at a time. A few of his patients have had knee, hip, and shoulder replacements. But one patient, in particular, stands out.

“It’s fun when you meet a patient who has the same passion for getting better as you have for getting them better,” Dr. Zelicof says. At age 78, Fred Krell, a volunteer kicking coach for Somers High School’s football team, was so determined to get back on the gridiron that he impressed his own surgeon with the tremendous strides he made in recovery.

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“This is a guy who, two weeks after his hip surgery, came to the office to show me how well he could walk without his cane,” says Dr. Zelicof, chief of orthopedic surgery at Sound Shore Medical Center. He says Krell’s case illustrates that “age is really a state of mind” and that, even as our joints give in to the wear-and-tear of aging and to disease, there’s hope for maintaining an active lifestyle, particularly when we are determined to give it our all.

“He basically said he was going to fight to regain his mobility, and, today, he’s back coaching,” he says. “That’s really what I think makes him sort of the ‘Bionic Man.”’

In December 2008, Dr. Zelicof first met his new patient, who complained that his knees were killing him. Anti-inflammatory drugs had failed to provide relief. On examination, it turned out that “he had wicked bad arthritis both in his hips and his knees,” the surgeon recalls. Krell’s osteoarthritis battered the cartilage that provides cushioning to the joints. X-rays showed that the ball of each hip had completely worn through the socket on each side.

When a patient has bad knees and hips, Dr. Zelicof typically operates on the hips first because replacing the hips may help to lessen the pain that radiates from the hips to the knees and ease recovery by providing some mobility. “The hips really allow you to flex your leg up, to rotate your leg, so you can put on your shoes and socks, things like that.” Krell had bilateral hip surgery in March 2009, but his knees still bothered him. He says he got to the point where he could barely walk.

Dr. Zelicof tried injecting hyaluronic acid, a lubricant, in his patient’s knees to ease friction between bones and boost the joints’ shock absorption, but that didn’t help. Ultimately, knee surgery seemed to be the best option, as long as it didn’t interfere with football. “His big question was, ‘When can I get back onto the field?’” Dr. Zelicof says.

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In April 2010, Krell had both knees replaced.

Prior to each surgery, Krell says he did two to three months of physical therapy just to “build myself up” for the use of his new joints. And after the surgeries, he did more PT to regain mobility. “If they couldn’t replace my knees, couldn’t replace my hips, I’d be in a wheelchair for the rest of my life,” he says.

This past June, two years and three months after his first surgery, Krell had shoulder surgery to replace the worn-out joint on his left side. Dr. Yasmin Dhar, head of Sports Medicine at Sound Shore, assisted. Just six weeks later, the former band director and his wife were vacationing in Las Vegas.

So what does the future hold? “My right shoulder will eventually go on me,” Krell says. But right now, he just wants to focus on football.

Photo by Chris Ware

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