st. clair checkup

Derrick J. Fluhme, M.D.

Pain is the greatest concern for patients anticipating knee replacement surgery. Now, surgeons at South Hills Orthopaedic Surgery Associates (SHOSA) who share that concern and want their patients to do well in post-operative rehabilitation have developed new techniques in knee replacement surgery that translate to less soft tissue trauma, less pain and a faster, more effective rehabilitation.

Derrick Fluhme, M.D., an orthopaedic surgeon with SHOSA, has developed cutting-edge approaches to total knee replacement that make a world of difference. He makes a smaller incision, controlling bleeding in an innovative and less traumatic way and prevents post-operative pain through a multi-modal pain protocol. This translates into an all-around better experience for the patient: far less pain, less reliance on narcotic pain medications, and a more successful rehabilitation.

“The technology of the implants really hasn’t changed. What has changed is how we are approaching post-op pain,” Dr. Fluhme explains. “Our focus is on pain control, in order to facilitate rehab and ultimately achieve patient satisfaction and functionality. We don’t want our patients to be in pain, but we also don’t want them on narcotics and pain pumps, feeling groggy and nauseated. A patient in that state will take longer to recover. Knee replacement is not pain-free, but our approach minimizes pain and promotes faster healing.”

Dr. Fluhme, a graduate of Notre Dame and Georgetown University School of Medicine, specializes in knee and shoulder surgery and sports medicine. He says rehabilitation after knee replacement is the key to a good outcome, and a patient’s performance in rehab is directly related to their pain level. In traditional knee replacement surgery, the surgeon might make a 12-inch incision, which results in more pain and makes it difficult to bend the knee. “I do a different type of incision that is only about four inches long,” he says. “It’s a minimally invasive approach. It makes it easier for the patient to get their strength and mobility back in rehab.”

Another source of post-op pain is trauma from a large tourniquet placed tightly on the thigh during the operation to reduce blood flow to the site. It may be left in place for two hours, and when it is finally released, the blood flows rapidly back into the knee and may cause swelling and severe pain. To prevent this, Dr. Fluhme uses a probe that coagulates the blood vessels, controlling blood loss and reducing the length of time the tourniquet is needed.

Dr. Fluhme begins treating post-op pain before it begins, with a multi-modal pain protocol that includes anti-inflammatories and pain medications given before, during and after surgery. “All of these measures are intended to limit the patient’s discomfort and maximize their chances of success in rehab. I’m excited to be able to offer this to people who need knee replacement but have been avoiding it, for fear of pain.”

Dr. Fluhme can be contacted at 412-283-0260.