Karen Willis , Orthopedics

Karen Willis loves to dance. In the kitchen, in the living room -- anywhere there's music.

So even knee replacement surgery in May 2008 wasn't about to keep her from cutting the rug at a wedding in California a month later.

"I danced for two hours," said the 52-year-old rural Richland mother of seven.

Two months before that wedding, and just before the surgery at Borgess Medical Center, Karen not only couldn't dance but she found it difficult just getting up and down stairs.

A gregarious, extroverted bundle of energy, Karen did her best to ignore the discomfort in the years leading up to the surgery. She remained busy, driving the kids to school and sporting events, attending games at Michigan State University, and serving as a community volunteer and on various PTO boards for Gull Lake Schools.

Little slowed her down, despite the pain that began after she fell while visiting Rome in the late 1990s.

"Our daughter Kelli and I traveled to Ireland with the Gull Lake High School soccer team in 1999," she said. "We left a little early and went to Rome. When we were climbing the marble steps at the Sistine Chapel, which were under construction, I slipped and fell on my right knee, twisting it badly."

Discomfort persisted, but still Karen didn't slow. The damaged, twisted knee contributed to several more falls over the next few years and she began to worry that something was wrong beyond a damaged knee.

In 2004, she visited Dr. Thomas Ryan, whose family she knew through contact at Gull Lake schools. Ryan, of Kalamazoo Orthopaedic Clinic PC, "cleaned-up" her knee with arthroscopic surgery and the pain was greatly diminished.

"He told me, though, that I had about two years before I needed knee replacement surgery," she said. "And he was right. It got to the point where I didn't have any cartilage left. The muscles and tendons were damaged and I couldn't straighten my knee."

While she knew she needed surgery the demands of work and motherhood still called and she put off surgery until the Willis' youngest, Keegan, got his driver's license. Until then, mom was still needed to haul the kids around.

In May 2008, however, she walked into Borgess, a bit apprehensive about surgery, and was greeted by the first in a long series of very friendly, very helpful people.

"The receptionist was absolutely fabulous," she said. "And the nurses were all so friendly and helpful. They even all signed a card that they gave to me when I left."

Even as she was wheeled down the hallway to the operating room, there were smiling and friendly faces -- even people she knew -- all along the way.

"For some reason I had two songs in my mind as I went to the OR," Karen said. "One was an old Christian hymn and the other a disco tune. They said I sang a mix of gospel and disco until I went fully under with the anesthetic."

As with all joint replacement patients at Borgess, Karen participated in the Joint Replacement Program, better known as Joint Camp.

"I loved Joint Camp," she said. "At first I thought the idea was a little ridiculous, but it was wonderful. It was so useful going through an experience with others who were going through the same thing. And the staff was so encouraging."

She said that her experience at the Borgess Health and Fitness Center, where physical rehabilitation continued, was also an encouraging and positive experience.

"Some replacement patients choose to avoid physical therapy because at first it is very uncomfortable," she said. "But it is worth the work."

Karen's husband, Randy, is a registered nurse at Borgess. He said he occasionally sees the Joint Camp people and they still ask how Karen is doing.

Karen was walking not long after surgery and was discharged after three days. "The arthritic pain was gone," she said. "It hurt, but in a way that you would expect after surgery. But the loss of the arthritic pain was such a relief. Within two weeks I was driving again."

Karen can't say enough about the care and treatment she got at Borgess. "It was such a positive experience," she said.

She needed more physical therapy than many patients who have knee replacement surgery because the muscles and tendons were so badly damaged over the years. It was several months, for example, before her right knee had regained enough movement to complete a cycle on a bicycle.

"My goal is to lose the weight I gained because I couldn't exercise before the knee replacement surgery," she said. "I can ride a bike now, swim, play doubles tennis and walk. I can't jog yet."

She can, however, dance. And she didn't dance around her admiration for Dr Ryan.

"I don't know him well. But it's one thing to know someone and another thing to trust him to open up your knee and put in a new one," she said. "I talked to several people who had Dr. Ryan as a surgeon and they all spoke highly of him. I really trusted him. That was really important to me. I knew that he would do the very best job possible."

Dr. Ryan has practiced in Kalamazoo for more than two decades and has seen dramatic changes in the way knees are replaced and how long they last. One key has been the introduction of computer-aided systems that allow the surgeon to implant the artificial knee very precisely, ensuring a better outcome. When he first started implanting knees, he said, he had to "eye-ball" the proper angle that the knee is placed.

Today he can implant the knee with 1 degree of accuracy. "If the knee is well-balanced, it can last much longer," he said.

"There has also been significant improvement in the metals and plastic used in knee implants," he said. "For every 100 knees we replace, more than 95% will do well for at least 10 years and at least 88% for 20 years. The new techniques also mean smaller incisions during surgery and less cutting of muscle and tendons. And that means faster rehabilitation and better pain management."

A lot of knee implants are done in the elderly, he said, and with knees that last longer than ever, many will never need further surgeries.

Knee replacement surgery is also done on younger people, many in the 50s and 60s and who can expect a long life. He tells his patients that they should avoid high impact activities such as jumping and basketball. "They can walk, swim and play golf," he said. "A few patients even downhill ski, but I warn them to avoid moguls and jumps."

While some patients play doubles tennis, he warns all his patients that they should not play any sport competitively since that puts their knees at risk for damage.

"Recreational sports are fine," he said. "But no running and lunging and quick pivoting."

Exercise and physical therapy are critical to rehabilitation after knee surgery. Karen said that she benefited from an exercise video both before and after the surgery that Dr. Ryan gave to her. Dr. Ryan not only produced the video but also wrote the music.

Raised until age 10 in East Lansing, Karen has lived in the Gull Lake area since 1966. Her father, Russell G. Mawby, is the retired president of the W. K. Kellogg Foundation. He lives next door to Karen and Randy.

Karen said that her father also had significant success working with the Borgess physical therapists. She said that he had neuropathy and in three years went from needing a wheelchair to walking. "Borgess physical therapy helped our whole family," she said.