At Orthoca, everything is about progress. About people who want to move, live and enjoy themselves again.
For us, an intervention is not an end point, but the beginning of something new.
Pascale proves that like no other. What started with persistent knee problems grew into a tough journey and eventually: a life without pain, with running competitions.
From pain to perspective
In 2014, Pascale, then 48, began experiencing pain in her right knee again. The cause was in the distant past: a skiing accident in 1993 that tore her anterior cruciate ligament. In addition, due to an initial misdiagnosis followed by incorrect treatment, she developed Sudeck syndrome. That’s a condition in which the nervous system overreacts, resulting in persistent pain and swelling. That hypersensitivity made her knee especially vulnerable, even years later. The pain increased year after year.
“The pain was gnawing at first, but got progressively worse. Walking was no longer possible, cycling became difficult. Even daily life became tough.”
After several attempts to control the pain, the family doctor finally referred Pascale to Professor Verdonk, knee specialist at Orthoca. During the initial consultation, it became clear that her knee was severely damaged. A knee replacement was the best solution.
“In young patients, like Pascale, we always take extra time to carefully consider the decision,” Professor Verdonk explains. “A knee replacement at 48 is not an obvious choice. But Pascale had tried everything: medication, physical therapy, injections… The pain remained and her functional possibilities were severely limited. Then you know that a prosthesis is the logical next step.”
Although that realization came in as a blow, Pascale immediately felt taken seriously. The explanations were clear, the contact human and respectful.
“That took some swallowing. I was only 48. But the explanation was clear, and I immediately felt understood. That gave me confidence.”
Rehabilitating while life goes on
The surgery went well, but the first few weeks after surgery were tough. Because of Sudeck syndrome, Pascale suffered from intense pain and mobility problems. Meanwhile, life at home continued as usual. With adolescent children and a household, taking rest was no easy task.
“Mentally, it was a challenge. You want to recover, but family life doesn’t stop. Still, I persevered, one step at a time.”
Over time, Pascale began to make progress. She rehabilitated intensively under professional guidance and slowly regained strength. Meanwhile, she also worked on her general health and lost no less than 45 kilos; a huge boost to her body and motivation.
“The recovery was not a straight line” says Prof. Verdonk. “Pascale was dealing with additional complications. Her knee folded with difficulty, so we had to perform a mobilization under anesthesia. Later it turned out that the lower part of the prosthesis also came loose. A second surgery followed in 2015. Not an easy road, but she continued to progress. And that is entirely to her credit.”
She owed that progress not only to her perseverance but also to her impressive weight loss.
“Obesity is a determining factor in premature wear of the knee joint,” Prof. Verdonk explains. “It also increases the risk of complications after a prosthesis. But healthy exercise with a worn-out knee is often impossible. This is why we make clear agreements in advance: we perform the surgery, but also expect the patient to actively commit to weight loss. You could call it a tacit pact; a mutual commitment. Pascale is the perfect example of that.”
Walking as victory
Today Pascale is 59 and feels better than ever. What once seemed impossible, she now does effortlessly: walking, biking, living an active life without pain. She participates again in running races, from 6 km to even the 10 Miles – with Professor Verdonk’s permission.
“I run three times a week: 8 km during the week, 10 km on weekends. And I bike 80 km to and from work every day. My knee replacement is not a limitation, it is my freedom.”
According to Prof. Verdonk, the strength of Pascal’s recovery lies mainly in her very positive mindset:
“Surgery can do a lot, but not everything. A patient’s motivation makes all the difference. Pascale really regained her life. Not only because of what we did in the operating room, but because of what she did afterwards. Such a story is exceptional.”
Stronger together
For Pascale, trusting her doctor was an important part of her recovery. That sense of recognition and security gave her the strength to persevere.
“You have to have a good feeling with whom you are being treated. I had that with Professor Verdonk.”
One of the moments that has stayed with her most is her permission to participate in the 10 Miles once. Not only a sporting milestone, but also a sign that her body and mind were ready for the future again.
“Life doesn’t stop with a knee replacement – on the contrary, you get a second chance. The journey is tough and certainly not to be underestimated, but with the right support often much more is possible than you think. Do not limit yourself, persevere: step by step you will get further than you ever dared to dream. When I look back on it, only one feeling prevails: gratitude.”
Professor Verdonk’s view: when is a knee replacement the right choice?
A knee replacement is not the first step in a treatment regimen. Especially in younger patients, this procedure is not considered until all other options have been exhausted. Professor Verdonk is very clear about this:
“Patients must meet three clear criteria before we consider total knee replacement. First: there must be bone-on-bone contact, i.e. advanced osteoarthritis. Second: there must be functional limitation, meaning a person can no longer walk five kilometers, for example. And third: daily pain. If these three elements are present AND previous treatments such as physical therapy, injections or medication no longer offer any improvement, then a prosthesis comes into the picture.”
But even then, it is not a light decision. “A knee replacement is permanent, you can’t go back and there is no plan B. That’s why we never schedule surgery at an initial consultation. We take the time to explain everything clearly: what the procedure entails, what the risks are – think infection, permanent pain or stiffness – and most importantly, what you can realistically expect from it.”
This is done with full disclosure at Orthoca. “I’d rather say too much than too little. Too often I see people who have had surgery elsewhere and say afterwards, ‘If I had known all that, I wouldn’t have had it done. I wasn’t actually that bad.’ We just want to avoid such reactions.
Underpromise and overdeliver: that’s a basic principle for me. Rather a pleasant surprise afterwards, than a harsh reality that no one had seen coming.”
An example often used by Professor Verdonk is the comparison to a school report card. “If someone comes in with a 3 out of 10 for quality of life, with a prosthesis we can often give them a 7 or 8. Not a perfect 10 but certainly a huge improvement. That metaphor often makes it immediately clear.”
Pascale’s story shows what is possible when all those puzzle pieces are right. “She is the perfect example of how a knee replacement can not only eliminate pain, but also bring back quality of life. Provided you start together with realistic expectations .”
You too can get moving again
A knee replacement is not an endpoint. At Orthoca, we believe in recovery tailored to your life, your goals, your pace. This courageous story proves that even after a difficult course, an active, pain-free life is once again within reach.
Contact us with no obligation. We would love to listen to your story.