Issue link: http://viewer.e-digitaledition.com/i/753672
" Clots aren't very common in young, healthy people like Crystal. She was only 28 at the time that the clots occurred. But there is a risk for blood clots when someone has an orthopedic injury. Because she'd been in the hospital and then told not to use the leg, she hadn't been moving very much, which can cause clotting. Later, we found out that her mother has a clotting disorder. It was a perfect storm. " —MATTHEW WERT, M.D. and Dr. Keshava, Crystal's embolism was healing. But her knee was still nonfunctional. Because blood thinners make it challenging to control bleeding, surgery would have to wait. Dr. Wert and Dr. Keshava worked together to decide when it would be safe for Crystal to have the procedure. "All of the soft tissue in Crystal's knee was damaged," Dr. Wert says. "There was nothing holding it together, and she still couldn't put any weight on it. I started her on a prehabilitation physical therapy program to improve the range of motion in her leg joints because the better joints move before surgery then the better they do after surgery." After several weeks, Dr. Keshava and Dr. Wert decided that it was safe to take Crystal off blood thinners long enough to perform surgery for her knee injury. She was admitted to the Hospital on October 6, 2015, the night before her procedure, so she could be weaned off the medication and her clotting could be monitored. With the support of Dr. Keshava and the anesthesia team, Dr. Wert reconstructed Crystal's knee the next day. He used small incisions and secured her leg with a tourniquet to minimize bleeding. All of Crystal's major ligaments were torn, allowing for absolutely zero stability. Dr. Wert rebuilt and replaced the ligaments and tendons through minimally invasive arthroscopic surgery. "Each person's knees are balanced a little differently," Dr. Wert says. "I looked at Crystal's right knee to find out how her left should be, and lined things up the same way so that it would feel natural when she walked." After surgery, Crystal started taking blood thinners again and continued physical therapy to regain her strength. She spent time recovering at her parents' home in New Jersey and followed up with Dr. Wert regularly to make sure that her recovery was on track. One year later, Crystal is back running around with her girls. She has a new commitment to being active and healthy, is going to school to become a radiology imaging technician, and is even wearing high-heeled shoes again. "I loved working with Dr. Wert and Dr. Keshava," Crystal says. "They're wonderful people. They explained what was going on each step of the way and helped me through this, even though it was scary. They really saved me. Now, I'm focused on being as healthy as I can be. Someday soon, I'm going to be able to dance again. I'm so thankful." thrive P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE 15