May 20, 2014. “Why drive when you can ride,” asked Gregg Marland, Research Professor at Appalachian State University. The 71 year-old educator, who specializes in environment, energy and economics had opted to ride his bike to work faithfully every day for two years.
“I enjoy both the sustainability and the recreational and competitive opportunities that riding a bike can provide,” said Marland, an experienced rider and weekend cyclocross racer.
Cyclocross, also known as cross country bicycle racing is a well-known European sport that is growing in popularity in the United States. The High Country has long served as an attraction for bicycle enthusiasts and provides an ideal backdrop for cyclocross events.
These mountain bike racers can expect the unexpected as they are challenged in each race to navigate through an array of manmade obstacles and overcome a verity of natural terrain barriers.
Last October, Marland entered into a cyclocross race that the Watauga County Fairgrounds. Fueled with adrenaline, Marland was having a great race when tragedy struck. While banking in a slippery hairpin turn, Marland lost control of his bike and crashed.
“I was big time hurting,” said Marland, who at the time was stranded in the middle of the course unable to move.
Boone Bike, the sponsor of the race, responded quickly by helping Marland safely off the course. Bonnie, Marland’s wife, was next on the scene. With the help of the race event staff, she was able to quickly load her husband into their car and head to a nearby urgent care.
The situation escalated after several anxious minutes and an x-ray scan which revealed that he had fractured his femur in the crash. The urgent care staff quickly placed Marland on a backboard and loaded him into an ambulance in route for the Emergency Department at Watauga Medical Center (WMC).
“I’ll never forget what happened next,” said Marland, referring to when Orthopaedic Surgeon Dr. Evan F. Ekman approached his bedside in the emergency room. Dr. Ekman, Medical Director of Appalachian Regional Orthopaedic and Sports Medicine Center (AROSMC), informed Marland that he has suffered an injury to his hip and his knee. He went on to state that it was imperative to address the hip injury first and once repaired, they would address the injured knee.
Marland gave an understanding nod as Dr. Ekman proceeded to share with his patient that he would need hip surgery and that he had a procedural decision to make. Dr. Ekman explained that the first and most common treatment option was to repair the femur fracture through an open reduction internal fixation procedure. This option is typically popular and effective choice for patients in their 70s with limited functionality.
However, after getting to know the patient and appreciating his active lifestyle, Dr. Ekman recommended waiting 24-hours for parts to be ordered for a second procedural option called a standard endoprosthetic replacement.
This procedure involves replacing one half of the hip joint with a prosthetic, while leaving the other half intact. Dr. Ekman explained that this option would entail installing a prosthetic femoral head in the knee socket that would swivel during movement, thus helping to reduce the amount of wear and tear on the new joint for longer lasting results. He also added that the second option should allow him to get back on a bike within six weeks.
“Dr. Ekman did not write me of as an old man. He saw beyond the injury to the person and was truly committed to helping me maintain my lifestyle,” said Marland.
Due to considerable misplacement from his injuries, Marland spend the night at WMC with Bonnie by his side. As planned, he was scheduled for surgery the next day and the procedure was completed without complication.
After his surgery, Dr. Ekman referred his patient to the healthcare system’s Rehabilitation Center in Boone. Located within a mile of WMC, the outpatient rehab facility offers its patients convenient and comprehensive care. The team of physical therapists spent the next month restoring Marland’s strength, range of motion and balance.
At a follow up appointment just weeks after his hip surgery, Dr. Ekman marveled at how quickly his patient’s level of function has been restored.
Eager to get back on his bike, Marland asked, “Can we get to my knee now?”
“You bet,” said Dr. Ekman as a smile spread across his face. As before, the surgeon took great care in explaining to his patient that there was a minimally invasive surgery option available to correct his injured knee.
By means of outpatient surgery at WMC, Dr. Ekman was able to correct his patient’s injured meniscus through two tiny pinhole incisions inserted into Marland’s knee. Within an hour after surgery, Marland was literally feeling better in the recovery room. This was welcome news to the professor who had reluctantly driven his car to work since the crash.
In a follow up appointment, right at six weeks post injury, Dr. Ekman gave Marland permission to get back on his bike again.
“The whole process has been seamless,” said Marland with a grin.
“The transition from surgery to rehab to mounting my bike again within such a short time span has been truly remarkable.”
“The goal of App Ortho as it aligns with the healthcare system is to provide a continuum of care that simply put, ‘makes life better’ for its patients,” said Dr. Ekman. “The fact that we were able to customize a treatment plan to address the multiple injuries suffered by this high functioning adult without impairing his pace of recovery speaks volumes to the quality of care available here in the High Country.”
To learn more about Appalachian Regional Orthopaedics and Sports Medicine Center in Boone call 828-386-BONE or visit www.apprhs.org/ortho.