David Collins had both his knees replaced within 90 days of one another. TONY KUKULICH

When David Collins decided it was time to schedule knee replacement surgery, he likely had a better understanding of what he was getting into than even the best-informed patients.

Collins sold orthopedics for one of the major manufacturers of replacement joints for much of his career. His new knees were, in fact, crafted by his former employer.

“I’ve been in the operating room any number of times,” he said. “I saw knee replacements and hip replacements and knew what the procedure involved.”

Now 70, the Bluffton resident is extraordinarily active. In addition to his successful real estate business, Collins enjoys hiking, biking, kayaking and spending time in the gym. And he’s a lifelong rugby enthusiast, remaining involved with the sport – known for its high level of physical contact and the toughness of its players – until relatively recently.

“I played rugby until three years ago,” he said. “I was the slowest guy on the field, but I was still playing.”

Despite Collins’ familiarity with joint replacement surgery, he made the decision to delay replacing his painful knees for as long as he could. He based that on a number of factors, including his understanding of the expected lifespan of a replacement knee, an expectation of his likely lifespan, and his desire to avoid knee revision – having the replacement knee replaced after it wears out – later in life. As a result of that calculus, Collins held off on the surgery until earlier this year.

“My surgeon, Dr. Kevin Jones at Beaufort Memorial, told me my knees were among the worst he had seen due to the longtime ‘bone-on-bone’ situation,” said Collins. “In retrospect, I should have done it earlier so I could have been pain-free sooner and enjoyed a better quality of life.”

But when he did make the move, he made it quickly. He had total knee replacement surgery done on both knees within 90 days of one another.

“I was in Savannah with my wife, walking over cobblestone, up and down stairs, and I’d had it,” he said. “I just couldn’t do it anymore. There’s nothing that relieves that kind of pain.”

Dr. Jones, the board-certified orthopedic surgeon who performed both of Collins’ knee replacements, used the Mako Robotic Arm-Assisted Surgery System. According to Jones, the technology allows him to create a surgical plan unique to a patient’s anatomy, and then use the robotic arm to implant the components with greater precision. 

“With the robot, we can more closely customize the ideal position of the knee implant, increasing its longevity,” said Jones, adding that the precision of the robotic arm allows cuts to occur in a way that they do not impact the tissue surrounding the bone. Further, computer modeling helps surgeons determine where to make the cuts to ensure that the knee is balanced, meaning that the tension on the ligaments is equal on both sides of the knee.

“If we’re able to balance the knee throughout the range of motion, we’re able to get the range of motion back more easily, and we’re able to see a quicker recovery,” Jones said.

After each of Collins’ surgeries, he was able to leave the hospital the same day. Most Beaufort Memorial joint replacement patients will spend one night in the hospital, but about a third are able to go home the same day.

“Leaving the hospital on the day of surgery isn’t for everyone, but patients who are healthy and who have a support system at home often prefer to do that,” said Jones.  “And we see the same outcomes as patients who stay in the hospital.”

Collins believes that his general level of fitness and given that his wife Maureen is a BMH nurse, helped him avoid the overnight stay.

Three weeks after his knee replacements, Collins was back in Savannah, this time for a concert. Unlike the trip that prompted his decision to replace his knees, this time he had no such discomfort.

“Knee replacement has changed my life,” he said. “I’m bouncing around, going up and down stairs. For 20 years, handrails had been my best friend. I don’t need a handrail anymore.”

With two new knees, Collins is now cautiously considering a return to the rugby pitch.

“My goal would be to play rugby again,” he said. “There’s a tournament every year in Aspen. At 71 or 72, I think I would be like a 35-year-old against those guys.”

Writer and photographer Tony Kukulich of Bluffton is a recent transplant to the Lowcountry from Delaware, by way of the San Francisco Bay area.