Hockey has always played a significant role in Ken Caine’s life.
“When I was growing up here in Pittsburgh, my dad would put a rink up in our side yard, and we would skate in the winter,” says Ken, 65, of Crafton, Pa., just outside Pittsburgh.
Ken played both ice hockey and street hockey for years, and the rink was a special place for him. So, when knee pain from osteoarthritis threatened to sideline him, he decided to pursue knee replacement surgery.
Upon the recommendation of Melissa McLane, DO, UPMC primary care sports medicine provider, Ken sought care from joint replacement surgeon Brian Klatt, MD. Dr. Klatt performed a right knee replacement on Ken in February 2024.
After intense physical therapy, Ken returned to playing hockey three months after surgery. More than a year after surgery, he’s playing in three separate hockey leagues and feeling strong.
“This new knee is fantastic,” Ken says.
“It was hard — a lot of PT, a lot of work, a lot of pain to get back to where I am now. But I’ll tell you what: It’s fantastic.”
Living With Chronic Pain
Ken’s right knee began to bother him significantly four to five years ago. It continued to worsen to the point that he couldn’t walk more than 20 yards without stopping.
“It was becoming difficult to do normal things,” Ken says. “To cut the grass, I’d cut it for 10 to 15 minutes and have to take a break because the knee hurt.
“It was just worn out from being used. I was using a homemade cane to try to take some pressure off my knee when I walked on it.”
Ken couldn’t do as much with his grandchildren as he would have liked, which also bothered him.
However, while Ken’s knee troubled him on land, he didn’t feel pain when he skated — and that kept him from getting surgery.
“It didn’t hurt so much on the ice, and that was kind of like, ‘OK, but it doesn’t hurt on the ice — I can still do that,’ which I loved a lot,” he says. “I could still go kayaking. It didn’t hurt too bad riding a bike because it wasn’t that heavy pressure on the knee.
“So, I found ways to get around (the pain). I couldn’t play baseball anymore. I couldn’t do any more basketball. I really couldn’t go for any hikes or walks. So, I just adjusted what I was doing to still get the exercise and everything that I needed without having to worry about that knee.”
He also knew others who had negative experiences from knee surgery, which caused more hesitation.
One of his friends from hockey recommended he see Dr. McLane. In addition to her work at UPMC, Dr. McLane is the assistant team physician for the Pittsburgh Penguins and head team physician for Carlow University and LaRoche University athletics.
Dr. McLane treated Ken with cortisone shots and other nonsurgical treatments to keep him on the ice.
“She knew what my goals were, and she knew what I wanted to continue to do,” he says.
Seeking Surgery
In November 2023, Ken’s knee began to bother him when he played hockey.
“All of a sudden, my knee said, ‘I’m not doing this,’” he remembers. “I couldn’t push off on it. And it was almost like it was a dangling, ‘What is this leg here?’ It didn’t really hurt; I just couldn’t put anything on it.”
At that moment, it became clear to Ken that he would need surgery. Dr. McLane recommended Dr. Klatt, who treats many athletic patients with hip and knee arthritis. Dr. Klatt also plays hockey.
Ken met Dr. Klatt for the first time in December 2023.
“The first question my wife asked him was, ‘Can he play hockey after his surgery?’ And he goes, ‘Absolutely,’” Ken says.
Dr. Klatt told Ken about cementless knee replacement, an alternative approach to traditional knee replacements. Traditional knee replacement uses cement, a polymer, to attach the implant to the bone. The cementless knee replacement has a porous surface that allows the bone to grow onto the implant.
The cementless knee replacement would allow Ken to return to high-impact activities without the risk of the implant coming loose.
“When he said, ‘You can go ahead and play (hockey),’ I said, ‘Let’s go ahead and do it. I don’t know if I’ll be able to play or not, but I’m going to give it everything I can to get back on the ice,’” Ken says.
“So, he gave me that confidence.”
Ken knew that Dr. Klatt understood his desire to return to the ice because Dr. Klatt treats many older patients who want to continue playing sports.
Returning to the Ice
Dr. Klatt performed Ken’s surgery in late February 2024.
For the first two weeks after surgery, Ken worked with Bobbi Rodgers, PT, a UPMC Home Healthcare physical therapist who came to his house. They worked together on walking up and down steps, working on hills, and other home exercises.
After that, he began physical therapy with Juliane Russell, PT, at UPMC Rehabilitation Institute – Green Tree. Ken had worked with Juliane previously for back and shoulder problems.
“She started the regimen on the bike. I got on the bike — and forget about going all the way around — I could go about 20 degrees,” Ken says. “But I just diligently worked with her. Every day, except for Sunday, I would do my exercises in the morning and at night.”
About six weeks after his surgery, Ken asked Juliane for exercises that would benefit his skating technique. He brought his hockey stick to physical therapy appointments as they focused on exercises that would help him return to the ice.
About two months after surgery, Ken felt ready to play again, but Dr. Klatt recommended he wait longer. At three months, he was back on the ice.
“I wasn’t really good, but I was on the ice,” he says.
Ken took his return to the ice slowly, not wanting to push it. About five months after his surgery, he says he felt he was skating well again.
“I had to gain confidence in what I could do on this new knee,” he says. “I could get on the ice OK, and I could skate. Well, could I go backward? Could I go to a corner hard? Could I stop quickly?”
A breakthrough moment for him came when he was going into a corner to retrieve a puck with an opposing player chasing him.
“I’m thinking, ‘I’m either going to make this turn, or I’m going to wipe out into the boards,’” he says. “I made the turn, and it was like perfect. The new knee held.
“It was like, ‘This is great!’”
Still Going Strong
More than a year after surgery, Ken’s new knee is holding up well. He plays hockey in three different leagues: a pickup league that he runs, an over-50 league, and another adult league.
He recently played four games in five nights and felt fine afterward.
“Now, guys say they think I’m skating better than they’ve ever seen me skate,” he says.
Ken says he feels liberated when he plays hockey. He’s thankful to Dr. Klatt, Dr. McLane, and the rest of his care team for helping him return to the ice.
“Every time I go over those boards, I feel like I’m on vacation,” he says. “The rest of the world gets shut out. Every time I go to the rink, it’s just a blessing to be able to be there.”
Beyond the ice, he’s spending time with his wife, three kids, and seven grandchildren. He’s no longer struggling with the amount of pain he was before. He’s swimming, kayaking, and getting recertified for scuba diving. He can walk without needing to stop and rest.
“Everything that I want to do, I’ve been able to do,” he says.
Ken says while his right knee is holding up well, his left knee is beginning to cause him pain. He knows he’ll probably need a replacement eventually. When he does, he plans to visit Dr. Klatt again.
For people who need a knee replacement, Ken cautions that recovery isn’t easy. But he strongly urges people to put in the work making a successful recovery takes.
He says it helps to have an end goal, whether it’s returning to a sport or simply walking without pain.
“Choose a good doctor, get your knee done, and then put your work in to make it work,” he says. “Because it’s your knee now. You can’t take it back for a refund. It’s your knee; make it work. Do your physical therapy and work hard, and you’ll be all right.”