Seyward Darby

My left kneecap started dislocating and subluxating in early adolescence, when I was playing soccer and basketball regularly and also growing tall rather quickly (I wound up close to 5’8). Over the next 15 years, the condition was a constant in my life–I lived with the pain when my kneecap popped out of place a couple of times each year. It didn’t hold me back from anything, exactly… I ran 35 miles a week, hiked in the Himalayas and the Andes, and did all sorts of other intense activities. I saw several doctors, but all of them said, “If you can walk, you’re fine.” Some people, they insisted, just had weird knees.

Then, when I was 28, I was walking across my apartment one morning when my knee sublaxated terribly–so badly, in fact, that I could feel pieces of something (cartilage, it turned out) floating around the joint for weeks after the fact, as I struggled to walk even short distances without pain and instability. I had to give up running and wear a brace almost constantly; my left leg became noticeably small as I favored my right. I tried physical therapy, but I couldn’t lift my leg while in a seated position without the kneecap popping out of place; same went for doing leg presses.

Finally, my PT recommended that I go to Dr. Sabrina Strickland at HSS. Within two weeks, I had an appointment. Dr. Strickland came in, took one look at my MRI, and said she could help me. She recommended surgery–specifically, a tibial tubercle transfer with an MPFL replacement and Denovo cartilage implants. I wouldn’t be able to walk for about six weeks while my leg was in a locked brace, and then I would be in physical therapy for several months. It would be a very involved process. But Dr. Strickland said she operated on young women like myself all the time, and that I would be able to resume the activities I so enjoyed. (I should say that at this moment, I burst into tears imagining major surgery; a nurse practitioner kindly came into the room to comfort me and offer tissues.)

A little over a month later, Dr. Strickland and Dr. Beth Shubin Stein performed my surgery. It was bizarre to walk into an operating theater and then, when I woke up, not be able to walk at all. But my care at HSS for the first two days was fantastic; nurses came by my room regularly, not just to check my pain but also offer a smile. A PT taught me how to hop up stairs (I live in a third floor walk up apartment), another showed me how to use an RPM machine, and I was given clear instructions for followup with my doctors.

The next six weeks were very hard–I’d never had major surgery and certainly had never been unable to walk. My fiance was my full-time caretaker, and he was incredibly attentive, even renting a wheelchair so he could push me around Brooklyn a bit each day (I hated being trapped inside). I would hobble on crutches to the local YMCA to do arm and abdominal exercises, trying to keep my fitness up. Dr. Strickland’s office was always available if I needed advice from a nurse.

At six weeks, I saw the doctor and was told I could start putting my left foot back on the ground–and that I was ready to start PT full time. Here, things got great because I met Theresa Chiaia, the best PT at HSS–or, I’d wager, maybe even the world. For the next 14 or so months, I saw “T” twice a week at HSS (an hour commute for me, but well worth it). Bit by bit, she helped me get better; if ever I felt discouraged with my range of motion or muscle strength, she assured me it would improve. She kept in constant touch with my doctors, to keep them abreast of my progress. The day that I was told I could ride a bike at the Y, on my own, felt like my birthday: I’ve never been so excited to work up a sweat! The big goal, though, was for me to be fully on my feet and able to dance at my wedding, which happened to be scheduled for about six months after my surgery. T and I worked hard to make sure I was ready; she even helped me pick out shoes that would make me comfortable and stable.

Things took a turn when, in May 2015, three weeks before my wedding, I was in the Amtrak 188 crash outside Philadelphia. I was in a front car, which flipped over when it derailed; my seatmate was killed. Purely by luck, I emerged with a hurt lower back and ribs; my “new knee,” as I called it, was bruised but structurally sound. Within a day of the accident, Dr. Strickland called me in Philadelphia to check on me and said she could see me immediately. I went in for an appointment and she checked not only my knee but my whole body, offering to recommend a back specialist if I needed one. (Thankfully, that wasn’t the case.) I was extremely anxious that my injuries would set back my PT progress. But the staff at HSS rehab were amazing, and I kept getting better. I danced at my wedding. I hiked (lightly) in Utah a few weeks later. I started riding hills on the bike at the Y, and using an elliptical trainer. One day, for the first time in my adult life, I realized I could do a leg raise without my kneecap popping out. The cherry on top came when I saw MRI pictures: The juvenile cartilage that Dr. Strickland had implanted looked good, and seemed to be growing.

I went for my first run in almost two years in March 2016, when my husband and I took a belated honeymoon to Hawaii. I jogged slowly along the Kauai coastline, thinking there was no better place to celebrate being healthy again. When we hiked the Na Pali Coast, my husband took pictures of me and I texted them to T, thanking her for getting me back on my feet. These days, I work out 5 days a week: biking, using the elliptical, and doing light jogging, in addition to PT exercises that help my strength and flexibility. I feel the best I’ve ever felt: confident, fit, and unafraid that my kneecap might suddenly slip out of place, tearing cartilage as it goes.

To say that I’m thankful for HSS is an understatement. The doctors and PTs changed my life. There’s a reason it’s the best orthopedics hospital in the country. The staff does procedures routinely that other doctors (including ones I saw) do rarely. I’m so glad I got my surgery and rehabilitation at HSS, and I will be singing its praises forever.

Beth Shubin SteinSeyward Darby