Published 10/1/2008
Annie Hayashi

“Operation Walk” gives life to damaged joints

Orthopaedic surgeons find volunteering reaps huge rewards

Video of "Operation Walk" in Cuba

“Operation Walk not only changes the lives of patients, it affects the lives of the orthopaedic surgeons who participate,” says Lawrence D. Dorr, MD, the organization’s founder and winner of the 2005 AAOS Humanitarian Award. “It renews their interest in medicine and makes them better, more compassionate surgeons.”

Operation Walk, established in 1994, is a private, nonprofit, volunteer medical service that offers free orthopaedic surgery for impoverished patients in developing countries as well as in the United States. The program’s orthopaedic surgeons, nurses, and other healthcare professionals also educate their overseas’ counterparts on advanced surgical techniques and other related surgical care.

Since Dr. Dorr’s first trip to Havana, Cuba, in 1995, more than 2,500 patients in 10 countries—including the United States—have received treatment from Operation Walk’s volunteers. All services—preoperative and surgical care, implants, postoperative care, medications, and therapy—are provided at no cost to patients.

“In developing countries where the economic situation is dire, the disabled become the discarded,” said Dr. Dorr. “Our goal is to help these people regain their ability to live as productive members of society.”

Operation Walk now has teams in Mooresville (Ind.), Denver, Chicago, Baltimore, Alexandria (Va.), Salt Lake City, and London (Ontario, Canada). New teams are forming in Boston, Pittsburgh, and Plano (Texas). Each team plans up to two international medical missions per year. On each mission, surgeons hope to perform at least 50 hip or knee replacement surgeries.

In the beginning
After a trip to St. Petersburg, Russia, in 1994, where Dr. Dorr and his medical team presented the latest techniques in joint replacement surgery and operated on local patients, he realized “how many doctors needed education and patients needed operations.”

Dr. Dorr knew the need was even greater in developing countries and, with the help of a core of dedicated volunteers, established Operation Walk. Two of those volunteers—Jeri Ward, RN, and Mary Ellen Sieben, RN—continue to serve Operation Walk as medical director and operating room director, respectively.

Before each mission, they visit the host country’s local hospitals and plan logistics. As the medical director, Ms. Ward quickly evaluates a hospital for joint replacement surgery—from electrical service to equipment compatibility.

A 25-year veteran of international medical missions, she understands the complexities of foreign governments and customs as well as the steps that must be taken to accommodate them.

“We have to make contact with someone in the country who is in a position of authority to get our cargo through without any problems,” she says. “We have to ship 9,000 pounds of cargo for a mission and the cargo list has to be translated into the language of the host country. If the cargo isn’t described correctly, the entire shipment can be rejected.”

She loves being a nurse when she is on a mission. “We get so caught up in so many details in the United States that we can’t even see our patients. When I am on a mission, I can really be a nurse—taking care of my patients and teaching their families how to care for them after surgery,” she says.

Preparing for a mission
Merrill A. Ritter, MD,
president of Operation Walk—Mooresville, remembers feeling fortunate to be asked to join Dr. Dorr in Cuba in 1997. “This is all it takes for anyone to realize what is important in our careers—giving back.”

Since that first trip, Dr. Ritter and his team have made regular missions to Nicaragua, Cuba, and Guatemala. They have established regular follow-up with their patients and ongoing relationships with local surgeons and medical staffs.

According to Dr. Ritter’s team coordinator, Amy Robertson, RN, “Planning a mission trip is a big job that one person cannot do alone.” She emphasizes the need for a “contact in the host country, companies that are willing to donate supplies because they believe in the program, and experts on your team who are willing to serve.”

Ms. Robertson coordinates the packing and storage of all of the donated items at a local Indiana hospital’s distribution center where staff volunteer to help during critical packing and loading times.

“The host country’s representative and I begin communicating a year before our trip on almost a weekly basis,” she says. “About 10 months before the trip, we receive radiographs and medical histories for about 100 patients. The surgeons select the 60 most difficult cases and then we request donations of the necessary implants and supplies.” Counting bilateral joint replacements, the team performs approximately 70 joint replacements on each trip.

The team’s foot-and-ankle surgeon receives about 40 radiographs and medical histories and selects 20 patients for surgery.

“We work long days to complete all the surgeries in one week; normally, our case load would take doctors in the host country a year to complete all the surgeries,” Ms. Robertson says.

“The people we see have terrible deformities,” says Dr. Ritter. “But after surgery, they can walk again. They are so appreciative. Everyone who goes reaps tremendous benefits. I can’t begin to describe the joy.”

For daily updates and real-time commentary on Dr. Ritter's Operation Walk mission to Guatamala, Feb. 1-7, 2009, click here. (http://www.epsilen.com/grp/OpWalkGroup)

A passion for helping patients
“One of the hardest parts for me is turning people away,” says Douglas A. Dennis, MD, executive director of Operation Walk—Denver. “Because we want to do about 70 procedures on each mission, we have to recruit more than that number.”

After reviewing about 100 potential candidates’ radiographs and histories prior to each trip, Dr. Dennis and his surgical team see 60 to 70 of those patients in a preoperative clinic. “Many patients need operations but we have to prioritize because we can only do a certain number of procedures,” Dr. Dennis explains.

“We only take patients with absolutely no economic means to ever have a joint replacement done without Operation Walk. The severity of the arthritic disease we see is many magnitudes greater than what we find in our home communities,” he says.

Before a recent visit by Operation Walk—Denver to the Dominican Republic, the local surgeon placed an ad in the paper letting the community know that Operation Walk was coming to the area. More than 2,000 patients responded in less than a week.

One of the patients was a 37-year-old woman who had been born with a congenitally dislocated hip and had never received any treatment. “The hip had become severely arthritic and, as a result, she had developed a severe adduction contracture, making it difficult for her to have a normal vaginal child birth” recalls Dr. Dennis.

“In the preop holding area, she only wanted to know one thing. If we fixed her hip, would she be able to have a normal, vaginal birth? She was so poor that she couldn’t afford a Cesarean section. I told her she would be able to have a normal delivery.

“On our next mission, 18 months later, I saw the same patient in our postoperative clinic. She came with her new baby, whom I got to hold,” Dr. Dennis continues. “It is for that reason and so many others that I am so passionate about this program.”

Annie Hayashi is the senior science writer for AAOS Now. She can be reached at hayashi@aaos.org

Interested in getting involved?
If you are interested in participating in Operation Walk or starting a new team in your area, please contact Jeri Ward, RN, at

Participating surgeons must be experienced and perform a minimum of 150 to 200 joint replacements per year. Please include your resume and a cover letter explaining why you are interested.