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Friday, June 22, 2012 - New Knee Replacement Technology Speeds Recovery and Movement
For Jim Zinke, 67, chronic knee pain was part of daily life. He was diagnosed with osteoarthritis years ago and the pain gradually increased to the point where his range of motion was affected and he could no longer play golf, a favorite activity. His orthopedic surgeons, Mark Mackey, M.D. and Mark Kamil, M.D., told him “You’ll let us know when you’re ready for surgery.” 

That day came in May, 2012 when Zinke had a total knee replacement using the iTotal® knee replacement system, a procedure approved for use last year. This knee replacement process uses specialized software to create a patient-specific knee implant, based on a CT scan of the patient’s knee. Since Zinke is a computerized machine programmer, he is familiar with the use of computer software that creates a three-dimensional image as the basis of fabrication—in this case a knee replacement designed specifically for him.

Dr. Mackey began using the iTotal® knee replacement at DMC Huron Valley-Sinai Hospital in 2011. “It is better able to be customized so it fits better and feels more like a normal knee. More bone is conserved and there is less bleeding. It is recommended for people who are more active,” he explained. In addition, patients typically manage without walkers or canes sooner and return to work more quickly than with traditional knee replacement surgery.

As Zinke was prepared for surgery, Dr. Mackey chatted with Zinke’s wife, Ann, who happens to be the office manager for the orthopedic surgeons. He explained that Zinke would be out of bed later that day and would begin walking the next day. His hospital stay would be only two to three days.

All went according to plan and about a week after leaving the hospital Zinke began physical therapy at home. “The surgery was nothing. The pain is gone and the joint doesn’t hurt at all. The PT (physical therapy) is a little challenging. I exercise in between the sessions, getting the muscles to bend and stretch,” he said. 

More rigorous physical therapy began soon—three sessions a week for four weeks at Mobility Plus Rehab in Rochester. These sessions included knee massage to remove fluid and reduce swelling. The physical therapist also stretched Zinke’s joint capsule and soft tissue to regain range of motion for the knee. 

The iTotal® knee replaces all compartments of the diseased knee joint and is made of a composite of chrome and cobalt with durable plastic. Since it has been available for only a short time, its longevity isn’t established yet but it could last up to 25 years, Dr. Mackey said. “This is not for everyone but it is another tool that I use.” Dr. Mackey trained at Harvard before performing his first iTotal® procedure and discussed the technology with engineers and physicians from Conformis, its manufacturer. 

Zinke is pleased that he can walk and exercise at home with very little pain. He plans to return to work soon, although initially part-time and in a seated job. And golf? Zinke hopes to learn when he can reserve a tee time during an upcoming appointment with Dr. Mackey, who expects that he’ll be back on the course soon.