John Dykstra was literally at sea when his knee pain
began.
“I was working on a ship in April 2009, and basically my
left knee just swelled up as we were working,” he describes. “I don’t remember
hitting it on anything but it swelled quite a bit. It got kind of stiff, too – it
wouldn’t bend.
“I went to see the company doctor and they said I better
get it looked at. Eventually, I went and got an MRI and found out that I had a
torn meniscus.”
John consulted board-certified orthopaedic surgeon Norman
A. Palmeri, MD, of Coastal Orthopaedic & Sports Medicine Center, for an
arthroscopic procedure.
“In May, Dr. Palmeri went in and cleaned out the meniscus
area,” explains John. “Then I got five injections, once a week over a period of
five weeks. But that didn’t eliminate the pain.”
Fortunately, Dr. Palmeri had good news: John was a perfect
candidate for a leading-edge procedure new to the Treasure Coast area – MAKOplasty®
Unicompartmental Knee Surgery.
“Dr. Palmeri called me and asked if I was interested in trying
this new machine they just got,” he recalls. “I trust him, and I ended up
getting a partial knee replacement using the MAKOplasty machine.”
Precise partial knees
“John failed arthroscopic surgery due to underlying
arthritis in the knee,” explains Dr. Palmeri. “He continued to have severe pain
after arthroscopic examination, but his arthritis was limited to only part of
his knee, so a limited surgical approach was appropriate.”
The knee is actually considered to be three miniature
joints: the medial and lateral sides, and the patellofemoral joint, educates
Dr. Palmeri. “Younger patients, especially those who have sustained an injury
to the knee, oftentimes only have arthritis in the medial part of the knee, or
the arthritis is so minimal in the other compartments of the knee that partial
knee replacement is the best option for them.
“The philosophy of partial knee replacement is that it’s a
smaller operation than a total knee, with a targeted approach to arthritis,”
reflects the doctor. “Historically, however, there have been a limited number
of orthopaedic surgeons who perform partial knee replacement procedures because
previous methods relied heavily on the surgeon for precise measurements of the
knee. It was a good deal of trial and error, and it was virtually impossible to
make precise adjustments for larger patients or those with congenital
abnormalities in the knee.”
All that has changed now, thanks to MAKOplasty, which is a
major breakthrough in partial knee replacement technology.
“This operation is for people who have somewhat limited
arthritis,” explains Dr. Palmeri. “It benefits younger patients who have been
told they can’t have a knee replacement because they’re too young, and patients
who have failed arthroscopic surgery. These are both large patient
populations.”
Why it’s better
As Dr. Palmeri explains, the robotic technology of
MAKOplasty enables the surgeon to combine the data provided by a CT (computed
tomography) scan with the precision of a surgeon-interactive robotic arm.
“The MAKOplasty is a tremendous refinement in the
procedure because it is so customized to a patient,” he observes. “We use the
CT scan prior to surgery, and the CT scan measures the exact shape of the
patient’s bone, the looseness of the knee, and the severity of the damage to
the knee. Then it can analyze what the best approach is for that patient even
more accurately than a physician can. There are measurements and determinations
that are so fine that we could never measure them ourselves.”
Preoperative planning with MAKOplasty enables the surgeon
to have a visual reconstruction of the patient’s knee in three dimensions. The
combination of technology and surgical planning and skill is the key, says Dr.
Palmeri.
“With the MAKOplasty procedure, we can address arthritis
in the medial compartment, lateral compartment, or the patellofemoral
compartment of the knee, or a combination of two compartments, so it’s a very
targeted approach. Patients with this type of procedure have a smaller incision
[than with traditional knee surgery], and can anticipate less time in the
hospital, a faster recovery, and, most likely, less pain.
“John was the first patient to have this procedure done in
the tri-county area,” reports Dr. Palmeri. “He’s only a few weeks out from
surgery, but is doing well. We’re pleased to have been able to bring this
leading-edge technology to our practice.”
“Normal” again
John says that he has been on the
move ever since his surgery.
“They got me up and moving around
right after the operation, which I thought was good,” he recalls. “When I first
came out of the operating room, I only had a ninety-degree bend, and today it’s
already up to one hundred and thirty-five.
“I can really move it around now,
and I can bend it back, too, so I feel good about it.”
He says he is looking forward to
finishing his therapy and returning to work.
“I’m walking normal again, but I
have to complete therapy first before I can get back on a ship,” explains John.
“I’m just doing the exercises they gave me and trying not to mess it up,” he
adds with a chuckle.
After such debilitating pain, John
is glad Dr. Palmeri recommended the MAKOplasty procedure for him.
“I really like Dr. Palmeri: I
asked him quite a few questions, he told me everything I wanted to know, and
explained all the pros and cons,” adds John. “I trusted him, I knew what to expect, and I got what I
expected. Everything turned out fine, and you can’t beat that!”
FHCN - Michael J. Sahno