Unlike traditional silicon implants, the PyroCarbon joints help patients recover a normal range of motion.
By CANDACE RONDEAUX
Published August 10, 2003
[Times photos: Scott Keeler]
Dr. Brian Williams, left, and scrub technician Yianni Grigoris perform joint replacement surgery on June Hirschberg.
An X-ray of Hirschberg's hand shows joint replacement inserted in her finger.
An X-ray shows the deformed joints in her left hand.
TARPON SPRINGS - June Hirschberg was fed up. After years of suffering from rheumatoid arthritis, she was disgusted with the way the disease had left her hands gnarled and nearly useless.
Not to mention the searing ache in her fingers.
"It's very painful," Hirschberg, 81, said.
Hirschberg, who has lived on her own in Holiday for years, feared the pain and increasing immobilization in her hand could soon rob of her of her independence. So when her doctor suggested she try a new kind of joint replacement surgery recently introduced at Helen Ellis Memorial Hospital, she leapt at the chance.
"I'm afraid that they're going to become more deformed," she said of her hands. "So I thought, "Why not.' "
Hirschberg is one of the roughly 2.1-million Americans estimated by the American College of Rheumatology Research and Education Foundation to suffer from rheumatoid arthritis. Thousands more suffer serious pain in their joints from injuries.
Helen Ellis officials hope the surgery technique, which uses an artificial joint made out of uniquely durable and flexible material called PyroCarbon, will help usher in a new era of treatment. On Wednesday, Palm Harbor hand specialist Dr. Brian Williams performed the joint replacement surgery on Hirschberg's index and middle fingers at the hospital.
"She came in, and her fingers were kind of bent," Williams said. "This can be used in fingers, wrists, elbows, hips, knees, ankles, toes. Just about anyplace you've got a joint, it can be replaced."
The first step of the finger surgery is to remove the damaged joint. Then, two, specially contoured, pencil-thin cylinders of hard, ceramic-coated graphite are placed where the bones normally bend. Unlike traditional silicon implants, which are less flexible, the specialized material and fit of the implants help patients recover a normal range of motion, Williams said. Hirschberg wore a splint for several days after the surgery but said she expected to be wiggling her fingers after a few weeks of physical therapy. She hopes for a quick recovery so she can drive again.
"I'd be lost without my car," she said.
Williams discovered the technique shortly after the federal U.S. Food and Drug Administration approved Ascension Orthopedics artificial joint implant in 2002. Despite an exceptionally high success rate noted during clinical test of the technique, Williams, 35, says it's not always an easy sell.
"A lot of folks when you mention the idea of replacing joints in their fingers all of the sudden their fingers don't hurt so much anymore," he said.
But when Williams explains to patients that the joint will allow for greater flexibility and reduce the chance of follow-up surgery typical for a standard silicon joint implant, he finds them a lot more interested. The PyroCarbon joints are designed to contour more to the body's natural anatomy, bending easily with the movement of a finger, toe or other joint, he said.
He is the only Pinellas County doctor who performs the unique surgery, as far as he knows, and one of two surgeons in the Tampa Bay area to introduce the technique, he said. Patients typically receive local anesthesia on the affected area and leave the hospital the same day. The majority of people who elect the surgery gain full use of the joint after one or two months of regular physical therapy sessions, Williams said.
Outpatient hand joint replacement can cost around $7,000, part of which can be reimbursed under Medicaid, said Helen Ellis spokesman Jerry Touchton. The cost of surgery and treatment for other joint implants varies.
