For 40 years—since he was 14 years old—Jim N. has built and rebuilt transmissions inside the shop started by his father. “It’s the only job I ever had,” he says. “I work on a bench all day for 10 hours a day.”
But all those years of sitting and standing on the concrete floor at Wayne Transmissions, a business Jim now co-owns with his brother, took its toll.
Over the last decade, Jim, who had knee surgery as a teenager, developed severe arthritis in both of his knees. “At first the pain was just at the end of the day,” says Jim, now 55. “Then it started right from the morning and got more severe as the day went on.”
By September 2018, the pain became too much for Jim to bear. So, he sought help from David Gold, MD, a board-certified, fellowship-trained orthopedic knee surgeon with Chilton Medical Center. Dr. Gold recommended that Jim try a series of conservative treatments—from medication to corticoid steroid injections to hyaluronic acid (“gel”) injections. “But they didn’t seem to have much effect on me,” Jim says.
For the next three years, Jim chose to keep living with the pain. But finally, in late 2021, he returned to Dr. Gold’s office. “He said to me, ‘Where have you been?’” Jim says with a chuckle.
Choosing to get both knees done at once
Jim knew the time had come for knee replacement surgery, and he asked Dr. Gold to replace both his knees in the same procedure. “I knew the recovery time would be a little longer, but doing both at once meant I wouldn’t have to go back and get it done again,” Jim says.
The procedure, called a bilateral knee replacement, is relatively rare. Orthopedic surgeons at Chilton Medical Center perform around 250 total joint replacement surgeries each year. “Of those, only about 2 – 3% of knee replacement surgeries I do each year are bilateral,” Dr. Gold says.
The best candidates for bilateral knee replacement are patients in relatively good health overall. To make sure Jim was one of them, Dr. Gold ordered a series of tests—including bloodwork, EKGs and a chest X-ray—all of which came back normal and confirmed Jim was a candidate for a two-at-once approach.
Jim also underwent one other key pre-surgery test—a CT scan that would prepare him for a robotic-arm assisted joint replacement procedure that Dr. Gold would perform using the Mako™ Robotic Arm-Assisted Surgery System by Stryker.
“Mako gives Dr. Gold and our other surgeons real-time feedback in the operating room,” says Gary Drillings, MD, Chair of Orthopedic Surgery at Chilton Medical Center. “It allows for more precise cuts of the bone, which in turn creates better implant placement and better long-term function of the implant.”
The best benefit of Mako, Dr. Gold says, is the way it speeds recovery after joint replacement surgery. “Without exception, patients are getting better quicker and having less pain and better function earlier with Mako,” he says.
In addition to Dr. Gold, several orthopedic surgeons at Chilton now use Mako for the majority of hip and knee replacement procedures. “Ninety percent of our joint replacement patients now go home within 24 hours—and home is the best and safest place to recover after a procedure,” Dr. Drillings says.
‘A world of difference now’
On January 31, 2022, Dr. Gold performed Jim’s bilateral knee replacement using Mako. Just a couple of hours after surgery, Jim was standing. The next morning, he was walking down the hallway on Chilton Medical Center’s 3 Ortho unit with a walker.
Jim returned home after two days in the hospital. He then received at-home physical therapy for two weeks. “In just a couple of days, I was outside walking up and down my driveway,” Jim says. “In a week-and-a-half, they had me going up and down stairs.”
Jim estimates he walked with a walker for two weeks, used a cane for a couple of more days, and then was walking on his own.
Today, he’s back to building transmissions. “Being able to stand on a bench now is an accomplishment without taking breaks to ice down my knees every day,” he says.
Next up, Jim plans to get back to his favorite hobbies, including hunting, fishing, and riding on his boat at the Jersey Shore.
“I have much more range of motion,” he says. “Even climbing up on things like ladders is much easier. It’s a world of difference now.”
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