As so many other fans around the world, I watched the Super Bowl this past weekend. While The Seattle defense stifled the Broncos, arguably the best NFL team ever assembled was the 1985 Chicago Bears; and just as any Chicago Bears football fan, I was reminded of the past. In 1985, the Bears dominated the Super Bowl; in 1984, I replaced the right hip of Coach Mike Ditka with a new generation hip replacement wherein I was involved in the Clinical Trial, the Cement-less prosthesis. Our scientific study ultimately changed the way joint replacements were done around the world. From the introduction of the Total Hip Replacement in England during the 1960’s, fixation had required cement. The cement interface had no greater than a ten-year average survivorship. By the early 1980’s, hip prosthetic fixation became cement-less in part, because of our research. Cement-less fixation carried with the possibility of a 25 to 30 year survivorship of an artificial joint. I am not claiming I had anything to do with the 1985 Bears victory; but again this past Sunday, as in 1985, I watched. I also paid particular attention to the Coach’s gait only this time when he served as a wrecking ball on Pepsi “Halftime” ad first debuted at the Grammy Awards. There was no alternative to treating arthritis of the hip in 1984. Now let’s go back to the present and future and how I might have treated that arthritic hip impairment today or tomorrow.
Starting with an arthritic hip, I would measure the range of motion before looking at the X-ray. I have observed that at the hip, the range of motion has more significance for determining if a patient would benefit from a stem cell intervention than the images. As an example, a 40-year old woman was assessed two weeks ago with an arthritic left hip impairment. So much so that she walked with an awkward gait, lived in constant pain, had a severe pelvic obliquity and secondary scoliosis all presenting as an apparent 1 and 1/2 inch leg length inequality. My diagnosis after review of X-rays was Adhesive Capsulitis and arthritis secondary to a congenital hip dysplasia. Rather than refusing to treat her because of the X-Ray, I first addressed the Adhesive Capsulitis (frozen joint) with capsular distention using 10CC of fluid. In five minutes, her motion was restored, the pelvic obliquity and associated scoliosis were corrected, her leg lengths now measured the same, and her gait was 90% improved. Now she is a candidate for the Bone Marrow Aspirate Concentrate Stem Cell procedure; the latter will be completed on Wednesday of this week. Incidentally, I replaced Coach Ditka’s left hip in 1992; the question is rather what might I do today?
Addendum: for the best commentary on the Super Bowl commercials, go to My Super Bowl predictions: