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VOL. 132 | NO. 110 | Friday, June 02, 2017

OrthoMemphis Calls Its First NUsurface Implant a Success

By Michael Waddell

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Dr. Tim Goldsmith, chief clinical officer at Youth Villages, had never been a guinea pig before, but now he is glad he was. Last year, Goldsmith became the first person in Tennessee to receive meniscus replacement surgery through his involvement with an ongoing clinical trial in Memphis for Active Implants’ NUsurface meniscus implant device.

Currently in clinical trials, the NUsurface implant is inserted in the knee joint to replace an injured meniscus, the tissue pad between the thigh and shin bones. (Submitted)

OrthoMemphis and Active Implants recently earmarked the procedure, which took place in April 2016, a success after closely monitoring Goldsmith’s recovery and progress over the past year.

Goldsmith, 60, had meniscus surgery on his right knee years ago following a beach accident when he stepped into a hole and inverted his knee backwards. Then he injured his left knee, the one that underwent the recent meniscus replacement, two years ago while practicing twisting lunges during a workout session.

That second injury led him to undergo alternative treatments to treat the pain, including muscle-strengthening physical therapy, injections and finally a partial meniscectomy. But he continued to experience consistent daily pain that impacted any activity, from playing golf and working out to simply walking up and down stairs.

“I had already had my other knee operated on, so I knew what meniscus surgery was like and I knew what to expect afterwards. But I was unprepared for the range of motion and the lack of pain that I have now,” Goldsmith said. “With this new replacement it’s just incredibly different. It feels like a new knee to me.”

Now he’s able to once again play golf and exercise, including spin classes and interval strength and resistance training.

“One of the reasons that I wanted to do this is the long-term prognosis of not having to have a costly and painful total knee replacement later,” he said. “If I start to have problems with the device or it wears out, they just take this one out and pop a new one in. That’s the nicest part about it.”

The meniscus is a tissue pad between the thigh and shin bones. Once it is damaged, the meniscus has a very limited ability to heal, so meniscus surgery often is performed to remove the torn painful portion. More than 1 million partial meniscectomies are performed in the U.S. every year, more than the number of hip and knee replacement surgeries combined.

While partial meniscectomy surgery is tremendously successful, some patients continue to experience pain following meniscal surgery due to deteriorating meniscus cartilage, which can evolve into arthritis requiring a total knee replacement.

“The meniscus can take a beating,” said Dr. Randall Holcomb, OrthoMemphis president and sports medicine orthopedic surgeon. “It can take an injury, it can take surgery and continue to work very, very well, but there are some configurations of injury patterns that necessitate removing important parts of the meniscus, and that renders the knee meniscus-deficient.”

Holcomb was selected to perform the procedures for the clinical trial due to his 30 years of expertise in the area of cartilage restoration and transplantation.

OrthoMemphis is the only center in Tennessee and one of only 10 sites nationwide participating in the VENUS (Verification of the Effectiveness of the NUsurface System) clinical trial, which is likely to continue for at least a couple more years. Participants must be between the ages of 30 and 75 and have pain after medial meniscus surgery that was performed at least six months ago.

“We receive a tremendous number of inquiries from people who continue to hurt following what they and their doctors thought would be a pain-relieving procedure,” he said.

Participants are randomized to receive either the NUsurface device or nonsurgical treatment, which is the current standard of care for patients with persistent knee pain following meniscus surgery.

“We have four implanted patients now and another one scheduled, and we have several in various phases of evaluation right now,” said Holcomb.

NUsurface has been used in Europe since 2008 and Israel since 2011, and it has shown positive results since an early-stage redesign.

The implant is inserted into the knee joint through a small incision, and patients typically can go home on the same day of the operation. After surgery, they undergo a six-week rehab program.

“The patient can tell something is different about the knee early on after two or three weeks, and most patients start seeing some significant relief after six weeks,” Holcomb said.

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