Wounded Knees: Dr. Zelicof on News 12 Long Island

A simple task like making a cup of tea is very difficult for Miriam Rios. “To make something in the kitchen, my supper, I couldn’t do it. It was very, very painful.”

Miriam’s orthopaedic surgeon, Dr. Steven Zelicof, says the cartilage which acts as a shock absorber has worn away in Miriam’s knees, so the bones are rubbing together with every step she takes.

“You can get pain, you can get instability where the joint tends to buckle a little bit. You can get swelling, crunching, grinding, just a feeling of discomfort.”

Miriam has undergone at least five arthroscopic surgeries over the years to treat the problem, but Dr. Zelicof says at this point, the only solution is complete knee replacement. Miriam agrees.

“I am a very active person. So for me, to do something and go sit down, it’s not life.”

The surgery involves shaving off a portion of the ends of the thigh and shin bones, then creating grooves for the prosthesis to fit in.

“We sort of seat it right inside the bone, and that locks it into place – nice and snuggly. Then we put the piece right on top of the femur. Once that’s locked in, that allows the knee to move smoothly.”

In addition to a prosthesis that is now made to last longer and fit better, Dr. Zelicof and his surgical team at Sound Shore Medical Center in New Rochelle have another instrument that takes the operation to a whole new level.

This computer, called the Stryker Navigational System, allows surgeons to place the prosthesis with a level of accuracy never seen before.

“The computer can tell us exactly where we are in terms of the size, where we need to be in terms of how much bone we need to take out, and that makes a huge difference.”

After being prepped and saying goodbye to her husband, Miriam is wheeled into the operating room, on her way to a more active life.

“I am a little nervous. But meanwhile, I said ‘this is the best thing I could do for myself.’”

After years of dealing with painful, arthritic knees, Miriam Rios and her doctors agreed: it was time of arthritic knee surgery.

Orthopaedic surgeon Steven Zelicof and his team at Sound Shore Medical Center will perform the operation with the help of the Stryker Navigation System: a computer that guides surgeons through the operation.

First a tourniquet is applied to minimize blood loss. The leg is then placed in a movable track. Doctors will use this to check movement throughout the surgery. An incision is made to get inside the knee. Muscle and the knee cap are moved to get to the femur, or thigh bone.

Doctors attach several probes to the bone through an infrared device that sends information to the computer. The computer marks the arthritis in the bones and even gives directions.

“This is telling us – really, within a degree or two – exactly where our position wants to be. It really is like a GPS. [With this machine,] you can see how worn out these areas are.”

Using a saw, the end of the femur, or thighbone, is removed. Next comes the end of the tibia, or shinbone. Cuts are made and holes drilled into the bones, where the prosthesis will lock in. But doctors first try the test part to make sure it all fits.

Dr. Zelicof then prepares actual cement that will keep the prosthesis in place. The cement is poured into the grooves of the bones, created by the team. And then the replacement knee is locked in. And with that, Miriam’s new knee, made of cobalt, chrome, titanium and plastic is in place.

A year later, Miriam works in her garden, walks several times a week, and is pain-free. She has her life back.

“What would you say to anyone who was in your shoes a year ago?”

“What I can say is – do it! You’re not going to regret it. You have to put into your mind, it’s going to be better. And it’s worth it, 100%.”


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