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New technology improving knee replacement surgery

When Ira Guttentag was a medical student in the late 1980s, MRI technology was just coming to the commercial forefront.

In those days, magnetic resonance imaging offered a decent three-dimensional view of the body but took almost five minutes to produce one image.

Today's MRI machines produce a high quality, detailed image exposure in just a few seconds. They have become an invaluable diagnostic tool, especially for doctors like Guttentag, 47, an orthopedic surgeon specializing in knee and shoulder reconstruction.

Guttentag, a partner at the Florida Medical Clinic in New Tampa and the team doctor for the Tampa Bay Lightning, is the only Tampa-area physician to utilize personalized positioning molds created based on MRI data. The molds serve as cutting guides during knee replacement surgery.

"Everyone's body is different," said Guttentag. "Using this method, we can create a patient-specific prosthesis. So regardless of a person's size, gender or race, the knee is made exactly to fit that specific person."

Almost 500,000 total knee replacement surgeries are performed each year, according to the American Academy of Orthopaedic Surgeons. In the past, X-ray technology produced two-dimensional pictures of the knee, which were used to determine all the logistics of the knee replacement surgery. Then, during the actual operation, the surgeon would drill pins into the bone canal to help align and position the new knee.

With the MRI technology, images of the hip, knee and ankle are obtained from the side. The resulting three-dimensional images are then used by Guttentag for preoperative planning, and for the design and construction of guide molds. Guttentag then uses the molds as cutting guides during surgery.

"The three-dimensional pictures give us a much better view of the knee," said Guttentag. "Using the mold makes the knee alignment perfect and we don't drill in those pins, which makes the surgery much less invasive."

Because the alignment is perfect, the new knee has the best possible range of motion. That makes the leg stronger and allows the replacement to last longer, he said.

In August, Victor Echevarria became Guttentag's first patient to undergo surgery using the new technology.

After three years of physical therapy and various medical treatments, it became apparent that Echevarria, 54, had almost no cartilage left in his knee and would need a total knee replacement. While he was eager to undergo the new procedure, he was nervous about his recuperation because his brother had suffered weeks of tremendous soreness after a traditional knee replacement.

But Echevarria, a Temple Terrace resident and owner of a computer repair business, was pleasantly surprised.

"He had much more swelling than I did," Echevarria said. "I was out of the walker in two weeks and using a cane only on a limited basis after that, but he was still using his walker after four weeks, and had much more pain and discomfort than I did."

Contact reporter Sheryl Kay at, or call (813) 230-8788.


Knee replacement

For more information on Guttentag's new surgery, call Florida Medical Clinic at (813) 979-0440. Information on the molds can be found at

New technology improving knee replacement surgery 11/06/08 [Last modified: Thursday, November 6, 2008 3:30am]
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