After washing up, throwing on some scrubs, a facemask and shoe covers, I was ready to enter the surgical suite. It took me a few seconds to adjust to the new surroundings. The patient was already anesthetized and in position, lying atop the surgical table. Directly behind him were the anesthesiologist and his slew of computers on which he attentively analyzed the patient's readouts. Glancing around the room, I noticed two men in what appeared to be futuristic spacesuits out of a sci-fi thriller. I soon realized that these two men, were in fact, the orthopedic surgeon and his resident and that what looked like a really cool Halloween costume, was actually a suit would help prevent contamination and infection of the incision during surgery.

The doctor placed me at my observation site - atop a small wooden box a few feet away from where he would soon begin to operate. From there, I had almost a bird's eye view of the surgery. Following the surgical prep, the doctor began the incision over the knee, delicately cutting through the layers of skin and fat to expose the bones of the knee joint beneath. After the initial incision, the doctor proceeded with what I perceived to be the fun stuff - the sawing of the bones to make way for the artificial joint to come!

Although the sight might be gruesome to an unfamiliar onlooker, to me the intricate carpentry of the bones was fascinating. Using a high-tech electric saw and strategically aligned spacers and pins, the surgeon carved away precisely the right amount of bone from the tip of the tibia and end of the femur to fit a brand new metal and plastic joint. This artificial joint would replace the old and severely arthritic joint that had formerly caused the patient persistent and unbearable pain. During a trial run with provisional implant components, like trying on clothes for the correct fit, the surgeon tested the artificial knee by bending it back and forth, noting the improved alignment and decreased "bow-leggedness." Satisfied with the fit, the newly cut bone was then cleaned and prepped for the actual implant. A nurse prepared a liquid and powder mixture bone cement that the surgeon quickly smeared over the freshly cut areas of bone. Racing against time, the surgeon precisely placed all the components of the artificial knee, including the plastic tip of the tibia, metal end of the femur and a plastic kneecap, all before the cement was able to completely solidify and adhere the pieces together. With the addition of a few stitches and bandaging, the surgery was complete. The new knee would be ready for trial by the patient the very next day. Neat!!

Emily Marcus, UBRPer in Dr. David Besselsen's lab, University Animal Care