SJRI Helps Bring Affordable Joint Replacement Surgery to Impoverished Communities Outside the U.S.

A shared commitment to healing and enhancing patient mobility is the cord that binds the surgeons and staff at Southern Joint Replacement Institute (SJRI). A mutual calling to deliver quality care with compassion and dignity to impoverished patients in developing and underserved countries led to the creation of The Walk Strong Foundation.

For the past decade, Walk Strong's medical team of doctors, nurses, physical therapists and support volunteers have provided hundreds of knee and hip replacements at no cost to patients in Mexico. They have relieved pain and suffering, restored mobility, self-dignity, self-reliance and enabled their patients to return to a normal, productive life.

Despite millions of dollars in donated medical equipment and supplies, and thousands of volunteer hours, the work of The Walk Strong Foundation has been limited by the sheer costs related to each joint replacement performed, according to Dr. Michael Christie, Orthopaedic Surgeon at SJRI.

"We have relied heavily on donations from the appliance and instrument manufacturers to enable us to fulfill the mission of Walk Strong," said Dr. Christie. "We have been blessed by extraordinary support and contributions to our mission, but the need so significantly exceeds the generosity, we have been looking for other solutions for helping more patients. In developing countries, the cost of an implant is more than most families earn in an entire year."

"In these areas of the world, individuals usually have to work well into their old age just to survive and typically their low-paying jobs are physically demanding," he said. "If they are crippled by debilitating osteoarthritis, then literally their lives are at risk."

The burning question for the founders of The Walk Strong Foundation has been, "Can we make joint replacement more affordable so we can treat more patients?" Now there is a glimmer of hope that a solution is within reach with a newly developed knee replacement device called, "The World Knee."

About a year ago, Dr. Christie met with Signature Orthopaedics based in Ireland and joint implant researchers Declan Brazil and Tim McTighe. Brazil is the CEO and chief engineer for Signature Orthopaedics. The small core group set out to develop a low cost knee joint implant. With some thoughtfulness and very clever engineering, "The World Knee" was born and now can be produced for less than $500.

"Declan has devoted the resources of Signature to developing an economical and high quality alternative to currently available implants," said Dr. Christie. "Our objective is to combine regional manufacturing of both knee and hip implants with surgeon training sites in order to make this life changing surgery available to the hundreds of thousands of people who need it in the developing world."

Dr. Christie believes this project has the potential to be a real game changer.

"It is a no frills knee replacement, not as versatile and not as easy for the surgeon to use," he said. "But it is durable, predictable and functional. It eliminates pain, restores mobility and allows patients to return to work and other daily activities."

The Walk Strong Foundation also collaborated with Dr. Michael Mason, an orthopaedic surgeon at New England Baptist Hospital in Boston to help overcome the cost barrier associated with the surgical instrumentation required to perform joint replacement surgery. Instrument sets typically cost nearly $40,000 for a single set of tools, according to Dr. Christie.

"Dr. Mason was clever and innovative," said Dr. Christie. "He basically created the Swiss Army Knife of total knee instruments that affords a surgeon everything needed to perform the surgery for less than $2000.

"The World Knee" and instrumentation for implanting the device is now a reality and has received approval from the Federal Drug Administration for use. The next step is to begin training surgeons in the countries where the devices are needed.

"Training and education has been central to our foundation work," said Dr. Christie. "For the past 10 years our work has been focused in Vera Cruz, Mexico. We have worked with and trained Dr. Octavio Amador, who completed a yearlong fellowship in Nashville with the SJRI surgeons. He has now returned to Vera Cruz to continue building the joint replacement program at Hospital Regional de Vera Cruz.

"We have achieved our goal to replace ourselves in Vera Cruz. In fact, Dr. Amador has done more knee replacements in the 18 months since he returned to Vera Cruz than Walk Strong performed in the 5 years we have been going there," said Dr. Christie. "We will now shift our focus to a new region in Serbia as well as in Jamaica where we will be working with the medical school there to continue refining "The World Knee" and related instrumentation. We will work to educate and train our replacements there as well."

The partners in The Walk Strong Foundation are excited about what the future has in store to help them further their mission and vision. Plans are to build the implants and instrumentation, and sell them for just enough to cover costs and keep manufacturing so they can help more patients who need it the most.