Doctor performs first meniscal transplant at Saline Memorial

By Wayne Bryan Published February 2, 2014 at 12:00 a.m.
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PHOTO BY: Rusty Hubbard

Dr. Mark “BJ” Bailey Jr., an orthopedic surgeon at Saline Memorial Hospital in Benton, is one of few doctors in Arkansas who is currently performing a procedure that replaces the meniscus in a person’s knee. Bailey did such a surgery on an 18-year-old girl late in 2013. The patient, who played basketball, had injured her meniscus after tearing the anterior cruciate ligament in both her left and right knees.

Jamie Cope of White Hall was a basketball player. But as in any athletic activity, the sport can also create injury and pain. She tore her right ACL, or anterior cruciate ligament, in her knee when she was in the eighth grade. A year later, she tore the left one.

Surgeons worked to repair the ligaments several times; yet by the time she was 18, the knee would painfully buckle when she walked.

Doctors placed a camera placed in her knee to examine the damage and told her that what she needed was a new meniscus, the C-shaped tissue that cushions the knee and makes it more stable when a person walks or runs.

The doctors referred her to specialists in Cleveland, Ohio, but both Jamie and her mother, Karen, wanted to stay closer to home, said Rebecca Jones, marketing and community relations specialist for Saline Memorial Hospital in Benton.

“She really didn’t want

to miss any school,” Jones said, “so she was referred to Dr. Mark “BJ” Bailey Jr.,

an orthopedic surgeon at Saline Memorial, one of the only doctors in the state who can perform the procedure.”

“I saw her in August, and we started looking for a new meniscus,” Bailey said, “We had to have a perfect match.”

So began a nationwide search. The surgeon said there are many qualities needed in the donor tissue, but the most important factor is size.

“We took an MRI and X-rays from every direction with size markers,” Bailey said. “The donor tissue will have to be within 2 millimeters from every angle. It has to be the exact size. If not, all the mechanics will go haywire.”

The doctor said the tissue does not have to be of the same blood type, but it needs to be good cartilage and the same knee alignment as Jamie’s.

After three months, a match was found in Miami.

“It was a younger guy, and the size was perfect,” Bailey said. “Three months is about the usual time it takes to find the match.”

Bailey, a Harrison native, studied medicine at the University of Arkansas for Medical Sciences in Little Rock, then followed up his studies with a fellowship in sports medicine at Jackson State University in Jackson, Miss.

Bailey said the meniscal transplant is not a new procedure, but it is a rare one.

“The same 10 people have been doing them for about 15 years,” he said. “They are now training others, and I studied with one in Jackson.”

Bailey had already performed four of the procedures before joining Arkansas Bone and Joint in Benton and Saline Memorial Hospital.

Although it was a new procedure for the hospital, Bailey said, Saline Memorial’s medical officials approved the transplant quickly. He said the hospital also made a small investment in some of the equipment needed for the procedure.

With the tissue, the hospital and the patient ready to go, things moved fast. Once the tissue is found, there is only a two-week window to perform the surgery.

The meniscus comes still attached to the tibia, the larger leg bone. Bailey worked to create pegs in the bone and drilled matching holes in the patient’s tibia, then fitted the new tissue and bone together.

“It interlocks the two pieces, and and we stitch it up using materials from blood plasma that are filled with good healing factors,” he said. “I make an incision, and like stuffing a handkerchief into a little bitty hole, I fit the meniscus into the C shape and stitch her up. I also fixed her ACL with a piece of her Achilles tendon.”

“Jamie had surgery the day before Thanksgiving and was back at school the following Monday,” Jones said, “walking without pain for the first time in a long time.”

She started therapy almost immediately, but something wasn’t going right, Bailey said.

“There was pain, and I thought things just needed a break,” he said. “I told her to hold off for a week and let it rest.”

Today, Jamie is walking without a brace, and Bailey said the entire healing process will take about a year.

“She can jog in a straight line at four months and cut turns in eight months,” the doctor said. “She will not be as good as new, but she will be pain-free for years. The main things is to keep her from doing too much.”

Bailey said his patient should be able to make her way around the campus at Arkansas State University-Jonesboro when she starts college in August.

“The transplants are not for everyone,” Bailey said. “The patients need to be young, maybe up to 35 to 40. After that, the knee becomes what we call crusty, or harder, and loses elasticity.”

“Having the surgery done here was convenient for her and her family,” Jones said. “It allows the hospital to provide services to new patients who would normally go out of state.”

Staff writer Wayne Bryan can be reached at (501) 244-4460 or wbryan@arkansasonline.com.

Tri-Lakes Edition Writer Wayne Bryan can be reached at 501-244-4460 or wbryan@arkansasonline.com.

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