Published in the Kent County Daily Times
November 5 2007

Jessica Selby

When a local man found himself facing knee surgery, he found he also had an opportunity to try something new.

Dr. Franklin E. Mirrer, an orthopedic surgeon at Kent Hospital, offered his 23-year-old patient, Jaroslaw Cuzytek, an alternative to traditional knee surgery. Mirrer said he told Cuzytek he could repair his torn knee ligament, known as the anterior cruciate ligament, using a new procedure in place of the standard arthroscopic one.

With the new procedure, Mirrer said, immediate recovery time is faster because the surgery is less invasive.

“The difference is in the drilling with the anterior cruciate ligament reconstruction,” Mirrer said. “With the old procedure, I would have had to drill tunnels from the outside in all the way through the bone, making significant incisions two to four inches on the front of the knee and sometimes on the side of the knee.”

“With the standard procedure, we also have to drill through bone the whole way,” he said. “It can be very painful and sometimes causes heavy bleeding.”

“Now what we are able to do is drill using the arthroscope from the inside outward and we do not have to make any incisions,” Mirrer said. “We do drill into the bone but we do not have to go all the way through.”

“What we do is reverse drill; we put the drill inside the knee, slipping it through a portal incision in the front of the knee that is about 9 to 10 millimeters in circumference,” Mirrer said. “I use a thin metal wire as a guide through the skin to the knee.”

Mirrer said the technicalities of the procedure are so complicated the average person may not be able to grasp them but the noteworthy differences between the old and the new way of performing the procedure are limited scarring, lessened initial recovery time and decreased level of pain.

“Considering the short term, there is going to be much less pain and the patient will recover much quicker in the first few months with the new way of doing the procedure; but, because of the rehab required with such a surgery, the long term repair of the knee is basically going to be about the same,” Mirrer said. “In my opinion, I think the final end result will be much better even when you just consider the scarring, but, being so early on in the process, I cannot prove that yet.”

Cuzytek is serving as Mirrer’s first official specimen. He recently underwent the new procedure with Mirrer and, just weeks after the surgery, he said, he is able to move his knee with little or no pain.

“I am feeling pretty good now,” he said. “My knee is still a little agitated but I am starting physical therapy on Thursday so it should hopefully start to improve.”

Cuzytek said he personally didn’t have much hesitation about being Mirrer’s first full arthroscopic procedure patient and if anyone else had uncertainty about the newness of the procedure he would encourage them to go for it.

“My doctor told me that with the new procedure there would be less scarring and that there wouldn’t be as much pain and he was definitely right,” Cuzytek said. “You can barely see the cuts. I can’t even really see them around my knee. There is one small one on the side, two underneath and one on top, but they are tiny.”

Cuzytek said he wound up in this situation following an accident on his four-wheeler. He said he turned the machine too quickly which forced his leg into the ground, twisting his knee sideways. 

“I fell and, although my knee hurt, I thought nothing of it for a while,” he said. 

Over time the pain worsened, Cuzytek said, and while at work one afternoon several weeks ago, his knee just gave out. This incident propelled him to act, Cuzytek said, and he paid a visit to Kent where he met Mirrer and first learned of the new option available to him.

Mirrer said he had learned the new procedure as a result of work he does among athletes in the state.

In addition to being an orthopedic surgeon at Kent, Mirrer also serves as the head team physician for Providence College men’s basketball team. 

“I learned it at a teaching course for sports injuries,” Mirrer said. “I briefly heard it mentioned and I said ‘wow, this sounds like a great technique’ and if I had to have my knee done, this is how I would want to do it.”

Mirrer said he spent the next three months mastering the new techniques. He attended courses, participated in practice surgeries and has been slowly implementing small parts of the new procedure into the old way of doing the surgery. It wasn’t until Cuzytek, however, Mirrer said, that he finally decided to go for the whole thing.

To date Mirrer said he has completed three of these procedures and has another coming up on an athlete from CCRI.

“I may be the only one doing this now but I think, in the next 10 years, this is going to be the standard of care for this type of injury,” Mirrer said.

In addition to the recognition Mirrer earned for the most recent work he has done with this procedure, he has also been commended as the first to use a number of surgical procedures at Kent. He was the first to perform an arthroscopic rotator cuff repair, an all arthroscopic reconstruction for shoulder instability and also for shoulder arthritis.

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Franklin E. Mirrer, Orthopaedic Surgeon, Inc & MJI, Inc. - 215 Toll Gate Road, Suite 206 - Warwick, RI 02886 - Phone: 401-739-9050