 Seventy six year-old Edna Apostol found out the hard way that five decades of working in a hospital radiology department-25 years as an X-ray technician - not only got her a nice retirement package, but also caused a lot of wear and tear on her body.
"Fifty years of working in a hospital, being on my feet all day long, led to stiffness in both of my knees," Apostol said. "My job involved a lot of walking, lifting and standing. I was in so much pain."
Apostol found the pain to be so unbearable that Dr. William Gondring, an orthopaedic surgeon at Heartland Regional Medical Center in St. Joseph, Missouri, recommended knee replacements as the best option for her. In 1992, Apostol took her doctor’s advice and underwent surgery for both knees.
Over the next few years, Apostol also received two hip replacements. Within five years, Apostol had four cobalt chrome implants in her body. While all of the surgeries performed were successful, the end result, unfortunately, was disastrous. The problems started with pain and irritation in Apostol’s hip.
"I was in and out of the emergency room with hives and breathing problems," Apostol remembers. "I couldn’t talk…it was very severe."
Apostol’s doctor performed a needle biopsy of the synovial fluid in her hip to rule out any infection. Then metal disks were applied to Apostol’s skin to test for any allergies. While Apostol had no reaction to the titanium disk, she had a dramatic reaction to the disk which contained cobalt chrome and nickel.
"My illness was purely an allergic reaction," Apostol says. "I have idiopathic allergies, which means it takes awhile for my body to react. After the first exposure to cobalt chrome, nothing happened. But after four joint replacements, I had developed enough antibodies that I had reached the limit and my immune system began to fight."
And fight it did. Apostol recalls the pain grew so intense she needed a special brace for her knee. As the pain and stiffness worsened, Apostol had to use a walker to get around.
 Dr. Gondring, who had positive results with Apostol’s titanium hip revision using a Smith & Nephew product, consulted the company for other options. He knew the only way to alleviate her pain was to remove the implants. The problem he was faced with was finding a suitable – and allergy-friendly – implant material to use.
"I asked what my options were," Apostol says.
"They could have taken out my implants and fused my knees,
but then I would not be able to bend down."
Dr. Gondring was told of a new material called Oxinium oxidized zirconium, which is made of a metallic zirconium alloy that is heated to convert the surface to a ceramic (zirconia). Best of all for allergy-prone patients like Apostol, the Oxinium material contains no detectable nickel, as compared to cobalt chrome. So, in August 1999, Apostol underwent surgery yet again to replace the first of her knee implants.
This time, however, the results have been excellent. Since her surgery, Apostol has been able to ride a stationary bike and practice her floor exercises every morning. She also plans on having her other knee replaced with an Oxinium implant when the time comes. With results – and allergies – like hers,
she says she’d be afraid to have anything else.
"I feel just marvelous," Apostol says. "I’ve
had no complications and I have excellent mobility. I have no pain,
no stiffness, no swelling – nothing. I’ve had such wonderful
results with an Oxinium knee replacement. I now have a dependable
knee. You know that day in and day out, it’s there for you."
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