Driven to help knees from the age of 5
James (Jimi) L. Cook, DVM, PhD, DACVS, DACVSMR, holds dual appointments in veterinary and human medicine at the University
of Missouri in Columbia, Mo. On this particular morning he's in the process of moving his office. His dual appointment has
been 75 percent in the veterinary school and 25 percent in the medical school, but now the proportions have reversed and his
new office will be a few long strides away in the medical building.
Dr. James Cook of the University of Missouri holds a vial containing orthopedic donor tissue stored in a special fluid. The
preservative, which he helped develop, keeps donor tissue healthy for two months, compared to the more traditional 30-day
window. This means less wasted tissue.
Cook heads a team of 30 colleagues who work in two labs, one biologic and one engineering, both under the umbrella of the
Comparative Orthopaedic Laboratory (COL) at Missouri. Its motto: "Finding joint solutions." Cook has been searching for joint
solutions in dogs since he entered Mizzou's PhD program in the mid-1990s, always with the aim of helping their human counterparts.
In fact, Jimi Cook has been driven since the age of 5 to do something about the pain in human knees. In 1975, his grandfather,
Robert B. Gordon, had just undergone knee surgery and the prescription for rehabilitation was bike riding. So every morning
he took his grandson out for a spin.
"I became part of his rehab," Cook says. "We'd ride bicycles every morning. We'd talk about everything under the sun on those
bike rides. In my mind we were trying to solve this arthritis problem with my grandfather."
The memory is bittersweet because his grandfather's arthritis was a constant battle between science and pain. A tennis player
and water skier, Gordon had severe primary degenerative arthritis in both knees. His first surgeon implanted a pair of pound-on
prostheses, which Cook still has in his office. It's not hard to imagine how a researcher holding those metal wedges in his
hands might be driven to produce true replacements from living tissue.
"When I'm speaking around the world I ask the people in the crowd to hold up their hands if they would love to have metal
or plastic parts in their joints," Cook says. "I say, 'Raise 'em up real high and keep 'em up.' And, of course, no one ever
raises their hand, anywhere I've been. So, while metal and plastic are better than the alternative, they're not perfect. There's
pain, rehabilitation, complications. Even if the surgery goes well, honestly, you're still limited in function. No orthopedic
surgeon will tell you that after your knee is replaced you're going back to what you were doing before."
Seven additional surgeries were doubtless not what his grandfather envisioned either in the mid-1970s when he trusted his
knees to his first surgeon. Gordon was, in Cook's words, a self-made man who rose from sweeping floors at Airetool Manufacturing
to president of the company. He wasn't the sort to give in to disease; instead he started researching the journals. He found
an article in Scientific American describing the pound-on procedure. Cook has a rendering of the magazine cover and his grandfather's hand-written notes in
the margins on a plaque. "I think he may have been the fifth person in the country to have that surgery," Cook says. "It was
still very rare."
Pioneering as the procedure was, and as helpful as the seven additional surgeries were—certainly preferable to a wheelchair,
amputation or joint fusion—Gordon still had skin grafts and infection, leg length and loosening—"all the problems associated
with metal and plastic," Cook says.
Much like his grandfather, people hear about what Cook is doing at Missouri and write him letters desperate for the latest
advances. He puts them on a list that now numbers over a hundred. "They say, 'I'll sign any release you want me to sign; I'll
fly you to Europe or China or wherever you can do it.' And I say, 'I'm a veterinarian,' and they say, 'I don't care. I don't
want metal or plastic. I want you to do it. I'll sign any release. I'll pay any amount of money.'"