• The Bionic Golfer

    Four knee injuries from football and skiing didn’t keep sixtytwo- year-old J.R. (James Richard) Delich off the golf course. Yet, a year ago this scratch player and frequent winner of United States regional titles almost had to give up golf as the result of a severe form of arthritis. “I would hit a shot and the club would go flying out of my hand,” recalls the Indian Wells resident. The problem actually began five years earlier. During the European Senior Golf Tour — where his scoring average was just over 72 — J.R. noticed his left hand started to ache just a little bit. “I started getting nodes or bumps in my left hand,” he remembers, “and my left index finger started to curve. Eventually, it went from being straight to 30 degrees to the left.” At the same time, J.R.’s left index finger started to swell in the first knuckle and to ache a lot. But he ignored it. “I thought maybe I had a little gout or something,” he says today.

    For two years he managed to keep the pain somewhat under control by taking Advil®, aspirin and other antiinflammatory drugs. But, finally, when he saw a doctor in Philadelphia (his home town), he discovered that he had osteoarthritis — one of the oldest and most common types of arthritis, characterized by the breakdown of the joint’s cartilage. “They started giving me cortisone injections in my knuckles,” he says. “I’d go for two to three months where there wouldn’t be any pain at all and then it would flare up again.” But the injections themselves were, at times, as painful as the osteoarthritis. “The injections were so painful,” J.R. says, “that a couple of times I passed out.” J.R. soon discovered that he was starting to have similar symptoms in his right hand, though not as painful.

    Fortunately, by now J.R. had met Stephen J. O’Connell, MD, a Board Certified Orthopedic Surgeon at Eisenhower and Director of Hand and Upper Extremity Surgery at Desert Orthopedic Center. Dr. O’Connell suggested to J.R. that he might think about knuckle replacement surgery. “I returned to my home in Philadelphia and thought about it all summer,” says J.R. “Finally, I decided to do it when I got back to the desert in October 2003.” By then, Dr. O’Connell had been in contact with Robert D. Beckenbaugh, MD, an Orthopedic Surgeon at the Mayo Clinic in Rochester, Minnesota, and the inventor of a new artificial knuckle implant made from a new kind of material called pyrolytic carbon (pyrocarbon). Dr. Beckenbaugh had indicated he would like to be in the operating room to watch as Dr. O’Connell performed the operation.

    On January 29, 2004, Dr. O’Connell replaced the middle knuckle on J.R.’s ring finger and the middle knuckle on the middle finger of the left hand. He also fused the first knuckle of J.R.’s index finger and fused his left thumb. Finally, he cleaned out the tendon in the palm of J.R.s left hand. “He also put in some wires to stabilize the joint because the first joint in my left thumb had deteriorated so badly,” J.R. says.

    “Before Dr. Connell operated,” J.R. explains, “he put a golf club in my hand and had me show him how I wanted to hold the club. They did an x-ray with the club in my hand. So he knew how to position my hand so I could hold onto the golf club.”

    After the four-hour operation J.R. was in rehab for about 14 or 15 weeks. And the results? “Everything is phenomenal,” says J.R. “I can’t believe it. My hand is a little stiff, particularly in the morning. But I can control the golf club and I have no pain in my hand! It’s unbelievable.”

    “…They did an x-ray with the club in my hand.” — J.R. Delich

    Before After

    J.R. gives a lot of credit for his recovery to his wife Carol. “Throughout this long, difficult process,” he says, “my wife has stood behind me 100 percent,” he says. “She has been a tremendous support and inspiration. She’s the best,” he adds with a warm smile.

    Following the surgical procedure, during his rehabilitation period, J.R. played golf one-handed for about 15 weeks — every day for the first 10 weeks and then twice a week and finally, by May, once every two weeks. “It is good exercise; it keeps the right hand strong, and coordination and watching the golf ball helps a lot.”

    During the first two days he was back on the golf course in May 2004, he shot 67 and 66. “Even though it was just local, it made me excited,” he says. He also played in one competition in May and shot 74, “which I felt very good about,” he says modestly.

    After the operation Dr. Beckenbaugh spoke with J.R., praising the operation and the skill of Dr. O’Connell. As J.R. recalls, “Dr. Beckenbaugh told me that he had observed a lot of surgeons in his life and Dr. O’Connell was one of the finest he had ever seen — very diligent and extremely good.”

    Adding his own thoughts, J.R. says about Dr. O’Connell, “He’s not only a good doctor but a great human being.”

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