MU dynamo Jimi Cook is revolutionizing knee replacement surgery.
Once upon a time at a lake house in Indiana, Jimi Cook’s mother peered out the kitchen window to see her 4-year-old son zipping through the water on skis. Encouraged by his uncles to try the sport, Cook was a natural. His skills behind a speedboat would eventually catapult him to Florida State University on a water skiing scholarship and to a professional career in the sport.
Decades later, Cook — the William and Kathryn Allen Distinguished Professor in Orthopaedic Surgery — continues to rocket across the horizon as one of Mizzou’s top researchers and medical minds. He and the team at MU’s Comparative Orthopaedic Laboratory have developed a revolutionary “biologic knee,” a method of growing living tissue to replace patients’ arthritic joints. More recently, they perfected a way of preserving tissue for speedier and more effective cartilage-graft surgeries, and it’s propelling Mizzou to the international forefront of orthopedics.
The Jimi Cook Rule
Long before Cook, DVM ’94, PhD ’98, sought to cure arthritis, build schools in developing nations and heal life-changing service dogs, he was just a college graduate looking to catch some air. Extreme sports were all the rage in 1988, and Cook was competing in the Michelob Light Professional World Tour when a catastrophic crash altered his course.
The accident, footage of which ESPN SportsCenter used in a recurring video montage during the 1990s, left Cook with a torn rotator cuff, two torn medial collateral ligaments, a collapsed lung, liver contusions, and fractures of his spine and ribs. The severity of the crash prompted the sport’s governing body to enact the “Jimi Cook rule,” which put emergency medical personnel at the ready on a safety boat during competition.
It also motivated Cook to pursue a safer career: veterinary medicine.
“That was the catalyst,” says Cook, who in 1989 moved in with his sister in St. Louis while he recovered from injuries and established in-state residency. Cook had developed a love for animals during his formative years on his dad’s horse ranch. He got into the MU College of Veterinary Medicine and then took an internship at the University of Minnesota before returning to Mizzou to complete his small-animal surgery residency and a doctoral degree in pathobiology.
It was Cook’s late grandfather’s debilitating osteoarthritis that nudged him toward orthopedics and, ultimately, the Missouri Orthopaedic Institute (MOI). Cook and his grandfather, who endured eight total knee-replacement surgeries, bonded through bike riding, a low-impact activity.
“I witnessed the miracle of orthopedic research when he had his first knee replacement, but I also saw the limitations of the technology,” Cook says about the procedure, which employs plastic and metal knee parts. The artificial joints wear out quickly under the stress of vigorous exercise. “My goal is to create options for patients that result in high-function outcomes and restore long-term quality of life.”
Cook’s “biologic knee,” formed by growing cartilage cells in a high-tech mold, takes a big step in that direction. It has been successful in dogs, and the team is pursuing the arduous pathway for proposed use in humans through a Coulter Foundation-funded project in collaboration with Clark Hung of Columbia University in New York.
Human and veterinary paths merged for Cook at Mizzou’s Comparative Orthopaedic Laboratory, where he and his colleagues conduct translational research, developing and testing products that benefit both humans and animals. He has also developed surgical procedures, including one that repairs rotator-cuff damage often found in working dogs.
One such dog — a service golden retriever named Eagle serving his quadriplegic owner, Michael Ray of Deltona, Florida — sustained shoulder damage from opening doors and pulling his master’s wheelchair. Ray, the victim of a road-rage gun assault that left him paralyzed, implored Cook to travel south and perform the surgery.
“I was able to get Eagle back to work, form a friendship with Michael, and pass on the technique to a friend and colleague at the University of Florida,” says Cook of the surgical method he developed in veterinary cases, which is now used in humans. “It was a win-win.”
After the successful surgery in 2005, Ray nominated Cook for the Morris Animal Foundation’s Best Veterinarian in America award, which Cook accepted in Las Vegas. Ray, who’d told Cook he couldn’t attend, not only appeared on stage but also presented Cook with a golden retriever puppy. Cook named him Vegas, and the pup became the first of five service dogs Cook and his wife, Cristi, DVM ’93, MS ’98, also an MU veterinarian, have raised through the New Horizons Service Dogs program.
“Because of our multidisciplinary teamwork approach and work in veterinary patients, our research [at the Comparative Orthopaedic Laboratory] takes ideas and discoveries from the bench top to the [human] patient much quicker than other places,” Cook says. “But we also bring it back the other way to help animals. I will always be a veterinarian at the core, and I love being able to help the species that are helping us improve human health care. That really completes the mission for me,” Cook says.
Better Biologic Joints
For his latest trick, Cook and crew are on their way to revolutionizing the method used to preserve donated tissue for human biologic joint-replacement surgeries. Currently, clinics are forced to discard approximately 80 percent of this tissue because of its 28-day shelf life. Two weeks of testing to ensure the tissue’s safety, combined with additional time to find a size match for the patient, make the window for use even smaller. About 2,500 people receive these types of grafts every year, but many more are turned away.
The Comparative Orthopaedic Lab team has developed the Missouri Osteochondral Allograft Preservation System (MOPS). This “special sauce,” complete with a containment method, not only triples the length of time tissue is available for transplant but also maintains quality so patients have a better success rate. The system stores grafts at room temperature, which is cheaper than the medical-grade refrigeration required for current storage methods. Clinical trials are underway and are expected to be complete in two years.
James Stannard, MOI medical director and J. Vernon Luck Sr. Distinguished Professor of Orthopaedic Surgery, who performs the biologic joint reconstruction surgeries, estimates the new system could quadruple the number of these types of grafts over the first five years of use. If clinicians worldwide start using MOPS, the number could grow to more than 100,000. “It’s a game changer,” says Stannard, who also serves as interim dean at the School of Medicine.
Global perspective comes naturally to Cook, who in his spare time founded Be the Change Volunteers, a nonprofit organization that builds schools in developing nations, including India, Malawi, Papua New Guinea, Peru and Rwanda. For all of Cook’s technical and scientific brilliance, his ability to individually connect with people — and animals — is just as much a part of him.
“He is a really good guy and an enthusiastic researcher,” Stannard says. “But he’s also different in that he pushes hard for translation. He always keeps an eye on what we can do with the research to make a difference for his animal patients and our human patients.”