Dr. James Helgager, an experienced orthopedic surgeon, implanted the first vitamin E Total Knee Replacement in San Diego County on July 31 at Tri-City Medical Center in Oceanside. Helgager is the Medical Director of Joint Replacement for the Orthopaedic & Spine Institute at Tri-City Medical Center. He has been practicing medicine for more than three decades and has performed thousands of total knee replacements.