The future dawns
Sports surgery advances toward new horizons
EANN WAR
REN’S KNEES
have spanned
the history of
sports knee
surgery in the
last ten months.
They have
passed through the grey twilight
of the past, seen the soft glow of
the present and caught a glimp
se of the rosy dawn of the future.
What did they find?
A future when ligaments will
be made of tire fibers, when limb
banks will offer "used” knees to
athletes.
A past when the trauma from
surgery often was greater than
the surgery on the injury, and
when a new tool to examine
knees often broke off in the
joint, leaving a miniature
lightbulb imbedded in the joint.
And a present that offers the
wonders of arthroscopic
surgery, a technique that often
allows an athlete to go home im
mediately after an operation
without a cast or crutches.
“Because injury is inherent to
sport, athletes have always look
ed for ‘the answer,’ ” says Dr.
Stan James, an nationally
known orthopedist with the Or
thopedic and Fracture Clinic of
Eugene.
“And arthroscopic surgery
has taken a surgical procdure
which used to require common
post-operative care and turned it
into almost an out-patient pro
cedure,” James observes.
Arthroscopic surgery is a
technique that has grown by
leaps and bounds since its ap
pearance in the early 1970s, ac
cording to James.
So what is so wonderful about
this technique?
The answer is two-fold, says
James. “It gives us another
diagnostic tool that can look in
all joints, and it allows us to get
Football knee Injuries are often too severe to take advantage of ar
throscopic surgery
in without an incision, which
reduces the recovery time."
The arthroscope is a fiber
optic tube which a physician in
serts into the injured joint and
looks into interior of the joint
without causing major trauma to
the area.
Another tube can be inserted
into a separate incision if certain
types of surgery are required,
says James.
He likens the procedure to
“building a boat in a bottle” with
the world’s smallest tools.
However, only certain types of
joint injuries can be treated, ac
cording to James.
“We can't do ligament
reconstruction — that’s open
surgery,” James emphasizes.
“We use the arthroscope to
repair torn cartilage the most
often.”
Often, though, the net result
is that an athlete can compete
again within weeks of the
operation.
James offers American runner
Tom Byers as a textbook exam
ple. Byers, an internationally
ranked miler, was sidelined in
June 1982 with a knee problem.
James operated using an ar
throscope, and Byers was able
to catch the tail end of the Euro
pean outdoor track season.
"He would have been done for
the season with a conventional
operation," James says.
Warren knows the truth to that
statement. Last January, in the
midst of performing ar
throscopic surgery on her right
knee, Warren’s doctor in Los
Angeles decided to open up the
knee using conventional surgery
techniques because of the
severity of the problem.
The surgery kept Warren from
competing in track for Oregon
last spring, and necessitated an
eight-month recovery that seem
ed didn’t have her running
steadily until August.
Warren had been face-to-face
with the past in sports surgery.
But less than a month ago, War
ren saw a glimpse of the future
when she walked out of her doc
tor’s office after an operation
without a cast encasing her
knee or crutches under her
arms.
Like Byers, she had had an ar
throscope done on her knee, and
the lack of trauma from the
surgery won’t shelve Warren’s
plans for a shot at the Olympics.
“It used to be that the alter
natives were to cut or not to
cut," says Tom Heinonen,
Oregon women’s track and
cross country coach. “And if you
didn’t cut you waited."
The waiting often produced an
even more severe injury, says
Heinonen, while allowing ex
ploratory surgery to diagnose
the problem generally entailed
months of casts and crutches.
Conventional surgery often re
quires a three or four day stay in
the hospital following the
surgery, then two to three weeks
of crutches or casts and a “vaca
tion” from training for three
months, according to James.
With arthroscopic surgery, the
time spent on crutches is cut to
three to five days, and an athlete
can often resume light training
in three weeks, he says.
Arthroscopic surgery bridges
the void between those two
unappetizing choices of waiting
or cutting for the athlete and
coach, says Heinonen, who won
the AAU marathon title in 1969.
‘‘It gives us a middle ground,”
he says. “The more options you
have in a medical sense, the bet
ter off you are going to be.
Before the arthroscope, there
would have been no good alter
natives for Leann.
“Now the athlete and coach
have more options,” emphasizes
Heinonen. “Leann took 10 mon
ths to get back last time (with
conventional surgery), and she
didn’t want to risk that this
time.”
Steven Roy, a physician with
the Eugene Center for Sports
Medicine and Running Injuries,
has seen a change in attitude in
athletes since the inception of
arthroscopic surgery.
"There wasn’t much of a
choice in between rest or
surgery. That produced a lot of
negative feelings about doc
tors,” he recalls.
But an “information explo
sion" that went hand-in-hand
with the refinement of ar
Continued on Page 6B
Athletes' attitudes toward doctors have changed from negative to positive over the last decade, accor
ding to Or. Steven Roy._ _