The Proof is in the Package
Like anything in life, a major surgery is easiest on those who are best prepared. Unfortunately, as far as major surgeries go, preparedness is a luxury that’s usually unavailable.
But it doesn’t have to be, says the team of surgeons at The Steadman Clinic in Vail, Colorado. If the major surgery you need is a total joint replacement, you may be able to delay that operation without causing more pain, long-term damage or a reduced quality of life. The Steadman Clinic is of the opinion that you should absolutely opt for that delay, and use the extra time to prepare yourself.
And they have the research to back it up.
INFLUENCING ORTHOPAEDICS WORLDWIDE
Founded in 1988 by orthopaedic surgeon Dr. Richard Steadman as the Steadman Sports Medicine Foundation, the Steadman Philippon Research Institute (SPRI) is a 501(c)(3) charitable organization dedicated to keeping people of all ages physically active through orthopaedic research and education in arthritis, healing, rehabilitation and injury prevention.
It all started with a wing of the surgery center Dr. Steadman called the Clinical Research Department, recalls Karen Briggs, the Director of the Center for Outcomes-Based Orthopaedic Research who has been with Steadman for nearly two decades.
“Our goal was to build a database of all the patient-derived outcomes — how the patients felt — along with all the surgical information,” says Briggs. “And that, 25 years later, has driven us to the point where we are now a center for outcome-based orthopaedic research, where we determine how patients do based on their opinion and the physician’s opinion. We publish those outcomes, and share that knowledge with the world.”
These days, the SPRI database consists of more than 20,000 patients. They’ve found most patients are more than willing to share their opinions on the outcomes — those patients are tracked for as long as 20 years following a surgery.
“It’s a long-term commitment by the research institute to improve orthopaedic care throughout the world,” says Briggs.
SPRI’s latest research paper, “Ten Year Survivorship Following Knee Arthroscopy in Patients with Moderate to Severe Osteoarthritis of the Knee,” won the Richard O’Connor Research Award at the Arthroscopy Association of North America annual meeting in April.
The paper — co-authored by Henry B. Ellis, MD, and Lauren M. Matheny, BA, along with Steadman and Briggs — details the long-term results of 81 knees that received Steadman’s surgery-delaying treatment. All the patients involved in the study had osteoarthritis and were candidates for total knee replacement (called total knee arthroplasty, or TKA) due to pain and symptoms. However, for various reasons, none of these patients wanted to actually go through with the surgery at that time, and so they opted to try and delay it.
These patients received Steadman’s arthroscopic regimen for knee osteoarthritis, a treatment package he calls, simply, “The Package,” and tracked the results. Over the course of a decade, The Steadman Clinic learned that patients who underwent arthroscopy for the treatment of osteoarthritis of the knee were able to delay TKA for five to 10 years, with approximately 40 percent of patients who were originally candidates for TKA able to delay arthroplasty for 10 years.
“The patient satisfaction on this is huge,” says Briggs. “People who can put it off for two years are very happy, and when you get into three, four, five and beyond, they’re even more relieved.”
NEEDS BEYOND KNEES
While SPRI’s Richard O’Connor-award winning research was limited to the knee, joint preservation and the ability to delay total replacement has been embraced by The Steadman Clinic as a whole.
Dr. Marc Philippon, hip specialist at The Steadman Clinic, is using a joint-preserving arthroscopic technique he personally developed to cure a painful condition in the hip that was once extremely difficult to fix. His results were presented in the summer of 2012 at the American Orthopaedic Society for Sports Medicine (AOSSM) meeting in Baltimore.
“In our review of 21 male, elite athletes who had hip pain and instability issues (hypoplastic or labrum tear), 81 percent returned to play at a similar level as before they were hurt, after receiving an arthroscopic reconstruction technique using an ipsilateral iliotibial band autograft,” says Philippon.
Ed Reed, who won the Super Bowl with the Baltimore Ravens in 2013 and now a Houston Texan, sought Philippon out for his arthroscopic reconstruction technique.
“I knew I was making the right decision,” says Reed. “Dr. Philippon is a great man, very smart and very cool to be around.”
Dr. Tom Hackett, an elbow, shoulder and knee specialist at The Steadman Clinic, says “expanding the frontiers of joint preservation” is among his goals as a surgeon.
“What happens with arthritis is your brain tries to trick your body into not being able to use that part anymore,” says Dr. Hackett. “Our joint preservation techniques don’t work for everybody, maybe six or seven out of 10 people, but with those people you can buy them several years, or sometimes even more, before they have to look at joint replacement.”
The Steadman Clinic shoulder specialist Dr. Peter Millett is the pioneer of a joint preservation technique for the shoulder called Comprehensive Arthroscopic Management, or the CAM procedure. The CAM procedure treats osteoarthritis of the shoulder and offers a precise combination of surgical procedures aimed at treating all of the major pain generators in the shoulder region. Clinical studies have shown it to decrease pain and improve function and can be performed in young, active patients with arthritis who wish to preserve their shoulder joints, or in older patients who wish to avoid joint replacement surgery.
For more information about The Steadman Clinic or The Steadman Philippon Research Institute, visit www.thesteadmanclinic.com.
THE STEADMAN CLINIC
Richard Steadman, MD
Marc J. Philippon, MD
Randy W. Viola, MD
Specialty: Hand, Wrist & Elbow
Donald S. Corenman, MD, DC
Spine & Neck
David C. Karli, MD
Spine & Neck
Tom Hackett, MD
Specialty: Knee, Shoulder & Elbow
Peter J. Millett, MD, MSc
Specialty: Shoulder & Elbow
Thomas O. Clanton, MD
Specialty: Foot, Ankle & Knee
Rob LaPrade, MD, PhD
Michael Cassat, MD
Specialty: Primary Care Sports Medicine