If your young athlete suffers a severe injury, surgery may be the only option. The difficult combination of the need for immediate care, a potentially large financial expense, and an emotional atmosphere can sometimes make the selection of a surgeon very difficult. When it comes to kids and sports, look for fellowship-trained sports medicine surgeons who specialize in adolescent athletes.
Experts in their field
Dr. Nathan Mall, associate physician for the St. Louis Cardinals and a physician with an interest in skelatally immature athletes, recalls his experience during his fellowship at Rush University in Chicago.
"I did my 5-year residency at an institution that does a relatively high volume of ACLs [reconstructive surgery following a tear of the anterior cruciate ligament]. I spent a grand total of about 6 months on sports medicine and assisted on around 30-50 ACL reconstructions. But during my one-year fellowship, I did nothing but sports medicine and shoulder and elbow surgery, and during this time participated in well over 125 ACL reconstructions."
The point is that fellowship training in sports medicine surgery allows physicians opportunities to work with the best in their fields over a longer period of time, so that when they are later in surgical practice you will know that they are employing the most evidence-based approach and surgical techniques, skills which they have honed over the course of their orthopedic surgery fellowship.
Minimizing surgical risk
While many orthopedic operations, such as ACL reconstruction or rotator cuff repair, have high success rates, not every patient, as Dr. Mall reports, is "by the book." MRIs, x-rays, and years of training are only part of the equation. Sometimes, surgeries do not go exactly as planned, and a skilled fellowship-trained orthopedic surgeon can turn around even the worst situations.
"Doing a high volume of surgeries during fellowships assures that you have seen various ways the surgery can go wrong and know how to fix them. Many orthopedic surgeons could read a paper and see how to do the surgery as long as it goes well, but if it doesn't go by the book they don't know how to bail themselves out of trouble."
Adolescent athletes require specialized expertise
The growing bodies of younger patients with serious sports-related orthopedic injuries (ACL tears, torn meniscus, torn UCL etc.) may require special care and attention. Fellowship-trained orthopedic surgeons are skilled to care for adult athletes, as well as pediatric patients.
"Most academic institutions do not have a pediatric sports medicine surgeon," Dr. Mall reports, "and thus the adult guys do all of the pediatric and adolescents, as it was at Rush. Therefore, during a sports medicine fellowship we get exposure to pediatric and skeletally immature ACL reconstructions."
Selecting a surgeon for your young athlete is an emotional and, often, a "spur of the moment" decision. If your young athlete is involved in sports, it is important to know ahead of time where to go to get the best in orthopedic and physical therapy care, even if it is never needed. You want to be sure your healthcare team communicates well and will provide your child the best outcome, while communicating regularly with yourself and coaches.
Dr. Cronin gratefully acknowledges the assistance of Nathan Mall, MD, Director of St. Louis Center for Cartilage Restoration and Repair at Regeneration Orthopedics and Associate Team Physician for the St. Louis Cardinals, in the preparation of this article.