Specialty care for the athlete in all of us
Sports medicine is all grown up — and still growing! Since emerging as a distinct specialty in the late 20th century, sports medicine has become one of the most diverse and dynamic areas of healthcare. Today, it encompasses a broad swath of services ranging from activity-related injury prevention, rehabilitation, and surgical and non-surgical treatments to nutrition and training for maximizing athletic performance.
In fact, many sports medicine practitioners now dedicate their work to specific parts of the body, such as particular joints. Others, whether by design or circumstance, focus on a particular condition, such as overuse, repetitive-motion, or traumatic injuries.
It probably comes as no surprise that few places in the world need first-class sports medicine services more than the Roaring Fork Valley. Our collective focus on fitness and outdoor activities make this a great place to practice for Tom Pevny, MD, orthopedic surgeon, at Aspen Valley Hospital (AVH).
“We see a lot of sports-related injuries, given how athletic our community is,” says Dr. Pevny, who completed a fellowship in sports medicine as part of his medical training and is board certified in both orthopedics and sports medicine. “In particular, we see a lot of athletes who fall. In areas of the country where baseball is huge, for example, you would see more overuse injuries. Here in Aspen, most of our orthopedic patients are injured in falls, like on a ski slope or bike path.”
“We see a lot of sports-related injuries, given how athletic our community is.”
Individualized care for individual patients
Every injury is as unique as the person who suffers it. And for that reason, individualized care is the only way to achieve the best possible results. “You can’t just treat the injury; you have to treat the whole patient and consider what he or she wants in terms of function and activity,” Dr. Pevny says.
“We have people with very bad knee X-rays — the joint is not aligned, bone is rubbing on bone — and yet they are very functional,” he explains. “I’ll be thinking, ‘How did you walk in here?’ and the patient will say he’s still skiing, swimming, hiking, and biking. So, we would treat that patient very differently from a person who comes in with the same type of X-ray but has severe pain and limited range of motion.”
With any patient, Dr. Pevny begins with a conservative approach to treatment. Options such as physical therapy and activity modification often will effectively alleviate symptoms. If the results are not satisfactory, however, a next step might be injections with cortisone, platelet-rich plasma, or stem cells harvested from the patient’s fat or bone.
Only if conservative therapies do not provide sufficient relief will Dr. Pevny consider a surgical procedure. When that is the case, several options are available to AVH patients.
Arthroscopic surgery to clean the joint of damaged tissue, bone fragments, and other debris may work. Or depending on the joint affected and the extent of the damage, a partial joint replacement may be appropriate. For the knee, a partial joint replacement procedure called Mako® has been very successful, because it preserves bone. However, it can be used only under certain circumstances, such as for patients who still have good range of motion and no major misalignment issues in the joint.
If the joint suffers from severe damage or is affected by an advanced condition such as arthritis, the only definitive treatment may be total joint replacement. Here, the physician’s expertise can
make a significant difference in the results. For instance: When performing a total knee replacement, Dr. Pevny orders special images of the entire leg, from hip to ankle. The images are sent to the replacement joint’s manufacturer so the new knee will be made to fit exactly to the patient’s anatomy with perfect alignment.
“Getting the alignment right is analogous to getting the foundation right when you’re building a house,” Dr Pevny explains. “You can have a beautiful home — but if the foundation isn’t right, it’s going to fall apart. It’s the same with a total knee replacement. If the alignment isn’t right, there’s going to be increased stress and, over time, a higher risk of failure.”
The return to an active lifestyle
For most sports medicine patients, the ultimate goal of treatment is a return to athletic activities that have not been possible, or at least not enjoyable, for a long time. That’s why AVH has physicians who specialize in the treatment of ailments of the knee, shoulder, foot and ankle, hip, hand, and wrist.
“Most people understand that procedures such as total knee replacement can be life-changing, but we don’t always have to resort to surgery to see significant improvements in comfort and functionality,”
Dr. Pevny says. “We approach every situation with a focus on helping people get back to the healthy, active life they want to lead.”
For most sports medicine patients, the ultimate goal of treatment is a return to athletic activities that have not been possible, or at least not enjoyable, for a long time.