With the weather warming and the days lengthening, many people are becoming more active and participating in sports. Unfortunately, this also means an increase in sports-related injuries. Frank Chen, M.D., a sports medicine doctor at PAMF's Palo Alto Center, shares some information about new cutting-edge sports medicine procedures and therapies.

Q: Arthroscopic (minimally invasive) surgery is in the news media a lot lately. What is it?

Dr. Chen: Arthroscopic surgery allows a doctor to diagnose and treat damage inside a joint by making a small incision and inserting a tiny camera (called an arthroscope) with a magnifying lens. The lens allows the doctor to visualize the inside of the joint by transmitting a picture to a video monitor.

Arthroscopic procedures can be performed either to evaluate or to treat many conditions, including damage to cartilage and ligaments. The advantage of arthro-scopy over traditional "open" surgery is that only small incisions are made – one for the arthroscope and others as needed for surgical instruments. And fewer incisions mean less trauma to the tissue, and thus less pain and recovery time.

Q: What new arthroscopic procedures are PAMF doctors performing?

Dr. Chen: There are many advances for arthroscopic surgery right now. In PAMF's Sports Medicine Department, we're now performing "all-inside" ACL reconstruction. (Damaging the anterior cruciate ligament (ACL) is a common knee injury for athletes who participate in quick-motion sports like skiing, football and soccer.) The all-inside ACL reconstruction eliminates additional incisions altogether, and thus, patients usually experience less pain and swelling and a faster recovery time. The all-inside procedure is also more accurate than standard techniques and allows the ACL to be in a better position. This means the knee is more stable and the repair is more durable – all of which help patients return to their normal activities.

We're also performing arthroscopic surgery to repair shoulder separations and rotator cuff injuries using a combination of smaller incisions instead of one large incision. Like using minimally invasive techniques to reconstruct the ACL, less invasive techniques here allow us to minimize pain and recovery time. Using an arthroscope, we can better visualize the damage because it is magnified on a video monitor.

For rotator cuff damage, we're now using a technique called "double-row" repairs, which uses a double row of sutures and anchors instead of just a single row of sutures. This creates more points of fixation to help improve healing and strengthen the anchoring of the tendon to the bone – and it can be done without losing shoulder function.

Q: Are there new non-surgical procedures to help repair sports injuries?

Dr. Chen: Yes. One emerging and very promising treatment that we hope to offer soon at PAMF is a form of "biologic healing" called platelet rich plasma (PRP) therapy in which a portion of a patient’s blood (platelets and related healing proteins) is injected directly into the injured body part. This augments the body's natural healing instincts to repair muscle, bone and other tissue – and may help to regenerate damaged ligament and tendon tissue. PRP therapy is particularly exciting because it can potentially shorten injury and recovery time and may even eliminate the need for surgery in some cases. It is promising in helping heal conditions such as tennis elbow, patella (knee) tendonitis and rotator cuff injuries. Unfortunately, because the therapy is still considered experimental, it is currently not covered by health insurance.

Visit www.pamf.org/sports to find out more about services at PAMF’s Department of Sports Medicine.