Dr. Robert LaPrade on the biggest thing to hit sports medicine since the arthroscope


Robert LaPrade, MD, PhD, a complex knee and sports medicine surgeon, joined Golden Valley, Minn.-based Twin Cities Orthopedics June 3. 

Here, he explains why he picked TCO to continue his career and discusses the future of knee surgery.

Note: Responses were edited for clarity and style.

Question: Why join Twin Cities Orthopedics?

Dr. Robert LaPrade: It is an honor and privilege to be joining Twin Cities Orthopedics, with their top surgeons and state-of-the-art facilities. Minnesota is home to my family, and I am eager to be back providing specialized care in our hometown. I have trained over 25 TCO surgeons as orthopedic residents or sports medicine fellows and almost all have reached out to me to "welcome me back home." This has made my decision to join TCO very easy.

Q: Concerning advances in knee surgery, what do you view as the next big trend?

RL: The next big trend in knee surgery will be the increasing role of osteotomies around the knee to address knee pathology. The increased recognition of bony geometry, especially tibial slope, on cruciate ligament reconstructions, especially for revisions, will definitely lead to an increased number of osteotomies being performed over the next few years.

I also believe that as we further recognize the role of the menisci on preventing arthritis and providing stability to a cruciate ligament-deficient knee, there will continue to be a large increase in the number of meniscal repairs over the next few years. We have now validated that root, radial and complex meniscal repairs improve clinical outcomes and the increased trend for repairs of these types of tears will only continue to increase and lead to further improved patient outcomes due to it.

Q: Pivoting to sports medicine, three years down the road what do you see as sports medicine's biggest pressing issue?

RL: Our most pressing issue is to define the correct use of biologics to aid or augment healing of sports medicine pathology. I still truly believe that biologics will be the next big thing to hit sports medicine since the arthroscope, but we require much more basic science studies before we use it on the masses. What we do know is that preparing and reinjecting minimally manipulated plasma-rich platelets and bone marrow aspirate stem cell concentrate without knowing what is in these individual patients' products may certainly not be cost effective and in some cases could interfere with healing, so we need to be very specific in who we choose to inject these products.

I would be concerned about those who are using it in every patient (unless one has a true prospective study) until we better define how to use it and when to use it most effectively. The science is just not there to support this practice, and the cost to patients does not support it either.

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