Current challenges & future opportunities in knee surgery from Dr. Adam Yanke

Written by Laura Dyrda | December 26, 2018 | Print  |

Adam Yanke, MD, is a sports medicine, knee and shoulder specialist at Midwest Orthopaedics at Rush in Chicago.

He is also involved in clinical trials using stem cell injections for arthritis and provides team coverage for the Chicago Bulls and White Sox. Here, Dr. Yanke discusses his top challenges headed into next year and where he sees the biggest opportunities for innovation.

Question: What are the top challenges you're facing heading into 2019?

Dr. Adam Yanke: While many of the surgical procedures we perform for the knee are very successful, there are still patients that continue to have pain or need another surgery. The standard approach has been to fix structural problems that we diagnose, but the reality is that pain can come from many sources, including non-structural problems such as inflammation. Treating structural problems in isolation is similar to treating heart disease with a stent alone. When someone has a heart attack, standard of care includes weight loss, monitoring risk factors such as cholesterol and blood pressure, and rehabilitation.

This same approach needs to be adopted when treating almost any knee condition where we take into account all of the other factors that can contribute to symptoms and disease progression. Moving toward treating the knee as an organ and taking into account all sources of pain including cartilage, bone, synovium (lining of the joint), synovial fluid and dynamic control is likely going to help accomplish this goal. One potential solution is biologic injections into the knee to help improve the synovial environment of the joint either to avoid surgery or to improve outcomes after surgery. We have several trials enrolling now to help understand this problem and improve outcomes in this setting.

Q: What technology are you most excited about in the future?

AY: While many surgical treatments are improving, I am currently the most excited about biological augmentation of non-operative and surgical treatments. The technologies that we are employing most frequently are platelet rich plasma, amniotic product injections and bone marrow aspirate injections. These can be applied for non-operative treatment of arthritis and tendonitis or during surgery to improve outcomes of rotator cuff repairs, anterior cruciate ligament reconstruction and meniscus tears.

Q: What is your best opportunity for growth?

AY: Currently I think we can grow through learning the best indications for injection therapy versus surgical intervention for knee arthritis. We know that patients with more severe arthritis do not respond as well to injections, but we do not have an advanced algorithm to predict success of each treatment. This leads us to work up the ladder of complexity and severity of treatment in all patients, which may not always be necessary.

To participate in future Becker's Q&As, contact Laura Dyrda at

For a deeper dive into the future of orthopedics, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.

More articles on orthopedic surgery:
Dr. Jason Weisstein: 3 Qs on the big challenges and best opportunities for orthopedic surgeons next year
Dr. Alpesh Patel: The biggest challenge in spine today + new innovations in spinal biologics
Tips for marketing an orthopedic practice in 2019

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