Jeffrey R. Dugas, M.D.
“It’s a game changer.”
That phrase is often just hype, but when you hear it come from not one, but four of the top orthopedic surgeons in the country, it’s time to take note.
True changes in sports medicine come about once in a generation. Tommy John surgery, the arthroscope, the use of orthobiologic agents — these innovations are now part of the sports medicine landscape, and regularly help athletes come back from injuries that were career-altering or even career-ending not that long ago.
The latest new method isn’t on the drawing board; it’s in athletes already. And we’re about to see a lot more of it.
The innovation is really a product, not a surgery. It’s called SutureTape and it’s made by Arthrex, the large medical device manufacturer, after consultation with some of the top orthopedic surgeons. It’s use in surgery is called “InternalBrace.” The tape is affixed during surgery to brace a ligament or reconstruction as it heals, allowing early load and sometimes even return to play prior to complete biologic healing.
Many of the surgeons who consulted Arthrex on the development of SutureTape were on the stage at the recent Lewis Yocum Baseball Medicine Conference, run by the Kerlan-Jobe Clinic and super-surgeon Neil ElAttrache’s staff. A discussion among ElAttrache, Dr. John Conway of the Ben Hogan Clinic in Fort Worth, Dr. Orr Limpisvasti and Dr. Steven Shin of Kerlan-Jobe showed just how much potential this has.
Dr. Orr Limpisvasti is at the forefront of this research, working closely with Arthrex to develop the techniques and the best practices for this surgery. “We’re actively researching what the best ways and places to use this. Obviously, we’re always guided by the patient and getting the best result for him or her. What this technique is allowing us to do is safely putting the athlete back in the game faster while decreasing their risk of reinjury during the healing process.”
In essence, Limpisvasti’s technique is to use the SutureTape to enhance the injured ligament or tendon, weaving it into the structure. It acts as a check on the ligament, strengthening and limiting the motion. This allows a much quicker return to function, because the SutureTape doesn’t need to heal. It provides immediate strength and stability, allowing the ligament itself to heal.
What that means for the athlete is more of their most valuable resource: time. In some cases, Limpisvasti has seen the time it takes for an athlete to return to play cut in half. For a severe knee injury like an ACL tear, that could mean reducing recovery time from nine months to four. For a thumb injury, it could go from three months to four weeks. In one example, a bull rider was able to return from an elbow reconstruction in four months, not the year it typically takes.
“It’s not appropriate for everyone,” said Limpisvasti. “It needs good tissue to repair, so a lot of chronic to acute — like what we see with pitchers who wear out their elbow until it finally pops — might not be candidates. We’re learning where it can best be used.”
However, the technique is already being used on athletes. Dr. Jeff Dugas of Andrews Sports Medicine in Birmingham recently reported that he’s done 50 operations on damaged elbow ligaments. The results are almost too good, with no documented failures. By comparison, Tommy John surgery has about a 17 percent failure rate over a large population.