Not Just Your Average Teenager
Matt Peters was a typical teenager — before a complex knee injury took him away from the typical activities a vibrant 15-year old partakes in. Prior to meeting Dr. LaPrade and going through countless doctor’s visits and surgeries, Matt could easily be found weight-lifting with friends, dirt-biking in the wilderness, or hanging out with peers on any given Colorado night. He was just one of the guys.
As a talented athlete and highly active young man, Matt played hockey year-round since the age of 5. He also played club Lacrosse from 2005 until 2009 before making the AAA Colorado Rampage Ice Hockey Team in 2010. It was around this time when he was playing Lacrosse that he began to complain about a dull ache behind his knee. Because he was so active, his parents assumed that the causes of knee pain were the result of not enough stretching or other benign causes. The pain went on for two years before it became constant and more severe. After visiting with his local primary care physician, who measured the circumference of Matt’s thigh determining that it was almost two inches smaller than his good leg, he was referred to an orthopaedic knee doctor in Colorado Springs, who again, referred Matt to a specialist.
The Diagnosis
It was this doctor in March of 2012 that told Matt the causes of knee pain he was experiencing were due to osteochondritis dissecans of the knee. Osteochondritis dissecans is a joint condition where a variable amount of bone and its nearby cartilage loses its blood supply. As in Matt’s situation, the causes of this knee condition are often unknown, however, symptoms include aching, pain, locking of the joint and limited range of motion. Matt’s knee was operated on in April 2010 where the loose piece of bone was screwed back into place and dissolvable pins inserted to hold the bone and cartilage. After this surgery, Matt was not allowed to put weight on his leg for three months. He was also advised not to do physical therapy. It was a difficult time over the weeks that followed as Matt was confined to his crutches and at times, a wheelchair.
In July of 2010, Matt began to walk without his crutches but found it very problematic. The causes of knee pain during this transition were occurring because all of the tendons in his knee had tightened up and all of his leg muscles had atrophied severely. He began to train and work out with his hockey trainers and in August was given the green light to play hockey again. Weeks later, during a follow-up appointment, it was discovered that a screw had broken in Matt’s knee. Although his doctor wanted to surgically place three more screws into Matt’s knee, Matt declined. Matt had minimal pain during that hockey season which he and his trainer associated with tendonitis and at the end of that hockey season, Matt began more intensive training including plyometrics and treadmill skating, which he continued throughout the summer of 2011.
Matt was committed to play for the Pikes Peak Rampage hockey team and after participating in the final try-out in August of 2011, Matt’s knee had significant swelling and he walked with a severe limp. His symptoms were not going away and so it was at this time that his family made a commitment to seek out a more qualified orthopedic knee doctor.
They had heard years ago that The Steadman Clinic in Vail, Colorado had a good reputation for repairing athletic injuries of the knee and other joints. Because they were unsure if the clinic could get Matt in right away, another orthopaedic clinic in Denver was also called. It took a couple of days for the Denver clinic to call back, but The Steadman Clinic called back the very same day, and an appointment with Dr. Hackett, another knee surgeon with the Clinic, was scheduled. In early September, upon performing an MRI and physical exam of Matt’s knee, Dr. Hackett confirmed the diagnosis of osteochondritis dissecans of the knee, but realized that the piece of bone which was previously screwed in had not completely healed. He wanted Matt to rest his knee and see if it might finally repair itself.
Matt took Dr. Hackett’s advice and rested his knee. However, on the morning of September 30, 2011, because the pain and swelling in his knee had receded, Matt decided to go ice skating. After leaving the rink, he began having pain that increased throughout the day until it became unbearable.
Meeting Dr. LaPrade
According to Matt’s mom, Rae, “We called The Steadman Clinic to get advice. The Dr. on call actually took the time to discuss the situation with both myself and Matt and explained what our options were and what might be happening in Matt’s knee. Since Matt could not move at all without excruciating pain, an ambulance had to be called and they had to transport him to the local hospital emergency room. At the ER it took six hours before a Dr. examined Matt and looked at his x-ray. He was treated for the pain and the doctor diagnosed him with a sprained knee. I asked to see the x-ray, which showed that the broken screw had migrated across Matt’s knee. I showed the ER doctor what the real problem was and that he had osteochondritis dissecans of the knee, but he appeared disinterested and unconcerned. I photographed the x-ray and emailed it on Monday morning to the Steadman Clinic. They immediately contacted us and we had an appointment secured for Matt that day with a complex knee surgeon, Dr. Robert LaPrade.”
Matt and his parents arrived in Vail, Colorado late that day, but the Clinic got him in for an MRI and exam and scheduled surgery for the next day to remove the screw. After leaving the Clinic, Matt, his dad and mom, were walking to find a restaurant in Vail Village that would serve a good meal prior to Matt fasting that night. The Village was dark and very quiet. They saw a gentleman walking his dog and approaching them and it was then that Matt’s Dad, Don, asked the stranger if he knew where they could get a good steak. At that moment in time, the gentleman said, “I had a look at that MRI”. It was then that Matt and his family realized that it was Dr. LaPrade. They didn’t recognize him out of his office.
According to Rae, “He went out of his way to chat with us about what he discovered in Matt’s knee. He was patient, kind, looked us warmly in the eyes and discussed the matter and upcoming surgery with us in great detail. He put our anxiety at ease about what was going to happen the next day. At the end of our conversation, he told us he would see us in the morning and then proceeded to give us a restaurant recommendation.”
The next day, after surgery, Dr LaPrade informed Matt that the bone fragment in his knee hadn’t healed and would likely never heal as it was. He removed the broken screw and removed the fragment as well as cleaned up other debris during the surgery. According to Matt, “My condition seemed really complicated to me. But Dr. LaPrade was so good and so nice explaining everything he had done it made me feel better. He also gave my family reading material and a study that he had put together on osteochondritis dissecans of the knee and then he detailed the plan of action he proposed to repair the damaged bone and cartilage. I can’t imagine any of the other doctors I had seen before being able to make me feel as calm as he did because I was really scared that my knee would never be the same.”
Dr. LaPrade placed Matt on a fresh cartilage donor list and from there Matt and his parents were educated by Dr. LaPrade and his Fellows on the surgery, physical therapy, and what to expect during the recovery process which would occur after the next surgery that involved installing the allograft.
“When we arrived home after that visit, a few days later, we received by mail a detailed description of the entire diagnosis and surgery which transpired days before. None of us had ever received such a detailed document from a physician, ever. Family members were so impressed that a doctor would be so specific and transparent to his patients; a testament of his confidence and acute knowledge in his area of expertise. I knew from the bottom of my heart that Matt was in the greatest hands with Dr. LaPrade. For a worried mom, that means the world.”
On November 3, 2011 Matt had his surgery using the allograft. His surgery went great. Right out of the operating room, Dr. LaPrade met with Matt’s parents. “Immediately after the surgery was over, Dr. LaPrade met with us and discussed thoroughly what had been accomplished. He was descriptive, utilizing both words and hand gestures. His attitude was reassuring which brought us immense relief. He appeared confident, but not egotistical, and very pleased with how the surgery went. It was an exceptional experience and one will not ever forget,” said Rae.
“From the very first visit to The Steadman Clinic, every single staff member appeared to go out of their way to make us comfortable, educate us, and answer every question carefully. Even during physical therapy, which started immediately, we had kind and knowledgeable therapists who had immediate access to Dr. LaPrade. All of our questions or concerns were not only addressed immediately, but delivered in a way to educate us.”
Today, nine weeks later, Matt continues with daily physical therapy with a Dr. LaPrade-designed protocol that Matt can do without a therapist. Although the road to recovery has been long, under the guidance of Dr. LaPrade, Matt continues to get stronger and better every single day. In the weeks that follow he will gradually be able to put his full body weight onto his knee and at that time he will see Dr. LaPrade again and the next phase of his recovery will be outlined.
Rae cannot say enough about the experience her family encountered with Dr. LaPrade, “He is more than just a complex knee surgeon, he is an incredible person, outstandingly thorough, intelligent, extremely nice and he is an unparalleled surgeon. He will be recommended to friends and family members for years and years to follow.
While clinical studies support the effectiveness of these procedures, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine the appropriate treatment for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctor are not necessarily those of Robert LaPrade, MD and should not be considered as substitute for medical advice provided by your doctor.
