A quick look at improvements in orthopaedic surgery
Benjamin Thomasson, DO, with Florida Orthopaedic Associates brings the strategic mindset of a top athlete to his profession as a sports medicine and joint replacement orthopaedic surgeon.
"Patients with sports-related injuries typically know their bodies well and understand that there's a specific problem we need to correct -- they simply need guidance, expertise and rehabilitation," said Dr. Thomasson. "Both the patient and the doctor are very motivated in that relationship."
Thomasson treats athletes at all levels of competition, focusing on arthroscopy and joint replacement for the shoulder, hip, and knee. He has a special interest in complex shoulder instability, multiple ligamentous knee injuries, cartilage restoration techniques and meniscal transplantation.
Finding a calling
Thomasson's professional passion began at The University of Northern Arizona as an intramural athlete and exercise science major studying advanced treatment protocols for athletes.
"I was excited about the chance to tailor rehabilitation methods to help people return to activities they enjoy and also to physically improve the structures that were injured," he said. "The repair process and the opportunity to correct pathologies in the skeleton fascinate me."
Thomasson pursued that interest through an orthopaedic surgery residency at Rowan University in Southern New Jersey, where he gained exposure to both community hospital and research-oriented settings, including the Center for Sports Medicine at Alfred I. duPont Hospital for Children.
Afterward, he completed a fellowship in sports medicine at The University of Texas Health Science Center in San Antonio. There, he assisted the physicians for multiple San Antonio-based professional, collegiate and high school teams.
In 2015, Thomasson and his family relocated to Central Florida. Thomasson serves as a team physician for Pine Ridge High School in Deltona and University High School in Orange City, treats Stetson University athletes, and works as an orthopaedic consultant for Justin Sports Medicine in Central Florida, serving the Professional Rodeo Cowboys Association. He will also be on-staff at a Florida Orthopaedic Associates walk-in clinic set to open in Orange City in late 2018.
In his many roles, Thomasson starts with thorough assessments, asking patients about their positions on the teams, their activity levels and whether they are at risk of overusing specific muscles, joints or tendons. Rather than treating injuries in isolation, he evaluates each patient as a whole.
"People may think that the shoulder is the most important part of their range of motion, and they don't understand why they get elbow pain, so it's a process of educating them on shoulder and elbow mechanics," he explained. "Or, we might talk about core strength as it relates to abdominal, back and hip muscles. Then, we discuss how we can improve their overall well-being."
Advancements in surgical procedures
While Thomasson starts with nonsurgical treatments such as pain-relieving injections and physical therapy whenever possible, sometimes surgery is unavoidable. With the continued evolution of minimally invasive procedures and early rehabilitation principles, patients benefit from shorter downtime.
One of the more challenging injuries to recover from is a torn rotator cuff. A relatively new procedure known as superior capsular reconstruction (SCR) is a promising alternative treatment for irreparable posterosuperior rotator cuff tears, using a graft from the superior glenoid to the greater tuberosity to stabilize the humeral head. A study cited in Orthopedics Today found that in "patients who underwent SCR with a fascia lata autograft at a minimum of two years follow-up, the American Shoulder and Elbow Surgeons (ASES) score improved significantly from 23.5 preoperatively to 92.9."
Meanwhile, "a postoperative MRI showed 83 percent of patients had intact reconstructions with no progression of muscle atrophy." As a result, many patients can avoid having a shoulder replacement.
According to Thomasson, SCR delivers a distinct advantage. "With traditional techniques, even if you repair rotator cuff tendon back to the bone, many people won't regain full function of the shoulder for overhead activity, or they have persistent pain or risk of re-rupture," he said. In patients that have failed rotator cuff surgery or have tendons that are irreparable, "SCR uses a dermal graft, so we can reconstruct the superior restraint, which allows the rotator cuff to function more regularly."
As one of a handful of local surgeons conducting hip arthroscopies, Thomasson also employs minimally invasive techniques to treat femoroacetabular impingement (FAI). In this condition, extra bone grows along one or both bones that form the hip joint, causing groin pain and a "locking" sensation. FAI can be debilitating for soccer, football, baseball and softball players, as well as dancers. Thomasson uses arthrograms to evaluate the tissue and then performs laparoscopic surgery to trim the bone and repair torn cartilage.
Empowering the patient
Changes in the medical landscape are allowing orthopaedic surgeons to perform a wider range of outpatient procedures. The Centers for Medicare and Medicaid Services recently began allowing eligible Medicare patients to have total knee arthroplasty in hospital outpatient departments.
Thomasson recently performed his first outpatient total knee replacement at Central Florida Regional Hospital, which holds The Joint Commission's Total Knee Replacement Certification. The patient is an attorney and Winter Springs resident in her 40s. In the past, surgeons typically restricted joint replacement to elderly patients -- but as the success rate improves, they are increasingly offering these procedures to help younger, low-risk patients maintain an active lifestyle.
Educating patients about newer options and empowering them through the process is a foundational part of Thomasson's practice. "Patients do the best when they're the primary decision-makers," he said. "My job is to provide counsel and reduce stress. When patients meet with me, it doesn't necessarily mean they're going to have surgery. We're going to guide them toward the best treatment path, so they can return to what they love."