Hurray for Sports Medicine

I t's a cause for celebration! Sports medicine is no longer the deprived and despised orphaned child of the orthopaedic community. From its humble beginnings in the late sixties and early seventies, sports medicine and its practitioners have been viewed as being on the fringe of academic orthopaedics. Those of you in your fifth decade and better may remember when university orthopaedic departments openly ridiculed sports medicine practitioners and referred to the arthroscope as an evil instrument. As a resident, I was once laughed out of grand rounds for saying that I could see the knee joint more completely with the arthroscope than with an open incision. It wasn't cool to be a sports person back then. Much of the early development of sports medicine occurred in private practice, away from the hallowed halls of academic medicine. Traditional orthopaedics was slow to recognize the value and impact of a more aggressive approach to the treatment of athletes and active individuals. Accordingly, some of the highest profile sports medicine centers are not in university settings. Many of the centers that take care of collegiate athletic teams are not located on campus but are nearby in the community. In large part, this estrangement stemmed from major differences between academicians and sports practitioners. Many academic chairs were slow to recognize the role that sports medicine would eventually assume in modern-day orthopaedics. Those departments that did embrace sports medicine benefited handsomely in clinical care, research, and financial support, while those that didn't soon paid for their shortsightedness. I doubt anyone could have predicted 30 years ago that nearly one-third of all orthopaedic residents completing their training would pursue sports medicine fellowships, even as many traditional orthopaedic fellowship slots went unfilled. What a turnaround! How did this all transpire? When did sports medicine gain not only legitimacy but, indeed, preeminence in orthopaedics? In reality, our success is based on our research. Sports medicine's founders were true innovators—solving common orthopaedic problems in ways that challenged and, in many cases, eventually overturned traditional orthopaedic thinking. For example, everything didn't heal in casts; joint motion was an important factor in rehabilitation after injuries or operations. Menisci were not useless structures but, in fact, deserved attempts at preservation and repair. Not only was the knee joint seen better with the arthroscope, but in many cases, so were the shoulder, hip, ankle, and elbow. True, many of the above insights, …