A SPORTING CHANCE
New knee-regeneration surgery puts young Marshall County athlete back in the game.
By Susan Flansburg
The sound resonated in 14-year-old Peyton Pope’s ears. Pain shot from his knee as he tried to land his high jump event. He realized he was in trouble.
Peyton had played sports since he was in first grade. He loved sports so much that his parents always knew where to find him. He was either on the field or the court practicing football, basketball and baseball constantly. He ran track, too, until the day he tried to go a little higher during an 8th grade high jump competition.
In the blink of an eye, the up-and-coming State Center athlete was facing a career-ending injury.
We have two kinds of
cartilage in our joints.
Meniscus cartilage is the
cushioning between joint bones.
Articular cartilage is the cushioning
that adheres to the bone itself.
You’ve seen articular cartilage on
a chicken bone. It’s the smooth,
white tissue on the end.
Worse than Anticipated
“It felt like I had a bubble under my knee cap,” Peyton remembered. “I thought maybe I just needed to work through it, so I tried jogging. But it hurt too much.”
The cause of the pain wasn’t visible on an x-ray, but an MRI showed a cartilage tear. A torn meniscus was suspected – it’s a common injury among athletes – so Peyton’s pediatrician referred him to McFarland Clinic orthopedic surgeon Dr. Tom Greenwald. Known for his work with student-athletes throughout central Iowa, including Iowa State student-
athletes, Greenwald examined the young man and recommended an arthroscopy to diagnose and treat the expected problem.
What he found during surgery was not what anyone had expected. Peyton’s parents, Dana and Tedd Pope, were stunned.
“Dr. Greenwald came into the Mary Greeley waiting room after the surgery and said the injury was worse than we thought,” Dana said. “He said more surgery would be needed. There would be no football this season. Maybe no basketball. How was I going to look my 14-year-old in the eyes and tell him that he couldn’t do what he loved to do?”
On the Rise
One in 10 kids under 14 years of age gets hurt playing sports every year, according to the American Academy of Pediatrics. A recent study published in the JAMA Pediatrics journal indicates that knee surgery on teens is on the rise, climbing 44 percent between 2002 and 2014 for teen boys and 59 percent for teen girls.
With more kids playing more sports, it’s no wonder the surgery rate is rising. And it’s often warranted. Unrepaired damage can set the scene for degenerative arthritis down the road. The National Institutes of Health note that more than 80 percent of American football players who have experienced a knee injury have evidence of osteoarthritis within 10 to 30 years of their careers.
Greenwald shared his concern for Peyton’s future with his parents.
“Dr. Greenwald took the time to really educate us,” Tedd said. “He said there are quicker ways to repair the damage, but also wanted to serve his adult knee down the road. He was very encouraging. He emailed us lots of information about the new procedure. We agreed to have it done two weeks later.”
A New Approach
Peyton had suffered an articular cartilage injury, meaning the cartilage on – not between – his knee bone had been damaged. Such a large piece of cartilage had been knocked off the top of his femur that he now had what might be described as a pothole in its place.
Greenwald would repair the hole using an orthobiological treatment called BioCartilage. He is one of the few surgeons in central Iowa trained to perform the new procedure.
The BioCartilage procedure pastes a mixture of donated cartilage cells and the patient’s own blood directly onto the hole. There, the material doesn’t simply harden and sit alongside the existing cartilage, like asphalt on a concrete road. Rather, it creates a tissue scaffold that the patient’s own bone marrow cells can attach to and produce new cartilage within.
The BioCartilage surgery took place May 25, and Peyton went home in a straight brace to let his knee heal itself.
A Long Summer
Choosing BioCartilage meant choosing the longer route, one requiring intense rehab and dedication. It required a total team effort.
“I always look the parents in the eye and say, ‘We’re a team,’” Greenwald said of the decision-making process. “You, your child, the therapists, me: We’re a team. We have to work together.”
Peyton wore his straight brace all summer to give the new cartilage time to grow and strengthen. For five minutes a day, the brace came off to help shape the cartilage with very slight knee bends as he lay on his bed. Otherwise, all activities had to be accomplished with his brace on.
“We looked for ways to fill the time,” Dana said. “We went to a lot of movies. We went fishing. We went on a couple of vacations, to the Ozarks and to Yellowstone.”
Off the Couch
After three months, the brace came off and Peyton began physical therapy. It would be another five months before he could join his friends on any team.
“Everyone was at practice,” he remembered. “I was in the weight room by myself every day.”
The 2016 football season ended with Peyton cheering on his West Marshall High School football team from the sideline. Basketball began without him. Every time he asked,
Greenwald and his physical therapists said he wasn’t strong enough to go back yet.
Finally, Peyton got the green light to practice with his team. He started playing again in January 2017, and in his first game scored 35 points. By the end of the season he had been moved to the varsity team and earned a letter. The 2017/2018 season has been great, too.
“Everyone has the fear, ‘Can I get back to my sport’?” Greenwald said. “Peyton worked very hard. He’s the reason he’s where he is today.”
Dana, Tedd and Peyton credit Greenwald with the vision and expertise needed to bring the advanced treatment to central Iowa.
“It’s a very specialized procedure,” Greenwald said. “Not that many people are candidates for it. But when they are, it can be great.”
Mary Greeley Expands Acute Rehab Unit
To meet the increasing need for rehabilitation care, Mary Greeley has made more beds available in its Acute Rehabilitation unit. The unit now offers 17 private rooms, up from 12. Acute Rehab provides rehabilitation care for adult patients who have experienced stroke, neurological conditions, orthopedic surgery, or trauma.
Many of the unit’s patients initially receive treatment at Mary Greeley. However, the unit is increasingly receiving referrals for patients who have had treatment in Des Moines, Iowa City and other locations outside of Ames.
“No matter where a patient has received initial treatment, if they need rehabilitation they want to be able to do it close to home at a place that they know will provide quality care,” said Jodi Schwickerath, BSN, RN, director of Acute Rehab at Mary Greeley. “By making more beds available, Mary Greeley can better serve the needs of central Iowans.”
The rooms in Acute Rehab recently were renovated. The unit has added staff specially trained in rehabilitation to provide care for the increased patient volume.
Mary Greeley’s Acute Rehab services are accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). The accreditation demonstrates that Mary Greeley’s service has met rigorous criteria for high quality rehabilitation care.