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Knees get no respect

Toronto, May 7, 2014

By Geoff Koehler

Dr. Daniel Whelan
Dr. Daniel Whelan inspects the leg of a knee repair patient. (Photo: Katie Cooper)

Multi-ligament knee treatment has always taken a back seat in the pecking order of trauma injuries.

Some of that makes sense. Severe conditions such as brain swelling and blood loss should take priority. But even after such issues were treated and multi-ligament knee injuries became the primary concern, patients had nowhere to turn. There was no specialist to whom clinicians could refer patients with these complex knee traumas.

“I came quickly to recognize that there was a gap in this city for these patients,” said Dr. Daniel Whelan, an orthopedic surgeon at St. Michael’s. “And I knew that we had the specialists here who could fill that gap better than any other place.”

St. Michael’s has the most experienced and comprehensive multi-ligament knee injury program in southwestern Ontario and sees the highest volume of multi-ligament knee injuries and knee dislocations in the province.

Traumatic multi-ligament knee injuries are distinct from the type of knee injuries most people hear about. These are not like a torn ACL during a basketball game.

“By conducting focus groups and developing a patient outcome tool, I’ve come to realize that these patients really are different than the traditional type of ACL tear, meniscus tear and knee pain patients,” said Dr. Whelan. “These patients have so many other things that can influence their ability to get back to their normal life. It’s not just their knee. It’s their psychological recovery; it’s their physiological recovery after profound trauma.”

Because of St. Michael’s overall trauma expertise, the hospital can treat not only the knee injury but also handle all of the complications that often result from high-velocity accidents. More often than not, these patients have injuries to other bones and joints and can have nerve or vascular damage in those areas as well.

“We treat multi-ligament knee injuries and everything that goes along with them: vascular, nerve or fractures or wounds,” said Dr. Whelan. “We have a multidisciplinary approach with services that can help people. So we’ve given patients results that might not have been possible anywhere else.”

It takes a village

All of these areas of expertise needed to come together to put St. Michael’s on the map for multi-ligament knee injury management.

  • peripheral nerve surgeon
  • soft tissue management experts
  • orthopedic surgeons
  • vascular surgeons
  • outpatient physiotherapists often see these patients daily both before and after surgery
  • occupational therapists provide splints, braces and prosthetics for patients during their recovery from injury

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.