Possibilities

Much of medicine is about possibilities. There are so many unknowns, so much individual variation, and so many different ways to get a great outcome that the pathways are ripe with possibilities. Here are some of my favorite factors:

1. You can use your injury as an opportunity to get fitter, faster, and stronger. The chance of that outcome coming true is mainly in your hands but also influenced by the choices made by your physician and rehab team.
2. It is possible to repair many meniscus tears and replace missing meniscus tissue. But is that the best choice for you at this moment? Can you take the time to heal? Can you follow the careful rehab program?
3. It is possible you will develop arthritis from your injury. Can you mitigate that risk? Can you take advantage of the newly available anabolic injections and the biologic tissue replacement techniques, and optimize your weight loss program?
4. It is possible to stabilize most ligament ruptures. The techniques used are now so varied, and with so many tissue choices, that it is impossible for a patient to know all the pros and cons. It is only reasonable for a surgeon to pick the methods that produce the best result in their hands. It is possible to get back to full sports as long as all the choices work together. And though arthritis may result from your knee injury, it is possible to reduce that risk.
5. It is possible to have an artificial total or partial knee replacement and return to full running and even impact sports. Years of telling patients they could not do this led to weaker muscles and bones, depressed patients, and more joint failures than less. A return to full sports is possible only through precise surgery, biomechanical balancing, and superb rehab. This is achievable thanks to advanced robotics, 3D modeling, and advanced planning—with a clear goal of full sports participation.
6. It is possible to have your own bone grow into porous metal surfaces of an implant, therefore avoiding cement in many artificial knee joint replacements. No cement means the connection is unlikely to loosen. And no loosening means full sports participation.
7. Stem cells hold huge possibilities. Each of us has billions of them in our bodies, attached to blood vessels. When you have an injury a clarion call goes out to those cells, mobilizing them to divide, rush to the injury site, and direct the repair. The most exciting possibility lies in recruiting those cells by injecting the chemotactic factors found in the blood platelets and in birth tissues. We will get better at isolating those factors, eventually regenerating cartilage and bone with injections.
8. It is possible to embark on the “hero’s journey,” where you take your injury, overcome the anger at the accident, acknowledge the depression of lost activities, deal with the pain effectively, and establish new goals for fitness—but only if you have the mental toughness required, and a supportive team to do it with.
9. It is possible to be happy even when many things appear to be uncomfortable. Happiness is a direction, a philosopher said, and if you are getting better that is a great direction.
10. It is possible to play forever...or at least until you drop dead at age 100 playing the sport you love.