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of therapy is typically a modification of the patient's athletic routine, though that is not an option for all active patients. Nonsteroidal anti-inflammatory drugs and physical therapy are also included in treatment regimens. For FAI, Summit Orthopedics' physical therapists prescribe exercises to strengthen core, gluteal and hip muscles. Next, some patients may be offered cortisone injections and, Dr. Skendzel says, "when they still experi- ence pain despite all those options, we consider surgery." Performing the surgery arthroscopically, the Summit Orthopedics team completes the outpatient procedure through three small incisions, repairing the labral tears due to FAI in only a few hours. "We remove any bony prominences, which cause impingement to the labrum," Dr. Skendzel says. "We then affix the labrum to the cup with sutures placed with the aid of an arthroscope." Despite its minimally invasive nature and relatively short operating time, labral tear repair is still a major surgery. Patients recover over four to six months. "A properly organized rehabilitation protocol is as important as the surgery itself," Dr. Skendzel says. "We help patients rebuild muscle tone and regain firing patterns, ultimately returning the hip joint to normal." Knee Injuries and Repairs Similar to hip repair, knee reconstruc- tion involves open communication with the patient, Dr. Skendzel says. A careful physical examination and detailed history accompany a discussion about the patient's activities and goals. From there, Dr. Skendzel can tailor a treat- ment program from among his highly technical offerings. "My niches are high ligament knee reconstruction, torn anterior cruci- ate ligament [ACL], media collateral ligament [MCL] and posterolateral cor- ner injuries, and revision ACL surgery," Dr. Skendzel says. "We also treat complex meniscus injuries." "In sports medicine, a treatment plan cannot be simply 'good enough' — it must be perfect. We strive to return patients to the activity level they attained before treatment or even higher." Jack Skendzel, MD, sports medicine physician, Summit Orthopedics Physicians are becoming increasingly aware of the meniscus' role in patients' ongoing well-being, accord ing to Dr. Skendzel. In addition to its importance as a shock absorber, it prevents people from developing arthritis later in life. "Meniscal preservation is a fundamen- tal principle of knee surgery," he says. "We typically trim or repair the meniscus, removing as little as possible." Torn ACLs and MCLs also occur more often among active people. "In repairing ligament tears, physicians must consider the best graft selection," Dr. Skendzel says. He finds that cadaver tissue results in a higher graft failure rate in young and active patients as compared to a graft from the patient's own tissue. "Every patient is different," he says. "Sometimes I use a graft from the patient's hamstring or patella tendon, whereas other patients have a bias toward an allograft. I construct a treatment plan based on the whole person, including their age, activity level and general health." Dr. Skendzel also helps patients who have had less-than-successful knee surgeries elsewhere. Grafts can fail due to technical error or missed injury as well as graft selection, but Summit Orthopedics' physicians are available to help patients analyze and correct the problem. "The surgeon may not have placed the tunnels correctly in an ACL reconstruc- tion, or he or she may have missed another ligament tear," Dr. Skendzel says. "If you treat only an ACL injury while overlooking other injuries, you place too much strain on one ligament, increasing the chances of failure." Most of all, the physicians at Summit Orthopedics wa nt to help patients achieve their goals. "We ta ke pride in educating our patients," Dr. Skendzel says. "We show them their X-rays or MRIs, tell them about their patholog y, and explain options to them. In sports medicine, we take the time to make the best decisions that will keep patients safe and benefit them in the long run." To learn more about Summit Orthopedics, visit www.summitortho.com. ■ M D N E W S . CO M ■ MD NEWS Minnesota | 1 1