By LAWRENCE BUSER
Treatments at OrthoSouth evolving through the years
As an orthopedic surgeon specializing in sports medicine, Marcus Biggers, MD, doesn’t need to see leaves changing colors or azaleas coming into full bloom to mark the change of seasons.
He can pretty much tell by the types of injuries he sees at OrthoSouth.
“It seems like now each sport has its own subset of injuries that we’ll see depending on whatever sport is in season at the time,” said Biggers, who treats shoulders, elbows, hips, and knees, and has expertise in shoulder and knee replacements. “With football revving up now, we’re starting to see those athletes circle in with their injuries with anything from an ankle sprain to ligament injuries around the knee which we see in a lot of football linemen. Many times, it’s an MCL injury which most of the time can be managed with braces and does not require surgery.
“Once basketball season gets up and going, we’ll see a very different subset of injuries. You tend to seed more patellar tendonitis issues with basketball players and more ACL injuries with soccer and football players. You see more shoulder and elbow injuries with baseball players, especially with pitchers.”
Despite his expertise as an orthopedic surgeon, Biggers said his goal first consideration is to treat his patients’ injuries without surgery.
“Our initial goal is, if non-operative management can be an option, that’s always my preferred strategy,” he said. “We’re able to diagnose and confirm what we’re dealing with, so we know when it’s safe to let the body heal on its own. We also know when that simply is not an option. A ligament is not going to repair itself, so we have to go in and do surgery to stabilize the joint.
“When I was growing up there were certain situations where if a player tore an ACL on the football field, the doctors probably would have put them in a brace and told them they could play to the end of the season and then have surgery. We now know that’s probably not a good option to allow recurring instability. When we see an ACL tear, that’s an immediate indication to stop playing, to have an operation, and to stabilize the knee. Whether you’re a running back for Alabama or on second-string for a small high school, the treatment for an ACL tear is going to be the same.”
Less serious injuries to the ACL, such as a sprain, can be managed with a few weeks of rest, a brace and some physical therapy, he added.
Just as the understanding of injuries, treatments and healing is ever-evolving, so too is the development of new medical devices and surgical techniques.
“Arthroscopy is kind of the center of what my practice is with minimally invasive surgery using a camera inside the joints,” said Biggers. “That was something that came to be just a generation ago. It developed in the 1980s and added a lot of evolvements in the 1990s and 2000s, and now it’s something that many of us are very, very comfortable with.
“I see (older) patients now who had injuries when they were in high school, and they’ve developed arthritis and have had knee replacements and I’ll look at the incisions along their knee. I would treat a
similar problem they had in the past in a very different way. In their defense, doctors did a good job and a lot of those older surgeries worked, but they were just different than what we do now, which is a smaller incision resulting in less pain, a little faster rehabilitation and recovery, and return to the sport.
“I hear people say they had ACL surgery and were put in a cast for six weeks and I just cringe at the thought because patients would get a really stiff knee and have a really bad outcome. When I do an ACL reconstruction, I’ll have them in physical therapy the next day and working on that range of motion. At times it can be crazy to think of what was done in the past, but at the end of my career I’m sure I’ll be doing things differently that I’m doing now.”
The age of a patient is always an important factor, particularly with the elbow’s ulnar collateral ligament more commonly known as the Tommy John ligament that helps maintain the function of the elbow and allows overhead-throwing athletes maintain velocity and control.
Doctors helped former major league pitcher Tommy John extend his career by replacing his worn-out UCL with a tendon from elsewhere in his body. For younger pitchers with less mileage on their arms, a UCL problem is more likely to be an acute tear caused by throwing too hard and playing all year round.
“The ligament will just tear off the bone, but the ligament is still pretty healthy. It’s just not attached anymore,” said Biggers, who underwent specialty training at the prestigious American Sports Medicine Institute in Birmingham, whose patients include many of the biggest names in sports. “For a high school kid with a nice healthy ligament, we’ve found that if we just go in and sew that ligament back down and reinforce it with some newer implants that are available and get the athlete back to pitching in about half the time we were able to when we were doing the full-out reconstruction surgery.”
Biggers has always been a sports fan and played high school football and soccer while growing up in Greenwood, Miss., where his father is an attorney and his mother a pharmacist. He majored in microbiology at Mississippi State University and soon after entering the University of Mississippi Medical Center School of Medicine, he spent a month with a group of orthopedic surgeons.
“After about a week with them, I knew that’s exactly what I have to do and that this was where my passion was really going to be,” said Biggers, who for some 10 years spent Friday nights on the sidelines covering high school football games as a team physician. “It always seems a lot less like work when I enjoy what I’m doing.”
He and wife Anna have a 10-year-old daughter and an 8-year-old son, both of whom are involved in a variety of activities ranging from horseback riding to football.
“In the past year, with my children now playing sports, most of my free time involves their extracurriculars,” he said. “I wasn’t working last Friday, but I still was at a football game.”