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I was listening to NPR on the way to the office this morning Eek and Frank Deford was commenting on Orthopedists that were at a gathering discussing the ramifications of surgically repairing athletes joints (notably the knee, but others included) and they were lamenting the idea that these doctors knew that as a result of the surgeries they were performing, the athletes that received those procedures would be back in action on a field playing their sport.

And because of this they would continue to do significant wear and tear on these joints, especially when cartilage was compromised, resulting in painful chronic illnesses such as arthritis on setting at very young ages and these athletes or former athletes at that time would suffer a life of pain for perhaps decades.

The doctors were wrestling with the ethics involved with their trade, noting that when advised of the likely longer term consequences of a procedure, a young athlete is more than willing to take on that potential life of pain later on in exchange for the opportunity to stay on the field of play for a few more years.

I thought it was an interesting discussion. My son had a bone surgically repaired in his femur, and I know we were advised that at some point he may be more prone to arthritis in the surrounding area because of the procedure.

The Journey Continues!

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The problem is that yes those athletes may subject themselves to more pain down the line, but it's also been shown that if they DON'T have the surgery they are also subject to similar if not worse pain. ACL injuries especially they have are finding that while one may not need it to live a "normal" life, the aftermath may be worse if they do not have the surgery.

Fact is choices you make today will have consequences, good or bad, later on in life..
I don't see the ramifications for athletes being any different than the ramifications for the general public. E.G. You develop carpal tunnel syndrome from repetive actitivity on your job. You have surgery to decompress the nerve and you're fine. BUT, if you return to that job you are likely to develop CTS again at some point. OR, you work on the railroad, jumping on and off of railroad cars. You develop knee problems as a result. You have surgery and you're fine. BUt if you continue in that job you're more likely to develop additional problems.

Where are the doctors' ethical dilemmas in these situations?

To me this is a non-issue.
Back in the late 80s, I was an exercise rider for thoroughbred racehorses. It's a pretty exciting job - imagine taking a 1000 pound teenager, getting him strong and fit, then making him stay in his room 23 hours a day. He's going to be pretty hopped up when he gets out for an hour!

In separate incidents, I tore cartilage in my shoulder, and also in my ankle. The ankle required 2 surgeries. I could have let it heal on its own, but I would have probably never ridden again. My knees are shot (think of how a catcher uses his knees - jockeys do something similar).

The docs told me I would probably walk with a cane when I got older, and the ankle does stiffen up if I get lazy and don't exercise. My shoulder hurts. My knees snap, crackle and pop.

I wouldn't trade one millisecond of the time I spent on those horses to be pain-free. I couldn't imagine quitting then, and I'm glad I didn't. It was worth it! I think that a ball player who loves his sport probably feels the same way.
Last edited by 2Bmom
Interesting. The article ends with...

"It's a cruel moral dilemma for the doctors, as the youthful sweet seduction of sport trumps the everyday grace of a healthy middle age."

This is not a moral dilemma for the doctor. It's none of the doctor's business whether the athlete decides to continue playing. It's the athlete's decision. While the doctors should give considerations for the future experiences, it's not their decision. What are they going to do, not repair the body so the athlete can't play again?
I'm pretty sure I have a torn labrum in my right shoulder and a rotator issues in my left. Both injuries happened years ago but I decided not to have them repaired since my days of playing were over

Now at 46, the arthritis is creeping in and I know when a storm front is moving in long before the weather man.

I now wish I had gotten them both worked on years ago. Today I may or may not still be the best weather man around but I would still have been able to throw BP with a little zip on the ball.

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