Seeing the Future: Steadman Philippon Research Institute Provides Unparallleled Technologies in Sports Medicine Research & Development
Tim Jitloff, Tommy Ford and Tucker Perkins have seen the future.
The three U.S Ski Team members have all had surgery at the Steadman Clinic and on Wednesday, they were taken on an insider's tour of the bio-motion and bio-mechanical testing laboratories at the Steadman Philippon Research Institute in Vail.
One lab looks like something out of the movie “Ironman,” with robots buzzing around doing tests on cadavers. The other looks like the Hollywood studio where that film was made.
By having both labs under one roof, it allows the doctors at Steadman to get pre- and post-surgical evaluations of motion. Restoring normal motion would be the primary goal of any surgery performed at the Steadman Clinic and Dr. Marc Philippon, who has restored motion to countless numbers of people from pro athletes and everyday working men, says having the lab right downstairs at Steadman is crucial to his success as a surgeon trying to restore normal motion to patients.
“It's really a big, big part of understanding of how these injuries happen and how we can correct them,” says Philippon.
In addition to having a 10-camera motion-capture system like the ones used to create characters in video games and animations in movies, at Wednesday's tour we see the bio-motion lab also has a bunch of sports equipment lying on the floor. One end of the lab itself actually looks like the inside of a hockey arena, right down to the plexiglass barrier protecting the fans from wayward pucks. In front of it is a soccer ball, a tennis racquet, a hockey stick, a baseball glove, a golf club, a basketball, and a good-looking woman wearing ski boots on an Astroturf surface. Her name is Katharine, and she tells Jitloff, Ford and company that while she's no ski racer herself, she can simulate the motions well enough to learn what forces the body is enduring while racing, and where. She does her demonstration, standing on a force plate and leaning into turns like a ski racer would, with assistants using ropes on either side of her to keep her from falling.
She's wearing a number of reflective markers, which infrared lights shine on and reflect off of. A nearby computer picks up the reflective markers, which are assigned to specific anatomical locations, and generates an image in real time.
“From that, we can calculate angles,” says Dr. Eric Giphart, a senior staff scientist in the bio-motion lab. ”So we can see how deeply we're squatting, and from the force plate we can actually figure out what the loads are on the joints. We can do that with any kind of sport.”
‘Outcome based' research
It has a setback, though, says Giphart. If you want to study leg muscles and you put a marker on a leg, he explains, the skin can move more than the muscles, which move relative to the bone and not the skin.
Which is why the Steadman Philippon Research Institute is one of only a five places in the world that has a biplane fluoroscopy system — a stereoscopic X-ray machine that uses multiple “eyes” to record and create a 3-D movie of a moving joint. It records your motion at 1,000 frames per second, so doctors can slow it down and really see how the joint is functioning under regular motion, like walking or jumping.
“The main thing that's different here,” says Giphart, “is that we have these two systems side-by-side.”
Giphart explains that following a surgical treatment, Steadman Clinic patients walk through the biplane fluoroscopy system so doctors can “see if surgery really returned that motion back to normal.”
The Steadman Philippon Research Institute is a leader in what they call “outcome based” orthopedic research. Following surgery, they track patients for 20 years, and their database consists of more than 20,000 people. The goal is to publish the outcomes so that the medical community may benefit from the information in the database.
A walk through the bio-motion lab's biplane fluoroscopy system following a surgery would be one example of the institute studying the outcome of a procedure.
But before walking through that machine, you'll be thankful to know that next door, in the institute's bio-mechanical testing lab, there's a room full of machines designed to gather info about how your surgery should best be performed, before it is performed. Those machines test out devices that are to go into the body, before they go into the body, so doctors don't have to learn the hard way that, while they are FDA approved, not all devices are created equal.
On Jitloff, Ford and Perkins' tour of the bio-mechanical lab, they were introduced to a robot named Rosie.
Doctors insert cadaver knees and shoulders into Rosie, who does tests on those joints. Doctors will then cut the ACL on that knee, repeat the test to identify things like where the variation in weight displacement is occurring, before doing a reconstruction on that same knee and repeating the tests to see how well the reconstruction went.
“There's a lot of ways to do a reconstruction,” explains Dr. Coen Wijdicks, a senior staff scientist. “What we're trying to figure out, using the robot, is what is the best way to do a reconstruction.”
And by most accounts among their patients, they have it pretty well figured. The Steadman Clinic's reputation among U.S. professional athletes is virtually undisputed as the top center for knee, hip, shoulder, ankle and hand injuries.
Following the tour, Tucker Perkins talks about his particular procedure.
“It's so obvious that all care isn't the same and that these guys are the best in the world,” he says. ”I have two weeks left on an ACL injury, I had the surgery in March and I haven't felt better. We have other guys on the team with knee injuries who have had surgery elsewhere, and they aren't where I'm at right now.”
For him, returning his motion back to normal means launching 20 feet out of a 22-foot halfpipe.
“Forty-five to 50 percent of the men's field didn't finish the season due to ACL injuries,” says Perkins.
He says for him and the rest of those injured freeskiers, the mental component to getting back on the snow is as large as the physical.
“I have all the confidence in the world in the institute and the doctors,” he said. “And that's a huge piece of it, just the trust you have of everyone here.”