When an athlete comes to the end of his/her career, there is an emotional and physical transition process that takes place. With a career-ending injury, however, the cause of this change is sudden. An abrupt and unexpected halt leaves no time or opportunity to plan for a transition out of the sport. An athlete is hard-pressed to come up with solid coping strategies to alleviate the shock and make the necessary lifestyle adjustments associated with unanticipated sports’ retirement. The distress is even more severe when the injury is unusually complicated, with no defined protocol on how to address it or professional consensus on how to repair it. A complex knee ligament injury with severe cartilage damage ended my collegiate athletic career. Prior to Dr. Minas, I was heading in a downward spiral, living each day in chronic pain. I had seen multiple doctors and had multiple procedures which failed to resolve my problems; my injury proved to be very challenging to the top in the orthopedic field. Upon meeting Dr. Minas, however, I knew I was in excellent care. He took interest in me both as a person and an athlete. Dr. Minas took the time to understand my personal well-being goals, which were considered in his overall approach and plan. He addressed the complexities of my injury in a confident and pragmatic manner, thoroughly explaining his surgical plan while answering all my questions and concerns. In addition to being extremely talented and highly accomplished in orthopedics and cartilage repair, Dr. Minas was one of the most down to earth and approachable surgeons I had ever met. Even after an extended day of surgeries where it was well after hours, he stopped in the post-op room to explain my procedure outcomes. The next day, Dr. Minas personally checked on me before being released from St. Mary’s Hospital. To put me on the path of healing and regaining an active lifestyle, Dr. Minas recommended an innovative cartilage procedure called matrix autologous chondrocyte implantation (MACI) with a high tibial osteotomy. With MACI, Dr. Minas took a small sample of cartilage from my knee and sent it off to a lab, where new cartilage (my own) was grown. Dr. Minas then implanted these tissue cells back into my knee. For the first six weeks after surgery, I was touch-down weight-bearing and used a CPM (continuous passive motion) machine for 6-8 hours a day to prevent stiffness and promote healing. Several months of physical therapy enabled me to build muscle and regain strength in my leg. After a total recovery period of about a year, I am happily enjoying hiking, biking, and other physical activities that previously caused me great pain. I recently celebrated with a trip with friends to Denver, Colorado, where we hiked over 15 miles up and down beautiful mountains. Dr. Minas’s compassion and dedication to his patients is evident. It was clear that I was more than just a damaged knee; Dr. Minas treated me as a person–a young athlete going through a full healing process. I am very grateful and fortunate to be under his care.

Twenty years ago, at the age of 46, I was told that I needed a total knee replacement. At the time, I was managing my busy orthodontic practice, coaching Little League baseball, and raising a young family. The news was devastating. As I traveled the country seeking other opinions, I became accustomed to hearing the same dire descriptions of my knee’s poor prognosis. It wasn’t until I met Dr. Tom Minas that I began to regain a sense of hope and optimism. I had suffered a rare complication of routine knee arthroscopy. A long-time runner, I had felt a pinch in my knee after a long run, and I was diagnosed with a torn meniscus. A few weeks later, I had a 15-minute knee ‘scope’ and was told to return to normal activities within a few days. But the pain and swelling persisted and subsequent x-rays revealed that I had developed avascular necrosis of my femoral condyle. The blood supply of my thigh bone had somehow been compromised during the surgery and now I was limping on a progressively deteriorating knee. The only option seemed to be surgical removal of the necrotic area and prosthetic joint replacement. Fortunately, one of my orthopedic surgeon friends referred me to Dr. Minas. At the time he was seeing patients at his Cartilage Repair Center at The Brigham and Woman’s Hospital in Boston. Dr. Minas introduced me to the concept of biologic joint preservation and cartilage repair. In 2001 I had an A.C.I. procedure (autologous chondrocyte implantation) along with a High Tibial Osteotomy. The post-operative physical therapy was at times challenging, but I was soon able to return to an active lifestyle which included hiking, cycling, and swimming. Most importantly, my knee was no longer a limiting, defining factor in my life. I also discovered that although Dr. Minas is a world-class expert in the field of joint preservation, in person, he behaves more like a small-town doctor. He always took the time to listen to my questions and concerns and he has surrounded himself with wonderful, compassionate people. Since my initial surgery, I have had a few more procedures, and that’s the nature of joint preservation. The process requires careful monitoring and realistic expectations. But by choosing an option other than total knee replacement, I extended the life of my biologic joint and I’m living proof that this treatment approach is remarkably valuable. Now, 20 years after my initial injury, I am so grateful to Dr. Minas and his exceptional staff. As a Florida resident, I was thrilled to hear of his recent move to the Paley Institute in West Palm Beach. But the truth is that I would willing to travel to see him regardless of his practice location, and I’m sure that most of his patients feel the same way. Thank you, Dr. Minas!

Dr. Minas was recommended to me by my primary care physician about 10 years ago after I injured my knee playing rugby. Being a rugby player, I dismissed it, took a few aspirins, and played for another 6 years before the pain became too great to continue. I finally broke down and decided to look into MACI. I learned what I could about the procedure, and although the rehab and total recovery time seemed brutal, the technology was fascinating enough to me (as a chemical engineer) that I decided to go ahead with it. Basically, part of the reason I got MACI is because it sounded cool. Prior to surgery, I was able to walk and sprint without too much pain, but any jogging caused me excruciating pain in my knee. This would cause my knee to swell, which would then make any movement more painful, and further increase swelling… and the cycle continued. Ibuprofen multiple times a day was part of my routine – sometimes 4 or 5 pills at a time on practice days. The arthroscopy was incredibly quick and easy, and I could have walked out of the operating room if I wanted. The next phase I knew would not be so easy…The MACI I got required an osteotomy as well, so determining what parts of the recovery were specific to that, and which to the MACI is difficult. Either way, there is no sugar coating it… the weeks following surgery were some of the most unpleasant of my life. I had never had major surgery before, and as an active person, sitting on a couch for weeks at a time with uncontrollable leg swelling was a private hell. Someone should contact the pope, because my wife truly deserves sainthood for dealing with me through it all. While she was working, anything I could do to take my mind off the pain and the boredom was a welcome distraction. I wrote some poetry I had been thinking about for years. I taught myself stone carving and carved a chess set. I planned and executed a live-action Clue night at my house, with me as the crippled party host. I built several massive spreadsheets to determine my fantasy football teams’ best strategies. I started writing a gratitude journal (my wife was obviously the first entry). Mostly though, I just became far too familiar with my couch cushions. But when the day came I was allowed to start walking on my own again, the real path to recovery began, and it has been a long road I’ve still not fully finished (I am 15 months post-surgery at the time of this story). Feeling strength return and finding myself able to do small things again (walking downstairs normally, putting on socks standing up, etc) has been more satisfying than I anticipated. The biggest excitement for me though has come with being able to do the larger things again. I got married a few months before my surgery, and with the craziness of the year, we didn’t have the time to take a honeymoon. As a result, we knew it was going to have to wait until after the surgery… Which complicated the type of honeymoon we could do. My wife and I both enjoy hiking (the western hemisphere’s most-climbed mountain – Mt. Monadnock – is in our backyard, and hiking it five or six times a year isn’t unusual) so we knew no matter what we did, I would need to be able to at least hike on it. We scheduled the honeymoon for 14 months after surgery and hoped for the best. Throughout physical therapy, I had one question that I kept asking: Will I be able to hike? My exercises focused on the muscles needed for that movement, and despite the initial atrophy from 3 months of no movement, after a year the only way to tell which leg had surgery was by the scar. I hiked Monadnock’s 2,100 vertical feet a little over a year after surgery, and though I wobbled a bit on the way down (turns out the stabilizer muscles take longer to get back, and it’s hard to stay in cardiovascular shape with gimpy legs) I made it up and down. I had passed my self-imposed first test for the honeymoon hike. We decided to take our honeymoon in South Africa, and Table Mountain (one of the seven natural wonders of the world) is right in the heart of Cape Town. Since we were planning to be in Cape Town for three days, we decided that climbing it absolutely had to be one of our activities. It is about 50% taller than our hometown mountain, and the top is a massive plateau that can be accessed by foot, or by cable car. I had originally chosen the shortest hiking route up, but after how good my knee felt on my hike back home, we decided to take a much more scenic route that was over twice the length and covered much rougher terrain. We made a great decision, and this was truly one of the most scenic hikes I had ever taken in my life (for perspective, I proposed to my wife on Katahdin’s Knife Edge, which was previously my top pick). Many of the plants in this part of the world are found nowhere else on earth, and at times it was like hiking through Jurassic Park – only the dinosaurs were about 6 inches long and scurried under rocks when you approached. After three hours of hiking, I was exhausted, but of all the parts of me that hurt (every muscle of my legs and feet), my knee was not one. It actually felt better after three hours of scrambling up ladders, rocks, dirt paths and logs that than it did prior to surgery. I was in much worse cardio shape, no question, but my knee actually didn’t hurt. And I’m not even close to done healing. The last hour of

I was referred to Dr. Minas in May 2019 after an unsuccessful autograft revealed that my 33-year-old knees had more damage to the bone than the procedure could fix. It was recommended that I get an allograft procedure, which was a specialty of Dr. Minas’ and his office quickly reached out to set up a consultation. The appointment was promising: I was a perfect candidate. I had X-rays and an MRI of my right knee and I was placed on a waiting list for an allograft from an organ donor. I received a call on a Friday in November after work that they had found a match. It was exciting and nerve-wracking all at the same time–I was told I had 6 days to get an appointment with my primary care physician to get medical clearance for surgery, notify my job, and book a flight to get down to Florida for surgery. It was a whirlwind and a lot to process, but the plans fell into place and I was able to accept this donor’s gift. The staff at St. Mary’s was wonderful, the surgery was a success, and Dr. Minas and his team made sure I was set up for a successful recovery. Many weeks were spent on crutches and a cane, countless hours on a continuous passive motion machine, many months of physical therapy, but in the end, the payoff was worth it! My knee was almost pain-free for the first time in years. I went back down to the Paley Institute for my 3-month post-op appointment and Dr. Minas was very happy with my results. I knew that my other knee was as bad or perhaps worse than the first, and I was eager to see if my left knee was also a candidate for an allograft, so we started the process over again! X-rays, MRI, the waiting list… with a global pandemic thrown in the mix. There were some temporary layoffs at the hospital which put things on pause for a bit, but once the staff was back at work, it was only a few short weeks before they found a match and I had my left knee allograft at the end of June 2020. The experience was slightly more stressful because of COVID-19, but I felt confident in the precautions the hospital had in place and the surgery went smoothly. I’m now again around my 3-month post-op mark, and still have a long road ahead. My left knee had more damage than the right so I have spent 12 weeks on crutches and had a much more conservative physical therapy regimen. Even so, I’m looking forward to jumping on an elliptical at the 6-month mark, increasing my muscle strength, improving my balance and range of motion, and generally being more active without being limited by pain. Hopefully for many, many years.