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June 30, 2010

Top 10 Week

The Super Surgeons

by Will Carroll

It's hard to say "ignore the rankings" when I'm about to give you a Top-10 list, but I'm telling you—ignore the rankings. From 1-10, these are some of the top orthopedic surgeons in the world. The rankings were based on a short survey I gave to several players and front-office types, but barely have any meaning. If anything, think of this as the program to the next time an athlete goes on a tour to find a doctor he likes. They say you can't tell the players without a program, but for years we've been asked to just accept that our favorite players and teams are relying on doctors. While I could write a book on this topic, a few hundred words on each is more than most know about any of them. So, tip your cap to the medical heroes, the super surgeons that have to put our athletic Humpty Dumpties together again:

Dr. James Andrews
Practice: Andrews Sports Medicine (Birmingham, Alabama); The Andrews Institute (Pensacola, Florida)
Team: Rays
School: LSU School of Medicine
Speciality: Elbow, shoulder, knee
Signature Surgeries: Roger Clemens (shoulder, 1985); John Smoltz (elbow, 2000)
Why He's No. 1: In baseball, Andrews is perhaps known best for things he really didn't found. Many think he invented Tommy John surgery. (That was Dr. Frank Jobe, of course.) Many think he was the first consulting surgeon. Instead, Andrews should be known for being the athlete's choice. There's a confidence that athletes seem to get when dealing with Andrews. Perhaps it's that he's known as the best, but if you get the chance to speak with him, his deep Louisiana drawl goes from being "Wow, I didn't expect that" to comforting when paired with his matchless confidence. Birmingham became synonymous with injuries, but while going to Birmingham was bad, there was always a tag on it, that a player fully expected to come back healed. An article a few years ago tabbed Andrews as "the most valuable man in sports." No one's going to argue with Andrews being at the top of the list and moreover, his American Sports Medicine Institute Fellows program helped put a couple more on the list below. His influence is going to last far beyond the careers of the men he did surgery on.

Dr. Lewis Yocum
Practice: Kerlan-Jobe Orthopedic Clinic (Los Angeles, California)
Team: Angels
School: University of Illinois Medical School
Speciality: Elbow, shoulder
Signature Surgery: Francisco Liriano (elbow, 2006)
Why He's No. 2: Yocum took over the mantle and the practice of Dr. Frank Jobe, who was baseball's first super-surgeon. Yocum didn't slow down. His work has not only followed in the footsteps of Jobe and Robert Kerlan, but he's helped oversee the expansion of the Kerlan-Jobe Clinic and its influence. Yocum has been most associated with the Angels, the team for which he's served as team doctor for years, but meanwhile he became the go-to guy for West Coast surgeries. One former GM jokingly said that he thought Yocum and Andrews had negotiated some sort of territorial agreement. "This side of the Mississippi is Andrews," he laughed. "That side is Yocum." For much of the '90s it seemed that way, with almost no other surgeons getting the attention or the high-profile patients. While Yocum has slowed down, like Andrews, he's a long way from retirement. With several high-profile doctors such as Dr. Orr Limpisvasti and Dr. Neal ElAttrache in place at Kerlan-Jobe, Yocum's influence is assured for decades to come.

Dr. Neal ElAttrache
Practice: Kerlan-Jobe Orthopedic Clinic (Los Angeles, California)
School: University of Pittsburgh School of Medicine
Speciality: Knee, shoulder
Signature Surgery: Tom Brady (knee, 2008); Blake Griffin (knee, 2009)
Why He's No. 3: The first time I heard of Neal ElAttrache, he was on a panel talking about one of the most controversial topics in sports medicine, humeral retroversion. Andrews was asked what the first thing he did when he got a new shoulder patient. He said, "I call Neal ElAttrache." ElAttrache is more known in football than baseball, but no matter the sport, he's fast becoming the go-to guy. ElAttrache got a lot of media attention surrounding the early complications with Brady's ACL reconstruction, but the results speak for themselves. ElAttrache's research has focused on shoulders, recently showing the importance of the holistic structure and coming up with an objective measuring stick for shoulder injuries. Based in LA, ElAttrache is often described as having "movie-star looks." As the brother-in-law of Sylvester Stallone, it fits.

Dr. Richard Steadman
Practice: Steadman-Hawkins Clinic (Vail, Colorado)
Team: None
School: University of Texas Southwestern Medical School
Speciality: Knee, hip
Signature Surgery: Grady Sizemore (knee, 2010); Carlos Beltran (knee, 2010)
Why He's No. 4: Steadman is in Vail for a reason. Sure, it's a nice vacation spot, but it's also ground zero for the bulk of his patients: skiers. As the long-time physician for the US Ski Team, Steadman's work on the high-impact injuries they took translated out. After the beating taken by knees of skiers was ending many careers, Steadman developed the technique now known as microfracture surgery to bring some of them back. While the surgery is still in its nascent stages in sports, more and more athletes are having the procedure and having success coming back. In essence, baseball has come to him. As the procedure gains more acceptance, more and more athletes are likely to head to Vail. Between Steadman and his associate, Dr. Marc Phillipon, who focuses on hips (Alex Rodriguez), the Steadman-Hawkins Clinic is becoming a real hotbed for baseball.

Dr. Timothy Kremchek
Practice: Beacon Orthopedic (Cincinnati, Ohio)
Team: Reds
School: University of Cincinnati Medical School
Speciality: Elbow, knee
Signature Surgery: Edinson Volquez (elbow, 2009); Ken Griffey Jr. (hamstring, 2004)
Why He's No. 5: One of the earliest of the ASMI Fellows, Kremchek is known in Cincinnati as "Doc Hollywood" for his penchant for talking with the media. It can come off as a bit corny, but once you understand the passion that Kremchek has for athletes at all levels, it makes a bit more sense. He sees his position as a chance for education. He's taken up many causes, but is focused on preventing youth arm injuries. His medical reputation has been made on his ability to get athletes back from surgery quickly. Two of the fastest recorded returns from Tommy John surgery belong to Kremchek patients. Kremchek remains one of the go-to guys for any elbow injury. Recently, I was asked by a father where he should send his college-age son. He had surgery with Kremchek in May.

Dr. David Altchek
Practice: Hospital for Special Surgery (New York, New York)
Team: Mets
School: Cornell School Of Medicine
Speciality: Shoulder, knee, elbow
Signature Surgery: Joe Nathan (elbow, 2010)
Why He's No. 6: Altchek grew up around medicine, but came to baseball in a roundabout manner. His focus on the shoulder came through his work with the Association of Tennis Professionals. He is still one of the physicians of choice when the tennis world stops in Flushing each year for the US Open. Known in baseball for his work with the Mets, Altchek has become a magnet for elbow issues due to his "docking technique," a modification of the Jobe-created Tommy John procedure. Altchek gets a lot of attention for being one of the top "second-opinion" doctors, often consulted by players that like Altchek's ability to explain things on their terms. "He makes you feel like you get it before he moves on," said one of his former patients. Given the issues that the Mets had in 2009, almost none of it attached itself to Altchek's reputation. Then again, he might have been a bit higher if this list was put together a year ago. Altchek was once in an ad campaign for one of his patient's products—Ralph Lauren.

Dr. Keith Meister
Practice: Texas Institute for Sports Medicine (Arlington, Texas)
Team: Rangers
School: Boston University Combined BA/MD Program
Speciality: Shoulder
Signature Surgery: Brandon Webb (shoulder, 2009)
Why He's No. 7: Meister is another of the Andrews proteges that started out as an ASMI Fellow. After a few years as team physician for the University of Florida, Meister headed west to start his own practice in association with the Rangers and other sports teams in the area. Meister's confidence is why many thought that Brandon Webb chose Meister over the many others he consulted with about his shoulder problem. Meister has been very hands-on, with many thinking he sees this as a career maker. No, Meister is always hands-on, no matter the athlete or the affect on his career. Ben Sheets may have already lived in Dallas when Meister did his elbow surgery, but there is a reason Sheets joked that he nearly moved in with Meister during his year-long rehab. 

Dr. Lyle Cain
Practice: Andrews Sports Medicine (Birmingham, Alabama)
Team: None
School: University of Alabama Medical School
Speciality: Knee, ankle, elbow
Why He's No. 8: Cain isn't a name that is known to many in baseball, but his work is well known within the circles of team doctors and sports medicine. "He's Andrews Jr.," said one doctor. "Every paper, every surgery coming out of Birmingham these days has Cain right there in Andrews' shadow." That's both positive and negative. Cain isn't seen as much more than Andrews' protege at this point, but the day will come when Andrews steps away from the scalpel, leaving Cain in the enviable position of trying to maintain the Andrews Sports Medicine Clinic's position as the center of sports medicine. In essence, Cain is where Yocum was 15 years ago. While he may not have a signature surgery, he has been so involved on every level, before and after the split of ASMOC, that he's well prepared. He still needs to close the deal, but almost everyone I spoke to expect Cain and ASMOC to stay at the forefront of sports medicine over the next decade. His ace in the hole is the presence of ASMI and Champions Sports Medicine, which means he's relying on Glenn Fleisig and Kevin Wilk, two of the most respected names in their fields, to help out. That's a nice gamble. If he's worried, all he needs to do is look at No. 2 for an object lesson in how to do this right.

Dr. William Raasch
Practice: Medical College of Wisconsin (Milwaukee, Wisconsin)
Team: Brewers
School: University of Chicago Medical School
Speciality: Shoulder, elbow
Signature Surgery: Yovani Gallardo (knee, 2008)
Why He's No. 9:  Raasch's Midwestern reserve keeps him off the airwaves and out of the media, but his work behind the scenes is some of the most groundbreaking. Studies he's done on mound height could change how the game is played, literally. His focus on functional shoulder anatomy and the forces created by pitching keep him and the Brewers on the cutting edge. Raasch might be best known outside of baseball's insular circles for his work on Yovani Gallardo, not only putting his knee back together, but supervising the rehab that got him back in time for the playoffs after being injured in May remains a singular feat. Raasch's low profile and focus on research may never lead athletes to line up at his door, but he's certainly deserving of his place on the list.

Dr. Koco Eaton
Practice: Eaton Orthopedics (St. Petersburg, Florida)
Team: Rays
School: Johns Hopkins Medical School
Speciality: Knee
Signature Surgery: Akinori Iwamura (knee, 2009)
Why He's No. 10: Another of the ASMI fellows to make his way onto the list, Eaton's medical background goes back further. His uncle, Vivien Thomas, is a pioneer in cardiac surgery and the subject of the HBO film Something The Lord Made. Eaton is best known for his work with knees, including being one of the first doctors that began to routinely avoid reconstructing the MCL. He has also had a solid focus on research and, following in his uncle's footsteps, has several patents for anchors and other devices used in surgery. Eaton is somewhat overshadowed in Tampa Bay by the presence of Andrews, but the results that the Rays have put up over the past few years are in large part due to the day-in, day-out presence of Eaton and his work with the Rays' medical staff. More outside patients are starting to come in to Eaton's practice, though it doesn't hurt that St. Pete is a nice place to spend a rehab.

Kevin Gengler contributed research to this article.

5 comments have been left for this article.

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