High-tech medicine for all of us


Knee cartilage that regenerates itself. Surgery performed by doctors operating miles away from their patients. Physical tests that can predict gold medal prospects for budding athletes.

Medical technology is on the edge of tantalizing breakthroughs, says Dr. Bill Howard, director of sports medicine at Union Memorial Hospital in Baltimore. And most of the discoveries are expected to benefit athletes of all shapes and ages.

"We're on the cusp of some really good stuff," says Howard. "When these [innovations] occur, the headlines will go to the injured stars who come off of the bench and go back into the game. But the guy who will really gain is the man on the street, the average Joe who suffers from arthritis or a torn [anterior cruciate ligament]. He's the one who'll reap the benefits."

Most intriguing: the work being done on cartilage regeneration. Cartilage is the smooth, pliable tissue that cushions one's joints and keeps the bones from rubbing together. But when cartilage wears out or is torn, it cannot be replaced - up to now, at least.

Loss of cartilage can trigger osteoarthritis, which affects millions of Americans - from the star running back crippled by a bum knee to grandma, who struggles to open her jar of pickles.

All of that may change in the next decade because of stem cell research, Howard says.

"We've tried using chemical substitutes for cartilage and taking grafts from cadavers, but the work with stem cells seems most promising," he says. "If we can find a way to genetically engineer cartilage from stem cells and teach those cells to grow like cartilage, think of all the athletes and geezers we can help."

Also in the offing: long-distance robotic surgery that would enable doctors to perform delicate operations without ever having met their patients.

"Imagine having a hotshot elbow specialist in Arkansas operate on a tennis player in South Dakota," says Howard. "The surgeon wears a pair of gloves hooked electronically to an operating machine that might be a thousand miles away. As he moves his hands, they move the surgical instruments over the patient."

Such procedures are five to 10 years off, Howard says.

In the near future, more sophisticated tests - an outgrowth of those that gauge a person's aerobic fitness - should be able to predict athletic success. At present, there are treadmill tests, used widely by marathoners, cross-country skiers and triathletes, to measure the amount of oxygen their bodies can utilize.

The tests, called VO2 max, are relatively inexpensive ($100) and available to anyone who fancies himself a high-powered athletic machine.

"Those studies can tell you if you have the genetic wherewithal to be an elite athlete, a Lance Armstrong," says Howard. "But those tests are only a help for endurance sports that include huffing and puffing.

"I suspect the time is coming when we'll be able to better predict a person's hand-to-eye coordination and tell if he or she will become a race car driver, a pingpong player or a baseball star who can hit a 100-mile-an-hour fastball. Or not."


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