Research, Rest, Recovery After Knee Injury

A young basketball player searched for the best doctor to treat his osteochondritis dissecans before finding Dr. Kevin Shea at Stanford Medicine Children’s Health.

Thomas Harrison loves sports. All of them, especially basketball.

So imagine Thomas’s devastation at being told he wouldn’t be able to play any sports for at least a year, and possibly never. “I cried when I heard that,” he recalls.

That was a year ago. Today, Thomas, 15, is back, fitter than before, playing sports with his friends and feeling great. The limits that the COVID-19 pandemic placed on playing contact sports did not cut down on the joy he felt reconnecting with his teammates, even on a reduced scale, on the court or the field.

Pain in the knee

In 2019, Thomas was a high school freshman and was playing basketball every day. In midyear, he started to feel a faint pain in his knee. He tried to ignore it. People told him it was probably “growing pains.” But it worsened over time to the point where he couldn’t walk, let alone play basketball.

He was diagnosed with osteochondritis dissecans (OCD), a condition in which the blood supply to the knee is limited. As a result, the cartilage softens or disintegrates. Though the exact cause of OCD is not known, there are surgical techniques available to treat it, but they all come with a degree of uncertainty as to how the knee will heal and whether its function will be restored.

“I was scared,” Thomas recalls. “I knew I needed surgery, but I worried about how it would turn out. Sports are a big part of my life, and I was always thinking, ‘What if it doesn’t heal?’ Worrying was distracting me from my schoolwork.”

A quest for the best

Thomas set out to find the best possible surgeon for his treatment. He looked far and wide on the internet, reading about physicians’ experience with treating OCD and the degree to which they were involved in research. He interviewed three physicians but wasn’t happy with any of them. He finally came upon Kevin Shea, MD, a pediatric orthopedic surgeon at Stanford Medicine Children’s Health.

“When I met with Dr. Shea, I was blown away by how much he knew about OCD. Not only was he an expert in treating it; he also leads an international research group focused on finding causes and treatments for OCD,” Thomas says.  

Dr. Shea was the fourth physician Thomas met with and was his first choice for taking care of his knee. “Some people like to have lots of information before they make a decision,” Dr. Shea says. “Others just defer to the physician to recommend next steps. I try to respect all approaches and help people find the best information available to help them make their choices.”

Surgery: Will it work?

“OCD is the end stage of a condition that can develop along various pathways,” says Dr. Shea. “In Thomas’s case, his athletic involvement triggered the condition, because of excessive use. Acute injury can also end up as OCD. But some people may have the condition without ever having symptoms, since they’re not athletic or never had a trauma to the knee.”

The treatment for OCD in young people usually begins with nonoperative approaches, such creating a healing environment with activity modification. However, since Thomas had had pain and other symptoms for such a long period of time, he was scheduled for surgery right away.

The procedure Dr. Shea used is called OCD drilling. A small needle probes the area through tiny holes in the knee to promote blood flow. The challenge is that there’s no way to predict how much healing to expect.

Thomas was diligent in his follow-up with physical therapy, doing his exercises every day. But the hardest thing about recovery? “By far, it was the mental aspect, dealing with the unknowns: Will I recover? Will I be able to play? I was a prisoner of my own thoughts for the entire recovery period,” he says.

Rehab and recovery

Athletic trainers are usually seen rushing in to help during games when a player is injured. But they are also a part of the sports medicine team at Stanford Medicine Children’s Health.

“I admire Thomas for being an advocate for his own health care,” says Katie Harbacheck, the athletic trainer who worked with Thomas. “He’s a go-getter and very motivated. He wanted the best outcome he could get and put the time and effort into recovery to make that happen.”

Harbacheck worked with Thomas’s trainer at his school to coordinate the workouts and exercises that Thomas needed to make a full recovery and come back stronger than ever.

Six months after the surgery, Dr. Shea gave Thomas the go-ahead to play sports again. Of course, Thomas was ecstatic. “Dr. Shea said I was completely healed. He couldn’t even see the scar!”

The COVID-19 pandemic has been challenging for Thomas because it makes seeing his teammates and his friends difficult. But on the positive side, he had the time to focus on his recovery without the stress of getting ready for the start of competitive playing. Now that basketball practice has started again, he’s thrilled to be back on the court.

“I’m still working on my speed and strength,” he adds, “but it’s great to be back.”