Past Issues  |  Subscribe  |  Advertise  |  About Us  |  Log In  |  My Account

  28.0F  |  Weather & Snow Report »

Park City Magazine / Winter-Spring 2009 / The Knee Docs

The Knee Docs

Ask around town — heck, ask around the nation or even the world for that matter — for the docs you want to fix your gimpy knee, and the answer may well come back, “Rosenberg and Cooley.” It comes with bragging rights, as in “Tiger Woods’ docs fixed my knee too!” Whether it’s Tiger, a Kamas farmer, or practically the entire U.S. Ski Team, doctors Tom Rosenberg and Vern Cooley use the same advanced techniques Rosenberg began perfecting three decades ago.

Ryan Archbold is Dr. Cooley’s patient. With Archbold under anesthesia, Cooley makes an inch-and-a-half long slice below the front of the knee and extracts what looks like a foot-long flat noodle. It’s actually a hamstring tendon — one of six in a knee joint. Within half an hour, it will become a new ACL, replacing the one Archbold snapped in a soccer game.

Physician Assistant Steve Klatt goes to work on the hamstring tendon on a separate table, folding it over twice and sewing it into one piece, creating a fat new ACL. Meanwhile, Cooley pokes three more holes around the knee. A small camera — the arthroscope — goes into one of the holes. A drain tube goes in another, and a straw-sized steel tool with a spinning surgical blade goes into the third. These are motions the medical team goes through a thousand times a year, year after year. No one has to say a word or ask for a tool. Everything is delivered exactly when needed.

“We get known for being proficient because we’re so ultra sub-specialized,” Dr. Cooley says post-surgery. His mentor and partner, Dr. Tom Rosenberg, pioneered the techniques. Rosenberg’s own early mentor was the father of a third partner, Dr. Mike Metcalf (who specializes in shoulder injuries). His father, Dr. Robert Metcalf, was experimenting with arthroscopy — seeing inside the body through cameras — in the late ’70s at the University of Utah College of Medicine. “He was the first great teacher,” Rosenberg recalls.

Post-surgery infection risks and recovery times increase with incision sizes, so the notion of using a camera to see inside the body and inserting small tools through straw-sized holes to do surgery was revolutionary. Robert Metcalf was the pioneering teacher, while Rosenberg designed the surgical tools that go inside and do the work. Both the tools and the techniques are now in use around the globe.

As his career was starting, Dr. Rosenberg moved to a house near East High School in Salt Lake City, where high school jock Vern Cooley was a neighbor. Suddenly, at age 18, Cooley found himself with testicular cancer. He was in and out of hospital rooms for the next six months.

“The physicians and nurses and people working in the hospital played a huge role in my life,” Cooley says. “When I saw what an impact a doctor could have, I said, ‘I’d like to do that.’” After finishing medical school at Harvard and a residency in Seattle, Cooley returned to Utah to study sports medicine under the tutelage of his old neighbor.

Rosenberg pioneered the technique of using one hamstring folded twice to replace the ACL, using a screw on one end and his own device called an “endo button” on the other to secure it into place. Many surgeons use two hamstrings, or take tissues from cadavers, and use different attachment techniques.

“We’re pushing the knee beyond what it was designed to do,” Rosenberg says of today’s athletes. He speculates that the first widespread ACL injuries probably began when Native Americans invented the game that evolved into lacrosse. The knee, quite simply, is now being used in ways that exceed its evolutionary purpose. “Put on a six-foot ski and a rigid ski boot — why would [the knee] withstand those stresses?” he asks.

Rosenberg now concentrates on arthritis and total knee replacement surgeries, while Cooley handles most of the ACL repairs, using his mentor’s techniques and tools. They team up occasionally in the OR, like when Tiger Woods came limping in for ACL surgery last summer. Woods had just won the U.S. Open Golf Tournament, in a heroic 19-hole playoff, where he clearly played through intense pain, leaning on his club like a crutch whenever he could. After winning the famed tournament, he came knocking on the door in Park City, his third trip to the clinic since 2002.

“We’ve learned a lot from Woods,” golfer Rosenberg says of Woods’ involvement in his care and rehabilitation, “… [about] making your own decisions, the value of work, the value of concentration.” Cooley, also a golfer, agrees. “He’s down to earth and a lot of fun. He tries to be an everyday guy.”

The knee docs are high on all of their patients. Cooley says they’re extremely motivated to get better. And, notes Rosenberg, “The Summit County population is the healthiest population in the whole state.” Both doctors stress good nutrition and year-round conditioning as keys to avoiding injury. “Park City can lead and be a model in preventative health,” Rosenberg says, adding some advice he’s learned over the years:

“Never repeat a negative thought. No baggage. No worries. And … no desserts!”

Frequent contributor Larry Warren is crossing his fingers that he won’t be a patient for a second time at the Rosenberg Cooley Metcalf Clinic.

Rosenberg Cooley Metcalf Clinic, 1820 Sidewinder Drive, Park City, 435.655.6600, rcmclinic.com