David Mack, MD, board-certified orthopedic surgeon and sports medicine physician, practices with North Cypress Sports Medicine Center in Houston. Dr. Mack has served as the center's medical director since its inception. He focuses on reconstructive surgery of the shoulder and the knee. Dr. Mack performs procedures at North Cypress Medical Center, Cy-Fair Surgery Center, Methodist Willowbrook Hospital and Wortham Surgery Center.
Here he discusses what fields he considered before committing to orthopedics, his current involvement in a clinical study and what he sees down the line for shoulder and knee surgery.
Q: Did you consider another specialty before becoming an orthopedic surgeon?
Dr. David Mack: I didn't know which specialty I wanted to pursue when I started medical school, but I always knew I was interested in surgery. I seriously considered being a heart surgeon during the first part of my training, but quickly ruled that out after seeing the lifestyle that specialty demanded: being on call 24/7, never seeing your family, etc. It wasn't for me.
I then looked into otolaryngology and head and neck surgery. I worked with very reputable doctors at the school, and it seemed like a plausible career choice. However, I soon learned that the field was often closely associated with head and neck cancer. The procedures are necessary, but are often mutilating and sad for the patients.
I decided on orthopedic surgery very late in school. The more I learned, the more I liked it. And here I am today.
Q: How has your experience treating athletes contributed to your overall view of the orthopedics and sports medicine?
DM: Athletes really typify the reasons I went into orthopedics. Many doctors deal with life and death, and it's very admirable, but orthopedics is more focused on quality of life. An athlete is the kind of person I really enjoy treating. They have a focused problem and treatment often allows them to go back to enjoying what they do. They are very motivated patients, which offer a very goal-oriented approach to the program. I get them back to playing soccer, tennis and so on. It's very satisfying for them and me.
Q: Orthopedics procedures are routinely performed in the outpatient setting. Do you think this will become more and more common over the next few years?
DM: Orthopedic procedures in the outpatient setting have really exploded in the last 15 years – virtually all that can be done in that setting is (there is almost nothing you can't do as an outpatient today). While I think we've maximized on the practice, it's possible they may become even more common with Obamacare and other drastic changes in the healthcare system. There is a huge emphasis on cost-control these days: we have lots to do, but with a limited budget.
Q: What areas of orthopedics and sports medicine research are you currently interested in?
DM: Lots of really exciting things are in the works. I personally am currently involved in a 10-year follow-up trial of the ConforMIS iUni® G2 knee resurfacing device, an FDA cleared implant for patients with osteoarthritic damage in a single compartment of the knee. The clinical study has been in place for a little over two years and is being conducted by seven physicians across the nation. What's interesting about this implant is that it is the only unicompartmental implant designed specifically for each individual patient. Other research that I'm keeping an eye on is cartilage preservation, which may eventually eliminate the need for joint replacement. I see a lot of potential there in the next five to 10 years.
Q: How do you think knee and shoulder surgery will change over the next decade?
DM: The research I mentioned definitely plays in here. For the knee, I think cartilage-preserving technology and products will be more widespread. Much is being done with cartilage growth as well, either via stem cells or genetic engineering. Small, niche companies are spearheading many of these projects now, but that won't be the case for long.
In terms of shoulder surgery, there has been an explosion in understanding of how rotator cuffs heal after rotator cuff surgery and how we can improve upon that. Patients who don't do well after rotator cuff surgery often need to go back under the knife for a total shoulder replacement, and we're trying to eliminate that next step. A lot of our knowledge today comes from stem cell research-based technology, and as a result improved outcomes are on the way.
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