Leaping forward with lower limb research

You are a clinician-scientist at the Sports Surgery Clinic and Dublin City University – what drew you to surgery?

My father was a doctor, so I was interested in medicine growing up in Dublin. I was also sports-mad as a teenager, I played everything I could and my main sport was rugby. I was drawn to sports medicine, so I could be a doctor and go to work in my tracksuit. My father asked me if I was interested in diagnosing injuries or if I wanted to treat them as well. I wanted to treat them, and that led me to train as a surgeon.

Along the way you have published prolifically – what sparked your interest in research?

I knew that having research on your CV gave you that bit extra, so when I was doing my basic surgical training in Cork I did some research with James Harty on hip resurfacing prostheses. Then I went to Cappagh to specialise in orthopaedics and I knew I had found my calling. I did my MD there with John O’Byrne looking at metal-on-metal hip replacements. I spent around 18 months growing cells in the lab and exposing them to metal ions.

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What influence did that experience have on you?

Once you have plugged into that way of scientific thinking, you can apply it to your clinical work. I really loved it, it crept up on me. I enjoyed writing, and seeing your papers published is such an achievement, it is like winning a match. I found it became addictive. I wrote about a dozen papers during my fellowship in Colorado, when we were living up in the mountains.

I don’t really see the surgery as work, but when I’m not at work I enjoy cycling and running – my days of contact sports are behind me

When did knees become your thing?

My wife wanted to live in Australia for a while so we went to Melbourne. I became director of research at Orthosport Victoria, and I also did my PhD there with Julian Feller, who specialises in soft tissue injury of the knee. I was particularly fascinated by the anterior cruciate ligament or ACL. Then I came back to Ireland last year to take up a professorship in Dublin City University and a consultant position at the Sports Surgery Clinic.

[ Surgery waiting lists: ‘Emergency department patients will always win over elective patients’ ]

What has changed in the last couple of decades about lower limb surgery?

We can do so much more for injuries such as ACL ruptures or meniscus tears – we can diagnose them much more efficiently now compared to 10 or 20 years ago. The tools we have as surgeons have improved too, including cameras to see inside a joint during surgery and numerous devices that can be deployed inside the knee to repair the meniscus or reconstruct the ligaments. There are some really brilliant inventions that make surgery a lot easier.

What is keeping you busy now?

Key for me starting off in this new practice is to develop a registry at the Sports Surgery Clinic. That means we collect data at baseline from patients, then measure changes during and after the intervention, whether it was surgery or not. I’m also looking at radiological and clinical methods beyond MRI to assess joints more effectively ahead of surgery.

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And if you ever get to take a break, what do you do?

I don’t really see the surgery as work, but when I’m not at work I enjoy cycling and running – my days of contact sports are behind me – and listening to audiobooks. Most of all though, I love spending time with my family. I used to bring our kids snorkelling in Australia, and that’s something I want to start doing again. There is nothing like plunging your face in the sea to clear the mind, though the brain freeze might be more of a thing in Ireland.