Dr. Scott Gillogly
Getting Atlanta's athletes back on their feet and back in the game.
by Graham Garrison
When two professional football players collide on the field, Scott Gillogly, M.D., knows the feeling. As a quarterback for Army at West Point, Gillogly felt all the aches and pains that today's professional athletes do. That's what led him into a career in sports medicine and orthopaedic surgery. Along the way to becoming the team physician for both the Atlanta Thrashers and Falcons, Gillogly has served as the Chief of Orthopaedics at an evacuation hospital during the Gulf War during his military service, worked with sports medicine pioneer James Andrews, M.D., and started his own practice in Atlanta, which has grown into the Atlanta Sports Medicine and Orthopaedic Center.
Georgia Physician sat down with Gillogly to learn more about him and the advancements in sports medicine.
Georgia Physician: What are your responsibilities as team physician for the Atlanta Thrashers and Falcons?
Dr. Scott Gillogly: My title is head team physician and orthopaedic surgeon. Certainly there's a large part of injuries that have to do with orthopaedics, but by the same token there's an awful lot of other medical problems and other types of injuries. For example, in hockey, pucks to the face or head happen frequently, and so you need a team doctor. So my responsibilities are for the total healthcare and total welfare of the athletes. That involves coordinating with other physicians, experts in their own area, to be able to give athletes the best care, and with the goal toward the fastest recovery so the athlete can return to play. That's really what it's all about.
GP: Are injuries often specific to certain sports?
SG: In hockey, lacerations to the face are some of the most common injuries. Just getting hit by a puck or an elbow, and there are certainly some common things that occur in both sports. Knees, shoulders and ankles are the most common in both sports. It's a little bit different mechanism obviously with ice skates on, but remember that ice skates allow you to go fast. If you run into a person or the boards, that can certainly cause trouble. But by the same token, in professional football, you've got big, strong athletes, all performing at the highest level of their field, and that produces injuries as well.
GP: There seems to be a shorter amount of recovery time for injuries, and career-threatening injuries are almost vanishing. What are some injuries that were career threatening a few years ago that now athletes can come back from?
SG: I think we do a much better job of treating knee ligament injuries. And although it's typically a season-ending injury, it's certainly not a career-threatening injury. The results are much more reproducible and reliable. Rehabilitation is much more accelerated. Also, with shoulder injuries, we now do so many things through an arthroscope, that we're able to minimize the things that go with surgery, and therefore allow them to recover faster. I think we understand injury better, fixing fractures Ñ and the fixation of fractures allows early motion so that when the bone heals, you've already done the rehabilitation and you're almost ready to go, as opposed to the old days when you were in a cast. That's been a major change in the last decade, too.
GP: What are some serious injuries today, possibly career-threatening, that you see being able to be healed in the future.
SG: There's been a lot of research and emphasis on head injuries, in both (football and hockey). The NHL and NFL both have registries that track these things very diligently and try to come up with better equipment, rule changes and things like that to minimize the potential for head injuries. We're doing a better job of that, a better job of picking up even subtle head injuries and, therefore, preventing someone from returning too early and maybe minimizing the effect of cumulative head trauma. Back injuries, ruptured disks and things of that nature are managed much more aggressively than they used to be with minimally invasive surgery. They'll recover more rapidly.
GP: You had a chance to work with Dr. James Andrews in Birmingham, Ala. What was that experience like?
SG: I was fortunate early on in my training, even as a resident in the early '80s when a lot of these concepts were being thought up, to be exposed to those early on in my career. It really gave me a great platform to continue to develop further. I've sustained close communication with (Dr. Andrews) on all kinds of issues. I actually had an opportunity to do a fellowship after I'd been in practice for a while, which is even better because then you know where some of the problems are and things that you can further help refine. So I enjoyed a very strong relationship with (Dr. Andrews). He certainly was a mentor and set the stage for procedures and the quality of sports medicine.
GP: Do you think players are much more aware of injuries and their bodies now than in the past?
SG: Much more. With the emphasis on injuries with the media and Internet, I think there's an emphasis on medicine in general to keep the patients, and in this case players, better educated. Of course, sometimes a little education is bad, but they understand that there's a big emphasis on second opinion, agents and other people are involved ferrying people around. For the most part it has improved sports care.
GP: How is taking care of an athlete whose livelihood at work depends on his body differ from an average person who is just recovering from an injury?
SG: From an anatomic or physiologic basis, an injury is an injury. I think what sports medicine entails is a little bit more of the psychology of sports. The psychology of body, image and function that someone who makes a living through sports, they're obviously very in tune with their bodies and in tune with the fact that this is their livelihood. A weekend athlete who tears up his knee and a professional football player who tears up his knee, the physiology is going to be the same. We use the same techniques in fixing them. But you have to be much more sensitive to the psychology Ñ the motivation to return, motivation to go through the rehabilitation, the education so they don't go too fast. All things that you have to be more attentive to in the athlete. That's not to say that the weekend athlete doesn't get the same care. They've got a job and it's very important to remember that it's important to them that they can function. Think about somebody who is a laborer, who requires their legs to be able to do their job Ñ stand all day or carry things. I think that's a challenge that I enjoy, taking the common injury and the everyday guy in the everyday job and really use some of the same principles that we use in athletes to try and get them better quicker.
GP: Talk about autologous chrondrocyte implantation, a procedure you've been pioneering in the United States.
SG: When the knee, and all joints, are lined with smooth articular cartilage, it's this smooth white stuff inside the joint. When it's damaged, imagine that it's like a pothole being on the road. Well what's underneath is bone. Bone is where the pain fibers are, and it really hurts. It can happen from a lot of different mechanisms. But it's one area in the body where it just doesn't repair. It just doesn't recover, and it's been known since Hippocrates. It's a system that just doesn't repair itself. What that procedure entails is taking a little sample of the patient's articular cartilage and then it's grown in a lab, essentially in a petrie dish in Boston. We multiply the cells and we come back and put a little patch over the defect or the pothole and stretch it tight. It's not perfect, but it's a whole lot better than anything else that the body will do on its own, or any other technique that we have. That's been a problem that's been difficult for everybody to treat. There are a lot of referrals for people out of state and that sort of thing to treat people with difficult problems. As time goes on, it seems like they get more and more difficult. In other words, people who really don't have another option.
GP: You were an orthopaedic surgeon during the first Gulf War at an evacuee hospital. What was that experience like?
SG: First of all, it's war, but there was also just a lot of sitting around and waiting for the war to start. I graduated from West Point and trained at Walter Reed (the Army Medical Center in Washington D.C.) in the Army. I was an Army orthopaedic surgeon, and that's where you need to be, with the troops. So we spent a lot of time preparing for what was predicted, which were high casualties and that sort of thing. Fortunately, that didn't really pan out, so we ended up taking care of a lot more Iraqi Republican Guards and a very few number of Americans, because most Americans weren't hurt. Of course, sitting in the desert for six months is no fun. You make the best of it. There's a lot of camaraderie among the medical staff.
GP: How is your practice set up for having a complete level of care for athletes?
SG: We do have two orthopaedic surgeons, and we also have what's called a primary care sports medicine doctor, someone who has done primary care. We also have a fellowship in muscular and skeletal care Ñ running injuries, things like that. So we're very in tune with how we talk about a lot of things in how we talk about the body, but we also bring the treatment of diabetes, treatment of asthma and skin conditions, things like that, to our practice. That helps a lot to have that additional expertise.nGP
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