Carl Maronich (Host): Welcome to UK HealthCast, a podcast presented by UK HealthCare. I'm Carl Maronich. And joining me today is Dr. Austin Stone, an orthopedic surgeon and Sports Medicine physician. And we're going to be talking about the American Orthopedic Society for Sports Medicine Traveling Fellowship, which is a mouthful. So, we're going to call it the AOSSM. Dr. Stone, welcome to the podcast.

Austin Stone, MD, PhD: Thank you very much.

Host: And we're going to be getting to your selection as a fellow in that program and what all that means. But before we do that, let's talk a little bit about your background. I know with sports medicine and athletics, you've got a pretty extensive background.

Austin Stone, MD, PhD: Yes. Thank you. I am an orthopedic surgeon here at the University of Kentucky HealthCare. I practice sports medicine with orthopedic surgery, so that means I actually do the operations. I'm a team physician for the University of Kentucky and also for the Lexington Sporting Club. And then, I also take care of Eastern Kentucky University, just south of here in Richmond.

Host: Quite a bit hands-on, literally, in the orthopedic and sports programs; your own athletic background, which is pretty extensive as well.

Austin Stone, MD, PhD: Well, you know, I grew up playing sports, like most people do. I think the comradery from team sports is really a lot of fun. And then, as it evolved, I ran in high school and some in college as well, but really got into racing bicycles as an alternative once I got out of college and was in the workforce. So, cycling was a huge part of my life until it became a little bit too dangerous with all of my other responsibilities. And so, I had to hang that up. So now, I enjoy playing golf and tennis with my kids.

Host: Well, with that extensive athletic background, you were able to shift that into caring for folks. And let's talk about the American Orthopedic Society for Sports Medicine Traveling Fellowship, or we're going to call it the AOSSM, and your selection as a fellow, which I'm sure was not an easy process.

Austin Stone, MD, PhD: Yes. So, the AOSSM traveling fellowship is really unique. It's part of the society, it's a national society for sports medicine, orthopedic surgeons, and it's really also a multidisciplinary society where we interact with others practicing sports medicine, including athletic trainers and physical therapists.

So, it's a really great society that lays the foundation for providing top quality care to our athletes, not only around the nation, but around the globe. And so, it's really an honor and a privilege to be part of the society. As a full member of the society, we are sports medicine-trained orthopedic surgeon, so that's a little bit unique from the general orthopedic surgeon. And with that, we spend time educating one another, but also educating our colleagues and then also those who we work with. And so, the traveling fellowship is really meant to launch your sports medicine academic career to the next level as part of representing the society and exchanging ideas with those in other societies, on other continents.

Host: Fascinating. So, where all did your travels take you?

Austin Stone, MD, PhD: This particular traveling fellowship took us to the continent of Asia. And so, we were honored and privileged to be welcomed there. We went to Hong Kong, then to mainland China, to Shanghai and Ningbo to Seoul, South Korea, and then several places in Japan, including Fukuoka, Kobe and Tokyo, finishing our traveling fellowship at the Japan Orthopedic Society meeting there for sports medicine.

Host: Quite extensive travel. And what different sports were you exposed to? And athletes who participated in a variety of sports, I'm sure, what sports were you seeing athletes from?

Austin Stone, MD, PhD: Well, I think that the most important aspect of the traveling fellowship is really an information exchange. And so, these surgeons take care of a broad spectrum of sports. And so for instance, at the Hong Kong location, they have the Hong Kong Sports Medicine Institute where there are athletes from all over training in all the Olympic sports that they have there.

And so, you had everything from top-level swimming to table tennis and fencing, and it's really, really extensive there. And then, at the meeting in China, they had a sports medicine conference. And so, that was really focusing more on exchange of ideas with other sports medicine surgeons in China. And then, we were honored guests there, which was really a privilege to be a part of this and discuss our experiences in the United States in comparison to their experiences in China.

And then, moving forward to Korea and Japan, they have different sports complements and so I think football or American soccer is pretty universal, so we saw those athletes all over.

Host: Obviously, as a surgeon, technology is a big part of the work that you do. How was the technology different-- if it was-- when you were abroad?

Austin Stone, MD, PhD: Yeah. So, I think that in areas and countries where they have limited use of some of the resources that we do, especially including allografts. And allografts are tissue banks and donated tissue that we have ready access to in the United States. That's not the case in many of the other countries we visited.

One of the technologic innovations that we saw in China was the use of an artificial anterior cruciate ligament reconstruction. And so, that's really interesting because here in the United States we use lots of autograft tissue. But in revision settings or in settings where patients may not have the ability to use autograft tissue, which is tissue that comes from your own body, they needed a substitute. And so, one of the innovations that we saw there was the use of the artificial ligament there. And while there have been several attempts at this in the past, there's offers promising early success. So, it'll be interesting to keep an eye on that and see how that evolves.

I also think that there was a lot of different strategic changes in the operating room where when you're using autograft for reconstruction, you may have limited use of that. And so, they're really adept at maximizing the autograft tissue for their ligament reconstructions, especially in the knee.

Host: Would their surgical techniques be any different? Did you hear of things that maybe they were doing from a technique standpoint that were a bit different than what we do here in the states?

Austin Stone, MD, PhD: Well, I think there's a lot of technical overlap. However, I think relying on the use of the autograft tissue, your patient's own tissue, that sometimes, especially in revision settings, they had to change perhaps the grafts that we might use a little differently. And so, I think having that discussion and that compliment and understanding how we come at the same technical problem differently was really enlightening.

And I think it's a testament to their surgeon's expertise and adept at using materials that, while we have access to here in the United States, we may not always choose to use autograft when we have a readily bank of allograft tissue. I think that was a very important difference in sports medicine reconstruction.

Host: To kind of go to a higher level, even culturally the idea of sports medicine and treating of athletes and how athletes are dealt with, from a medical standpoint. Did you sense any real cultural differences in the way those two cultures handle that?

Austin Stone, MD, PhD: Well, I think we all share a very similar culture of caring for athletes and weekend warriors and any patient to the best of our ability, and I think that that is the most important. I think one of the major differences that we see is that their healthcare systems are very different. The cultural differences are really interesting because patients who have an injury to their knee, such as an ACL tear or a shoulder dislocation here in the United States would be seen very soon and perhaps booked with surgery within a few weeks, where it could still take four to six months or even longer in the system in Hong Kong and China. And so, I think that's a major cultural difference, that we have different expectations here in the United States of the timeliness to care, but no difference in expectation for the quality of care.

Host: Kind of extending that answer a bit. How do you think participating in the fellowship will affect your approach to patient care here in Kentucky?

Austin Stone, MD, PhD: I think that it really emphasizes that while we have our challenges here in the United States and certainly in Kentucky, that we still do an outstanding job of delivering the best care for our patients, and I think that the most important aspect that we share from this fellowship is the exchange of information and the exchange of ideas.

Every single one of us wants to deliver the best care possible to our patients, and this is an international expectation of surgeons. And so, I think sharing our experiences, sharing our understanding, and sharing our knowledge gaps are really the way to enhance the delivery of care. And bringing back that global expertise while representing the state of Kentucky was an honor and a privilege and something that I'll certainly take with me to my patients.

Host: Any other trips planned in the future that you'll be a part of?

Austin Stone, MD, PhD: Every year, we have our annual meeting. This year the annual meeting for the American Orthopedic Society for Sports Medicine will be taking place in Seattle. So, I'll be looking forward to representing the state there and in the future national meetings where we continue to have discussions will be throughout the United States. So in the short term, no, I do not plan on any more traveling fellowships. This was a once-in-a-lifetime opportunity. But I look forward to paying that forward to both my patients here in Kentucky and then participating in the national organization.

Host: Very good. Well, it sounds like it was a great trip, and we appreciate you sharing all that information with us today.

Austin Stone, MD, PhD: Thank you very much. It's great to be here.

Host: Dr. Austin Stone, thank you again. And if you enjoyed this podcast, please share it on your social channels and don't forget to check out our entire podcast library for topics of interest. And this is UK HealthCast, a podcast from UK HealthCare. Thanks for listening.