Orthopaedics may primarily be a surgical specialty associated with conditions of the musculoskeletal system, but it is also about keeping people well and moving, without necessarily going under the knife.
At Quantum Orthopaedics, Dr James Tan aims to quash the common misconception that seeing him for orthopaedic treatment will invariably lead to surgery.
He emphasises his mission to partner with patients in their musculoskeletal health through a spectrum of treatments with surgical intervention only where appropriate.
As a doctor and avid cyclist, runner, and golfer, his goal is to help people regain their function and quality of life and be as active as possible in the sports and activities they love.
With over 10 years of experience in sports surgery and exercise medicine, Dr Tan is an expert in treating sports injuries of the knee, shoulder, and elbow joints, as well as cartilage and meniscus.
He is also well-versed in minimally invasive keyhole tendon and ligament repair, joint replacement, and muscle and tendon transfers of the shoulder joint.
Apart from surgery, Dr Tan has a keen interest in non-surgical joint rejuvenation and restoration treatments. One promising area is biologics, such as hyaluronic acid and platelet-rich plasma (PRP) injections.
Hyaluronic acid injections are often used to treat osteoarthritis and arthritis in the knee.
The gel-like substance is injected into the knee joint, increasing lubrication and improving the 'cushioning' effect between the bones to reduce pain. It may also promote the regrowth of cartilage and bone.
PRP injections use platelets taken from the patient’s own blood mixed into a plasma base.
When injected into an injured area, the platelet-rich plasma releases growth factors that stimulate and increase the number of reparative cells, enhancing the body's natural healing process.
PRP injections are usually used for soft tissue injuries, such as minor rotator cuff and Achilles tendon tears, tendonitis, and conditions such as tennis elbow or golfer's elbow. They can also be used to treat ligament and muscle injuries.
“There is new evidence that PRP plus the gel, when used in conjunction, can help reduce symptoms much more effectively,” he adds.
Other treatments include collagen injections that are administered directly into injured soft tissues.
“This form of collagen is more effective than oral supplements and is especially useful in instances when tissues are inflamed but not necessarily injured; it is good for chronic neck and back pain.”
One of the newest protocols is polynucleotide injections. According to Dr Tan, this gel contains salmon DNA, a bio-stimulator that promotes tissue regeneration and has an anti-inflammatory effect.
“It can be used for knee osteoarthritis, bursitis, as well as injuries in the tendons, ligaments, and cartilage.”
Such treatments address the root of the problem, compared to pain or anti-inflammatory medications, which only tackle the symptoms, he notes.
“We are moving away from not only symptom relief, but getting to the source of the problem.”
“We are moving away from not only symptom relief, but getting to the source of the problem.”Dr James Tan
He adds that it is important to approach musculoskeletal health beyond surgery but to find ways to extend the ‘runway’ of health by alleviating joint damage and minimising pain for more sustained periods, so surgery can be delayed for as long as possible without compromising activity levels.
He also highlights that joint rejuvenation and restoration are a two-part approach.
“First, we treat what is happening inside the joint, but just as important, we want to strengthen what's outside the joint – the muscles.”
This is where he takes a multidisciplinary and big-picture approach to care. Depending on a patient’s injury and preferred activity, he refers them to physiotherapists with niche specialties in specific sports and injury expertise to transition safely back to their sport.
He also emphasises that his partnership with patients does not end with the healing of an injury or the conclusion of successful surgery.
“I believe in managing people at every stage,” he says.
“There is the wellness phase, making sure people stay well with good, healthy joints. And there is the early disease stage, where I try to prevent issues from progressing and push them towards wellness and maintain them at this stage. But if things advance and surgery is required, I am focused on not just the surgery itself but the healing that takes place afterward.”
His philosophy, he adds, is that “exercise is medicine”.
“My goal is to help people go back to the sport they love. It may require more monitoring and some modifications, but it is about taking people back to what gives them pleasure.
"For many people, their sport is about quality of life and may even be what defines them. So, it's very important to me to meet a patient's goals.”
The information provided in this article is meant purely for general information purposes only and may not be used as a substitute for medical advice, diagnosis or treatment. If you have any questions or concerns about your health, please seek the advice of your doctor or qualified healthcare provider. The views, information or opinions expressed in this article are solely that of the writer and the interviewees and do not necessarily reflect those of, and are not endorsed by, Camden Medical.