Dr. Wahl joined the faculty of the UW Department of Orthopaedics and
Sports Medicine as an assistant professor and UW team physician in July
2004. He sees patients at the UW Sports
Medicine Center and at the Eastside Specialty
Center.
Dr. Wahl received his medical degree and graduated AΩA from Yale
University in New
Haven, Connecticut. He completed his orthopaedic training with
the Yale University Department of Orthopaedics and Rehabilitation. He served as a fellow in sports medicine and
shoulder surgery at Cornell’s Hospital for Special Surgery in Manhattan,
and subsequently traveled to Augsburg, Germany
and Zurich, Switzerland
as the 2002 AO John Border European trauma fellow. His practice focuses on the care of athletes
and sports medicine injuries, arthroscopic and minimally-invasive surgery of
the shoulder, elbow, knee, hip and ankle, non-replacement options for cartilage
restoration, and complex dislocations about the shoulder and knee.
Dr. Wahl comes to the University
of Washington from New
Haven, Connecticut, where he
served as assistant clinical professor of orthopaedics at Yale. He currently serves as a faculty instructor
with the AO (an international society for the study of orthopaedic trauma
surgery) and the Arthroscopy Association of North America. He is a member of the American Orthopaedic
Society for Sports Medicine, and formerly sat on the Connecticut State Medical
Society Committee on Sports Medicine.
Dr. Wahl’s research interests include the study of bony and
soft-tissue injuries occurring during shoulder dislocations, reconstruction of
complex knee dislocations, and new techniques for tissue fixation.
What
do you most enjoy about your work?
Sports medicine is like a sport in and of itself. I enjoy the challenge and teamwork of working
with motivated individuals to prevent injuries, and to restore a maximum level
of function after an injury has occurred.
I couldn’t miss the opportunity to come to Seattle and UW, where I’m
surrounded by some of the best collegiate athletes in the country, and also a
population of people who really enjoy their physical health. The nature of athletics makes the types of
injuries we treat incredibly varied, and the treatment of all injuries must be
tailored to the individual’s expectations and physical needs. At the same time, the new opportunities and
revolutionary new techniques afforded the surgeon by arthroscopy are reshaping
the practice of sports medicine. While
in the past we strove to do things “as well” during arthroscopic procedures, we
are now finding ways to exceed the results of more traditional open
procedures using minimally-invasive techniques and equipment.
The financial and legal environment of medial care today
prioritizes business efficiency over careful consideration for the individual,
teaching and research. However, as a
surgeon I think the later are the things that matter most. The ability to carefully evaluate what we’ve
done in the past, what we’re doing now and how we’re going to improve in the
future—that’s what make sports, surgery and life rewarding.
What
is your treatment philosophy?
I think as a sports medicine surgeon you need to really find
out what matters most to a patient and make their goals your
goals. An anterior cruciate ligament
(ACL) injury in a cutting athlete is an entirely different injury than an ACL
injury in a cyclist. The restoration of
shoulder stability in the overhead athlete is inherently different than the
same injury after a traumatic dislocation.
My role in care of patients is to find out what matters most to them,
how their injury affects their life, and how to best restore their function,
using the best available, proven techniques.
I strive for
teamwork and try hard to make myself available to my patients. Both parties (surgeon and patient)
should share in the burdens and responsibility of a therapeutic
relationship. When patient and physician
function together as a team, they can identify and diffuse problems together as
they arise; and when things are looking up—they share in the enthusiasm in a
more gratifying way.
A supportive environment can make the process of
recuperation and rehabilitation enjoyable.
Because the Sports Med
Center is literally part of the UW
athletic environment and facilities, I think my patients get a sense that they
are part of an elite extended family of students, athletes, trainers,
therapists, and physicians.
What
are your interests outside of medicine?
Since I grew up in Colorado,
I’ve always loved the outdoors. Both my
wife (Rebecca) and I enjoy mountain biking, hiking, sailing, and skiing (both
alpine and backcountry). I love to spend
time with our two dogs upland bird hunting, fly fishing, and generally playing
around. What little time I have left
over is dedicated to watching others enjoy sports.
What
is the focus of your teaching efforts?
I think in many
ways, the teaching of sports medicine is the most difficult task in
Orthopaedics. This is because the skills
employed for arthroscopy are entirely different from those of the other
orthopaedic disciplines, and the number of different kinds of surgeries
performed (and the indications for each) is astounding. Furthermore, sports medicine relies heavily
on a skilled and comprehensive physical examination.
My charge as an
educator is to teach residents to develop their skills in a controlled lab
environment, and allow them to observe how those techniques are refined in the
operating room. Most procedures are best
performed with two operating surgeons, one to “view” with the scope and one to
work. Outside a university setting, the
surgeon relies heavily on non-physician employees during these procedures. At UW, I have the luxury to work with some of
the best and brightest young doctors in the country. In the clinic, I like to teach by example and
by repetition. Orthopaedic residents
will observe and (later) perform examinations, and then I’ll examine patients
and we discuss the exam. I think the
benefit to a person of having two sets of skilled hands addressing a problem
are frequently superior to one.
On the national level, I am a faculty member for the AO (an
international organization dedicated to the study and treatment of traumatic
injuries) and the Arthroscopy Association of North America. As part of these faculties, I teach both
residents and other orthopaedic surgeons how to refine their skills and
judgement in the treatment of fractures and soft tissue injuries.
What
do your most recent research efforts focus on?
Shoulder instability: I
have recently applied for a grant to study the effects of traumatic shoulder
dislocation on the bone and cartilage of the shoulder joint, and the outcomes
after surgical reconstruction. Many
patients who suffer a shoulder dislocation will never require surgery, and
others will re-dislocate even after an appropriate surgery has been
performed. I am interested in using
novel MRI techniques to evaluate the initial injury, and better define which
factors contribute to the failure of non-surgical and surgical therapies.
Cartilage
regeneration/reconstruction: I have also received grants and performed
basic science research on the regeneration of meniscal tissues using chemical
inductive substances called “cytokines”, and have recently begun work with a
Ph.D. candidate to work with novel biomaterials that may eventually serve as
cartilage substitutes. Injuries to
cartilage (both meniscal cartilages and articular cartilage) are very common in
athletic populations, but the body has an exceedingly limited ability to
regenerate this tissue. My research has
focused on how to induce the body to re-grow cartilage, and in trying to find
suitable biological substitutes that can be used to repair such injuries before
arthritis develops.
Soft tissue fixation: The “weak link” in arthroscopic rotator
cuff reconstruction techniques remains the attachment of the adequately
mobilized rotator cuff to bone. My
research efforts here focus on refining existing and finding alternative
techniques to provide more stable, low-profile fixation.
What
is the focus of your clinical efforts?
I have a special
interest in advancing the minimally-invasive and all-arthroscopic techniques
and instrumentation in the treatment of knee and shoulder injuries. My particular interests lie in problems of
“laxity”—that is, the dislocating shoulder, the subluxing patella (kneecap) and
in knee ligament injuries and dislocations (which can be plagued by chronic
knee instability). I also enjoy working
with biological alternatives to knee replacement for injuries to the articular
cartilage of the knee and ankle. My
training in both sports medicine and trauma are useful for realignment
procedures to address premature arthritis, the dislocating patella, and
post-traumatic injuries to the bone and cartilage. I work closely with surgeons at the Harborview Medical Center in treating the complex knee dislocations
and ligament injuries associated with severe traumatic injuries.
As one of the team physicians for the University
of Washington Athletics, I am
privledged to treat the operative and non-operative problems encountered by
UW’s elite student-athletes.
Selected bibliography of Dr. Wahl’s recent publications.
- Wahl CJ, Warren RF and Altchek DA. "Shoulder
Arthroscopy." in Rockwood CA and Matsen FA (ed.) The Shoulder(3rd ed),
New York, W.B. Saunders.
- Wahl CJ and Warren RF.
"Reconstruction Methods for the Lateral Side of the Knee: What I Do."
in Williams RJ (ed.) Controversies in Orthopaedic Surgery: Sports
Injures to the Knee., London, Oxford University Press (in press).
- Wahl
CJ, Warren RF, Adler RS, Hannafin JA, and Hansen B. Internal Coxa
Saltans (Snapping Hip) as a Result of Overtraining: A Report of Three
Cases in Professional Athletes, with a Review of Causes, a Comment on
Early Diagnosis and an Algorithm for Treatment. (In press, Am. J.
Sports Med., 2004)
- Wahl CJ, Wickiewicz TL. Surgical Treatment of Rotator Cuff Tears. Current Opinion in Orthopaedics. Vol. 13, No. 4, 2002.
Latest Article by Dr Wahl
Dr. Wahl’s Contact Information:
Clinics: UW Sports Medicine Center: (206) 543-1552 or web site or Eastside Specialty Center (425) 646-7777 or web site.