In addition to his duties at Rothman, Dr. Courtney also serves as an Assistant Professor of Orthopaedic Surgery at Sidney Kimmel Medical College at Jefferson. He teaches medical students, residents, and fellows training in orthopaedics. Photo by Al Thompson

When you have to have surgery, regardless of the severity, it is an anxious time for the patient.

If your surgery is for a damaged knee or hip, and you’re looking at a replacement, how reassuring it would be to have a great athlete treating you, someone who understands and has experienced how the body works at extreme levels?

That surgeon would be someone who understands how you feel about getting back to doing your thing; whether it be sports or a job that requires physical activity like construction, delivering mail or coaching.

If that’s the case, Dr. Paul “Max” Courtney is your guy.

Dr. Courtney works for the Rothman Institute, located at the Sidney Kimmel Cancer Center in Center City Philadelphia as a hip and knee replacement surgeon.

Dr. Courtney was and continues to be a standout in athletics. He wrestled for LaSalle College High School, where he earned All-Catholic honors as 6-foot-4, 171 pounder. The Explorers won the 2003 Catholic League Championship.

Dr. Courtney continued his wrestling career at Washington and Lee University in Lexington Virginia where was an undergraduate. “Max” Courtney. as he was known then and still wants to be called Max, wrestled all four years for the Generals as a 184 pounder, earning the honor as the 2005 NWCA Scholar All-American.

He is currently involved with the wrestling program at LaSalle College High School informally, where is brother Ben is the assistant head coach.

Max Courtney -all 6-foot-4 of him – listens to his coach at a wrestling match during his standout career at Washington and Lee University. Photo courtesy of Washington and Lee athletic department.

“I did, I got hurt wrestling, I had concussions,” Dr. Courtney recalled in a recent one-on-one interview. “I had wrist fractures that required treatment by an orthopaedic surgeon…both wrestling injuries, once in high school and the other as a freshman in college.”

Dr. Courtney said his interest grew from being around sports medicine; not from one incident or one doctor he met. He said seeing athletes return to the field, court or mat after being injured was very attractive to him as a career choice.

“I’ve seen a lot orthopaedic surgeons, being a career athlete myself,” Dr. Courtney said. “It wasn’t one particular injury that prompted me to look into orthopaedics. But watching my teammates and my friends be able to recover from injuries and get back out to doing the sports that they liked.

And the same with me, with my injuries as well,” Dr. Courtney continued. “That’s one of the most rewarding things that we can do as orthopaedic surgeons…is getting people back to what their pre-activity functions were…getting them back on the golf course, the tennis court or the football field.
That’s what really prompted me to get into orthopaedics. When you can see his or her results…see a person up and doing what they love doing, or need to do, is what makes what you do so real.”

Dr. Courtney completed his internship and residency at the University of Pennsylvania and then pursued fellowship training in Adult Reconstruction at Rush University Medical Center in Chicago, IL.

He specializes in partial and total knee arthroplasty, complex primary and revision arthroplasty of the hip and knee, periprosthetic fractures, and periprosthetic infections of the hip and knee.

Dr. Courtney also serves as an Assistant Professor of Orthopaedic Surgery at Sidney Kimmel Medical College at Jefferson. He teaches medical students, residents, and fellows training in orthopaedics.

He talked about how wrestling and coaching the sport has enriched his life through the friendships he has made over the years. As a doctor, he can continue to be part of the athletic community at every level. He says he still meets people he competed against back in the day in Philly, plus those involved in the community today.

“It really does make a difference,” Dr. Courtney said. “And the relationships you make with sports. A lot of the PAL (Police Athletic League) kids who wrestled and went to North Catholic when I wrestled Eddie Alvarez (North Catholic Prep All American wrestler). He’s now in MMA. I’m still talking to these kids, running into these kids and I am now 15 years out of high school. Wrestling is like a small fraternity.”

Dr. Courtney says the patient he treats are a lot like him. Career “Weekend Warrior” athletes, most compete because that’s what they’ve always loved to do…play sports, and being active.

“They’re my patient population,” Dr. Courtney said with a smile. “Yes I operate on some twenty-somethings but they are more rare. In the case of student athletes or pro athletes, it is a different type of specialist.

“They’re going to see the sports surgeon,” Dr. Courtney continued “A joint replacement, unless you’re Bo Jackson, who played major league baseball for three years on his hip replacement, your career is over if you get a joint replacement. What most people don’t realize is, I see a lot of people in their 40s, 50s who are still weekend warriors who still run 5Ks, that are still playing recreational basketball, that like tennis and golf. The biggest change is that hip and knee replacements used to be seen as an elderly patient’s surgery.”

Not anymore. Dr. Courtney said advancements in joint replacements can keep people in the game, whatever that is.

“Joint replacements, this is something that your grandma got at 75 or 80 years old. They were low activity, they are not functioning a lot. I think one of the biggest advances that we have is being able to get people back to high activity levels and get them back sooner.”

Dr. Courtney talked about what it used to be like getting a knee or hip replacement.

“Even when I was training at Penn ten years ago, patients were getting narcotic pumps, they were staying in the hospital for three or four days, they were going to rehabilitation facilities, they weren’t going home,” he said. “We’d have them in these continuous passive motion torture devise machines, plus blood transfusions every day.”

Not anymore.

“Now we don’t do any of that,” Dr. Courtney said. “At Rothman we’ve really pioneered our recovery protocols and our short-stay rehab protocols so patients are going home the same day or the next after surgery as long as they don’t have a lot of medical equipment needed.”

Today, with the emphasis on keeping patients away from narcotic pain medicine, it is even more important to get people back on their feet as soon as possible.

“If you’re healthy enough you can go home the same day or the next day after surgery,” said Dr. Courtney, who is a long time Eagles fan. “Which makes the weekend warriors I’m seeing…they are up and all they have is a assisted devise (cane, walker, crutches) for a couple of weeks, and most of them by six weeks are back (to normal activities). At Rothman, over 80 percent of our patients go home after surgery.”

Dr. Courtney continued to talk about the advances with joint replacement.

“At Rothman, after joint replacement surgery, our patients don’t go to rehab. Even formal physical therapy isn’t necessary in everybody. A lot of people can do exercises on their own, particularly with our weekend warrior population.”

Dr, Courtney says you can do whatever you want, except to stay away from doing extreme acts of physicality.

“I don’t encourage people to go run a marathon on a joint replacement,” Dr. Courtney said. “It’s like a car. If your drive your car 20,000 miles you’re going to run it out faster than If you drive the car 5,000 miles a year. But you don’t have any restrictions from activities.”

There have been so many advances with regards to joint replacements, particularly with the parts themselves, orthopedic surgeons need to stay aware of all the changes. Dr. Courtney talked about those advances.

“With hip replacements particularly, we’ve done a much better job with bearing surfaces,” he said. “Or the type of surface your hip, the ball and socket is made of. Most people are now using ceramic ball heads with a plastic liner, and the wear weights are very minimal. I’m not seeing a lot of hip replacements wearing down. We have pretty good ten-year results with the new technology. These new bearings surfaces, the new ceramics and new plastics really work.

“Hip replacements do not loosen like they did in the past,” Dr. Courtney continued. “Hip replacement components are cement-less. So once your bone grows into the hip replacement, that’s part of you. Unless you get an infection, that is never going to come loose. We’re not quite there with knee replacements, though some (surgeons) are doing cement-less knees or these press-fit knee replacements that people are talking about for younger patients. About 90 percent of the knee replacements in this country are cemented. The cemented knees can wear out over time. We’re trying to come up with the ideal design for a cement-less knee.”

Dr. Courtney said he only offers cement-less knees to males in their 50s. “The success rate for that isn’t quite there yet. But we’re getting there. when we do, it will be good for younger people, the weekend warriors. who are getting knees that will last.”

Rothman Orthopaedics sounds like they have a plan and it’s working.*

Some bio information on Dr. Courtney taken from rothmaninstitute.com

Follow Al Thompson on Twitter @thompsoniii