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ALUMNI ALBUM

Kenneth DeHaven, M.D., '63: A well-timed career


acquired an arthroscope but hadn't been very successful using it, so Evarts was happy to send DeHaven to be trained by Jackson. In Toronto, DeHaven watched carefully as Jackson manipulated the arthroscope to peer inside patients' injured knees.

"I could tell right away that he was doing two or three things differently," says DeHaven. Today, a trainee would be able to observe an instructor's every move on a video screen. But "this was before there were teaching attachments," says DeHaven, "so I [used] what I call the lean-in, lean-out" method of observation. (Back then, arthroscopy was used only to diagnose the extent of injuries; its role in fixing them would come later.) Jackson would get an injury lined up in the scope, then step back so DeHaven could look through it. The trainee, recalls DeHaven, would "hope nothing changes in the meantime, because the scene might be totally different when you look." Despite the rudimentary equipment, DeHaven continues, "I looked in there and I could see, 'Yeah there it is.' So then [Jackson] handed me the scope and said, 'Now you [find] it.'Well, I was able to do it."

One of Jackson's techniques was to keep the knee tissues constantly irrigated; he had a resident closely monitor the irrigation system throughout a procedure. At the Cleveland Clinic, the irrigation setup wasn't watched as closely. Often the system would get clogged, fluid would stop flowing, and the operating field would get murky.

DeHaven also noticed a difference in how Jackson's team positioned the patient. If they wanted to look in the back of a knee, they kept the leg straight. But the Cleveland team put the knee at a 90-degree angle. "I went back to Cleveland," DeHaven recalls, "and I said to Dr. Collins, 'Roy, you can't believe how close we were'" to doing successful arthroscopy. "I showed him what I'd learned in Toronto, and from that moment on, the two of us were able to do it."

Soon, Collins and DeHaven had

Grew up: Kettering, Ohio—a suburb of Dayton
Education: Dartmouth College '61 (A.B. in history), Dartmouth Medical School '63 (B.M.S.), Northwestern University Medical School '65 (M.D.)
Training: Residencies in general surgery and orthopaedic surgery at the Cleveland Clinic and a fellowship in sports medicine at the Sports Medicine Clinic of Atlanta
Military service: U.S.S. Galveston (1967-68); U.S. Naval Hospital at Camp Pendleton, California (1968-69)
Avocation: Repairing and restoring antique clocks
Organizations he's been president of: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America

The dexterity DeHaven honed doing arthroscopic surgery comes in handy as he now tinkers with antique clocks.

progressed from doing diagnostic arthroscopy to putting a probe in the knee so they "could touch the tissues . . . as well as look at them," DeHaven says. "That just made the diagnostic part of things more complete, more accurate." By 1975, DeHaven was doing meniscus repairs arthroscopically.

While arthroscopic surgeons were perfecting their technique, medical equipment companies were perfecting miniature instruments and cameras. By 1980, tiny light-sensitive cameras could project images from inside the joint on video monitors so everybody in the OR, including the patient, could see what was going on.

But despite the progress, arthroscopy "wasn't welcomed with open arms by established knee surgeons," says DeHaven, "especially the sports knee surgeons. . . . They thought it was a passing fad [and said], 'Why look through a keyhole when you can open the door and walk right in—with a big incision.'"

DeHaven used diplomacy to persuade recalcitrant surgeons. "I was still a young pup in the field, and I was giving talks about it," he recalls. So he'd praise senior surgeons' skill and experience with tricky knee injuries, then add that arthroscopy allowed him to be as accurate as they were. "And then," he chuckles, "I would say, 'But I think if you did learn [arthroscopy], you'd be even better.'"

It took a high-profile case to really grab the attention of the nonbelievers. A professional football player who had had a torn meniscus repaired arthroscopically "played five days later and played well," says DeHaven. "That hit the press like gangbusters. . . . Then the people who hadn't bothered to learn [arthroscopy] wanted to instantly" become proficient in the technique.

When Evarts was recruited to chair orthopaedics at the University of Rochester, he took DeHaven along to establish a sports medicine division there. DeHaven soon became a leader in the field and built up a corps of physicians, physical therapists, and athletic trainers who worked with high school, college, and professional athletes. He himself was the team physician for the Rochester Rhinos professional soccer team and the Rochester Red Wings minor league baseball team. He saved many an athlete's career, published papers on his clinical research, and mentored young surgeons. In 2006, he was elected to the prestigious Sports Hall of Fame of the American Orthopaedic Society for Sports Medicine.

He's semiretired now but still serves as Rochester's senior associate dean for clinical affairs and practices part-time. He also has some new "patients"—antique pendulum clocks. The dexterity he honed doing arthroscopic surgery comes in handy as he now tinkers with clocks' tiny gears. And who knows: If he learns to repair clocks through their keyholes, he might end up revolutionizing that field, too.


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Laura Carter is Dartmouth Medicine magazine's associate editor.

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