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Thursday January 7, 2010

Doctor was Canadian pioneer in arthroscopic surgery

Robert Jackson, the Canadian pioneer in the field of arthroscopic surgery and a prime mover in the Paralympic movement for athletes with physical disabilities, died yesterday.

Dr. Jackson was credited with bringing the field of arthroscopic surgery - a less invasive way of tending to joint injuries - to the Western world. The arthroscopic method, developed in Japan in the 1960s, has been used thousands of times in pro sports since the 1970s to treat knees of hockey players, footballers and skiers and shoulders of baseball pitchers.

Doctors such as orthopedic specialist Frank Jobe built their reputations as healers by using arthroscopic methods, which replaced wide-open surgeries with small incisions.

With this system, a tiny filament camera is inserted in one side of the injured joint, and surgical instruments through another. The images of the inside of the joint are displayed on a screen for the surgeon to do his work. The less invasive treatment of floating cartilage, trimming of damaged cartilage and reconstruction of ligaments allows for faster healing.

James Andrews would use arthroscopy in treating pitcher Roger Clemens. Dr. Jobe would develop a method known as Tommy John elbow surgery.

"In the old days, we didn't have much choice but to open up and explore," Dr. Richard Hawkins of the University of Western Ontario, as a reporter was invited to perform "surgery" on the shoulder of a plastic patient during a seminar at the 1985 Masters Games in Toronto.

"Now we can see so much better."

Dr. Jackson and Dr. Hawkins concurred that it was better to be aggressive about diagnosis but conservative about cutting - which often meant a year of rehabilitation or the end of an athlete's career.

Dr. Jobe, then the shoulder expert to the Los Angeles Dodgers and to pro golf's PGA Tour, said the arthroscopic approach "lets us help players before it's too late."

"A pitcher is operating on a level just below that which would cause him injury. If his mechanics are off just a little, he's going to be suffering micro-traumas inside the joint. Rest, exercise and stretching is the first line of defence. If that hasn't relieved him, then I consider an arthroscopic exam and surgery."

Dr. Jackson began a serious acquaintance with arthroscopy when he went to Japan as doctor for the Canadian Olympic team in 1964. There, he encountered Masaki Watanabe and discovered that the method had first been proposed in the 1930s to study and to treat arthritic conditions of the elderly. According to a 1994 Sports Illustrated report, in which Dr. Jackson's contribution to sport medicine was identified as a key to changing the sports world, the Canadian doctor learned about arthroscopy in exchange for teaching Dr. Watanabe English: "Twice a week Jackson would show up at the old man's clinic in Tokyo and, over plates of fried eel and rice, go through the conjugations. That was 30 years ago, and even then Jackson suspected he was getting the better deal."

Robert W. Jackson graduated from the University of Toronto Medical School in 1956, to pursue a career in academic orthopedic surgery.

Nine years of postgraduate clinical and research work included training at the Toronto General Hospital, the Massachusetts General Hospital in Boston, the Royal National Orthopedic Hospital in London and the Bristol Royal Infirmary, England, the Royal Infirmary in Bristol, England, and the University of Tokyo.

After his 1964 Olympic shift, he taught at Toronto General Hospital and became director of orthopedic research at the Banting Institute, a position he held for 10 years.

In 1976 he moved from Toronto General to become chief of the Division of Orthopaedic Surgery at Toronto Western Hospital, and in 1982, was promoted to the rank of professor in the Department of Surgery at the University of Toronto.

In 1985 he became chief of surgery and chief of staff at the Orthopedic & Arthritic Hospital in Toronto - the largest orthopedic unit in Canada. He held this position until 1992 when he moved to Baylor University Medical Center in Dallas 1992 as chief of the Department of Orthopaedic Surgery.

He retired in 2004, returned to the Baylor lab as the medical director of orthopedic research and finally left the active practice of surgery in 2007.

He was a team doctor for the Toronto Argonauts 1976 to 1991 and basketball's Dallas Mavericks from 1992 to 1995.

Dr. Jackson was the first president of the Wheelchair Sports Association of Canada, took Canada's first wheelchair team to a world championship and was president of the international Stoke Mandeville Games.

His honours include an Order of Canada and Olympic order, both in 1997.

Dr. Jackson leaves wife Marilyn, five children and eight grandchildren.

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