“I’ve skied 1.7 million vertical feet in the last five years,” says 36-year-old Philip ‘Puck’ Wheaton. It’s an awful lot of skiing, especially for a guy who was born without an anterior cruciate ligament (ACL)—the critical ligament that holds the knee together.
When Puck had started walking in 1979, he seemed to wobble a bit—like most toddlers do, says his mother Liz Wheaton. At his 18-month checkup, his pediatrician determined there was more to Puck’s unsteadiness than run-of-the-mill toddler wobbliness. He referred Puck to Lyle Micheli, MD, director of Boston Children’s Hospital Sports Medicine Division.
“Dr. Micheli was right on the case and determined that Puck was missing his ACL,” says Liz.
An innovation in ACL surgery
Puck’s condition made for a very challenging surgical dilemma. Surgery to reconstruct torn ACLs was pioneered in the late 1960s, but it required drill holes through the knee. The operation couldn’t be safely performed on growing children because the drill holes could damage the growth plates of the knee and disrupt future leg growth. In fact, no surgeon had attempted ACL reconstruction surgery on a child younger than age two at the time.
Micheli did what the world’s best surgeons do. He improvised and innovated.
He decided to thread Puck’s iliotibial band (the ligament that runs down the outside of the leg from the hip to the shin) in and around his knee to devise a makeshift ACL.
Even though the procedure had never been attempted before, Liz and her husband Bill had no hesitation about the surgery. “We knew we were in good hands.”
Puck’s surgery was a success.
He was released from Boston Children’s with his right leg in a cast and “the tiniest walker ever made,” says Liz. “He never slowed down. The walker was never used.” Puck ran around on the cast until he wore down the plaster on its bottom.
His enthusiasm for activity has only grown since then.
“I’ve been playing sports for as long as I can remember,” says Puck. He started playing soccer at age 5 and immersed himself in team sports from basketball to lacrosse during childhood.
But it was downhill skiing that really captured his heart. Puck started skiing at age 5 and hasn’t looked back. He moved to Colorado nearly 15 years ago and takes advantage of the state’s extra long snowy winter by skiing 50 days a year.
For Puck, his surgery was the start of a healthy, active lifestyle, including a successful career in Denver and a recent wedding on a Colorado mountain top. “He would have been like a character in a Dickens’ novel if he hadn’t had the surgery,” says Liz.
For Micheli, Puck’s surgery inspired him to innovate a game-changing surgical procedure. The surgery provides a way to reconstruct a child’s torn ACL so she can return to healthy activity and sports without risking an injury to the growth plates.
“After Puck’s successful surgery, I began to cautiously use this surgery in other young children with ACL injuries. At first, I told the parents this could be a temporary fix, and the child would likely require the drill-hole surgery when they were older. This turned out not to be the case; most children, like Puck, required no further surgery for their ACL reconstruction,” says Micheli.
The rest, so they say, is history. This “experimental” surgery done on Puck is now being done by surgeons worldwide for ACL injury in younger patients.
Read more about how Boston Children’s ACL Program cares for children and teens with ACL tears.