Knees the focus of Scripps’ doctor’s new book

Knees are complex, says Dr. Adam Rosen, a resident of Torrey Hills in the Carmel Valley area.

Dr. Adam Rosen

(Courtesy)

That’s one reason why Rosen chose to focus his career as an orthopedic surgeon on knee replacements.

It’s also why he decided to write “The Knee Book: A Guide to the Aging Knee” — to make the complicated subject easily understood.

The book can be ordered online at Amazon and Barnes & Noble.

As the Scripps Clinic physician explains in the introduction, much of his job consists of analyzing patients’ knee pain and advising them of therapies that often do not require surgery.

Rosen strives to make his explanations as transparent as possible to people without medical degrees, as reflected in his 99-page text.

“The goal of the book, which was written for patients and to patients, was to try to make it as easily digestible as possible,” he said in a recent interview. “I find that when you talk to somebody passionate about anything and they start to go off on a tangent, you can see many people’s eyes glaze over and it just gets too complicated. But I think breaking it down gives people a really good understanding.”

The cover of “The Knee Book: A Guide to the Aging Knee”

(Courtesy)

In “The Knee Book”, Rosen excels at rendering his subject matter in common language rather than “doctor-speak.” He applies analogies that compare knee issues to experiences with which everyone is familiar.

For instance, to explain why patients with arthritic knees sometimes hear crackling or clicking coming from them, he compares it to a car going down a highway made of smooth pavement, then veering onto a rumble strip.

“In an arthritic knee, the surface is irregular, it does not glide smoothly. ... Your irregular cartilage can make loud noises too,” he writes.

He describes the phenomenon of sudden, unexpected shooting pains in a knee as akin to the experience of biting one’s cheek while eating.

“That sharp pain is because you bit down on the soft tissue inside your cheek,” he writes. “Occasionally, we ‘bite’ down on the tissue inside the knee, especially if you have arthritis. The tissue can get caught because the knee is loose or you have bone spurs.”

Step by step, Rosen takes the reader through such subjects as the knee’s anatomy, symptoms, arthritis, exercise, weight loss, over-the-counter treatments, walking aids, injections, arthroscopy and replacement surgery.

Rosen patient Harry Paul, a best-selling author himself, reviewed the book as a favor to the doctor. The Kensington resident found it to be a cogent reinforcement for what he had already learned during his first knee replacement about two years ago.

“I was playing golf in five weeks,” he said.

Paul had his second knee replacement performed by Rosen in December. He plans to hit the golf course again in a week or so.

“I found the book very easy to read and understand because a lot of times when you have a medical book, they get into all of those words that you and I can’t pronounce,” Paul said.

“What I found out by looking at this (book), it was all the stuff that he and I would talk about — letting me know this is the procedure, this is what we’re going to do, this is what I need you to do before (the surgery). Everything that he was saying was in the book. It’s a good book to read before (surgery).”

Paul became acquainted with Rosen when his wife, now a retired nurse, had a knee replacement done in 2012. So when he started having knee problems, it was natural he would turn to Rosen.

“It’s major surgery, but she felt very comfortable with him and he had a very nice and easy-going personality and attitude about him,” Paul said. “Then when it came time for me to start seeking someone out for help with my knees, she said, ‘Go see Dr. Rosen. He’s a good surgeon and a really nice guy.’”

The genesis of the book, Rosen said, stems from a lecture he did at Scripps Green Hospital on Torrey Pines Mesa about a half-dozen years ago.

“Hundreds of people turned out,” he said. “It was actually video-taped so it’s up on YouTube. We used that as a reference for a while for patients that were new consults.”

Rosen’s staff would recommend first-time patients view the video before coming to his main office at Scripps’ Geisel Pavilion, also on Torrey Pines Mesa.

“It was great because many patients would come in and say, ‘I had a lot of questions, but you answered all of them in the talk. But I wanted to come in and meet you, and see if there was anything else,’” Rosen said.

“It really kind of showed me that we started hitting all the major questions that people had. What I found is many people who come to see me don’t always want surgery or need surgery.

“A lot of them just had questions and it was a matter of giving them the answers to the questions to explain why they feel the way they do and what things they can do on their own to make themselves feel better.”

Those experiences combined with his ongoing observations over the 15 years of his practice inspired him to distill that knowledge in book form.

Finally, with down time resulting from the coronavirus pandemic, Rosen was able to achieve his goal.

Rosen’s fascination with knees began while in medical school and doing his residency in his hometown of Philadelphia.

“I think the two biggest factors were having really good mentors that were big-time knee surgeons,” he said. “Working with people who have that passion really kind of stimulates your passion.”

The other factor was that he relishes the challenge of working on knees as opposed to other joints such as hips.

“It really makes your mind think a lot harder to try to balance a knee replacement and try to get as close to normal as possible,” Rosen said.

When considering where to pursue his fellowship, Rosen told his mentor, a noted knee surgeon, that he was interested in going out West, though he wasn’t sure where.

Rosen’s mentor recommended he go to San Diego to study under a celebrated knee expert. The completion of Rosen’s fellowship led to Scripps’ offer of a position on its orthopedic staff.

“It’s hard to turn down Scripps Clinic and it’s hard to turn down Southern California, so that was sort of a no-brainer,” he said.

In his career to date, Rosen estimates he has performed about 300 knee replacements per year, which amounts to some 4,500 operations.

“It still humbles me,” he said. “A this point, I’m seeing some of my patients back for 15-year follow-ups. It’s really humbling to be seeing somebody you operated on 15 years ago and it’s great to see that they’re still doing well.”