Knees are complex, says Dr. Adam Rosen, a resident of Torrey Hills in the Carmel Valley area.
This is one of the reasons Rosen chose to focus his career as an orthopedic surgeon on knee replacements.
This is also why he decided to write “The Knee Book: A Guide to the Aging Knee” – to make the complicated subject easily understandable.
The book can be ordered online at Amazon and Barnes & Noble.
As the Scripps Clinic doctor explains in the introduction, a big part of his job is to analyze patients’ knee pain and advise them on therapies that often don’t require surgery.
Rosen strives to make his explanations as transparent as possible for people without a medical degree, as evidenced by his 99-page text.
“The goal of the book, which was written for patients and for patients, was to try to make it as digestible as possible,” he said in a recent interview. “I find that when you talk to someone who is passionate about something and they start going off on a tangent, you can see a lot of people’s eyes go glassy and it gets too complicated. But I think breaking it down gives people a really good understanding.
In “The Knee Book”, Rosen excels at rendering his subject matter in common language rather than “doctor-talk”. It applies analogies that compare knee problems to experiences everyone is familiar with.
For example, to explain why patients with osteoarthritis of the knees sometimes hear crackling or popping sounds coming from them, he likens it to a car driving down a freeway made of smooth pavement and then veering into a rumble strip.
“In an arthritic knee, the surface is irregular, it doesn’t slide well. … Your irregular cartilage can also make loud noises,” he writes.
He describes the phenomenon of sudden, unexpected shooting pains in one knee as akin to the experience of biting one’s cheek while eating.
“This sharp pain is due to you biting the soft tissue inside your cheek,” he wrote. “Occasionally we ‘bite’ the tissue inside the knee, especially if you have arthritis. The fabric can get caught because the knee is loose or you have bone spurs.
Step by step, Rosen guides the reader through topics such as knee anatomy, symptoms, arthritis, exercise, weight loss, over-the-counter treatments, walking aids, injections , arthroscopy and replacement surgery.
Rosen’s patient Harry Paul, himself a best-selling author, reviewed the book as a favor to the doctor. The Kensington resident found it a compelling reinforcement of what he had already learned during his first knee replacement around two years ago.
“I was playing golf in five weeks,” he said.
Paul underwent his second knee replacement surgery by Rosen in December. He plans to return to the golf course in about a week.
“I found the book very easy to read and understand because a lot of times when you have a medical book they go into all these words that you and I can’t pronounce,” Paul said.
“What I found out looking at this (book) was all he and I were talking about – letting me know this is the procedure, this is what we’re going to do, this is what I’m talking about. I need you to do before (surgery). Everything he said was in the book. It’s a good book to read before (surgery).
Paul got to know Rosen when his wife, now a retired nurse, had knee replacement surgery in 2012. So when he started having knee issues, it was only natural that he turn to Rosen. .
“It’s major surgery, but she felt very comfortable with him and he had a very pleasant, easy-going personality and attitude about her,” Paul said. “Then when it came time for me to start looking for help for 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 gave at Scripps Green Hospital in Torrey Pines Mesa about half a dozen years ago.
“Hundreds of people came,” he said. “It was actually recorded on video, so it’s on YouTube. We used it as a reference for a while for patients who were new consultations.
Rosen staff would recommend first-time patients view the video before heading to their main office at Scripps’ Geisel Pavilion, also on Torrey Pines Mesa.
“It was great because a lot of patients came in and said, ‘I had a lot of questions, but you answered all of them during the conference. But I wanted to come in and meet you, and see if there was anything else,” Rosen said.
“It really showed me that we’ve started to answer all the major questions people had. What I’ve found is that a lot of people who come to see me don’t always want surgery or don’t do not need to be operated.
“A lot of them just had questions and it was about giving them the answers to the questions about why they feel the way they do and what they can do on their own to feel better.”
These experiences combined with his continued observations over the 15 years of his practice inspired him to distill this knowledge into book form.
Finally, with the downtime resulting from the coronavirus pandemic, Rosen was able to achieve his goal.
Rosen’s fascination with the knees began while he was in medical school and doing his residency in his hometown of Philadelphia.
“I think the two biggest factors were having really good mentors who were great knee surgeons,” he said. “Working with people who have that passion really fuels your passion.”
The other factor was that he liked the challenge of working on the knees rather than other joints like the hips.
“It really makes your mind think a lot more about trying to balance a knee replacement and trying to get as close to normal as possible,” Rosen said.
When considering where to pursue his fellowship, Rosen told his mentor, a well-known knee surgeon, that he was interested in going out West, although he wasn’t sure where.
Rosen’s mentor recommended that she go to San Diego to study with a famous knee expert. Completion of Rosen’s fellowship led to Scripps being offered a position on his orthopedic staff.
“It’s hard to turn down the Scripps Clinic and it’s hard to turn down Southern California, so it was kind of a no-brainer,” he said.
In his career to date, Rosen estimates that he has performed around 300 knee replacements per year, which amounts to some 4,500 operations.
“It always humbles me,” he said. “At this point, I am seeing some of my patients again for 15-year follow-ups. It’s really humbling to see someone you operated on 15 years ago and it’s great to see that they are still doing well.