Doc Star: Dr. Freddie Fu
Dr. Freddie Fu travels the globe as an educator teaching medical professionals about a unique orthopaedic surgery technique. He is also an “ambassador,” spreading the good news about Pittsburgh and pushing for positive change, including greater diversity, in his profession.
Photo by Frank Walsh
Dr. Freddie Fu has yet to visit Antarctica. But work has taken him to nearly every corner of the globe during the 13 years he has served as chair of the Department of Orthopaedic Surgery at the University of Pittsburgh School of Medicine and UPMC.
These days, Fu spends about one-third of his life on the road, returning from trips just long enough to connect with his staff and family before preparing for his next journey. He crisscrosses America and the rest of the planet to share his medical knowledge and publicize the groundbreaking research happening in Pittsburgh. But even on his busiest days, Fu doesn’t experience the world as simply a blur of airports, hotels and hospitals. This is a man who does not generalize. This is a man who notices the details.
On a recent trip to Europe where he shared his pioneering surgical technique on anatomic ACL reconstruction with other doctors, Fu stayed at the posh Four Seasons Hotel in Milan. While there, he savored meals in the hotel’s three-star gourmet restaurant—just as you’d expect any guest to do. But he wanted more than just one perspective on “good Italian food.”
So, he searched out local hole-in-the-wall trattorias, the kind that are hardly noticed by most tourists but happen to serve exquisite pasta for just a handful of euros. “I like to see the places where people hang out,” Fu says. “I check it out and see who is eating inside.”
It’s a theme that runs through every aspect of Fu’s life: He deals with all things—people, meals, cultures, even surgeries others consider routine—by looking at the individual details.
And because this is Fu’s approach to all things, he has changed the way some doctors perform surgery on anterior cruciate ligaments, which are more commonly known as ACLs.
If you need ACL surgery someday, you will be glad that Dr. Fu came to Pittsburgh from his native Hong Kong more than 25 years ago. And you will also be glad he is a person who notices the details.
Fu seeks to restore not just function to damaged ACLs, but also the proper amount of movement and rotation.
Photo by Harry Giglio
In the world of ACL surgery, Fu is known for pioneering the anatomic ACL reconstruction technique. Preliminary research has shown that the technique better restores knee anatomy and function. It has also been criticized because it is more challenging for surgeons and more time-consuming than the one-size-fits-all ACL surgery that came before.
As Fu explains it, traditional ACL surgery treats every knee the same way: The ligament is rebuilt as a single strand and connected from one point to another. That technique has been used for the past 30 years, and it works. Fu has done it thousands of times.
“By the mid-’90s,” he says, progress in arthroscopic surgery “had pushed us to the point that we could be fast and efficient.” An experienced surgeon could finish the procedure in less than 30 minutes; that made it cost-effective for doctors and hospitals. Generally, patients’ knees return to a reasonably acceptable working order—at least for a while.
But Fu noticed that traditional ACL repair didn’t always last, especially in younger patients. “It was like putting a new tire on but not balancing it,” he explains. Just as unbalanced tires wear unevenly, “you get a worn-out knee over time.”
So, he went back and looked at the actual anatomy of an ACL— something he’d barely been taught at Pitt Medical School. He considered that it actually isn’t just one strand that connects from “A” to “B.”
“There are two bundles,” he says. “ So, you need to connect A to A and B to B. … It sounds simple, but we forgot where to put things.”
Fu learned about a new method for re-attaching the ACL as two distinct bundles. He also realized that a younger, more active patient needed a different level of connection and rotation in order to have a satisfactory, long-lasting outcome.
“For an active person, you may need more of the native ACL,” Fu says. “For me—I’m 60—maybe it would be different.”
His method of ACL surgery requires more work, but he believes that his patients get better results. Today, he travels the world challenging surgeons to look at the unique structure of every knee they encounter and the particular lifestyle of each patient.
Fu patiently gives lectures in crowded rooms. He carefully teaches in operating rooms. And as he travels, he tells people all over the world about the research and medicine happening in Pittsburgh, trying to improve their understanding of what the city has become in the decades since steel stopped dominating its landscape.
But change hasn’t come easy.
“It sounds very simple, but telling people to change is the hardest thing,” he says, sounding energized rather than beleaguered. He understands why surgeons are resistant: “They’re not paid more to do this anatomic ACL surgery, and it takes a little more time to do it.”
And changing people’s perceptions of Pittsburgh can be met with similar resistance. That’s part of what motivates Fu to get on so many planes and go to so many places: He is passionate about spreading the word that today’s Pittsburgh is a cutting-edge medical and technology greenhouse rather than a place where factories belch smoke into the sky.
Obviously, some people have taken note of the medical developments happening in Pittsburgh: Recently, Fu and colleagues received a $2.8 million grant from the National Institutes of Arthritis, Musculoskeletal and Skins Diseases (part of the National Institutes of Health) to compare the outcomes of anatomic single- and double-bundle ACL reconstruction surgeries. This study will provide a clear justification of the role of each surgery in restoring knee function and improve understanding of how knee kinematics after ACL reconstruction contribute to the development of post-traumatic knee osteoarthritis.
With Fu as its medical director, the UPMC Center for Sports Medicine has become one of the world’s most comprehensive and highly respected sports medicine centers.
Photo by Harry Giglio
Changing the Faces of His Field
Showing people a new perspective and asking them to look at things with fresh eyes is something Fu has been doing since the earliest days of his career. He left Hong Kong and enrolled at Dartmouth College in 1970, where he received his undergraduate and post-graduate degrees and received his medical degree from the University of Pittsburgh School of Medicine seven years later.
As a young immigrant, he saw that many people in the U.S. were comfortable with sticking to the generalizations they learned early in life. That has not only influenced his approach to medicine and his work promoting Pittsburgh, but also has given him motivation to mentor students and hire colleagues from diverse ethnic backgrounds as well as both men and women.
“When I came to Pittsburgh in 1975, my boss Dr. Albert B. Ferguson Jr., former chair of the Pitt Department of Orthopaedic Surgery, who was a giant, treated me no differently than anyone else,” he says. “He gave me a chance and could see in me that I could have potential.
“This is what I’m trying to do,” he says, “helping people of different cultures and genders enter my field.” If a multitude of unique voices and perspectives can be brought into his program, he says, “it becomes a better specialty” because each brings slightly different skills and ideas.
Fu has trained 600 sports-medicine fellows worldwide and has specifically encouraged women to enter the field of orthopaedic surgery. “I see in female surgeons,” he says, “sometimes a different kind of patient thought and also a different skill set in terms of surgery.”
Under Fu’s leadership, the Pitt Department of Orthopaedic Surgery has become the most diverse orthopaedic department in the country.
“At Pitt, we have some very outstanding students, and I’ve tried to talk to them and have them interested in our field,” he says.
In February, the American Academy of Orthopaedic Surgeons (AAOS) presented Fu with its 2011 Diversity Award. He was thrilled that more than 65 colleagues nominated him. The Diversity Award recognizes members of the Academy who have distinguished themselves through their outstanding commitment to making orthopaedics more representative of and accessible to diverse patient populations.
But he stresses that accolades aren’t the point. “I am highlighting our diversity in orthopaedics because we’re just trying to get the best people to strengthen our profession,” he says. “It’s not because I want to win diversity awards.”
Real diversity within medicine is still a work-in-progress. But Fu reasons that each time someone who has a minority or different background joins the field, it’s more likely that others will join as well.
“In orthopaedics, females still are only 4 percent,” he says. “But once you get a critical mass of 5, 10, 15 percent, then more people come because they feel comfortable.”
It can be tough to convince people to put aside old generalizations and experience foreign cultures or foods with fresh eyes. It can be tough to convince people to perceive Pittsburgh as something other than a steel town. It can be tough to convince some people to respect female surgeons or minority surgeons in the way that they’ve long respected white, male surgeons.
And without a doubt, it can be tough to convince surgeons of any stripe that they should rethink their approach to what was once routine surgery and motivate them to look at each patient as a unique individual.
But Fu has devoted his professional and personal life to doing just that. And he’s made remarkable progress on those fronts.
He’ll tell you much of his success can be attributed to having a talented team around him and having good friends who inspire him to keep exploring and experiencing new things.
But it only takes a few minutes of conversation with Fu to hear the passion in his voice and to notice just how deeply committed he is to experiencing each day, each meal, each person as something truly unique.
Melissa Rayworth writes about a mix of cultural issues for a variety of national news outlets, including The Associated Press. She lives in Allison Park with her husband and two sons.