Dr. Scott A. Sigman is a board-certified orthopaedic surgeon with over 27 years of experience in sports medicine. As a leading expert at Orthopaedic Surgical Associates of Lowell, he has specialized in treating knee and shoulder injuries and has served as Team Physician for the US Ski Jump Team and UMASS Lowell. His extensive background includes training at Tufts University and the prestigious Kerlan-Jobe Orthopaedic Clinic, where he worked with top professional sports teams.
Throughout his career, Dr. Sigman has been at the forefront of innovation in orthopaedics, particularly in promoting opioid-sparing techniques to improve patient outcomes. His dedication to advancing the field and his compassionate approach to patient care have earned him numerous accolades, including the Castle Connolly Top Doctor Award.
In this Q&A feature, Dr. Sigman shares insights from his career including his motivation for adopting opioid-sparing methods, the impact of laser therapy in orthopaedics, and advice for young surgeons building their brand in today’s digital age.
I noticed that you like to adopt opioid-sparing techniques. What motivated you to adopt these opioid-sparing techniques in a practice, and what have been the key benefits for your patients?
I’ve grown up inside of the opioid crisis. I started my training in 1995. At that time, opioids were really the only way in which we’re using pain medication. We were told that they were minimally addictive and that they were relatively inexpensive. That couldn’t be further from the truth. They were highly addictive and overall, a tremendous cost to society, let alone factoring in the loss of life associated with opioid addiction. We used opioids for postoperative pain management because that’s the only solution we had, and surgery became an inadvertent gateway to the opioid crisis. In about 2012, five young individuals were in my local community—high school students who had undergone elective surgery—and all passed from an opioid overdose six months after their surgery. That was the moment I decided we needed to make a change. A long-acting anesthetic known as Exparel, also known as liposomal bupivacaine, came onto the market, and we started using it. That anesthetic provided significant pain relief, around upwards of three days after the surgery. This was a tremendous game changer, and I have never looked back. I continue to use all potential available non-opioid treatment options to improve patient outcomes for a patient so that they can safely and effectively undergo orthopaedic surgery without having to become addicted to opioids.
As the Chief Medical Officer for Ortho Laser Orthopedic Laser Centers. Can you explain how laser therapy is revolutionizing orthopaedic care?
Fantastic. So, laser is also known as photobiomodulation. Photo meaning light, bio meaning living cells, and modulation means to effect. We are a species on a planet that has a sun. We’re a successful species on that planet for over 300,000 years. So, it should not come as a surprise that in our deepest genetic code, we are sensitive to light. If you can shine the right wavelength, the right frequency of light, the right intensity of light to ourselves, what we can do is change the cellular milieu and physiology. And so, I’m going to take you back to high school days and the Krebs cycle, for example, of the mitochondria. If you shine the right wavelength of light, enzymes inside the mitochondria get excited. They make energy, which is ATP, if we remember ATP creates an energy source for cells to increase their metabolism. It creates increased blood flow to the tissues. It increases the migration of fibroblasts, which are the healing cells of the body, and it creates proteins that are called cytokines that help to block inflammation and pain. So, with photobiomodulation therapy, we can shine the right wavelength of light, for example, over a patient that has a knee replacement, we can dramatically reduce the swelling and the pain, dramatically reduce the need for post-operative pain medication, and improve our patient’s function. So photobiomodulation therapy is going to revolutionize pain management post-operatively, for acute orthopaedic conditions, and for chronic conditions.
Can you discuss some of the latest innovations in orthopaedic surgery that you are most excited about?
There’s a lot of great innovations that are happening in orthopaedic surgery. One of the more common topics is robotics in knee replacements and hip replacements. It’s now advancing into shoulder replacements and we’re probably going to also have it for spine surgery. The robotics allow us to preoperatively plan and then be very precise with our technique and instrumentation. One of the other things that is really exciting, for example, is artificial intelligence. We’re going to use artificial intelligence to gather information, to develop a consensus on patients’ diagnoses and appropriate treatment recommendations. Just the other day, I used an awesome augmented reality glass system that allowed me to operate on a patient with cameras in the room. Doctors in Tampa, Florida, while I was operating in Boston, were able to virtually be in the room and completely visualize my surgical techniques through my point of view. So, technology is finally making its way into the operating room, and it’s exciting times.
You’ve been in orthopaedics for a long time. So, what advice would you give orthopaedic young orthopaedic surgeons who are just during their careers?
I’ve been an orthopaedic surgeon for 27 years, and one of my passions is really communicating and messaging to my patients. 75% of patients at this time will do a Google review of you prior to coming to your first appointment, they’re going to look at the reviews that they put about you as a physician. They’re going to want to know where you’re trained. They want to know what it is that you’re passionate about. And so, what I like to say is that you are what you say you are, you are what Google says you are, and you are what your patients say you are. So, the time to establish your messaging and your brand as a physician is now, and by doing so, you can circumvent the long analog process of developing a practice that may take upwards of 10 or 15 years. If you can develop your message, if you can share that message, your ideal patients will be able to find you. And if you’d like to know more about that, you should read my book, Physician Brand RX, which is co-authored with Matthew Ray Scott and will be published within the next two months.
This Q&A has been lightly edited for clarity.
