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Tuesday, December 4, 2012
Updated: December 5, 1:09 PM ET
The doctor is in

By Chris Jones
ESPN The Magazine

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Jones Illustration
Biologics, or stem cells, is something Andrews is experimenting with -- very quietly.

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DR. JAMES ANDREWS is watching the weekend's football highlights, and nearly every one features a patient of his, a man whose career has been saved by his hands. He's rattling off the names in his Southern drawl as they appear on his screen, the grand sum of their repaired parts: Drew Brees, Alex Smith, Matthew Stafford ... The 70-year-old Andrews has taken their broken shoulders and made them capable of magic again. He won't reveal the exact number of surgeries he's performed because he fears it will sound like bragging. "Let's just say too many to count and not enough to quit." He turns his attention back to his TV. "There's Manning. I've seen him too." Which Manning? "Both of 'em," Andrews says.

In his decades of practice, he's seen hundreds of athletes overcome injuries that would have finished them not long ago. Knee dislocations, patellar tendon ruptures, ligament and rotator cuff tears -- he has mastered each of these former impossibilities, bringing dead arms and legs back to life.

But Andrews still sees damage that even he can't repair. It's one of the reasons he often still works seven days a week: Enemies remain. He has spearheaded prevention programs for young athletes (visit StopSportsInjuries.org to find out more), but he knows that hurt will always be part of the game. He calls one injury in particular "the nemesis." It cripples football players especially, dooming them to pain and early retirement. When the articular cartilage in their battered knees wears away, when Andrews hears that telltale grind of bone on bone, he knows the fight is over. "We can patch it, but we can't fix it," he says, and he sounds almost wistful, the way a cop might admire a really good thief.

For the past three years, however, Andrews has been experimenting with a new strategy. "Stem cells," he says. "What we call biologics. They're on their way, and that will be a transformational event." Very quietly -- "We don't advertise it," Andrews says, "and we don't want to sensationalize it" -- he and his colleagues at clinics in Birmingham, Ala., and Gulf Breeze, Fla., have been performing stem cell injections on professional athletes. He won't name names, but Andrews has mostly employed stem cells in the deteriorated knees of football players, and virtually all of them have reported significant decreases in pain and inflammation. "It's early," he says, "but the results have been remarkable."

Stem cells are unique in that they can become any other type of cell, including that elusive articular cartilage. They are the universal part. Embryonic stem cells -- what most people think of when they think of stem cells -- are set with religious and political traps, but adults carry stem cells too. Andrews mines them from the marrow in the patient's pelvic bone and then injects them directly into the damaged joint. That's the only stem cell procedure the FDA presently allows -- the self-donation of unaltered adult stem cells. "We're neophytes," Andrews says. But this is the first step.

Other countries, such as South Korea, Japan and Germany, have far more advanced programs in stem cell therapy. (Peyton Manning reportedly had his neck treated in Europe.) Andrews agrees with the FDA that more research is needed, but he doesn't like seeing his prize patients going overseas. "We have to do the work here," he says. He's been trying to arrange clinical trials, but those require two things in short supply: money and patients willing to take the risk, not because the procedure is dangerous but because some patients will receive stem cells and others a placebo. Athletes aren't interested in saline. Time is never on the side of the suffering.

That's the other reason Andrews still works seven days a week. He had long predicted that stem cell therapies would be routine by now. Today he hopes that another decade might be enough and that he will still be working whenever his prediction finally comes true. Along with his urgency, his optimism is the most essential part of his practice. Andrews dreams constantly of marvels, of hearts grown fresh in labs, of Tommy John surgeries sidelining players for weeks rather than months. It's easier to believe in miracles, of course, when you see them throwing perfect spirals on your TV, Brees and Smith and Stafford, each one a bridge between a past that couldn't be saved and a future that always could be.

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