Goble Medical | Publications/Presentations/Distinctions
16634
page,page-id-16634,page-template-default,ajax_fade,page_not_loaded,,qode-title-hidden,qode-theme-ver-7.4,wpb-js-composer js-comp-ver-4.5.2,vc_responsive

How Dr. Goble came to specialize in MAT surgery.

Dr. Goble was first introduced to MAT in 1990 when a colleague, Dr. John Garrett of Atlanta Georgia,  consulted with Dr. Goble in the possible development of a standard surgical approach to replacement of a native meniscus by a donor meniscus. Conceptually, there were would be many  advantages of meniscal transplantation over knee replacement – if a practical and reliable procedure could be developed. A new transplanted meniscus would rejuvenate and protect an otherwise healthy knee joint.  It would provide an alternative to a total knee procedure and avoid the limitations it imposes.

To that point, Dr. Garrett had pioneered early MAT transplantation by use of fresh cadaver harvest and transplantation, within 48 hours. However, Dr. Garrett was confronted with the practical difficulty of using fresh meniscal tissue because of issues concerning supply, sizing, disease transmission, and cost.

Dr. Garret presented his early research and development to a group of knee surgeons: Doctors Wjoyts, Stone and Wolf. They accepted the challenge and began their own efforts to develop a practical MAT procedure.

Over the next 10 years, Dr. Goble implanted well over 100 Meniscal Allograft Transplantations. The surgical indications, allograft preparation, sizing, surgical technique and patient results are reported by Dr. Goble in these publications. The research and innovation performed by Doctors Goble, Wjoyts, Stone and Wolf resulted in an effective and practical MAT surgical procedure.

However, the MAT procedure is not widely offered by orthopedists who perform total knees for several reasons. First, the current Meniscal Allograft Transplantation procedure takes over 4 hours, and is very difficult for a surgeon to learn and perform. Second, it is relatively time consuming and expensive compared to alternatives. Last, insurance companies do not reimburse doctors who perform the surgery at a rate which makes the surgery cost effective for regular practice.

The MAT surgery works. For the proper patient it is a superior alternative to a total knee.  Although only a few surgeons are trained to perform this procedure, it is available to the educated candidate.

Dr. Goble accepts candidates for Meniscal Allograft Transplantation after referral from a local doctor. He will also accept a candidate who is otherwise sufficiently informed about their options regarding the procedure.

How Dr. Goble came to specialize in ACL repair

In 1977 an injured Anterior Cruciate Ligament was rarely reconstructed. Indeed, as resident in  Utah Dr. Goble had no knowledge of the function or the treatment of the Anterior Cruciate Ligament, or its injury. His first substantive venture into the knee wasn’t until 1979 when he published an article with doctorial candidate Paul France,  called “Simultaneous Quantitation of Knee Ligament Forces” in 1979. This landmark publication in the Journal of Biomechanics was the first quantitative analysis of the then-misunderstood function of the cruciate ligament pair.

In the years immediately thereafter, he completed a sports medicine fellowship at the Slocum Clinic (Eugene, Oregon) and a European fellowship tour in 1982 and 1983.

While studying with Werner Mueller in Bazel Switzerland, Dr. Goble imagined his first medical invention. Upon his return, he developed a new devise (and accompanying arthroscopic surgical technique) for reattaching torn ligaments back to their long origins. He applied for a patent in 1984 called a ‘suture anchor’. The “Suture Anchor” has since matured into the single most important arthroscopic implant in Sports Medicine. While primarily developed for use in the knee, variations of the original idea are now used in the repair of major joints throughout the body.

IN 1986 Zimmer Inc. hired Dr. Goble to develop a surgical technique for a Prosthetic (nonbiological) Anterior Cruciate Ligament. During this development period (1986-1988) they learned that artificial Anterior Cruciate Ligaments would not consistently survive within the knee for more than one year. Instead, Dr. Goble, together with other researchers, developed a Straight Tunnel Anterior Cruciate Ligament reconstruction surgical technique. This introduced arthroscopic Anterior Cruciate Ligament reconstruction. Today, this same basic technique is still used, with only minor changes, in almost all Anterior Cruciate Ligament reconstruction surgeries.

The development of the Suture Anchor and the Arthroscopic Anterior Cruciate Ligament surgery led the establishment of Medicine Lodge Inc, a sports medicine research and development company, in 1990.

This extant research enterprise has been responsible for the creation of several orthopedic companies, all located (initially) in Logan, Utah.

  1. Innovasive Devices
  2. IMDS
  3. Facet Solutions
  4. Venture M.D.

Alan Chervitz and Wade Fallin, two Georgia Tech engineers co-founded these companies with Dr. Goble. Working through these companies the creation of many ACL implants and surgical techniques would come about over the next 15 years. These patented systems which are currently utilized include:

  1. Cannulated Interference Screw
  2. Cross Pin Femoral Fixation for Anterior Cruciate Ligament Grafts
  3. Set Screw Anterior Cruciate Ligament fixation
  4. Tibial Tunnel Drilling System
  5. Cross Pin Interference Screw
  6. Periosteal Femoral Anterior Cruciate Ligament Fixation

Of all the above, the Cannulated Interference Screw, co-developed by David McQuire and Dr. Goble, is the most universally utilized. This rigid femoral and tibial implant is used in 65% of Anterior Cruciate Ligament surgeries worldwide.

Dr. Goble has utilized all of the above Anterior Cruciate Ligament systems over the past 30 years.

The development moves forward, on the horizon is yet another new system, called non-rigid Anterior Cruciate Ligament fixation. It is currently still in the development process. This new system, to be released in 2012, will decrease the rate of late occurring degenerative arthritis in Anterior Cruciate Ligament Reconstructed knees.

How Dr. Goble came to specialize in Minimally Invasive Total Knee Arthroplasty

In 1992 Dr. Goble performed the first Minimally Invasive Surgical Total Knee Arthroplasty. He utilized a Lateral Incision and made the bony cuts from lateral to medial – 90 degrees from the conventional Anterior approach with its 12-15 inch incision.

Dr. Goble along with Dr. Dick Caspari spent the next 8 years perfecting devices and accompanying technique so that it would be easily teachable to other physicians. In 2002 Zimmer and Medicine Lodge Inc. signed an agreement where Dr. Goble, in conjunction with Doctors Coon and Dr. Tria, agreed to develop a minimally invasive total knee procedure and it’s accompanying devices. Today, every major orthopedic company selling Total Knee Arthroplasty systems has reacted with some form of their own Minimally Invasive Surgery Total Knee Arthroplasty.

In one form or another, minimally invasive or less invasive total knee arthroplasty is now the standard approach used in total knee surgeries.

Patents

(2002 – present) five patents contributing to MAT method and devices.

  1. (2009 MAT)System and method for meniscal repair through a meniscal capsular tunnel
  2. (2009 MAT)Methods and apparatus for forming a tunnel through a proximal end of a tibia
  3. (2007 MAT & ACL)Apparatus and method for attaching a graft ligament to a bone
  4. (2007 MAT o& ACL)Bone fixation systems and related methods
  5. (2002 MAT & ACL)Self-tensioning soft tissue fixation device and method

(1988 – present) 63 patents involving ACL reconstruction methods and devices:

(2007 MAT or ACL) Apparatus and method for attaching a graft ligament to a bone
(2007 MAT or ACL) Bone fixation systems and related methods
(2006 ACL) Method and apparatus for reconstructing a ligament
(2003 ACL) Apparatus and method for attaching a graft ligament to a bone
(2002 ACL) Adjustable length strap and footing for ligament mounting and method for its use
(2002 MAT or ACL) Self-tensioning soft tissue fixation device and method
(1999 ACL) Bone fixator for a ligament anchor system
(1999 ACL) Suture anchor assembly
(1999 ACL) Fixation device chemical dispensing system
(1999 ACL) Surgical site chemical dispensing system
(1998 ACL) Suture anchor assembly
(1998 ACL) Ligament fixator for a ligament anchor system
(1998 ACL) Modular drill and method for using the same
(1998 ACL) Anterior cruciate ligament tensioning device and method for its use
(1997 ACL) Ligament bone anchor and method for its use
(1997 ACL) Bone-tendon-bone drill guide
(1997 ACL) Variable angle drill guide and ligament fixation method
(1997 ACL) Chemical dispensing system
(1997 ACL) Suture anchor system and method
(1997 ACL) Soft tissue anchor and method 
(1996 ACL) Suture anchor loader and driver
(1996 ACL) Orthopaedic washer
(1996 ACL) Orthopedic washer
(1996 ACL) Ligament replacement cross pinning method
(1996 ACL) Orthopedic washer
(1996 ACL) Orthopedic washer
(1996 ACL) Modular surgical drill
(1996 ACL) Method and apparatus for tensioning grafts or ligaments
(1996 ACL) Orthopaedic washer
(1995 ACL) Surgical drill guide
(1995 ACL) Cross pin and set screw femoral and tibial fixation method
(1995 ACL) Instrument with dual holding feature
(1995 ACL) Bone fixation and fusion system
(1995 ACL) Suture anchor and driver combination
(1995 ACL) Anchor driver
(1995 ACL) Pin for securing a replacement ligament to a bone
(1995 ACL) Process of endosteal fixation of a ligament
(1995 ACL) Process for endosteal ligament mounting
(1995 ACL) Sight barrel arthroscopic instrument
(1994 ACL) Procedure for verifying isometric ligament positioning
(1994 ACL) Drill guide apparatus for installing a transverse pin
(1994 ACL) Arbor press staple and washer and method for its use
(1994 ACL) Method for securing a ligament replacement in a bone
(1994 ACL) Method for forming a tunnel intersecting a straight cruciate ligament tunnel
(1994 ACL) Channel ligament clamp
(1993 ACL MAT) Mutliple guide sleeve drill guide
(1993 ACL) Ligament attachment method and apparatus
(1992 ACL) Femoral tunnel entry drill guide
(1992 ACL) Endosteal ligament fixation device
(1992 ACL) Harpoon suture anchor
(1992 ACL) Endosteal ligament retainer and process
(1991 ACL) Procedure for verifying isometric ligament positioning
(1991 ACL) Soft tissue anchor system
(1991 ACL) Endosteal fixation stud and system
(1991 ACL) Drill guide
(1990 ACL) Channel ligament clamp and system
(1990 ACL) Process of endosteal fixation of a ligament
(1990 ACL) Drill guide
(1989 ACL) Ligament anchor system
(1988 ACL) Ligament attachment method and apparatus
(1988 ACL) Suture anchor system

17 patents involving MIS TKA method and devices

(2005 MIS) Integrated infusion and aspiration system and method
(2006 MIS) Tibial tubercle osteotomy for total knee arthroplasty and instruments and implants therefor
(2006 MIS) Modular femoral components for knee arthroplasty
(2009 MIS) Methods for mounting a tibial condylar implant
(2009 MIS) Femoral components for knee arthroplasty
(2010 MIS) Line lock graft retention system and method
(2010 MIS) Milling system and methods for resecting a joint articulation surface
(2010 MIS) Milling system with guide paths….for resection a Joint articulating surface
(2010 MIS ) Modular bone implant, tool, and method
(2010 MIS) Tibial condylar hemiplasty tissue preparation instruments and methods
(2010 MIS) Method of Rasp for resurfacing joint articulation surface
(2010 MIS) Modular Bone Implant and method
(2010 MIS) Tibial condylar hemiplasty implants, anchor assemblies, and related methods
(2010 MIS) Modular progressive implant for a joint articulation surface
(2011 MIS) Implants and Method for Securing Implant to Surface of Knee.
(2011 MIS) Methods for mounting and using tethered joint bearing implants
(2011 MIS) Instruments and methods for preparing a joint articulation surface for an implant

11 patents involving facet methods and devices
(2002 SPINE) Prosthesis for the replacement of a posterior element of a vertebra
(2003 SPINE) Multiple facet joint replacement
(2003 SPINE) Facet joint replacement
(2006 SPINE) Facet joint replacement
(2006 SPINE) Multiple facet joint replacement
(2006 SPINE) Method and apparatus for spine joint replacement
(2008 SPINE) Method and apparatus for spine joint replacement
(2009 SPINE) Prosthesis for the replacement of a posterior element of a vertebra
(2009 SPINE) Facet joint replacement
(2009) SPINE) Multiple facet joint replacement
(2009 SPINE) Facet joint replacement

Publications

(1995- present) 11 published peer reviewed articles & chapters regarding MAT techniques, technologies and issues.

  1. Goble, E.M. (1995) Meniscal Transplantation: Arthroscopic Technique, Current Techniques in Arthroscopy, 2nd Edition.
  2. Goble, E.M., Kane, S.M., Wilcox, T.R., Doucette, S.A. (1996) Meniscal Allografts, Operative Arthroscopy, Second Edition, Chapter 20: 317-331.
  3. Goble, E.M., Wilcox, T.R., (1996) Indications for Meniscal Allograft Reconstruction, The American Journal of Knee Surgery, Winter 1996/Vol 9 No 1.
  4. Goble, E.M., Wilcox, T.R., Doucette, S.A. (1996) Goble Technique of Meniscus Transplantation, The American Journal of Knee Surgery, Winter 1996/Vol 9 No 1.
  5. Goble, E.M., Verdonk, R., Kohn, D., (1999) Arthroscopic and Open Surgical Techniques for Meniscal Replacement – Meniscal Allograft Transplantation and Tendon Autograft Transplantations, Scandinavian Journal of Medicine and Science in Sports 1999; 9:168-176.
  6. Goble, E.M., Kohn, D., Verdonk, R., Kane, S.M., (1999) Meniscal Substitutes – HumanExperience, Scandinavian Journal of Medicine and Science in Sports 1999; 9:146-157.
  7. Goble, E.M., (2000) Meniscal Allograft Technique Operative Techniques in Orthopedics, Vol 10, No. 3 (July), 2000:pp220-226.
  8. Goble, E.M., Kane, S.M., (2000) Meniscal Allograft Transplantation, Advanced Arthroscopy, Chapter 31: 367-380. Goble, E.M., Kane, S.M. (2001) Meniscal Allograft Transplantation, Surgery of the Knee, 3rd Edition, Vol. 1, Chapter 27:545-563.

(1980 – present) 11 peer reviewed articles or chapters regarding ACL repair

  1. France, E.P., Daniels, A.U., Goble, E.M. and Dunn, H.K. (1983)  Simultaneous Quantitation of Knee Ligament Forces, J. Biomechanics, 16(8):553-564.
  2. Bertin, K.C. and Goble, E.M. (1983) Ligament Injuries Associated With Physeal Fractures About the Knee, Clinical Orthopaedics, July-August; 177:188-195.
  3. Goble, E.M. (1988)  Fluoroarthroscopic Allograft Anterior Cruciate Reconstruction, Techniques Orthop, 1988;2(4):65-73.
  4. Goble, E.M., Downey, D.J, and Walton, C.N. (1993)  Freeze-Dried Nonirradiated Experience:  Fascia Lata Allograft ACL Reconstruction, Sports Med. and Arthros. Review, 1:71-76.
  5. Goble, E.M., Somers, W.K., Clark, R., Olsen, R.E. (1994) The Development of Sutures Anchors for Use in Soft Tissue Fixation to Bone, Am. J. of Sports Medicine, 22(2): 236-239.
  6. Goble, E.M. (1994) Review of “Case Report: Revision Anterior Cruciate Ligament Reconstruction,” Arthroscopy: The Journal of Arthroscopic and Related Surgery, 10(2): 153-155.
  7. Goble, E.M. (1995) Arthroscopic and Endoscopic Allograft Reconstruction, Operative Techniques in Sports Medicine, Vol 3, No 3 (July), 1995: 165-172.
  8. Goble, E.M., Downey, D.J., Wilcox, T.R. (1995) Positioning of the Tibial Tunnel forACL Reconstruction, Arthroscopy: The Journal of Arthroscopic and Related Surgery, December 1995
  9. . Goble, E.M., Kane, S.M., Wilcox, T.R., Olsen, R.E. (1996) Advanced Arthroscopic
  10. Instrumentation, Operative Arthroscopy, Second Edition, Chapter 2: 7-12. Clark, R, Olsen, R.E., Larson, B.J., Goble, E.M., Farrer, R.P., (1998) Cross-Pin Femoral Fixation: A New Technique for Hamstring Anterior Cruciate Ligament Reconstruction of the Knee, Arthroscopy: The Journal of Arthroscopic and Related surgery, Vol 14, No 3 (April), 1998: pp 258-267).

Other Publications:

Presentations

(1991- Present) Presentations at 36 different seminars to informing and instructing other orthopedists regarding MAT developments.

  1. 5th International Knee Surgery Course – Bormio, Italy  09/1991
    1. Fluoroscopic ACL Reconstruction,
    2. Meniscal Allograft Transplant.
  2. 2nd Annual Fall Education Conference (Nevada Donor Network) – Las Vegas, NV  12/1991
    1. Allograft Meniscus;
    2. ACL Transplantation.
  3. Meniscal Transplantation Study Group – Washington, DC  1/1992  (AAOS)
    1. Two Year Meniscal Allograft Clinic Study Status Report.
  4. AANA Specialty Day – Washington, DC  1/92 (AAOS)
    1. Meniscal Allograft
  5. 11th Annual Cherry Blossom Seminar – Washington, D.C.  4/1992
    1. Meniscal Allograft Indications Technique,
    2. ACL Endosteal Fixation with Radioisometry, Perpendicular Endosteal Femoral Fixation of the ACL.
  6. 1993 Arthroscopy Seminar – Snowbird, UT  1/1993
    1. Meniscal Allograft Reconstruction (Two Year Experience, Interference Fit BTB and Cross Pin Femoral Fixation, Fascia Lata, Arthroscopy for Treatment of Soft Tissue Impingement Following Total Knee Replacement). 
  7. .  Meniscal Transplantation Study Group – San Francisco, CA  2/1993
    1. Developments in Lateral Allograft Meniscal Reconstruction
  8. 12th Annual Cherry Blossom Seminar – Washington, DC  3/1993
    1. Present Status of Meniscal Allograft,
    2. Perpendicular Endosteal Femoral Fixation in ACL Reconstruction.
  9. 6th International Knee Surgery Course – Bormio, Italy  5/1993
    1. Autograft and Autograft Ligaments,
    2. Meniscus Transplants (Allograft).
  10. Course Director; Meniscal Allograft Transplantation Workshop Sun Valley, ID  7/1993
  • Meniscal Allograft Transplantation A Cadaver Laboratory Workshop – San Francisco, CA  8/1993
    1. Indications for Meniscal Allograft Transplantation Results, Surgical Demonstration:  Lateral Meniscal Transplantation.
  1. AAOS – Steamboat Springs, CO  1/1994
    1. ACL Reconstruction/Fixation Techniques,
    2. Meniscus Transplantation,
    3. Arthroscopic Meniscus Transplantation
    4. Rehabilitation Following Meniscus Transplantation.
  2. Arthroscopic Surgery 1994 – Scottsdale, AZ  1/1994
    1. ACL Graft Fixation, Principles and Techniques, Transendosteal BTB/ACL Femoral Fixation,
    2. Meniscal Allograft Transplantation-Update.
  3. AAOS Annual Meeting – New Orleans, LA  2/94
    1. Fairbanks and His Effect on the Indications for Meniscal Allograft Reconstruction,
    2. Complications and Pitfalls of Arthroscopic Anterior Cruciate Ligament Reconstruction. 
  4. Mountain West Winter Retreat 1994 Grand Targhee, Alta, WY  3/1994
    1. Meniscal Allograft/Repair/Results/Technique.
  5. New Perspectives in Arthroscopy and Sports Medicine – Palm Springs, CA  3/1994
    1. Endoscopic/Flouroscopic Allograft,
    2. Meniscal Allograft
  6. 13th Annual Cherry Blossom Seminar – Washington, DC  4/94
    1. Present Status of Meniscal Allograft, Indication, Technique and Result,
    2. Use of Allograft in ACL Reconstruction Indication and Technique,
    3. Perpendicular Endosteal ACL Reconstruction.
  7. 13th Annual AANA Meeting – Orlando, FL  4-5/1994
    1. Case Presentation to Experts: Arthroscopic Treatment of Meniscal Injuries.
  8. 3rd European Conference on Tissue Banking and Clinical Application of Grafts – Vienna, Austria  10/1994
    1. Meniscal Transplantation: Experience with Allograft Ligament Surgery. 
  9. 1995 Arthroscopic Surgery Seminar – Sun Valley, ID 1/1995
    1. Technique: Meniscal Repair, Meniscal Allograft Reconstruction: Five Year Experience, Anterior Drift of the Tibial Tunnel,
    2. Tensioning of ACL Graft, Cross
    3. Pin BTB ST/G ACL Reconstruction
  10. 14th Annual Cherry Blossom Seminar – McLean, VA  4/1995
    1. Present Status of Meniscal Transplantation: Allograft 5 Year Follow-Up,
    2. Right Angle Set Screw BTB ACL Reconstruction, Anterior Tibial Tunnel Shift,
    3. ACL Graft Tensioning.
  11. Current Concepts in Sports Injuries (AOSSM) – Kamuela, HI  4/1995
    1. Rationale and Technique for Meniscal Allograft. 
  12. 59th Annual WOA Meeting – Santa Fe, NM  10/1995
    1. Today’s State of the Art: Meniscal Allograft Techniques
  13. Arthroscopic Surgery 1996 – Scottsdale, AZ  01/96
    1. Technique and Six-Year Follow-Up: Meniscal Allograft Transplantation,
    2. Is Meniscal Allograft Reconstruction a Reasonable Approach to a Meniscal Deficient Compartment?
    3. ACL Reconstruction – Principles and Personal Choice
  14. 15th Annual Cherry Blossom Seminar – Nassau, Bahamas 03/1996
    1. Meniscal Allograft, Arthroscopically Assisted ACL Reconstruction w/Perpendicular Endosteal Fixation. 
  15. 15th Annual AANA Meeting – Washington, DC 04/96
    1. Course 104 – Meniscal Surgery.
  16. Arthroscopy and Reconstructive Surgery 1997 – Sun Valley, ID 01/97
    1. ACL Graft Tensioning: Biomechanical Principles and Techniques, Revision for Lax
    2. ACL Reconstruction, Evaluation of the Osteoarthritic Knee: Arthroscopy is a Valuable Tool, Surgical Consideration for the 30-40 Year Old with Significant Osteoarthritis,
    3. Meniscal Transplantation: Technique and Follow-up
  17. Evaluation and Treatment of the Injured Athlete: Sports Medicine Update Winter 1997 – Snowmass Village, CO  03/97
    1. Mini Symposium: Primary ACL Reconstruction, Current Techniques: Allograft,
    2. ACL Graft Tensioning,
    3. Graft Fixation: Comparison of Current Methods and Future Concepts, Anterior Tibial Tunnel Drift: A Complication of ACL Reconstruction, Late Tensioning of the ACL Graft: Treatment of Unintentional Laxity,
    4. Meniscal Allograft Transplantation.
  18. Arthroscopy and Reconstructive Surgery 1998 – Scottsdale, AZ  1/98
    1. Fundamentals of Modern ACL Reconstruction, BTB and Quadriceps Tendon ACL
    2. Reconstruction, Meniscal Transplantation,
    3. Braveheart: Why Physicians Must Fight for Autonomy Against the Increasing Interference by Managed Care  
  19. ACL Study Group – Vail, CO  3/1998
    1. Clinical Follow-Up of Meniscus Allograft Replacement
  20. Meniscus Transplantation Symposium – Copenhagen, Denmark  9/1998
    1. Clinical Experience with Meniscus Grafts: Healing Rate, Pain         
    2. Relief, Prevention of Arthrosis, Complication Rate, Immunologic Reactions on Meniscus Transplants,
    3. Harvest of the Graft: Goble Technique with Bone Plugs, Fixation            
    4. Techniques: Bone Anchors, Operative Techniques: Bone Plugs or Sutures (Guides),         Arrows/Sutures, Portals, and Positioning of the Patient: Necessary Equipment, Lateral     Meniscus Transplantation with Bone Plugs,
    5. Indications for Meniscal Transplantation,     
    6. Should Meniscal Transplantation Be Combined with Correction of Instability or             Deformity and/or Repair of Cartilage Defects?
    7. Meet the Experts: Discussion of Cases
  21. 14th  National Congress of the Italian Arthroscopy Society – Forte Dei Marmi, Italy 5/1999
    1. Meniscal Repairs,
    2. ACL:Present and Future,Knee Condral Defects.
  22. Arthroscopy and Reconstructive Surgery 2000,  Scottsdale, AZ 1/2000.
    1. Indications and Outcome of Meniscal Transplantation,
  23. Arthroscopy and Reconstructive Surgery 2001. Sun Valley, ID 1/2001
    1. Meniscal Allograft Reconstruction,
    2. Principles of Cross-Pin ACL Fixation,
  24. AAOS, San Francisco, CA. 2/2001
    1. Meniscal Allograft; 11 yr. Follow-up (single case),
    2. Meniscal Transplant Study Group,
  25. Arthroscopy and Reconstructive Surgery 2002, Salt Lake City, UT  1/2002.
    1. New Ideas for Tibial Fixation, Lateral Tibial Plateau Trauma, Medial
    2. Meniscal Allograft Transplantation

(1980 present) invited to speak at 65 international speaking / instruction seminars presented to other orthopedists regarding ACL reconstruction.

  1. Goble, E.M. and Dunn H.K. (1980)  Simultaneous Quantitation of Knee Ligament
    Forces.  Western Orthopedic Association – Honolulu, Hawaii  10/80.
  2. Goble, E.M. (1987)  Fluoroarthroscopic Allograft Anterior Cruciate Reconstruction.
    University of Utah Grand Rounds – Salt Lake City, Utah 11/87
  3. Goble, E.M. (1988)  Review of papers for General Meeting.  American Academy of
    Orthopedic Surgeons – Las Vegas, Nevada  2/88
  4. Goble, E.M. (1988)  Fluoroarthroscopic Allograft Anterior Cruciate Reconstruction.
    Advances in Cruciate Ligament Reconstruction of the Knee:  Prosthetic vs. Autogenous –
    Palm Springs, California  3/88
  5. Goble, E.M. (1988)  The Anterior Cruciate Deficient Knee.  West Coast Regional Senior
    Residency Program – Newport Beach, California  9/88
  6. Goble, E.M. (1988) Fluoroarthroscopic Allograft Anterior Cruciate Reconstruction.  The
    Knee: Form, Function and Philosophy – Jackson Hole, Wyoming  4/88
  7. Goble, E.M. (1989)  Proximal Endosteal Fixation for ACL Reconstruction.  6th
    International Symposium: Advances in Cruciate Ligament Reconstruction of the Knee:
    Autogenous vs. Prosthetic – Century City, California  3/89
  8. Goble, E.M. (1989)  Endosteal fixation of the ACL Reconstruction.  Annual Meeting,
    Arthroscopic Association of North America – Seattle, Washington  4/89
  9. Goble, E.M. (1989)  Outpatient Arthroscopic ACL Reconstruction Using Endosteal
    Fixation of a Fascia Lata Allograft.  Czechoslovak Institute for Sports Medicine – Prague,
    Czechoslovakia  11/89
  10. Goble, E.M. (1990)  A New Endosteal Technique for ACL Reconstruction in an
    Outpatient Setting.  Arthroscopic Surgery 1990 – Snowbird, Utah  1/90
  11. Goble, E.M. (1990)  Fluoroscopic Arthroscopic ACL Reconstruction.  Prosthetic
    Ligament Course – Palm Springs, California  3/90
  12. Goble, E.M. (1990)  ACL Endosteal Femoral Fixation.  ACL Study Group – Engleberg,
    Switzerland  3/90
  13. Goble, E.M. (1990)  ACL Endosteal Femoral Fixation.  Grand Rounds, University of
    Utah – Salt Lake City, Utah  4/90
  14. Goble, E.M. (1990)  An Outpatient Method for ACL – Reconstruction Using an Allograft
    and Endosteal Fixation.  Concept Arthroscopy Study Group – Paris, Tennessee  6/90
  15. Goble, E.M. (1990)  ACL Endosteal Femoral Fixation.  Goodwill Games – Seattle,
    Washington  7/90
  16. Goble, E.M. (1990)  Endosteal Fixation Techniques.  Arthroscopic ACL Cadaveric
    Meeting – Dana Point, California  7/90
  17. Goble, E.M. (1990)  Ligament and Soft Tissue Repair; Suture Anchor Technology.
    Grand Rounds, Southwestern Medical Center – Dallas, Texas  7/90
  18. Goble, E.M. (1990)  Pertinent Knee Topics.  Panel Discussion, Second Annual Dunbar
    Memorial Sports Medicine Lecture, University of Utah Medical Center -Salt Lake City,
    UT  9/90
  19. Goble, E.M. (1990)  Suture Anchor Technology.  Zimmer Amelia Island Meeting –
    Amelia Island, FL  12/90
  20. Goble, E.M. (1991)  ACL Graft Fixation / Isometry, Meniscal Allografts,
    Flouroarthroscopic ACL Reconstruction, Suture Anchor Technology.  Arthroscopic
    Surgery 1991 – Scottsdale, AZ  01/91
  21. Goble, E.M. and Walton, C.N. (1991)  Endosteal ACL Graft:  Original Study.
    A.O.S.S.M/J.O.S.S.M. Trans-Pacific Meeting – Kauai, Hawaii  01/91
  22. Goble, E.M. (1991)  ACL Endosteal Femoral Fixation, Meniscal Allografts, Suture
    Anchor Technology for Tissue Reattachment.  10th Annual Cherry Blossom Seminar –
    Washington, DC  03/91
  23. Goble, E.M. (1991)  Endosteal Allograft Cruciate Ligament Reconstruction.  AANA
    Annual Meeting – San Diego, CA  04/91
  24. Goble, E.M. (1991)  Outpatient Fluoroarthroscopic Endosteal ACL Reconstruction,
    Suture Anchor Technology, Meniscal Allograft Reconstruction.  Second Congress of
    Knee and Orthopaedic Sports Medicine Section of W.P.O.A. – Seoul, Korea  07/91

26, Goble, E.M. (1991)  Soft Tissue Repair.  Management of Complex Fractures / Zimmer –
Sun Valley, ID  08/91

  1. Goble, E.M. (1991)  Allograft Ligament Replacement.  Sports Related Injuries – London,
    England  09/91
  2. Goble, E.M. (1991)  Fluoroscopic ACL Reconstruction, Meniscal Allograft Transplant.
    5th International Knee Surgery Course – Bormio, Italy  09/91
  3. Goble, E.M. (1991)  ACL Endosteal Fixation & Radioisometry.  AANA Annual Fall
    Meeting – Palm Desert, CA  11/91
  4. Goble, E.M. (1991)  Allograft Meniscus and ACL Transplantation.  2nd Annual Fall
    Education Conference (Nevada Donor Network) – Las Vegas, NV  12/91
  5. Goble, E.M. (1992)  Perpendicular Endosteal Femoral Fixation of the ACL.  1992 ACL
    Study Group – Vail, CO  1/92
  6. Goble, E.M. (1992)  Fixation of Grafts in ACL Reconstruction, ACL Reconstruction with
    Allograft: Technique Results.  Update, 1992:  New Perspectives in Arthroscopy and
    Sports Medicine – Palm Springs, CA  3/92
  7. Goble, E.M. (1992)  Meniscal Allograft Indications Technique, ACL Endosteal Fixation
    with Radioisometry, Perpendicular Endosteal Femoral Fixation of the ACL.  11th Annual
    Cherry Blossom Seminar – Wasington, D.C.  4/92
  8. Goble, E.M. (1992)  Graft Fixation & Tensioning, Flouroscopic/Endoscopic
    Reconstruction with Fascia Lata Allograft.  11th Annual AANA Meeting – Boston, MA
    4/92
  9. Goble, E.M. (1992)  Endoscopic (Endosteal) ACL Reconstruction, Meniscal Allografts,
    Soft Tissue Anchors.  Steadman Hawkins Knee and Shoulder Workshop – Vail, CO  7/92
  10. Goble, E.M. (1992)  ACL/PCL Graft Dynamics Graft Placement, Meniscal Allograft
    Indications & Techniques, Radioisometry / Fascia Lata, Radioisometry ACL.
    Arthroscopic ACL Cadaveric Meeting – Dana Point, CA  7/92
  11. Goble, E.M. (1992)  Mechanics of Soft Tissue to Bone Repair Utilizing Site Specific
    Suture Anchors.  Trauma Update Complex Fractures (ZIMMER) – Baltimore, MD  8/92
  12. Goble, E.M. (1992)  Mechanics of Soft Tissue to Bone Repair Utilizing Site Specific
    Suture Anchors.  Trauma Update Complex Fractures (ZIMMER) –  New York City, NY
    11/92
  13. Goble, E.M. (1993)  ACL Reconstruction: Allografts vs. Autograft Selection.
    Arthroscopy Association of North America Specialty Day – San Francisco, CA  2/93
  14. Goble, E.M. (1993)  Present Status of Meniscal Allograft, Perpendicular Endosteal
    Femoral Fixation in ACL Reconstruction.  12th Annual Cherry Blossom Seminar –
    Washington, DC  3/93
  15. Goble, E.M., Hammesfahr, J.F., Malek, M.M. (1993)  Course 203: Anterior Cruciate
    Ligament: Principles and Techniques of Reconstruction.  12th Annual AANA Meeting –
    Palm Desert, CA  4/93
  16. Goble, E.M. (1993)  Intra-articular and Extra-articular Reattachment of Ligaments of the
    Knee.  55th Annual American Fracture Assn. – St. Louis, MO  4/93
  17. Goble, E.M. (1993)  Mechanics of Soft Tissue to Bone Repair Utilizing Site Specific
    Suture Anchors.  National Fracture Meeting – San Diego, CA  6/93
  18. Goble, E.M. (1993)  Soft Tissue Attachment Device, Meniscus Reconstruction by Graft,
    45. ACL Reconstruction by Graft.  JOSSM Seminar – Miyazaki, Japan  7/93, Kobe
    University Seminar   – Kobe, Japan 7/93, Nagoya University Seminar – Nagoya, Japan
    7/93
  19. Goble, E.M. (1993)  Course Director.  Tensioning of ACL Graft:  A New Device for
    Measurement, 90 Degree Set Screw and Cross Pin Femoral Fixation:  Mechanical and
    Clinical Results, Live Interactive Lab Session, Mechanical Comparison for Tibial
    Fixation of ACL Graft, Cannulated Interference Screw Fixation and Set Screw Fixation
    of BTB ACL Graft.  Sun Valley Arthroscopic Seminar – Sun Valley, ID  9/93
  20. Goble, E.M. (1993)  Soft Tissue Attachment.  Current Issues in Orthopedics -Davenport,
    IA  10/93
  21. Goble, E.M. (1993)  Feature Speaker.  St. Louis Arthroscopy Association Fall Meeting –
    St. Louis, MO  11/93
  22. Goble, E.M. (1993)  Technique of Meniscal Allograft—Lateral, Allograft ACL
    Flouroscopic Techniques, Demonstration—ACL Flouroscope Allograft,
    Demonstration—Allograft Lateral, Demonstration—Demonstration Medial.   The Sports
    Clinic – Laguna Hills, CA  11/93
  23. Goble, E.M. (1993)  Clinical Applications of Soft Tissue Anchors, Bioskills Lab Soft
    Tissue Attachment.  Management of Complex Fractures Problems and Solutions – Amelia
    Island, FL  12/93
  24. Goble, E.M. (1994)  AC Reconstruction/Fixation Techniques, Meniscus Transplantation,
    Arthroscopic Meniscus Transplantation, Meniscus Transplantation Video Presentation,
    Rehabilitation Following Meniscus Transplantation.  AAOS – Steamboat Springs, CO
    1/94
  25. Goble, E.M. (1994)  ACL Graft Fixation, Principles and Techniques, Transendosteal
    BTB/ACL Femoral Fixation, Meniscal Allograft Transplantation-Update.  Arthroscopic
    Surgery 1994 – Scottsdale, AZ  1/94
  26. Anterior Drift of the Tibial Tunnel, Tensioning of ACL Graft,
    Cross Pin BTB ST/G ACL Reconstruction.  1995 Arthroscopic Surgery – Sun Valley, ID
    1/95
  27. ACL Reconstruction – Principles and Personal Choice.  Arthroscopic Surgery 1996 – Scottsdale, AZ  01/96
  28. Goble, E.M. (1996)  Future Directions of Graft Fixation.  63rd Annual AAOS Meeting –
    AANA Specialty Day – Atlanta, GA  02/96
  29. Arthroscopically Assisted ACL Reconstruction w/Perpendicular Endosteal Fixation.  15th Annual Cherry Blossom Seminar – Nassau,
    Bahamas 03/96
  30. Goble, E.M. (1996)  Course 104 – Meniscal Surgery.  15th Annual AANA Meeting –
    Washington, DC 04/96
  31. Goble, E.M. (1997)  ACL Graft Tensioning: Biomechanical Principles and Techniques,
    Revision for Lax ACL Reconstruction, Evaluation of the Osteoarthritic Knee:
    Arthroscopy is a Valuable Tool, Surgical Consideration for the 30-40 Year Old with
    Significant Osteoarthritis, Meniscal Transplantation: Technique and Follow-up.
    Arthroscopy and Reconstructive Surgery 1997 – Sun Valley, ID 01/97
  32. Goble, E.M. (1997)  Mini Symposium: Primary ACL Reconstruction, Current
    Techniques: Allograft, ACL Graft Tensioning, Graft Fixation: Comparison of Current
    Methods and Future Concepts, Anterior Tibial Tunnel Drift: A Complication of ACL
    Reconstruction, Late Tensioning of the ACL Graft: Treatment of Unintentional Laxity,
    Meniscal Allograft Transplantation.  Evaluation and Treatment of the Injured Athlete:
    Sports Medicine Update Winter 1997 – Snowmass Village, CO  03/97
  33. Goble, E.M. (1998) Fundamentals of Modern ACL Reconstruction, BTB and Quadriceps
    Tendon ACL Reconstruction, Meniscal TransplantatioReconstructive Surgery 1998 – Scottsdale, AZ  1/98
  34. ACL Study Group – Vail, CO  3/98
  35. Goble, E.M. (1998)  Clinical Experience with Meniscus Grafts: Healing Rate, Pain
    Relief, Prevention of Arthrosis, Complication Rate, Immunologic Reactions on Meniscus
    Transplants, Harvest of the Graft: Goble Technique with Bone Plugs, Fixation
    Techniques: Bone Anchors, Operative Techniques: Bone Plugs or Sutures (Guides),
    Arrows/Sutures, Portals, and Positioning of the Patient: Necessary Equipment, Lateral
    Meniscus Transplantation with Bone Plugs, Indications for Meniscal Transplantation,
    Should Meniscal Transplantation Be Combined with Correction of Instability or
    Deformity and/or Repair of Cartilage Defects?, Meet the Experts: Discussion of Cases.
    Meniscus Transplantation Symposium – Copenhagen, Denmark  9/98
  36. Goble,E.M. (1999) Meniscal Repairs, ACL:Present and Future,Knee Condral Defects.
    14th  National Congress of the Italian Arthroscopy Society – Forte Dei Marmi, Italy 5/99
  37. rinciples of Cross-Pin ACL Fixation, Arthroscopy and Reconstructive Surgery 2001. Sun Valley, ID 1/01.
  38. Goble, E.M. (2002) Cross Pin Interference Screw,  ACL Study Group, Big Sky, MT 3/02

Two presentations regarding MIS TKA technique.

Goble, E.M. (1992)  The Arthroscope after TKA.  9th Annual Snowbird Arthritic Hip,
Knee and Shoulder Symposium – Snowbird, UT  1/92

Goble, E.M. (2004) Minimally invasive total knee replacement, Principles and
Technique, Orthop Clin. North AM 2004, 150(4):750-2