Friday, February 5, 2016

Meniscal Healing Research Update

Healthy human knee meniscus
Basic biology research related to the knee meniscus is focusing on cell-based uses for meniscal healing and the use of scaffold materials for cells to induce meniscal regeneration.

Cell origin include stem cells from several sources, including intrinsic meniscal cells.

To date, most of the research is at the preclinical level (animal model).

Science has not progressed to the stage where lessons learned in the lab and preclinical level can be utilized in every day practice of Orthopedic Surgery.  Current clinical options include meniscal repair (suturing to save the meniscus) or menisectomy (removal of the torn portion that does not have any healing potential).

Friday, January 29, 2016

Stem Cell Research Update for Orthopedic Surgery

Stems Cells research is primarily being done in the lab and in animals.  Very little human investigation has occurred in the last few years.

In the past year new sources for stem cells are being studied including blood origin and synovial fluid (joint fluid) cells.

The use of stem cells for articular cartilage defects is an active area of research.  Methods of delivery include injection into the joint to implantation on scaffolds.

The use of stem cells for meniscal replacement/repair is progressing.  Cell source is meniscal or synovial or blood vessel or bone marrow.  One human study showed 24 % meniscus regeneration.

Science has not advanced to allow clinicians to recommend stem cell therapy as there are no studies to direct us as to how and where to use stem cell therapy.

Friday, January 22, 2016

Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes

Published in the American Journal of Sports Medicine

  1. David R. Bell, PhD, ATC,,

Background: Previous studies have identified abnormalities in brain and motor functioning after concussion that persist well beyond observed clinical recovery. Recent work suggests subtle deficits in neurocognition may impair neuromuscular control and thus potentially increase risk of lower extremity musculoskeletal injury after concussion.
Methods: Included in this study were 87 cases of concussion among 75 athletes (58 men; 17 women) participating in NCAA Division I football, soccer, hockey, softball, basketball, wrestling, or volleyball at a single institution from 2011 to 2014. The 90-day period after return to play for each case of concussion was reviewed for acute noncontact lower extremity musculoskeletal injury. 
Results: The incidence of acute lower extremity musculoskeletal injury was 17 % for recently concussed athletes (15/87; 17%) compared with 9 % for matched controls (17/182; 9%). 
Conclusion: Concussed athletes have increased odds of sustaining an acute lower extremity musculoskeletal injury after return to play than their nonconcussed teammates. The study results suggest further investigation of neurocognitive and motor control deficits may be warranted beyond the acute injury phase to decrease risk for subsequent injury.

Monday, December 14, 2015

MRI Study Shows How Weight Loss Protects the Knee Joint

Obese people who lose more than 10 % of their body weight can significantly slow the damage to the cartilage in their knee.  This slowed knee degeneration and decreased the risk of knee osteoarthritis.  Weight loss between 5-10 % had no protective effect.

The study was done over a 4 year period and used MRI knee scans to assess the health of knee articular cartilage.  Weight loss had a protective effect, and more weight loss was more beneficial.

Alexandra Gersing, MD was the lead researcher.  Her work was presented at the Radiologic Society of North America on November 30, 2015.

Monday, December 7, 2015

Psychology Important For Recovery Process after ACL Knee Surgery

Arthroscopic ACL Reconstruction with Hamstring Graft
Orthopedic Surgeons have optimized surgical techniques which has helped improve recovery after ACL knee surgery.  However, the recovery process has been described by pateints as arduous, and requires months of committment to the process.  Issues related to emotional disturbance, motivation, self-esteem, locus of control, and control over one's own motivation, behavior, and social environment are examples of psychological factors that play a critical role in a person's recovery.  

Psychological aspects of recovery play a critical role.  We need to better understand this concept. 

There are times when a sports psychologist should be enlisted to help athlete's with the ACL recovery process.