CENTER FOR EXCELLENCE IN SPORTS MEDICINE

The Center for Excellence in Sports Medicine is dedicated to treating and learning about injuries and conditions affecting young and growing athletes. In some cases, these injuries are acute, but other conditions may occur from repetitive motions over time. Common conditions we treat are osteochondritis dissecans of the knee, elbow injuries in throwing athletes, shoulder instability and dislocations, and sports concussions. Many of our patients are still growing, and this must be considered when treating young, active athletes.

Our research ranges from preventing sports-related injuries and conditions to identifying how to return an athlete back to sports safely after an injury or surgery. Our team of pediatric sports medicine specialists is focused on helping and encouraging children to be active well into adulthood. In addition to our local projects, we lead and work on projects with other pediatric sports medicine practitioners across the country. This allows us to study larger populations and collaborate to establish the best practices. Much of this work is done in partnership with peers in the Pediatric Research in Sports Medicine Society.


Learn more about injuries and conditions affecting young athletes on our Sports Medicine page.
 

Current Studies

This retrospective study was designed to look at trends in removal from play, symptoms reported and time to recovery after a sports-related concussion. In the first phase, records for all patients seen by Shane M. Miller, M.D. for a sports-related concussion over a 10-month period were reviewed. The results from this phase indicate that 38 percent of the 185 young athletes (ages 7-18) reviewed had returned to play or continued to play on the same day they sustained a concussion. These athletes were more likely to report symptoms and to report that those symptoms were more severe when they arrived at the clinic for evaluation. Except for playing after sustaining an injury, there were no differences in these athletes with regard to age, gender or sport they played.

After learning of these findings, Miller and the research team wanted to examine data from a single sport to determine if this return to play rate was consistent in a specific sample and if any additional differences could be seen. The team conducted a sub-study and reviewed records of 87 patients who sustained a concussion while playing soccer. Of those patients, 40.2% returned to play or continued to play on the same day as their injury. This is consistent with the results of the larger study group. Additionally, the results indicated that girl soccer players were five times more likely than boys to return to play on the same day as their concussion. This revealed further cause for concern, especially with previous literature showing that girls suffer twice as many concussions as boys.

Our team has since identified additional questions to answer and is currently working on the next phase of the project. We will include a larger group of athletes and review additional data points with the purpose of understanding why some athletes return to play on the same day and others do not. We aim to use this information to educate the community, change behaviors and transform the culture of concussions in youth sports.

IN THE NEWS

The purpose of this study is to capture comprehensive, long-term data on patients with concussion and traumatic brain injury in collaboration with our local partners. Information gathered will include information prior to injury, after injury, throughout recovery and beyond. By collecting information on how injuries occur, type of sport played, management strategies during recovery, and treatments and outcomes, this comprehensive database will help to determine which tests, treatments and services are most effective and result in the best outcomes. This evidence will be available to guide care for future patients after a concussion.

Since the project’s initiation in 2015, we have enrolled over 1,700 participants across all sites and 600 participants at Scottish Rite Hospital alone. Of these participants, a vast majority are sports concussions. Access to this wealth of data has generated many interesting findings in this population that our providers have used to educate young athletes and their families. 

One such finding has been the impact that sleep quality may have on a young athlete’s recovery following a sports concussion. Sports medicine physician Jane S. Chung, M.D., pulled data from the registry and examined athletes that were diagnosed with a sport-related concussion, less than 19 years old and had completed a sleep quality questionnaire at their clinic visit. Based on results from the sleep quality questionnaire, the research team was able to divide the young athletes into two groups – those with good sleep quality and those with poor sleep quality. From this data, the research team discovered that young athletes with poor sleep quality were more likely to have symptoms for over one month and took two weeks longer to return to play compared to young athletes with good sleep quality. Read the full article


 

  • Patient 5 years old or older
  • Clinical diagnosis of concussion from any cause

Docosahexaenoic acid (DHA) is an omega-3 fatty acid commonly found in both fish oils and algae. It has been shown to improve development of the eyes and brain in young children. The purpose of this study is to trial the use of DHA for the treatment of sports concussions in the pediatric population. The hypothesis is that the patients in this study who take a specific dose of DHA will recover faster than the patients taking a placebo pill without DHA.

INCLUSION CRITERIA

  • Patients between 14 and 18 years old 
  • Diagnosed with concussion from a sports-related injury
  • Concussion within 4 days prior to starting the study
The purpose of the Factors Associated with Clavicle Treatment Study (FACTS) is to develop a better understanding of the healing, costs and best treatment options for patients with clavicle shaft fractures. One way to accomplish this goal is by combining efforts with our partners from around the country to obtain a large, demographically and geographically diverse sample. This study is led by our colleagues at Boston Children’s Hospital and joined by six other institutions. To date, we have enrolled almost 1,000 participants across all sites, with around 150 coming from Scottish Rite Hospital.

One of the primary focuses of the group has been to compare patients that receive operative vs. non-operative treatment for their clavicle fractures. Recently, the research team investigated functional outcomes, patient-reported outcomes, and complications of patients with completely displaced, midshaft clavicle fractures (clavicle looks like a Z) who received operative or non-operative treatment. The group discovered that operative treatment did not offer a long-term benefit in terms of pain, quality of life, patient satisfaction or shoulder/upper extremity function. Additionally, operative treatment had a higher risk of a secondary or unexpected surgery and more complications with their treatment. This study recently won “Best Clinical Paper Award” at the 2019 Annual POSNA Conference.

INCLUSION CRITERIA

  • Patient between 10 and 18 years old
  • Diagnosis of a primary diaphyseal clavicle fracture
  • Fracture must be completely displaced
  • Enrolled within 59 days of the initial injury (primary fracture)
  • All study patients (across all sites) must agree to be contacted by a long-term follow-up coordinator based out of Boston Children's Hospital for long-term follow-up questions (out to the two-year time point). This can/will be done via phone, mail, text message and/or email. 
An anterior cruciate ligament (ACL) tear is a common injury in young athletes. The time to recover from surgical reconstruction of the ligament is long and the rehabilitation is intense. This has been designed to study the characteristics for patients who do and do not return to their previous level of sports competition 12 months after their ACL reconstruction. This information will help surgeons better counsel athletes based on presurgical physical and psychological characteristics.

INCLUSION CRITERIA

  • Patients between 12 and 18 years old 
  • Recommended for ACL reconstruction with or without other procedures in the knee at the same time
  • Participated in team sports prior to surgery
This study looks at patients with a condition of the cartilage and bone on the weight-bearing surface of the thighbone in the knee. This condition is called osteochondritis dissecans (OCD). A standard nonoperative treatment consists of wearing a hinged knee brace while non-weight-bearing and then progressing to weight-bearing with activity restrictions.


The purpose of this study is to examine the patient satisfaction and compliance of a different brace frequently used in this population, the valgus unloader brace. Comparing this common brace to the standard treatment will help determine if the treatment options are equivalent and patient satisfaction and compliance can guide treatment recommendations.

INCLUSION CRITERIA

  • Patients between 7 and 18 years old
  • Patients that are still growing; this is called skeletally immature
  • Diagnosis of a stable OCD lesion in the femoral condyle of the knee
  • MRI to confirm lesion stability
  • Patient must be able to walk
The Research OsteoChondritis of the Knee (ROCK) study group is comprised of more than 30 surgeons at more than 20 national and international major medical centers. The purpose of this study is to develop a registry of all patients seen at these participating institutions with a diagnosis of osteochondritis dissecans (OCD) of the knee. Data will be recorded throughout the care stages from diagnosis through long-term follow-up.

Watch this video to learn more about osteochondritis dissecans of the knee.

INCLUSION CRITERIA

  • Diagnosis of OCD of the knee

Latest News: Sports Medicine