Editorial
Contemporary Research Areas in Sports Medicine
Daniel J Kaplan*
Department of Otolaryngology- Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
*Corresponding author: Daniel J Kaplan, Department of Otolaryngology- Head and Neck Surgery, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
Published: 31 Mar, 2017
Cite this article as: Kaplan DJ. Contemporary Research
Areas in Sports Medicine. Clin Surg.
2017; 2: 1393.
Editorial
I am currently focusing on sports medicine research-specifically: outcomes-based investigations
to evaluate the utility of certain procedures, innovative surgical techniques, and biomarker
diagnostic/therapeutic potential.
Meniscal root repair surgery has gained favor in the past 10-15 years as a means to save the
meniscus and theoretically slow cartilage degeneration. Given the relative novelty of the procedure,
we wanted to investigate our own patient cohort and determine the actual benefit of the procedure.
In a recently submitted study, despite improved patient subjective findings (consistent with
previous studies); we did appreciate a functionally restored meniscus on follow-up MRIs, indicating
the procedure may not be as beneficial as hoped [1].
Although anterior cruciate (ACL) ligament reconstruction using the anteromedial (AM) portal
has an excellent success rate, femoral tunnels drilled through the AM portal may be shorter than
desired, and requires hyper flexion of the knee [2]. A retrograde drill allows for inside-out drilling, thus circumvents both these problems; however, it was unclear if this tool could produce tunnels
at an angle that would allow collinear interference screw placement. In a now published cadaver
experiment, we demonstrated one could use the retrodrill with screw fixation and achieve minimal
divergence [3]. We continue to study the feasibility of this technique and plan to move to a clinical
investigation.
Despite the remarkably good clinical and functional outcomes of ACL reconstruction, a large
number of patients still go on to develop post-traumatic osteoarthritis [4]. To find a possible cause, we evaluated different inflammatory biomarker concentrations in three groups of patients: patients
with ACL injures and cartilage damage, patients with ACL injuries and no cartilage damage, and
patients with healthy knees. In an accepted study, we found that inflammatory markers were
increased in all patients with ACL injuries, but there were no differences between those with
and those without cartilage damage [5]. This suggests that the ACL tear leads to a change in the
inflammatory milieu which may be the proximate cause of post-traumatic osteoarthritis, as opposed
to cartilage damage suffered at the time of injury.
References
- Kaplan DJ, Dold AP, Fitzgerald Alaia E, Alaia MJ, Meislin RJ, Strauss EJ JL. Discrepancy Between Radiographic and Clinical Outcomes at Two Year Follow-Up Following Transtibial Medial Meniscal Root Repair. Knee Surgery, Sport Traumatol Arthrosc. 2016.
- Lubowitz JH, Akhavan S, Waterman BR, Aalami-Harandi A, Konicek J. Technique for creating the anterior cruciate ligament femoral socket: Optimizing femoral footprint anatomic restoration using outside-in drilling. Arthroscopy. 2013;29:522-8.
- Capo J, Kaplan DJ, Fralinger DJ. Femoral Screw Divergence via the Anteromedial Portal Using an Outside-In Retrograde Drill in Bone–Patella Tendon–Bone Anterior Cruciate Ligament Reconstruction: A Cadaveric Study. Arthroscopy. 2016;33(2):355-61.
- Lohmander LS, Ostenberg a, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50(10):3145-52.
- Kaplan D, Cuellar VG, Jazrawi LM, Strauss EJ. Biomarker Changes in ACL Deficient Knees Compared With Contralaterals. Orthop J Sports Med. 2016;4(7).