MARCH/APRIL 2011

www.sportsmed.org

N E W S L E T T E R O F T H E A M E R I C A N O R T H O P A E D I C S O C I E T Y F O R S P O R T S M E D I C I N E

STOP SportsInjuries Update

Annual Meeting 2011Around the Corner

Baseball StudyParticipants Wanted

SICKLECELLTRAIT

CO-EDITORS

EDITOR William N. Levine MD

EDITOR Daniel J. Solomon MD

MANAGING EDITOR Lisa Weisenberger

PUBLICATIONS COMMITTEE

Daniel J. Solomon MD, Chair

Kenneth M. Fine MD

Robert A. Gallo MD

Richard Y. Hinton MD

David M. Hunter MD

Grant L. Jones MD

John D. Kelly IV MD

William N. Levine MD

Brett D. Owens MD

Kevin G. Shea MD

Brian R. Wolf MD, MS

BOARD OF DIRECTORS

PRESIDENT Robert A. Stanton MD

PRESIDENT-ELECT Peter A. Indelicato MD

VICE PRESIDENT Christopher R. Harner MD

SECRETARY Jo A. Hannafin MD, PhD

SECRETARY-ELECT James P. Bradley MD

TREASURER Robert A. Arciero MD

TREASURER-ELECT Annunziato Amendola MD

UNDER 45 MEMBER-AT-LARGE David R. McAllister MD

UNDER 45 MEMBER-AT-LARGE Mininder S. Kocher MD

OVER 45 MEMBER-AT-LARGE Mark E. Steiner MD

PAST PRESIDENT James R. Andrews MD

PAST PRESIDENT Freddie H. Fu MD

COUNCIL OF EDUCATION Andrew J. Cosgarea MD

COUNCIL OF RESEARCH Constance R. Chu MD

COUNCIL OF COMMUNICATIONS Daniel J. Solomon MD

EX OFFICIO COUNCIL OF DELEGATES Patricia A. Kolowich MD

JOURNAL EDITOR, MEMBER EX OFFICIO Bruce Reider MD

AOSSM STAFF

EXECUTIVE DIRECTOR Irv Bomberger

MANAGING DIRECTOR Camille Petrick

EXECUTIVE ASSISTANT Sue Serpico

ADMINISTRATIVE ASSISTANT Mary Mucciante

DIRECTOR OF CORPORATE RELATIONS Debbie Cohen

DIRECTOR OF FINANCE Ken Hoffman

DIRECTOR OF RESEARCH Bart Mann

DIRECTOR OF COMMUNICATIONS Lisa Weisenberger

COMMUNICATIONS ASSISTANT Joe Siebelts

STOP SPORTS INJURIES CAMPAIGN DIRECTOR Michael Konstant

DIRECTOR OF EDUCATION Susan Brown Zahn

SENIOR ADVISOR FOR CME PROGRAMS Jan Selan

EDUCATION & FELLOWSHIP COORDINATOR Heather Heller

EDUCATION & MEETINGS COORDINATOR Pat Kovach

MANAGER, MEMBER SERVICES & PROGRAMS Debbie Turkowski

EXHIB ITS & ADMIN COORDINATOR Michelle Schaffer

AOSSM MEDICAL PUBLISHING GROUP

MPG EXECUTIVE EDITOR AND AJSM EDITOR Bruce Reider MD

AJSM SENIOR EDITORIAL/PROD MANAGER Donna Tilton

SPORTS HEALTH EDITORIAL/PROD MANAGER Kristi Overgaard

SPORTS MEDICINE UPDATE is a bimonthly publication of the American Orthopaedic Society for Sports Medicine (AOSSM). The AmericanOrthopaedic Society for Sports Medicine—a world leader in sports medicine education, research, communication, and fellowship—is a nationalorganization of orthopaedic sports medicine specialists, including national and international sports medicine leaders. AOSSM works closely withmany other sports medicine specialists and clinicians, including family physicians, emergency physicians, pediatricians, athletic trainers, andphysical therapists, to improve the identification, prevention, treatment, and rehabilitation of sports injuries.

This newsletter is also available on the Society’s Web site at www.sportsmed.org.

TO CONTACT THE SOCIETY: American Orthopaedic Society for Sports Medicine, 6300 North River Road, Suite 500, Rosemont, IL 60018,Phone: 847/292-4900, Fax: 847/292-4905.

1 From the President

6 STOP Sports InjuriesCampaign Update

7 Research News

8 Annual MeetingPreview

10 Society News

11 Travelling FellowshipTours Around the World

11 Names in the News

12 Upcoming Meetingsand Courses

2 Team Physician’s CornerSickle Cell Trait

MARCH/APRIL 2011

March/April 2011 SPORTS MEDICINE UPDATE 1

FROM THE PRESIDENT

AS A HISTORY MAJOR AT WILLIAMS, I have a special appreciation for how the past has shapedour present, and how our current activities will influence the lives of those that come after us. I was reminded ofthis fact last year when the Society leadership held a unique Past President’s Retreat.

Robert A. Stanton, MD

Twenty-one of the 24 living Society presidents gathered to reviewactivities and provide a constructive critique to current and pastactivities while providing guidance for AOSSM’s future. Duringthe retreat, there were many fascinating stories about AOSSM’sinception 40 years ago. Many of the stories were first hand, buta decidedly fewer number of the original founding memberswere still with us to tell those stories.After this meeting, I and several of my predecessors felt it was

important to preserve our history. I am happy to report that theBoard supported my recommendation and the AOSSM HistoryCommittee was created. Among its goals will be to record thesefirsthand accounts about the development of orthopaedic sportsmedicine and our Society. Chaired by Art Boland, MD, a formerSociety president whose career has spanned several decades, thecommittee also includes a number of other remarkable individuals,including past presidents, Royer Collins, MD, (a fellow Williamsalum) and Bob Leach, MD. Royer helped found the Societyand Bob helped found the American Journal of Sports Medicine(AJSM), our flagship journal, which has served as the intellectualcornerstone of our profession. Also on the committee is BernieBach, MD, a past president who has been a strong advocate forthis project, and Carol Teitz, MD, a former treasurer who servedon the Board during our recent era of growth. The committeeis completed by Paul Sethi, MD, who is one of our youngermembers. He will be providing a unique perspective on whatwill be important to those assuming our profession’s leadershiproles in the future.The committee met twice during the first quarter of 2011 to

outline the work ahead, and to consider a format that capturesand presents our history in a way that is not just restrictedto print but that can be shared through the Internet and in

exhibits. This end-product will allow us to maintain an active,collective cognizance of our Society’s unique role in orthopaedicsports medicine.The value of looking back, however, is minimized if we also

do not take the time to look forward. Consequently, my secondpriority in 2012 is to engage our leadership in strategic planningso that we can establish direction for our immediate future. We’veenlisted the assistance of Tom Nelson, who in his youth was oneof the Society’s first executive directors before moving on to bethe executive director of the American Academy of OrthopaedicSurgeons. In addition, Morna Conway, our external publishingconsultant, will help us assess our publishing priorities. Both haveworked with us before and facilitated our decision to developa more robust research program, public education program andlaunch our second journal, Sports Health: A MultidisciplinaryApproach. Tom has an amazing ability to motivate the Boardto look to the future, as I have witnessed first-hand, having hadthe pleasure of sitting through these planning meetings twicein the past 12 years. I look forward to sharing with you ournew priorities as we continue to grow and evolve as a Society.Although AOSSM is a professional organization—not a

historical society—I believe an informed sense of our professionalevolution is a key ingredient for our continued success. If weunderstand our past successes, as well as appreciate our currentstrengths and limitations, then we will have the tools to continuethriving as a profession. I welcome your thoughts and suggestions.

2 SPORTS MEDICINE UPDATE March/April 2011

On April 13, 2010, the National Collegiate Athletic Association(NCAA) acted to implement universal sickle cell trait screening in allDivision I athletes. Starting the academic year 2010–2011, more than150,000 student athletes have been or will be tested for the first yearthey are eligible to compete.1 While the wisdom of instituting suchan extensive program has been questioned1 the mandatory screeninghas brought to the forefront an alarming, and often neglected, cause ofsudden death in athletes, exertional sickling, and resultant rhabdomyolysis.The purpose of this paper is to review sickle cell trait, its medicalimplications, and the controversies surrounding screening programs.

SICKLE CELL TRAIT

T E A M P H Y S I C I A N ’ S C O R N E R

MATTHEW L. SILVIS, MDDepartment of Orthopedics and RehabilitationDepartment of Family and Community MedicinePennsylvania State University College of MedicineMilton S. Hershey Medical CenterHershey, Pennsylvania

ROBERT A. GALLO, MDDepartment of Orthopedics and RehabilitationPennsylvania State University College of MedicineMilton S. Hershey Medical CenterHershey, Pennsylvania

BackgroundSickle cell trait is a condition in whichan individual has inherited one genefor normal hemoglobin and one genefor sickle hemoglobin. Sickle hemoglobinhas an increased propensity to formlarge polymers on the erythrocyte cellmembrane when deoxygenated.2 Thissickling, or change in erythrocyte shapefrom coin-shaped to quarter-moon,causes sluggish flow through smallervessels and may lead to end-organdamage, especially within the kidney.Those with sickle cell trait differ from

those with sickle cell disease because thosewith sickle cell trait have a much lowerconcentration of sickle hemoglobin. Whenthe intensity of activity increases, local pHdecreases and temperature increases. Inboth subgroups, these conditions lead toincreased concentrations of deoxygenatedhemoglobin and therefore increases inthe amount of erythrocyte sickling.2 Thepropensity to sickle is amplified at higheraltitudes. While sickling does occur duringdeoxygenated states, those with sickle celltrait usually remain asymptomatic withoutany effects of exercise performance becausethese individuals possess a higher ratio ofnormal hemoglobin.3

Grave consequences can occur atextremes of physical exertion, even in thosewith sickle cell trait. Multiple case reportshave described athletes and/or militarypersonnel with sickle trait who sustaineddisastrous complications, such as fulminantrhabdomyolysis and exercise-associatedsudden death, caused by erythrocytesickling during periods of increasedactivity.2,4 Indeed, the exercise-relatedsudden death rate is 10 to 30 times higherin sickle cell trait carriers compared tonon-carriers.2 Heat exposure, dehydration,and intense physical activity are thecommon denominators that potentiateerythrocyte sickling and predispose theseindividuals to potential catastrophe.One recent review cited exertional

sickling as the leading killer in NCAADivision I football in the last decade.5

In the review of 16 conditioning-related

deaths, ten (63 percent) were presumed tobe due to exertional sickling. Other causesincluded cardiac (four), asthma (one), andexertional heat stroke (one). Overall, theactual incidence of exercise-related suddendeath due to exertional sickling is likelyunderestimated. Lack of recognition ofsickle cell trait and few distinct pathologicalfindings cause exertional sickling andits sequelae to be misdiagnosed asexertional heat stroke and hypertrophiccardiomyopathy during autopsies.6

The relative neglect of sickle cell trait bymany medical professionals is surprisinggiven the high prevalence of the disease,which affects more than 2 million

Americans.1 Experts have estimated thatone in 12 African-Americans and one in2,000 Caucasians possess the sickle celltrait.1 This condition is more prevalentin athletes whose ancestors come frommalarial regions of the world suchas Africa, South or Central America,Caribbean or Mediterranean countries,India, and Saudi Arabia.

Exertional Sickling and RhabdomyolysisExertional sickling is dangerous for athletesbecause of the potential for progressionto rhabdomyolysis, a disease characterizedby skeletal muscle death and release ofbreakdown products. Rhabdomyolysispreferentially affects those with sickle celltrait because of the erythrocyte sicklingthat occurs within the vessels supplyingskeletal muscle.3 When the circulation toskeletal muscle is limited, skeletal muscledeath occurs and the intracellular contentsof the skeletal muscle cells are releasedinto the systemic circulation. This processinitiates a potential fatal cascade of events,including myoglobinuria and electrolyteabnormalities.3

Myoglobin, a component of theintracellular space within normal skeletalmuscle, is responsible for much of the renaldamage incurred during rhabdomyolysis.Myoglobin contributes to acute renalfailure in two major ways:� Direct cytotoxicity onrenal epithelial cells

� Cast formation creatingintra-tubular obstruction.7

While potentially reversible,rhabdomyolysis and acute renal failure mayrequire renal dialysis and has mortalityrates estimated at 20 percent.8

In addition to acute renal failure,electrolyte imbalances, including

hyperkalemia and hypocalcemia, are gravethreats during rhabdomyolysis. Whenskeletal muscle cells die, potassium, whichis found predominantly in the intracellularspace, is released into circulation and serumpotassium can reach perilous heights. Atserum potassium levels above 5.0 mEq/l,serious cardiac arrhythmias can occur andlead to cardiac arrest. The cardiotoxicityassociated with hyperkalemia is furtherpotentiated by the hypocalcemia andmetabolic acidosis that accompaniesrhabdomyolysis.Recognition of the exertional sickling

is important to prevent or limit progressionto rhabdomyolysis. Features of exertionalsickling collapse are often confused withheat cramping and heat stroke. However,several key distinctions exist. Becauseexertional sickling is an ischemic processand not solely a product of hyperthermiaand lactic acidosis, athletes sufferingfrom exertional sickling can have corebody temperatures less than 105°F andoften appear to be in less pain than thosehaving heat-related problems.6 Additionally,heat-related illness typically progresses

March/April 2011 SPORTS MEDICINE UPDATE 3

Those with sickle cell trait differ from those with sicklecell disease because those with sickle cell trait havea much lower concentration of sickle hemoglobin.

over a period of time with painful heatcramping often preceding heat stroke.Exertional sickling can occur quicklyand without warning signs. If symptomsexist, pain and weakness in the workingmuscles, such as the thigh, buttocks,and back, are most common amongexertional sicklers. Other differencesbetween athletes suffering from exertionalsickling and heat cramping have beendescribed by the National Athletic Trainers’Association and outlined in Table 1.Prompt recognition and treatment of

rhabdomyolysis, especially among thosewith sickle cell trait, is critical to limitpotentially fatal consequences. If exertionalsickling and/or rhabdomyolysis aresuspected, initial efforts should includeremoval from play and fluid resuscitation.Rehydration to expand the intravascularvolume increases renal blood flow andhelps limit further erythrocyte sickling andbuildup of myoglobin casts. If symptomspersist, the athlete should be transportedfor further treatment and closer monitoring.While rhabdomyolysis and its sequelae

account for the majority of sudden-deathfatalities among those with sickle cell trait,evidence suggests that asymptomaticrepetitive exertional sickling may havelong-term effects on renal function.Repetitive renal papillary necrosis causedby intermittent ischemia eventually leadsto isothenuria, the inability to maximallyconcentrate urine.10 The chronic renaldamage and resultant isothenuria maycontribute to the eight-fold higher deathrate of 28–29 year olds versus that of17–18 year olds with sickle cell trait.2

ScreeningWith the treatment of exertional sicklingand rhabdomyolysis largely supportive,most efforts have been focused upon theidentification of those with sickle cell traitto prevent or limit episodes of exertionalsickling. While no clear evidence existsthat screening for sickle cell trait preventsdeath, athletic programs have begunto develop programs to identify thosecarrying the sickle cell trait. Manyprofessional organizations have alreadyelectively chosen to screen athletes withblood tests to confirm sickle cell status.Screening practices among most highschools are less sophisticated and consistsolely of the following question on thePre-Participation Physical Evaluationmonograph: “Do you or someone inyour family have sickle trait or disease?”

The NCAA’s decision to institute auniversal screening program represents thelargest effort to detect athletes possessingthe sickle cell trait. The decision toproceed with the testing resulted largelyfrom the settlement of Dale Lloyd IIagainst the NCAA and Rice University.1

Lloyd, a 19-year-old freshman withsickle cell trait, died from exertionalrhabdomyolysis after football practice in2006. According to the new regulations,all Division I student-athletes must betested for sickle cell trait, show proofof a prior test, or sign a waiver so thatathletes with sickle cell trait can beidentified and precautions instituted.It is expected that as a result of thistesting program between 400 and500 new cases of sickle cell trait willbe identified each year.1

4 SPORTS MEDICINE UPDATE March/April 2011

Table 1. Exertional Sickling and Heat CrampingDifferences (NATA Consensus Statement)

Exertional sickling Heat cramping

Slump to the ground Muscle twingeswith weak muscles

Muscles appear normal Pain

Quick recovery “Hobble to a halt”

Visible contractedand spastic muscles

Slower recovery

1. Bonham VL, Dover GJ, Brody LC. Screening student athletesfor sickle cell trait—a social and clinical experiment.N Engl J Med. 2010. 363:997-999.

2. Mitchell BL. Sickle cell trait and sudden death—bringing it home.J National Med Assoc. 2007. 99:300-305.

3. Dincer HE, Raza T. Compartment syndrome and fatalrhabdomyolysis in sickle cell trait. Wisc Med J. 2005. 104:67-71.

4. Harrelson GL, Fincher AL, Robinson JB. Acute exertionalrhabdomyolysis and its relationship to sickle cell trait.J Athl Training. 1995. 30:309-312.

5. Eichner RE. Sickle cell trait in sports. Curr Sports Med Rep. 2010.9:347-351.

6. Scheinin L, Wetli CV. Sudden death and sickle cell trait.Am J Forensic Pathol. 2009. 30:204-208.

7. Chatzizisis YS, Misirli G, Hatzitolios AI, Giannnoglou GD.The syndrome of rhabdomyolysis: complications and treatment.Europ J Int Med. 2008. 19:568-574.

8. Huerta-Alardin AL, Varon J, Marik PE. Bench-to-bedside review:rhabdomyolysis—an overview for clinicians. Crit Care. 2005.9:158-169.

9. NATA Consensus Statement: Sickle cell trait and the athlete,June 2007. Found at: http://www.nata.org/sites/default/files/SickleCellTraitAndTheAthlete.pdf

10. Statius van Eps LW, Earley LE. The kidney in sickle cell disease.In: Earley LE, Gottschalk CW, eds. Strauss and Welt’s Diseasesof the Kidney. Vol 2. 3rd ed. Boston, MA. Little, Brown, and Co.1979. 1229-1240.

References

March/April 2011 SPORTS MEDICINE UPDATE 5

The use of routine screening for sicklecell trait has been questioned by researcherswho argue that the program may resultin more harm than benefit. A recentcommentary in the New England Journalof Medicine suggested that the new NCAAprogram has many of the potential pitfallsthat plagued sickle cell trait screeningefforts in the past.1 The authors cited thesince-abandoned screening efforts for sicklecell trait during reproductive counseling.This voluntary screening effort was halteddue to lack of counseling and confusionin conveying proper information to patientsdifferentiating sickle cell trait versus sicklecell disease.1 Furthermore, due in partto potential discrimination against sicklecell trait carriers, the Sickle Cell DiseaseAdvisory Committee of the National Heart,Lung, and Blood Institute (a section of theNational Institute of Health) has urgedthe military to halt routine testing of theirrecruits.2 Pundits of mass screening forsickle cell trait claim that the costs, bothfinancial and discriminatory, and benefitsof these screening programs have notbeen clearly elucidated.The goal of sickle cell screening is not

to disqualify or prevent these athletes fromparticipating in intercollegiate athletics.

Rather, the knowledge gained fromscreening efforts may enable health careproviders to establish simple precautions toprevent complications of exertional sicklingand enable athletes with sickle cell trait toexcel in their sport. To this end, the NationalAthletic Trainers’ Association has offereda series of guidelines in the managementof athletes with the sickle cell trait.These guidelines are outlined in Table 2.In conclusion, sickle cell trait has

become increasingly recognized as a cause

of sudden death among athletes. Promptrecognition of exertional sickling, whichoccurs during periods of increased physicalexertion, is critical to avoiding complicationsfrom rhabdomyolysis. In an effort toidentify athletes at risk of developingexertional sickling, the NCAA has initiatedmandatory sickle cell screening among itsfirst-year athletes. It is hoped that in theathletic cohort preventive measures andearly detection will eradicate sudden deathamong those with sickle cell trait.

Table 2. NATA Guidelines in the Management of Athletes with Sickle Cell Trait(NATA Consensus Statement)

1. All athletes with sickle cell trait who develop symptoms (e.g., cramping, pain, weakness, fatigue, shortnessof breath) should stop exercise immediately and report to their athletic trainer and coach. Symptoms ofsuspected sickling can occur after just 2 to 3 minutes of sprinting or similar sustained exertion.

2. Preventive measures include decreasing exercise intensity, encouraging a slow build-up of conditioningactivities, allowing for frequent rest and recovery periods, and increasing opportunities for hydration.Athletes with sickle cell trait often function best if they are allowed to set their own pace.

3. All athletes with sickle cell trait should avoid timed serial sprints and sustained exertion for greater than2 to 3 minutes without a break.

4. Because environmental heat, stress, dehydration, asthma, and illness predispose athletes with sicklecell trait to exertional sickling, activities should be adjusted.

5. Athletes with sickle cell trait who plan to exercise and/or compete at an elevated altitude (5,000 feetor greater) should be closely monitored when new to the altitude. In these situations, training effortsshould be reduced and oxygen should be readily available to prevent exertional sickling.

The STOP Sports Injuries campaign continues toconsistently grow and add supporters and resources. If youhave not become a collaborating supporter yet and wouldlike more information on how to become involved, e-mail MikeKonstant, campaign director, michael@stopsportsinjuries.orgor visit our Web site at www.STOPSportsInjuries.org andclick on the “Join Our Team” button. In the past month wehave added these collaborators to our team:

Campaign in the MediaThe STOP Sports Injuries campaign has continuedto keep the issue of youth sports safety in the spotlightin the past several months. Some highlights include:

� A special report in Sports Illustrated for Kids focusedon the growing number of young athletes overdoingit in sports. The article discussed how the STOPSports Injuries campaign aims to prevent this withadditional commentary from AOSSM members andSTOP Sports Injuries supporters, Drs. James Andrews,John Hurley, Matthew Matava, and Kevin Shea.

� In January, AOSSM member Dr. WilliamLevine joined the SIRIUS Satellite stationDoctor Radio to speak about the injuryepidemic in young athletes while alsopromoting the campaign.

� The campaign sent out a press releaseon a study by leading overuse researcher,Glenn Fleisig, PhD, and published inthe American Journal of Sports Medicineregarding a 10-year analysis of pitching

injuries in young kids. It receivednationwide media attention,

including hits onMSN.com andthe LA Times.

Medical InstitutionsCenter for SportsMedicine at Children’sMercy Hospital

Cleveland Clinic

Columbia Memorial Boneand Joint Centers

Kaiser Permanente

Professional HealthOrganizationsAmerican OsteopathicAcademy of SportsMedicine

Professional BaseballAthletic Trainers Society

Sports Medicine PracticesAdvanced Therapy Solutions

Azzatori Chiropractic

Breland Physical Therapyand Sports Rehab Clinic

Georgia Sports Medicine

Harborview Sports Medicineand Physical Therapy

Preferred Therapy Providers, Inc.

Shoulder Center ofKentucky—Lexington Clinic

Virtual Center for Sports Medicine

Individual DonationMichael Immel, MD

STOP Sports Injuries Continues to Educateand Grow Support

Spreading the WordLocal EventsCJW Sports Medicine of Virginia held the “Stop It Before It Starts”youth sports safety clinic in January. The event featured presentationson a variety of topics, including concussion regulations, hydration,and overtraining, as well as a discussion on reducing ACL injuryrates in young athletes. The group made use of the STOP SportsInjuries campaign as a model for helping young athletes understandand avoid more serious consequences of sports injuries. More than100 people attended the event.

Prepare Now for April’s Youth Sports Safety MonthBe sure to check your inbox and the Web site for the STOP SportsInjuries Event Toolkit which includes a sample agenda, press releases,and other pertinent tips on organizing a youth sports safety event.

BONUS: Register your event online with the campaignand receive a free STOP Sports Injuries campaignstarter kit ($110 value). The kit includes 50 copiesof each of the 30 tip sheets, folders, stickers, tattoos,and lapel pins. Be sure to e-mail pictures and detailsof your event to Joe Siebelts at joe@aossm.org.

6 SPORTS MEDICINE UPDATE March/April 2011

!

March/April 2011 SPORTS MEDICINE UPDATE 7

R E S E A R C H N E W S

The AOSSM Research Committee will be holding a workshop on “ClinicalOutcomes Research” the afternoon prior to the 2011 AOSSM AnnualMeeting in San Diego. The workshop will be highlighted by a keynote address,“Clinical Outcomes Research: Its Importance and Barriers for Cliniciansand Physician-Scientists,” to be presented by Mohit Bhandari, MD, MSc.Dr. Bhandari holds the Canada Research Chair in Musculoskeletal Trauma

and Surgical Outcomes at McMaster University, is an Associate Memberof the Department of Clinical Epidemiology and Biostatistics, and recentlyserved as the Section Editor of Evidence-Based Orthopaedic Surgery for theJournal of Orthopaedic Trauma.Dr. Bhandari has received the Edouard J. Samson Award for a Canadian

orthopaedic surgeon with the greatest impact on research in the last five years,the Founder’s Medal for Research, and the Randomized Trial MentoringAward from the Canadian Institutes of Health Research. He is widelyacknowledged as the one of the foremost authorities in the translationof orthopaedic research to clinical practice.Other presentations during the workshop will include using evidence-based

medicine to guide clinical practice, the role of randomized clinical trials andprospective longitudinal cohort studies, clinical study design, interpreting theorthopaedic literature, and how to conduct clinical research in your practice.The workshop is open to all free of charge and will run from noon to

5:30 p.m. on Wednesday, July 6, 2011, in the Manchester Grand Hyatt inSan Diego. Please see the AOSSM Annual Meeting Preliminary Programfor more information and for registration information.

AOSSMYouthBaseballProjectWith the baseballseason right aroundthe corner, AOSSM will once again becollecting data on the pitching practicesand upper extremity injuries among youngpitchers. Last year, AOSSM membersrecruited almost 700 subjects from21 states into the project The goal is tohave representation among as many statesas possible so as to explore regionaldifferences in pitching and injury patterns.States from which we particularly wouldlike more subjects include Arizona,California, Texas, New York, Illinois, Ohio,Pennsylvania, Massachusetts, Washington,and North Carolina. To find out moreinformation about the project and howto get involved, go to www.sportsmed.org,then click the “Research” tab and clickon “Youth Baseball Studies.”

2011 Pre-Conference ResearchWorkshop at 2011 Annual Meeting

AOSSM is pleased to announce a newgrant sponsored by Smith & Nephewto support development of innovativeapproaches to measuring the effects ofsurgical procedures in orthopaedic sportsmedicine. This $25,000 grant is meant toadvance the evaluation of clinical outcomesrelated to surgery by encouraging develop-ment of novel approaches, techniques,and methodology that will facilitate andenhance clinical research. Examples mightinclude new Web-based instruments toallow inter-institutional collaborativeefforts, tools to quantify joint laxity, orinnovative methods to measure the resultsof arthroscopic procedures about the hip.

The intent of the award is to providestart-up funding for the development oftools and technology that can be leveragedand used for future, larger-scale clinicalresearch studies.Applications are limited to three

pages and will be judged on threecriteria: 1) innovation, 2) feasibility, and3) clinical significance. The proposalshould define the limitations withcurrently available assessments, clearlydescribe the proposed innovativeapproach, state how the new assessmentwill be tested, and discuss the clinical sig-nificance of this novel method to the fieldif successful. Because this grant is

intended to foster new ideas and creativity,prior data related to the innovation is notrequired but can be presented to establishfeasibility.The deadline for applications is

April 18, 2011. Submissions along withbiosketches in NIH format should besent as e-mail attachments to Bart Mann,bart@aossm.org, AOSSM Directorof Research. The principal investigatoror a co-investigator must be an AOSSMmember in good standing. The grantwinner will be announced at the 2011AOSSM Annual Meeting in San Diego.

AOSSM and Smith & Nephew Innovative Outcomes Assessment Grant

In the second of a series of articles on thisyear’s Annual Meeting, we provide a focusedlook at what to expect from the educationalactivities and some insights on our socialactivities. Be sure to be on the lookout inyour mailbox and inbox in March for the2011 Annual Meeting Preliminary Program.

his year’s AOSSM Annual Meetingtravels to the Pacific Coast and thebeautiful, sun filled city of San Diego.

San Diego has a multitude of activities forthe whole family along with some greateducational offerings to take advantageof at the Annual Meeting.The meeting begins on Wednesday,

July 6, with a half-day, free pre-conferenceworkshop on clinical outcomes research.AOSSM Research Committee Chair,Constance Chu, MD, and her teamhave worked diligently to create aninformative workshop on clinical research,study design, outcome measures, andimplementation. Dr. Mohit Bhandari,of McMaster University, will give thekeynote presentation, “Clinical OutcomesResearch: Its Importance and Barriersfor Clinicians and Physician-Scientists.”Be sure to sign up early for this excitingopportunity to learn from some of thetop sports medicine researchers.On Thursday, July 7, the meeting begins

in full swing with an incredible line-up ofresearch and poster presentations. ProgramChair, Marlene DeMaio, MD, and hercommittee have masterfully selected papersfrom more than 350 abstract submissions,including such hot topics as the disabledathlete, side-line management of theconcussed athlete, and many more.Also taking place on Thursday afternoon

are the live surgical demonstrations on the

upper extremity. This new educationalopportunity will allow attendees to learntechniques from some of the top surgeonsin the country.In addition, 24 instructional courses

have been developed by InstructionalCourse Chair, Charles Bush Joseph, MD.Attendees can choose from a variety ofoptions, including knee cartilage defects;platelet rich plasma uses; “Young AdultHip—From Hip Dysplasia to FAI: A CaseBased Approach to Open and ArthroscopicManagement;” “Performance Issues inthe Masters Athlete II: Return to Sport;”and “Game Day Decisions: How to KeepThem in the Game and Off the Sideline.”Each instructional course has limitedavailabiliy so be sure to register earlyto get the courses you want.One of the highlights of the meeting is

always the Presidential Guest Speaker, who

this year will be well-known sports writerand NPR radio host, Frank Deford. In hisspeech, Sports: The Hype and the Hypocrisy,he will talk about modern sports issues andcontroversies. Mr. Deford is also the authorof fourteen books, the senior correspondenton Real Sports with Bryant Gumbel onHBO, and a senior contributing writerat Sports Illustrated.An exciting Saturday afternoon activity

is always the Young Sports MedicineSpecialist Workshop which offers practicaland pragmatic examples of how to succeedin sports medicine and set up your ownpractice. Come listen and interact withsome of the top sports medicine faculty,including Dr. DeMaio and many ofher esteemed colleagues. The informalsmall groups give everyone involvedan opportunity to benefit from shareduniversal experiences and proven solutions.

8 SPORTS MEDICINE UPDATE March/April 2011

Annual Meeting 2011Brings Education and Fun Together

T

Experience San Diego and all there is learn,see, and do at the 2011 AOSSM Annual Meeting.

The social activities at any AOSSMAnnual Meeting are always a good wayto entertain and interact with family andcolleagues and this year’s activities areno different. A few highlights include:

Thursday, July 7

Welcome ReceptionSupported by BREG, Inc.

Join us for an informal outdoor gatheringpoolside at the Manchester Grand Hyatt.This reception is an AOSSM traditionthat offers an enjoyable evening forrenewing acquaintances and socializing.A full complement of beverages andappetizers is provided in addition tochild friendly activities. Everyone andtheir families are welcome to attend.

Friday, July 8

Walking Tour of Coronado Island

What better way to discover the magicof Coronado Island than on a leisurelyguided walking tour? Coronado is oneof San Diego’s unspoiled gems and richin history. On this unique outing, guestswill enjoy a strolling 1.5 hour tour led

by a knowledgeable local guide. The touris recommended for ages 13 and up andincludes round trip transportation fromthe Manchester Grand Hyatt and lunch.Coronado Island is approximately10 minutes from the hotel.

Golf TournamentSupported by DJO Inc.

The Coronado Municipal Golf Course hasbeen selected for the 22nd Annual GolfTournament on Friday with a shotgun startat 1:00 p.m. Opened in 1957, the coursecontinues to reign as one of the finestpublic golf courses in Southern Californiawith dramatic views of the Coronado BayBridge and San Diego skyline. The courseis approximately 15 minutes from theManchester Grand Hyatt.The tournament is open to men

and women, members and nonmembers.Pre-registration is required.

Saturday, July 9

San Diego Zoo Behind the Scenes Tour

Come to a timeless place where thesurroundings are as exotic as the animals,and the adventure changes with everystep you take. This legendary zoo neverdisappoints, with winding trails shroudedin heavy mists and rushing waterfallsringed in tropical ferns. On this tour,visitors see the zoo the way everyonewishes they could . . . from behind thescenes. The “Inside Story” gives guests an

exclusive two-hour tour that’s filled withexperiences and information you couldn’tget anywhere else. The tour may include:� The giraffe barn, where you’ll visit thegiraffes’ bedrooms. Watch from up closeas your tour guide feeds them grass.

� The forage warehouse, where you’llsee the myriad of foods it takes to feedall the zoo’s inhabitants. Even moreinteresting are the diets posted onthe wall listing the menus, everythingfrom bear breakfast to snake suppers.

� The elephant barn, where you’ll ventureinto the cavernous elephant bedroomsand see the keepers’ tools of the trade.

Afterward, explore the zoo’s sprawling 100acres by foot or aboard the aerial tram forspectacular panoramas of the grounds andSan Diego’s beautiful bayside skyline.

A Night at the New Children’sMuseum San Diego6:00–10:00 p.m., Free

Situated in the heart of downtownSan Diego and less than a 10 minutewalk from the Manchester Grand Hyatt isthe newly renovated Children’s MuseumSan Diego. The museum spans three storiesand offers an assortment of dynamic artsbased education and exhibits. There arenumerous interactive exhibits for peopleof all ages, including doodle stations,bubble machines, a teen studio, climbingwall, and much more. Regain youryouthful spirit and join us for thisunique and interactive event for all ages.

March/April 2011 SPORTS MEDICINE UPDATE 9

Annual Meeting preliminary programs will be arrivingin your inbox and mailbox in late March. Be on thelookout and register early.

Attendee lodging for the 2011 AOSSM Annual Meeting is now available. TheManchester Grand Hyatt is the host hotel and location for exhibits, scientificsessions, and instructional courses. Book your housing at www.sportsmed.orgor call 888-421-1442 or 619-232-1234 and identify yourself as an AOSSM2011 Annual Meeting attendee. Rates are $229 per night. Rooms with a vieware limited but available at an additional premium. Rates are guaranteed untilJune 4, 2011, but are subject to availability. You are encouraged to book early.

Family OlympicsNo Charge

Thanks to the generoussupport of Breg Inc., weare excited to be bringingback the tradition of theFamily Olympics. TheManchester Grand Hyatt’sBackyard Activity Area willhouse the Olympics withvarious sports and gamesfor attendees and theirfamilies. This will include,volleyball, horseshoes,and a basketball shoot outamongst other activities.

10 SPORTS MEDICINE UPDATE March/April 2011

Got News We Could Use?Sports Medicine Update Wants to Hear from You!Have you received a prestigious award recently? A new academicappointment? Been named a team physician? AOSSM wants to hear fromyou! Sports Medicine Update welcomes all members’ news items. Sendinformation to Lisa Weisenberger, AOSSM Director of Communications,at lisa@aossm.org, fax to 847/292-4905, or contact the Society office at847/292-4900. High resolution (300 dpi) photos are always welcomed.

S O C I E T Y N E W S

Review Annual Meeting andSpecialty Day PresentationsDid you know you can access presentations fromthe AOSSM Annual Meeting, Specialty Day, andsport specific meetings by purchasing a yearlymeeting subscription with your dues renewalor you can pay for each meeting individually?For information visit www.sportsmed.org andclick on “Education and Meetings.”

Revised CME MissionStatement from AOSSMThe AOSSM Board of Directors recently approveda revised CME mission statement to guide ourCME program. The Society has a broad-rangingand highly effective education program basedon our Educational Curriculum. Our activitiessupport both CME and MOC requirements.

Need MOC? Register for SelfAssessment and Board Review—2011

The print version of the AOSSMSelf Assessment and Board Reviewfulfills the ABOS requirement for a“scored and recorded self assess-ment examination” for Maintenanceof Certification (MOC). Complete

the print version and submit your answers to beeligible for both MOC™ and CME credit. Visitwww.sportsmed.org and click on “Education andMeetings” then “Self Assessment” to register.

Sports Health Call for Papersfor T. David Sisk Awards forResearch ExcellenceThe AOSSM is announcing the T. David SiskAwards for Research Excellence in clinical,laboratory, and international research. Winners willbe selected from the best papers in each categorysubmitted to Sports Health: A MultidisciplinaryApproach. These annual awards will include a$2,500 cash prize and a plaque. All manuscriptssubmitted through May 1, 2011, will be considered.Winners will be announced at the AOSSM AnnualMeeting in San Diego, California, July 7–10, 2011.Visit http://submit.sportshealthjournal.org to submityour manuscript. Contact Kristi Overgaard, SportsHealth Editorial Manager, at kristi@aossm.org,with any questions.

Subspecialty Certification GrandfatherOption Ends March 31, 2011If you did not attend an ACGME or Canadian Orthopaedic Associationaccredited orthopaedic sports medicine fellowship, you must registerwith the American Board of Orthopaedic Surgery (ABOS) by March 31,2011, to take the subspecialty certification exam. After that deadline,individuals who did not attend an accredited program will no longer beeligible to sit for the exam. This deadline is especially important becauseafter 2011, a combined subspecialty certification written recertificationexam will only be offered to individuals who hold a general certificateand a subspecialty certificate.The 2011 exam will be offered on November 3, 2011. In order

to sit for the exam, applicants must complete the application, submittheir case list, provide the supplemental required documents, and paythe $450 fee by March 15, 2011. Late applications to sit for the examwill be accepted until March 31, 2011, for an additional $350 late fee.The application process is detailed and requires preparation, so anyone

interested in sitting for the exam is encouraged to get an early start inlearning the requirements and collating the materials. Specific details areavailable under the Diplomates section of the ABOS site, www.abos.org.

March/April 2011 SPORTS MEDICINE UPDATE 11

Freddie Fu Receives Prestigious AAOS AwardCongratulations to AOSSM Past President, Dr. Freddie Fu who received the American Academy of OrthopaedicSurgeons (AAOS) Diversity Award during its annual meeting in San Diego, February 17, 2011. A video salute toDr. Fu was shown at the beginning of the award ceremony. The Diversity Award recognizes members of AAOS whohave distinguished themselves through their outstanding commitment to making orthopaedics more representativeof and accessible to diverse patient populations. The award is in recognition of Dr. Fu’s efforts over the past 30 yearsto provide top opportunities in orthopaedic surgery to talented individuals without regard for sex, race, ethnicity,

nationality, or socioeconomic background. Dr. Fu’s nomination was supported by 65 heartfelt letters written by residents, fellows,faculty, and national and international luminaries.

N A M E S I N T H E N E W S

Latin American Tour

This year AOSSM will be involved in three Traveling Fellowshiptours. The first tour will be between AOSSM and SLARD withNorth America visiting Latin America. This tour will be led byGodfather, Walt Curl, MD. Dr. Curl’s companions will be SethGamradt, MD, from the University of California at Los Angeles,Steven Svoboda, MD, from West Point, and Christopher Wahl,MD, from the University of Washington.The Latin America tour will be held April 24–May 19.

Members will be hosted by many former traveling fellows andmake stops in Mexico, Colombia, Chile, Argentina, and Brazil.Their final stop on the tour will be at the ISAKOS Congressin Rio de Janeiro, Brazil.

European Tour

The second tour will be between ESSKA and AOSSM withEurope visiting North America. Our visitors will includeGodfather, Prof. Jon Karlsson, MD, from Sweden, Mislav

Jelic, MD, from Croatia, Olaf Lorbach, MD, from Germany,and Sebastien Lustig, MD, from France.The fellows on the North American tour will be hosted

by Fowler Kennedy Sports Medicine Center, the University ofRochester, the U.S. Naval Academy, Johns Hopkins Hospital,the University of Virginia, the University of Iowa, the Universityof Wisconsin-Madison, Mayo Clinic, and the Steadman-PhilipponResearch Institute. The final stop on this tour will be the AOSSMAnnual Meeting in San Diego, July 7–10.

Asian-Pacific Tour

Finally, the Asian-Pacific Tour will be between AOSSM andAPOSSM with North American fellows visiting the Asia Pacific.The tour will be lead by Godfather, Champ Baker, Jr., MD. JoiningDr. Baker is Mark Slabaugh, MD, from Brooke Army MedicalCenter, John Tokish, MD, from Tripler Army Medical Center, andDaniel Whelan, MD, from St. Michael’s Hospital in Toronto.The fellows will visit Manila, Jakarta, Sydney, Melbourne,

and Auckland, and finish in Queenstown, New Zealand, at thecombined meeting of the Australian Knee Society and NewZealand Knee & Sports Medicine Society held October 5–7.

The AOSSM, Traveling FellowshipCommittee, and all past participants ofthe Traveling Fellowship Program thankDJO for their continued generous support.

Newest Members Added to the Travelling Fellowship Family

M E M B E R S H I P N E W S

Dr. WahlDr. SvobodaDr. Curl Dr. Gamradt

Dr. JelicDr. Karlsson Dr. Lorbach Dr. Lustig

Dr. Slabaugh Dr. Tokish Dr. WhelanDr. Baker

12 SPORTS MEDICINE UPDATE March/April 2011

3rd Combined Meeting of the Japaneseand American Orthopaedic Societiesfor Sports MedicineMaui, HawaiiMarch 26–29, 2011Advanced registration closes January 7, 2011.

AOSSM 2011 Annual MeetingSan Diego, CaliforniaJuly 7–10, 2011

AOSSM/AAOS Review Coursefor Subspecialty Certificationin Orthopaedic Sports MedicineChicago, IllinoisAugust 5–7, 2011

For more informationand to register visitwww.sportsmed.org andclick on the “Educationand Meetings” tab.

Check Out the New Format and Bonus Featuresfor Board Review CourseIf you are going to be sitting for your boards, the 2011 AOSSM/AAOS Review for SubspecialtyCertification in Sports Medicine is the ideal course. Held in Chicago, August 5–7, the three-daycourse with renowned faculty provides a comprehensive resource for the ABOS subspecialtycertification in orthopaedic sports medicine or recertification. Presenters review in-depth thekey sports medicine topics. New this year, all attendees will receive post-meeting onlineaccess to all PowerPoint presentations, videos, and faculty commentary, along withonline access to AOSSM’s Self-Assessment 2011 ($165 value).

Upcoming Meetings and Courses

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Sports Medicine UpdateAOSSM6300 North River RoadSuite 500Rosemont, IL 60018

Need a Gift for Your AthleticTrainer? Give Them Sports HealthAOSSM members can give subscriptions toSports Health: A Multidisciplinary Approachto athletic trainers in their institutions andcommunities for the special rate of $45. Theamount of subscriptions you may sponsor isunlimited. Visit www.sportsmed.org/shj to entera gift subscription. Contact Kristi Overgaardat kristi@aossm.org for information.

Your Front Row Seat to the Latest Information

2010 Athletic Health HandbookUpdates AvailableThe 2010 Team Physician Corner articlesfrom SMU are now available to insert intoyour Athletic Health Handbook. Log in to yourMy AOSSM page at www.sportsmed.org andclick on the resources tab to download. If youhaven’t ordered your copy of the handbook,we still have copies available for just $10.Order this valuable resource today!

Personalize In MotionAOSSM offers members the ability to addtheir practice name and logo to the electronicversion of In Motion for just $300 for all fourissues, which includes the high-resolutionand low-resolution PDFs to print the newsletteryourself, e-mail to patients, or post on yourWeb site. Get this exciting newsletter into yourpatients’ hands today. E-mail Lisa Weisenbergerat lisa@aossm.org for information.

AOSSM thanks Biomet for their generous support of Sports Medicine Update.