Bulletin Board

By Staff

Training & Conditioning, 12.4, May/June 2002, http://www.momentummedia.com/articles/tc/tc1204/bulletinboard.htm

Order A New ACL

Wouldn’t it be great if doctors could remove a torn ligament and replace it with a new, undamaged one? That idea could become reality. Greg Altman, a Tufts University doctoral candidate, is developing a method for literally growing a replacement anterior cruciate ligament (ACL) out of cells obtained from a patient’s own bone marrow.

"The technology for this tissue repair and ligament growth could fundamentally change the way we treat this very common injury," says Altman, who is developing this procedure under the guidance of David Kaplan, PhD, Director of Tufts’ Bioengineering Center, and with John Richmond, MD, professor of orthopedic surgery at Tufts’ Medical School.

"Since the ACL has poor healing capabilities, our new ligament tissue could significantly reduce the recovery time to weeks rather than months for professional athletes and sports enthusiasts compared with current surgery practices," says Altman, who suffered a season-ending ACL tear himself five years ago as a preseason All-American offensive tackle for the Division III Jumbos.

Under Altman’s procedure, new ACLs are grown in a bioreactor using stem cells obtained from the injured athlete’s bone marrow. It takes four to six weeks for the new ligament to grow. Once the new ligament is complete, it can be implanted immediately or stored until surgery can be performed.

The process must undergo rigorous testing, but it could be ready for use in as little as five years. For more information on the procedure, visit www.tufts.edu/communications/altman.htm. For information about ACL injuries, visit www.AthleticSearch.com and enter "acl."


NCAA Bans PPA

Phenylpropanolamine (PPA), a stimulant and chemical relative of methamphetamine, will be banned by the NCAA starting on August 1, 2003.

The NCAA move to ban PPA follows a November 2000 warning issued by the U.S. Food and Drug Administration requesting that pharmaceutical companies remove PPA from over-the-counter products. Researchers have found a link between hemorrhagic strokes and use of PPA by women.

Athletic trainers can encourage student-athletes who have questions about banned substances in sports to visit the online Resource Exchange Center at www.drugfreesport.com/rec.


Duke Launches Women’s Sports Medicine Program

There is a growing awareness that the health issues of female athletes differ from male’s in many cases. With that in mind, Duke University recently opened the Women’s Sports Medicine Program within the Duke University Medical Center to address those unique needs both with its own student-athletes and female athletes in general. Only the second of its kind, the program is modeled after the first such program, at the Hospital for Special Surgery, in New York City.

"There are certain medical issues, such as the female athlete triad—disordered eating, amenorrhea (absence of menstruation), and stress fractures—that are unique to women," says the program’s head, Alison Toth, MD. "Also, we have seen a boom in women participating in athletics since Title IX passed in 1972. At the same time, the speed, contact, and intensity of sport and exercise have increased, so more and more women are getting injured. Unfortunately, they don’t always get the attention from the healthcare community that they should."

Along with overseeing the program, Toth, an orthopedic surgeon, will serve as team physician for Duke’s women’s sports, as well as provide much of the athletes’ surgical care. She is joined by two more full-time medical professionals: a primary care physician and a physical therapist. The three will work closely with other specialists at Duke as well as enlist consultants in areas such as nutrition, cardiology, endocrinology, obstetrics and gynecology, and mental health.

"Before the Center was established, we had one doctor who oversaw all sports," says Jen McCollum, MA, ATC, Assistant Athletic Trainer at Duke. "He did a great job, but having a doctor who is especially aware of some of the women’s issues is great for us in two ways. First of all, it’s easier for us to access her because she doesn’t have as big a load. And she’s established a network of providers who are experienced in treating things like menstrual cycle and nutritional issues."

This allows the athletic trainers and team physician to not just address the athletes’ injuries, explains McCollum, but to look at the bigger picture—the athletes’ histories, issues with their menstrual cycles, what’s going on with their bones, and how those factors intertwine.

Toth is also working with Duke’s athletic trainers on ACL injury prevention. "She gave a workshop on a prevention program that we’re integrating with our athletes in the off-season," says McCollum. "And some of our athletic trainers have also taken the program and done instruction at the local high schools.

"Because of the center, we’re also getting a lot of people interested in some of the other things we’re seeing more of in women athletes, like femoral stress fractures," says McCollum. "For example, our MRI technicians want to look into what’s going on, and other people want to research the issues of proper healing and bone density. That’ll help us address the full spectrum of the injury better."

Duke’s program may soon be joined by others around the country. UCLA, Harvard, and several other medical centers currently have similar centers planned.