Today, we’re diving into one of the most serious injuries in American football, and that is a knee dislocation. Dolphins star wide receiver Tyreek Hill recently suffered a devastating knee injury in the Monday Night Football game versus the Jets. He dislocated his knee resulting in multiple torn ligaments, including his ACL. Tyreek was taken to the hospital directly from the game for further evaluation and ended up undergoing urgent surgery for ligament reconstruction and repair. The team has obviously declared that this is a season-ending injury, and we wish him the best in his recovery.

Welcome to another episode of Game Plan! These Game Plan episodes are specifically designed for patients – to hopefully answer some of the questions you have about the most common sports medicine conditions and surgical treatments. But today’s episode is a little different and we’re excited about it! Today, we’re focusing on common injuries in the NFL and how these injuries impact time missed and player performance once athletes ultimately return to play.

This is something that each NFL team looks at carefully when evaluating rookie prospects before draft day. Teams look at the number of previous injuries, the types and severity of the injuries and treatment rendered when trying to decide on the ranking of a draft candidate. Now, this is just one facet of the evaluation – a physical examination is performed at the NFL Combine and performance metrics post-injury are obviously taken into account. 

But as the literature continues to grow in this area, it is becoming more feasible to project a player’s injury risk, career length and even performance in the NFL. This is useful information for NFL teams but also fantasy football enthusiasts who want to make sure they draft the best players for their team. So, our discussion today is going to focus on common injuries in the NFL and how that injury history may impact player reliability (games played), longevity for the season and performance. 

In this episode, we’re going to continue our discussion with Dr. Travis Matheney and focus on surgical treatment options for borderline hip dysplasia.

Our conversation picks back up with a review article published in the December 2024 issue of Current Reviews in Musculoskeletal Medicine titled “Borderline Hip Dysplasia - Best Treated with Hip Arthroscopy or Periacetabular Osteotomy?” Dr. Andrea Spiker and colleagues summarized the current research comparing isolated hip arthroscopy to periacetabular osteotomy for patients with borderline hip dysplasia.  They noted improved postoperative clinical outcome scores and low rates of conversion to total hip arthroplasty in both groups.  The authors concluded that successful clinical outcome seem to rely on treating underlying clinical pathology as well as appropriate surgical indications and surgical techniques.

Then, from the April 2021 issue of OJSM, we review an article titled “Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip.” This systematic review authored by Dr. Marc Philippon and his team at the Steadman Clinic in Vail found that outcomes improved across all patient reported outcome measures whether patients were treated using arthroscopic surgery or PAO.  They noted that revision surgery was also common in both procedures. 

We finish up with an article from the September 2017 issue of AJSM titled “Early Functional Outcomes of Periacetabular Osteotomy After Failed Hip Arthroscopic Surgery for Symptomatic Acetabular Dysplasia.” Bryan Kelly and his team at HSS investigated the effect of prior arthroscopic hip surgery on clinical outcomes after periacetabular osteotomy or “PAO”. They found that patients who previously underwent hip arthroscopy had inferior functional outcomes at 6 months and 12 months after PAO compared to patients with no prior hip surgery. The authors note that both groups significantly improved post-op and there was no difference in complications or reoperation between the groups. 

On today’s episode we’re focusing on the management of borderline hip dysplasia with Dr. Travis Matheney, a pediatric orthopedic surgeon at Boston Children's Hospital. We have some great articles for you that contribute well to our conversation on the treatment options for borderline hip dysplasia. 

We’ll start off our discussion today with an article titled “Periacetabular Osteotomy Improves Pain and Function in Patients With Lateral Center-edge Angle Between 18° and 25°, but Are These Hips Really Borderline Dysplastic?” Dr. Michael McClincy and team at Boston Children’s Hospital concluded that patients with a lateral center edge angles of 18-25 frequently have other radiographic features of dysplasia suggestive of abnormal femoral head coverage by the acetabulum and that these hips may be inappropriately labeled as “borderline” or “mild” dysplasia.  The authors recommended a more thorough radiographic evaluation of the patient with suspected dysplasia, including measurement of the Tonnis angle, FEAR index, anterior and posterior wall index, and anterior center edge angle.

We are joined today by Dr. Travis Matheney, an Assistant Professor of orthopedic surgery at Harvard Medical School and pediatric orthopedic surgeon at Boston Children’s Hospital.  He has a particular interest in pediatric hip pathology and is part of the Child & Young Adult Hip Preservation program at Boston Children’s. Dr. Matheney trained Ashley and I during our residency at Harvard, so we’re very excited to have him join us today and share his wisdom on this controversial topic.

Our conversation picks back up with an article published just last month in AJSM titled “Player Tracking Metrics to Predict Risk of ACL Injuries During Change-of-Direction Scenarios in the NFL.” The authors analyzed 216 ACL injuries that occurred in the NFL from 2018–2022 to determine how player tracking data could help predict injury risk, particularly during change-of-direction or “CoD” plays. They found that nearly half of ACL injuries occurred during CoD scenarios, most often involving high speeds followed by rapid deceleration. 

The authors noted that 98% of players were decelerating at the moment of injury. Using synchronized video and player tracking, the researchers found that maximum speed and normalized maximum deceleration power were significant predictors of ACL injury risk. Additionally, special teams plays showed the highest rates of CoD ACL injuries, though when motion data were factored in, the elevated risk was better explained by player speed and deceleration demands rather than play type alone. These findings highlight the potential to use tracking metrics for real-time risk monitoring, improved prevention programs, and possibly even future changes to training or game rules to reduce injury risk.

We’re going to wrap up today with a study that is currently ongoing and not yet published. Funded by the AOSSM Playmaker Grant, this clinical trial is investigating the use of wearable muscle oxygenation sensors to improve return-to-play assessment after ACL reconstruction. Dr. Voos, Dr. Calcei, and their team at the UH Drusinsky Sports Medicine Institute have found that muscle oxygenation recovery lagged behind clinical clearance in several cases. 

Eight athletes did not regain normal muscle oxygenation even when they were deemed ready to return. These findings suggest that wearable muscle oxygen saturation monitoring may add a valuable physiologic layer to current return to play protocols, potentially predicting safer and more individualized recovery timelines.

On today’s episode we’re focusing on wearable technology for athlete performance, recovery and injury prevention with Dr. Jacob Calcei, an orthopedic surgeon at University Hospitals in Cleveland and team physician for the Cleveland Browns. 

We’ll start off our discussion today with an article titled “Wearable Performance Devices in Sports Medicine” from the January 2016 issue of Sports Health. The authors review the rapid rise of wearable sensor technologies in athletics, highlighting their ability to track real-time physiologic and movement data for optimizing performance and reducing injury risk. These tools can provide valuable insights into workloads, biomechanics, and fatigue, supporting tailored training programs and early injury prevention strategies. While wearable devices have shown promise, evidence for their effectiveness in professional sports remains limited, and further research is needed to validate accuracy, develop standardized training protocols, and address practical challenges such as reliability and usability.

Then, from the January 2020 issue of Sports Heath, we review an article titled “Does Overexertion Correlate With Increased Injury? The Relationship Between Player Workload and Soft Tissue Injury in Professional American Football Players Using Wearable Technology.” This study investigates whether sudden increases in training load, as measured by wearable GPS and accelerometry technology, are associated with higher rates of soft tissue injury in professional American football players.  

The authors analyzed two NFL seasons and found that injured players experienced significantly greater spikes in workload during the week of injury compared to the prior month. Specifically,  they found that those exceeding an acute-to-chronic workload ratio (ACR) of 1.6 being 1.5 times more likely to sustain an injury. The effect was particularly pronounced in the preseason, when workloads were higher and hamstring injuries were most common. The findings suggest that rapid workload increases predispose athletes to soft tissue injury, while consistent training loads may offer a protective effect. The authors conclude that monitoring player workload with wearable technology could help medical and training staff design safer, more individualized training regimens to reduce injury risk.

We are joined today by Dr. Jacob Calcei, a board-certified orthopedic sports medicine physician and shoulder surgeon at University Hospitals and an assistant professor of Orthopedic Surgery at Case Western Reserve University School of Medicine. He is a team physician for the Cleveland Browns as well as several local high schools. Dr. Calcei has published extensively on a variety of sports medicine topics, has a particular interest in injury prevention and finding ways that we can make sports safer while optimizing athlete performance. So, we’re very excited to have him join us today.

Today’s episode is going to focus on the management of rotator cuff retears — including tips and tricks for successful revision repair and augmentation options.

We are joined today by two outstanding guests! 

Dr. Brian Waterman is a Professor of orthopedic surgery at Wake Forest University School of Medicine, Chief of Sports Medicine & Shoulder Surgery at Wake Forest Baptist Medical Center and Director of the Sports Medicine & Shoulder Surgery Fellowship. He is on the editorial board of the Arthroscopy Journal and American Journal of Orthopaedics. Dr. Waterman is a team physician for Wake Forest University, Winston-Salem Dash and US Ski and Snowboard.

Dr. Gabriella Ode is an orthopedic surgeon specializing in sports medicine and shoulder surgery at the Hospital for Special Surgery, Assistant Professor of orthopedic surgery at Weill Cornell Medical College and adjunct faculty with the Department of Bioengineering at Clemson University. She is also a team orthopaedic surgeon for the New York Liberty of the WNBA.

So, without further ado, let’s get to the Exhibit Hall!

Pitch, please: Managing UCL Injuries in Throwing Athletes

Dr. Michael Banffy and Dr. Christopher Camp

Today’s episode is going to focus on the management of UCL injuries in throwing athletes.

We are joined today by two outstanding guests! 

Dr. Michael Banffy is a Professor of Orthopedic Surgery and Chief of Orthopedic Sports Medicine at Cedars-Sinai, as well as Director of the Orthopedic Sports Medicine Fellowship at Kerlan-Jobe. He is a team physician for the Los Angeles Dodgers and Los Angeles Rams.

Dr. Christopher Camp is a board-certified orthopaedic surgeon specializing in sports medicine and shoulder and elbow surgery. Since 2019, he has been Medical Director, Team Physician, and Director of High Performance for the Minnesota Twins Baseball Club. Dr. Camp conducts clinical and basic science research on injuries of the shoulder, elbow and knee, including a focus on the throwing athlete. 

So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on addressing hip pathology in the setting of dysplasia — soft tissue management alone or with a periacetabular osteotomy.

We are joined today by two outstanding guests! 

Dr. Jorge Chahla is an Associate Professor of orthopedic surgery at Rush University Medical Center and serves as the Director of Biomechanical Research and Director of the International Fellowship Program at Midwest Orthopaedics at Rush. He is a team physician for the Chicago White Sox, Chicago Bulls and The Joffrey Ballet.

Dr. Robert Parisien is an Associate Professor of orthopedic surgery at Mount Sinai Orthopedics and is a team physician for US Ski and Snowboard and USA Fencing. He has published extensively on the topic of hip preservation and received numerous research awards over the years, so we are very excited to hear his take on this topic!

So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on lateral augmentation procedures to supplement ACL reconstruction, including lateral extraarticular tenodesis versus anterolateral ligament reconstruction.

We are joined today by two outstanding guests!  

Dr. Alan Getgood is the Chief of Surgery at Aspetar and Adjunct Professor of orthopedic surgery at the University of Western Ontario. He is a clinician scientist who has secured over $9 million in peer-reviewed and industry-funded grants to build his research program focused on complex knee reconstruction. Dr. Getgood is member of the AOSSM Board of Directors, Herodicus Society, ACL Study Group and was the program chair for the ISAKOS Biennial Congress last month.

Dr. James Voos is a Professor of orthopedic surgery at Case Western Reserve University School of Medicine and Chairman of the orthopedics department at University Hospitals. He successfully launched the UH Drusinsky Sports Medicine Institute and served at the Chief of Sports Medicine and Medical Director. Dr. Voos is the head team physician for the Cleveland Browns, Medical Director for the Cleveland Ballet and current President of the NFL Physicians Society.

So, without further ado, let’s get to the Exhibit Hall!