Happy New Year from The Sports Docs Podcast! 🎆

As we reflect on an incredible year of growth for our podcast, we’d like to take a moment to thank our amazing listeners, guests and supporters for making this podcast such a success!

Our podcast has been downloaded in over 60 countries, is in the top 25% of @buzzsprout podcasts and is ranked in the top sports medicine podcasts 📈🎙️ We are very excited to see what 2024 has in store.

Our latest segment addition - “Ask The Sports Docs” - Drs. Logan & Bassett answer listeners' most pressing orthopaedic & sports medicine questions, giving  insight to their opinions and expertise on these topics. 

On this episode, The Sports Docs will touch on the use of stem cells in sports medicine, our thoughts on open kinetic chain (OKC) exercise after knee surgery, and when ACL repair is recommended.

We appreciate this episodes questions from Daniel, orthopedic surgeon in California; Dan, physical therapist in Maryland and Delaware; and an anonymous patient.

Would you like your question answered by The Sports Docs? Send inquiries to:

[email protected]

Welcome to another episode of the Injury Report! Today, we’re focusing on core muscle injuries in the NFL, also known as “sports hernias”, most recently plaguing lead wide receiver for the Jaguars Christian Kirk. But this injury is quite common in the NFL affecting players from DeSean Jackson, Kareem Hunt, OBJ, Mike Evans, JJ Watt, Adrian Peterson to name a few. 

So, it’s about time that we cover this injury. As always, our plan today is to start with an overview of the relevant anatomy, discuss the mechanism of injury followed by treatment options for these players, and then wrap up with what you all want to know – when do players typically return to play after this injury and how do they do once they return?

We return today with Dr. Brett Owens to shift our discussion of MCL tears on to the treatment of isolated and combined MCL injuries, then wrap up with a discussion on safe return to play.

Our conversation picks back up with a level 1 prospective multicenter RCT from the March 2022 issue of AJSM titled “Comparative Outcomes Occur After Superficial Medial Collateral Ligament Augmented Repair vs. Reconstruction.” Fifty-four patients with grade III MCL injuries were randomized to either MCL augmented repair or MCL reconstruction using a free semitendinosus autograft. At 1-year post-op, there was no difference in objective outcomes (including gapping on post-op valgus stress x-rays). However, patient-reported outcomes – including IKDC scores and Lysholm scores – favored reconstruction.

We finish up today with an article from the March issue of AJSM this year titled “Nonoperative Management, Repair, or Reconstruction of the Medial Collateral Ligament in Combined Anterior Cruciate and Medial Collateral Ligament Injuries – Which Is Best?” This systematic review and meta-analysis investigated the outcomes of three different approaches to ACL-MCL combined injuries: ACL reconstruction with either (1) non-op treatment of the MCL tear, (2) MCL repair, (3) MCL reconstruction.

There was no difference in patient-reported outcomes, range of motion and quadriceps strength at final follow up. The rate of arthrofibrosis was similar between non-op and surgically treated MCL injuries, and the authors note that this rate has steadily decreased, likely relating to advancement in surgical technique.

On today’s episode we’re focusing on medial collateral ligament injuries with Dr. Brett Owens. We’ll start off our discussion today with an article authored by our guest, Dr. Brett Owens, titled “The Epidemiology of Medial Collateral Ligament Sprains in Young Athletes” from the 2014 issue of AJSM.

The authors performed a longitudinal cohort study of US military cadets and found that MCL injuries are relatively common in the athletic population. Male athletes are at significantly greater risk than females –of the 128 injuries in this study, 89% occurred in males. Intercollegiate athletes are also at greater risk than athletes participating in intramural sports. The incidence of MCL injury was highest in wrestling and hockey. In terms of time missed, the average amount of time was 23 days but this differed based on the grade of injury – with grade I sprains only missing a median of 13.5 days.

Up next is a Current Concepts Review article from JBJS authored by Robert LaPrade and colleagues at the University of Minnesota. Some takeaways from this paper: First, the medial structures of the knee (including the superficial and deep MCL as well as the posterior oblique ligament) are the most commonly injured ligamentous structures of the knee. The majority of medial knee ligament tears are isolated injuries. Physical examination is the initial method of choice for diagnosis and includes application of a valgus load to the knee in both full extension as well as in 20 to 30 degrees of knee flexion. In terms of imaging, valgus stress radiographs and MRI are useful to confirm and grade the injury.

We wrap up Part I with a discussion on the prevention of MCL injury and review an article from the August issue of OJSM this year titled “Prophylactic Knee Bracing in Offensive Lineman of the NFL – A Retrospective Analysis of Usage Trends, Player Performance and Major Knee Injury.” 

Dr. Robert Gallo and team at Penn State found that brace wears had a significantly lower rate of major knee injury, defined as an injury requiring time missed. The most common knee injury in nonbracers was an isolated MCL injury. There was no difference in player performance between bracers and nonbracers. Interestingly, despite this data, brace usage has steadily declined – from 16.3% in 2014 to 5.6% in 2020 – specifically at the rookie level.

We are joined today by Dr. Brett Owens, a board-certified orthopedic surgeon at University Orthopaedics in Providence Rhode Island, who specializes in complex shoulder, knee and sports medicine. He is the Chief of Sports Medicine at the Miriam Hospital in Providence, RI and the Director of the Rhode Island Cartilage Repair Center. 

He is a Professor of Orthopaedic Surgery at Brown University Alpert Medical School and is currently a Team Physician for Brown University and the Providence Bruins. Prior to joining University Orthopaedics, Dr. Owens served as the Chief of Orthopedics and Sports Medicine at Keller Army Hospital at West Point New York, where he cared for soldiers and cadets at the US Military Academy and was the Team Physician for Army lacrosse, rugby, and football teams. While deployed in Iraq during Operation Iraqi Freedom, Dr. Owens served as Chief of Orthopedics at the 86th Combat Support Hospital. He has also served as Team Physician for US Lacrosse like Catherine! Needless to say, he is a very accomplished person and we are excited to have him join us today.

On this episode, we’re going to continue our discussion with Dr. William Bugbee and focus on OCA surgical technique and then discuss clinical outcomes including return to sports.

Our conversation picks back up with a recent paper from the July issue of Cartilage this year titled “Young Age and Concomitant or Prior Bony Realignment Procedures are Associated with Decreased Risk of Failure of Osteochondral Allograft Transplantation in the Knee.” This retrospective nationwide database study represents the largest OCA cohort study to date and found that less than 2% of patients required salvage surgery. Young age, less than 29, and having a bony realignment procedure were associated with a significantly lower rate of salvage surgery – include revision cartilage procedures and arthroplasty.

We finish up today with an article from the June 2017 issue of AJSM titled “Return to Sport and Recreational Activity after Osteochondral Allograft Transplantation in the Knee.” Dr. Bugbee and colleagues at Scripps Clinic in La Jolla California reported that at a mean follow up of 6 years, 75% of patients were able to return to sport or recreational activity. Patients who did not return were more likely to be female and have a large graft size. 25% of knees underwent further surgery and 9% were considered allograft failures. Of the patients without OCA failure, 91% were satisfied with the results of surgery.

On today’s episode we’re focusing on osteochondral allograft transplantation or “OCA” with Dr. William Bugbee. We have some great articles for you that contribute well to our conversation on OCA, including allograft preparation and storage, graft choice, surgical technique, clinical outcomes of OCA and return to sport. 

We’ll start off our discussion today with an article authored by our guest, Dr. William Bugbee, from the May 2022 issue of AJSM titled “Fresh Osteochondral and Chondral Allograft Preservation and Storage Media: A Systematic Review of the Literature.” 

There was significant variability in experimental designs and incomplete reporting across the studies, so no real conclusions could be drawn regarding optimal storage conditions. While 60% of animal model studies suggest storage time may impact outcomes and 80% indicate inferior outcomes with frozen OCA compared to fresh OCA, the authors note that 75% of clinical studies reported no correlation between storage time and outcomes. So, we have a lot left to learn here.

Then, from the March 2022 issue of AJSM, we review an article titled “Association of Sex Mismatch Between Donor and Recipient With Graft Survivorship at 5 Years After OCA Transplantation.” Dr. Gomoll and colleagues at Brigham and Women’s reported that a significantly lower rate of graft survival was observed after different sex donor-recipient transplant compared to same sex donor-recipient OCA – 63% compared to 92%. Patients who received a donor-recipient sex-mismatch transplantation were 2.9X more likely to fail. Male donor to female recipient demonstrated the highest likelihood of failure compared to all other combinations.

We are joined today by Dr. William Bugbee, a board-certified orthopedic surgeon specializing in joint reconstruction and cartilage restoration at Scripps Clinic in La Jolla, California. Dr. Bugbee received his medical degree from UC San Diego and remained at UC San Diego for his orthopedic surgery residency.  He then went on to complete a fellowship in joint reconstruction at the Anderson Orthopaedic Research Institute. Dr. Bugbee has published extensively on the topic of osteochondral allograft transplantation, so we’re very excited that he is joining us today to share his expertise with all of you!

Our latest segment addition - “Ask The Sports Docs” - Drs. Logan & Bassett answer listeners' most pressing orthopaedic & sports medicine questions, giving  insight to their opinions and expertise on these topics. 

On this episode, The Sports Docs will touch on Anterior Knee Pain after knee surgery and the use of Blood Flow Restriction (BFR) in their practice.

We appreciate this episodes questions from Jenny L. fromTennessee and Gary P. from Indiana.

Would you like your question answered by The Sports Docs? Send inquiries to:
[email protected]

Today, we’re focusing on acromioclavicular or “AC” separations in the NFL, also known as “AC sprains."

Derek Carr, quarterback for the New Orleans Saints, sustained an AC sprain in the loss to the Green Bay Packers. As always, our plan today is to start with an overview of the relevant anatomy, discuss the mechanism of injury followed by treatment options for these players, and then wrap up with what you all want to know – when do players typically return to play after this injury and how do they do once they return?

 Links to discussed papers:

https://pubmed.ncbi.nlm.nih.gov/24057030/

https://pubmed.ncbi.nlm.nih.gov/22869625/

Welcome to an episode of the Injury Report! Yes, initially these were included in our patient-focused Game Plan episodes but we get so many questions each week about different NFL injuries (How long will they be out? How will they do once they return?) that we decided to create an entirely different episode type. 

Today, we’re focusing on high ankle sprains in the NFL – most recently plaguing Khalil Herbert of the Chicago Bears and Saquon Barkley earlier this season of the NY Giants. 

We’ll discuss the mechanism of injury, treatment options for these players and  importantly, when do they typically return to play and how do they do?