current concepts in orthopedic sports medicine
TRANSCRIPT
Current Concepts in
Orthopedic Sports Medicine
L. Pearce McCarty, III M.D.Shoulder, Elbow, Orthopaedic Sports Medicine
Sports and Orthopaedic Specialists
Team Physician - Minnesota Twins
Abbott Northwestern Innovation Conference – September 26, 2014
Current Concepts in Sports
Medicine
Concussion management
Cartilage restoration
Autologous chondrocyte
implantation
Osteochondral allograft
Hip arthroscopy
Biologics
Platelet Rich Plasma
Stem Cells
Scaffolds
Concussion Management
Traumatic brain injury
in collision / contact
sports
Risk of chronic
traumatic
encephalopathy
(CTE)
Pugilistica dementia
Depression
Personality changes
Parkinsonism
Dementia
Concussion Management
ImPACT neurocognitive
testing
Baseline
Post – injury
Sideline management
SCAT3
Post – injury management
Diagnosis
Physical therapy
Return to play decisions
Concussion Management
ANW – affiliated and all -
Allina ATC education for
sideline diagnosis and
care
Downstream follow-up
with Primary Care
Sports Medicine and
physical therapy
Return to play
Cartilage Restoration
Focal injury to cartilage
inside joint (predominantly
knee)
Not arthritis (think “pothole”
instead of “gravel road”)
Function and quality of life
affected to same degree
as ACL rupture or patients
with OA
Increasing capacity to
restore damaged area of
cartilage
Mitigate risk of OA
Cartilage Restoration
Autologous chondrocyte
implantation
Juvenile cartilage allograft
Osteochondral
allo/autograft
Cartilage Restoration
Utilizing these
restoration
techniques at ANW
Pushing boundaries
of accelerated
rehabilitation using
Alter G with Courage
Kenny Institute
Hip Arthroscopy
It’s not just for knees and
shoulders any more!
Increased role for
arthroscopy in treatment of
Femoral Acetabular
Impingement (FAI)
Pincer: socket issue
Cam: ball issue
Labral issues (“ligament”
that encircles socket)
Hip Arthroscopy
Up to 96% pain relief with
FAI corrective procedure
Labral pathology
Labral repair reported to
have better outcomes
92% good to excellent
results vs 68% good to
excellent results
Biologics
Platelet Rich Plasma
Concept: harness natural
“growth / healing factors”,
concentrate them and
apply them at site of injury
/ tissue damage
Traumatic injury
Degenerative processes
Liquid / gel form
Injectable
Semi – solid form
Can be sutured
Biologics
Current applications
Non – surgical
(injection)
“Tennis” elbow
“Jumper’s” knee
(patellar tendon)
Proximal hamstring
Osteoarthritis of knee
Surgical
Tendon (e.g. rotator
cuff) repair
Labral repair
Biologics
Scaffolds
Collagen
Dermis
Growth – factor imbued
Tendon repair
Rotator cuff
Gluteus medius
Summary
Concussion diagnosis
and management
Cartilage restoration
and joint preservation
Hip arthroscopic
treatment
Biologics for traumatic
tissue repair and
degenerative tissue
regeneration