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NEWSLETTER OF THE AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE
NOVEMBER/DECEMBER 2008
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SHOULDER
INSTABILITY
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NOVEMBER/DECEMBER 2008
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Barry P. Boden MD
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Robert A. Arciero MD
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Team Physician’s Corner
Shoulder Instability and Surgical Stabilization:
Return to Sports and Activities
JOURNAL EDITOR, MEMBER EX OFFICIO
Bruce Reider MD
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SPORTS MEDICINE UPDATE is a bimonthly publication of the American Orthopaedic Society for Sports Medicine (AOSSM). The American
Orthopaedic Society for Sports Medicine—a world leader in sports medicine education, research, communication, and fellowship—is a national
organization of orthopaedic sports medicine specialists, including national and international sports medicine leaders. AOSSM works closely with many
other sports medicine specialists and clinicians, including family physicians, emergency physicians, pediatricians, athletic trainers, and physical
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:
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PRESIDENT’S MESSAGE
IN THIS DAY of economic uncertainty and change, AOSSM’s imperative is to
respond so that members and the profession can continue to thrive. In this context,
I want to highlight some of the Society’s current activities to support you as an
orthopaedic sports medicine specialist.
After the New Year, AOSSM members will
receive their inaugural issue of Sports Health: A
Multidisciplinary Approach. This new clinical
publication is a unique resource and an added
benefit to your Society membership. The
publication will be informative for both our
members and our sports medicine colleagues, and it will provide
a common forum for professional collaboration. We are grateful
to Ed Wojtys, MD, Editor-in-Chief of Sports Health, and Bruce
Reider, MD, Executive Editor of the AOSSM Medical Publishing
Group, for their work in developing the editorial vision for this
new and exciting publication. Equally important, I want to
recognize and thank David Sisk, MD, Chair of the AOSSM
Medical Publishing Board, for his leadership. His wise stewardship of our intellectual and financial resources will ensure that
AOSSM members and the sports medicine profession will
benefit from Sports Health just as we have from AJSM.
Another area of concern has been the potential burden
of maintaining dual certification under the American Board
of Orthopaedic Surgeons (ABOS) certification requirements
for general orthopaedics and for subspecialty certification in
orthopaedic sports medicine. As explained on page 10, we were
pleased to learn that the ABOS has decided to combine the
two so that orthopaedic surgeons can take one combined sports
examination, as presently is the case with the hand specialty.
The Society also has been working to integrate a number of
its educational programs online so that members have convenient,
expansive, and cost-effective access to AOSSM’s resources. In
October, the Society launched the Online Library—a unique tool
in the orthopaedic world that provides one location for several
search engines to both identify and access AOSSM’s content
from your home and/or office. Best of all, this service provides
members with free (or in some instances modestly priced) access
to all of our educational content. I strongly encourage you to
familiarize yourself with this resource. You will find it invaluable especially in the months to come as we integrate our
Self-Assessment Exam into it and add an image library for
our collaborators to use in developing educational content.
AOSSM’s strength is founded on maintaining a rigorous
forum for education, research, and publication. As we stay
focused on that mission, we are also focusing on developing
practical and tangible benefits that allow our members and our
profession to thrive in the midst of a changing and uncertain
sports medicine practice environment.
FR E D DI E H. FU, M D
November/December 2008 SPORTS MEDICINE UPDATE
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TEAM PHYSICIAN’S CORNER
SHOULDER INSTABILITY AND SURGICAL STABILIZATION:
RETURN TO SPORTS AND ACTIVITIES
DANIEL J. SOLOMON, MD
MATTHEW T. PROVENCHER, MD
Department of Orthopaedic Surgery
Naval Medical Center
San Diego, California
Shoulder dislocations, or subluxations, are
the most common athletic injuries of the shoulder in young
patients. Given the risk of recurrence in younger patients and
challenges with these injuries especially with in-season athletes, there is tremendous variability in the criteria to return
athletes to full activity. The optimal treatment for dislocation
in a young, athletic patient is usually surgical stabilization.
However, that may not always be feasible or reasonable.
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SPORTS MEDICINE UPDATE November/December 2008
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Other controversies include:
䡲 Sling use (type of sling or other form
of shoulder immobilizer and shoulder
position in the immobilizer)
䡲 Duration of sling use
䡲 Specific strength or range of motion
goals to meet before return
䡲 Brace use during high-risk activities—
such as contact sports like football,
hockey, or rugby
The objectives of this article are to
outline specific goals and criteria for
physicians, therapists, trainers, coaches,
and athletes to use in determining when
return to athletic training and competition
is feasible after a shoulder dislocation or
instability surgery.
Dislocation Injury Location
Affects Treatment
Surgeons often describe the primary lesion
of a shoulder dislocation as a Bankart
lesion of the
glenoid labrum.3
(See Figure 1A.)
Others emphasize capsular
tear or injury
Figure 1A. Left shoulder as the primary
(lateral position) poste- reason for the
rior portal arthroscopic patient to expeview showing anterior
rience persistent
inferior labral tear
instability.2
and fraying.
In the authors’
experience, a
combination of
labral injury, as
well as capsular
injury occurs in
Figure 1B. An anteromost patients
superior portal view
with instability.
helps define the amount
(See Figure 1B.)
of anterior inferior
glenoid chondral
Taylor and
wear in this patient.
Arciero evaluated
the physical examination and arthroscopy
findings in 63 first-time anterior dislocation patients. These were all United States
Military Academy cadets with an average
age of 19.6 years. There were 59 men and
four women, all of whom had shoulder
arthroscopy within 10 days of dislocation.
All had hemarthrosis. Sixty-one had
Bankart lesions; two had a humeral
avulsion of the glenohumeral ligaments
(HAGL); 57 had Hill-Sachs lesions; and
six had superior labrum anterior-posterior
(SLAP) tears. The study reported a 90
percent recurrent dislocation rate in the
patients involved in collision sports.17
Yiannakopoulos et al compared patients
with first-time and recurrent shoulder
dislocations and found slightly different
results than those of Taylor and Arciero.
In 127 patients, 88 percent had Hill-Sachs
lesions; 83 percent had Bankart lesions;
20 percent had SLAP lesions; 15 percent
(all of whom had recurrent dislocations)
had an inverted pear configuration of their
glenoid with anterior bone loss; 10 percent
(also all of whom had recurrent dislocations) had anterior labrum periosteal sleeve
avulsions (ALPSA); and 1.5 percent (all of
whom were acute, first-time dislocators)
had HAGL lesions. Of those patients with
acute dislocation, 78 percent had Bankart
lesions compared to 97 percent of patients
with chronic, recurrent dislocations with
ALPSA or Bankart lesions.20
In patients with instability, the authors
feel that if no labral tear is identified,
closely evaluating the humeral insertion of
the glenohumeral ligaments is appropriate.
Pre-operatively, a humeral avulsion of the
glenohumeral ligament lesion can be identified on an MR arthrogram coronal image.
These types of lesions cause the normal
U-shaped axillary recess to assume a J-shape.
The affected capsular area is readily identifiable arthroscopically. In contrast to
the studies of Yiannakopoulos and Taylor,
Wolf et al suggest that nearly 10 percent
of patients with shoulder instability have
a HAGL (six of 64 patients in their study)
while 73.5 percent (47 of 64 patients)
had Bankart lesions.19
Patients over 40 years old have a
decreased risk of recurrence, but an
increased risk of a rotator cuff tear from
the dislocation event. This was not noted
Continued on page 4
TABLE 1. Considerations at initial evaluation after dislocation
Dislocation
Sling or
immobilizer
Goals for return
Type of sport
or position
Energy or force
of injury
What position?
Motion
Risk—is a safe
return possible?
Type/direction
How long?
Strength
Timing during
season
Chronicity
Functional brace
for return to play
Pain
Patient’s age
Subjective/objective
instability
Structures injured
Nerve injury
November/December 2008 SPORTS MEDICINE UPDATE
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in any of the younger patients in the
previously mentioned studies. However,
rotator cuff tears, especially tears of the
subscapularis, can certainly occur in
younger patients.
Less common or frequent than a traumatic anterior dislocation is a posterior
dislocation and/or posterior instability and
multidirectional instability. These injuries
when combined comprise less than 10
percent of all recurrent instability patients.
The complex injury pattern and dysfunction
related to multidirectional instability is
beyond the scope of this review.
Recurrent dislocation can lead to glenoid
bone loss, large humeral head defects, and
extensive labral tears, which can then lead
to increased recurrence and decreasing
possibilities of returning to normal shoulder
function especially without some stabilization procedure. (See Figures 2A and 2B.)
Figure 2A. This is an arthroscopic view
(beach-chair position) from the posterior
portal in the right shoulder of a 25-year-old
football player who had more than 25
recurrent dislocations.
Figure 2B. The view from the anterosuperior portal confirms significant chondral
and bony deficiency of the anteroinferior
glenoid. The bare area of the glenoid
is seen in the center of the image. This
patient underwent an open Latarjet
coracoid transfer and regained stability.
Immobilization After Dislocation
or Surgery as a First-Line Treatment
Hovelius et al prospectively studied 257
patients with an age range of 12 to 40 years
treated non-operatively after an initial
primary anterior shoulder dislocation.
They found no significant difference
between those patients immobilized for
three to four weeks and those allowed
early range of motion.7
In contrast, Bottoni et al compared
recurrence rates of first-time dislocation
treated with arthroscopic stabilization
or four weeks immobilization followed
by rehabilitation. While the groups were
small, they found a statistically significant
difference. Nine of 12 patients (75 percent)
treated with immobilization had at least
one recurrence; only one (11.1 percent)
of the arthroscopically treated patients
had a recurrence.4
For the first-time dislocator, immobilization and rehabilitation has a much
higher rate of recurrent dislocation than
surgery. Kirkley et al presented their longterm results of a prospective randomized
study of 40 subjects, under 30 years old,
treated with either immobilization and
rehabilitation or arthroscopic stabilization.
At an average follow-up of more than six
years, there was a significant difference
in the rate of redislocation, a small but
significant difference in their Western
Ontario Shoulder Instability (WOSI)
score, but no statistical difference in
their American Shoulder and Elbow
score (ASES) or Disability of the Arm,
Shoulder, and Hand (DASH) score.11
Standard Sling May Not Be
the Best Immobilization After
Initial Dislocation
Itoi evaluated immobilization in external
rotation as a means of possibly improving
outcomes without surgery for a similar
group of patients. With 20 patients in
each of two randomized groups, there
was a 30 percent recurrence rate in the
conventional immobilization group and
a 0 percent recurrence rate in the external
rotation immobilization group at a mean
15.5 months follow-up. For younger
patients under age 30, their result was
even more dramatic, with a 45 percent
recurrence in the conventional immobilization group.9
Itoi’s clinical trial validated his previous
MRI study showing that the anterior-inferior labrum was held in a reduced position
after dislocation when an immobilizer held
the arm externally rotated. Whereas, with
the arm internally rotated the Bankart
lesion displaces away from the glenoid.8
Cryotherapy Benefits
A few studies have demonstrated a significant benefit of cryotherapy after shoulder
surgery. Speer evaluated 50 consecutive
patients—all of whom had one night
hospitalization after either open Bankart
repair, rotator cuff repair, or total shoulder
arthroplasty. Twenty-five were treated
with cryotherapy, 25 were not. Their
postoperative treatment was otherwise
identical. The cryotherapy group noted
better sleep, post-operative day 1, less
pain medication use, and by post-operative day 10, less pain, less swelling, and
less pain with rehabilitation exercises.16
Singh randomized 70 post-operative
shoulder patients to continuous cryotherapy
or no cold-therapy treatment. He evaluated
VAS on post-operative day 1, 7, 14, and
21. The cryotherapy group experienced
less pain during sleep on post-operative
day 1, less pain (frequency and intensity),
and less pain with rehabilitation on
post-operative days 7–21.14
While neither of these studies addresses
an acute dislocation, cryotherapy may be
a useful adjunct to help decrease pain and
return the athlete to activities faster.
Rehabilitation After First-time
Dislocation
Progressing in a step-wise, goal-related
rehabilitation program may help patients
return to athletic activity more reliably than
immobilization alone. The first stage in that
program is typically aimed at decreasing
the pain and swelling related to a shoulder
dislocation. An immobilizer in neutral
or external rotation is preferred. External
rotation beyond 15 degrees typically is
poorly tolerated due to pain. The patient
should progress rapidly to scapular motion
exercises and gentle Codman exercises.
Performing patient-guided passive range
of motion can be easily done with the
patient supine on a firm surface. Once
motion has progressed to a comfortable
elevation to 90 degrees, abduction to
90 degrees, and external rotation to
30 degrees, isometric rotator cuff exercises
with the arm adducted can commence.
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After weaning off the immobilization,
the second phase of another four to six
weeks includes active assisted and active
range of motion until full range of motion
is achieved. The patient is encouraged to
first address forward elevation and protect
external rotation, especially in abduction.
More vigorous periscapular strengthening
and rotator cuff strengthening is allowed.
The third phase begins about eight to 12
weeks after surgery, as the patient demonstrates near full active range of motion
and scapular control, strengthening is
advanced. Finally, the patient progresses
to sport specific rehabilitation, including
body weight strengthening and a throwing
program, if necessary.
Restoring synchronous scapulothoracic
motion is critical to restoring glenohumeral
stability. If one thinks of the unstable
glenohumeral joint more as a seal trying
to balance a ball on its nose than as a
golf ball on a golf tee, one appreciates the
critical role of the scapula. The scapula
must be able to accommodate and adjust
to keep the humeral head centered.
Isometric scapular muscle exercises can
also start early in the patient’s post-injury
course. Furthermore, the rotator cuff,
the dynamic stabilizers of the shoulder,
bear an increased load with loss of static
stability. Rotator cuff strengthening plays
a critical role in restoring stability to the
post-dislocation shoulder. Aronen and
Regan report good results in decreasing
recurrence with an internal rotation and
adduction strengthening program. In 20
men, aged 18 to 22, their rehabilitation
program led to only a 25 percent redislocation rate with a mean follow up of
almost three years.1
Functional Brace Prescription
There are several off-the-shelf braces available to augment shoulder stability. The
Sully brace can be used in overhead sports,
such as basketball or volleyball. The Duke
Wyre brace can be used in contact sports
such as football, lacrosse, or rugby. Some
sports do not allow or are not amenable
to bracing such as wrestling or swimming.
Chu et al concluded that a Sully neoprene brace improves active joint-reposition
sense at 10 degrees from full external rotation for subjects with unstable shoulders.
They supposed that an improvement in
patient’s proprioception rather than a restriction of rotation accounts for the patient’s
improved stability in the Sully brace.6
In a study of the effectiveness of the
Duke Wyre harness and Sawa brace using
a motion analysis system, Weise et al
found that neither brace could control
abduction to their preset limit. The braces
protected against the vulnerable position
of 90 degrees abduction and external
rotation when the preset limit was set
at 45 degrees. The Sawa brace was more
effective than the Duke Wyre brace for
that purpose.18
Rehabilitation After Surgical
Stabilization
Most surgical rehabilitation programs
divide the post-operative course into phases.
Typically, the design of the first phase
includes a period of four to six weeks of
immobilization depending on the extent
of the surgery performed and the patient’s
tissue quality. During that period the
patient progresses with protected assisted
range of motion and isometrics of the
periscapular muscles. As previously mentioned, emphasizing synchronous scapular
motion is critical early in rehabilitation.
Rehabilitation After Surgical
Stabilization—Arthroscopic
Kim et al randomized 66 patients who had
received arthroscopic Bankart repair into two
different therapy protocols. Group 1 had
pillow sling immobilization for three weeks,
followed by pendulums and forward elevation using pulley. At four weeks, internal
rotation strengthening started, but external
rotation was prohibited. At six weeks, external rotation strength started. At nine weeks,
they allowed more vigorous exercise. Group 2
had sling in sleep only for two weeks.
Forward elevation was limited to 90
degrees for two weeks, and at four weeks
full range of motion was allowed except
extreme external rotation. There was no
recurrence in either group but two patients
in each group had positive apprehension.10
This article supports the concept that
immobilization need not be prolonged in
many cases after arthroscopic stabilization.
Rehabilitation After Surgical
Stabilization—Open
After open shoulder stabilization, one additional concern is healing of the subscapularis
tendon. Slaybaugh evaluated when the liftoff test and belly-press tests return to normal
in patients after open capsular shift. Average
time for return to normal for the lift-off
test was 8.4 weeks, and all returned by
12 weeks. For the belly-press test, average
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November/December 2008 SPORTS MEDICINE UPDATE
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return to normal was 8.8 weeks, and all
returned by 20 weeks.15
The function of the subscapularis after
an open Bankart repair may be the critical
factor with regard to patients’ results and
satisfaction. Sachs et al found 23 percent of
30 patients evaluated four years after open
Bankart repair had an incompetent subscapularis, with 27 percent internal rotation
strength of the affected shoulder compared
to the patients’ normal side. Only 57 percent
reported good or excellent results, and only
57 percent would have the surgery again.
In contradistinction, of the patients with an
intact, normally functioning subscapularis,
91 percent reported good or excellent
results and 100 percent would have the
surgery again.13
Given those findings, rehabilitation of
an athlete after open shoulder stabilization
must adequately protect the subscapularis.
Those patients may require a longer period
of immobilization and longer period
of protected external rotation as well as
avoidance of active internal rotation.
Returning to Play
In 2004, McCarty et al comprehensively
reviewed return to play after glenohumeral
dislocation or reconstructive surgery
for shoulder instability. Their ideal
criteria include:
䡲 Little to no pain
䡲 Patient subjectivity
䡲 Near normal range of motion
䡲 Near normal strength
䡲 Normal functional ability
䡲 Normal sports-specific skills
They also emphasized that the pathology related to microinstability in baseball
pitchers and some other high-velocity
overhand athletes is a different entity than
that of more typical traumatic instability.
Those patients do not often develop
macroinstability with frank dislocation
or subluxation events and respond much
better to rehabilitation efforts.
Their review is an extremely valuable
resource for anyone treating athletes with
shoulder instability.12
Buss et al evaluated the ability of
in-season competitive athletes to return to
competition after anterior shoulder instability treated with non-operative measures
of early mobilization, physical therapy, and
bracing. Their study comprised 30 high
school and college varsity athletes, with
an average age of 16.5 years (range 14–20
years), including 21 first-time dislocators
and nine recurrent dislocators. No immobilization or sling was prescribed. Physical
therapy was initiated, as needed, for early
range of motion or if strength was less than
4/5. Athletes returned to their sports when
they had symmetric bilateral strength and
a functional range of motion that would
allow full participation in their sport or
position. A Duke Wyre brace was recommended for non-overhead throwing,
contact athletes and a Sully brace was
suggested for overhead throwing athletes,
if their sport allowed. Twenty-seven out
of 30 returned to their sport for all or part
of their season. Ten of the 27 who returned
(37 percent) had at least one additional
dislocation or subluxation. Sixteen patients
(59 percent) were stable. An average of
1.4 recurrent instability episodes (range
0–8 episodes) per athlete per season was
calculated for athletes who returned to their
sport. For the 27 who returned in-season,
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SPORTS MEDICINE UPDATE November/December 2008
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average number of missed days was 10.2
(range 0–30). Although 40 percent of
their patients had recurrent instability
episodes during their current season, only
one athlete who returned to the current
season was not able to complete it.5
This article suggests that some patients
can be returned to athletics without
significant consequences.
Conclusion
The decision to return to athletic activities after shoulder dislocation must be
thoroughly contemplated. Ramifications
to return to play too soon after a dislocation could include an early re-dislocation,
or risk of further injury, perhaps devastating and detrimental to future activities.
However, a select group of patients might
be able to safely return in a relatively
short period of time to a fairly high level
of competition.
After instability surgery, the results
are generally excellent with appropriate
rehabilitation geared toward functional
and sport-specific activities accomplished
prior to return. The range for this therapy
is about three to 20 months, with most able
to return by six to eight months depending
on several factors, such as sport or position
played, and specific shoulder structures
injured and repaired. Often it can be difficult to define “safe-to-return” and maximal medical improvement. The decision
process for how best to treat an athlete after
shoulder dislocation must include a discussion of limitations, anticipated activities,
and goals with the athlete, parent, trainer,
therapist, coach, and surgeon.
References
2. Baker CL, Uribe JW, Whitman C. Arthroscopic evaluation of acute
anterior shoulder dislocations. Am J Sports Med. 1990.18:25-28.
11. Kirkley A, Werstine R, Ratjek A, Griffin S. Prospective randomized
clinical trial comparing the effectiveness of immediate arthroscopic
stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: Long-term evaluation.
Arthroscopy. 2005.21:55-63.
3. Bankart A. The pathology and treatment of recurrent dislocation
of the shoulder joint. Br J Surg. 1923.2:23-29.
12. McCarty EC, Ritchie P, Gill HS, McFarland EG. Shoulder instability:
Return to play. Clin Sports Med. 2004.23(3):335-351.
4. Bottoni CR, Wilckens JH, DeBerardino TM, D’Alleyrand JG,
Rooney RC, Harpstrite JK, Arciero RA. A Prospective, Randomized
Evaluation of Arthroscopic Stabilization Versus Nonoperative
Treatment in Patients with Acute, Traumatic, First-Time Shoulder
Dislocations. Am J Sports Med. 2002.30:576-580.
13. Sachs RA, Williams B, Stone ML, Paxton L, Kuney M. Open
Bankart repair. Correlation of results with postoperative subscapularis
function. Am J Sports Med. 2005.33:1458-1462.
1. Aronen JG, Regan K. Decreasing the recurrence of first time
anterior shoulder dislocations with rehabilitation. Am J Sports Med.
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5. Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ.
Nonoperative management for in-season athletes with anterior
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6. Chu JC, Kane EJ, Arnold BL, Gansneder BM. The effect of a neoprene shoulder stabilizer on active joint reposition sense in subjects
with stable and unstable shoulders. J Athl Train. 2002.37(2):141-145.
7. Hovelius L, Augustini BG, Fredin H, Hagberg G, Hussenius A,
Lind B, Thorling J, Weckstrom J. Primary anterior dislocation
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J Bone Joint Surg. 1996. 78A(11):1677-1684.
8. Itoi E, Sashi R, Minagawa H, Shimizu T, Wakabayashi I, Sato K.
Position of immobilization after dislocation of the glenohumeral
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J Bone Joint Surg. 2001.83A:661-667.
9. Itoi E, Hatakeyama Y, Kido T, Sato T, Minagawa H, Wakabayashi I,
Kobayashi M. A new method of immobilization after traumatic
anterior dislocation of the shoulder: A preliminary study. J Shoulder
Elbow Surg. 2003.12:413-415.
10. Kim SH, Ha KI, Jung MW, Lim MS, Kim YM, Park JH.
Accelerated rehabilitation after arthroscopic Bankart repair for
selected cases: A prospective randomized clinical study. Arthroscopy.
2003.19(7):722-731.
14. Singh H. The efficacy of continuous cryotherapy on the postoperative
shoulder: A prospective randomized investigation. J Bone Joint Surg.
2001.10A:522-525.
15. Slabaugh M. Timing of return of subscapularis function in open
capsular shift patients. J Shoulder Elbow Surg. 2007.16:544-547.
16. Speer KP. The efficacy of cryotherapy in the postoperative shoulder.
J Shoulder Elbow Surg. 1996.5:62-66.
17. Taylor DC, Arciero RA. Pathologic changes associated with shoulder
dislocations. Arthroscopic and physical examination findings in
first-time, traumatic anterior dislocations. Am J Sports Med.
1997.25(3):306-311.
18. Weise K, Sitler MR, Tierney R, Swanik KA. Effectiveness of
glenohumeral-joint stability braces in limiting active and passive
shoulder range of motion in collegiate football players. J Athl Train.
2004.39(2):151-155.
19. Wolf EM, Cheng JC, Dickson K. Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability.
Arthroscopy. 1995.11:600-607.
20. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of intraarticular lesions in acute and chronic anterior shoulder
instability. Arthroscopy. 2007.23:985-990.
November/December 2008 SPORTS MEDICINE UPDATE
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FELLOWSHIP MATCH
PARTICIPANTS
American Sports Medicine
Institute Program
James R. Andrews, MD,
and Lawrence J.
Lemak, MD
Birmingham, AL
Fellowship Match
Garners High Participation Rate
AANA and AOSSM are pleased to announce that the following 94 sports
medicine/arthroscopy fellowship programs are participating in the
AANA/AOSSM Match and represent 226 fellowship positions. The
Match, administered through the San Francisco Matching Program
(www.sfmatch.org), will provide an orderly, equitable selection process
for applicants and fellowship programs. For the most current match
information, please visit www.sportsmed.org/fellowships.
University of South
Alabama Program
Albert W. Pearsall IV, MD
Mobile, AL
University of Arizona
Program
Robert E. Hunter, MD
Tucson, AZ
Congress Medical
Associates Program
Gregory J. Adamson, MD
Pasadena, CA
Kaiser Permanente
Orange County Program
Brent R. Davis, MD
Irvine, CA
Kerlan-Jobe Orthopaedic
Clinic Program
Neal S. ElAttrache, MD
Los Angeles, CA
Los Angeles Orthopaedic
Institute Program
Domenick J. Sisto, MD
Sherman Oaks, CA
San Diego Arthroscopy &
Sports Medicine Program
James P. Tasto, MD
San Diego, CA
San Diego Knee &
Sports Medicine
Research Program
Donald C. Fithian, MD,
and Edmond P.
Young, MD
El Cajon, CA
Santa Monica
Orthopaedic & Sports
Medicine Program
Bert R. Mandelbaum, MD
Santa Monica, CA
SOAR Sports Medicine
Program
Michael F. Dillingham, MD
Redwood City, CA
Southern California
Center for Sports
Medicine Program
Peter R. Kurzweil, MD
Long Beach, CA
Southern California
Orthopaedic Institute
Program
Richard D. Ferkel, MD
Van Nuys, CA
Stanford University
Program
Marc R. Safran, MD
Stanford, CA
The Sports Clinic
Orthopedic Medical
Associates, Inc. Program
Wesley M. Nottage, MD
Laguna Hills, CA
UCLA Medical Center
Program
David R. McAllister, MD
Los Angeles, CA
University of California,
San Francisco
Christina R. Allen, MD
San Francisco, CA
USC Orthopaedic Surgery
Associates Program
James E. Tibone, MD
Los Angeles, CA
West Coast Sports
Medicine Foundation
Program
Keith S. Feder, MD, and
Carol Frey, MD
Manhattan Beach, CA
Aspen Sports Medicine
Foundation Program
N. Lindsay Harris, Jr., MD
Aspen, CO
Panorama Orthopedics
Program
James T. Johnson, MD, and
Charles A. Gottlob, MD
Golden, CO
Steadman Hawkins –
Denver Program
Theodore F. Schlegel, MD
Denver, CO
Steadman Hawkins
Clinic Program
J. Richard Steadman, MD
Vail, CO
University of Colorado
Health Science Center
Program
Eric C. McCarty, MD
Boulder, CO
University of Connecticut
Program
John P. Fulkerson, MD,
and Robert A.
Arciero, MD
Farmington, CT
Andrews/Paulos Research
and Education Institute
Program
Lonnie E. Paulos, MD
Gulf Breeze, FL
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SPORTS MEDICINE UPDATE November/December 2008
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Listed alphabetically by state. Fellowship program directors’ names also included.
Doctors’ Hospital Program
F. Harlan Selesnick, MD
Coral Gables, FL
UHZ Sports Medicine
Institute Program
John W. Uribe, MD
Coral Gables, FL
University of South
Florida
Robert Pedowitz, MD
Tampa Bay, FL
Atlanta Sports Medicine
Program
Scott D. Gillogly, MD
Atlanta, GA
Emory University
Program
Spero G. Karas, MD
Atlanta, GA
The Hughston
Foundation Program
Champ L. Baker, Jr., MD
Columbus, GA
University of Iowa
Hospitals & Clinics
Program
Ned Amendola, MD, and
Brian Wolf, MD
Iowa City, IA
Rush University Medical
Center Program
Bernard R. Bach, Jr., MD
Chicago, IL
University of Chicago
Program
Sherwin S.W. Ho, MD
Chicago, IL
University of Illinois
Center for Athletic
Medicine Program
Preston M. Wolin, MD
Chicago, IL
Indiana School
of Medicine
Program/Methodist
Sports Medicine
Arthur C. Rettig, MD
Indianapolis, IN
University of Missouri
at Kansas City Program
Jon E. Browne, MD
Leawood, KS
University of
Kentucky Program
Darren L. Johnson, MD
Lexington, KY
Ochsner Clinic
Foundation
Deryk G. Jones, MD
New Orleans, LA
Boston University
Medical Center Program
Anthony A. Schepsis, MD
Boston, MA
Brigham & Women’s
Hospital
Scott D. Martin, MD
Boston, MA
Children’s Hospital
(Boston) Program
Lyle J. Micheli, MD
Boston, MA
Massachusetts General
Hospital/Harvard Program
Thomas J. Gill IV, MD
Boston, MA
New England Baptist
Hospital Program
Mark E. Steiner, MD
Boston, MA
University of
Massachusetts Program
Brian D. Busconi, MD
Worcester, MA
University of Manitoba
Peter B. MacDonald,
MD, FRCS
Winnipeg, Manitoba
Union Memorial
Hospital Program
Richard Y. Hinton, MD
Baltimore, MD
Detroit Medical Center
Program
Stephen E. Lemos, MD, PhD
Madison Heights, MI
Henry Ford Hospital
Program
Henry T. Goitz, MD
Detroit, MI
University of Michigan
Program
Bruce S. Miller, MD
Ann Arbor, MI
William Beaumont
Hospital Program
Kyle Anderson, MD
Royal Oak, MI
Minnesota Sports
Medicine Program
J. Patrick Smith, MD
Minneapolis, MN
TRIA Orthopaedic
Center Program
David A. Fischer, MD
Bloomington, MN
Washington University
Program
Matthew J. Matava, MD
Chesterfield, MO
Mississippi Sports
Medicine &
Orthopaedic Center
Program
Larry D. Field, MD
Jackson, MS
OrthoCarolina Sports
Medicine Center
James E. Fleischi, MD
Charlotte, NC
Duke Sports Medicine
Center Program
Dean C. Taylor, MD
Durham, NC
Wake Forest University
Program
David F. Martin, MD
Winston-Salem, NC
New Mexico Arthroscopy
& Sports Medicine
Associates Program
Anthony F. Pachelli, MD
Albuquerque, NM
Taos Orthopaedic
Institute Program
James H. Lubowitz, MD
Taos, NM
University of New Mexico
Program
Robert C. Schenck, Jr., MD
Albuquerque, NM
Barton/Lake Tahoe
Sports Medicine Program
Keith R. Swanson, MD
Zephyr Cove, NV
Hospital for Special
Surgery Program
Scott A. Rodeo, MD, and
David W. Altchek, MD
New York, NY
Lenox Hill Hospital
Program
Barton Nisonson, MD
New York, NY
NYU Hospital for
Joint Diseases
Orrin H. Sherman, MD
New York, NY
Plancher Orthopaedic
Sports Medicine Program
Kevin D. Plancher, MD
New York, NY
Staten Island Sports
Medicine/Arthroscopic
Fellowship
Mark F. Sherman, MD
Staten Island, NY
University at Buffalo
Program
Leslie J. Bisson, MD
Buffalo, NY
University of Rochester
Medical Center Program
Michael D. Maloney, MD
Rochester, NY
Cincinnati Sports
Medicine & Orthopaedic
Center Program
Frank R. Noyes, MD
Cincinnati, OH
Cleveland Clinic
Foundation Program
Mark S. Schickendantz,
MD
Cleveland, OH
Ohio State University
Hospital Program
Christopher C. Kaeding,
MD
Columbus, OH
Wellington Orthopaedic/
University of Cincinnati
College of Medicine
Robert S. Heidt, Jr., MD,
and Angelo J.
Colosimo, MD
Cincinnati, OH
Fowler Kennedy
Orthopaedic Sport
Medicine Program
J. Robert Giffin, MD,
FRCSC
London, Ontario
3B Orthopaedic at
Penn/Penn Orthopaedics
Program
Arthur R. Bartolozzi, MD
Philadelphia, PA
Allegheny General
Hospital Program
Patrick J. DeMeo, MD
Pittsburgh, PA
Penn State University/
Milton S. Hershey
Medical Center
Wayne J. Sebastianelli, MD
State College, PA
Thomas Jefferson
University Program
Michael G. Ciccotti, MD
Philadelphia, PA
University of Pittsburgh
Program
Christopher D. Harner, MD
Pittsburgh, PA
Brown University Program
Paul D. Fadale, MD
Providence, RI
Steadman Hawkins Clinic
of the Carolinas Program
Richard J. Hawkins, MD
Spartanburg, SC
Sports Orthopedics
& Spine Education
Foundation Program
Keith D. Nord, MD
Jackson, TN
University of Tennessee –
Campbell Clinic Program
Frederick M. Azar, MD
Memphis, TN
Vanderbilt University
Program
John E. Kuhn, MD
Nashville, TN
Baylor College of
Medicine Program
Walter R. Lowe, MD
Houston, TX
Methodist Hospital
(Houston) Program
David M. Lintner, MD
Houston, TX
Plano & Associated
Orthopedics Sports
Medicine Fellowship
Program
Alexander Glogau, MD,
and F. Alan Barber, MD
Plano, TX
University of Texas at
Houston/Foundation for
Orthopaedic, Athletic &
Reconstructive Research
Leland A. Winston, MD,
and Thomas O.
Clanton, MD
Houston, TX
University of Utah
Program
Robert T. Burks, MD
Salt Lake City, UT
Georgetown University
Hospital Program
Robert P. Nirschl, MD, MS
Arlington, VA
Orthopaedic Research
of Virginia
John F. Meyers, MD
Richmond, VA
University of Virginia,
Department of
Orthopaedics, Division
of Sports Medicine
David R. Diduch, MD
Charlottesville, VA
University of Wisconsin
Hospitals & Clinics
Program
John F. Orwin, MD
Madison, WI
November/December 2008 SPORTS MEDICINE UPDATE
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ABOS Sports Medicine Certification
Rules Change in 2011
Seasons change, politicians change,
children change, and in 2012 the rules
for taking the subspecialty certification
in orthopaedic sports medicine will
change. The grandfather period ends
in 2011 for the American Board of
Orthopaedic Surgery’s (ABOS) subspecialty certification in orthopaedic sports
medicine. Applicants that wish to test
in 2012 and later must have completed
one full year of education in an accredited ACGME sports medicine fellowship
program or the Canadian equivalent.
Equally important, the ABOS
recently decided to phase out the
current recertification Sports Medicine
Practice Profile Exam by 2012. This
means that those surgeons who have
not taken/passed the Primary Sports
Medicine Subspecialty Certification by
the end of 2011 will have to take their
computer based recertification exam
using the general orthopaedic examination. In addition, after 2011, those who
wish to recertify through Maintenance
of Certification (MOC) without having
a sports subspecialty certificate, may
choose the oral exam with a panel of
sports examiners. The oral exam for
MOC is helpful for those in a highly
focused sports practice who do not wish
to prepare for the 80 core orthopaedic
questions on a computer exam.
Those Diplomates who hold a
Subspecialty Certificate in Orthopaedic
Sports Medicine may renew their sports
certification at the same time that they
renew their General Certificate by choosing the Combined Sports Examination.
Upon passing that examination, the
Diplomate will receive two certificates.
Both certificates will be dated from
the expiration date of their general
certificate. Individuals who get their
subspecialty certification in orthopaedic
sports medicine will only need to take
one recertification exam.
The time limit to become recertified
(in sports and in general orthopaedics)
will now coincide with the 10 year expiration date of general orthopaedic certification. The ABOS expects that the first
recertifying exams will be given in 2010.
The Recertification Examinations are
for Diplomates of the ABOS who wish
to renew their certification. Diplomates
are eligible to take a recertification
examination up to two years prior to the
expiration year of their certificate. They
may apply up to three years prior to the
expiration of their certificate, as the
application is due in the year prior to
the examination. The application, once
approved, is then valid for three years.
For more details on certification
requirements, visit www.abos.org.
Deadline for 2009 Subspecialty Certification in Sports Medicine Exam Approaching
The application for the 2009 examination is currently available online at www.abos.org. The deadline to apply is March 15, 2009.
The absolute late deadline is March 31, 2009, with an additional $350.00 late fee. Applicants will either need to enter a current
ABOS username and password or create a new username and password to access the application. For more information and
details on subspecialty certification requirements and the changes regarding recertification, visit www.abos.org.
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SPORTS MEDICINE UPDATE November/December 2008
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RESEARCH ROUNDUP
AOSSM Post-Joint Injury
Osteoarthritis Conference
to Be Held in December
The Society will hold a conference
exploring the strong association between
joint injury and the development of
osteoarthritis. Both clinical leaders
and basic scientists will discuss the
current and emerging areas of research
and develop a consensus on future
areas of cooperative research. Conference
attendees will also develop new collaborations and strategies for translating basic
research into patient care. The conference
will be held December 11–14, 2008, in
New Orleans and the proceedings will
be made available online and in print.
This meeting is made possible through
the generous support of the National
Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS), Genzyme
Biosurgery, Mesoblast, Össur, RTI
Biologics, and TiGenix.
HA Predictive Study
Enrolls Patients
As described in the March/April 2008
issue of SMU, the Society is conducting
a pilot study to evaluate predictors of
response to hyaluronic acid (HA) for
knee osteoarthritis. The ultimate goal
of the project is to develop a method of
predicting which patients are most likely
or least likely to respond well to HA.
The study began enrolling patients in
October and will continue until 500
patients have been followed for one year,
post-treatment. Ferring Pharmaceuticals
joins Genzyme Biosurgery and GE
Healthcare in providing financial and
product support for this study.
MARS Achieves Enrollment Milestone
The MARS (Multi-center ACL Revision Study) achieved a milestone
this fall with the enrollment of its 300th patient. MARS is already one
of the largest prospective clinical trials in the history of orthopaedics
in terms of numbers of sites involved (49). Dr. Chris Kaeding is in first
place for the number of patients enrolled with 29. Dr. Daniel Cooper
is in second place with 26 patients enrolled. Dr. Rick Wright, principal
investigator, submitted a revised application to NIH in November to
fund the long-term follow-up.
Ligament and Tendon Repair
and Regeneration Think Tank
Kicks Off in January
As part of the AOSSM three-year research
initiative program, the Research Committee
selected the topic of ligament and tissue
repair and regeneration as its next focus.
The research initiative will kick off with
a consensus conference involving the top
leaders in tissue repair and regeneration.
This conference will be held January 24–25,
2009, in Miami. In the summer of 2009,
the Society will conduct a grant workshop
in which proposals to study a specific
problem within the initiative focus will
be presented and discussed to stimulate
multi-institutional collaboration between
basic scientists and scientist-practitioners.
The research initiative will conclude in
late 2009 with a competitive grant submission and review process for an award
of $250,000. For more information visit
www.sportsmed.org.
Grants for Sports Injury Research
The National Operating Committee
on Standards for Athletic Equipment
(NOCSAE) has a grant funding program
available to researchers interested in sports
injury research. Since the grant program’s
inception in 1994 NOCSAE has awarded
more than $1.5 million towards research.
Grant funding is usually for two years
and approximately $100,000 each year.
Additional information can be found
at www.NOCSAE.org. The next date
for pre-proposals is May 1, 2009. For
more information contact Fred Mueller,
NOCSAE Research Director, CB 8700,
Fetzer Gymnasium, Chapel Hill, NC
27599-8700, [email protected],
919/962-5171.
RESEARCH GRANT
DEADLINES
Young Investigator Grant
December 1, 2008
This grant is specifically
designed to support young
researchers who have not
received prior funding.
Kirkley Grant
December 1, 2008
This grant provides start-up
or supplemental funding for
an outcome research project
or pilot study (not restricted
to young investigators).
All submissions for grants
must be made online. See
the Research page at
www.sportsmed.org.
November/December 2008 SPORTS MEDICINE UPDATE
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SOCIETY NEWS
Check Out AOSSM’s
New Online Library
AOSSM’s new Online Library is a free,
unique, Web-based search engine that
allows members to customize and save
searches on relevant orthopaedic sports
medicine terms. The new tool allows
members to view AOSSM publications
online, including articles from the
American Journal of Sports Medicine,
Sports Health: An Interdisciplinary
Approach (January 2009), Sports
Medicine Update, AOSSM online
meetings, abstracts, patient education
materials, and much more. The Online
Library is free to members and
non-members. To access the library
go to www.sportsmedlibrary.org.
Self-Assessment and Board
Review — Version 4 Released
AOSSM’s new self-assessment and
board review tool was released in
September and will help members:
䡲 Prepare for the sub-specialty exam in
sports medicine given by the ABOS
䡲 Test knowledge in seven critical
areas of sports medicine
䡲 Identify strengths and weaknesses
in clinical and practice management
issues
䡲 Review diagnostic, surgical, and other
therapeutic measures and techniques
used in sports medicine
Product features include:
125 NEW questions, images,
and answers
䡲 Citations and references that can
be used as a study guide
䡲 Reports that compare your results
to peers
䡲 Question completion at your
own pace
䡲 Maximum earning of 12 AMA PRA
Category 1 Credits™
䡲
For more information and to order your
copy visit www.sportsmed.org.
New 3-D Surgical Animations and Free Downloadable
Patient Education Flyer Now Available
AOSSM’s new patient-friendly, 3-D surgical animations library of common
orthopaedic sports medicine procedures, all with audio narration and text is now
available in the patient education section of the Society’s Web site. More than
20 different procedures are available, including ACL reconstruction, rotator
cuff repair, and arthroscopy. Members also receive a 15 percent discount from
Understand.com if they choose to develop their own personalized library.
AOSSM has also developed a free, downloadable flyer to give to your
patients, directing them to the new animations and other educational materials.
For more information and to see for yourself this exciting new tool, visit
www.sportsmed.org and click on the patient education tab.
Got News We Could Use? Sports Medicine Update
Wants to Hear from You!
The AOSSM bimonthly newsletter for members, Sports Medicine Update, runs a continuous column,
“Names in the News.” Have you received a prestigious award
recently? A new academic appointment? Been named a
team physician? AOSSM wants to hear from you! Sports
Medicine Update welcomes all members’ news items. Send
information to Lisa Weisenberger, AOSSM Director of
Communications, at [email protected], fax to 847/292-4905,
or contact the Society office at 847/292-4900. High
resolution (300 dpi) photos are always welcomed.
Continued on page 13
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SPORTS MEDICINE UPDATE November/December 2008
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SOCIETY NEWS
Sports Health Launches in January 2009
Published bimonthly, Sports Health is a collaborative publication from AOSSM, the
American Medical Society for Sports Medicine (AMSSM), the National Athletic
Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
Sports Health will be an indispensable resource for all medical professionals involved
in the training and care of the competitive or recreational athlete, including primary
care physicians, orthopaedic surgeons, physical therapists, athletic trainers, and
other medical and health care professionals.
Members of AOSSM, AMSSM, and SPTS will receive Sports Health as a benefit
of membership, while members of NATA will receive a subscription discount.
For more information on having your institution subscribe to the journal, visit
www.sportshealthjournal.org.
Check Sports Health out on Facebook and Twitter and help us create the true
meaning of a multidisciplinary approach through the exciting medium of an
online professional network.
SPORTS HEALTH CALL FOR
PAPERS: Do you have a review
article, original research article, case
study, image, short update, or legal
brief that would be beneficial to
medical professionals involved in
the training and care of the competitive
or recreational athlete? Submit
your paper to Sports Health at
http://submit.sportshealthjournal.org.
For more information on
submission guidelines please visit
www.sportshealthjournal.org.
MEMBERSHIP NEWS
For further information
on AOSSM membership
categories, renewals, or
the application process,
contact the Society office
at 847/292-4900 or visit
the AOSSM Web site at
www.sportsmed.org
(click on Membership).
Membership Application Deadline
Candidate Membership
December 15, 2008
Members don’t forget to log on to
www.sportsmed.org and update your
demographics information. By updating
your information we can provide you
with improved education and service.
November/December 2008 SPORTS MEDICINE UPDATE
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NAMES IN THE NEWS
AOSSM member, Richard T.
Herrick, MD, served as one
of four physicians with the
International Weightlifting
Federation for the Olympics
in Beijing. He continues to teach
orthopaedic sports medicine
to others overseas, usually to
those involved with the sport
of Olympic weightlifting.
Dr. Herrick is on the right.
AOSSM
affiliate
members
William S.
(Sandy)
Dr. Quillen
Quillen, PT,
PhD, SCS (Tampa, FL),
and James Zachazewski,
DPT, ATC, SCS, have
co-edited the third volume,
Pathology and Intervention
in Musculoskeletal
Rehabilitation, in the four
volume Musculoskeletal
Foundations Series,
published by Elsevier.
Dr. John F.
Meyers was
chosen to
receive
the 2008
Dr. Meyers
Richard B.
Caspari memorial award
for community service.
The award is presented by
the Richmond, Virginia,
chapter of the Association
of Operating Nurses.
Previous recipients have
been local physicians,
philanthropists, the president of the Richmond
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Chamber of Commerce,
and the president of
Virginia Commonwealth
University. Dr. Meyers was
Dr. Caspari’s partner and
a co-resident with him at
Washington University.
Member Andrew J.
Cosgarea, MD, was
promoted to the rank
of professor at Johns
Hopkins University
(JHU), Department
of Orthopaedic Surgery.
He is also the Director
of Sports Medicine and
Shoulder Surgery at JHU.
Member Stephen S. Haas,
MD, was recently named
Medical Director of the
National Football League’s
Player Benefit Plan.
Medical Staff and past
inductee into the Virginia
High School Hall of
Fame (1991). He has
devoted his life to serving
student athletes.
Why isn’t your name listed
here? We love to list
members’ accomplishments,
achievements, and awards!
Don’t be shy! Send your
“Names in the News” items
to AOSSM Director
of Communications,
Lisa Weisenberger at
[email protected], fax to
847/292/4905, or by
calling the Society office.
Please send a photo with
your submission, if possible.
This is your space to let
your colleagues know
what you’ve been up to!
Frank McCue, MD, was
recently named a recipient of the National High
School Athletic Coaches
Association, Distinguished
Service Award. Dr. McCue
is a member of the
University of Virginia’s
SPORTS MEDICINE UPDATE November/December 2008
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New Physical
Activity Guidelines
for Americans
Announced
N
ew physical activity guidelines from the U.S. Department
of Health and Human services further highlight the benefits of exercise for people of all ages and physical conditions. According to the report released in October 2008,
adults gain substantial health benefits from two and a half hours
a week of moderate aerobic physical activity, and children benefit from an hour or more of physical activity a day.
AOSSM staff participated in a series of meetings to help
market and deliver the guidelines in conjunction with other nonprofit organizations, including the American Heart Association,
National Athletic Trainers’ Association, and American College
of Sports Medicine. The guidelines are designed so people can
easily fit physical activity into their daily plan and incorporate
activities they enjoy.
“It’s important for all Americans to be active, and the guidelines are a roadmap to include physical activity in their daily
routine,” HHS Secretary Mike Leavitt said. “The evidence is
clear—regular physical activity over months and years produces
long-term health benefits and reduces the risk of many diseases.
The more physically active you are, the more health benefits
you gain.”
Regular physical activity reduces the risk in adults of early
death, coronary heart disease, stroke, high blood pressure,
type 2 diabetes, colon and breast cancer, and depression. It
can improve thinking ability in older adults and the ability to
engage in activities needed for daily living. The recommended
amount of physical activity in children and adolescents improves
cardiorespiratory and muscular fitness as well as bone health,
and contributes to favorable body composition.
The Physical Activity Guidelines for Americans are the most
comprehensive of their kind. They are based on the first thorough
review of scientific research about physical activity and health in
more than a decade. A 13-member advisory committee appointed
in April 2007 by Secretary Leavitt reviewed research and produced
the extensive report.
For more specific recommendations on activities for each age
group and a free tool kit on how to get your patients to become
more active, visit www.health.gov/paguidelines.
November/December 2008 SPORTS MEDICINE UPDATE
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CALL
for
VOLUNTEERS
Every year, AOSSM accepts new volunteers to serve on its committees. These volunteer committees form the lifeblood of nonprofit organizations like AOSSM and provide guidance for Society
programs and projects. Those who join committees not only
heighten their experience as an AOSSM member, but form ties
of fellowship with their colleagues that can last throughout their
career. Because different committees work so closely with each
other to help accomplish the Society’s mission, participating in
a committee is an excellent way to see how AOSSM develops
its meetings, courses, publications, and other resources.
Although requirements and duties vary by committee, volunteers must be able to attend regular committee meetings, which
are typically scheduled in conjunction with Specialty Day each
spring and the AOSSM Annual Meeting each summer. With
the range of Society programs and corresponding committees,
there are many opportunities to share your unique perspective.
All membership categories are eligible to serve on AOSSM
Committees. Term of service is a four-year non-renewable term.
Appointment of volunteers to the Society’s standing committees
is made by the Committee on Committees, which meets in the
spring of each year. Volunteers will be notified if they have been
selected by May 2009.
If you are interested in serving on an AOSSM committee,
simply fill out the Volunteer Form on the facing page and fax it
back to the Society office by January 9, 2009 (fax 847/292-4905)
or complete the form posted at www.sportsmed.org, and e-mail
it to [email protected].
Thank You AOSSM Volunteers!
The Society thanks all the volunteers who have given so generously of their time in service to AOSSM committees throughout
the years. Your commitment drives the Society’s contributions to
the entire orthopaedic community.
The following committees will have vacancies in 2009 (current Chair in parentheses):
Education Committee
(Michael G. Ciccotti, MD)
Provides educational opportunities
to membership. Develops, monitors,
and implements a core curriculum
of knowledge and skills appropriate
for a range of stakeholders.
Fellowship Committee
(Christopher D. Harner, MD)
Monitors issues relating to sports medicine
fellowship accreditation and fellowship training. Selects winners
of the DJO Award for
Basic Science and the
DJO Award for Clinical
Science. Maintains
the Sports Medicine
Fellowship Curriculum.
Publications
Committee
(Barry P. Boden, MD)
Provides editorial
content, as needed,
for Sports Medicine
Update. Identify new
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projects and solicit content as appropriate
for patient and/or physician education
materials. Monitors sales of publications
and joint efforts to ensure effective use
of Society resources.
Public Relations Committee
(Matthew Matava, MD)
Develops proactive communications
strategies to promote the Society and its
membership as sports medicine experts
on local and national levels. Identifies and
promotes newsworthy papers from The
American Journal of Sports Medicine, as well
as from Society meetings and courses.
Disseminates educational information
to the media, general public, and other
health care providers.
Research Committee
(Scott A. Rodeo, MD)
Evaluates applications and selects recipients of Young Investigator Grants and
AOSSM Research Awards. Selects
the AOSSM Exchange Lecturer for the
NATA Annual Meeting. Develops initiatives
for AOSSM-sponsored research education.
Technology Committee
(John C. Langland, MD)
Oversees AOSSM Web site. Reports new
and developing information technologies
to the AOSSM Board of Directors and
membership. Promotes technology usage
through education and member services.
Note: Access to the Internet and ability
to communicate via e-mail is necessary
for full participation on this committee.
Traveling Fellowship Committee
(Marc R. Safran, MD)
Selects Traveling Fellows and works
with AOSSM President-Elect to choose
a Godparent for upcoming tours. Develops
and maintains relationships with ESSKA,
APOA, and SLARD. Oversees Traveling
Fellowship Tours, including selection
of hosts and itinerary. Note: Eligibility
is contingent on previous participation
as a Traveling Fellow.
Continued on page 17
SPORTS MEDICINE UPDATE November/December 2008
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AOSSM COMMITTEE SERVICE VOLUNTEER FORM
Name ____________________________________________________________________________
Practice Name/Institution _______________________________________________________________
City _________________________________________________________ State ____________________
Age __________________________ Year Joined AOSSM__________________________________________
Committee(s) you are interested in serving on:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Please use the area below to outline your interests, abilities, and experience, particularly as they relate
to your committee of interest, in 200 words or less, or submit a letter with same. Do not attach your
curriculum vitae or additional pages. The Committee on Committees will use the information to assist
them in their selection of committee members in April 2009. This information will be kept confidential.
Return to the Society office no later than January 9, 2009, by mail or fax to 847/292-4905, or e-mail
to [email protected].
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
November/December 2008 SPORTS MEDICINE UPDATE
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IN MEMORIAM
AOSSM Mourns Passing of Former President
AOSSM and the rest of the sports medicine community recently mourned the passing of Bernard R.
Cahill, MD, 79, a true sports medicine pioneer and
former AOSSM president and founder. Dr. Cahill was
a visionary in orthopaedic sports medicine having
been one of the founders of the Great Plains Sports
Medicine Foundation—the oldest sports medicine
foundation in the United States along with the
American Society of Biomechanics, the Cruciate
Society, and the International Society of the Knee.
His AOSSM accomplishments are many, including
founding member, president from 1986 to 1987, developer of the Asian Travelling Fellowship, recipient of the
Robert E. Leach Mr. Sports Medicine Award (1984),
George D. Rovere Education Award (1989), and then
election into the AOSSM Hall of Fame in 2004.
In addition to his accomplishments with AOSSM,
Dr. Cahill served in various capacities all over the
world, including roles with the Reagan White House
as a member of the President’s Council on Physical
Fitness and chair of a Sports Medicine Symposium
on Children and Adolescents in Competitive Sports.
He also served as a team physician for the 1980
Winter Olympics in Lake Placid, New York.
Close friend and former AOSSM President, H.
Royer Collins, MD, remarked, “We all have cherished
memories of Bernie—the fun times we had with
him and his great sense of humor. He was an avid fly
fisherman and golfer, and he delighted in watching
his petite wife out drive the men from the men’s tee.
Bernie was a mentor to many young individuals
in our society and beloved by them. This dapper
gentleman with his ever-present ascot will be greatly
missed. We have lost a dear and close friend.”
Dr. Cahill’s research and clinical contributions
include authoring more than 40 scientific publications
and more than 200 lectures. One of Dr. Cahill’s most
long lasting contributions included his work with
orthopaedic examinations of lower extremities of
varsity football players in the conferences of central
Illinois with subsequent establishments of football
injury data. These evaluations led to pioneering
and landmark studies by Dr. Cahill, which allowed
the Illinois High School Athletic Association to
authorize pre-season, state-wide conditioning in
1974. Dr. Cahill was also instrumental in patient
care regarding the effects of preseason conditioning,
juvenile osteochondritis dissecans, osteolysis of the
distal clavicle, the quadrilateral space syndrome,
and strength training in the prepubescent athlete.
These clinical conditions are now commonplace,
but it was Dr. Cahill who introduced the concept
to sports medicine physicians.
Dr. Cahill was also a member of the United States
Marine Corps, serving his country as a ground officer
in the Korean War from 1950 to 1954. Dr. Cahill
received his Bachelor of Science and Doctor of
Medicine degrees from the University of Illinois.
He is survived by his wife, Sandra, three daughters,
one son, and five grandchildren.
Dr. Cahill was known to his colleagues as a
humble man with deep personal and professional
convictions. He was a shining example of professionalism, scholarship, and service to sports medicine
and will be missed.
Memorial contributions may be made in his
honor to the Orthopaedic Research and Education
Foundation, designated to AOSSM.
Continued on page 19
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SPORTS MEDICINE UPDATE November/December 2008
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2004 Hall of Fame Inductee,
Robert R. Oden, MD, Passes Away
AOSSM mourns the passing of Hall of Fame member, Dr. Robert
R. Oden. A driving force in ski related sports medicine, Dr. Oden
began his career in Chicago, attending medical school and residency at Northwestern University. Following his formal education,
Dr. Oden established the first orthopaedic practice in Aspen,
Colorado. He later became the first board certified orthopaedist
in a major ski area in the United States. He then went on to
become the U.S. Ski Team Physician for the 1960 Olympic Games.
Recognizing the need for continued care for the U.S. Ski Team,
Dr. Oden established a pool of physicians to travel with the
team, founding their medical program and becoming the Chief
Orthopedic Surgeon for the U.S. Ski Team from 1967 to 1980.
He served as a medical advisor to the U.S. Olympic Committee,
a board member of the U.S. Ski Team, U.S. representative to the
Federation of International Skiing (FIS) Medical Committee,
and an organizer for many FIS Aspen World Cup programs.
Dr. Oden also founded and served as a board member of
the U.S. Ski Team Educational Foundation, helping to provide
not only for the medical needs, but also the education of team
members beyond their ski careers.
Sports medicine education was paramount to Dr. Oden. He was
the driving force in the establishment of the Aspen Foundation for
Sports Medicine Education and Research, including its fellowship
program which he established in the 1970s. Dr. Oden had been
a member of AOSSM since 1973. He was recognized for his
contributions to sports medicine with his induction into the
AOSSM Hall of Fame in 2004 and through several other honors
and grants, including the Bleagen Award in 1985 for outstanding
service to the U.S. Ski Association, the Aspen Hall of Fame in
1995, and the U.S. and Colorado Ski Hall of Fame in 2002.
Dr. Oden’s passion for the U.S. Ski Team and the desire for
improved sports medicine education made him a key part of its
history and a good friend and mentor to many in the sports
medicine community.
AOSSM marks the passing of the following members
from September 2007 through October 2008.
Charles W. Brown, MD
Bernard Cahill, MD
Gerald L. Dales, Jr., MD
David Latta, MD
Alexander Kalanak, MD
John K. McCormick, MD
John T. Murphy, MD
Robert Oden, MD
Marcus J. Stewart, MD
E. Harvey O’Phelan, MD
Harry Weller, MD
Basilius Zaricznyj, MD
Sports Medicine Pioneer Kalenak Dies
Dr. Alexander Kalenak, Professor in the
Department of Orthopaedics and Rehabilitation
at the Penn State Hershey Medical Center, died
on September 9, 2008, at his home after a four
year battle with pancreatic cancer. Dr. Kalenak
first joined the department in 1973, and was one
of the early pioneers of orthopaedic sports medicine. In addition
to his clinical and academic responsibilities at Hershey, he served
for many years as team physician for Penn State University. His
remarkable career accomplishments were recognized by the
Department of Orthopaedics in 2006 with the creation of the
Alexander Kalenak, MD, Professorship in Orthopaedics. Also, in
2006, he was named to the AOSSM Hall of Fame. He was also
routinely selected as one of the “Best Doctors in America.”
Dr. Kalenak’s life personified service to others. In 2003, he
created the Kay Kalenak Golf Tournament to benefit palliative
care at the Hershey Medical Center. His other accomplishments
included serving as a United States Navy flight surgeon during
the mid 60s, volunteer physician for the U.S. Olympic Committee
in 1984, and team physician for the Big 33 Football Classic over
many years. His commitment to excellence, courage, and passion
for life will be his legacy. To many of us he was a colleague. To
others he was a physician. But, to all of us, he was a kind and
gentle friend.
November/December 2008 SPORTS MEDICINE UPDATE
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UPCOMING
MEETINGS
AND COURSES
Advanced Team Physician Course
December 11–14, 2008
Hilton Austin
Austin, Texas
(administered by American College of Sports Medicine)
Visit www.acsm.org for more information and registration.
AOSSM 2009 Specialty Day
February 28, 2009
Las Vegas, Nevada
All registrations handled by AAOS.
10th Annual AAOS/AOSSM Sports
Medicine Course: From the Sidelines
to the Slopes — An Update
March 11–15, 2009
Steamboat Springs, Colorado
All registrations handled by AAOS.
AOSSM 2009 Annual Meeting
July 9–12, 2009
Keystone, Colorado
Sports Medicine and the NFL:
A Sideline Perspective
May 7–9, 2009
San Francisco, California
Catch the excitement of an interactive learning
environment and
䡲
Enhance your understanding of
prevention and management strategies
of medical and musculoskeletal injuries
䡲
Upgrade your sideline management skills
䡲
Balance the art and science of your return
to play decisions
䡲
Weigh the evidence on performance
enhancement strategies and healing efforts
䡲
Expand your knowledge of the business
of sports medicine
䡲
Improve your physical exams
䡲
Earn 16 AMA PRA Category 1 Credits™
or 16 hours of Category A CE
Stay at the Palace Hotel, located steps from Union
Square and the Financial District, and discover the
charms of San Francisco. Book your housing by calling
reservations at 415/512-1111 or 888/627-7196 toll
free and identify yourself as a meeting attendee.
Watch your mail for the preliminary program and visit
www.sportsmed.org for additional information.
20
For more information on upcoming
meetings and courses, or to view preliminary programs, please visit our Web site
at www.sportsmed.org, click on
the education tab or call 847/292-4900 or
877/321-3500 (toll free).
SPORTS MEDICINE UPDATE November/December 2008
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AOSSM THANKS BREG FOR THEIR GENEROUS SUPPORT OF SPORTS MEDICINE UPDATE.
Sports Medicine Update
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