PRiSM 2017 — Dallas

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Dr. Jim Andrews, one of the pioneers of pediatric sports medicine, gives the keynote address at PRiSM 2017, Dallas photo: Kevin Ford

The last time we wrote about the Pediatric Research in Sports Medicine Society (PRiSM) we were in sunny San Diego.  This year’s annual meeting took place in another sunny, albeit slightly cooler, locale:  Dallas.

PRiSM is a relatively young society, but one which is up and coming.  There were 250+ attendees at this year’s meeting, the 4th annual gathering.  What makes this organization special is its focus and membership:  1) its focus is pediatric sports medicine research; 2) its membership is multidisciplinary, drawing from physicians, surgeons, physical therapists, athletic trainers and radiologists.  One of the speakers this year, in fact, came from the world of veterinary medicine: Cathy Carlson of the Univ. of Minnesota gave several interesting talks on aspects of osteochondritis dissecans (OCD), focusing on the animal models (swine, caprine) she uses in her research.  Her insights into the early development of OCD were among the most powerful, I thought, of the conference.

The keynote conference was delivered by a true pioneer in the field:  the world-renowned Dr. Jim Andrews, from the Andrews Sports Institute.  He bemoaned the epidemic of pediatric sports injuries and spent time identifying many of the factors contributing to this important public health issue.  At the same time, he described some of the success stories out there — models for how we can improve injury prevention in our young athletes.  These include the @safekids initiative he is involved with.  I would add MomsTeam Institute to any list of such safety initiatives.  This is the non-profit youth sports safety group I am involved with.

[on a side note — I am presenting research that MomsTeam has done, along with Executive Director Brooke de Lench, at the IOC World Conference on Prevention of Injury & Illness in Sport in Monaco in March — expect posts a plenty coming from that conference]

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David Howell, of Boston Children’s Sports Medicine, wins the best scientific poster of PRiSM 2017. Photo: Greg Myer

The faculty at PRiSM 2017 was simply stellar, including several who have graced the pages of our journal and our blog: Read more of this post

PRiSM — An Acronym to Know

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Drs. Min Kocher (L) Boston Children’s Hospital & Hank Chambers (R) Rady Children’s Hospital

I’m just wrapping up a productive, educational, and enjoyable few days in San Diego, where I attended the 3rd Annual Meeting of the Pediatric Research in Sports Medicine (PRISM).unnamed

Don’t know that acronym?  I suspect you’ll be hearing it more frequently over the next several years.

The brainchild of Hank Chambers, pediatric orthopedic surgeon at Rady Children’s Hospital, San Diego, PRISM aspires to join the forces of several stakeholders and raise the bar in terms of research in pediatric sports medicine.  It brings together primary care sports medicine physicians, orthopaedic surgeons, athletic trainers, physical therapists and musculoskeletal radiolgists.

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Things got heated up between some of the presenters at PRISM: ‘in the ring’ were Drs. d’Hemecourt (L) and Minor (R)–debating the relative merits of bracing in spondylolysis

Dr. Chambers just turned over the president’s reins to Mininder Kocher, a pediatric orthopedic surgeon at Boston Children’s Hospital.  Dr. Kocher must have called in the chips on the folks he knows from Boston Children’s, as a great number of the speakers at PRISM have had (past/present) some affiliation with that institution.  A short list of these presenters, all of whom have been authors at some time in the pages of CJSM, include:  Andrea Stracciolini, Lyle Micheli, Pierre d’Hemecourt, Kate Ackerman, Anthony Luke and Dai Sugimoto.  And Benton Heyworth presided over all as the head of the programming committee.

It was a pleasure seeing these folks, as they are like family (I trained at Boston Children’s too).  And it was great seeing other friends as well, like Andrew Gregory (Nashville), Greg Canty (Kansas City) and Greg Myer (Cincinnati).  But it was a special pleasure, and a unique feature of these sorts of meetings, to make the acquaintance of folks whose names I have heard on several different occasions but had heretofore never met.  Christina Master of Children’s Hospital, Philadelphia for instance.  She gave a great talk on clinical tools in the evaluation of pediatric sports related concussions and was tweeting up a storm during the entire conference.

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Greg Myer of Cincinnati Children’s, fielding questions after his talk on return to play post ACL reconstruction.

I found it particularly inspiring to hear the updates from orthopedic colleagues on multi-center trials looking at important injuries in the pediatric athlete:  ranging from knee OCD (the ‘ROCK’ study) to ACL reconstructions (the ‘PLUTO’ study)–I am really looking forward to the results coming from these studies, as they are sure to affect the clinical management of so many patients I serve in the future.

Finally, there was San Diego–a bit of sun and warmth in the middle of winter!  I swam in an outdoor pool three days in a row–I haven’t enjoyed that pleasure in four months.

I lacked for nothing here at PRISM–I gained in knowledge, friendship, and Vitamin D.  Who could ask for more?  I’ve already got the meeting in 2017 (to take place in Dallas) on my calendar–I hope to see you there too!

 

CJSM Podcast: The effect of race and insurance status on ACL injury outcomes in children and adolescents

ACL injuries are a common subject for sports medicine publications:  according to a 2019 study in the Orthopaedic Journal of Sports Medicine, there have been 18,696 ACL publications in PubMed during the past 40 years, trending upwards from 26 articles published in 1979 to 1380 articles published in the year 2018 alone.

The reasons for this are clear. ACL injuries are a common injury in the young and physically active, and the ligament itself is the most commonly operated ligament of the knee.  The injury is consequential, both in its impact on athletic performance as well as on long-term morbidity, with a well-known risk of early onset osteoarthritis which can cause long-term pain, functional limitations, and decreased quality of life.

Another phenomenon also all too common in American medicine is that of health care disparities.  You name the disease or injury in medicine and the therapy or intervention in question, and dollars to donuts you’ll find a study showing that race, ethnicity, and socioeconomic status can have negative consequences on outcomes.

A new study in the November 2020 CJSM looks at the intersection of these two common phenomena, and reports on the impact of race and insurance status (a proxy for socioeconomic status) on outcomes in the care of pediatric ACL injuries. As soon as I finished reading the study, I wrote a blog post.

I also knew whom I had to have on as the next guest for the CJSM podcast.

Neeraj Patel M.D., M.P.H. performing knee arthroscopy in the O.R.

Neeraj Patel M.D., M.P.H., corresponding author of the study — How do race and insurance status affect the care of pediatric anterior cruciate ligament injuries — is an attending physician at Lurie Children’s Hospital in Chicago, USA and an Assistant Professor of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine. He joined me one morning to do a deeper dive into the work he and his team from Children’s Hospital of Philadelphia (CHOP) did to bring this excellent study to the pages of CJSM.

Dr. Patel and the senior author, Dr. Ted Ganley, are both members of the Pediatric Research in Sports Medicine Society (PRiSM), which I have profiled in previous blog postsPRiSM is conducting its annual meeting January 28 – 30 and, not surprisingly in this COVID era, it is taking place virtually.  By all means attend if you can to hear from researchers like Dr. Patel.

Also, go now to the the study itself in CJSM.  And finally, as ever you can subscribe to our CJSM podcasts at iTunes or go to the journal website and find this podcast with Dr. Patel and all of our podcasts.

Disparities in sports medicine care — the pediatric ACL

MRI Sagittal view of left knee in a pediatric patient with an ACL tear

As 2020 winds down I want to bring to the attention of the blog readers a particularly important study published in our last edition of the year.  In our November 2020 issue you will find:  How do race and insurance status affect the care of pediatric anterior cruciate ligament injuries?

The group of authors hails from Children’s Hospital of Philadelphia (CHOP), which routinely vies for the top spot as best pediatric hospital in the U.S. 

Physicians from my home institution of Nationwide Children’s Hospital take a knee to protest racism June 2020

In a year like no other, 2020 saw the news dominated not just by the novel COVID pandemic but a pandemic much much older and more persistent: structural racism.  Around the world, sparked by incidents in the US in late May 2020, there was a passionate outcry from all segments of society, including the medical community, about this insidious problem.

The issues that are being discussed with renewed vigor are old, but the energy and insight surrounding this current moment feel anything but. Read more of this post

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