Whatʼs New in Sports Medicine

Abstract

It is once again an honor and a privilege to be asked to present this update for the subspecialty of sports medicine. Sports medicine continues to be an expanding subspecialty field that crosses many boundaries. As mentioned in previous updates, however, our central mission remains the same—the care of the athlete. This update is based on scientific and organizational activities in sports medicine that took place from September 2003 to August 2004. It includes a summary of the Annual and Specialty Day Meetings of the American Orthopaedic Society for Sports Medicine (AOSSM), the Arthroscopy Association of North America (AANA), and the American Academy of Orthopaedic Surgeons (AAOS). These meetings featured more than 200 scientific presentations, including both clinical and basic-science studies, that focused primarily on sports medicine. The three most influential journals in our field will be reviewed again this year, specifically, The Journal of Bone and Joint Surgery, The American Journal of Sports Medicine, and Arthroscopy. ### Anterior Cruciate Ligament The optimum graft choice for anterior cruciate ligament reconstruction remains controversial. Several recent randomized, controlled studies showed equivalent results in association with both bone-patellar tendon-bone and quadrupled hamstring grafts, effectively endorsing a “double gold standard.” An additional randomized, prospective trial from Australia showed satisfactory functional outcomes in association with both types of grafts after three years of follow-up1. As in other studies, however, the authors noted increased kneeling pain in the bone-patellar tendon-bone group and slightly increased laxity and femoral tunnel widening in the hamstring group. Recent histological studies have shown that neither type of graft regenerates to a normal functional tendon. In two independent studies involving the use of magnetic resonance imaging and ultrasound examination following bone-patellar tendon-bone graft harvest, the patellar tendon had not normalized by six to ten years postoperatively2,3. Both groups of authors …