Researchers at HSS Receive Grants to Study Bone Stress Injuries

New York, NY—September 12, 2017

Two research teams at Hospital for Special Surgery (HSS) have been awarded grants by the NBA and GE Healthcare Orthopedics and Sports Medicine Collaboration. This strategic partnership between NBA and GE Healthcare was launched to collaborate with leading clinical researchers to address the prevention, diagnosis and treatment of musculoskeletal injuries affecting NBA players and everyday athletes.

A team led by Brett Toresdahl, MD, primary care sports medicine physician at HSS, received a grant of nearly $300,000 that will go towards investigating the use of ultrasound imaging to monitor healing and guide readiness of return to play in athletes with bone stress injuries.

Bone stress injuries of the lower leg and foot are common among elite basketball players and can require a long period of rest in order to fully recover. Determining when a player is ready to return to play has historically been difficult as it relies primarily on a player’s symptoms since signs of healing are not reliably seen with standard imaging (such as MRI and X-ray).

"There is little known about the connection between ultrasound findings, symptoms, and readiness for return to sport for athletes with bone stress injuries," said Dr. Toresdahl, principle investigator of the study. "Our goal is to evaluate the use of serial ultrasound to assess bony healing to optimize treatment and more accurately predict readiness for return-to-play."

The investigators will recruit adults between 18 and 50 years of age who have a bone stress injury in the lower leg or foot as a result of sport or exercise and diagnosed by MRI.

Participants will receive standard treatment of rest and crutches, splint and/or walking boot. An ultrasound will be performed every two weeks for 12 weeks at the site of the injury. Simultaneously, patients will be tracking their pain, activity and return to activity. A radiologist will grade the amount and appearance of bony callus formation and then a repeat MRI will be performed at 12 weeks.

"Our findings could provide doctors with a new way to guide athletes to safely return to play after a bone stress injury with a minimal risk of re-injury," added Dr. Toresdahl.

The Athlete’s Foot

The other grant received by HSS went to a team led by Martin O’Malley, MD, foot and ankle surgeon at HSS.  This $100,000 grant will be used to assess risk factors and intervention strategies for fifth metatarsal stress fractures, the most common type of stress fractures for basketball players. These fractures can be difficult to treat, leading to long-term consequences for an elite basketball player.

"Currently, there is limited knowledge on how to identify athletes who are at a high risk for a fifth metatarsal stress fracture," said Dr. O’Malley, principle investigator of this study. "Additionally, we don’t have a clinical understanding on how to intervene before such injury occurs."

This research will utilize data from the screening of collegiate and professional basketball players to identify factors of foot structure that are common in those who sustained a fifth metatarsal injury. The investigators will employ a specialized robotic device that will stimulate walking and jumping in cadavers to find features that increase the mechanical burden on this bone.

Testing will also be done to assess the ability of intervention strategies to reduce this mechanical burden and thus, the risk of injury.

"We hope to gain objective biomechanical evidence that will rationalize intervention strategies such as orthotic devices and targeted muscle activation in order to reduce risk of injury and re-injury," added Dr. O’Malley.