Jan 29, 2015
Bulletin Board

Improved ACL Reconstruction Reaches U.S.

For almost as long as anterior cruciate ligament (ACL) reconstructions have been performed in the U.S., the single-bundle technique–reconstruction of only one of the ligament’s two bundles of fibers–has been the only available option. But complaints of weak knees and the early onset of arthritis have become common after the procedure, prompting surgeons to explore new and better ways to reconstruct the ACL.

Enter the double-bundle technique: reconstruction of both the anteromedial and posterolateral bundles, a procedure that originated in Asia almost a decade ago and is now being performed by a handful of doctors in the U.S. “The double-bundle procedure more closely duplicates the normal anatomy of the knee,” says John Samani, MD, of the Michigan Knee and Shoulder Institute in Auburn Hills, where he and partner Thomas Perkins, DO, started performing the technique earlier this year. “Not only does it prevent abnormal motion front-to-back, but it also prevents rotational movement that many athletes still experience after a single-bundle procedure.”

Perkins says long-term studies have yet to be completed, but initial feedback from patients who have undergone the double-bundle surgery has been overwhelmingly positive. “In the short term, patients have said their knee feels more normal, especially if they had the single-bundle procedure on one knee and the double-bundle procedure on the other,” Perkins says. “We hope that by controlling both the front-and-back and rotational motion, we may be able to halt degenerative arthritis, and the indications so far are very encouraging.”

The procedure typically doubles a patient’s time in the operating room, but rehab time is similar to that for the single-bundle technique and a rapidly growing number of doctors are interested in learning and refining the procedure. Samani and Perkins believe that if the research backs up the anecdotal evidence available thus far, this surgery will soon become the standard in ACL reconstruction. “It really is exciting to be able to tell a patient, ‘With this procedure, instead of 10 years of good function, we may be able to give you 30 years of great function,'” Samani says.

Not Safe For Use

New drugs called myostatin blockers are showing great promise in the lab against muscle-wasting diseases like muscular dystrophy and Lou Gehrig’s disease. But even though they’re still being researched and are not yet approved for human use, they have created a buzz in the athletic world, and some bodybuilding Web sites are already hawking products touted as blocking myostatin.

“I get angry about it,” Se-Jin Lee, MD, PhD, a Professor of Molecular Biology and Genetics at the Johns Hopkins University School of Medicine, told Bloomberg News. “The scientific potential to make people’s lives vastly improved is incredible. And all we can talk about is whether some athlete can use it to hit a baseball farther.”

Myostatin is a naturally occurring protein that limits muscle growth in mammals. It occurs in differing levels in humans and is one factor that contributes to individuals’ ability to build new muscle. Myostatin blockers, in theory, can boost muscle growth by inhibiting myostatin production, but their overall effect on the body is not yet known.

The World Anti-Doping Agency has banned myostatin blockers even before they’ve been fully tested, but athletes may be tempted by the promise of a non-steroid, hard to detect route to bigger muscles and better performance. Because myostatin blockers are injected directly into targeted tissues, they won’t show up in urine or blood tests.

Lee, who discovered myostatin over a decade ago, said he has received e-mails and phone calls asking about the drugs from several athletes and coaches, including a bodybuilder from Brazil who already had a test version of one myostatin blocker in his possession. Other researchers have expressed concern that a lab could be built fairly cheaply to make the untested drugs and distribute them to athletes. For now, the bottom line is that myostatin blockers are not safe for human use and athletes should be strongly warned against taking them.

New Injury Data Center Launched

A new non-profit research center is hoping to have a big impact on sports injury prevention. The Datalys Center, which opened in Indianapolis in April, was formed by the NCAA, the American College of Sports Medicine, and BioCrossroads, an Indiana initiative to grow the life sciences. The center aims to provide research and trend data to sports governing bodies and academic researchers looking to reduce the number of sports injuries suffered in the U.S. each year.

“The Datalys Center is about trying to prevent, diagnose, and potentially even treat injuries more effectively,” says the center’s President, Troy Hege, MBA, also a Project Director at BioCrossroads. “Through our own research and by facilitating other organizations’ research, we’re looking to translate the data into useful information that can benefit athletes and athletic trainers.”

The center’s first initiative involves taking over data collection for the largest ongoing collegiate sports injury database in the world–the NCAA’s Injury Surveillance System (ISS). Though the Datalys Center is a separate entity, the NCAA is its first collaborative partner and will share ISS tools and research. The two groups are currently working on a data transition plan to distribute to member institutions during the next academic year, and the Datalys Center aims to be collecting data from schools on behalf of the NCAA by the fall of 2009.

“We aren’t taking ownership of the NCAA’s data,” Hege says. “Rather, we’re a vehicle to help the NCAA–and eventually groups like the NFHS and other sports governing bodies–to more efficiently and effectively promote athletes’ health and safety.”

For more information on the Datalys Center for Sports Injury Research and Prevention, visit: www.datalyscenter.org.

Benefits of Green Tea Extend to Sports

A small study published in the May issue of the journal Nutrition has found that regularly consuming green tea may counter some of the detrimental effects of resistance training. This adds to the growing body of evidence about green tea’s health benefits.

Resistance exercise can increase the production of free radicals beyond the body’s antioxidant defense capacity, which causes oxidative stress and often leads to tissue damage. Antioxidant-rich green tea may protect the body in part by raising the level of glutathione, a protein that helps prevent oxidative damage.

“There is evidence that supplementation with antioxidants may decrease the oxidation of blood glutathione after exercise,” the researchers stated in the study. “Furthermore, our findings demonstrate that dietary strategies, such as daily green tea intake, may also benefit the glutathione system of athletes by elevating blood glutathione levels before and after effort.”

The study, conducted by researchers from the Federal University of Santa Catarina in Brazil, required 14 healthy men ages 19 to 30 to consume either water or green tea (two grams of green tea leaves in 200 milliliters of water) three times per day for seven days. At the end of the week, they performed four sets of 10 to 14 bench presses, and researchers analyzed blood samples taken both before and after the exercise.

The group that consumed green tea had on average 37 percent higher levels of glutathione, as well as a 64 percent reduction in lipid hydroperoxide–an indicator of oxidative stress–post-exercise. The group’s blood levels of polyphenols (another chemical thought to have antioxidant qualities) were also 27 percent higher both before and after performing the bench presses.

To view the abstract of the study, “Consumption of green tea favorably affects oxidative stress markers in weight-trained men,” go to: www.nutritionjrnl.com and click on the May 2008 issue.

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