Osteochondritis dissecans (OCD)
Research & Innovation
For more than a century, orthopedic surgeons and investigators at Children’s Hospital Boston have played a vital role in the field of musculoskeletal research—pioneering approaches and major advances in the care and treatment of joint trauma, scoliosis, polio, TB, hip dysplasias and traumas to the hand and upper extremities.
Our advanced research helps answer the most pressing questions in pediatric orthopedics today—providing the children we treat with the most innovative care available.
Children’s research shows that too much high-impact training can lead to stress fractures in pre-teen and teen girls
Today’s kids are urged to participate in sports at younger and younger ages and at greater levels of intensity. While weight-bearing activity is generally thought to increase bone density, a Children's study found that for preadolescent and adolescent girls, too much high-impact activity can lead to stress fractures.
If stress fractures are detected too late in children and adolescent athletes, they pose a risk of true fracture, deformity or growth disturbance requiring surgical treatment, say the researchers, led by Alison Field, ScD, of Children's Division of Adolescent Medicine, and Mininder S. Kocher, MD, MPH, associate director of Sports Medicine at Children's.
Their study, published online on April 4, 2011, by the Archives of Pediatric and Adolescent Medicine, followed 6,831 girls aged 9 to 15 participating in the large national Growing Up Today study, co-founded by Field. During the seven years after enrollment, 4 percent of the girls developed a stress fracture. The most significant predictors were high-impact activities—particularly running, basketball, cheerleading and gymnastics. Read more about this study.
Children’s Sports Medicine Research Laboratory, led by principal investigator Martha M. Murray, MD, focuses on sports medicine injuries, including those of the ACL (anterior cruciate ligament), knee meniscus and articular cartilage. Murray’s research includes studying ways to stimulate self-healing in the ACL.
In conjunction with our collaborators, we are studying these problems on multiple levels: gene, protein, cell, tissue and organism.
Researchers at Children’s Sports Medicine Research Laboratory
The lab’s research includes projects in:
- molecular orthopedics
- platelet optimization and characterization
- tissue engineering
- joint imaging
- biomechanics of injury repair
- histology and immunohistochemistry
- device design and development
- injury prevention
- outcomes research
The Orthopedic Center conducts research into:
- the mechanisms of sports injuries
- the techniques of rehabilitation and treatment
the physiology of exercise and conditioning
Ongoing research includes the study of:
- knee injuries
- running injuries
- injuries to pre-adolescent children
- the psychological impact of sports and sports injuries
the treatment and prevention of injuries to dancers
Sports Medicine Division director Lyle J. Micheli, MD, is one of the world's leading authorities on sports care. Micheli has treated world-renowned dancers and professional athletes, and is the author of hundreds of published clinical studies and scholarly review articles and books.
Innovations for tendon and ligament treatment
Platelet-rich plasma. For tendon repair, as with tennis elbow, the Orthopedic Center is now incorporating the latest in tendon regeneration—the application of platelet-rich plasma (PRP). This treatment has been popular in Europe—and now in the United States—for stimulating tissue regeneration in difficult-to-heal areas such as tendons (including Achilles, elbow and patella) that don’t respond to physical therapy or to limits on activity.
There are normally many healing growth factors in our platelets. The process involves isolating these growth factors in the patient’s blood platelets, and then injecting them into the affected areas under ultrasound guidance. This special procedure is performed by Children’s Pierre d'Hemecourt, MD.
Physeal sparing. A series of innovative, age-specific reconstruction techniques for treating the ACL injuries of growing children has been developed by Children’s orthopedic surgeon and director of the Division of Sports Medicine Lyle Micheli, MD. These are classified as physeal sparing procedures—that is, they spare the child’s growth plates (physes) from disruption that would occur in traditional ACL reconstructive surgery.
These physeal sparing treatment techniques are customized to the growing child’s age: pre-pubescent, adolescent or older adolescent. Originally developed as a temporary procedure until a child reached skeletal maturity, follow-up studies have found that five years after their surgeries, 95 percent of children who’d had physeal sparing procedures were doing so well that they didn’t need ACL reconstructive surgery, after all.
Children speak about what it’s like to be a medical research subject
View a video of a day in the life of Children’s Clinical and Translational Study Unit, through the eyes of children who are “giving back” to science.