Stress Fractures | Research & Innovations

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 treatment approaches and major advances in the care and treatment of trauma to the joint, 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.

Published research on stress fractures

Repetitive, high-impact sports linked to stress fractures in girls
April 4, 2011

Sports Medicine Research Laboratory

Boston 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.

In conjunction with our collaborators, we are studying these problems on multiple levels: gene, protein, cell, tissue and organism.

Researchers at Boston Children’s Sports Medicine Research Laboratory

The lab’s research includes projects in: The Orthopedic Center conducts research into:

•   molecular orthopedics
•   platelet optimization and characterization
•   Tissue Engineering
•   joint imaging
•   biomechanics of injury repair
•   histology and immunohisto chemistry
•   device design and development
•   injury prevention
•   outcomes research  

•   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. Dr. 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.