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SEPTEMBER/OCTOBER 2010 www.sportsmed.org NEWSLETTER OF THE AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE STOP Sports Injuries Continues Making Impact Most Successful Match Ever Traveling Fellowship Tours Announced PATELLA DISLOCATION

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SEPTEMBER/OCTOBER 2010

www.sportsmed.org

N E W S L E T T E R O F T H E A M E R I C A N O R T H O P A E D I C S O C I E T Y F O R S P O R T S M E D I C I N E

STOP SportsInjuries ContinuesMaking ImpactMost SuccessfulMatch EverTraveling FellowshipTours Announced

PATELLADISLOCATION

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CO-EDITORS

EDITOR William N. Levine MD

EDITOR Daniel J. Solomon MD

MANAGING EDITOR Lisa Weisenberger

PUBLICATIONS COMMITTEE

Daniel J. Solomon MD, Chair

Kenneth M. Fine MD

Robert A. Gallo MD

Richard Y. Hinton MD

David M. Hunter MD

Grant L. Jones MD

John D. Kelly IV MD

William N. Levine MD

Brett D. Owens MD

Kevin G. Shea MD

Brian R. Wolf MD, MS

BOARD OF DIRECTORS

PRESIDENT Robert A. Stanton MD

PRESIDENT-ELECT Peter A. Indelicato MD

VICE PRESIDENT Christopher R. Harner MD

SECRETARY Jo A. Hannafin MD, PhD

TREASURER Robert A. Arciero MD

UNDER 45 MEMBER-AT-LARGE David R. McAllister MD

OVER 45 MEMBER-AT-LARGE Mark E. Steiner MD

SECRETARY-ELECT James P. Bradley MD

TREASURER-ELECT Annunziato Amendola MD

COUNCIL OF EDUCATION Andrew J. Cosgarea MD

RESEARCH Constance R. Chu MD

COMMUNICATIONS Daniel J. Solomon MD

MEMBERS EX OFFICIO (MEMBERSHIP) John D. Kelly IV MD

MEMBER-AT-LARGE Mininder S. Kocher MD

PAST PRESIDENT James R. Andrews MD

PAST PRESIDENT Freddie H. Fu MD

MEMBER EX OFFICIO COUNCIL OF DELEGATES

Patricia A. Kolowich MD

JOURNAL EDITOR, MEMBER EX OFFICIO Bruce Reider MD

AOSSM STAFF

EXECUTIVE DIRECTOR Irvin Bomberger

MANAGING DIRECTOR Camille Petrick

DIRECTOR OF COMMUNICATIONS Lisa Weisenberger

DIRECTOR OF RESEARCH Bart Mann

DIRECTOR OF EDUCATION Susan Zahn PhD

DIRECTOR OF CORPORATE RELATIONS Debbie Cohen

DIRECTOR OF FINANCE Ken Hoffman CPA

SENIOR ADVISOR FOR CME PROGRAMS Jan Selan

EDUCATION AND MEETINGS COORDINATOR Patricia Kovach

EDUCATION AND FELLOWSHIP COORDINATOR Heather Heller

EXHIB ITS AND ADMINISTRATIVE COORDINATOR

Michelle Schaffer

MANAGER OF MEMBER SERVICES AND PROGRAMS

Debbie Turkowski

EXECUTIVE ASSISTANT Susan Serpico

ADMINISTRATIVE ASSISTANT Mary Mucciante

AOSSM MEDICAL PUBLISHING GROUP

MPG EXECUTIVE EDITOR AND AJSM EDITOR Bruce Reider MD

SENIOR AJSM EDITORIAL/PRODUCTION MANAGER Donna Tilton

SPORTS HEALTH EDITORIAL/PRODUCTION MANAGER

Kristi Overgaard

SPORTS MEDICINE UPDATE is a bimonthly publication of the American Orthopaedic Society for Sports Medicine (AOSSM). The AmericanOrthopaedic Society for Sports Medicine—a world leader in sports medicine education, research, communication, and fellowship—is a nationalorganization of orthopaedic sports medicine specialists, including national and international sports medicine leaders. AOSSM works closely with manyother sports medicine specialists and clinicians, including family physicians, emergency physicians, pediatricians, athletic trainers, and physicaltherapists, to improve the identification, prevention, treatment, and rehabilitation of sports injuries.

This newsletter is also available on the Society’s Web site at www.sportsmed.org.

TO CONTACT THE SOCIETY: American Orthopaedic Society for Sports Medicine, 6300 North River Road, Suite 500, Rosemont, IL 60018, Phone:847/292-4900, Fax: 847/292-4905.

1 From the President

7 STOP Sports InjuriesContinues Making Impact

8 Research News

9 Membership News

10 Society News

12 Names in the News

12 Dr. Harry H. Kretzler, Jr.Passes Away

13 Traveling FellowshipTours Announced

14 Fellowship Match

16 Upcoming Meetingsand Courses

2 Team Physician’s CornerPrimary, Traumatic Patella Dislocation:Operative Indications

SEPTEMBER/OCTOBER 2010

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September/October 2010 SPORTS MEDICINE UPDATE 1

FROM THE PRESIDENT

AOSSM’S OBJECTIVE IS STRAIGHTFORWARD—to provide a forum through whichits members and the profession can succeed. The relationship by nature is symbiotic. Members contribute tocommon objectives, whether they involve education, research, communication, or governance. Those relatedactivities in turn enable members to draw from our collective wisdom and efforts to function with greatersuccess than otherwise would be possible. The results can be striking.

Robert A. Stanton, MD

No example is more compelling than the Orthopaedic SportsMedicine and Arthroscopy Match, with 96 fellowship programshaving signed up to offer 228 fellowship positions for theupcoming Match year. In 2005, the National Residency MatchingProgram (NRMP) dropped our match because fewer than 35fellowship programs participated. After several years of frustrationwith an “open season” in fellowship selection, AOSSM, AANA,and the fellowship directors decided to institute a new matchwith significantly greater accountability. Today, 96 percent of allaccredited programs—representing 98 percent of all accreditedpositions—participate in the Match. Moreover, 74 percent ofall fellowship applicants in the Match received either their firstor second choice in fellowship. While we must continue tostrive to build upon this success, it is important that we stopand reflect on our remarkable achievement—an outcome thatseemed truly impossible a few short years ago, and one thatwould not have occurred without our collective efforts.Another example of successful collaboration is the upcoming

Post-Injury Osteoarthritis (OA) Conference, chaired by ConstanceChu, MD, to be held December 2–5, 2010, in New Orleans. Theworkshop is a follow-up to the first one held in 2008 in whichAOSSM worked with the National Institutes of Health, ArthritisFoundation, industry and leading researchers to identify thecritical components in OA research to investigate. The upcomingmeeting involves the same organizational participants and will:� Determine the state-of-the-art in multi-center OA research� Determine the current and emerging outcome measuresfor this research

� Develop recommendations for study designs in this areaThe success of this approach was further affirmed this past year

by a generous commitment by Genzyme to provide AOSSM$100,000 annually to support OA research. After 33 years inpractice, post-injury OA is one of the most frustrating issues I face

daily. Athletes, young and old, all too often present with developingarthritis after an injury, occasionally associated with a successfulsurgical procedure. I can help them, but not cure them. The researchthat the AOSSM sponsors may change this. This conference fitswith our strategic goal to be a world leader in research.There are also two recent examples of professional collaboration

under the auspices of AOSSM to further the education of ourmembers. In August, more than 280 orthopaedic surgeonsattended the 4th annual AOSSM & AAOS Review Coursefor Subspecialty Certification in Orthopaedic Sports Medicine,co-chaired by Augustus D. Mazzocca, MD, and Michael J.Stuart, MD. The co-chairs assembled more than 20 leadingexperts to provide in-depth talks on the entire range of sportsmedicine. The evaluations of the course are a testament tothe contributions provided by these noted educators.That same weekend, on the opposite side of Chicago, 28 other

leading educators on the Self-Assessment Committee, underthe direction of Tom DeBerardino, MD, gathered to review,refine, and assemble 125 test items that will comprise the 6thSelf-Assessment Examination (SAE). For the uninitiated, test itemdevelopment is a remarkably demanding task that requires thequestion writers and reviewers to be on top of their professionalgame. The quantity and quality of the AOSSM SAE would not befeasible without these individuals collaborating for all our benefit.As president, I want to thank the hundreds of individuals who

are actively involved with the above programs and so many more,because they have enabled our profession to enjoy a remarkablelevel of success. I hope that you, as members, reflect upon thissuccess and look for opportunities to contribute and grow ourprofession and Society. AOSSM is your organization and Iencourage you to participate in any and all ways you can.

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2 SPORTS MEDICINE UPDATE September/October 2010

Though controversial, the historicalconsensus has been to treat primary, traumaticpatella dislocation in the athletic population non-operatively.With an increased appreciation of the anatomy andbiomechanics of the medial patellofemoral ligament thereis a growing interest in anatomic repair or reconstructiveprocedures for this condition.

PRIMARY, TRAUMATIC PATELLADISLOCATION: OPERATIVE INDICATIONS

T E A M P H Y S I C I A N ’ S C O R N E R

RICHARD Y. HINTON, MD, MPHDirector, Sports Medicine Fellowship,Union Memorial HospitalAssistant Professor, Johns Hopkins Institutes

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It seems intuitive to compare thetreatment of acute patellar dislocationswith acute shoulder dislocations whichare often successfully treated with primaryarthroscopic repair. However, the currentliterature is controversial and patelladislocators represent a complex population.To be successful, early surgical interventionwill have to be tailored to the individualpatient’s risk factors, injury mechanisms,and sporting demands.Traumatic primary patella dislocation is

not benign. Despite directed rehabilitation,many patients continue to suffer recurrentinstability, patellofemoral pain, andsignificant functional sporting disability.So does early surgical intervention improvetheir situation? Historically, no consensusexists concerning best surgical practicesfor patella instability. Many studies sufferfrom flawed methodology, mixing patientpopulations with regard to underlyingpathology, gender, age, and risk factors.Furthermore, many previous studies poorlydefine outcomes, surgical techniques andlack standardization.In an excellent set of epidemiologic

studies, Atkins and Fithian et al2,8 havedefined at least two populations of patientssuffering patella dislocations: recurrentdislocators and first-time dislocators.The recurrent group represents patientswith higher rates of patellofemoraldysplasia, lower extremity malalignment,multi-ligamentous instability and femalepredominance.First-time dislocators had relatively

normal knees which were subjected tovalgus external rotation overload during

high demand activities. These patientshave significantly lower rates of recurrentinstability and contralateral involvement. Inhis classic work, Runow12 classified patelladislocators with regard to the presence orabsence of generalized ligamentous laxityand patella alta. If both risk factors werepresent, instability presented at a youngerage. Furthermore, contralateral involvementwas higher, and recurrent dislocation rateswere greater. However, if both risk factorswere absent, then the age of onset waslater, recurrence was lower, significanttrauma higher, and the concurrent riskof osteochondral fractures greater. Aftera thorough review of the literature andclinical consideration, Hinton andKrishn11 have suggested a classificationof patella dislocators into two large groupsbased on patient characteristics, relativerisk factor, and natural history: LAACSand TONES (see descriptions below).

LAACSL: Laxity, generalized andLower-aged at initial dislocation

A: Atraumatic in natureA: Abnormal patellofemoral architectureand Abnormal ligamentous laxity

C: Chronic in nature,Contralateral involvement

S: Sex dependent with greaternumber of females

TONEST: Traumatic, sports related mechanismO: Older at initial dislocation,Osteochondral fracture more common

N: Normal patellofemoral architecture,Normal alignment

E: Equal sex distributionS: Single occurrence, Single leg involvementThe TONES group more commonly

includes patients with medial patellofemoralligament (MPFL) disruption and concurrentosteochondral fractures; this may requirearthroscopic intervention. However, thisgroup tends to have significantly lower rateof recurrent instability. Yet, these patientsare often athletic and even infrequentepisodes of instability may be poorlytolerated. Prevention of future instability

may also decrease the risk of recurrentosteochondral fractures within thispopulation.We typically recommend non-operative

management and activity modificationfor LAACS patients. However, thesepatients are more likely to developrecurrent instability without surgicalintervention. But, the LAACS patient’sinstability episodes are not associatedwith the same consequences as thosefor the TONES patients. In LAACSpatients, recurrent episodes of instabilityare less traumatic, result in fewerosteochondral fractures, less soft tissuedisruption, and less disruption of dailyroutine. If surgery becomes necessaryfor LAACS patients, they typically willnot do well with isolated MPFL repair.The native soft tissues are not robustand the extensor mechanism is oftendeficient. When surgery becomesnecessary, these patients will oftenrequire both MPFL reconstructionand distal-based realignment. Thesecan be complex, difficult and extensivesurgeries.

September/October 2010 SPORTS MEDICINE UPDATE 3

Acute, traumatic patella dislocation

Patella dislocation is often associatedwith higher energy mechanisms forTONES patients

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Anatomy and BiomechanicsThe medial patellofemoral ligament is anhourglass-shaped ligamentous structurerunning transversely from the posteriorpart of the medial epicondyle/adductortubercle area towards the superior medialpatella. Though present as a distinctstructure, the ligament varies greatly instructure and size. The MPFL is locatedwithin layer two of the medial knee softtissues and its femoral attachment isintimately associated with the adductortendon and superficial medial collateralligament. It has attachments to theunderside of the Vastus Medialis Obliquus(VMO) and the quadriceps tendon towardits patella insertion. The MPFL is theprimary soft tissue stabilizer to lateralpatella displacement. It primarily works inthe functional range of early flexion priorto engagement of the patella to the trochlea.Imaging and anatomic studies have

found the MPFL to be routinely injuredat the time of an acute lateral patelladislocation. Disruption appears to be mostcommon at the femoral origin but cantake place anywhere along the ligament’slength or in multiple locations. Thepattern of disruption may have functionalconsequences with regard to long-termoutcomes and surgical intervention.

In a recent study analyzing the injurypattern to the MPFL with acute lateraldislocation, Balcarek et al3 found the MPFLinjured in 99 percent of patients. Completetears were present in 51 percent, withpartial tears in 49 percent. Injury tothe femoral attachment, mid substance,and patella attachment were found in50 percent, 14 percent, and 14 percentrespectively. Combined injury locationswere noted in 22 percent of patients.Sillanpaa et al15 reported similar results in53 acute lateral dislocators and reportedfemoral attachment involved in 35 of 53,mid-substance 11 of 53, and patellainsertional involvement in 7 of 53.These 53 patients were treated witha non-operative treatment programand patients with a femoral insertionalinjury had significantly higher ratesof re-dislocation and lower rates offunctional ability compared to those withmid-substance or patella insertional injuries.Balcarek et al4 have also reported similar

patterns of MPFL injury in adolescentacute dislocators. In their study, 91 percentof adolescents suffered MPFL injuries at thefemoral origin, combined, mid-substanceor patellar origin (in 40 percent, 35 percent,15 percent, and 10 percent respectively).These studies highlight the need to obtainan MRI in acute dislocators, if surgicalintervention is considered to help focusthe acute repair at the appropriateanatomical site.

Current LiteratureThe current literature on acute lateralpatella dislocation is controversial.Small case series lacking controls reporton successful early surgical repair, butlarger randomized prospective studieshave often shown no significant advantageof surgical versus non operative care.Unfortunately, many of these large studieshave had significant methodologicalflaws mixing patient populations andusing surgical interventions. Camanhoet al5 reported significantly decreasedrecurrent dislocations and higherfunctional scores in 33 randomized

patients undergoing acute, site-specificsuture or suture anchor repair of theMPFL compared to non-operativecare. In eight patients undergoing acutefemoral side MPFL repair after lateraldislocation, Ahmad et al1 reported norecurrent dislocations and a 86 percentreturn to pre-injury activity levels. Nikku13

reported no difference in surgicalversus non operative care in a group of127 randomized acute lateral dislocators.However, this study included a mixedgroup of risk factors and non-standardizedsurgical interventions.In a large, randomized group of military

recruits, Sillanpaa16 reported that comparedto nonoperative care, arthroscopic medialretinacular repair did not result in improvedpatella stability, functional status orprevention of recurrent dislocation.However, in a similar patient populationthe same authors reported that an openanatomic-based MPFL repair did yieldlower redislocation rates.16 Christiansenet al7 found no difference in outcomesbetween operative and non-operativere-dislocation rates in acute lateral dislocatorswhen comparing delayed femoral sideMPFL repair versus non-operative care.However, their technique included suturingwhich was placed “more anterior” inthe femoral insertion. Camp et al6 hadpreviously showed anterior misplacementof MPFL repair to be a primary cause offailure in recurrent patella dislocators. Nam9

reported no significant improvement inre-dislocation or subjective outcomes ina group of adolescent dislocators treatedwith surgery. However, many of thesesubjects had significant patellofemoraldysplasia and other predisposing LAACStype risk factors.

Current Treatment SuggestionsThe appropriate treatment of acutetraumatic patella dislocation continuesto evolve. Treatment must include aconsideration of each individual patient’srisk factors and sporting demands.From a review of the current literature,some suggestions can be made:

4 SPORTS MEDICINE UPDATE September/October 2010

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September/October 2010 SPORTS MEDICINE UPDATE 5

� MRI should be considered in allacute patella dislocators especially inTONES type patients. Osteochondral/chondral fractures are common in thisgroup and are often missed on plainfilms. If acute surgical interventionis considered, MRI plays a significantrole in localizing the area of injuryand the degree of disruption.

� Acute medial patellofemoral ligamentrepair must be site-specific andanatomic. Medial reefing in achronic situation may be successfulin tightening up a lax, healed MPFL.

� Femoral avulsion injuries of the MPFLmay warrant early operative interventionsince outcomes appear to be worsecompared to intra-substance or patellarinsertional site injuries. Special attentionshould be given to anatomic repair ofthe MPFL which is relatively posterioron the femur.

Femoral attachment site MPFL

Dual loaded anchor fixation for patellainsertional repair

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1. Ahmad CS, et al. Immediate surgical repair of the medial patellarstabilizers for acute patellar dislocation. AJSM. 28 (6).

2. Atkin DM, et al. Characteristics of patients with primary acutelateral patellar dislocation and their recovery within the first6 months of injury. AJSM. 28:4.

3. Balcarek P, et al. Magnetic resonance imaging characteristics ofthe medial patellofemoral ligament lesion in acute lateral patellardislocations considering trochlear dysplasia, patella alta, and tibialtuberosity-trochlear groove distance. Arthroscopy. 2010. 26(7): 926-35.

4. Balcarek P, et al. Patellar dislocations in children, adolescents andadults: A comparative MRI study of medial patellofemoral ligamentinjury patterns and trochlear groove anatomy. EURR-4862.

5. Camanho GL, et al. Conservative versus surgical treatment forrepair of the medial patellofemoral ligament in acute dislocationsof the patella. Arthroscopy: The Journal of Arthroscopic and RelatedSurgery. 2009. 25,(6): 620-625.

6. Camp CL, et al. Medial patellofemoral ligament repair for recurrentpatellar dislocation. AJSM Pre-View, published on August 17, 2010as doi:10.1177/0363546510376230

7. Christiansen SE, et al. Isolated repair of the medial patellofemoralligament in primary dislocation of the patella: A prospectiverandomized study. Arthroscopy: The Journal of Arthroscopic andRelated Surgery. 2008. 24(8): 881-887.

8. Fithian DC, et al. Epidemiology and natural history of acutepatellar dislocation. AJSM. 32(5)

9. Nam EK, et al. Mini-open medial reefing and arthroscopic lateralrelease for the treatment of recurrent patellar dislocation. AJSM. 33 (2).

10. Nietosvaara Y, et al. Acute patellar dislocation in children andadolescents. Surgical technique. J Bone Joint Surg Am. 2009 1 (91)Suppl 2 Pt 1:139-45.

11. Hinton RY, Krishn MS. Patellar instability in childhood andadolescence. Insall & Scott Surgery of the Knee, Fourth Edition,Volume 2.

12. Runow A. The dislocating patella. Etiology and prognosis in relationto generalized joint laxity and anatomy of the patellar articulation.Act Orthop Scan. 1983. suppl 201:1-53.

13. Nikku R, et al. Operative treatment of primary patellar dislocationdoes not improve medium-term outcome. Acta Orthopaedica.2005. 76 (5):699-704.

14. Palmu S, et al. Acute patellar dislocation in children and adolescents:a randomized clinical trial. J Bone Joint Surg Am. 2008. 90(3):463-70.

15. Sillapaa PF, et al. Femoral avulsion of the medial patellofemoralligament after primary traumatic patellar dislocation predictssubsequent instability in men: a mean 7-year nonoperativefollow-up study. AJSM. 2009. 37(8):1513-21.

16. Sillapaa PJ, et al. Arthroscopic surgery for primary traumatic patellardislocation: a prospective, nonrandomized study comparingpatients treated with and without acute arthroscopic stabilizationwith a median 7-year follow-up. AJSM. 2008. 36:2301-2309.

17. Sillapaa PJ, et al. Treatment with and without initial stabilizingsurgery for primary traumatic patellar dislocation. A prospectiverandomized study. J Bone Joint Surg Am. 2009. 91(2):263-73.

References

6 SPORTS MEDICINE UPDATE September/October 2010

� LAACS type patients do not do wellover the long-term with acute medialpatellofemoral ligament repair alone.14,10

These patients will often requirecombined reconstruction proceduresto augment insufficient tissue combinedwith distal realignment to addressunderlying architectural problems.

� Anatomic, acute repair of a disruptedmedial patellofemoral ligamentmay decrease the risk of recurrentdislocation in TONES patients andmay be considered in the athletesin which recurrent dislocation maypresent significant disability. This ismore likely still if femoral attachmentdisruption is documented by MRI.

SummaryPatellar dislocators fall into two largegroups: TONES and LAACS. For

TONES patients, the primary issue isMPFL overload in an otherwise relativelynormal knee. The MPFL is the primarysoft tissue stabilizer to lateral patellardislocation and is routinely injured withdislocation episodes. Injury at the femoralorigin of the MPFL appears to resultin higher rates of re-dislocation andfunctional disability. Although TONESpatients have lower rates of repeatinstability, site-specific repair of theMPFL addresses the primary underlyingpathology and may be consideredto decrease sporting downtime withfuture instability events and preventosteochondral injury with futureinstability episodes.

Femoral insertion site injury of MPFL

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September/October 2010 SPORTS MEDICINE UPDATE 7

New Resources AvailableThe STOP Sports Injuriescampaign has been busy addingnew resources to the Web site,www.STOPSportsInjuries.org,

including downloadable public serviceannouncements and tip sheets on hockey,golf, and lacrosse. Other new additionscoming this fall include tip sheets onrowing, wrestling, figure skating, skiing/snowboarding, and martial arts. Our newblog written by members, organizationalsupporters, and parents was also recentlylaunched and hopes to provide additionalresources and insights. Don’t forget tobecome a fan and follower of STOPSports Injuries on Twitter and Facebook!If you have questions, suggestions or needmore information, please contact LisaWeisenberger at [email protected].

Supporter ActivitiesNathan Littauer HospitalInstitution supporter, Nathan LittauerHospital, in upstate New York has beentaking the STOP Sports Injuries messageto the practice field and the classroom. Theyrecently partnered with the local schooldistrict, Perth Broadalbin, to announcetheir participation in the campaign and theimportance of injury prevention during apress conference on August 25. The eventwas a pre-cursor to their youth sports safetyclinic that was held mid-September. Bothevents garnered significant local mediaattention, including front page stories inthe area newspapers and hits on the nightlynews. The hospital will be working with

the school district and local community toprovide a year-long educational endeavorrelated to youth sports injury prevention.“With our medical team, we are fullycommitted to help our area’s youth as theyparticipate in the sport of their choosing.With our region’s love of sports we werecompelled to take on this weighty, albeitlargely unknown issue,” explained LaurenceE. Kelly, Littauer’s CEO and President.

East Texas Rehabilitation Group,Longview, TexasAOSSM member, Randy Williams, MD,has been working the radio talk showcircuit and recently got the East TexasRadio Group (stations KOOI , KYKX,KOYE, KKUS) to publicize the campaignand add information and promotions totheir Friday night high school footballshow. He also has been putting theposters and handouts up around thelocal communities he works with.

First State OrthopaedicsAOSSM member, Dr. Randeep Kahlon,recently scored a new partnership withseven different Delaware YMCAs. Heis helping to coordinate prevention andtreatment talks with different physiciansaround the area as part of the “STOPSports Injuries Night at the Y.” “It shouldbe a great turnout and a good PSA donein person,” said Kahlon.

Get Your Practice, Sports Organizationor Hospital InvolvedYou can also easily get involved inthe campaign by becoming an officialsupporter. Simply fill out the onlineform under the Join Our Team taband submit your sporting organization,hospital/institution, or practice informationand then e-mail a bio and logo [email protected]. We will then add yourinformation to the site and you will haveaccess to a specialized logo to place onyour Web site, utilize in presentations,events or other materials. Visit the Website today to download the agreementand become a supporter!

Arthrex Joins CampaignThe campaign is pleased to announcea new supporter in the fight againstyouth sports injuries, Arthrex. Theorganization has committed to provide$250,000 over the course of thenext five years. We appreciate theirsupport and look forwardto a longpartnership.

Continues to Expand and Excite

William Oates, MD, sports medicine andrehabilitation team director for NathanLittauer and STOP Sports Injuries liaison,speaks during press conference.

STOP SPORTS INJURIES

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8 SPORTS MEDICINE UPDATE September/October 2010

R E S E A R C H N E W S

RESEARCH AWARDDEADLINES

AOSSM ResearchAward DeadlineNovember 1, 2010

Young Investigator Grant andSandy Kirkley Clinical ResearchGrant Application DeadlineDecember 1, 2010

For more information andto submit applications visit,www.sportsmed.org andclick on “Research.”

AOSSM MembersNeeded for YoungPitchers StudiesAOSSM launched two researchprojects this year that focus on elbowand shoulder problems in youngpitchers (9–18 years old). The first isa survey-based study that assesses theextent in which young pitchers engagein types and levels of throwing thatmay put them at risk for overuseinjuries. The second project will targetpitchers who seek treatment from anorthopaedic surgeon and explore therelationships among pitching variables,elbow and shoulder overuse injuries,and adaptive changes to the elbowand shoulder.AOSSM members who have ties

with youth leagues or teams in theircommunities and those who treat 20or more young pitchers each year areneeded to help conduct these studies.If you are interested in participatingor would like additional information,please email AOSSM Directorof Research, Bart Mann [email protected].

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September/October 2010 SPORTS MEDICINE UPDATE 9

For the fifth consecutive year, Ossur, has generously underwritten the AOSSMCandidate Member Starter Package for all fellows in ACGME-accredited sportsmedicine fellowships. This grant underwrites the $150 membership applicationfee as well as first-year Society dues of $250 for all sports medicine fellows inaccredited programs who apply for candidate membership.Interested fellows must submit their Candidate membership application and

Candidate reference forms by December 15, 2010. Society staff will review theapplication and ensure the application has met all requirements. Applicants thatmeet the December 15, 2010, deadline and Candidate membership requirementswill begin immediately receiving the following benefits:� Complimentary registration for the AOSSM Annual Meeting� Complimentary subscription to The American Journal of Sports Medicine� Complimentary subscription to Sports Health: A Multidisciplinary Approach� Complimentary subscription to the Society’s newsletter, Sports Medicine Update� Discounted registration fees for AOSSM-sponsored meetings and products� Access to the “Members Only” features on the Society’s Web site,www.sportsmed.org.If you haven’t yet taken advantage of this opportunity

and wish to do so, please contact Debbie Turkowski,Manager of Member Services at [email protected].

M E M B E R S H I P N E W S

Candidate Members Receive FREE “StarterPackage,” Including Application Fee andFirst Year Membership Dues

AOSSM thanks Ossur for their support of sports medicine fellows.

Don’t Forget to MeetYour AttendanceRequirements!Did you miss the fun in Providence?Just a reminder, that Active andCandidate members must attendone meeting every four years inorder to fulfill AOSSM’s membershiprequirements. Can’t remember thelast meeting you attended? Thisinformation is just a click away bylogging onto the Society’s Web siteat www.sportsmed.org and visitingthe My AOSSM page. You canalso call the Society office at847/292-4900 to check onyour past meeting attendance.

MEMBERSHIPAPPLICATION DEADLINES

Active, Associate andAffiliate MembershipNovember 1, 2010

Upgrade to Active orAssociate MembershipNovember 15, 2010

Candidate MembershipDecember 15, 2010

For more information ormembership applications,visit www.sportsmed.org,e-mail Debbie Turkowski [email protected], or call theSociety office at 847/292-4900.

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New Search Capabilities atthe AOSSM Online LibraryIf you haven’t visited the AOSSMOnline Library lately, check it out!You can search the AOSSM’seducational resources quicklyand efficiently with our improvedsearch. Need an image foran upcoming presentation?Download the perfect imagefrom the image library. Visitwww.sportsmedlibrary.org today.

10 SPORTS MEDICINE UPDATE September/October 2010

S O C I E T Y N E W S

Maintenance of Certification™ (MOC)is the process through which Diplomatesof the American Board of OrthopaedicSurgery (ABOS) can maintain theirprimary certificate in orthopaedic surgery.The MOC process requires documentationof a minimum of 20 credits of Category 1

CME credits obtained for completion and scoring ofself-assessment examinations (SAE) during a three-year cycle.AOSSM has developed the print version of the Self

Assessment and Board Review Version 5 to help you fulfillthis MOC requirement. The print version of the AOSSMSelf Assessment and Board Review contains 125 questionson eleven areas of orthopaedic sports medicine topics.Participants complete the answer sheet and submit theiranswers. Once the answer sheet is submitted it is scoredand recorded. The participant will receive a report notingresponses to each question and a comparative report thatnotes scores on each area in comparison to others who havesubmitted their Self Assessment responses. The participantwill also obtain the Preferred Response and Answer bookletand a CME certificate for up to 12 AMA PRA Category 1CME™ credit once completed.To order the print version of the Self Assessment and

Board Review Version 5 visit www.sportsmed.org and clickon the “Education and Meetings” tab.

CME for AJSM Current ConceptsArticles AvailableReaders are now able to earn journal-based CMEs throughAJSM. Each month there will be a Current Conceptsarticle eligible for 1 AMA PRA Category 1 Credit™ oncethe appropriate pre- and post-tests have been completed.All AJSM subscribers can receive two complimentary journalCME opportunities. Thereafter, the cost will be $15 perAMA PRA Category 1 Credit™. For more informationvisit www.ajsm.org.

GGOOTT EENNOOUUGGHH CCMMEE CCrreeddiitt??

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September/October 2010 SPORTS MEDICINE UPDATE 11

New Additions and Changes at AOSSM

Janisse Selan,Senior Advisor of CME ProgramsAfter the shortest retirement ever,Janisse (Jan) Selan former Director of Education, has decided to return to AOSSM as the Senior Advisor forCME programs. She will be assistingwith the development of our educationprograms, including the AnnualMeeting and Specialty Day. Please join us in welcoming Jan back.

Susan Brown Zahn, PhDDirector of EducationSusan has agreed to serve as the newAOSSM Director of Education and willcontinue to work on distance learningprograms for the Society as well asoversee all educational programming.Her background in education and technology development will serve the Society well. Congratulations to Susan on her new position.

Personalize In MotionHave you personalized In Motion for your practiceyet? It’s a quick, easy way to get importanthealth information into your patient’s hands.For just $300 for all four issues, you can includeyour practice’s name and logo on each issue andhave the ability to print the newsletter yourself,e-mail to patients or put up on your Web site.Personalizing In Motion gives your patient’s theeducational resources they need at a low price.Get this exciting product into your patient’shands today by e-mailing Lisa Weisenberger at [email protected] for more information.

New Sports Medicine Resource AvailableThe newest, most comprehensive and accessible resource available, The Encyclopediaof Sports Medicine, presents state-of-the art research and evidence-based applicationsfrom Sage Publishing, the publisher of the American Journal of Sports Medicineand Sports Health: A Multidisciplinary Approach. The four-volume work, edited by Lyle J. Micheli, MD, is broad ranging, covering all aspects of sports medicine withperspectives from the medical, behavioral, social sciences and physical educationperspectives. Pre-order your copy today by visiting www.sagepub.com.

Got News We CouldUse? Sports MedicineUpdate Wants to Hearfrom You!Have you received a prestigiousaward recently? A new academicappointment? Been named a team physician? AOSSM wants to hear from you! Sports Medicine Updatewelcomes all members’ newsitems. Send information to Lisa Weisenberger, AOSSM Director of Communications, at [email protected], fax to847/292-4905, or contact theSociety office at 847/292-4900.High resolution (300 dpi) photos are always welcomed.

2011 Annual Meeting Abstract Deadline ApproachingBe sure to submit your abstract for the 2011 AOSSM Annual Meeting in San Diego. The deadline for submissions is November 15. Visitwww.sportsmed.org and click on abstracts for details and requirements. At the time of submissions all clinical human studies must have approvedIRBs and all animal studies must have approved IACUCs in order to be considered for inclusion in any AOSSM educational program.

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12 SPORTS MEDICINE UPDATE September/October 2010

The second annual “SpectacUALR” eventpresented by Windstream Communicationswill honor, AOSSM member, Jack VanderSchilden, MD, on October 14 for his 25

years of service as team physician to the University ofArkansas at Little Rock (UALR). A 2003 inductee intothe UALR Athletic Hall of Fame, Dr. Vander Schildenbegins his 26th year with the program in 2010–11 and has donated countless hours to the care of Trojan student-athletes. He has been involved with UALR sincejoining the University of Arkansas for Medical Sciences in 1985, and currently serves as the Jackson T. StephensDistinguished Professor in the Department of OrthopedicSurgery at UAMS. “Dr. V’s contributions to the Universityfor the past 25 years have been immeasurable. His careand concern for the student-athlete is very special,” saidUALR Director of Athletics Chris Peterson. “UALR hasbeen extremely fortunate to have Dr. V as a friend.” The evening will feature unique silent and live auctionitems with all proceeds directly impacting UALR’s current student-athletes.

AOSSM Founding Member, Harry H. Kretzler, Jr., MD, Passes Away Dr. Kretzler was born on May 16, 1925, to Edna and Harry Kretzler, Sr. of Edmonds, Washington. He passed away on July 5, 2010, after a short illness. He graduated from Edmonds High School, and then the University of Washington after serving in the Navy. He went on to graduate from theUniversity of Pennsylvania Medical School, and completed his orthopaedic specialty training at the

University of Washington. He practiced orthopaedic surgery for approximately 50 years, primarily at Northwest andStevens Hospitals. He was a member of the American Academy of Orthopedic Surgeons and a founding member of the AOSSM. He was an accomplished woodworker, and also enjoyed golf, skiing, and other sports; as well as a Boy Scout leader for five years. In his later years, he and his wife traveled the world. He is survived by his wife of 57 years, Jean, and by sons Mike (Judy), Jon (Virginia), and Tom (Karen), daughter, Barbara (Chuck Harwood),and eight grandchildren. He will be greatly missed by all of his colleagues, friends and family.

N A M E S I N T H E N E W S

Dr. Jack Vander SchildenHonored at UALR

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Spring AOSSM/SLARD TourFor the Spring SLARD tour, theGodfather will be former AOSSMPresident, Walton W. Curl, MD, from Winston Salem, North Carolina.Dr. Curl will lead a contingent ofthree young fellows to Latin Americafrom approximately April 19 to May

18, 2011. This year’s sites will include Mexico City,Mexico; Bogota, Colombia; Buenos Aires andRosario, Argentina; Santiago and Puerto Montt,Chile; Sao Paulo, Brazil and conclude in Rio deJaneiro, Brazil at the ISAKOS Congress.

Fall AOSSM/APOSSM TourThe Fall tour will be to the AsiaPacific and led by former AOSSMPresident, Dr. Champ L. Baker, Jr.from The Hughston Clinic. The tour will start in Los Angeles on or about September 17 and continueto Manila, Jakarta; Sydney and

Melbourne, Australia; Aukland, New Zealand and then finish at the combined Australian KneeSociety/New Zealand Knee Sports Surgery Societymeeting on October 8, 2011, in Queensland.If you are interested in applying for the fellowship

you need to be: � An orthopaedic surgeon currently practicing in North America

� Under 46 years of age� Board certified � Either an AOSSM member or have completed an accredited sports medicine fellowship

� Interested in fostering a meaningful exchange of scientific information, stimulate research, anddevelop friendships with sports medicine colleagues.

Download the requirements and application tobecome a Traveling Fellow at www.sportsmed.org,under quicklink “Traveling Fellowship.” All applicationsmust be received no later than October 15, 2010.For further information, please contact DebbieTurkowski at [email protected] or by calling847/292-4900.

September/October 2010 SPORTS MEDICINE UPDATE 13

AOSSM Traveling Fellowship Tours Announced for 2011Applications now being accepted

Dr. Walton W. Curl

Dr. Champ L. Baker, Jr.

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14 SPORTS MEDICINE UPDATE September/October 2010

3B Orthopaedic at Penn/Penn Orthopaedics ProgramArthur R. Bartolozzi, MDPhiladelphia, PA

Allegheny General Hospital ProgramPatrick J. DeMeo, MDPittsburgh, PA

American Sports Medicine InstituteProgram - AndrewsJames R. Andrews, MDBirmingham, AL

American Sports Medicine InstituteProgram - LemakLawrence J. Lemak, MDBirmingham, AL

Andrews/Paulos Research &Education ProgramLonnie E. Paulos, MDGulf Breeze, FL

Aspen Sports Medicine Foundation ProgramN. Lindsay Harris, Jr., MDAspen, CO

Atlanta Sports Medicine & CartilageReconstruction Fellowship ProgramScott D. Gillogly, MDAtlanta, GA

Barton/Lake Tahoe Sports Medicine Fellowship ProgramKeith R. Swanson, MDZephyr Cove, NV

Boston University Medical Center ProgramAnthony A. Schepsis, MDBoston, MA

Brigham & Women’s Hospital,Harvard Medical SchoolScott D. Martin, MDChestnut Hill, MA

Brown University ProgramPaul D. Fadale, MDProvidence, RI

Children’s Hospital (Boston) ProgramLyle J. Micheli, MDBoston, MA

Cincinnati SportsMedicine & Orthopaedic CenterFrank R. Noyes, MDCincinnati, OH

Cleveland Clinic Sports Medicine ProgramMark S. Schickendantz, MDCleveland, OH

Congress Medical Associates ProgramGregory J. Adamson, MDPasadena, CA

Detroit Medical Center ProgramStephen E. Lemos, MD, PhDWarren, MI

Doctors’ Hospital ProgramF. Harlan Selesnick, MDCoral Gables, FL

Duke Sports Medicine Center ProgramDean C. Taylor, MDDurham, NC

Emory University OrthopaedicSports Medicine Fellowship ProgramSpero G. Karas, MDAtlanta, GA

Fairview/MOSMI ProgramJ. Patrick Smith, MDMinneapolis, MN

Fowler Kennedy Orthopaedic Sport Medicine ProgramJ. Robert Giffin, MD, FRCSCLondon, ON Canada

Henry Ford Hospital ProgramPatricia A. Kolowich, MDDetroit, MI

Hospital for Special Surgery ProgramScott A. Rodeo, MDNew York, NY

Indiana University School of Medicine ProgramArthur C. Rettig, MDIndianapolis, IN

Jackson Memorial Hospital/Jackson Health Systems ProgramLee D. Kaplan, MDMiami, FL

Kaiser Permanente Orange CountyProgramBrent R. Davis, MDIrvine, CA

Kaiser Permanente San Diego ProgramDonald C. Fithian, MD/Edmond Young, MDEl Cajon, CA

Kerlan-Jobe Orthopaedic Clinic ProgramNeal S. ElAttrache, MDLos Angeles, CA

Lenox Hill Hospital ProgramBarton Nisonson, MDNew York, NY

Long Beach Memorial MedicalCenter ProgramPeter R. Kurzweil, MDLong Beach, CA

Massachusetts General Hospital/Harvard Medical School ProgramThomas J. Gill, IV, MDBoston, MA

Mayo Clinic, College of MedicineMichael J. Stuart, MDRochester, MN

Mercy Hospital Anderson/Universityof Cincinnati College of MedicineRobert S. Heidt, Jr., MDCincinnati, OH

Methodist Hospital (Houston)ProgramDavid M. Lintner, MDHouston, TX

Mississippi Sports Medicine &Orthopaedic Center ProgramLarry D. Field, MDJackson, MS

New England Baptist HospitalProgramMark E. Steiner, MDBoston, MA

New Mexico Orthopaedic Associates ProgramAnthony F. Pachelli, MDAlbuquerque, NM

Northwestern University - McGawMedical Center FellowshipMichael A. Terry, MDChicago, IL

AANA/AOSSM Fellowship Match

ORTHOPAEDIC SPORTS MEDICINE FELLOWSHIP MATCH 2011

Fellowship Match Most Successful YetWe are very pleased to announce that 96 programs (95 accredited) are confirmed to participate in the SF Match for a total of228 positions! This is the highest turnout we have ever had. The updated SF Match system is now a “one stop shop” that allowsfellows to access their CAS application, edit their program listing, manage applications (notes, scores, track interviews, e-mail),rank list submission and view match results. We are looking forward to another successful match day on April 12, 2011.The list below includes all programs who will be participating in the Orthopaedic Sports Medicine Match for 2011. The

Match, administered through the San Francisco Matching Program (www.sfmatch.org), provides an orderly, equitable selectionprocess for applicants and fellowship programs. For the most current match information, please visitwww.sportsmed.org/fellowships.

Continued on page 15

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September/October 2010 SPORTS MEDICINE UPDATE 15

NYU Hospital for Joint DiseasesOrrin H. Sherman, MDNew York, NY

Ochsner Clinic Foundation ProgramDeryk G. Jones, MDJefferson, LA

Ohio State University Hospital ProgramChristopher C. Kaeding, MDColumbus, OH

OrthoCarolina Sports Medicine,Shoulder & Elbow ProgramJames E. Fleischli, MDCharlotte, NC

OrthoIndy ProgramJack Farr, II, MDIndianapolis, IN

Orthopaedic Research of VirginiaJohn F. Meyers, MDRichmond, VA

Panorama Orthopedics & Spine Center ProgramJames T. Johnson, MD, MPHGolden, CO

Penn State Milton S. HersheyMedical Center ProgramWayne J. Sebastianelli, MDState College, PA

Plancher Orthopaedics & Sports Medicine ProgramKevin D. Plancher, MDNew York, NY

Rush University Medical Center ProgramBernard R. Bach, Jr., MDChicago, IL

San Diego Arthroscopy & Sports Medicine ProgramJames P. Tasto, MDSan Diego, CA

Santa Monica Orthopaedic & Sports Medicine Group ProgramBert R. Mandelbaum, MDSanta Monica, CA

SOAR Sports Medicine FellowshipMichael F. Dillingham, MDRedwood City, CA

Southern California OrthopaedicInstitute ProgramRichard D. Ferkel, MDVan Nuys, CA

Sports Clinic Laguna Hills ProgramWesley M. Nottage, MDLaguna Hills, CA

Sports Orthopedics & SpineEducational Foundation ProgramKeith D. Nord, MDJackson, TN

Stanford Orthopaedic SportsMedicine Fellowship ProgramMarc R. Safran, MDRedwood City, CA

Steadman Hawkins Clinic - DenverTheodore F. Schlegel, MDGreenwood Village, CO

Steadman Hawkins Clinic of the Carolinas ProgramRichard J. Hawkins, MD, FRCSCGreenville, SC

Steadman Hawkins Clinic ProgramJ. Richard Steadman, MDVail, CO

Taos Orthopaedic Institute ProgramJames H. Lubowitz, MDTaos, NM

The Hughston Foundation ProgramChamp L. Baker, Jr., MDColumbus, GA

Thomas Jefferson University ProgramMichael G. Ciccotti, MDPhiladelphia, PA

TRIA Orthopaedic Center ProgramDavid A. Fischer, MDBloomington, MN

UCLA Medical Center ProgramDavid R. McAllister, MDLos Angeles, CA

UHZ Sports Medicine InstituteProgramJohn W. Uribe, MDCoral Gables, FL

Union Memorial Hospital ProgramRichard Y. Hinton, MD, MPHBaltimore, MD

University at Buffalo ProgramLeslie J. Bisson, MDBuffalo, NY

University of Arizona ProgramWilliam A. Grana, MD, MPHTucson, AZ

University of California (Davis)ProgramKirk J. Lewis, MDSacramento, CA

University of California San Francisco ProgramChristina R. Allen, MDSan Francisco, CA

University of Chicago ProgramSherwin S. W. Ho, MD, BAChicago, IL

University of Colorado HealthScience Center ProgramEric C. McCarty, MDBoulder, CO

University of Connecticut ProgramRobert A. Arciero, MDFarmington, CT

University of Illinois at Chicago -Center for Athletic MedicinePreston M. Wolin, MDChicago, IL

University of Iowa Hospitals & Clinics ProgramBrian R. Wolf, MD, MSIowa City, IA

University of Kentucky SportsMedicine ProgramScott D. Mair, MDLexington, KY

University of ManitobaPeter B. MacDonald, MD, FRCSWinnipeg, MB Canada

University of Massachusetts ProgramBrian D. Busconi, MDWorcester, MA

University of Michigan ProgramBruce S. Miller, MD, MSAnn Arbor, MI

University of Missouri at Kansas City ProgramJon E. Browne, MDLeawood, KS

University of New MexicoDaniel C. Wascher, MDAlbuquerque, NM

University of Pittsburgh ProgramChristopher D. Harner, MDPittsburgh, PA

University of Rochester MedicalCenter ProgramMichael D. Maloney, MDRochester, NY

University of South FloridaDavid Leffers, MDTampa, FL

University of Tennessee - Campbell Clinic ProgramFrederick M. Azar, MDMemphis, TN

University of Texas at HoustonWalter R. Lowe, MDHouston, TX

University of Texas Health ScienceCenter at San Antonio ProgramJesse C. DeLee, MDSan Antonio, TX

University of Utah ProgramRobert T. Burks, MDSalt Lake City, UT

University of Virginia Health SystemsDavid R. Diduch, MDCharlottesville, VA

University of Wisconsin Hospitals & Clinics ProgramJohn F. Orwin, MDMadison, WI

USC Sports Medicine FellowshipProgramJames E. Tibone, MDLos Angeles, CA

Vanderbilt University ProgramJohn E. Kuhn, MDNashville, TN

Virginia Hospital Center/NirschlOrthopaedic Center/GeorgetownUniversityRobert P. Nirschl, MD, MSArlington, VA

Wake Forest University School of MedicineDavid F. Martin, MDWinston Salem, NC

Washington University ProgramMatthew J. Matava, MDChesterfield, MO

West Coast Sports MedicineFoundation ProgramKeith S. Feder, MDManhattan Beach, CA

William Beaumont Hospital ProgramKyle Anderson, MDRoyal Oak, MI

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16 SPORTS MEDICINE UPDATE September/October 2010

Upcoming Meetings and Courses

JOSSM and AOSSM Collaborate for Upcoming MeetingAOSSM is collaborating with the Japanese Orthopaedic Society for Sports Medicine(JOSSM) for the 3rd Combined Meeting of the Japanese and American OrthopaedicSocieties for Sports Medicine. The meeting will be held in English March 26–29, 2011,at the Grand Wailea in Maui, Hawaii. It will feature noted faculty and scientific paperson the overhead throwing athlete and sports medicine. Robert Stanton, MD, AOSSMPresident noted, “the meeting is a replication of a similar exchange between Japan andthe U.S. in the early 1990s, and it affords AOSSM members with a unique educationaland cultural exchange in an unparalleled setting.”

Abstracts can be submitted from August 1–October 20, 2010. Early Bird registrationends on January 7, 2011. For more information, please visit www.congre.co.jp/3jaossm.We look forward to seeing you there.

Advanced Team Physician CourseWashington, D.C.December 9–12, 2010Advance registration closes November 12, 2010.

AOSSM Specialty DaySan Diego, CaliforniaFebruary 19, 2011

3rd Combined Meeting of the Japanese and American OrthopaedicSocieties for Sports MedicineMaui, HawaiiMarch 26–29, 2011Advance registration closes January 7, 2011.

AOSSM 2011 Annual Meeting San Diego, CaliforniaJuly 7–10, 2011

For more information and to register visitwww.sportsmed.org andclick on the “Educationand Meetings” tab.

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Sports Medicine UpdateAOSSM6300 North River RoadSuite 500Rosemont, IL 60018

www.sportsmed.org

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