Two research teams at the Hospital for Special Surgery (HSS) have recently been awarded grants by the NBA and GE Healthcare Orthopedics and Sports Medicine Collaboration to study bone stress injuries affecting NBA players and other athletes.

A research team led by Brett Toresdahl, M.D., a Hospital for Special Surgery primary care sports medicine physician, received an almost $300,000 grant to evaluate the use of ultrasound imaging to monitor healing and guide proper return to play in athletes with bone stress injuries.

Because signs of healing are difficult to see on standard imaging like MRI and X-ray, it is difficult to determine when an athlete is ready to return to the game.

"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 in a press release.

"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."

During the study, adults between 18 and 50 years of age who have had a bone stress injury in the lower leg or foot during sport or exercise will undergo traditional treatment, but in addition an ultrasound will be performed every 2 weeks for 12 weeks. The patients will also be asked to keep track of their pain and return to activity. A MRI will also 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," Toresdahl said.

HSS foot and ankle surgeon, Martin O’Malley, M.D., and his team also received a grant. They were awarded $100,000 to assess risk factors and intervention strategies for fifth metatarsal stress fractures, which is a common type of stress fractures for basketball players that can be difficult to treat.

"Currently, there is limited knowledge on how to identify athletes who are at a high risk for a fifth metatarsal stress fracture," said O'Malley, said in the release.

"Additionally, we don't have a clinical understanding on how to intervene before such injury occurs."

In this study, data from collegiate and professional basketball players will be used to identify elements of foot structure that are found in patients with a fifth metatarsal injury. The researchers will use a robotic device that will stimulate walking and jumping in cadavers to identify those features that will increase the mechanical burden on the bone.

"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," O'Malley said.

The Hospital for Special Surgery is located in New York City.