According to an editorial from Clinical Orthopaedics and Related Research, orthopedic surgeons should re-evaluate their support of American football as a recently published study in JAMA suggested exposure to the sport was linked with pathological changes in the brain.
“Individual athletes will decide what sports they will play, and I believe that individual surgeons can — and should — decide whether they are doing more benefit than harm by supporting football with their professional presence, since that sport appears to carry a real risk of permanent neurocognitive impairment,” Seth S. Leopold, MD, editor-in-chief of Clinical Orthopaedics and Related Research, told Healio.com/Orthopedics. “Orthopedic surgeons of course will treat whoever comes to the office or emergency room, regardless of how they were injured, but standing on the sidelines (and the other kinds of involvement we mention in the editorial) ties us to the activity in ways that I do not think are consistent with our best professional values.”
Leopold and colleagues based their opinion on a recent study published in JAMA. In that study, researchers performed a case series on the donated brains of 202 deceased football players who had participated in all levels of American football. Investigators conducted neuropathological evaluations and retrospective clinical assessments for evidence of traumatic encephalopathy (CTE).
Results from the study demonstrated 48 college football players out of 53, developed CTE and 110 National Football League players out of 111 developed CTE. The high proportion of CTE evidence suggested CTE may be linked with prior participation in the sport. In athletes with mild and severe CTE pathology, researchers found behavior, mood and cognitive symptoms were common. Suicidality and history of psychiatric illness were common among players with these symptoms.
“But if orthopedic surgeons stopped covering football teams, other physicians might likewise hesitate or withdraw their support, and the result could well be genuine changes at all levels of the sport, and a real reduction in the number of individuals experiencing irreversible brain injury,” the authors wrote. – by Monica Jaramillo
Leopold SS, et al. Clin Orthop Relat Res. 2017; doi:10.1007/s11999-017-5483-6.
Mez J, et al. JAMA. 2017:doi:10.1001/jama.2017.8334.
Disclosure: Leopold reports no relevant financial disclosures.