5 key takeaways from the Osteo Sports Network Sports Medicine Summit
Recently, Dr Tim attended the Osteo Sport’s Network’s inaugural Sports Medicine Summit.
The Osteo Sports Network was created by sports osteopath Dr Louise Bibby, and the agenda for the summit was to bring together osteopaths from across Australia with an interest in working with individual athletes and teams.
The aim was to allow them to network and share ideas while presenting a panel of specialists in the field of sports medicine to discuss sports injury management. It was also to introduce Osteopathy Australia’s first group of sports-titled osteopaths.
The summit was held in Melbourne, where Dr Tim has many friends and family!
Held at Whitten Oval (home of the AFL’s Western Bulldogs!), the panel of speakers included:
Physiotherapist Michael O’Brien on hip assessment and rehabilitation approaches.
Hip and knee orthopaedic surgeon Brian Slattery who presented on the management of hip osteoarthritis, with a particular focus on injectables and the relatively new ‘anterior approach’ to total hip replacements, which is less invasive and has a quicker recovery time.
Sports medicine registrar Dr Victoria Norbury on athlete management in high performance environments.
Specialist hand and upper limb surgeon Dr Avanthi Mandaleson spoke about management of upper limb injuries, particularly those affecting the elbow.
Sports physicians Dr Hussain Khan and Dr Sam Harkin delivered a humorous and engaging talk on osteoarthritis in the community (with a focus on hip and knee).
From Dr Tim…
“Much of the content was familiar to me given the areas of study I have applied myself over the past decade, however I solidified some of my current understanding and learnt plenty of new information as well, which we will share with you below.
These topics are areas that tend to be the subject of ongoing research, so what we mention below is not necessarily definitive but an indication of where research is up to at this point in time (particularly in relation to injectables).”
Our 5 key takeaways from the Sports Medicine Summit
1. Injectables for osteoarthritis (OA) related pain
There are 3 key injections for OA pain. These include cortisone, PRP and hyaluronic acid (HLA) injections.
There is consensus among orthopaedic surgeons that doing cortisone injections into a joint isn’t the most favourable option as it can cause thinning of the cartilage.
HLA on the other hand, is a complex sugar molecule that occurs naturally in our bodies, within cartilage and the synovial fluid. It acts as a shock absorber and lubricant, so that joints move smoothly over each other.
Because HLA is a naturally occurring substance in our bodies, it can be administered repeatedly as a pain-relief injection without any known side effects, and provides short-term relief for OA.
Yet studies indicate that PRP is the superior option to HLA and cortisone injections (these studies are related to knee OA specifically. Research for hip OA is less clear but trending in this direction).
PRP is an autologous blood product containing concentrated platelets, growth factors and anti-inflammatory cytokines that promote healing and regeneration.
PRP is chondroprotective, so although it can’t regrow cartilage, it can prevent further cartilage degradation.
These injections are repeatable (probably yearly) though unfortunately they aren’t currently covered by Medicare, making them more expensive.
Ultimately, each injection has their own merit depending on the patient and their circumstances, though it is likely that HLA and PRP injections will not cause any long-term side effects, unlike cortisone injections.
2. Nerve ablations
Radiofrequency denervation (ablation) can be highly effective for pain and may offer relief for up to 24 months for some patients.
A nerve ablation should be considered in certain scenarios (i.e. if an individual is on a wait list for a joint replacement).
To perform a nerve ablation, a radiofrequency probe is inserted via fluoroscopic guidance (sometimes via ultrasound) adjacent to sensory nerves.
It generates radiofrequency energy, which manifests as ionic heat typically ranging from 80 to 90 degrees for 120 seconds.
This effectively damages the nerve and stunts the sensory feedback from the joint tissue.
A nerve ablation won’t impact motor control of the area and peripheral nerves are regenerative so nerve function will eventually return (along with the pain) after a period of time.
3. Elmiron injections
There’s ongoing research into injections of Pentosan Polysulfate (Elmiron) to lower blood lipid levels. This is due to a link between dyslipidaemia (low or elevated lipids in the blood) and osteoarthritis.
It is also believed that Elmiron may reduce inflammation in the joints by modulating cytokines and enzymes that degrade cartilage.
Elmiron is another example of a drug that has long had use in one area, but researchers have since realised it’s impact on other conditions (like Ozempic traditionally being used for diabetes and now also for weight loss).
Traditionally Elmiron was used to manage high cholesterol, but it seems to also inhibit pro-inflammatory enzymes/substances.
Now researchers are trialling it for people with osteoarthritis as an intramuscular injection to help with pain.
It is generally a very safe product that is potentially helpful in several ways.
4. Return to running after a hip replacement
According to several studies, 73.6% of runners after hip arthroplasty (hip replacement surgery) return to running and 82-100% return to medium intensity activity post surgery.
Another study found that 11 yrs after a total hip replacement, 89% of pre-operative active patients had returned to sport - though they are more likely to have participated in lower impact activities such as walking, cycling and swimming.
Before investigating return to running post hip replacement, we had assumed that high impact activity would be unfavourable for patients.
This isn’t to say there’s no risk associated with higher impact exercise (as there always is some), but the durability of the implants used has drastically improved over time to allow this to be the case.
There is also evidence of the improved longevity of total hip replacements.
Previously it was believed that if a patient required a hip replacement at a younger age, it would likely need a revision within a couple of decades.
But current data indicates that a total hip replacement may last up to four decades before failure or need of a revision.
5. Weight loss? Focus on fibre
For those looking to lose weight, one study suggests that simply aiming to eat 30 grams of fibre each day can help you lose weight, lower your blood pressure and improve your body’s response to insulin just as effectively as a more complicated diet.
Conclusion
The Osteo Sports Network Sports Medicine Summit offered an incredible opportunity to connect with other osteopaths and leading professionals in the field, deepening our understanding of the latest research and treatments in sports injury and joint health.
From innovative injectable therapies and nerve ablations to the evolving evidence around return-to-sport after joint replacement, it’s clear that the landscape of musculoskeletal medicine continues to advance rapidly.
These insights reinforce the importance of taking an individualised, evidence-based approach to care that considers each patient’s unique goals, lifestyle and recovery timeline.
As research continues to evolve, we remain committed to staying up-to-date with the latest evidence to ensure our patients receive the best possible outcomes, whether that’s returning to sport, managing osteoarthritis or improving everyday mobility and performance.
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