Martha Murray, M.D.

What happens when an adrenaline-addicted athlete slows down? 

Julia Marino thrives at high speed and from great heights. In 2009, 17-year-old Julia was at the top of her game. Coaches and fellow slopestyle skiers had pegged her as a rising star on the World Cup circuit. Salomon, a top winter sports gear manufacturer, had signed on as her sponsor. Then, during the first event of the season, she crashed. 

Crashes are common in slopestyle. Skiers hit jumps at speeds up to 35 miles per hour, flying up to 50 feet in the air to perform aerial tricks.

Julia landed awkwardly on one ski, heard a resounding pop in her left knee and felt the “most intense pain” of her life. She braced herself and skied to the medical tent. 

The on-mountain medical crew insisted she wasn’t injured. But Julia and her mother doubted the diagnosis. 

An MRI at Boston Children’s Hospital confirmed the family’s worst fear. Julia had torn her anterior cruciate ligament (ACL), and her season was over. Although Julia wanted immediate surgery, Martha M. Murray, MD, orthopedic surgeon and co-director of the Female Athlete Program at Boston Children’s, advised waiting several weeks until the swelling subsided before undergoing ACL reconstruction. 

The anterior cruciate ligament (ACL) is a powerhouse and the perplexing nexus of a sports injury epidemic.

Providing primary stability across the knee joint, the ACL is remarkably susceptible to rupture or tear, with more than 400,000 surgical reconstructions performed annually in the U.S.

In the 2013 National Football training camps, more than a dozen players were sidelined with ACL injuries. This spate of ACL tears is sure to ripple through high school and college football and soccer fields this fall.

A complete ACL tear is a devastating injury for athletes, typically ending the player’s season and requiring surgical reconstruction. Although many athletes return to the field after reconstruction and physical therapy, studies suggest as many as 80 percent will develop arthritis within 14 years of the injury.

Moreover, children and adolescents are not considered good candidates for ACL reconstruction. The conventional procedure requires surgeons to drill tunnels through the growth plates—the developing cartilage near the end of long bones—but this can disrupt bone growth.

Boston Children’s Hospital orthopedic surgeon Martha M. Murray, MD, wants to change the game plan for ACL injuries. Her research focuses on bio-enhanced ACL repair that uses a bio-engineered scaffold saturated with the patient’s own blood to stimulate healing and to promote clotting, which is essential for ligament repair.

Boston Children’s Hospital announces the Female Athlete Program, co-directed by Kathryn Ackerman, MD, MPH and Martha Murray, MD, both of the Sports Medicine Division. One of the only programs in the country of its kind, the Female Athlete Program combines sports medicine specialties to help pediatric and adult female athletes stay as healthy as possible while competing.

Supported by a team of a world-class sports medicine physicians, the program offers multi-disciplinary care and stands out for its specialized treatment and research on the Female Athlete Triad (the interrelationship between bone health, nutrition and menstrual cycles). The team has also conducted landmark research on knee pain and anterior cruciate ligament (ACL) injuries, which are five to eight times more prevalent in girls.

There is a special kind of female athlete who is so dedicated that her sport becomes her life. Because research shows that girls and women are prone to higher rates of injuries and other health complications, these female athletes require a level of dedication not only to their sports, but also to their long-term health. And by pairing the two, they prevail.

For Krista Pinciaro, soccer player at Medfield High School, dedication to the sport came naturally. But when she tore her medial meniscus and re-tore her lateral meniscus (after tearing both her meniscus and anterior cruciate ligament (ACL) years before), she knew her senior-year soccer season was at stake.

It was one of the worst days of my life, says Krista. Soccer isn’t just a sport to me, it’s my everything. It made me feel like I belonged to something, and it made me succeed academically because I knew I had to in order to keep playing. My teammates and my coaches were all like members of my family. Not playing was devastating for me.

But Krista, like many female athletes, was no stranger to injury. Girls are more likely to tear an ACL than boys, and they’re also more likely to tear their lateral meniscus first, and then injure their medial meniscus later, explains Martha Murray, MD, co-director of Boston Children’s Hospital’s Female Athlete Program, who performed all three of Krista’s surgeries. So Krista was a textbook case, unfortunately.

Preclinical studies have shown promising results for the use of a “bioenhanced repair” technique for anterior cruciate ligament (ACL) tears as an alternative to ligament reconstruction.

The research, under the direction of Martha M. Murray, MD, and Braden C. Fleming, PhD, received the 2013 Ann Doner Vaughn Kappa Delta Award.

After a series of laboratory studies examining the biology of ACL injury and repair, Dr. Murray, of Boston Children’s Hospital, and Dr. Fleming, of Brown University, developed a technique involving application of an extracellular matrix (ECM)-based scaffold loaded with autologous platelets to a complete ACL rupture. The treatment encouraged both biologic and mechanical healing in large-animal studies.

The next step, reports Dr. Murray, is to conduct preclinical testing required by the U.S. Food and Drug Administration (FDA) to enable the technology to proceed to clinical trials.