Re-growing ACLs? Harvard NFL study not just about concussions

OTL: Accusations of flawed research by the NFL (6:37)

According to an investigation by the NY Times, the NFL omitted more than 100 diagnosed concussions from research papers playing down the dangers of head injuries. (6:37)

Born into contentious NFL collective bargaining politics, a Harvard University study on NFL player health and safety is nonetheless up and running. And it has some lofty, wide-ranging goals.

"It's a very conscious effort to really engage the players in a study that examines the actual problems they encounter during a life in football, telling us what we should be focusing on and establishing priorities," said Alvaro Pascual-Leone, one of the Harvard doctors involved in the study. "We're committed to finding out the reality of the health problems and, at the same time, exploring solutions."

Pascual-Leone is a cognitive neurologist, and he's well aware of the prominence that the discussion of CTE and concussion issues has assumed in the conversation about football player health and safety. But head trauma and the issues associated with it make up only a part of this study. Launched in 2014 with the backing of the NFLPA, this study is also pursuing parallel research tracks involving ACL repair, joint brace technology, cardiac care and a variety of other health issues NFL players might encounter during or after their careers.

"It's not a concussion study," Pascual-Leone said. "But concussion is a part of the problem that people have identified as being one of the grave concerns."

If this Harvard study sounds familiar, it's because it has been in the news before -- and not for the best reasons. It was announced three years ago as a CBA-established $100 million grant from the NFLPA to improve the health and well-being of NFL players. But as ESPN learned several months later, the union made that announcement as part of an effort to get the NFL to co-fund the study.

A dispute ensued, with the NFL preferring to fund an NIH study while the players remained locked in on Harvard. The Harvard study's website now reads, "The Study was founded in part through an award from the NFLPA, utilizing funds allocated for research by the collective bargaining agreement with the NFL. The costs of the research program are shared with multiple Harvard-affiliated institutions."

The premise is based on two tracks -- a survey of former NFL players in an effort to determine the health issues of greatest concern, and a simultaneous effort to find ways of addressing those issues.

"It's definitely the case that this is an ambitious study," Pascual-Leone said. "The survey is necessary because the data we have to date is based on too small a sample size. We have about 3,000 former players in the study, but we estimate there are about 14,000 or 15,000 former players from 1960 to today that we want to get information on. The problem with too small a sample size is that we could be sampling people who only have a certain set of issues. We don't know yet the true impact of a life in football.

"But at the same time, we don't want to wait until we have those answers to start exploring new interventions."

To that end, the Harvard study has tested a new procedure that would re-grow a torn ACL in a human knee, rather than replace it with tissue from another part of the body or a cadaver. The current procedure is effective with rehab, but it carries a high risk of arthritis. The new procedure, which would bridge the torn ends of the ACL and regenerate it within the body, would theoretically reduce that risk.

"Growing ACLs out of nothing is awesome, and you're going to be able to see guys come back from ACL injuries at a much more significant quality because they won't be having another tendon from somewhere else put in its place. It'll be a full ACL," said New York Giants linebacker Mark Herzlich, who as an NFLPA executive board member is also on the executive board of the Harvard study. "There have been successful ACL repairs on humans in this study. I don't think they're at a point now where it's going to be common practice in hospitals, but we're on the road to that."

Another part of the study is focused on soft, "protect-when-needed" knee braces that would support the knee joint at times of high or extensive stress, during a potentially traumatic on-field hit or misstep.

"This particular brace is designed to 'lock up' once it reaches a certain degree of extension/flexion, thus minimizing the risk of torn ligaments in the respective joint," said Giants long snapper Zak DeOssie, another executive board member. "Knee and elbow injuries are career-killers."

As for the concussion/CTE aspect, Pascual-Leone said the study recently published research showing antibody therapy that can eliminate a certain type of tau protein in the brains of mice thought to be connected with CTE. There has been no testing so far on human brains, but Pascual-Leone said the study has helped him and his fellow researchers understand the manner in which tau proteins thought to cause CTE form in the brain and can be altered to combat the disease.

"One could envision a situation where a person suffers a head trauma, and an antibody is administered after the trauma that clears up those symptoms," Pascual-Leone said.

As he pointed out, the study is ambitious. But the researchers and players involved are looking for ways to get more baseline information. The study recently launched a mobile app called "Team Study" that allows players, former players and the general public to log and receive health information that could help build their database.

"To study the player's overall health and well-being requires a more thorough approach," Pascual-Leone said. "We study all the different systems and how they interact with each other. The focus of the study is what we call, 'whole player, whole life.' We want to study what happens in their life before and after football, and when we do that, we're able to examine the overall total body health of the player."

The timetable for results remains murky. Some of the projects are further along than others. It could turn out that the most rewarding fruits of the study have more to do with the knee and the heart than the brain. But the general idea is to figure out what can be done and how. The 'when,' they believe, will take care of itself.

"Everyone hopes they're still playing when this stuff comes out and we can use it," Herzlich said. "But part of our job as current players [is] preparing the next generation of players for a better game. The idea of this study is to create a better, safer game for the future."