Review ArticleEmerging Options for Biologic Enhancement of Stress Fracture Healing in AthletesMiller, Timothy L. MD; Kaeding, Christopher C. MD; Rodeo, Scott A. MDAuthor Information From the Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH (Dr. Miller and Dr. Kaeding), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Rodeo). None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Miller, Dr. Kaeding, and Dr. Rodeo. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.jaaos.org). Journal of the American Academy of Orthopaedic Surgeons: January 1, 2020 - Volume 28 - Issue 1 - p 1-9 doi: 10.5435/JAAOS-D-19-00112 SDC Take the CME Test Metrics Abstract In an era of continual single-sport specialization and year-round training, overuse injuries, including stress injuries of bone, are increasingly common. These injuries can be season- or even career-ending. For many elite and professional athletes, the traditional treatment strategy of immobilization and extended rest from sports participation is often not practical or acceptable. An understanding of modern strategies for evaluating and treating stress fractures is paramount for maintaining athletic participation and optimal athletic performance. This begins with the ability to categorize and stratify bony stress injuries by both severity and risk of fracture progression. Surgical procedures such as open reduction and internal fixation or intramedullary fixation with possible bone grafting remain the standard of care for chronic or severe stress fractures. However, emerging techniques to augment the biologic environment are a minimally invasive adjunct for stimulating and supporting bone healing in elite-level athletes to optimize bone health, expedite recovery, and decrease the risk of nonunion or catastrophic fracture. Copyright 2019 by the American Academy of Orthopaedic Surgeons.