Increased age and modified fragility index increases risk of short-term complications after anterior cruciate ligament reconstruction surgery.

Background: Large data analysis of anterior cruciate ligament reconstruction (ACLR) short-term complications on age will help surgeons stratify and counsel at-risk patients. The purpose of this study is to assess if older patients are at greater risk for short-term complications after ACLR.

Methods: This retrospective cohort study included patients who underwent elective ACLR with or without concomitant meniscal procedures in the National Surgical Quality Improvement Program from 2005 to 2017.

Anatomic Osteochondral Allograft Reconstruction for Concomitant Large Hill-Sachs and Reverse Hill-Sachs Lesions.

Glenohumeral instability causing bipolar bone loss is increasingly being recognized and treated to minimize recurrence. Large Hill-Sachs and reverse Hill-Sachs lesions of the humerus must be addressed at the time of surgery to prevent recurrent dislocations and restore the native anatomic track. For patients with epilepsy, locked dislocations may create defects that must be addressed with bony procedures, including osteochondral allograft reconstruction as soft-tissue remplissage may not adequately addresses the magnitude of the bone loss.

Postless Tape Augmentation for Anterior Cruciate Ligament (ACL) Reconstruction.

Suture or tape augmentation for anterior cruciate ligament (ACL) reconstruction has been described as a technique to increase biomechanical strength and potentially improve clinical outcomes. However, the suture or tape used for augmentation usually requires independent tibial fixation from the ACL graft in the form of an anchor or post. This may introduce the potential for graft and augment tension mismatch, while increasing surgical cost.

Adolescent elbow osteochondral lesions following prior elbow fracture pinning.

Purpose: Pinning of pediatric elbow fractures has been shown to be a safe procedure with a low complication profile. This study identified patients who underwent cartilage surgery for elbow osteochondral lesions or osteochondritis dissecans who had prior ipsilateral elbow pinning.

Methods: Records of patients who underwent ipsilateral cartilage surgery for osteochondritis dissecans and prior percutaneous pinning for elbow fractures were identified.

Lateral T-Capsulotomy with Hip Arthroscopy for Access and Excision of Posterior Intra-Articular Mass.

There is a lack of literature regarding arthroscopic access to the posterior peripheral compartment of the hip. Compared with open surgery, arthroscopy offers less-invasive treatment for intra-articular mass excision. Arthroscopic hip mass excision has focused on selective resection of lesions in the central compartment and anterior peripheral compartment due to difficult and previously undescribed posterior access.

Arthroscopic Decompression of a Posterior Knee Cyst Causing Vascular Compression.

Intra-articular ganglion cysts in the knee large enough to cause neurovascular claudication are rare entities only identified in singular case reports. The severity of claudication can cause debilitating symptoms and pain to previously highly functional and asymptomatic patients. Total knee arthroplasty has been described to treat these cysts in elderly patients with osteoarthritis, although this treatment pathway may not appeal to patients without antecedent pain and high activity levels.

Injuries to Ice Hockey Referees and Linesmen: A Survey of International Ice Hockey Federation Officials.

Background: Ice hockey referees and linesmen are at risk for musculoskeletal injuries because of the lack of protective equipment and contact with players, sticks, pucks, the ice surface and boards.

Purpose: To quantify and analyze injuries reported by officials of the International Ice Hockey Federation (IIHF).

Study Design: Descriptive epidemiology study.

A Practical Guide to Lower Extremity Nerve Blocks for the Sports Medicine Surgeon.

Background: Peripheral nerve blocks (PNBs) are vital in the administration of surgical analgesia and have grown in popularity for use in lower extremity arthroscopic procedures because of their capacity to safely and effectively control pain. The number and specificity of PNBs, however, have made choosing the best option for a procedure nebulous for orthopaedic surgeons.

Purpose: To present a narrative literature review of the PNBs available for arthroscopic hip and knee procedures that is adapted to an audience of orthopaedic surgeons.

Combined Supracondylar Humerus Fracture, Monteggia Injury, and Radial/Ulnar Shaft Fractures in a 3-Year-Old Child.

Ipsilateral pediatric elbow and forearm injuries are uncommon, particularly those comprising a supracondylar humerus fracture, radiocapitellar joint dislocation, proximal ulna fracture, and distal forearm fracture. We present the case of a boy who was 3 years, 6 months old and sustained this constellation of injuries. He underwent urgent treatment with closed reduction and percutaneous fixation of the humerus and flexible intramedullary nail fixation of the ulna.

Open Versus Arthroscopic Surgical Management for Recalcitrant Trochanteric Bursitis: A Systematic Review.

Background: While excision of the trochanteric bursae to treat lateral hip pain has increased in popularity, no comparison exists between the surgical outcomes and complications of the open and arthroscopic techniques involving trochanteric bursectomy. The purpose of this study was to determine the efficacies and complication rates of arthroscopic and open techniques for procedures involving trochanteric bursectomy.

Methods: The terms "trochanteric," "bursectomy," "arthroscopic," "open," "outcomes," and "hip" were searched in five electronic databases.

Femoroacetabular Impingement and Core Muscle Injury in Athletes: Diagnosis and Algorithms for Success.

Athletic hip injuries account for a substantial portion of missed time from sports in high-level athletes. For both femoroacetabular impingement (FAI) and core muscles injuries, a thorough history and physical examination are paramount to guide the treatment. While advanced imaging including computed tomography and magnetic resonance imaging are frequently obtained, a wealth of information can be ascertained from standard radiographs alone.

The prevalence of high school multi-sport participation in elite national football league athletes.

: Early youth specialization is increasingly being researched and identified as a risk factor for overuse injuries and burnout. This study aimed to characterize high school sport specialization in top National Football League (NFL) athletes and determine whether associations exist between single-sport specialization and future injury risk, performance, and longevity.: For NFL first-round draft picks from 2008-2017, data on the number of games played in the NFL, overuse injuries causing athletes to miss one or more regular season games, Pro Bowl selections, and current status in the NFL were collected using publicly available information.

Opioid Prescriptions by Orthopaedic Surgeons in a Medicare Population: Recent Trends, Potential Complications, and Characteristics of High Prescribers.

Introduction: Orthopaedic surgeons prescribe an estimated 7.7% of all US opioid prescriptions, and understanding prescribing patterns is important to curtail the inappropriate dispensing of these drugs. The purpose of this study was to characterize recent trends in opioid prescribing patterns by orthopaedic surgeons within a Medicare population and to identify demographical characteristics associated with the highest prescribers.

The impact of age on 30-day complications following shoulder instability surgery.

Hypothesis: The purpose of this study was to evaluate short-term outcomes including medical complications, overnight admission, and 30-day readmission with regard to patient age at the time of shoulder instability surgery.

Methods: Patients undergoing surgery for glenohumeral instability were collected from the National Surgical Quality Improvement Program between the years of 2005 and 2016. These patients were separated into cohorts of younger than 25 years, 25-34 years, and older than 34 years.

The effect of age on short-term postoperative complications following arthroscopic rotator cuff repair.

Hypothesis: The purpose of this study was to assess short-term outcomes, including the rates of medical complications, non-home discharge, overnight hospital stay, and 30-day readmission, associated with patient age at the time of rotator cuff repair.

Methods: This study used National Surgical Quality Improvement Program data from 2005 to 2016 to analyze patients who underwent arthroscopic rotator cuff repair (ARCR). Patients were stratified into age cohorts of younger than 55 years, between 55 and 65 years, or older than 65 years.

Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis.

Background: While the indications for primary hip arthroscopic surgery in treating femoroacetabular abnormalities continue to be defined, the indications and outcomes for revision hip arthroscopic surgery remain ambiguous. However, revision hip arthroscopic surgery is performed in 5% to 14% of patients after their index procedure. While patient-reported outcomes (PROs) generally improve after revision procedures, the extent of their improvement is not well defined.

Prevalence of Posttraumatic Stress Disorder Symptoms Among Young Athletes After Anterior Cruciate Ligament Rupture.

Background: The risk of depression and the fear of reinjury were documented in recent investigations of patients after anterior cruciate ligament (ACL) ruptures. The extent of psychological trauma accompanying these injuries among young athletes, however, has never been assessed.

Hypothesis: Posttraumatic stress disorder (PTSD) symptoms after ACL injury are present among young athletes with high athletic identities.

Defining Platelet-Rich Plasma Usage by Team Physicians in Elite Athletes.

Background: The indications for the use of platelet-rich plasma (PRP) are vaguely defined despite the frequency of its use as a treatment for athletes. While select studies have advocated for its efficacy, the majority of orthopaedic research conducted on the topic has been equivocal.

Purpose: To define the use of PRP in elite athletes by team physicians from professional sports leagues.

Can We Reduce the Epidemic of Elbow Injuries in Youth Throwers?

As participation in youth sports continues to increase across the nation, more adolescents are participating in Little League baseball in the United States than ever before. Accompanying this increased participation is an epidemic of upper extremity injuries in young throwers. In this Viewpoint, the authors discuss the impetus behind the youth thrower elbow injury epidemic and how to best evaluate these patients.

Trends in Management and Complications of Anterior Cruciate Ligament Injuries in Pediatric Patients: A Survey of the PRiSM Society.

Background: Anterior cruciate ligament (ACL) injuries have been recognized and treated with increasing frequency in children and adolescents. ACL reconstruction (ACLR) in skeletally immature patients has unique considerations and there is a large practice variation in the management of these injuries. The purpose of this study was to survey the members of the Pediatric Research in Sports Medicine (PRiSM) Society regarding their experience with the management and complications of pediatric ACL injuries.

Factors That Drive Youth Specialization.

Background: Specialization in young athletes has been linked to overuse injuries, burnout, and decreased satisfaction. Despite continued opposition from the medical community, epidemiological studies suggest the frequency is increasing.

Hypothesis: Extrinsic pressures in addition to individual aspirations drive this national trend in sports specialization.

Quantifying Parental Influence on Youth Athlete Specialization: A Survey of Athletes' Parents.

Background: Youth athlete specialization has been linked to decreased enjoyment, burnout, and increased injury risk, although the impact of specialization on athletic success is unknown. The extent to which parents exert extrinsic influence on this phenomenon remains unclear.

Purpose/hypothesis: The goal of this study was to assess parental influences placed on young athletes to specialize.

Pectoralis Minor Contracture in Throwing Shoulders of Asymptomatic Adolescent Baseball Players.

Background: Although scapular malpositioning is commonly associated with rotational deficits and risk of injury, modifiable causes of such malpositioning in overhead athletes are not well described.

Purpose/hypothesis: The purpose of this study was to examine the scapulothoracic profile of adolescent baseball players, specifically, pectoralis minor (PM) length. We hypothesized that PM would be shorter in throwing shoulders compared with nonthrowing shoulders.

The Youth Throwing Score: Validating Injury Assessment in Young Baseball Players.

Background: Epidemic levels of shoulder and elbow injuries have been reported recently in youth and adolescent baseball players. Despite the concerning frequency of these injuries, no instrument has been validated to assess upper extremity injury in this patient population. Purpose/Hypothesis: The purpose of this study was to validate an upper extremity assessment tool specifically designed for young baseball players.