Clinical outcomes following open anterior shoulder stabilization for glenohumeral instability in the young collision athlete.

Background: Anterior glenohumeral instability occurs most commonly in those aged 15-29, with 72% of individuals younger than 22 years suffering recurrent episodes; collision athletes are at particular risk. In the setting of subcritical glenoid bone loss, arthroscopic Bankart repair is widely used despite concerns of recurrent dislocations when compared with open techniques. Furthermore, indications for bone-block procedures are evolving with the Latarjet procedure being favored amongst recent authors as a primary stabilization method in elite and contact athletes.

Contact Sports as a Risk Factor for Amyotrophic Lateral Sclerosis: A Systematic Review.

Study Design: Systematic review.

Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease, ultimately resulting in paralysis and death. The condition is considered to be caused by a complex interaction between environmental and genetic factors.

Functional Outcomes After the Surgical Management of Isolated Anterolateral Leg Chronic Exertional Compartment Syndrome.

Background: Failure rates of up to 20% have been reported after fasciotomy for chronic exertional compartment syndrome (CECS). There is some evidence that postoperative failure and complication rates are higher in the posterior compartments of the lower leg than the anterolateral compartments. Isolated compartment surgery may put patients at risk of requiring revision surgery because of the risk of developing posterior compartment disease.

Association of Tibial Plateau Fracture Morphology With Ligament Disruption in the Context of Multiligament Knee Injury.

Background: We identified common morphologies of tibial plateau fractures that arise with multiligament knee injuries (MLKIs), and investigated the relationship of the fracture with ligament tears. We also evaluated the correlation of 3 tibial plateau fracture classification systems (Schatzker, AO, and Duparc).

Methods: Over a 2-year period, a single orthopaedic surgeon at our institution managed 90 MLKIs.

Catastrophic Cervical Spine Injuries in Contact Sports.

 Systematic review.  To determine the incidence of catastrophic cervical spine injuries (CCSIs) among elite athletes participating in contact team sports and whether the incidence varies depending on the use of protective gear or by player position.  Electronic databases and reference lists of key articles published from January 1, 2000, to January 29, 2016, were searched.

The Value of Accurate Magnetic Resonance Characterization of Posterior Cruciate Ligament Tears in the Setting of Multiligament Knee Injury: Imaging Features Predictive of Early Repair vs Reconstruction.

Multiligament knee injury (MLKI) represents a complex set of pathologies treated with a wide variety of surgical approaches. If early surgical intervention is performed, the disrupted posterior cruciate ligament (PCL) can be treated with primary repair or reconstruction. The purpose of our study was to retrospectively identify a critical length of the distal component of the torn PCL on magnetic resonance imaging (MRI) that may predict the ability to perform early proximal femoral repair of the ligament, as opposed to reconstruction.

A 10-year Retrospective Review of Functional Outcomes of Adolescent Anterior Cruciate Ligament Reconstruction.

Background: Rupture of the anterior cruciate ligament (ACL) is an increasingly prevalent sporting injury in adolescents. Surgical reconstruction of the ACL in adolescents has been controversial and there has been little reported on functional outcomes after surgery.The aim of this study was to undertake a retrospective notes review and questionnaire survey of a group of adolescents who had their ACL surgically reconstructed over the previous 10 years, assessing delay to surgery, levels of meniscal damage, reoperation rates, and functional outcomes.

Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury.

Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee.

Osseous femoral avulsion of the anterior cruciate ligament origin in an adult.

Injuries of the anterior cruciate ligament are commonly encountered in clinical practice, and occur in a wide variety of settings, from sports-related injuries to polytrauma. Tears of the anterior cruciate ligament supersede osseous avulsion in the adult demographic; however, in the pediatric population, osseous avulsion reflects the most frequent injury. When osseous avulsion of the anterior cruciate ligament occurs in children or adults, the injury typically occurs at the level of the tibial eminence.

Arthroscopic treatment of anterior ankle impingement: a prospective study of 46 patients with 5-year follow-up.

Background: Midterm outcomes after arthroscopic debridement in patients with anterior ankle impingement without osteoarthritis are currently unclear.

Purpose: To assess the functional and radiological outcomes after arthroscopic treatment of anterior ankle impingement with a minimum 5-year follow-up in patients without osteoarthritis.

Study Design: Case series; Level of evidence, 4.

Early motion for Achilles tendon ruptures: is surgery important? A randomized, prospective study.

Background: Comparisons of surgically and nonsurgically treated Achilles tendon ruptures have demonstrated that those treated with surgery allow earlier motion and tend to show superior results. However, early motion enhances tendon healing with or without surgery and may be the important factor in optimizing outcomes in patients with Achilles tendon rupture.

Hypothesis: There is no difference in the outcome of acute Achilles tendon rupture treated nonoperatively or operatively if controlled early motion is allowed as part of the rehabilitation program.

Does the priority scoring system for joint replacement really identify those in most need?

The Priority Criteria for Major Joint Replacement Scoring System was introduced to prioritise patients on the basis of clinical and social need for surgery. The purpose of this study was to assess its correlation with the Western Ontario and McMasters Universities Arthritis Index (WOMAC) and musculoskeletal functional assessment questionnaires. Fifty patients placed on the waiting list for total joint arthroplasty were surveyed comparing the physician derived priority score and the patient-derived WOMAC and musculoskeletal functional assessment questionnaires.

Trauma care systems in New Zealand.

Trauma in New Zealand is modest in extent in relation to many other areas of the world. Trauma care is delivered in the context of an ad hoc trauma system which nevertheless seems to function reasonably well. Current funding strictures in the short term seem likely to prevent formal adoption of a trauma system which would have the prospect of providing information determining the real quality of trauma care in New Zealand.

Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases.

Objective: To evaluate soft-tissue injury patterns in a large series of patients with knee dislocations to identify frequency and associations that may aid in surgical planning.

Design: Prospective clinical study.

Setting: Two institutions, both level I trauma centers.