Time-sensitive injuries for the sports medicine surgeon - "Sports Medicine Trauma", Part 1: Upper Extremity.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, irreducible shoulder dislocations, acute traumatic rotator cuff tears, posterior sternoclavicular joint dislocations, high grade acromioclavicular joint dislocations, pectoralis major tendon ruptures, distal biceps tendon ruptures, and triceps tendon ruptures.

Time-Sensitive Injuries for the Sports Medicine Surgeon - "Sports Medicine Trauma", Part 2: Lower Extremity.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, multiligamentous knee injuries, proximal hamstring ruptures, quadriceps tendon ruptures, patellar sleeve avulsions, patellar tendon ruptures, tibial spine avulsions, posterior cruciate ligament avulsions, bucket handle meniscus tears, and achilles tendon ruptures.

Acetabular Labral Reconstruction: Review of Techniques and Outcomes.

Purpose Of Review: To analyze advances in labral reconstruction, and to discuss the literature relating to efficacy, outcomes, and technical considerations of labral reconstruction.

Recent Findings: The available evidence suggests that labral reconstruction is a safe and effective procedure that can improve pain and function in patients with severe and/or complex labral tears. The superiority of labral reconstruction over labral repair is uncertain, and it remains unclear what graft type and technique should be used in labral reconstructions.

Improved 2-Year Freedom from Arthroplasty in Patients with High-Risk SIFK Scores and Medial Knee Osteoarthritis Treated with an Implantable Shock Absorber versus Non-Operative Care.

Objective: Subchondral insufficiency fracture of the knee (SIFK) is associated with high rates of osteoarthritis (OA) and arthroplasty. The implantable shock absorber (ISA) is an extra-capsular implant that unloads the medial knee compartment. This study compared the 2-year freedom from arthroplasty rates in subjects with medial knee OA and SIFK when treated with an ISA versus a matched cohort of patients treated non-surgically.

Incidence and 30- and 90-day readmission rates after primary shoulder arthroplasty in the United States: an analysis using the National Readmissions Database.

Background: The field of shoulder arthroplasty has experienced a substantial increase in the number of procedures performed annually and a shift toward more common implantation of reverse shoulder arthroplasties (RSAs). Same-day discharge is perceived as beneficial for most patients as well as our health care system, and the number of shoulder procedures performed as same-day surgery has increased substantially. However, the potential benefits of same-day discharge after shoulder arthroplasty may be negatively influenced by unexpected readmissions.

Risk of Arthroplasty in Patients with Subchondral Insufficiency Fractures of the Knee: A Matched Study of the Implantable Shock Absorber using a Validated Predictive Model.

Subchondral insufficiency fractures of the knee (SIFK) can result in high rates of osteoarthritis and arthroplasty. The implantable shock absorber (ISA) implant is a titanium and polycarbonate urethane device which reduces the load on the medial compartment of the knee by acting as an extra-articular load absorber while preserving the joint itself. The purpose of this study was to evaluate whether partially unloading the knee with the ISA altered the likelihood of progression to arthroplasty utilizing a validated predictive risk model (SIFK score).

Are Baseball Statistics an Appropriate Tool for Assessing Return to Play in Injured Pitchers? Analysis of Statistical Variability in Healthy Players.

Background: Basic pitcher statistics have been used to assess performance in pitchers after injury or surgery without being validated. Even among healthy pitchers, the normal variability of these parameters has not yet been established.

Purpose: To determine (1) the normal variability of basic and advanced pitcher statistics in healthy professional baseball pitchers and (2) the minimum pitches needed to predict these parameters.

Post-arthroscopic Subchondral Insufficiency Fractures of the Knee Yield High Rate of Conversion to Arthroplasty.

Purpose: To evaluate both the potential causes and resultant outcomes in patients in whom subchondral insufficiency fracture of the knee (SIFK) develops after arthroscopy.

Methods: We performed a retrospective review of all patients with a magnetic resonance imaging diagnosis of SIFK after arthroscopic meniscectomy and chondroplasty over a 12-year period.

Results: A total of 28 patients were included, with a mean age of 61 years and mean follow-up period of 5.

Significant Changes in the Diagnosis, Injury Severity and Treatment for Anterior Shoulder Instability Over Time in a U.S. Population.

Purpose: To report the annual incidence of anterior shoulder instability (ASI) diagnosis, injury severity, and surgical stabilization in a U.S. population.

Hamstring Autograft Anterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement.

Purpose: To compare the (1) rates of complications and reoperations, (2) rate of anterior cruciate ligament (ACL) graft failure, and (3) patient-reported outcomes (PROs) among patients after hamstring autograft ACL reconstruction (ACLR) with and without independent suture tape reinforcement at a minimum 2-year clinical follow-up.

Methods: We performed a 1:2 matched-cohort comparison of patients who underwent hamstring autograft ACLR with and without independent suture tape reinforcement between July 2011 and July 2017. Patients were matched according to age, sex, body mass index, preinjury Tegner activity score, and concomitant meniscal injury.

Pre-operative patella alta does not affect midterm clinical outcomes and survivorship of patellofemoral arthroplasty.

Purpose: The purpose of this study was to evaluate the effect of preoperative patella alta on clinical outcomes, survivorship, and complication and reoperation rates on patellofemoral arthroplasty (PFA).

Methods: All patients who underwent PFA for isolated patellofemoral arthritis by a single surgeon at our institution were identified. Preoperative radiographs were measured by two independent observers for patellar height using the Caton Deschamps (CD), Insall-Salvati (IS), and Blackburne-Peele (BP) methods.

Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty.

Background: Spontaneous osteonecrosis of the knee has recently been termed subchondral insufficiency fracture of the knee (SIFK) to appropriately recognize the etiology of mechanical overloading of the subchondral bone. The purpose of this study was to assess clinical outcomes of SIFK based on progression to surgical treatment and arthroplasty, and to evaluate the risk factors that increase the progression to arthroplasty.

Methods: A retrospective review was performed on patients with a diagnosis of SIFK, as confirmed with use of magnetic resonance images (MRIs).

The SIFK score: a validated predictive model for arthroplasty progression after subchondral insufficiency fractures of the knee.

Purpose: The purpose of this study was to create a predictive model utilizing baseline demographic and radiographic characteristics for the likelihood that a patient with subchondral insufficiency fracture of the knee will progress to knee arthroplasty with emphasis on clinical interpretability and usability.

Methods: A retrospective review of baseline and final radiographs in addition to MRIs were reviewed for evaluation of insufficiency fractures and associated injuries. Patient and radiographic factors were used in building predictive models for progression to arthroplasty with Train: Validation: Test subsets.

Comparison of the effect of insulin glulisine to insulin aspart on breakfast postprandial blood glucose levels in children with type 1 diabetes mellitus on multiple daily injections.

Objective: Rapid-acting insulins, including insulin aspart (NovoLog) and lispro (Humalog), do not seem to effectively control postprandial glycemic excursions in children with type 1 diabetes mellitus (T1DM). The objective of this study was to determine if insulin glulisine (Apidra), another rapid-acting insulin analog, would be superior in controlling postprandial hyperglycemia in children with T1DM.

Methods: Thirteen prepubertal children ages 4 to 11 years completed this study.