Demographic and training descriptive analysis of National and American Hockey League team physicians.

Aims/objective: Assess the demographic/education backgrounds of team physicians (TPs) in the National Hockey League (NHL) and American Hockey League (AHL).

Materials/methods: Orthopedic Surgeon (O) and Primary Care (PC) TPs for each NHL and AHL team were recorded based on an internet search. Age, sex, and race were collected.

Limited Use of Supervised Physical Rehabilitation Beyond 3 Months After Arthroscopic Anterior Cruciate Ligament Reconstruction With Greater Use in Female and Younger Patients.

Purpose: To characterize the initiation and use of supervised physical rehabilitation after arthroscopic anterior cruciate ligament reconstruction (ACLR), including overall duration of rehabilitation and number of rehabilitation visits, and to describe demographic and clinical predictors of rehabilitation initiation and use characteristics.

Methods: Patients aged 14 to 64 years in the United States who underwent ACLR from 2017 to 2020 were identified using the Merative MarketScan Database. For patients initiating rehabilitation within 45 days postoperatively, the overall duration and number of visits within 1 year after surgery were determined.

Modified Bridge-Enhanced Anterior Cruciate Ligament Repair.

Historically, the treatment of anterior cruciate ligament (ACL) injuries shifted from primary repair to reconstruction because the native, intrasynovial location of the ACL precluded the formation of a fibrin-rich clot needed for ligament healing. However, increasing attention has been paid to augmenting the biological environment surrounding the ACL to facilitate its healing after arthroscopic repair. The bridge-enhanced ACL restoration implant uses resorbable collagen mixed with autologous blood to provide a biological scaffold for tissue healing.

Mediator kinase inhibition impedes transcriptional plasticity and prevents resistance to ERK/MAPK-targeted therapy in KRAS-mutant cancers.

Acquired resistance remains a major challenge for therapies targeting oncogene activated pathways. KRAS is the most frequently mutated oncogene in human cancers, yet strategies targeting its downstream signaling kinases have failed to produce durable treatment responses. Here, we developed multiple models of acquired resistance to dual-mechanism ERK/MAPK inhibitors across KRAS-mutant pancreatic, colorectal, and lung cancers, and then probed the long-term events enabling survival against this class of drugs.

Comprehensive Clinical Examination of ACL Injuries.

A comprehensive clinical examination of the potentially anterior cruciate ligament (ACL)-deficient knee should proceed as follows: inspection; palpation; range of motion; varus and valgus stress; neurovascular status; and finally provocative maneuvers. The Lachman, anterior drawer, Lever, and pivot shift tests are all greater than 90% specific for ACL pathology. Due to the relatively high coincidence of ACL injuries and those to the posterior cruciate ligament, posterolateral corner , posteromedial corner , and menisci, it is critical that the examiner perform provocative maneuvers to evaluate the integrity of these structures as well.

Anatomic total shoulder arthroplasty for B2 glenoids treated with asymmetric reaming has equivalent survivorship and patient outcomes compared with type A glenoids at a mean 9-year follow-up.

Background: Walch B2 glenoids can present a challenge to shoulder arthroplasty surgeons. Short-term studies have demonstrated that corrective reaming to 10° of retroversion in anatomic total shoulder arthroplasty (aTSA) can result in good outcomes; however, there is little data reporting the long-term outcomes in this cohort. B2 glenoids treated with high-side reaming present a theoretical risk of early glenoid component failure as one may ream into the subchondral bone.

Increased rate of out-of-network surgeon selection for hip arthroscopy compared to more common orthopedic sports procedures.

Background: Demand for hip arthroscopy (HA) has increased, but shortfalls in HA training may create disparities in care access. This analysis aimed to (1) compare out-of-network (OON) surgeon utilization for HA with that of more common orthopedics sports procedures, including rotator cuff repair (RCR), partial meniscectomy (PM), and anterior cruciate ligament reconstruction (ACLR), (2) compare the HA OON surgeon rate with another less commonly performed procedure, meniscus allograft transplant (MAT), and (3) analyze trends and predictors of OON surgeon utilization.

Methods: The 2013-2017 IBM MarketScan database identified patients under 65 who underwent HA, RCR, PM, ACLR, or MAT.

Mediator Kinase Inhibition Impedes Transcriptional Plasticity and Prevents Resistance to ERK/MAPK-Targeted Therapy in KRAS-Mutant Cancers.

Acquired resistance remains a major challenge for therapies targeting oncogene activated pathways. KRAS is the most frequently mutated oncogene in human cancers, yet strategies targeting its downstream signaling kinases have failed to produce durable treatment responses. Here, we developed multiple models of acquired resistance to dual-mechanism ERK/MAPK inhibitors across KRAS-mutant pancreatic, colorectal, and lung cancers, and then probed the long-term events enabling survival against this class of drugs.

Incidence and risk factors for pseudosubluxation of the humeral head following proximal humerus fracture.

Background: Humeral head pseudosubluxation (HHPS) in relation to the glenohumeral joint is a common finding following fractures of the proximal humerus. The temporary inferior subluxation of the humeral head may be secondary to a transient axillary nerve neuropraxia, pain inhibition of the deltoid, or hemarthrosis or capsular disruption that alters the physiologically negative pressure in the glenohumeral joint. Despite the frequency of this finding, it is not well described in the literature.

Survivorship of total shoulder arthroplasty vs. hemiarthroplasty for the treatment of avascular necrosis at greater than 10-year follow-up.

Background: Avascular necrosis (AVN) of the humeral head is a debilitating pathology that can be managed with an array of treatments depending on disease staging. Humeral head arthroplasty for AVN has demonstrated good short-term improvements in pain and range of motion, but the published long-term outcomes data are limited. The objective of this study was to report long-term survivorship and outcomes for patients undergoing hemiarthroplasty (HA) or total shoulder arthroplasty (TSA) for the treatment of AVN of the humeral head.

Athletic Hip Injuries in Major League Baseball Pitchers Associated With Ulnar Collateral Ligament Tears.

Background: Ulnar collateral ligament (UCL) reconstruction is a reliable treatment for elite overhand throwers with UCL tears. In recent years, this procedure has become increasingly common among Major League Baseball (MLB) pitchers. Predisposing factors and associated comorbidities, however, have not been fully elucidated.

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.

Variability of United States Online Rehabilitation Protocols for Proximal Hamstring Tendon Repair.

Background: The optimal postoperative rehabilitation protocol following repair of complete proximal hamstring tendon ruptures is the subject of ongoing investigation, with a need for more standardized regimens and evidence-based modalities.

Purpose: To assess the variability across proximal hamstring tendon repair rehabilitation protocols published online by United States (US) orthopaedic teaching programs.

Study Design: Cross-sectional study.