A randomized study of cryoablation of intercostal nerves in patients undergoing minimally invasive thoracic surgery.

Objectives: Minimally invasive thoracic surgery can cause significant pain, and optimizing pain control after surgery is highly desirable. We examined pain control after intercostal nerve block with or without cryoablation of the intercostal nerves.

Methods: This was a randomized study (NCT05348447) of adults scheduled for a minimally invasive thoracic procedure.

Meniscus Repair and Replacement.

The importance of preserving the function of the meniscus is seen with renewed interest. There has been an evolution of arthroscopic meniscus repair from inside-out, outside-in, meniscal fixators, to all-inside suturing techniques. Tear patterns once ignored or thought to be irreparable, such as root tears and horizontal cleavage tears, have recently been undergoing repair with promising results.

Return to Play in Athletes Receiving Cervical Surgery: A Systematic Review.

Study Design Systematic review. Clinical Questions Among athletes who undergo surgery of the cervical spine, (1) What proportion return to play (RTP) after their cervical surgery? (2) Does the proportion of those cleared for RTP depend on the type of surgical procedure (artificial disk replacement, fusion, nonfusion foraminotomies/laminoplasties), number of levels (1, 2, or more levels), or type of sport? (3) Among those who return to their presurgery sport, how long do they continue to play? (4) Among those who return to their presurgery sport, how does their postoperative performance compare with their preoperative performance? Objectives To evaluate the extent and quality of published literature on the topic of return to competitive athletic completion after cervical spinal surgery. Methods Electronic databases and reference lists of key articles published up to August 19, 2015, were searched to identify studies reporting the proportion of athletes who RTP after cervical spine surgery.

Injury Rate and Patterns Among CrossFit Athletes.

Background: CrossFit is a type of competitive exercise program that has gained widespread recognition. To date, there have been no studies that have formally examined injury rates among CrossFit participants or factors that may contribute to injury rates.

Purpose: To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants.

Acute traumatic tear of gluteus medius and minimus tendons in a patient without antecedant peritrochanteric hip pain.

Morphologic similarities between the abductor mechanisms of the hip and shoulder have given rise to the term rotator cuff tear of the hip. Although the true incidence of gluteus medius and minimus tears in the general population is unknown, the association between these tears and recalcitrant lateral hip pain has been described as greater trochanteric pain syndrome. Historically, tears of the gluteus medius and minimus have been thought to be attritional, and associated with chronic peritrochanteric pain, found incidentally during fracture fixation or hip arthroplasty, or with failure of abductor repair following arthroplasty utilizing the anterolateral approach.

Acute femoral "peel-off" tears of the posterior cruciate ligament: technique for arthroscopic anatomical repair.

Management of posterior cruciate ligament injuries remains a topic of discussion among treating physicians. Injury severity, anatomical location, and presence of concomitant associated knee injuries are important factors that may be used to guide treatment strategies. Various subtypes of posterior cruciate ligament injury have been identified.

Prevention of nosocomial infections in the intensive care unit.

Infections are considered nosocomial if they occur 48 hours or more after hospital admission or within 30 days after discharge. One third of these infections are considered preventable. Many studies have shown that with proper education and use of strict guidelines, we can prevent nosocomial infections in the intensive care unit.

Comparison of the collagen meniscus implant with partial meniscectomy. A prospective randomized trial.

Background: Loss of meniscal tissue leads to increased pain and decreased clinical function and activity levels. We hypothesized that patients receiving a collagen meniscus implant would have better clinical outcomes than patients treated with partial medial meniscectomy alone.

Methods: Three hundred and eleven patients with an irreparable injury of the medial meniscus or a previous partial medial meniscectomy, treated by a total of twenty-six surgeon-investigators at sixteen sites, were enrolled in the study.

Arthroscopic evaluation of radiofrequency chondroplasty of the knee.

Background: Considerable debate exists over the use of radiofrequency-based chondroplasty to treat partial-thickness chondral defects of the knee. This study used second-look arthroscopy to evaluate cartilage defects previously treated with bipolar radiofrequency-based chondroplasty.

Hypothesis: Partial-thickness articular cartilage lesions treated with bipolar radiofrequency-based chondroplasty will show no progressive deterioration.

Second-look arthroscopic observations after radiofrequency treatment of partial thickness articular cartilage defects in human knees: report of four cases.

Partial thickness articular cartilage defects in the knee are commonly encountered clinical problems. Recently, use of radiofrequency-based devices for performing arthroscopic chondroplasty has gained popularity. However, published experimental studies using different methods for evaluating the histologic effects of radiofrequency-chondroplasty on surrounding cartilage offer contradictory results.

Results of repeat meniscal repair.

Background: The efficacy of repeat repair of retorn menisci has not been demonstrated.

Purpose: To document clinical and radiographic results of repeat repair of retorn menisci that had previously undergone primary repair.

Study Design: Uncontrolled retrospective review.

Arthrofibrosis of the knee following ligament surgery.

Arthrofibrosis of the knee is one of the most serious complications that can result from ligament surgery. Reported incidence of arthrofibrosis following anterior cruciate ligament reconstruction ranges from 4% to 35%. The loss of motion caused by arthrofibrosis can be even more disabling than the instability for which the reconstruction was performed, often requiring extensive physical therapy and/or surgical lysis of adhesions.

Comparison of serum vascular endothelial growth levels between patients with and without ovarian malignancies.

The objective of this study was to determine if there was a relationship between serum vascular endothelial growth factor (VEGF) levels and ovarian malignancies by contrasting a population with ovarian malignancies and a population free of gynecological neoplasms. Two hundred forty four serum samples were obtained from the US National Cancer Institute's Prostate, Lung, Colon, and Ovarian Cancer Screening Project. These samples were analyzed by enzyme-linked immunosorbent assays in duplicate, and on completion of the assays, the samples were decoded for age and disease type.

Meniscus repair: considerations in treatment and update of clinical results.

The meniscus plays an important role in the function of the knee. Preservation of the meniscus is preferred if possible when considering treatment of a meniscus tear. A thorough understanding of the anatomy of the meniscus, the structure, the mechanics, and other factors of meniscal healing are critical when evaluating the torn meniscus for a reparative procedure.

Functional bracing for rupture of the Achilles tendon. Clinical results and analysis of ground-reaction forces and temporal data.

Fifteen patients who had sustained a rupture of the Achilles tendon were managed non-operatively with use of a functional bracing protocol, and clinical and functional performance measures were assessed after a mean duration of follow-up of thirty-one months (range, twenty-four to forty-five months). An age and gender-matched group of fifteen subjects was assessed to provide normative data for the comparison of side-to-side differences. Numerical scores were generated on the basis of subjective responses to a questionnaire, clinical measurements of the range of motion of the ankle and the circumference of the calf, and the results of the Thompson squeeze test and a single-limb heel-rise test.

The effect of a pneumatic leg brace on return to play in athletes with tibial stress fractures.

A total of 18 competitive and recreational athletes were enrolled in a randomized, prospective study looking at the effect of pneumatic leg braces on the time to return to full activity after a tibial stress fracture. All patients had positive bone scans and 15 had positive radiographic findings by Week 12. There were two treatment groups.

Arthroscopic medial meniscal repair in the athlete.

Meniscal tears are common sports injuries. This article details the clinical evaluation of the athlete presenting with knee pain. Conservative (nonoperative) treatment and arthroscopic procedures are discussed.

The management of meniscal tears in the ACL-deficient knee.

Concomitant ACL and meniscal tears pose a higher risk for premature osteoarthritis than either condition alone, especially in the active athlete. Given that the ACL-deficient knee is also at risk of initiating tears and propagating smaller tears, ACL reconstruction is advisable. The meniscal repair in the ACL-unstable knee is at a higher risk for retear.

Long-term results of open meniscal repair.

The purpose of this study was to document the long-term clinical and radiographic results of open meniscal repair. Thirty consecutive patients, involving 33 open repairs, were evaluated by history, physical examination, KT-1000 arthrometer testing, Lysholm II score, Tegner activity score, and weightbearing radiographs. The mean followup was 10.