Prospective Evaluation of Clinical Outcomes of the Subchondroplasty® Procedure for Treatment of Symptomatic Bone Marrow Lesions of the Knee.

Introduction: Bone Marrow Lesions (BMLs) have a strong correlation to patient reported pain, functional limitations, joint deterioration, and rapid progression to total knee arthroplasty. The Subchondroplasty® (SCP) Procedure uses AccuFill®, a calcium phosphate bone substitute material (BSM), to treat bone defects such as microtrabecular fractures and BML.

Methods: This observational, prospective, multicenter, cohort study evaluated the effect of the SCP Procedure at two-year follow-up for 70 patients with knee BML.

Corticosteroid injection prior to surgery had no effect on 2-year outcomes following arthroscopic rotator cuff repair.

Background: Corticosteroid injections (CSIs) can be an effective nonsurgical treatment for patients with rotator cuff tears. Recent large database studies have raised concern that CSI may result in a higher reoperation rate, increased infection risk, and worse outcome after arthroscopic rotator cuff repair (ARCR). The purpose of this study was to evaluate the reoperation rate, incidence of postoperative infection, and two-year outcomes of patients undergoing ARCR with and without the use of preoperative CSI.

Organizational risk profiling and education associated with reduction in professional pitching arm injuries: a natural experiment.

Background: Risk profiling and education are strategies implemented to help reduce injury risk; however, currently. there is little evidence on the effect of these interventions on injury incidence. The purpose of this study was to evaluate the influence of risk profiling and education on upper extremity injury incidence in minor league (MiLB) pitchers and to stratify by injury severity.

Improving Clinical Utility of Real-World Prediction Models: Updating Through Recalibration.

Bullock, GS, Shanley, E, Thigpen, CA, Arden, NK, Noonan, TK, Kissenberth, MJ, Wyland, DJ, and Collins, GS. Improving clinical utility of real-world prediction models: updating through recalibration. J Strength Cond Res 37(5): 1057-1063, 2023-Prediction models can aid clinicians in identifying at-risk athletes.

Including Modifiable and Nonmodifiable Factors Improves Injury Risk Assessment in Professional Baseball Pitchers.

Objectives: To (1) evaluate an injury risk model that included modifiable and nonmodifiable factors into an arm injury risk prediction model in Minor League Baseball (MiLB) pitchers and (2) compare model performance separately for predicting the incidence of elbow and shoulder injuries.

Design: Prospective cohort.

Methods: A 10-year MiLB injury risk study was conducted.

Professional Pitchers Display Differences in UCL Morphology and Elbow Gapping During Moving Valgus Stress Testing After UCL Reconstruction.

Background: Ulnar collateral ligament (UCL) reconstruction (UCLR) of the elbow has received much attention given the rise in incidence among baseball pitchers. Stress ultrasonography has been demonstrated to be a critical evaluation tool of the UCL. No study has dynamically evaluated the ability of UCLR to restore normal kinematics.

Development and internal validation of a humeral torsion prediction model in professional baseball pitchers.

Background: Humeral torsion (HT) has been linked to pitching arm injury risk after controlling for shoulder range of motion. Currently measuring HT uses expensive equipment, which inhibits clinical assessment. Developing an HT predictive model can aid clinical baseball arm injury risk examination.

Patellofemoral Replacement With Tibial Tubercle Osteotomy.

Patellofemoral arthritis that is due to patellofemoral instability or chronic patellofemoral maltracking can be a difficult treatment problem. Isolated patellofemoral arthroplasty (PFA) is a good option that preserves bone and can more accurately reproduce native kinematics when compared with total knee arthroplasty. Newer PFA designs have demonstrated improved survivorship, although survivorship has not shown equivalence with total knee replacement.

Does Functional Bracing of the Unstable Shoulder Improve Return to Play in Scholastic Athletes? Returning the Unstable Shoulder to Play.

Background: Functional bracing is often used as an adjunct to nonoperative treatment of anterior shoulder instability, but no study has evaluated the effectiveness of in-season bracing. The purpose of this study was to examine successful return to play in a nonoperative cohort of adolescent athletes with in-season shoulder instability and compare those athletes treated with bracing to those who were not.

Hypothesis: The use of functional bracing will improve success rates in a cohort of athletes treated nonoperatively for in-season shoulder instability.

Osteochondral Autograft Transfer Procedure: Arthroscopic Technique and Technical Pearls.

The Osteochondral Autograft Transfer System (OATS; Arthrex, Naples, FL) is an excellent option for the treatment of articular cartilage lesions within the knee. Current literature suggests that at early-term to midterm follow-up, patients experience improved function, alleviation of pain, and good satisfaction with acceptable complication rates. Although long-term data are lacking, studies in athletes have shown that the OATS can provide an adequate rate of return to sports.

High Tibial Osteotomy Performed With All-PEEK Implants Demonstrates Similar Outcomes but Less Hardware Removal at Minimum 2-Year Follow-up Compared With Metal Plates.

Background: High tibial osteotomy (HTO) is a valuable treatment option in the high-demand patient with chondral damage and an altered mechanical axis. Traditional opening wedge HTO performed with metal plates has several limitations, including hardware irritation, obscuration of detail on magnetic resonance imaging, and complexity of revision surgery. Recently, an all-polyetheretherketone (PEEK) HTO implant was introduced, but no studies to date have evaluated the performance of this implant with minimum 2-year outcomes compared with a traditional metal plate.

All-inside Arthroscopic Meniscal Repair Technique Using a Midbody Accessory Portal.

Treatment of symptomatic meniscal tears continues to evolve as we improve our understanding of the biomechanical role of the meniscus and its long-term importance to the health of the knee joint. Suture repair of meniscal tears is challenging, yet the incidence of repairs among our colleagues continues to rise as we aim to preserve meniscal tissue. Many elements of performing a repair are tedious and difficult, including proper meniscal preparation, reduction, mattress suture placement, and fixation.

Meniscal Allograft Transplantation With Soft Tissue in Bone Socket Fixation: Arthroscopic Technique With Technical Pearls.

Meniscal allograft transplantation may slow the progression of degenerative changes in the meniscus-deficient knee. The current literature suggests patients can experience good early to mid-term satisfaction and patient-reported outcomes with reasonable expectations of return to work. More ambitious applications in athletes have also shown good results although long-term data are lacking.

"Proprietary Processed" Allografts: Clinical Outcomes and Biomechanical Properties in Anterior Cruciate Ligament Reconstruction.

Background: The processing of allograft tissues in anterior cruciate ligament (ACL) reconstruction continues to be controversial. While high-dose irradiation of grafts has received scrutiny for high failure rates, lower dose irradiation and "proprietary-based" nonirradiated sterilization techniques have become increasingly popular, with little in the literature to evaluate their outcomes. Recent studies have suggested that the specifics of allograft processing techniques may be a risk factor for higher failure rates.

Osteochondral Autograft Transfer Technique for Glenoid Osteochondral Defect.

Glenoid osteochondral defects can be a significant source of pain and disability in an active population. Many treatments are available, but most joint-preserving procedures are limited to debridement, abrasion chondroplasty, or marrow-stimulation techniques, all of which depend on healthy underlying bone and none of which address underlying bony pathology. Osteochondral autograft transfer has been a successful form of treatment for lesions in the knee, elbow, and ankle, especially when subchondral bone is involved.

Humeral Torsion as a Risk Factor for Shoulder and Elbow Injury in Professional Baseball Pitchers.

Background: Numerous studies have demonstrated that humeral retrotorsion is increased in the dominant arms of throwing athletes. No study has clearly defined the relationship between humeral retrotorsion and shoulder and elbow injury.

Hypothesis: Uninjured professional pitchers will display more dominant humeral torsion (HT) than professional pitchers who sustain shoulder injuries but less than pitchers who sustain elbow injuries.

Professional Pitchers With Glenohumeral Internal Rotation Deficit (GIRD) Display Greater Humeral Retrotorsion Than Pitchers Without GIRD.

Background: Dominant shoulder glenohumeral internal rotation deficit (GIRD) has been associated with pitching arm injuries. The relationship of humeral torsion on development of GIRD is not clear.

Hypothesis: Pitchers displaying GIRD will display greater humeral retrotorsion when compared with those without GIRD.

Return to play after nonoperative management for a severe type III acromioclavicular separation in the throwing shoulder of a collegiate pitcher.

Background: Treatment of type III acromioclavicular (AC) separations is controversial, especially in the dominant shoulder of a high-level throwing athlete. This case report describes the return to play after nonoperative management of a collegiate baseball pitcher with a severe type III AC separation in his throwing shoulder.

Hypothesis/purpose: Case report of return to play with nonoperative management of a type III AC separation in the throwing shoulder of a collegiate pitcher.

Quadriceps tendon rupture: a biomechanical comparison of transosseous equivalent double-row suture anchor versus transosseous tunnel repair.

Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel technique, although a single-row suture anchor repair has recently been described. This study biomechanically tested a new transosseous equivalent (TE) double-row suture anchor technique compared with the transosseous repair for quadriceps repair. After simulated quadriceps-patella avulsion in 10 matched cadaveric knees, repairs were completed by either a three tunnel transosseous (TT = 5) or a TE suture anchor (TE = 5) technique.

Changes in passive range of motion and development of glenohumeral internal rotation deficit (GIRD) in the professional pitching shoulder between spring training in two consecutive years.

Background: Pitching causes increased mechanical stress to the arm and is thought to result in alterations in range of motion (ROM) as a result of osseous and soft tissue adaptations. Understanding the factors that contribute to alterations in ROM will allow for improved understanding of the pitching shoulder. This study examined humeral torsion (HT) and shoulder mobility over 2 consecutive years.

Bony adaptation of the proximal humerus and glenoid correlate within the throwing shoulder of professional baseball pitchers.

Background: Elite throwing athletes have increased proximal humeral retrotorsion (HRT) and glenoid retroversion (GRV) in their throwing shoulders compared with their nonthrowing shoulders. These adaptive morphologic changes are thought to be independently protective against shoulder injury; however, their relationship to each other is poorly understood.

Purpose: To determine if an association exists between HRT and GRV within the same shoulders of professional pitchers.

A comparison of glenoid morphology and glenohumeral range of motion between professional baseball pitchers with and without a history of SLAP repair.

Purpose: We sought to examine the relation among glenoid morphology, glenohumeral range of motion (ROM), and history of shoulder injury in professional baseball pitchers.

Methods: We studied 58 professional baseball pitchers. Internal rotation (IR) and external rotation (ER) ROM was measured at 90° of abduction.