ACL Reconstruction using Hamstring Autograft Plus Lateral Extra-articular Tenodesis and All-Soft Tissue Quadriceps Alone Have Lower Re-tear Rate and Pivot Shift Grade but Similar Outcome to Hamstring Autograft Alone in High Risk Patients.

Purpose: The purpose of this study was to compare the surgical outcomes of anterior cruciate ligament (ACL) reconstruction using hamstrings autograft (HA) plus lateral extra-articular tenodesis (LET), isolated all-soft-tissue quadriceps autograft (QA), and isolated HA.

Methods: A retrospective review was performed comparing high risk patients undergoing ACL reconstruction with isolated HA, isolated QA, or HA+LET from August 2013 to January 2023. High risk patients, as determined by high grade pivot shift or generalized ligament laxity, with at least 2 years of follow up were included.

Pediatric Concussion Injuries in Soccer: Emergency Department Trends in the United States From 2012 to 2023.

Background: Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week.

Purpose: To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season.

Study Design: Descriptive epidemiology study.

Arthroscopic Subpectoral Tenodesis of the Long Head of the Biceps Brachii.

The long head of the biceps brachii is a common pain generator in the shoulder that is often managed surgically with tenotomy or tenodesis. The clinical outcomes after tenotomy and tenodesis are comparable. However, tenodesis is preferred in the active population owing to complications associated with tenotomy, including cosmetic deformity, early fatigue, and cramping.

Shared Music Experiences During Bedside Neurosurgical Procedures: An ACGME-Sponsored Pilot Study on Fostering Patient-Clinician Alliance Through Music.

Background: Bedside procedures represent a substantial proportion of the neurosurgical resident's responsibilities. Although music interventions in healthcare have classically been employed for the benefit of the patient, there is evidence in support of its positive effects on healthcare workers as well.

Objectives: We aimed to create a novel framework-the shared music experience (SME)-which allows for patient and provider to discuss and mutually select a musical playlist during bedside procedural interventions.

Arthroscopic Technique for Headless Compression Screw Fixation of Large Bony Bankart Fractures in Anterior Shoulder Instability.

A bony Bankart fracture is a common injury pattern in anterior shoulder instability. The fracture fragment size varies and the larger the fragment the more likely recurrent instability will occur. When a large bony Bankart fracture is present, surgical fixation is preferred.

Hip Circumferential Labral Reconstruction Provides Similar Distractive Stability to Labral Repair After Cam Over-Resection in a Biomechanical Model.

Purpose: To evaluate the change in hip distractive stability after a cam over-resection, labral tear, repair, labrectomy, or circumferential 6- or 10-mm labral reconstruction in a biomechanical model.

Methods: Ten fresh-frozen matched-pair human cadaveric hips were analyzed using a materials testing system to measure the force and distance required to disrupt the suction seal of the hip (1) with an intact capsule and labrum; (2) after a capsulectomy and labral repair; (3) after a capsulectomy, 5-mm cam over-resection and labral repair; (4) after a capsulectomy, 5-mm cam over-resection and labral tear; (5) after a capsulectomy, 5-mm cam over-resection and labrectomy; and (6) after a capsulectomy, 5-mm cam over-resection and a 6- or 10-mm circumferential labral reconstruction with iliotibial band (5 hips each). Each specimen was retested at 0° flexion, 45° flexion, and 45° flexion and at 15° internal rotation and analyzed using nonparametric statistical methods.

Excision of Intra-articular Knee Heterotopic Ossification Using a 70° Arthroscope.

Heterotopic ossification is ectopic lamellar bone formation within soft tissue and can result in significant functional limitations. There are multiple underlying etiologies of HO including musculoskeletal trauma and traumatic brain injury. Intra-articular HO of the knee is rare and is typically located within the cruciate ligaments.

Single bundle hamstrings autograft preparation techniques for anterior cruciate ligament reconstruction: current concepts.

Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic procedures, and huge variation exists in the surgical technique. Single bundle hamstrings autograft reconstruction is a common method and has good clinical outcomes. A criticism of the hamstrings autograft is a small graft diameter, often less than 8-mm, which has been associated with increased re-rupture rates.

Hip Labral and Capsular Repair Are Unable to Restore Distractive Stability in a Biomechanical Model.

Purpose: To evaluate the change in hip distractive stability after a capsulotomy, labral tear, and simultaneous repair of both the capsule and the labrum in a biomechanical model.

Methods: Ten fresh-frozen human cadaveric hips were analyzed using a materials testing system to measure the distractive force and distance required to disrupt the hip suction seal under the following conditions: (1) native intact capsule and labrum, (2) 2- or 4-cm interportal capsulotomy (IPC), (3) labral tear, (4) T extension, (5) labral repair, (6) T extension repair, and (7) IPC repair. Each specimen was retested at 0° of flexion, 45° of flexion, and 45° of flexion with 15° of internal rotation.

Not all patient-reported outcome measures are equivalent at two years compared to one year after anterior cruciate ligament reconstruction based on a retrospective analysis.

Objective: This article aims to assess for clinically important differences in patient-reported outcome measures (PROMs) at one and two years post anterior cruciate ligament reconstruction (ACLR).

Methods: A retrospective comparison of prospectively collected PROMs for a single cohort who underwent a primary ACLR with or without associated meniscal surgery from 2016 to 2020 was assessed. Six externally validated PROMs were collected preoperatively and at standardized times postoperatively.

Pomalidomide Improves Motor Behavioral Deficits and Protects Cerebral Cortex and Striatum Against Neurodegeneration Through a Reduction of Oxidative/Nitrosative Damages and Neuroinflammation After Traumatic Brain Injury.

Neuronal damage resulting from traumatic brain injury (TBI) causes disruption of neuronal projections and neurotransmission that contribute to behavioral deficits. Cellular generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) is an early event following TBI. ROS often damage DNA, lipids, proteins, and carbohydrates while RNS attack proteins.

The Contribution of Soft Tissue and Bony Stabilizers to the Hip Suction Seal: A Systematic Review of Biomechanical Studies.

Background: Previous biomechanical studies have identified capsular closure, labral repair or reconstruction, and osteochondroplasty as important surgical interventions to improve hip stability.

Purpose: To investigate the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis.

Study Design: Systematic review and meta-analysis; Level of evidence, 4.

How do certain atmospheric aerosols affect Cu-binding organic ligands in the oligotrophic coastal sea surface microlayer?

It is still unclear how the chemical speciation of Cu in surface seawater is impacted by aerosols from various sources deposited on the sea surface, which is surprising, considering the environmental importance of Cu. Therefore, we used voltammetry to investigate Cu complexing capacity (CuCC) in the sea surface microlayer (SML) and in the underlying water (ULW) of the oligotrophic middle Adriatic Sea during February-July 2019. The focus was on the impacts of specific atmospheric processes such as open-fire biomass burning (BB), pollination season and Saharan dust intrusion.

If at first you don't succeed, should you try again? The efficacy of repeated closed reductions of distal radius fractures.

Introduction: A repeated closed reduction ("re-reduction") of a displaced distal radius fracture is a common procedure performed to obtain satisfactory alignment and avoid surgery when the initial reduction is deemed unsatisfactory. However, the efficacy of re-reduction is unclear. Compared to a single closed reduction, does a re-reduction of a displaced distal radius fracture: (1) improve radiographic alignment at the time of fracture union and, (2) decrease the rate of operative intervention?

Materials And Methods: Retrospective cohort analysis of 99 adults aged 20-99 years with extra-articular or minimally displaced intra-articular, dorsally angulated, displaced distal radius fracture with or without an associated ulnar styloid fracture who underwent a re-reduction, compared against 99 adults matched for age and sex who were managed with a single reduction.

Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations.

Background: Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed.

Objective: To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion.

Methods: We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis).

Ecotoxicity of PM emissions generated during controlled burning of waste PET.

Domestic waste is often burned either as fuel for winter heating or in open areas, simply to get rid of waste. Polyethylene terephthalate (PET) represents an important component of plastics usage as well as of plastic waste produced. While most studies attempt to characterize environmental risk of open burning of mixed household waste, present work evaluates chemical and ecotoxicological parameters of particulate matter (PM) produced during controlled burning of PET samples.

Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group.

Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the eattle nternational severe traumatic rain njury onsensus onference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care.

Intra-articular Soft Tissue Pathology of the Postpartum Hip: A Systematic Review.

Purpose Of Review: Pregnancy-related lumbopelvic and hip pain affects over half of postpartum females and has multiple aetiologies. The relative contribution of intra-articular soft tissue pathology to pregnancy-related hip pain is unknown. The current review investigates the available evidence regarding underlying intra-articular soft tissue aetiologies of hip pain in females during pregnancy and in the acute postpartum period.

Early Investigation and Bracing in DDH Impacts Maternal Wellbeing and Breastfeeding.

Background: The outcomes of Pavlik Harness (PH) management for Developmental Dysplasia of the Hip (DDH) are equivalent regardless of the initiation timing, if it is within the first 6 weeks of life. A PH may be a physical barrier to breastfeeding, which is important for nutrition, immunity, and normal child development. The diagnosis of DDH and early management with a PH may also negatively affect the maternal psychosocial wellbeing and the infant-maternal relationship.

Inpatient virtual shared medical appointments to improve health literacy, increase patient self-efficacy, and reduce provider burnout in acute cerebrovascular pathology patients and their caregivers: a pilot study.

Objective: Admission to the hospital for an acute cerebrovascular condition such as stroke or brain hemorrhage can be a traumatic and disorienting experience for patients and their family members. The COVID-19 pandemic has further intensified this experience in addition to exacerbating clinician and resident burnout. To ameliorate some of these concerns, a team of resident and medical student trainees implemented a virtual shared medical appointment (vSMA) program for inpatients with acute cerebrovascular disorders and their caregivers.

Rationale and Methods for Updated Guidelines for the Management of Penetrating Traumatic Brain Injury.

Penetrating traumatic brain injury (pTBI) affects civilian and military populations resulting in significant morbidity, mortality, and healthcare costs. No up-to-date and evidence-based guidelines exist to assist modern medical and surgical management of these complex injuries. A preliminary literature search revealed a need for updated guidelines, supported by the Brain Trauma Foundation.

Phytotoxicity of particulate matter from controlled burning of different plastic waste types.

According to careful estimations, open burning of plastic waste affects app. 2 billion people worldwide. While human health risks have become more and more obvious, much less information is available on the phytotoxicity of these emissions.

Variant-driven early warning via unsupervised machine learning analysis of spike protein mutations for COVID-19.

Never before such a vast amount of data, including genome sequencing, has been collected for any viral pandemic than for the current case of COVID-19. This offers the possibility to trace the virus evolution and to assess the role mutations play in its spread within the population, in real time. To this end, we focused on the Spike protein for its central role in mediating viral outbreak and replication in host cells.

Ecotoxic emissions generated by illegal burning of household waste.

The practice of burning household waste including different types of plastic is illegal in Hungary, still an existing problem. As environmental consequences are hardly known, this study attempts to give an initial estimation of the ecotoxicity generated during controlled combustion of different waste types. These samples included polystyrene (PS), polyethylene (PE), polypropylene (PP), polyvinyl chloride (PVC), polyurethane (PU), oriented strand board (OSB) and rag (RAG).