How Canada's Black Hockey League Shaped the Sport and the Path to Our Arrival in the NHL Today.

Willie O'Ree, known as the "Jackie Robinson of hockey," was the first Black player in the National Hockey League (NHL), debuting with the Boston Bruins in 1958. From the moment the Canadian-born player stepped onto the ice, he changed the notion of hockey as a "White sport," and he has dedicated his career to making it more accessible, including working with the NHL Diversity Task Force initiative Hockey Is For Everyone (HIFE). HIFE supports nonprofit hockey programs around the country and gives kids from all backgrounds the opportunity to try out their skills on the ice.

Comprehensive Case-Based Review of Knee Ligament Injuries.

The management of knee ligament injuries continues to evolve, and much debate persists over the timing of surgery, repair versus reconstruction, surgical technique, postoperative rehabilitation, graft selection, and fixation. Surgeons should be aware of updates on the best management strategies of knee ligament injuries in 2018 and understand the important history and physical examination findings of the knee with ligamentous injury; the anterior cruciate ligament; the role of the anterolateral ligament and lateral extra-articular tenodesis; combined anterior cruciate ligament and medial collateral ligament injuries; the posterior cruciate ligament; medial collateral ligament repair versus reconstruction; posterolateral corner repair versus reconstruction; the role of coronal plane osteotomies, including high tibial osteotomy and distal femoral osteotomy; the role of sagittal plane osteotomies, including anterior closing wedge osteotomy and anterior opening wedge osteotomy; the initial management of the multiligament-injured knee; and five keys to avoiding complications in the multiligament-injured knee. The best available evidence and sample case presentations help guide surgical decision making and improve patient outcomes.

Anterior Cruciate Ligament Injuries in Professional Hockey Players.

Background: Performance outcomes and return-to-play data have been reported after anterior cruciate ligament (ACL) injuries in professional football and basketball, but they have rarely been reported in professional hockey.

Hypothesis: The hypothesis was that performance after ACL reconstruction would be comparable to prior levels of play in a series of National Hockey League (NHL) players.

Study Design: Case series; Level of evidence, 4.

Isolated fibular collateral ligament injuries in athletes.

Isolated injuries to the fibular collateral ligament (FCL) are rare. Although recent data suggest that operative and nonoperative treatment can both result in good functional outcomes, limited data exist on return to play for nonoperative treatment of FCL injuries and the value of magnetic resonance imaging in predicting prognosis. In this article, we present a review of the current literature and present a focused review regarding the diagnosis, treatment, and prognosis of FCL injuries, as well as the senior authors experience and a cohort of National Football League players.

Part I: An anatomic-based tunnel in the fibular head for posterolateral corner reconstruction using magnetic resonance imaging.

Purpose: Currently, there are no studies that clearly define a method for the placement of the fibular tunnel between the fibular collateral ligament (FCL) and popliteofibular ligament (PFL) insertions when performing an anatomic-based posterolateral corner reconstruction. The purpose of this study was to use magnetic resonance-based anatomic landmarks to describe the orientation of a fibular tunnel between the FCL and PFL insertions.

Methods: Magnetic resonance imaging (MRI) of 105 patients with normal posterolateral corner knee anatomy was identified by a musculoskeletal radiologist, and the FCL and popliteofibular insertions were labelled.

Patient-specific instrumentation and return to activities after unicondylar knee arthroplasty.

In the past decade, there has been a major increase in the use of unicompartmental knee arthroplasty (UKA) as surgical techniques have been refined and patient selection has improved. UKAs now account for 8% to 10% of knee arthoplasty procedures. Recent studies have suggested excellent medium- and long-term results of UKA.

Accuracy and reliability of determining the isometric point of the knee for multiligament knee reconstruction.

Purpose: To compare the accuracy and reliability of the anatomic and radiographic techniques for identifying the isometric point of the knee.

Methods: Only four specimens were used; however, eight experienced multiligament knee injury surgeons were recruited to address this limitation. Surgeons estimated the isometric point (EIP) on the medial and lateral sides using an anatomic and radiographic method.

Correlating MRI findings with disability in syndesmotic sprains of NFL players.

Background: Syndesmotic sprains may be a significant source of missed playing time, especially in football players. Advanced imaging is frequently used to confirm the clinical diagnosis. Our purpose was to evaluate the prognostic ability of MRI in predicting time of disability.

Autograft versus allograft: an economic cost comparison of anterior cruciate ligament reconstruction.

Purpose: The purpose of this study was to compare the costs associated with anterior cruciate ligament (ACL) reconstruction with either bone-patellar tendon-bone (BPTB) autograft or BPTB allograft.

Methods: Surgical costs are reported, including supply costs, based on invoice costs per item used per procedure, and personnel costs calculated as cost per minute. All operations were performed at an ambulatory surgery center between March 2005 and March 2006.

Management of complex knee ligament injuries.

The ideal management of the dislocated knee remains controversial. These injuries often can be elusive; a significant number of dislocated knees spontaneously reduce and appear relatively benign on routine radiographs. A high index of suspicion, based on the mechanism of injury, soft-tissue assessment of the limb, and the level of knee instability should alert the physician to the possibility of a dislocated knee.

Surgical treatment of acute and chronic anterior and posterior cruciate ligament and lateral side injuries of the knee.

Combined anterior cruciate ligament, posterior cruciate ligament, and lateral-sided injuries of the knee most often occurs secondary to a forced varus moment or after knee dislocation. Management controversies include the optimal timing of surgery, operative techniques, and postoperative rehabilitation. Recent systematic literature reviews have demonstrated higher rates of failure with repair of the lateral and posterolateral corner structures, as opposed to reconstruction.

Diagnosis and management of knee dislocations.

An acute knee dislocation is an uncommon injury, with a high rate of associated vascular and neurologic injuries as well as potentially limb-threatening complications. High-energy trauma is the most common cause of an acute knee dislocation, although lower-energy injuries, such as those sustained during athletic competition, are increasing in incidence. Injuries to the popliteal artery and common peroneal nerve are relatively common, requiring a high index of suspicion and complete neurovascular examination in a timely fashion.

Decision making in the multiligament-injured knee: an evidence-based systematic review.

Purpose: The purpose of this systematic review was to address the treatment of multiligament knee injuries, specifically (1) surgical versus nonoperative treatment, (2) repair versus reconstruction of injured ligamentous structures, and (3) early versus late surgery of damaged ligaments.

Methods: Two independent reviewers performed a search on PubMed from 1966 to August 2007 using the terms "knee dislocation," "multiple ligament-injured knee," and "multiligament knee reconstruction." Study inclusion criteria were (1) levels I to IV evidence, (2) "multiligament" defined as disruption of at least 2 of the 4 major knee ligaments, (3) measures of functional and clinical outcome, and (4) minimum of 12 months' follow-up, with a mean of at least 24 months.

Controversies in the treatment of knee dislocations and multiligament reconstruction.

A systematic approach to evaluation and treatment is needed for the patient with knee dislocation. There is a paucity of high-level evidence on which to base treatment decisions. Reported controversies related to the treatment of the multiligament-injured knee include the selective use of arteriography for vascular assessment, serial physical examination with the ankle-brachial index, acute surgical treatment of all damaged structures, the selective application of preoperative and postoperative joint-spanning external fixation, arthroscopic reconstruction of the anterior cruciate ligament and posterior cruciate ligament, simultaneous open reconstruction with repair of the posterolateral corner, reconstruction and/or repair of the posteromedial corner, and the use of allograft tissue.

Understanding the politics of being a team physician.

The team physician landscape is littered with political land mines. In the high-stakes world of professional sports, the politics of each encounter and medical decision--from figuring out how to get hired, to setting up a communication chain of command, to treating visiting players, to fending off the media--must be identified, assessed, and resolved. Key information must be communicated according to the expectations and unique personalities of each owner, general manager, coach, trainer, and athlete.

Bilateral anterior cruciate ligament reconstruction as a single procedure: evaluation of cost and early functional results.

Background: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial.

Purpose: To evaluate cost and early functional results after bilateral ACL reconstruction at a single setting.

Study Design: Retrospective review.