Publications by authors named "Lyle Micheli"
Article Synopsis
- Research indicates a higher prevalence of upper lumbar spondylolysis in young athletes than previously thought, highlighting a lack of sport-specific studies on this condition.
- The study aimed to identify risk factors associated with upper lumbar stress injuries in pediatric and adolescent athletes by reviewing medical records from two academic centers.
- Results showed that the majority of diagnosed athletes had lower level injuries, while a smaller percentage experienced upper level injuries, which were linked to being older at diagnosis and shorter durations of low back pain.
Article Synopsis
- The study investigates the link between psychological readiness and physical recovery in patients who have undergone ACL reconstruction, noting that this relationship is not well understood.
- Researchers hypothesized that patients with greater psychological readiness would perform better in functional tests six months post-surgery.
- Their findings showed significant correlations between psychological readiness measures (like the ACL-RSI scale) and physical performance metrics, indicating that those who felt more psychologically prepared were likely to have better functional outcomes.
Background: Bridge-enhanced anterior cruciate ligament restoration (BEAR) combines suture repair of the anterior cruciate ligament (ACL) with an extracellular matrix implant plus autologous blood to facilitate native ACL healing.
Purpose/hypothesis: The purpose of this study was to compare the 6-year follow-up outcomes of patients who underwent the BEAR procedure with those of a nonrandomized concurrent control group receiving autograft ACL reconstruction (ACLR) in the first-in-human safety study of the BEAR implant (BEAR I trial). Based on the 2-year results, it was hypothesized that isometric hamstring strength after the BEAR procedure would be greater than that after ACLR and that there would be no other differences in outcomes at 6 years.
Purpose: To examine age- and sex-related differences in postoperative functional outcomes at approximately 6 months after anterior cruciate ligament reconstruction (ACLR).
Methods: In this study, patients who underwent primary ACLR performed a series of return-to-sport functional tests at 5 to 8 months after surgery. Functional tests included strength tests (knee extensors, knee flexors, hip abductors, and hip extensors), a balance test (Y-balance composite score), and hop tests (single, triple, crossover, and 6-m timed hop tests).
Article Synopsis
- The accessory navicular (AN) is a foot condition affecting 4% to 21% of people, where most don't experience symptoms, but those who do, particularly children, can suffer a decreased quality of life.
- This study involved 298 patients under 19 who underwent surgery after failing nonoperative treatments, with a median time to surgical intervention of 5.2 months.
- Factors linked to the failure of nonoperative management included older age, activity limitations, being female, higher BMI, right-side AN, and MRI findings like bone marrow edema, while most surgical patients reported pain relief and return to sports post-surgery.
Background: The rate of concomitant meniscal procedures performed in conjunction with anterior cruciate ligament (ACL) reconstruction is increasing. Few studies have examined these procedures in high-risk pediatric cohorts.
Hypotheses: That (1) the rates of meniscal repair compared with meniscectomy would increase throughout the study period and (2) patient-related factors would be able to predict the type of meniscal operation, which would differ according to age.
Prevalence and Predictors of Concomitant Meniscal and Ligamentous Injuries Associated With ACL Surgery: An Analysis of 20 Years of ACL Reconstruction at a Tertiary Care Children's Hospital.
Am J Sports Med
January 2024
Background: There is an increasing rate of procedures being performed for concomitant injuries during anterior cruciate ligament (ACL) surgery. Few studies have examined risk factors for these associated injuries in young patients.
Hypothesis: There are patient-related factors predictive of concomitant knee pathology that differ between age-based cohorts.
Introduction: Popliteal artery entrapment syndrome (PAES) is a rare condition in which the popliteal artery becomes compressed by adjacent soft tissue structures causing progressive claudication. Due to its low incidence, this disorder and its surgical management is poorly described in the literature. This study presents our institutional data surrounding PAES management to further optimize care of this syndrome.
View Article and Find Full Text PDFThis study compared lower extremity (LE) muscular strength by 3 groups of female athletes using chronological age and consideration of age of peak height velocity (PHV). Isometric quadriceps, hamstrings, and hip abductors strength were assessed from physically active, pediatric females. The body mass normalized isometric strength (N m/kg) was compared by the 3 age groups.
View Article and Find Full Text PDFBackground: Radiographic measurements of limb alignment in skeletally immature patients with anterior cruciate ligament (ACL) tears are frequently used for surgical decision-making, preoperative planning, and postoperative monitoring of skeletal growth. However, the interrater and intrarater reliability of these radiographic characteristics in this patient population is not well documented.
Hypothesis: Excellent reliability across 4 raters will be demonstrated for all digital measures of length, coronal plane joint orientation angles, mechanical axis, and tibial slope in skeletally immature patients with ACL tears.
Background: Successful return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR) can be affected by a patient's physical and psychological state throughout the rehabilitation process.
Purpose: To prospectively compare differences in patients at 6 months after primary ACLR with the ACL-Return to Sport after Injury (ACL-RSI), International Knee Documentation Committee (IKDC) or pediatric (Pedi)-IKDC, Hospital for Special Surgery Pediatric Functional Activity Brief Scale (Pedi-FABS), and Patient-Reported Outcomes Measurement Information System-Psychological Stress Experiences (PROMIS-PSE) scores.
Study Design: Prospective cohort study; Level of evidence, 2.
Significance: Quantitative measurement of perisurgical brain function may provide insights into the processes contributing to acute and chronic postsurgical pain.
Aim: We evaluate the hemodynamic changes in the prefrontal cortex (medial frontopolar cortex/mFPC and lateral prefrontal cortex) and the primary somatosensory cortex/S1 using functional near-infrared spectroscopy (fNIRS) in 18 patients ( years, 11 females) undergoing knee arthroscopy.
Approach: We examined the (a) hemodynamic response to surgery and (b) the relationship between surgery-modulated cortical connectivity (using beta-series correlation) and acute postoperative pain levels using Pearson's correlation with 10,000 permutations.
Article Synopsis
- The study aimed to assess whether using bone stimulation after surgery would enhance healing in pediatric patients with stable osteochondritis dissecans (OCD) of the knee.
- It was a matched case-control study at a pediatric hospital, comparing two groups: those who received postoperative bone stimulation and those who did not, with outcomes measured via MRI after three months.
- The results showed no significant difference in healing rates between the two groups, indicating that bone stimulation did not provide additional benefits in the healing process.
Background: Quantitative magnetic resonance imaging (qMRI) methods were developed to establish the integrity of healing anterior cruciate ligaments (ACLs) and grafts. Whether qMRI variables predict risk of reinjury is unknown.
Purpose: To determine if qMRI measures at 6 to 9 months after bridge-enhanced ACL restoration (BEAR) can predict the risk of revision surgery within 2 years of the index procedure.
Background: Anterior cruciate ligament (ACL) revision surgery is challenging for both patients and surgeons. Understanding the risk factors for failure after bridge-enhanced ACL restoration (BEAR) may help with patient selection for ACL restoration versus ACL reconstruction.
Purpose: To identify the preoperative risk factors for ACL revision surgery within the first 2 years after BEAR.
Background: The cross-sectional area (CSA) of the anterior cruciate ligament (ACL) and reconstructed graft has direct implications on its strength and knee function. Little is known regarding how the CSA changes along the ligament length and how those changes vary between treated and native ligaments over time.
Hypothesis: It was hypothesized that (1) the CSA of reconstructed ACLs and restored ACLs via bridge-enhanced ACL restoration (BEAR) is heterogeneous along the length.
Purpose: The purpose of this study was to evaluate the physical and psychological effects of COVID-related elective surgery delays on young sports medicine patients.
Methods: We conducted a cross-sectional study of patients (10-25 years old) who had elective sports medicine surgery delayed due to the COVID crisis. Electronic surveys were sent to patients and included the 12-item Short Form Health Survey (SF-12), which yields a physical component score (SF12-PCS) and a mental component score (SF12-MCS), the PROMIS Psychological Stress Experience survey (PROMIS-PSE), and self-designed questions about patient concerns regarding the COVID crisis and delayed surgery.
In order to examine the role of orthopedics in child development, longitudinal study designs are necessary [...
View Article and Find Full Text PDFBackground: Patellofemoral instability (PFI) occurs most commonly in pediatric and adolescent patients, with evolving indications for surgery and changes in surgical techniques over the past decade.
Purpose: To characterize the demographic, clinical, and radiologic characteristics of a large cohort of patients undergoing PFI surgery and investigate longitudinal trends in techniques utilized over a 10-year period at a tertiary-care academic center.
Study Design: Case series; Level of evidence, 4.
Introduction: Functional near-infrared spectroscopy (fNIRS) allows for ongoing measures of brain functions during surgery. The ability to evaluate cumulative effects of painful/nociceptive events under general anesthesia remains a challenge. Through observing signal differences and setting boundaries for when observed events are known to produce pain/nociception, a program can trigger when the concentration of oxygenated hemoglobin goes beyond ±0.
View Article and Find Full Text PDFBackground: Previous clinical studies have shown that psychological factors have significant effects on an athlete's readiness to return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR).
Hypothesis: We hypothesized that patients who underwent bridge-enhanced ACL restoration (BEAR) would have higher levels of psychological readiness to return to sport compared with patients who underwent ACLR.
Study Design: Randomized controlled trial; Level of evidence, 1.
: Functional near-infrared spectroscopy (fNIRS) has evaluated pain in awake and anesthetized states. : We evaluated fNIRS signals under general anesthesia in patients undergoing knee surgery for anterior cruciate ligament repair. : Patients were split into groups: those with regional nerve block (NB) and those without (non-NB).
View Article and Find Full Text PDFBackground: Little is known about sex-based differences in anterior cruciate ligament (ACL) tissue quality in vivo or the association of ACL size (ie, volume) and tissue quality (ie, normalized signal intensity on magnetic resonance imaging [MRI]) with knee anatomy.
Hypothesis: We hypothesized that (1) women have smaller ACLs and greater ACL normalized signal intensity compared with men, and (2) ACL size and normalized signal intensity are associated with age, activity levels, body mass index (BMI), bicondylar width, intercondylar notch width, and posterior slope of the lateral tibial plateau.
Study Design: Cross-sectional study; Level of evidence, 3.
Background: Differences in postoperative recovery after anterior cruciate ligament reconstruction (ACLR) between men and women have been demonstrated in the adult population. Sex-based differences have been incompletely investigated in adolescents, which represent the subpopulation most affected by ACL injury.
Purpose/hypothesis: The purpose of this study was to compare the 6-month postoperative functional recovery after ACLR between adolescent boys and girls.
Background: Bridge-enhanced anterior cruciate ligament repair (BEAR) has noninferior patient-reported outcomes when compared with autograft anterior cruciate ligament reconstruction (ACLR) at 2 years. However, the comparison of BEAR and autograft ACLR at earlier time points-including important outcomes such as resolution of knee pain and symptoms, recovery of strength, and return to sport-has not yet been reported.
Hypothesis: It was hypothesized that the BEAR group would have higher outcomes on the International Knee Documentation Committee and Knee injury and Osteoarthritis Outcome Score, as well as improved muscle strength, in the early postoperative period.