Ecological momentary assessment of sleep, pain, and opioid use among adolescents following surgery.

Background: Opioids are effective for acute pain management following surgery among adolescents, yet are associated with significant negative consequences, including respiratory depression and opioid misuse. Sleep deficiency is common following surgery and extant research indicates strong cross-sectional associations between sleep deficiency and increased problematic opioid use.

Objective: This study examined longitudinal associations between postsurgical sleep deficiency and opioid use among adolescents undergoing outpatient surgery.

Minimal differences in acute postoperative pain after anterior cruciate ligament reconstruction with quadriceps versus hamstring autograft.

Studies are lacking that evaluate early postoperative pain after all-soft-tissue quadriceps tendon anterior cruciate ligament reconstruction (ACLR), particularly in young patients. The purpose of this study was to investigate differences in early postoperative pain between adolescent patients undergoing ACLR with quadriceps tendon versus hamstring autograft. A retrospective review was performed of 60 patients (mean age, 15.

Effect of Increased Time to Surgery on the Ability of MRI to Rule Out Medial Meniscal Tears in Young Athletes With ACL Injury.

Background: The prevalence of meniscal tears in patients with anterior cruciate ligament (ACL) injury increases with extended time between injury and ACL reconstruction.

Purpose/hypothesis: The purpose of this study was to determine if there is a relationship between time from magnetic resonance imaging (MRI) to ACL reconstruction and the predictive value of MRI to diagnose meniscal tears in the young active population. It was hypothesized that increased time between MRI and ACL reconstruction would lead to a decrease in the negative predictive value of MRI in diagnosing meniscal tears, as more injuries may accrue over time in the ACL-deficient knee.

Effect of Delayed Anterior Cruciate Ligament Reconstruction on Repair of Concomitant Medial Meniscus Tears in Young Athletes.

Background: Delayed anterior cruciate ligament (ACL) reconstruction (ACLR) is associated with an increased risk of meniscal injury. Limited data are available regarding the relationship between surgical delay and meniscal repairability in the setting of ACLR in young patients.

Purpose: To determine whether time from ACL injury to primary ACLR was associated with the incidence of medial and/or lateral meniscal repair in young athletes who underwent meniscal treatment at the time of ACLR.

Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention.

Background: Softball pitchers exhibit high throwing shoulder distraction force, which is a theorized mechanism of throwing shoulder overuse injury. Windmill pitching involves a variety of highly individualistic pitching styles, and certain kinematics preceding ball release likely influence the amount of shoulder stress that a pitcher accrues.

Purpose: To examine the association of trunk and throwing arm kinematics, kinetics, and timing variables with peak throwing shoulder distraction force in high school softball pitchers.

Decreased Shoulder and Elbow Joint Loads During the Changeup Compared With the Fastball and Curveball in NCAA Division I Collegiate Softball Pitchers.

Background: Baseball leagues have implemented pitch count and pitch type restrictions based on biomechanical concepts associated with pitch type. Softball has not yet adopted these practices, although softball pitchers continue to pitch at a high volume and learn multiple pitches at a young age.

Purpose: To examine shoulder and elbow kinetics between the fastball, curveball, and changeup, as well as to provide descriptive upper extremity pain data in National Collegiate Athletic Association (NCAA) softball pitchers.

Successful Outcomes and Return to Sport After Arthroscopic Bankart Repair in National Collegiate Athletic Association and National Football League Football Players.

Objective: To characterize recurrent instability, return to sport (RTS), and patient-reported outcomes (PROs) after arthroscopic Bankart repair for acute traumatic anterior shoulder instability in National Collegiate Athletic Association (NCAA) and National Football League (NFL) football players.

Design: Case series.

Setting: Orthopaedic and sports medicine clinic.

Increased Upper Arm Length and Loading Rate Identified as Potential Risk Factors for Injury in Youth Baseball Pitchers.

Background: In the throwing elbow, increased elbow torque has been correlated with increased injury risk. Additional insight into the relationships between anthropometric factors and elbow joint loading is warranted.

Purpose: To investigate the relationship among physical limb length characteristics, elbow kinetics, and elbow kinematics in youth baseball pitchers and to examine the relationship between elbow varus loading rate and elbow kinetics.

Association Between 45° Flexion Anteroposterior Elbow Radiographs and Diagnostic Accuracy of Capitellum Osteochondritis Dissecans.

Background: An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD).

Purpose: To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP).

Study Design: Cohort study (Diagnosis); Level of evidence, 3.

Prevalence and Severity of Juvenile Osteochondritis Dissecans in Patients With Juvenile Idiopathic Arthritis.

Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of chronic arthritides presenting in patients aged ≤16 years, with a prevalence of 16 to 150 per 100,000. Juvenile osteochondritis dissecans (OCD) is an idiopathic disease of articular cartilage and subchondral bone, has an onset age of 10 to 16 years, and often affects the knee, with a prevalence of 2 to 18 per 100,000. Currently, there are few studies that have evaluated the relationship between JIA and OCD.

Postoperative Management Following Arthroscopic Bankart Repair in Adolescents and Young Adults: A Systematic Review.

Purpose: The purpose of this study was to review systematically the literature concerning postoperative management following arthroscopic Bankart repair for traumatic anterior shoulder instability in adolescent and young adult (≤ 25 years) athletes.

Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL), and Google Scholar databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting postoperative rehabilitation guidelines following arthroscopic Bankart repair in the adolescent and young adult population. The Methodological Index for Nonrandomized Studies instrument and Modified Coleman Methodology Score were used for quality assessment of the included studies.

Biceps Tendon Changes and Pitching Mechanics in Youth Softball Pitchers.

With the lack of pitch count regulation, youth softball pitchers are experiencing unremitting high stresses on the anterior shoulder. The purpose of this study was to examine the association of acute changes in the long head of the biceps tendon with pitching kinematics and kinetics in youth softball pitchers following an acute bout of pitching. Twenty-three softball pitchers (12.

Fresh Precut Osteochondral Allograft Core Transplantation for the Treatment of Capitellum Osteochondritis Dissecans.

Osteochondritis dissecans (OCD) of the elbow is a disease of unclear etiology that affects young children and adolescents, particularly overhead athletes and gymnasts. Common surgical options include fixation, debridement, loose body removal, and marrow stimulation (microfracture/drilling). For large, deep, and/or uncontained defects, osteochondral autograft transplantation (OAT) has been advocated.

Sex-Based Differences in Anterior Cruciate Ligament Injuries Among United States High School Soccer Players: An Epidemiological Study.

Background: Anterior cruciate ligament (ACL) tears are common among high school athletes, with sex-based differences accounting for higher injury rates in girls. Previous epidemiological studies on ACL injuries focusing on adolescent athletes have looked at injuries across multiple sports, but few have analyzed ACL tears in solely high school soccer athletes.

Purpose: To examine sex-based differences in the epidemiology of ACL injuries among high school soccer players in the United States (US).

Arthroscopic Suture Fixation of Comminuted Tibial Eminence Fractures: Hybrid All-Epiphyseal Bone Tunnel and Knotless Anchor Technique.

Tibial eminence fractures most commonly occur in young children and adolescents with open physes. Displaced fractures are typically treated with surgical reduction and fixation. Multiple arthroscopic techniques and fixation constructs have been described.

Clinical Outcome After Lateral Ulnar Collateral Ligament Reconstruction in an Adolescent Baseball Player: A Case Report.

Lateral ulnar collateral ligament (LUCL) reconstruction is a commonly used surgical procedure to treat posterolateral rotatory instability (PLRI) of the elbow. We report a 17-year-old right-handed pitcher with symptomatic PLRI after an injury to his LUCL during a baseball game. Having failed 8 months of conservative treatment, a LUCL reconstruction using the modified O'Driscoll technique was performed with the contralateral gracilis autograft.

High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: a systematic review.

Importance: Traumatic anterior shoulder instability remains common for the adolescent athletes.

Aim Or Objective: To perform a systematic review on the outcomes and return to sport (RTS) following Bankart repair in adolescent athletes.

Evidence Review: A systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines was conducted of studies reporting outcomes following open and/or arthroscopic Bankart repair using modern suture anchors following traumatic anterior shoulder dislocations in adolescent patients (ages 10-19 years).

Return-to-Sport Testing After Medial Patellofemoral Ligament Reconstruction in Adolescent Athletes.

Background: Return to sport (RTS) after patellar stabilization surgery involves the return of strength and dynamic knee stability, which can be assessed using isometric strength and functional performance testing.

Purpose: To investigate the results of isometric strength and functional RTS testing between the surgical and uninvolved limbs in adolescent patients who underwent medial patellofemoral ligament (MPFL) reconstruction for patellar instability.

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

Quadriceps Tendon Autograft Anterior Cruciate Ligament Reconstruction With Independent Suture Tape Reinforcement.

Anterior cruciate ligament (ACL) injuries are common among adolescent athletes and are rising with increased participation in higher level athletics at earlier ages. In these young patients, often with open physes, soft tissue grafts continue to be the primary graft choice for ACL reconstruction. Reinjury continues to be a concern in this high-risk age group, with failure rates 2 to 3 times higher than in adults.

PITCHING MECHANICS IN FEMALE YOUTH FASTPITCH SOFTBALL.

Background: Fastpitch softball is a popular sport for young females. However, data are limited describing youth pitching mechanics. Normative data describing pitching mechanics in the two youngest player pitch leagues are critical to gaining an improved understanding of proper mechanics in an attempt to establish injury prevention programs.

Differences in Segmental Speeds as a Function of Maturation in Youth Baseball Pitchers.

The purpose of this study was to determine how stride length, segmental sequencing of the pelvis, trunk, humerus, and forearm velocities and accelerations, and the timing of these values change as youth mature. Thirteen youth baseball pitchers participated at three consecutive time points: visit 1 (10.7±1.

Variability of Outcome Reporting Following Arthroscopic Bankart Repair in Adolescent Athletes: A Systematic Review.

Purpose: To conduct a systematic review of the literature to assess the variability of the reporting of outcome measures after arthroscopic Bankart repair for traumatic anterior shoulder instability in the adolescent population.

Methods: A systematic review was conducted investigating all studies reporting outcomes after arthroscopic Bankart repair in the adolescent population. Four databases (Medline, EMBASE, Ovid, and Google Scholar) were screened for clinical studies involving the arthroscopic management of anterior shoulder instability in adolescents.

Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015.

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies.

Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States.

A Modified Osteotomy for Anteromedialization of the Tibial Tubercle.

Tibial tubercle osteotomy is a common treatment option for a number of patellofemoral joint disorders including chondromalacia, "anterior knee pain" syndromes, patellofemoral arthritis, and patellar instability. Tibial tubercle osteotomy can modify tracking and/or patellofemoral contact forces to effect the unloading of chondral defects of the patella or trochlea, correct multiplanar suboptimal alignment, and be used in conjunction with soft-tissue stabilization procedures for instability. The purpose of this Technical Note is to describe, in detail, a modified osteotomy for anteromedialization of the tibial tubercle.