Disparities in Evaluation, Treatment, and Outcomes of Pediatric Knee Injuries.

Similar to other fields, there is growing evidence of disparities in pediatric sports medicine. For children and adolescents with knee injuries, disparities persist along the lines of sex, gender, race, ethnicity, insurance, socioeconomic status, and other determinants. These factors influence the evaluation, treatment, and outcomes for a variety of knee pathologies, including anterior cruciate ligament ruptures, meniscus tears, osteochondritis dissecans, cartilage injuries, and tibial spine fractures.

Evaluation of Tibial Slope on Radiographs in Pediatric Patients With Tibial Spine Fractures: An Age- and Sex-Matched Study.

Background: A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls.

Purpose: (1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients.

Targeting notch-related lncRNAs in cancer: Insights into molecular regulation and therapeutic potential.

Cancer is a group of diseases marked by unchecked cell proliferation and the ability for the disease to metastasize to different body areas. Enhancements in treatment and early detection are crucial for improved outcomes. LncRNAs are RNA molecules that encode proteins and have a length of more than 200 nucleotides.

Unlocking the secrets: Volatile Organic Compounds (VOCs) and their devastating effects on lung cancer.

Lung cancer (LCs) is still a serious health problem globally, with many incidences attributed to environmental triggers such as Volatile Organic Compounds (VOCs). VOCs are a broad class of compounds that can be released via various sources, including industrial operations, automobile emissions, and indoor air pollution. VOC exposure has been linked to an elevated risk of lung cancer via multiple routes.

Anterior Displacement of Tibial Spine Fractures: Does Anatomic Reduction Matter?

Background: Operative treatment of displaced tibial spine fractures consists of fixation and reduction of the fragment in addition to restoring tension of the anterior cruciate ligament.

Purpose: To determine whether residual displacement of the anterior portion of a tibial spine fragment affects the range of motion (ROM) or laxity in operatively and nonoperatively treated patients.

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

Trust and Regulation: Assuring Scientific Independence in the FDA's Emergency Use Authorization Process.

Since 2004, the US Food and Drug Administration (FDA) has had the authority to allow access to unapproved medical products via the Emergency Use Authorization (EUA) pathway during times of emergency. It was rarely used until the COVID-19 pandemic, when concerns arose regarding the role of political pressure in the FDA's issuance of some EUAs, such as for hydroxychloroquine. Although US government officials should be responsive to the public, democratic accountability must be balanced against the need for thoughtful science-based decision-making.

On the Rise: The Increasing Frequency of Pediatric Shoulder Stabilization Surgery in Children and Adolescents.

The management of shoulder instability in children and adolescents continues to evolve. The purpose of this study was to evaluate the epidemiology of shoulder stabilization procedures in a large, nationally representative pediatric population. The Pediatric Health Information System (PHIS) database was queried for patients 18 years and younger undergoing surgical shoulder stabilization between 2008 and 2017.

Resident muscle stem cell myogenic characteristics in postnatal muscle growth impairments in children with cerebral palsy.

Children with cerebral palsy (CP), a perinatal brain alteration, have impaired postnatal muscle growth, with some muscles developing contractures. Functionally, children are either able to walk or primarily use wheelchairs. Satellite cells are muscle stem cells (MuSCs) required for postnatal development and source of myonuclei.

Using Multiple Authorized Generics to Maintain High Prices: The Example of Entacapone.

Objectives: Brand-name drug manufacturers can market or license authorized generics (AGs), which are the same product sold under a generic name. By contrast, independent generics (IGs) are made by other manufacturers. The brand-name manufacturer of entacapone, a treatment for Parkinson's disease, established 4 AGs before IGs emerged.

The Impact of Race, Insurance, and Socioeconomic Factors on Pediatric Knee Injuries.

Disparities persist in pediatric sports medicine along the lines of race, ethnicity, insurance status, and other demographic factors. In the context of knee injuries such as anterior cruciate ligament (ACL) ruptures, meniscus tears, and tibial spine fractures, these inequalities affect evaluation, treatment, and outcomes. The long-term effects can be far-reaching, including sports and physical activity participation, comorbid chronic disease, and socio-emotional health.

Sex and Gender Differences in Pediatric Knee Injuries.

The participation of females in sports has increased significantly since the passage of Title IX. Sports participation may place young athletes at risk for knee injuries, including patellofemoral pain syndrome (PFPS), osteochondritis dissecans (OCD), and anterior cruciate ligament (ACL) rupture. Differences in anatomy, hormone production, and neuromuscular patterns between female and male athletes can contribute to disparities in knee injury rates with female athletes more vulnerable to PFPS and ACL injury.

Are Neighborhood Conditions Associated With Surgical Delays and Meniscus Tears in Children and Adolescents Undergoing ACL Reconstruction?

Background: Markers of a patient's social determinants of health, including healthcare insurance and median household income based on ZIP Code, have been associated with the interval between injury and ACL reconstruction (ACLR) as well as the presence of concomitant meniscus tears in children and adolescents. However, the aforementioned surrogate indicators of a patient's social determinants of health may not reflect all socioeconomic and healthcare resources affecting the care of ACL injuries in children and adolescents. The use of multivariate indices such as the Child Opportunity Index (COI) may help to better identify patients at risk for increased risk for delay between ACL injury and surgery, as well as the incidence of meniscus tears at the time of surgery.

Is Preferred Language Other Than English Associated With Delayed Surgery After ACL Injury in Children and Adolescents?

Background: Previous studies have investigated the impact of social determinants of health, such as the type of healthcare insurance and household income, on children and adolescents with ACL tears. However, despite the increasing incidence of ACL injury in young patients and a substantial proportion of families who may prefer languages other than English, the relationship between language and clinical care remains unclear.

Questions/purposes: To investigate the relationship between language and the care of children and adolescents with ACL tears, we asked: (1) Is a preferred language other than English (PLOE) associated with a delay between ACL injury and surgery? (2) Is a PLOE associated with a greater odds of a patient experiencing a meniscal tear and undergoing a meniscectomy than in those who prefer English?

Methods: We treated 591 patients surgically for ACL injuries between 2011 and 2021.

Reoperation After Osteochondral Autograft and Allograft Transfer in the Pediatric Knee.

Osteochondral autograft (OAU) transfer and osteochondral allograft (OAL) transfer are options for treating sizable articular cartilage lesions in the knee, but there is little evidence to support one technique over another. The goal of this study is to compare the rate of reoperation among children and adolescents undergoing OAU or OAL of the knee. In this retrospective cohort study, the Pediatric Health Information System, a national database consisting of 49 children's hospitals, was queried for all patients undergoing OAU and OAL between 2012 and 2018.

Interobserver and Intraobserver Agreement are Unsatisfactory When Determining Abstract Study Design and Level of Evidence.

Background: Understanding differences between types of study design (SD) and level of evidence (LOE) are important when selecting research for presentation or publication and determining its potential clinical impact. The purpose of this study was to evaluate interobserver and intraobserver reliability when assigning LOE and SD as well as quantify the impact of a commonly used reference aid on these assessments.

Methods: Thirty-six accepted abstracts from the Pediatric Orthopaedic Society of North America (POSNA) 2021 annual meeting were selected for this study.

Trends in Anterolateral Ligament Reconstruction and Lateral Extra-articular Tenodesis With ACL Reconstruction in Children and Adolescents.

Background: Anterolateral ligament reconstruction (ALLR) and lateral extra-articular tenodesis (LET) show promise in lowering the risk of rerupture after anterior cruciate ligament reconstruction (ACLR), but there are little data on surgeon practices and preferences in children and adolescents.

Purpose: To quantify surgeon practices regarding ALLR and LET in the pediatric population.

Study Design: Cross-sectional study.

Timeout? The Epidemiology of Pediatric Sports Injuries During the COVID-19 Pandemic.

Background: The COVID-19 pandemic resulted in closure of schools and playgrounds while requiring social distancing, changes that likely affected youth sports participation. The purpose of this study was to identify changes in the epidemiology of pediatric sports injuries during the COVID-19 pandemic.

Methods: This retrospective cohort study included patients between the ages of 4 and 18 years who presented to orthopaedic clinics within a single children's hospital network with an acute injury sustained during athletic activity between March 20, 2020, and June 3, 2020 (the strictest period of state-level shelter-in-place orders).

A Multicenter Comparison of Open Versus Arthroscopic Fixation for Pediatric Tibial Spine Fractures.

Background: When operative treatment is indicated, tibial spine fractures can be successfully managed with open or arthroscopic reduction and internal fixation (ARIF). The purpose of the study is to evaluate short-term treatment outcomes of tibial spine fractures in patients treated with both open and arthroscopic fracture reduction.

Methods: We performed an Institutional Review Board (IRB)-approved retrospective cohort study of pediatric tibial spine fractures presenting between January 1, 2000 and January 31, 2019 at 10 institutions.

The $5 Billion Hop: Glatiramer Acetate and the US Patent System.

New research and a government investigation have shed light on an anticompetitive practice called "Product Hopping" and specifically how it was employed in the case of the multiple sclerosis treatment glatiramer acetate beginning in 2014, which cost payers billions of dollars. We examine this case as well as a separate, impending instance of product hopping.