Efficacy of a high-intensity home stretching device and traditional physical therapy in non-operative management of adhesive capsulitis - a prospective, randomized control trial.

Background: Historically, in-person physical therapy serves as a foundational component of nonoperative treatment of adhesive capsulitis (AC). This study compares the effectiveness of an at-home high-intensity stretch (HIS) device to traditional physical therapy (PT) and to PT in combination with the HIS device. We hypothesize that the HIS device will be as effective as PT alone or as combination therapy in the first-line treatment of AC and use of the HIS device will exhibit improvement at higher rate.

Is Edema at the Posterior Medial Tibial Plateau Indicative of a Ramp Lesion? An Examination of 307 Patients With Anterior Cruciate Ligament Reconstruction and Medial Meniscal Tears.

Background: Medial meniscal tears are commonly seen during anterior cruciate ligament reconstruction (ACLR). A subset of these injuries includes posterior meniscocapsular junction or "ramp" tears. One criterion that may correlate with a ramp lesion is the presence of posterior medial tibial plateau (PMTP) edema.

Relationship Between Deltoid and Rotator Cuff Muscles During Dynamic Shoulder Abduction: A Biomechanical Study of Rotator Cuff Tear Progression.

Background: Previous biomechanical studies regarding deltoid function during glenohumeral abduction have primarily used static testing protocols.

Hypotheses: (1) Deltoid forces required for scapular plane abduction increase as simulated rotator cuff tears become larger, and (2) maximal abduction decreases despite increased deltoid forces.

Study Design: Controlled laboratory study.

Anatomic Repair of Posteromedial Meniscocapsular Separation Using an All-Inside Technique.

Separation of the posteromedial meniscocapsular junction (PMC) is a unique injury seen in patients with disruption of the anterior cruciate ligament. PMC tears may go unrecognized despite preoperative magnetic resonance imaging and diagnostic arthroscopy of the medial compartment. Unrepaired lesions may lead to persistent laxity of the knee after anterior cruciate ligament reconstruction.

Does Knowledge of Implant Cost Affect Fixation Method Choice in the Management of Stable Intertrochanteric Hip Fractures?

We conducted a study to determine if knowledge of implant cost affects fixation method choice in the management of stable intertrochanteric hip fractures. We retrospectively reviewed the cases of 119 patients treated with a sliding hip screw (SHS; Versafix), a short Gamma nail (SGN), or a long Gamma nail (LGN). Of the 119 fractures, 71 were treated before implant costs were revealed, and 48 afterward.

Novel case of Trevor's disease: Adult onset and later recurrence.

Dysplasia epiphysealis hemimelica (DEH), or Trevor's disease, is an osteocartilaginous epiphyseal overgrowth typically occurring in children. The literature reports 6 adult cases and none describe recurrence requiring additional procedures. We present a new-onset proximal tibial DEH in an adult recurring approximately 3 years after open excision.

Mini-Medical School Programs' Influence on Students' Desire to Pursue Medicine.

Purpose: Mini-Medical school programs have become an increasingly popular means of encouraging high-school students to consider medical professions. However, there is little research evaluating the long-term effect of these programs on influencing career choice. The purpose of our study was to determine the motivational factors for attending the Mini-Medical school programs at our institution, student satisfaction with their experience, and whether it impacts intended secondary education and career choices.

Medial epicondylitis: evaluation and management.

Medial epicondylitis, often referred to as "golfer's elbow," is a common pathology. Flexor-pronator tendon degeneration occurs with repetitive forced wrist extension and forearm supination during activities involving wrist flexion and forearm pronation. A staged process of pathologic change in the tendon can result in structural breakdown and irreparable fibrosis or calcification.

Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.

The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than one-third of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody.

On-field performance of national football league players after return from concussion.

Background: There are few data examining the short-term effects of concussions on player performance upon return to play. This study examined changes in on-field performance and the influence of epidemiologic factors on performance and return to play.

Hypothesis: On-field performance is different in players who return within 7 days after concussion compared with players who miss at least 1 game.

Subacute superior patellar pole sleeve fracture.

Patellar fractures are uncommon, representing 1% of pediatric fractures. Most of these injuries are sleeve avulsions of the inferior pole. Sleeve avulsion of the superior pole is rare, with only 14 cases reported in the English-language literature.

Is formal decompression necessary for parameniscal cysts associated with meniscal tears?

Background: Meniscal tears and associated parameniscal cysts have good outcomes after partial meniscectomy and cyst evacuation. Good outcomes have been noted after partial meniscectomy with recurrent cysts. This investigation asks if partial meniscectomy without meniscal cyst decompression is sufficient for positive patient outcome.

Diagnosis and treatment of triceps tendon injuries: a review of the literature.

Objective: To elucidate mechanism of injury, nonoperative protocols, surgical techniques, rehabilitation schedules, and return to sports guidelines for partial and complete triceps tendon injuries.

Data Sources: The PubMed and OVID databases were searched in 2010 and peer-reviewed English language articles in 2011.

Main Results: After a fall on an outstretched hand, direct trauma on the elbow, or lifting against resistance, patients often present with pain and weakness of extension.

How should unmatched orthopaedic surgery applicants proceed?

Background: Obtaining an orthopaedic surgery residency is competitive. Advisors must understand what factors may help unmatched candidates reapply successfully.

Questions/purposes: We determined (1) the attitude of leaders of orthopaedic surgery residency programs toward interviewing unmatched students; (2) whether a surgical internship or a research year is preferred in considering reapplicants; (3) the importance of United States Medical Licensing Examination (USMLE) scores, recommendations, and Alpha Omega Alpha (AOA) membership; and (4) whether academic and nonacademic programs evaluate reapplicants differently.

Does lateral release change patellofemoral forces and pressures?: a pilot study.

Background: One complication of TKA is postoperative anterior knee pain. Balancing retinacular tissue tension to improve patellar tracking is essential in preventing pain. Lateral release might help balance tension although the quantitative changes in patellofemoral force and pressure differentials after lateral release are unknown.

Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction.

Anterior shoulder surgery, using open or arthroscopic technique, places subcoracoid neurovasculature at risk. This study examines the relationships of the brachial plexus and axillary artery to four bony landmarks and provides clinical correlations for anterior shoulder surgery. The musculocutaneous nerve (MN), posterior cord (PC), lateral cord (LC), and axillary artery (AA) were identified in 27 shoulders.