Publications by authors named "Robert Parisien"
Background: Mountain biking (MTB) is a quickly growing sport, with many athletes sustaining high-impact injuries. Current literature has not analyzed the most recent MTB-related national emergency department (ED) injury data.
Hypothesis: It was hypothesized that (1) the total number of injuries presenting to US EDs would significantly increase over the study period, (2) male patients would experience higher rates of shoulder injuries and airborne injury mechanisms than female patients, and (3) youths would present more frequently with injuries of the head and face than adults.
Background: Pickleball is one of the fastest-growing sports in the United States. It is popular among seniors but has recently grown across all age groups. As pickleball has gained interest, its corresponding injury burden has also increased.
View Article and Find Full Text PDFBackground: Anterior cruciate ligament (ACL) tears are frequent injuries in athletes that often require surgical reconstruction so that patients may return to their previous levels of performance. While existing data on patient-reported outcomes are similar between bone-patellar tendon-bone (BTB) and hamstring tendon (HT) autografts, the literature regarding return to sport (RTS), return to previous levels of sport activity, and graft failure rate remains limited.
Purpose: To compare rates of RTS, return to previous activity levels, and graft retears among athletes undergoing primary ACL reconstruction using a BTB versus HT autograft.
Background: Within the realm of orthopedic literature, the determination of statistical significance for outcomes relies on probability analysis and the reporting of P-values. The aim of this study was to employ fragility analysis as a means of evaluating the resilience of randomized controlled trials (RCTs) that assess meniscus surgeries. It was hypothesized that dichotomous outcomes would be statistically fragile and comparable to other orthopedic specialties.
View Article and Find Full Text PDFPurpose: To analyze mechanisms, diagnoses, and incidence of youth snowboarding-related injuries presenting to US emergency departments.
Methods: Data from the National Electronic Injury Surveillance System were analyzed for pediatric snowboarding injuries (≤18 years old) from 2012 to 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition.
Objectives: Electric biking (e-biking) is a rapidly growing recreation, sport, and mode of transportation that often presents to emergency departments (EDs) with high-impact head injuries. This study aimed to evaluate the epidemiology of e-bike-related concussions and closed-head injuries (CHI) to inform more effective injury prevention strategies.
Methods: The National Electronic Injury Surveillance (NEISS) was queried for e-bike related concussions and CHIs presented to national EDs from 1 January 2013-31 December 2022.
Background: Wrestling is among the most common youth sports in the United States, with about 260,000 high school participants annually. There is a lack of literature investigating wrestling injury profiles and mechanisms of injuries. In the past 15 years, urgent care utilization has increased, and National Federation of State High School Associations (NFHS) concussion protocols have been developed and implemented.
View Article and Find Full Text PDFPurpose: To assess the distribution and mechanisms of lower-extremity injuries among high school and college age rugby players presenting to U.S. emergency departments (EDs) from 2008 to 2022.
View Article and Find Full Text PDFObjectives: Nearly 3 million children participate in youth soccer annually in the United States. Popularity of youth soccer within recent years has prompted investigation describing youth-soccer concussion trends presenting to United States emergency departments (EDs).
Methods: Data from National Electronic Injury Surveillance System were analyzed for soccer players 2-18 years old sustaining concussions from January 2013 to December 2022.
Background: Head injury rates in lacrosse may be higher among women compared with men. Understanding these trends can guide appropriate injury prevention for female athletes.
Hypotheses: Injuries most commonly involve the head, with no significant decline over the study period; contact with other players would be the most common injury mechanism.
Article Synopsis
- Mountain biking (MTB) injuries, especially fractures, have become a growing concern, particularly among adult males, with a significant increase in reported cases over the last decade.
- Data from the National Electronic Injury Surveillance System (NEISS) indicates that there were an estimated 35,260 MTB-related fractures in U.S. emergency departments from 2013 to 2022, showing a notable spike in injuries in recent years, notably a 247% rise from 2019 to 2020.
- Upper extremity fractures were the most common, while adult males accounted for nearly 88% of all fractures, having a greater likelihood of hospitalization compared to females, highlighting the increased risk among older riders.
Article Synopsis
- Research on patellar resurfacing in total knee arthroplasty (TKA) shows mixed results, prompting an analysis of statistical fragility using measures like fragility index (FI) and fragility quotient (FQ).
- A systematic review of RCTs revealed 19 relevant studies, finding that significant outcomes had a median FI of 3, while nonsignificant outcomes had a median reverse FI (rFI) of 5.
- The study concluded that outcomes related to patellar resurfacing are statistically fragile, especially those involving patient satisfaction and anterior knee pain, indicating that current data remains inconclusive.
Article Synopsis
- This study analyzed basketball-related shoulder dislocations reported in US emergency departments from 2013 to 2022, using data from the National Electronic Injury Surveillance System (NEISS).
- A total of 52,417 shoulder dislocations were recorded, with a significant decrease in incidents over the study period, particularly from 2019 to 2020.
- The main cause of dislocations was falling, predominantly affecting young adults and adolescents, while females were more prone to dislocations resulting from player contact.
Background: Hip arthroscopy has seen a significant surge in utilization, but complications remain, and optimal functional outcomes are not guaranteed. Artificial intelligence (AI) has emerged as an effective supportive decision-making tool for surgeons. The purpose of this systematic review was to characterize the outcomes, performance, and validity (generalizability) of AI-based prediction models for hip arthroscopy in current literature.
View Article and Find Full Text PDFArticle Synopsis
- * Researchers analyzed 76 RCTs published from 2005 to April 2024 across two pediatric orthopaedic journals, finding that only a small percentage reported various SDOHs like BMI, race, and educational level.
- * The findings indicate a significant gap in reporting SDOHs in pediatric orthopaedic surgery studies, highlighting the need for future research to include a broader range of demographic and social factors.
Background: The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.
Aim: To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.
Background: While prevention protocols have been implemented, skiing-related musculoskeletal injuries and concussions continue to present to emergency departments in the United States. Previous literature has suggested the pediatric population may constitute up to 40% of skiing-related injuries.
Purpose: To assess injury trends and the underlying mechanisms of skiing injuries in pediatric patients seen at emergency departments in the United States.
Article Synopsis
- Reverse total shoulder arthroplasty (RTSA) is often evaluated using patient-reported outcome measures (PROMs) and relies on metrics like minimum clinically important difference (MCID) and substantial clinical benefit (SCB) to determine its effectiveness.
- A systematic review analyzed 141 articles from various medical databases, ultimately including 39 studies with data on 11,984 patients who underwent RTSA, focusing on different thresholds used for MCID, SCB, patient acceptable symptom state (PASS), and maximal outcome improvement (MOI).
- Findings showed significant variability in reported MCID and SCB values across studies, highlighting the need for more standardized methods in calculating and applying these thresholds to improve clinical assessment of RTSA outcomes.
The Delayed Presentation and Diagnosis of Youth Wrestling Injuries: A 20-Year Analysis of National Injury Data.
J Am Acad Orthop Surg Glob Res Rev
May 2024
Article Synopsis
- - The study investigates the issue of delayed injury presentations among middle and high school wrestlers, as many athletes tend to hide their injuries, leading to an underreporting in youth wrestling injuries.
- - Data from the National Electronic Injury Surveillance System shows that approximately 5.6% of wrestlers presented their injuries after a delay, with most injuries occurring on Saturdays during the wrestling season.
- - Wrestlers with delayed injury presentations were found to be less likely to have fractures or head/neck injuries, highlighting the necessity for coaches and trainers to be attentive to potential injury signs.
Article Synopsis
- This study analyzes the robustness of cervical disc arthroplasty (CDA) literature by using the fragility index (FI) and fragility quotient (FQ) to evaluate statistical vulnerability in outcomes.
- A comprehensive PubMed search identified 35 randomized controlled trials (RCTs) from 2000 to 2023, revealing 693 outcome events, of which 130 were statistically significant.
- Findings indicate a lack of statistical robustness in CDA studies, as many did not adequately report loss to follow-up data, suggesting that relying solely on P values could misrepresent clinical conclusions.
Background: Surfing is an increasingly popular sport with a high propensity for both traumatic and atraumatic injuries.
Purpose: To analyze the trends, etiologies, and diagnoses of lower extremity orthopaedic-related surfing injuries presenting to United States (US) emergency departments (EDs) within a 21-year study period.
Study Design: Descriptive epidemiology study.
Article Synopsis
- Randomized controlled trials (RCTs) are considered the most reliable evidence in orthopedic surgery, but their statistical findings can sometimes lack stability, which this study aimed to investigate using fragility metrics.
- The researchers analyzed 108 RCTs on tranexamic acid (TXA) in orthopedic surgery, finding that many outcomes are "fragile" and small changes could affect their statistical significance.
- The study suggests using fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to better interpret the results of these trials in the future.
Article Synopsis
- The study evaluated the statistical stability of outcomes from randomized controlled trials (RCTs) focusing on the management of femoral neck fractures, using metrics like fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ).
- After screening 985 articles, 71 studies were analyzed, revealing a median FI of 4, indicating that a small number of event reversals could change the statistical significance of findings.
- The results suggest that many outcomes in these RCTs are fragile, prompting the authors to recommend standardized reporting of P-values to improve the reliability of the data.
Article Synopsis
- This study evaluated the statistical fragility of outcomes from randomized controlled trials (RCTs) on marrow stimulation for knee cartilage defects, using metrics like the fragility index (FI) and fragility quotient (FQ).
- The analysis of 21 RCTs revealed that most outcomes (32 statistically significant and 123 nonsignificant) had low FI values, indicating a tendency for results to change with minor variations in data, especially in studies with stem cell augmentations.
- The researchers concluded that the findings are statistically fragile and recommend that future studies report p-values alongside FI and FQ values for better understanding of results in cartilage restoration trials.
Article Synopsis
- This study analyzes the fragility of outcomes in orthopaedic research, particularly regarding periprosthetic joint infection (PJI) in total joint arthroplasty randomized controlled trials (RCTs) published from 2010 to 2022.
- It utilizes the fragility index (FI) and fragility quotient (FQ) to assess how many event reversals are needed to change the significance of the outcomes and reveals that many outcomes are statistically weak.
- The findings highlight the importance of conducting fragility analyses to better interpret outcomes in orthopaedic studies, indicating that many reported results may not be statistically robust.