Standardized Multimodal Pain Protocol Minimizes Inpatient Opioid Administration in Pediatric Orthopedic Surgery Population.

Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.

Is The "Sling Effect" of the Conjoint Tendon in Latarjet Procedures Real? A Systematic Review and Descriptive Synthesis of Controlled Laboratory and Comparative Clinical Studies.

Background: The Latarjet procedure is considered the gold standard for treating patients with anterior shoulder instability in the presence of critical glenoid bone loss. Proponents of the Latarjet contend that its efficacy is in-part attributable to the "sling effect" of the conjoint tendon; however, recent studies have demonstrated similar restoration of anterior stability in patients undergoing free bone block (FBB) procedures. The purpose of this systematic review was to evaluate the biomechanical and clinical evidence for the sling effect.

Making Sense of Topical Pain Relief Options: Comparing Topical Analgesics in Efficacy and Safety.

Context: In patients with musculoskeletal (MSK) conditions, pain is the leading contributor to disability and significantly limits mobility and dexterity. This narrative review describes the efficacy and safety of topical analgesics in common use today.

Evidence Acquisition: Secondary literature gained via a literature search using PubMed.

Nonsurgical Management of Adductor-related groin pain with Ultrasound-Guided Platelet-Rich Plasma Injection and Physical Therapy in a Competitive Soccer Player: A Case Report.

Introduction: Adductor-related groin pain involves an injury to the common aponeurosis connecting the rectus abdominus and adductor longus to the pubis. It commonly occurs in sports that require cutting and pivoting and can result in significant loss of playing time. Platelet-Rich Plasma (PRP) is often indicated for treatment of musculoskeletal disorders and may represent an alternative treatment for patients with adductor-related groin pain.

Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement.

Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury-A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician.

Diversity Within the Field of Orthopedic Sports Medicine: A Systematic Review.

Background: Orthopedic surgery is among the least diverse specialties in medicine. This systematic review analyzes gender, racial, and ethnic diversity within orthopedic sports medicine and aims to raise awareness and provide guidance for future strategies that support underrepresented minorities in medicine (URMs) and women in joining the orthopedic sports medicine workforce. We hypothesize that at all tiers of training, there is a lack of gender, racial, and ethnic parity in academic rank, leadership positions, and research productivity.

Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement.

Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury-A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician.

Arthroscopy and Microfracture for Osteochondritis Dissecans of the Capitellum in Adolescent Athletes Shows Favorable Return to Sport: A Systematic Review.

Purpose: To assess return to sport (RTS) in the high-risk young athlete population with capitellar osteochondritis dissecans (OCD) undergoing arthroscopic microfracture (MFX) with or without debridement as well as associated indications, clinical outcomes, radiographic outcomes, and complications.

Methods: A literature search of all published literature in the English language from PubMed, EMBASE, Scopus, and Cochrane from database inception to April 4, 2022, was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies presented demographics and outcomes for adolescent (<21 years old) patients diagnosed with capitellar OCD who underwent arthroscopic MFX (or drilling/subchondral drilling) or MFX (or drilling/subchondral drilling) with debridement (or loose body removal/chondroplasty).

Staged Repair of Simultaneous Bilateral Proximal Hamstring Rupture and 2 Year Outcome: A Case Report.

Case: A 53-year-old man presented with simultaneous, bilateral proximal hamstring ruptures. He underwent open, staged surgical repair of the proximal hamstrings, followed by a modified course of rehabilitation. At 2-year follow-up, the patient reports excellent outcomes.

Arthroscopic treatment for intra-articular fibroma of the tendon sheath in a teenager.

An adolescent female patient presented with atraumatic left knee pain and limited flexion. MRI demonstrated evidence of a soft tissue lesion abutting the posterior cruciate ligament. Differential diagnosis included pigmented villonodular synovitis (PVNS) and fibroma of the tendon sheath (FTS).

Management of bipolar shoulder injuries with humeral head allograft in patients with active, uncontrolled seizure disorder: case series and review of literature.

Background: The purpose of this study is to present surgical outcomes after humeral head allograft augmentation and glenoid-based procedures in patients with active, uncontrolled seizure activity and anterior shoulder instability.

Methods: A retrospective review of a surgical database for patients with active seizure disorder and with recurrent shoulder instability managed with humeral head augmentation was performed. All patients underwent surgical intervention.

In-line Pullout Strength of 2 Acetabular Fixation Methods for Ligamentum Teres Reconstruction of the Hip: A Cadaveric Study.

Background: Ligamentum teres (LT) reconstruction is an appropriate alternative in select cases of LT full-thickness tears, resulting in hip micro- or macroinstability. Graft fixation at the acetabular fossa is critical to achieving the best functional results.

Purpose: The purpose of this study is to compare the pullout strength of 2 graft fixation methods used for LT reconstruction of the hip.

Bone-Patellar Tendon-Bone Autograft Thickness Is a Risk Factor for Graft Failure. A Case-Control Analysis.

Background: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating complication. Risk factors such as patient characteristics and tunnel positions are well described. The relationship between graft dimension and failure rates has been investigated mainly in soft tissue grafts.

Biomechanical Evaluation of Anterolateral Ligament Repair Augmented with Internal Brace.

Injuries to the anterolateral ligament (ALL) of the knee are commonly associated with anterior cruciate ligament (ACL) ruptures. Biomechanical studies have demonstrated conflicting results with regard to the role of the ALL in limiting tibial internal rotation. Clinically, residual pivot shift following ACL reconstruction has been reported to occur up to 25% and has been correlated with poor outcomes.

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review.

Bone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones.

Microbial colonization of subscapularis tagging sutures in shoulder arthroplasty: a prospective, controlled study.

Background: Reducing intraoperative wound contamination is a critical preventive strategy for reducing the risk of prosthetic joint infection in shoulder arthroplasty. The aim of this study was to investigate the potential microbial colonization of subscapularis tagging sutures during shoulder arthroplasty.

Methods: In this prospective study, 50 consecutive patients undergoing primary shoulder arthroplasty (anatomic or reverse) were enrolled.

Bow Hunter's Syndrome in a Patient with a Right Hypoplastic Vertebral Artery and a Dynamically Compressible Left Vertebral Artery.

This is a case report of a 48-year-old man with multiple transient ischemic attacks and a known hypoplastic right vertebral artery (VA) who presented after a syncopal event while turning his head to the left. The objective of this study is to demonstrate the necessity of proper diagnosis and management of cerebrovascular pathology including imaging and surgical intervention in patients with known anatomical anomalies. This study was conducted at Massachusetts, United States of America.

Primary anterior cruciate ligament reconstruction: perioperative considerations and complications.

Anterior cruciate ligament (ACL) injuries are among the most commonly studied orthopaedic injuries. Despite having an excellent prognosis, complications do occur. The timely recognition and management of complications is imperative to ensure the success of reconstruction.