American Shoulder and Elbow Surgeons perspectives on political advocacy.

Background: Physician involvement in political advocacy has become increasingly important in recent years. This study aims to explore the types of involvement and barriers to involvement in political advocacy among American Shoulder and Elbow Surgeons (ASES) members, identify issues considered most important by ASES members, and assess demographic factors that might correlate with involvement in political advocacy efforts among ASES members.

Methods: This survey was conducted by the ASES Political Advocacy Committee over a 2-week period in June 2021.

Resorbable Bioinductive Collagen Implant Is Cost Effective in the Treatment of Rotator Cuff Tears.

Purpose: This study was conducted to investigate whether the use of resorbable bioinductive collagen implant (RBI) in addition to conventional rotator cuff repair (conventional RCR) is cost-effective when compared to conventional RCR alone, in the treatment of full-thickness rotator cuff tears (FT RCT).

Methods: We developed a decision analytic model to compare the expected incremental cost and clinical consequences for a cohort of patients with FT RCT. The probabilities for healing or failure to heal (retear) were estimated from the published literature.

Characteristics of Orthopaedic Sports Medicine Fellowship Directors.

Background: No study in the orthopaedic literature has analyzed the demographic characteristics or surgical training of sports medicine fellowship directors (FDs. Objective determinations as to what makes a physician qualified for this leadership position remain unclear; thus, it is important to identify these qualities as future physicians look to fill these roles.

Purpose: To illustrate characteristics common among sports medicine FDs.

Isolated bioinductive repair of partial-thickness rotator cuff tears using a resorbable bovine collagen implant: two-year radiologic and clinical outcomes from a prospective multicenter study.

Background: Current surgical treatment options for partial-thickness tears (eg, takedown and repair, in situ repair) are limited by the degenerative nature of the underlying tendon and may require extensive intervention that can alter the anatomic footprint. The complexity of available techniques to address these issues led to the development of a resorbable collagen implant, which can be used to create a bioinductive repair of partial-thickness tears.

Methods: We prospectively enrolled 33 patients with chronic, degenerative, intermediate-grade (n = 12), or high-grade (n = 21) partial-thickness tears (11 articular, 10 bursal, 4 intrasubstance, and 8 hybrid) of the supraspinatus tendon in a multicenter study.

Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study.

Background: Treatment of partial-thickness cuff tears remains controversial. Although conservative therapy may treat symptoms, these defects do not spontaneously heal and conversion to a full-thickness lesion with subsequent repair may alter the tendon footprint. The ability to induce new tissue formation and limit tear progression in intermediate- and high-grade partial-thickness tears without surgical repair may represent a significant advancement in the treatment paradigm for these lesions.

National Football League athletes' return to play after surgical reattachment of complete proximal hamstring ruptures.

Although hamstring strains are common among professional football players, proximal tendon avulsions are relatively rare. Surgical repair is recommended, but there is no evidence on professional football players return to play (RTP). We hypothesized that surgical reattachment of complete proximal hamstring ruptures in these athletes would enable successful RTP.

Quadriceps tendon injuries in national football league players.

Background: Distal quadriceps tendon tears are uncommon injuries that typically occur in patients older than 40 years of age, and they have a guarded prognosis. Predisposing factors, prodromal findings, mechanisms of injury, treatment guidelines, and recovery expectations are not well described in high-level athletes.

Hypothesis: Professional American football players with an isolated tear of the quadriceps tendon treated with timely surgical repair will return to their sport.

A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone-patellar tendon-bone autograft, hamstring autograft, and allograft.

Background: Anterior cruciate ligament (ACL) reconstruction, despite being one of the most common surgical interventions, is also one of the least agreed upon surgeries when it comes to optimum graft choice. Three graft choices stand among the most widely used in this procedure: (1) bone-patellar tendon-bone autograft (BPTB), (2) quadruple hamstring tendon autograft (HS), and (3) allograft.

Hypothesis: Bone-patellar tendon-bone ACL reconstruction is the most cost-effective method of ACL reconstruction.

Treatment of magnetic resonance imaging-documented isolated grade III lateral collateral ligament injuries in National Football League athletes.

Background: Isolated high-grade tears of the lateral collateral ligament (LCL) of the knee are rare, as most injuries are part of a broader pattern of damage to the posterolateral corner. Limited data exist in the literature about the ideal management of isolated LCL injuries, especially in elite-level athletes.

Hypothesis: Operative and nonoperative treatment of MRI-documented isolated grade III LCL injury can produce equal results in terms of return to play in the National Football League (NFL).

Success of nonoperative management of adductor longus tendon ruptures in National Football League athletes.

Background: Acute complete ruptures of the proximal adductor longus tendon are rare but challenging injuries to treat. The limited literature supports operative treatment, but data from management of chronic groin pain in athletes indicate that anatomical attachment of the tendon to the pubis may not be required for high-level function.

Hypothesis: Nonoperative management of complete adductor rupture can provide equal results to surgical repair in terms of return to play in the National Football League.

The effect of postoperative immobilization on the healing of radiofrequency heat probe modified tissue: assessment of tissue length, stiffness, and morphology.

The effect of postoperative immobilization on the length, stiffness, and structure of connective tissue after radiofrequency probe shrinkage was examined in a rabbit patellar tendon model. Tendon lengths were measured before, immediately following, and 2, 4, and 8 weeks following heat application, with the contralateral tendon as a control. The animals were randomly assigned to three groups.

An in vivo comparison of the modified Mason-Allen suture technique versus an inclined horizontal mattress suture technique with regard to tendon-to-bone healing: a biomechanical and histologic study in sheep.

The purpose of this study is to examine long-term tendon-to-bone healing, by use of a sheep animal model, after rotator cuff repairs performed with 2 different suture techniques: an inclined horizontal mattress suture pattern placed with special arthroscopic instrumentation (HMS) and the modified Mason-Allen pattern (MMA). After a pre hoc power analysis, 18 skeletally mature sheep were randomly assigned to either the HMS or MMA repair technique, with contralateral limbs used for the control group. At 26 weeks, the animals were euthanized.

The effects of augmentation with Swine small intestine submucosa on tendon healing under tension: histologic and mechanical evaluations in sheep.

Background: Rotator cuff failure after surgery may be attributed to inferior tissue healing properties that result from repetitive cyclic loading during early rehabilitation. Enhancing the biological healing process may reduce the incidence of failures after rotator cuff repairs.

Hypothesis: Augmentation of rotator cuff tissue using swine small intestine submucosa in a sheep model will improve the rate and quality of tissue repair.

Incidence and location of bone bruises after acute posterior cruciate ligament injury.

Background: In patients suffering from an anterior cruciate ligament injury, the incidence and location of bone bruises are well documented. This study reports data regarding bone bruises after acute posterior cruciate ligament injury.

Hypothesis: Bone bruises associated with posterior cruciate ligament injury are common, and their location differs from those seen with anterior cruciate ligament injury.

Triceps tendon ruptures in professional football players.

Background: Distal rupture of the triceps tendon is a rare injury, and treatment guidelines are not well established.

Hypothesis: Football players with triceps tendon ruptures will be able to return to their sport with minimal functional deficits.

Study Design: Uncontrolled retrospective review.

The microfracture technique in the treatment of full-thickness chondral lesions of the knee in National Football League players.

Between 1986 and 1997, 25 active National Football League (NFL) players underwent microfracture to treat full-thickness chondral lesions. Average follow-up was 4.5 years (range: 2-13 years).

Ketorolac use in the national football league: prevalence, efficacy, and adverse events.

Researchers who surveyed usage patterns, effectiveness, and possible adverse effects of ketorolac tromethamine among National Football League players found some common themes among the 31 teams that responded. Though isolated adverse events were noted, most team healthcare providers felt that ketorolac is effective and safe when the team physician directs its use.

Reliability of heel-height measurement for documenting knee extension deficits.

Background: Heel-height difference has been used to detect subtle knee flexion contractures, but the effects of thigh circumference differences and patient positioning during testing have not been evaluated.

Hypothesis: Differences in thigh circumference measurements and whether the patient's patellae are on or off the examination table during heel-height difference measurement will not affect the accuracy of detecting knee flexion contracture.

Study Design: Prospective cohort study.