Selective head cooling in the acute phase of concussive injury: a neuroimaging study.

Introduction: Neurovascular decoupling is a common consequence after brain injuries like sports-related concussion. Failure to appropriately match cerebral blood flow (CBF) with increases in metabolic demands of the brain can lead to alterations in neurological function and symptom presentation. Therapeutic hypothermia has been used in medicine for neuroprotection and has been shown to improve outcome.

AOA Critical Issues: Dichotomies in Leadership. Presidential Address to the AOA, June 17, 2022.

This speech was given at the 2022 American Orthopaedic Association (AOA) meeting in Providence, Rhode Island, on June 17, 2022, and discusses the most important elements of leadership. A sense of extreme ownership is required for effective leadership. Ownership allows leaders to delegate responsibilities to others and to instill confidence and trust in the people closest to them.

Head acceleration event exposure and cognitive and functional outcomes: a comparison of multiple football seasons.

Athletes in contact sports are exposed to repetitive impacts as an inherent part of sport. There is concern over the accumulative effect; however, much is still unknown regarding their short-term effects. This study investigated impact accumulation and outcomes over three seasons (2015, 2017, 2019) in NCAA Football Bowl Subdivision players.

Treatment, Return to Play, and Performance Following Meniscus Surgery.

Purpose Of Review: The standard of care in meniscal tear management is constantly evolving, especially for athletes and high-demand patients. Meniscus repairs, meniscus transplants, and partial meniscectomies are commonly performed, and rehabilitation methods following these operations are becoming more sophisticated. The ultimate goal of these procedures is returning patients to full activity with minimal risks.

Fluoroscopy-Guided Suture Anchor Placement Yields Excellent Accuracy for Arthroscopic Acetabular Labral Repair: A Cadaveric Study.

Purpose: To determine the accuracy of fluoroscopy-guided suture anchor placement for arthroscopic acetabular labral repair in cadaveric hip specimens.

Methods: Two sports medicine fellowship-trained surgeons performed arthroscopic hip surgery on 6 cadaveric specimens each. Suture anchors were placed at the 11-, 12-, 1-, 2-, 3-, and 4-o'clock positions of the acetabulum in each specimen using a previously described fluoroscopically guided technique.

The Tibial Tubercle-Trochlear Groove Distance/Trochlear Dysplasia Index Quotient Is the Most Accurate Indicator for Determining Patellofemoral Instability Risk.

Purpose: The primary aim of our study was to evaluate diagnostic accuracy of the tibial tubercle-trochlear groove (TT-TG) distance relative to associated quotients produced from trochlear width (TT-TG distance/TW) and trochlear dysplasia index (TT-TG distance/TDI) for detecting patellofemoral instability. Secondary aims included identifying thresholds for risk and comparing differences between cases and controls.

Methods: Consecutive sampling of electronic medical records produced 48 (21 males, 27 females) patellofemoral instability cases (19 ± 7 years old) and 79 (61 males, 18 females) controls (23 ± 4 years old) who had a history of isolated meniscal lesion, as evaluated by magnetic resonance imaging.

The accumulation of subconcussive impacts on cognitive, imaging, and biomarker outcomes in child and college-aged athletes: a systematic review.

Examine the effect of subconcussive impact accumulation on cognitive/functional, imaging, and biomarker outcomes over the course of a single season, specifically in contact sport athletes at collegiate level or younger. Systematic review following PRISMA guidelines and using Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence and Newcastle Ottawa Assessment Scale. PubMed MEDLINE, PsycInfo, SPORT-Discus, Web of Science.

Effects of sleep disturbance on functional and physiological outcomes in collegiate athletes: A scoping review.

Objective: To investigate sleep disturbances and circadian timing changes on functional and physiological correlates specifically in collegiate athletes.

Design: Scoping Review.

Data Sources: PubMed MEDLINE, SPORT-Discus, CINAHL, ERIC ProQuest, Web of Science.

The American Board of Orthopaedic Surgery Response to COVID-19.

The COVID-19 pandemic has disrupted every aspect of society in a way never previously experienced by our nation's orthopaedic surgeons. In response to the challenges the American Board of Orthopaedic Surgery has taken steps to adapt our Board Certification and Continuous Certification processes. These changes were made to provide flexibility for as many Candidates and Diplomates as possible to participate while maintaining our high standards.

Injury and illness epidemiology at a summer sport-camp program, 2008 through 2011.

Context: University-sponsored summer sport camps often employ athletic trainers; however, there is a dearth of epidemiologic studies describing the injury and illness experience of sport-camp participants to guide clinicians.

Objective: To describe the injury and illness experience of youth participants at a university-sponsored summer sport-camp program during a 4-year period.

Design: Descriptive epidemiology study.

Comparative immediate functional outcomes among cryotherapeutic interventions at the ankle.

Purpose/background: There is a lack of evidence detailing the immediate effects of different cryotherapy interventions at the ankle on functional outcomes such as balance and jumping tasks in a physically active population; therefore, the purpose of the present study is to compare the immediate effects of varied modes of cryotherapy applications to the ankle joint on Star Excursion Balance Test and vertical jump height performance. The authors hypothesized that cryotherapy would acutely decrease performance when compared to a control, and that concomitant compression would further hinder outcomes.

Methods: A crossover study was conducted in a controlled laboratory setting.

Standing flexion deficits predict self-reported outcomes in women after ipsilateral hamstring anterior cruciate ligament reconstruction.

Purpose: To profile the standing flexion angle and its association with subjective outcomes in ipsilateral hamstring tendon autograft anterior cruciate ligament-reconstructed patients. A secondary aim was to describe prone position-measured hamstring strength as a predictor of flexion angle.

Methods: Fifteen women (mean age, 20.

Injury/illness physician referral profile from a youth university-sponsored summer sport camp program.

Participation at university-sponsored summer sport camps is popular among youth athletes; however, there is a dearth of information to describe the injuries/illnesses experienced by camp participants. Data from a university-sponsored sport camp program from 2008 to 2011 were accessed retrospectively. The sport camp program had approximately 80 camps for 28 sports over 12 weeks annually.

The effects of two therapeutic patellofemoral taping techniques on strength, endurance, and pain responses.

Objective: To compare the effects of taping techniques on clinical measures in patellofemoral pain syndrome (PFPS) patients.

Design: Crossover experimental design.

Setting: Controlled laboratory.

The use of magnetic resonance spectroscopy in the subacute evaluation of athletes recovering from single and multiple mild traumatic brain injury.

Advanced neuroimaging techniques have shown promise in highlighting the subtle changes and nuances in mild traumatic brain injury (MTBI) even though clinical assessment has shown a return to pre-injury levels. Here we use ¹H-magnetic resonance spectroscopy (¹H-MRS) to evaluate the brain metabolites N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) in the corpus callosum in MTBI. Specifically, we looked at the NAA/Cho, NAA/Cr, and Cho/Cr ratios in the genu and splenium.

Residual brain dysfunction observed one year post-mild traumatic brain injury: combined EEG and balance study.

Objectives: There is still considerable debate and controversy about whether EEG can be used as a robust clinical tool for assessment of mild traumatic brain injury (MTBI). Nonhomogeneous subject populations, inaccurate assessment of severity of brain injury, time since injury when EEG testing was performed, the lack of EEG research conducted serially and in conjunction with other behavioral measures as injury evolves over time may contribute to the existing controversies. In this study, we implemented a concussion assessment protocol combining a series of EEG and balance measures throughout one year post-injury to document the efficacy of EEG and balance measures as relate to differential recovery of patients suffering from MTBI.

Incorporating virtual reality graphics with brain imaging for assessment of sport-related concussions.

There is a growing concern that traditional neuropsychological (NP) testing tools are not sensitive to detecting residual brain dysfunctions in subjects suffering from mild traumatic brain injuries (MTBI). Moreover, most MTBI patients are asymptomatic based on anatomical brain imaging (CT, MRI), neurological examinations and patients' subjective reports within 10 days post-injury. Our ongoing research has documented that residual balance and visual-kinesthetic dysfunctions along with its underlying alterations of neural substrates may be detected in "asymptomatic subjects" by means of Virtual Reality (VR) graphics incorporated with brain imaging (EEG) techniques.

Metabolic alterations in corpus callosum may compromise brain functional connectivity in MTBI patients: an 1H-MRS study.

After clinical resolution of signs and symptoms of mild traumatic brain injury (MTBI) it is still not clear if there are residual abnormalities of structural or functional brain networks. We have previously documented disrupted interhemispheric functional connectivity in 'asymptomatic' concussed individuals during the sub-acute phase of injury. Testing of 15 normal volunteers (NV) and 15 subacute MTBI subjects was performed within 24h of clinical symptoms resolution and medical clearance for the first stage of aerobic activity.

Default mode network in concussed individuals in response to the YMCA physical stress test.

We hypothesize that the evolution of mild traumatic brain injury (mTBI) may be related to differential effects of a concussive blow on the functional integrity of the brain default mode network (DMN) at rest and/or in response to physical stress. Accordingly, in this resting-state functional magnetic resonance imaging (fMRI) study, we examined 14 subjects 10±2 days post-sports-related mTBI and 15 age-matched normal volunteers (NVs) to investigate the possibility that the integrity of the DMN is disrupted at the resting state and/or following the physical stress test. First, all mTBI subjects were asymptomatic based upon clinical evaluation and neuropsychological (NP) assessments prior to the MRI session.

Alteration of brain default network in subacute phase of injury in concussed individuals: resting-state fMRI study.

There are a number of symptoms, both neurological and behavioral, associated with a single episode of r mild traumatic brain injury (mTBI). Neuropsychological testing and conventional neuroimaging techniques are not sufficiently sensitive to detect these changes, which adds to the complexity and difficulty in relating symptoms from mTBI to their underlying structural or functional deficits. With the inability of traditional brain imaging techniques to properly assess the severity of brain damage induced by mTBI, there is hope that more advanced neuroimaging applications will be more sensitive, as well as specific, in accurately assessing mTBI.

Differential effect of first versus second concussive episodes on wavelet information quality of EEG.

Objective: Recent reports have suggested that long-term residual brain dysfunctions from mild traumatic brain injury (MTBI) that are often overlooked by clinical criteria may be detected using advanced research methods. The aim of the present study was to examine the feasibility of EEG wavelet information quality measures (EEG-IQ) in monitoring alterations of brain functions as well as to determine the differential rate of recovery between the first and second concussive episodes.

Methods: Student-athletes at high risk for MTBI (n=265) were tested prior to concussive episodes as a baseline.

24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain.

Background: Collagen hydrolysate is a nutritional supplement that has been shown to exert an anabolic effect on cartilage tissue. Its administration appears beneficial in patients with osteoarthritis.

Objective: To investigate the effect of collagen hydrolysate on activity-related joint pain in athletes who are physically active and have no evidence of joint disease.