Evolution of the Surgical Treatment of Ulnar Collateral Ligament Injuries.

Since Dr. Frank Jobe performed the initial surgery on Tommy John in 1974, the ulnar collateral ligament (UCL) reconstruction (UCLR), colloquially "Tommy John Surgery," described in 1986 has evolved as the gold standard treatment for UCL tears. The crux of technique modifications involve flexor pronator mass (FPM) management, ulnar nerve transposition (UNT), graft selection, or graft-fixation options.

Florida Current transport observations reveal four decades of steady state.

The potential weakening of the Atlantic Meridional Overturning Circulation (AMOC) in response to anthropogenic forcing, suggested by climate models, is at the forefront of scientific debate. A key AMOC component, the Florida Current (FC), has been measured using submarine cables between Florida and the Bahamas at 27°N nearly continuously since 1982. A decrease in the FC strength could be indicative of the AMOC weakening.

Blood Flow Restriction Therapy After Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament reconstruction (ACLR) rehabilitation necessitates restoration of quadriceps strength to minimize reinjury and optimize return to sport (RTS). Patients recovering from ACLR are limited by pain and activity restrictions, resulting in quadriceps muscle atrophy. Blood flow restriction (BFR) therapy involves performing exercises while a specialized blood pressure cuff is applied to the proximal aspect of the operative extremity and inflated to 40% to 90% of the arterial occlusion pressure, as determined using Doppler ultrasonography.

Postoperative Opioid Usage and Disposal Strategies After Arthroscopic Procedures in a Young Cohort: A Prospective Observational Study.

Background: Although several studies have noted that patients are routinely overprescribed opioids, few have reported usage after arthroscopic surgery.

Purpose: To determine opioid consumption and allocation for unused opioids after common arthroscopic surgeries.

Study Design: Case series; Level of evidence, 4.

Patients' under 25 subjective readiness to return to sport after ACL reconstruction with bone-patellar-bone grafts: Autograft vs. allograft.

Purpose: To assess the difference in perceived readiness to return to sport (RTS) within the first year postoperative period between individuals undergoing anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BTB) autografts or allografts.

Methods: This was a prospective cohort study of patients undergoing primary ACL reconstruction done either with BTB autograft or allograft from 2010 to 2018. Skeletally mature patients aged 14 to 25 were eligible for inclusion.

The impact of preoperative benzodiazepine use on postoperative opioid use in total shoulder arthroplasty.

Background: As the rate of total shoulder arthroplasty (TSA) and preoperative benzodiazepine use rise, there is an increased need to understand the impact of preoperative benzodiazepine use on postoperative opioid consumption following TSA, especially amid the current opioid epidemic. The relationship between preoperative benzodiazepine use and chronic opioid use postoperatively has been well described following other orthopedic procedures; however, the impact on patients undergoing TSA remains unclear. This study aims to identify the impact of preoperative benzodiazepine use on opioid use following TSA.

ChatGPT Can Offer Satisfactory Responses to Common Patient Questions Regarding Elbow Ulnar Collateral Ligament Reconstruction.

Purpose: To determine whether ChatGPT effectively responds to 10 commonly asked questions concerning ulnar collateral ligament (UCL) reconstruction.

Methods: A comprehensive list of 90 UCL reconstruction questions was initially created, with a final set of 10 "most commonly asked" questions ultimately selected. Questions were presented to ChatGPT and its response was documented.

The Most Impactful Articles on the Shoulder Labrum From the United States or Europe, and Decreased Level of Evidence Is Associated With Increased Altmetric Attention Score.

Purpose: To use the top 100 articles pertaining to the shoulder labrum to understand the impact that social medial platforms have on the dissemination of shoulder research and to highlight bibliometric factors associated with Altmetric Attention Scores (AAS) to offer insight into the impact that social media platforms have on the dissemination, attention, and citation of shoulder research publications.

Methods: This was a cross-sectional study. In January 2023, the Altmetric database was searched using the PubMed Medical Subject Headings terms "shoulder labrum.

ChatGPT Provides Unsatisfactory Responses to Frequently Asked Questions Regarding Anterior Cruciate Ligament Reconstruction.

Purpose: To determine whether the free online artificial intelligence platform ChatGPT could accurately, adequately, and appropriately answer questions regarding anterior cruciate ligament (ACL) reconstruction surgery.

Methods: A list of 10 questions about ACL surgery was created based on a review of frequently asked questions that appeared on websites of various orthopaedic institutions. Each question was separately entered into ChatGPT (version 3.

Lower Opioid Prescription Quantity Does Not Negatively Impact Pain Control or Patient Satisfaction After ACL Reconstruction: A Randomized, Prospective Trial.

Background: The purpose of this study was to evaluate the effects of different quantities of prescribed opioid tablets on patient opioid utilization, postoperative pain and function, and satisfaction after anterior cruciate ligament reconstruction (ACLR).

Methods: This was a prospective, randomized trial enrolling patients undergoing primary ACLR. Patients were assigned to 1 of 3 prescription groups: 15, 25, or 35 tablets containing 5-mg oxycodone.

Towards two decades of Atlantic Ocean mass and heat transports at 26.5° N.

Continuous measurements of the Atlantic meridional overturning circulation (AMOC) and meridional ocean heat transport at 26.5° N began in April 2004 and are currently available through December 2020. Approximately 90% of the total meridional heat transport (MHT) at 26.

Atlantic meridional overturning circulation increases flood risk along the United States southeast coast.

The system of oceanic flows constituting the Atlantic Meridional Overturning Circulation (AMOC) moves heat and other properties to the subpolar North Atlantic, controlling regional climate, weather, sea levels, and ecosystems. Climate models suggest a potential AMOC slowdown towards the end of this century due to anthropogenic forcing, accelerating coastal sea level rise along the western boundary and dramatically increasing flood risk. While direct observations of the AMOC are still too short to infer long-term trends, we show here that the AMOC-induced changes in gyre-scale heat content, superimposed on the global mean sea level rise, are already influencing the frequency of floods along the United States southeastern seaboard.

Martial Arts: Orthopaedic Injuries and Related Biomechanics.

Martial arts are various systems of combat skills encompassing striking and grappling. Many styles have evolved into modern sports, and some have been included in the Olympics. The physicality of these can predispose practitioners to musculoskeletal injuries, such as anterior cruciate ligament ruptures; patellar, shoulder, or elbow instabilities; extremity fractures; and hand and spine injuries, which have been studied both clinically and biomechanically.

Seasonality of the Meridional Overturning Circulation in the subpolar North Atlantic.

Understanding the variability of the Atlantic Meridional Overturning Circulation is essential for better predictions of our changing climate. Here we present an updated time series (August 2014 to June 2020) from the Overturning in the Subpolar North Atlantic Program. The 6-year time series allows us to observe the seasonality of the subpolar overturning and meridional heat and freshwater transports.

Outcomes and Patient Satisfaction of Delayed Distal Biceps Repairs without Graft Augmentation: A Systematic Review.

Background: Distal biceps tendon tears are responsible for 3% to 10% of all biceps ruptures. Treated nonoperatively, these injuries result in poor endurance, loss of supination strength, and loss of flexion strength compared with those treated operatively with repair or reconstruction. When presenting in a chronic fashion, operative management can involve graft reconstruction or primary repair.

Minimally Invasive Surgery Using a Shannon Burr for the Treatment of Hallux Valgus Deformity: A Systematic Review.

Background: Recently there has been an increase in minimally invasive surgery (MIS) for the correction of hallux valgus deformity. This systematic review aims to evaluate and present the current literature on MIS hallux valgus correction in studies reporting the use of the Shannon burr with distal metatarsal osteotomies to help establish evidence-based guidelines for surgeons using this technique.

Methods: Two independent authors performed a systematic literature search using the following databases: PubMed, Embase, and the Cochrane library.

Distal Hamstring Muscle Injuries.

»: Distal hamstring muscle injuries, although relatively uncommon, can potentially lead to substantial morbidity in athletes; prolonged rehabilitation times and high rates of reoccurrence have been documented.

»: Overall, magnetic resonance imaging is considered the "gold standard" for evaluation of hamstring injuries because it allows assessment for concomitant pathology and can clarify return-to-sport timelines.

»: Complete tears of the distal biceps femoris and semimembranosus muscles respond well to surgical repair, whereas complete tears of the distal semitendinosus can be successfully treated nonoperatively or with surgical resection.

Lateral Release With Tibial Tuberosity Transfer Alters Patellofemoral Biomechanics Promoting Multidirectional Patellar Instability.

Purpose: The purpose of this study was to develop and validate a finite element (FE) model of the patellofemoral (PF) joint to characterize patellofemoral instability, and to highlight the effect of lateral retinacular release in combination with tibial tuberosity transfer with respect to contact pressures (CP), contact area (CA), and kinematics during knee flexion.

Methods: A comprehensive, dynamic FE model of the knee joint was developed and validated through parametric comparison of PF kinematics, CP, and CA between FE simulations and in vitro, cadaveric experiments. Using this FE model, we characterized the effect of patellar instability, lateral retinacular release (LR), and tibial tuberosity transfer (TTT) in the setting of medial patellofemoral ligament injury during knee flexion.

Topical Review: Bone Marrow Aspirate Concentrate and Its Clinical Use in Foot and Ankle Surgery.

Bone marrow aspirate concentrate (BMAC) is now commonly used in orthopedic surgery. Animal studies showed promising results for cartilage, bone, and soft tissue healing; however, many of these outcomes have yet to be translated to human models. While there has been an increase in the use of BMAC in foot and ankle procedures, the associated clinical evidence is limited.

Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

Background: Hemarthrosis after anterior cruciate ligament (ACL) reconstruction procedures can delay rehabilitation and have toxic effects on the cartilage and synovium. Tranexamic acid is widely used in adult reconstruction procedures; however, its use in ACL reconstruction is a novel topic of study.

Purpose: To analyze the available literature on hemarthrosis, pain, functional outcomes, and complications after administration of tranexamic acid in ACL reconstruction procedures.

Tranexamic Acid in Foot and Ankle Surgery: A Topical Review and Value Analysis.

Tranexamic acid (TXA) has become a commonly used perioperative intervention in total joint arthroplasty, shoulder and knee arthroscopy, and spinal procedures in order to minimize blood loss, hematoma formation, hemarthrosis, and wound healing complications. There is a potential role for TXA use in foot and ankle procedures, with limited studies suggesting a potential benefit in minimizing postoperative wound complications and blood loss without an increased risk of thromboembolic events. In light of the profound clinical and financial impact of TXA use in other orthopaedic subspecialties and the early successes in foot and ankle surgery, we aim to provide more information about TXA and its use in foot and ankle surgery.