Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic.

Objective: This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

Design: Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

Setting: Sports medicine and orthopedics clinic.

Accelerometer-based sedentary time and physical activity with incident and progressive tobacco smoking in 2503 children: A 13-year mediation and temporal longitudinal study.

Background: Long-term accelerometer-based studies examining whether engaging in physical activity (PA) reduces the risk of smoking in children are lacking, and whether directly measured adiposity increases smoking risk is uncertain.

Methods: From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2503 children aged 11 years with complete smoking and at least one valid time-point movement behaviour data were followed up until age 24 years. ActiGraph assessed sedentary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) at ages 11, 15, and 24-year clinic visits and smoking-based questionnaires were administered, whilst fat mass was measured with dual-energy x-ray absorptiometry scanner.

Factors that Influence Recovery From Concussion in Young Children and Preadolescents.

Objective: To examine differences in the presentation and management of concussion in younger children (aged 4-8 years) versus preadolescents (9-12 years) and identify factors that influence recovery time.

Design: Retrospective analysis of prospectively collected data.

Setting: Pediatric sports medicine and orthopedics clinic.

Time to Rehabilitation in Pediatric Concussion Patients Influences Recovery Outcomes.

Context: Targeted and directed rehabilitation with a healthcare provider can be an effective approach in the treatment of concussion, particularly for patients with protracted recovery, high symptom reporting, cervicogenic dysfunction, musculoskeletal involvement, and/or vestibular/oculomotor dysfunction. While many environmental and intrinsic medical history factors may influence concussion recovery, little is known about whether an individual's recovery trajectory can be influenced by the amount of time taken to receive rehabilitation. The purpose of this study was to evaluate recovery trajectories of concussion patients requiring targeted multimodal rehabilitation after a specialty concussion clinic visit within ≤3 days, 4 to 7 days, and >7 days.

Challenges and Research Opportunities for Integrating Quantitative Electroencephalography Into Sports Concussion Rehabilitation.

Although concussion management and return to play/learn decision making focuses on reducing symptoms, there is growing interest in objective physiological approaches to treatment. Clinical and technological advancements have aided concussion management; however, the scientific study of the neurophysiology of concussion has not translated into its standard of care. This expert commentary is motivated by novel clinical applications of electroencephalographic-based neurofeedback approaches (eg, quantitative electroencephalography [QEEG]) for treating traumatic brain injury and emerging research interest in its translation for treating concussion.

T. Howard Somervell: War Surgeon, Everest Pioneer, and Medical Missionary.

A full century has passed since George Leigh-Mallory and Andrew (Sandy) Irvine disappeared on the upper reaches of Mount Everest in June 1924. Theodore Howard Somervell (April 16, 1890-January 23, 1975), mountaineer, surgeon, and medical missionary, also was a key player in the 1924 expedition-as well as the 1922 Everest expedition where he was a member of the first ever team of climbers to break the 8000-m barrier. More commonly known as Howard or T.

Which Osteochondritis Dissecans Lesions Will Heal Nonoperatively? An Application of Machine Learning to the ROCK Prospective Cohort.

Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment.

Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors.

Study Design: Case-control study; Level of evidence, 3.

Post-concussion changes in the N200 and P300 ERPs are associated with cognitive symptoms and performance.

Purpose: To examine how post-concussion changes to the N200 and P300 event-related potentials (ERPs) are associated with cognitive symptoms and neurocognitive performance.

Methods: High-density electroencephalography (EEG) was recorded during a Go/No-Go task from 16 young adults within one month after their concussion and 16 matched controls. Participants were also administered the Cognitive-Linguistic Quick Test (CLQT) and self-reported concussion-like symptoms.

Early vestibular rehabilitation initiation is associated with faster recovery after sport related concussion.

Objectives: Vestibular rehabilitation is a recommended treatment after sport related concussion (SRC), but the optimal timing is not fully understood. This research examined the association between the timing of vestibular rehabilitation initiation and recovery time in adolescent patients with SRC.

Design: Retrospective cross-sectional.

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

Whipstitch and Locking Stitch Show Equivalent Elongation and Load to Failure Across 3 Suture Systems in a Biomechanical Model of Quadriceps Tendon Grafts for Anterior Cruciate Ligament Reconstruction.

Purpose: To compare the biomechanical properties of quadriceps tendon (QT) graft stitch methods using 3 different suture systems for anterior cruciate ligament reconstruction.

Methods: A total of 48 QTs were harvested from cadaveric knee specimens (age: 73 ± 7 years; range, 66-86 years). Samples were randomly divided into 3 groups where different suture needle systems were used to create 2 stitch methods: whipstitch (WS) and locking stitch (LS).

'Mind your head', tackle characteristics associated with concussions in rugby league: A case-control study.

Objectives: Identify tackle characteristics associated with concussions in male professional rugby league.

Design: Case-control study.

Methods: Tackles resulting in 196 clinically diagnosed concussions and 6592 non-concussive tackles were analysed, from the men's rugby league Super League between 2018 and 2022.

Finding the Right First Job: Academic.

Finding the right first academic sports medicine job is a complex undertaking. There are a number of factors that go into the decision, including finding the job opening, limited regional availability, various academic affiliations, and organizational nuances, as well as payment structures. This article details the many facets of academic sports medicine that make up a position and can greatly affect surgeon workflow, productivity, and overall happiness.

Culture Expansion Alters Human Bone Marrow-Derived Mesenchymal Stem Cell Production of Osteoarthritis-Relevant Cytokines and Growth Factors.

Purpose: The purposes of this study were to characterize the human bone marrow-derived mesenchymal stem cells (BM-MSCs) production of osteoarthritis-relevant cytokines and growth factors as they are purified and multiplied, a process termed culture expansion, and to compare the immunomodulatory potential of BM-MSCs based on source and medium used for culture expansion.

Methods: BM-MSCs were obtained from iliac crest bone marrow aspirates of 4 healthy donors. These 4 BM-MSC cell lines underwent 4 rounds, or "passages," of the institutional culture expansion protocol, using institutional culture media.

Patient satisfaction following unicompartmental knee arthroplasty: Current concepts.

Unicompartmental knee arthroplasty (UKA) has gained progressive popularity in recent decades, currently comprising approximately 10% of knee arthroplasties in the United States. Nonetheless, UKA has not yet solidified its position as the superior treatment for isolated compartment osteoarthritis, as initially reported implant survivorship was subpar, leading to hesitation in its utilization and stricter patient indications compared to total knee arthroplasty. Patient satisfaction following knee arthroplasty has emerged as a critical metric to gauge patient acceptance and contentment with surgical interventions.

Advancing the design of interspinous fixation devices for improved biomechanical performance: dual . single-locking set screw mechanisms and symmetrical . asymmetrical plate designs.

Background: Interspinous devices were introduced in the field of spine surgery as an alternative to traditional pedicle screw fixation in selected patients for treatment of spinal stenosis and fixation. These devices designs have evolved from non-fixated extension blocks to sophisticated interspinous fixation devices (IFDs). There is an absence of literature comparing the biomechanical fixation strength of different IFD plate designs and the role of set screw locking systems.

Reverse Total Shoulder Arthroplasty in an Adult With Achondroplasia.

Achondroplasia can result in many skeletal manifestations, and degenerative osteoarthritis can develop in patients with achondroplasia. Morphologic changes to both the humerus and glenoid-short humeri with patulous metaphyses and a medialized glenoid-can cause challenges that must be overcome to achieve a successful surgical result in a patient with shoulder dysfunction. Because patients with achondroplasia have near-normal life expectancies, the operative shoulder must be functional as well as quite durable in the long term.