Lower Extremity Injuries in Ice Hockey: Current Concepts.

Ice hockey is a fast-paced, collision sport requiring tremendous skill and finesse, yet ice hockey can be a harsh and violent game. It has one of the highest musculoskeletal injury rates in all of competitive sports. Razor sharp skates, aluminum sticks and boards made from high density polyethylene (HDPE), all contribute to the intrinsic hazards of the game.

Reattachment of the flexor and extensor tendons at the epicondyle in elbow instability: a biomechanical comparison of techniques.

Background: Elbow dislocation represents a common injury, especially in the younger population. If treated surgically, the reattached tendons require a high amount of primary stability to allow for an early rehabilitation to avoid postoperative stiffness. The purpose of this study was to assess the biomechanical properties of a single and a double row technique for reattachment of the common extensor and common flexor muscles origin.

Return to play after arthroscopic treatment for shoulder instability in elite and professional baseball players.

Background: This study evaluated the clinical outcome of arthroscopic treatment for anterior shoulder dislocation in elite and professional baseball players.

Methods: This study included 51 baseball players who underwent arthroscopic Bankart repair between 2008 and 2015. The follow-up duration was set at 24 months or longer, based on clinic visit or telephone survey.

Management of the Failed Arthroplasty for Proximal Humerus Fracture.

A variety of reasons exist for failure of arthroplasty performed for management of proximal humerus fracture. Revision surgery for these failures is complex and has a high likelihood of inferior outcomes compared with primary arthroplasty. Successful management requires consideration of various modes of failure including tuberosity malunion or resorption, rotator cuff deficiency, glenoid arthritis, bone loss, component loosening, stiffness, or infection.

Long - term survivorship and clinical results of the navigated withdrawn ASR ™.

Introduction: Primary goals of the study were to present the mid - to long - term survivorship and clinical, radiological and metal serological results of the first stem - navigated ASR resurfacing at our clinic. Secondary goals were to determine the influence of stem - navigation on the outcome and risk factors for revision in our cohort.

Methods: From Mai 2006 to Mai 2009 46 ASR resurfacing hip systems have been implanted in 43 patients with a median age of 55 years.

Age-Related Changes of Elastic Fibers in Shoulder Capsule of Patients with Glenohumeral Instability: A Pilot Study.

Background: Recurrent shoulder dislocations occur much more frequently in adolescents than in the older population but a clear explanation of this incidence does not exist. The aim of the present study was to define the age-related distribution of the elastic fibers (EFs) in the shoulder capsule's extracellular matrix as a factor influencing shoulder instability.

Materials And Methods: Biopsy specimens were obtained from the shoulder capsule of patients divided preoperatively into three groups: Group 1 consisted of 10 male patients undergoing surgery for unidirectional traumatic anterior instability (TUBS); Group 2 consisted of 10 male patients undergoing surgery for multidirectional instability (MDI); Group 3 represents the control, including 10 patients with no history of instability.

Elbow Arthroscopy for Treatment of Valgus Extension Overload.

Valgus extension overload syndrome (VEO) is the result of supraphysiologic stresses placed across the posterior elbow during pitching. Following failure of nonoperative measures, surgical options consist of arthroscopic or limited incision posteromedial decompression. Although technically challenging, arthroscopic treatment offers many advantages over open treatment, including improved joint visualization, decreased soft-tissue dissection, decreased postoperative pain, and quicker rehabilitation.

Does Anchor Placement on the Glenoid Affect Functional Outcome After Arthroscopic Bankart Repair?

Background: In arthroscopic Bankart repair, anchor positions can affect glenoid labral height and functional outcomes.

Purpose: To evaluate anchor placement on the glenoid during Bankart lesion repair and determine which placement would lead to better functional outcomes.

Study Design: Cohort study; Level of evidence, 3.

Preoperative Use of a 3D Printed Model for Femoroacetabular Impingement Surgery and Its Effect on Planned Osteoplasty.

Objective: The purpose of this study was to determine the effect that preoperative use of 3D printed models has on planned osteoplasty for femoroacetabular impingement (FAI) surgery.

Materials And Methods: This experimental study utilizing retrospective data included 10 consecutive patients from July 1, 2013, to January 1, 2015, with a clinical diagnosis of FAI and imaging consisting of radiographs, CT scans, and MR images. Three-dimensional models of each patient's affected hip were printed to scale from CT data.

Clinical Outcomes and Recurrence Rates After Arthroscopic Stabilization Procedures in Young Patients With a Glenoid Bone Erosion: A Comparative Study Between Glenoid Erosion More and Less Than 20.

Purpose: To evaluate the clinical outcomes and recurrence rates of arthroscopic stabilization procedures in young patients who had recurrent anterior shoulder instability with a glenoid bone erosion more than 20%, and to compare with those in patients with a glenoid bone erosion less than 20%.

Methods: A total of 161 patients who underwent an arthroscopic stabilization procedure for recurrent anterior shoulder instability with anterior glenoid bone erosions and at least 2 years of follow-up were included. Patients were divided into 2 groups based on the glenoid defect size (group I [32 patients]: erosion >20%, group II [129 patients]: erosion <20%).

Ulnar Nerve Complications After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review.

Background: While ulnar collateral ligament reconstruction (UCLR) of the elbow is an increasingly commonly performed procedure with excellent results reported in the published literature, less attention has been paid to specifically on the characterization of postoperative ulnar nerve complications, and it is unclear what operative strategies may influence the likelihood of these complications.

Purpose: The purpose of this study is to examine the prevalence and type of ulnar nerve complications after UCLR of the elbow based on the entirety of previously published outcomes in the English literature. In addition, this study examined how the rate of ulnar nerve complications varied as a function of surgical exposures, graft fixation techniques, and ulnar nerve management strategies.

Patellar Instability in the Skeletally Immature.

Purpose Of Review: This review will focus on the evaluation and management of patellar instability in the developing patient.

Recent Findings: A large number of surgical techniques have been described to prevent recurrent patellofemoral instability in the pediatric population, including both proximal and distal realignment procedures. The wide variety of treatment options highlights the lack of agreement as to the best surgical approach.

Prevalence and clinical outcomes of heterotopic ossification after ulnar collateral ligament reconstruction.

Background: Ulnar collateral ligament (UCL) reconstruction has become increasingly popular in elite athletes. However, the prevalence of heterotopic ossification (HO) formation after UCL reconstruction has not yet been reported. We sought to determine the prevalence of HO formation after UCL reconstruction and the clinical outcomes following HO treatment.

Arthroscopic Elbow Osteocapsular Arthroplasty.

Treatment of primary elbow osteoarthritis in the young active patient less than 50 years old presents a treatment challenge to the practicing orthopaedic surgeon. Following failure of nonoperative management, surgical goals are aimed at reducing pain and improving joint mobility from bony impingement. Arthroscopic osteocapsular arthroplasty is a viable treatment option with few post-operative limitations.

The effect of humeral tunnel locations on radiographic tunnel changes in baseball players following medial ulnar collateral ligament reconstruction: comparison of anatomic and nonanatomic locations.

Background: There has been no study on radiologic changes after medial ulnar collateral ligament (MUCL) reconstruction and related clinical features.

Methods: Data from 39 baseball players who underwent MUCL reconstruction were collected and analyzed. The baseball players were classified into 2 groups according to the starting point of the humeral tunnel: (1) the lower tip of the medial epicondyle (group NA, n = 21) and (2) the remnant of the MUCL (group A, n = 18).

Effect of recombinant human growth hormone on rotator cuff healing after arthroscopic repair: preliminary result of a multicenter, prospective, randomized, open-label blinded end point clinical exploratory trial.

Background: This study evaluated the effect of systemic injection of recombinant human growth hormone (rhGH) on outcomes after arthroscopic rotator cuff repair.

Methods: This multicenter, prospective, randomized, comparative trial, randomized patients who underwent arthroscopic repair of large-sized rotator cuff tears into 3 groups: rhGH 4 mg group (n = 26), rhGH 8 mg group (n = 24) , and control group (n = 26). Sustained release rhGH was injected subcutaneously once weekly for 3 months postoperatively.

Elbow Arthroscopy: 30-Day Postoperative Complication Profile and Associated Risk Factors.

Purpose: To analyze (1) the incidence and type of complications after elbow arthroscopy, (2) the incidence of returning to the operating room (OR) after elbow arthroscopy, and (3) patient and risk factors for complications across a national surgical outcome database.

Methods: Patients who underwent elbow arthroscopy from January 2005 through December 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database by use of Current Procedural Terminology codes. Basic patient demographic data and medical comorbidities were recorded.

Single versus double row suture anchor fixation for greater tuberosity fractures - a biomechanical study.

Background: Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Yet, no biomechanical study has been performed comparing fixation strength of arthroscopic single- (SR) vs. double row (DR) fixation.

Reliability of 3-Dimensional Glenoid Component Templating and Correlation to Intraoperative Component Selection.

Although implant-specific intraoperative targeting devices for glenoid sizing exist, a validated method for preoperatively templating glenoid component size in primary total shoulder arthroplasty (TSA) based on digital imaging does not. We conducted a study to determine if 3-dimensional (3-D) digital imaging could be used for preoperative templating of glenoid component size and to compare templated glenoid sizes with implanted glenoid sizes. We created 3-D digital models from 3 glenoid component implant sizes and preoperative scapular computed tomography scans of 24 patients who underwent primary TSA.

Head, Neck, and Shoulder Injuries in Ice Hockey: Current Concepts.

Ice hockey is a fast-paced contact sport that is becoming increasingly popular in North America. More than 1 million men, women, and juniors are playing hockey in the United States and Canada. With players colliding forcefully with one another and with the boards surrounding the ice, injury rates are among the highest in all of competitive sports.

Return to sports after plate fixation of humeral head fractures 65 cases with minimum 24-month follow-up.

Background: Humeral head fractures requiring surgical intervention are severe injuries, which might affect the return to sports and daily activities. We hypothesize that athletic patients will be constrained regarding their sporting activities after surgically treated humeral head fractures. Despite a long rehabilitation program physical activities will change and an avoidance of overhead activities will be noticed.

Reverse Shoulder Arthroplasty for the Treatment of 3 and 4- Part Fractures of the Humeral Head in the Elderly.

Background: Proximal humeral fractures in elderly patients present with severe comminution and osteoporotic bone quality. Reverse shoulder arthroplasty has lately been proven beneficial in treating patients with complex proximal humeral fractures. The above technique is recommended and has better results in elderly than in younger individuals.

Stress ultrasound in baseball players with ulnar collateral ligament injuries: additional value for predicting rehabilitation outcome.

Background: The purpose of this study was to evaluate the additional value of stress ultrasound (US) for predicting rehabilitation outcome in baseball players with ulnar collateral ligament (UCL) injury.

Methods: Stress US and magnetic resonance imaging (MRI) in 41 baseball players with UCL injury who received rehabilitation treatment for more than 6 weeks were retrospectively compared between the rehabilitation group (n = 23) and surgery group (n = 18). The MRI grade of UCL injury was assessed as intact continuity, low-grade partial tear, high-grade partial tear, and complete tear.

Athletic Hip Injuries.

Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration.

Relative individual workload changes may be a risk factor for rerupture of ulnar collateral ligament reconstruction.

Background: With an increasing number of Major League Baseball (MLB) players undergoing ulnar collateral ligament (UCL) reconstruction, there remains limited literature on appropriate post-reconstruction workload management to limit the risk of reinjury.

Methods: A total of 28 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction were identified and compared with 137 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared 3 years before and after primary reconstruction.