Cape-like Anomalous Confluence of the Long Head of the Biceps and Rotator Cuff in the Presence of a SLAP Tear: A Case Report.

Case: A 25-year-old woman sustained an acute tear of her superior anterior-posterior labrum with arthroscopic identification of an anomalous origin of the long head of the biceps arising exclusively from the supraspinatus tendon with no attachment to the supraglenoid tubercle or superior labrum.

Conclusion: This is the first report of a symptomatic superior labrum anterior-posterior tear in a patient with a rare anatomic confluence of the long head of the biceps to the supraspinatus. We recommend addressing the labral pathology with utilization of a standard technique because satisfactory results can be realized with isolated labral fixation to the glenoid, despite the absence of an attached biceps tendon.

Arthroscopic Posterior Glenoid Reconstruction Using a Fresh Distal Tibia Allograft for Recurrent Posterior Instability.

Posterior glenohumeral instability is a relatively uncommon cause of shoulder instability. Recurrent posterior instability with static posterior humeral head subluxation is often associated with critical glenoid bone loss. Unlike anterior instability, the amount of bone loss for posterior instability that requires surgical reconstruction remains a topic of debate.

USE OF AN UPPER EXTREMITY FUNCTIONAL TESTING ALGORITHM TO DETERMINE RETURN TO PLAY READINESS IN COLLEGIATE FOOTBALL PLAYERS: A CASE SERIES.

Background/purpose: Return to play decision making for upper extremity injuries is challenging due to a lack of evidence-based protocols and testing. Current guidelines utilize tests and measures with minimal evidence on re-injury risks and prediction. The purpose of this case series is to highlight a functional testing algorithm for upper extremities injuries and the outcomes for the patients that followed it.

REPEATABILITY OF SWAY MEASURES IN UPPER EXTREMITY WEIGHT-BEARING.

Background: Analysis of upper extremity weight bearing ability is important for athletes as some function largely in a closed chain capacity (e.g., wrestling, football, gymnastics); also, all require closed chain upper extremity function during strength and conditioning.

Profile of upper extremity strength and function in division 1 collegiate athletes.

Objectives: To profile shoulder strength and functional test scores in collegiate athletes across various sports.

Design: Cross-sectional.

Setting: Pre-participation physical screens for varsity athletes at a Division I university.

Comparison of core neuromuscular control and lower extremity postural stability in athletes with and without shoulder injuries.

Background: The kinetic chain theory is widely used as a rationale for the inclusion of core stability training in athletes. Core stability (muscle capacity and neuromuscular control) impairments may result in less than optimal performance and abnormal force dissipation to the shoulder complex that could lead to shoulder injuries. However, a paucity of literature exists to support this relationship, and no previous studies have investigated the relationship between isolated core neuromuscular control and shoulder injuries.

Comprehensive movement system screening tool (MSST) for athletes: Development and measurement properties.

Objectives: Non-traumatic extremity injuries are particularly common in sports, representing a significant economic, academic, and psychosocial burden on athletes. Proposed musculoskeletal risk factors for increased injury and decreased performance in athletes include movement pattern inefficiency, decreased regional stability, decreased mobility, and asymmetrical movement. The Movement System Screening Tool (MSST) is a comprehensive screening tool designed to assess these factors.

An algorithmic approach to rehabilitation following arthroscopic surgery for arthrofibrosis of the knee.

Background And Purpose: Loss of knee range of motion (ROM) has been reported as the most common complication following anterior cruciate ligament reconstruction (ACLR). Arthrofibrosis of the knee, or specifically Cyclops syndrome, has been described as the formation of a scar tissue nodule adjacent to the tibial tunnel of the anterior cruciate ligament (ACL) graft. This lesion often results in loss of knee extension ROM, pain, and impaired function.

Prevention and Management of Post-operative Complications Following ACL Reconstruction.

Purpose Of Review: The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery.

Recent Findings: ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissue-healing time frame.

T1ρ Magnetic Resonance Imaging to Assess Cartilage Damage After Primary Shoulder Dislocation.

Background: Patients who suffer anterior shoulder dislocations are at higher risk of developing glenohumeral arthropathy, but little is known about the initial cartilage damage after a primary shoulder dislocation. T1ρ is a magnetic resonance imaging (MRI) technique that allows quantification of cartilage proteoglycan content and can detect physiologic changes in articular cartilage.

Purpose: This study aimed to establish baseline T1ρ MRI values for glenoid and humeral head cartilage, determine whether T1ρ MRI can detect glenohumeral cartilage damage after traumatic primary shoulder dislocation, and assess for patterns in cartilage damage in anterior shoulder dislocation.

Prediction of in-season shoulder injury from preseason testing in division I collegiate football players.

Background: Collegiate football is a high-demand sport in which shoulder injuries are common. Research has described the incidence of these injuries, with little focus on causative factors or injury prevention.

Hypothesis: Football athletes who score lower on preseason strength and functional testing are more likely to sustain an in-season shoulder injury.

Delayed-onset ulnar neuritis after release of elbow contractures: clinical presentation, pathological findings, and treatment.

Background: Little information exists regarding delayed-onset ulnar neuritis (DOUN) after arthroscopic release of elbow contractures.

Purpose: To describe, in a large cohort of patients, the clinical presentation of and risk factors for developing DOUN after arthroscopic release of elbow contractures.

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

Anterior hip dislocation 5 months after hip arthroscopy.

Hip dislocation subsequent to hip arthroscopy is a rare complication. We report on a case of low-energy anterior hip dislocation that occurred 5 months after hip arthroscopy, a period notably longer than any previously reported event. The patient was a track and field athlete who presented and received treatment for a labral tear and cam lesion.

Anatomic and biomechanical fundamentals of the thrower shoulder.

The act of throwing requires proper functioning and timing of the entire kinetic chain musculature to generate a coordinated movement pattern for ball delivery. The role of the shoulder complex is vital in the transmission of force from the lower extremities and trunk to the arm and hand. A review of the anatomic and biomechanical factors of the shoulder girdle will be discussed as it pertains to the thrower.

Rehabilitation and functional outcomes in collegiate wrestlers following a posterior shoulder stabilization procedure.

Study Design: Case series.

Case Description: Five consecutive collegiate Division I wrestlers, with a mean age of 20.2 years (range, 18-22 years), were treated postsurgical stabilization to address posterior glenohumeral joint instability.

Suture bridge fixation of a femoral condyle traumatic osteochondral defect.

Unlabelled: Internal fixation of a traumatic osteochondral defect presents a challenge in terms of obtaining anatomic reduction, fixation, and adequate compression for healing. Fixation with countersunk intraarticular screws, Herbert screws, bioabsorbable screws and pins, mini-cancellous screws, and glue tissue adhesive have been reported with varying results. We present an alternative fixation method used in two patients for femoral condylar defects that achieved anatomic reduction with compression via a cruciate-shaped suture bridge construct tied down over a bony bridge.

Lateral femoral epicondylar osteotomy: an extensile posterolateral knee approach.

Unlabelled: Open exposure of the posterolateral corner of the knee is challenged by limitations of posterolateral ligamentous tissues and posterior neurovascular structures. We have used a modification of a lateral femoral epicondyle osteotomy, described historically for surgical management of posterolateral rotatory instability, as an approach to the posterolateral intraarticular structures. The historic technique for ligamentous reconstruction has been abandoned because its nonanatomic fixation does not restore ligamentous isometry.

Neer Award 2006: Biomechanical assessment of inferior tuberosity placement during hemiarthroplasty for four-part proximal humeral fractures.

Tuberosity malpositioning commonly occurs and is associated with a decline in clinical function after prosthetic shoulder reconstruction for proximal humeral fractures. This study assesses the biomechanical effects of inferior tuberosity position on glenohumeral joint forces and humeral head position at multiple positions. Eight fresh-frozen cadaveric shoulders were tested.

Case series utilizing drop-out casting for the treatment of knee joint extension motion loss following anterior cruciate ligament reconstruction.

Study Design: Case series.

Case Description: Four patients who had developed knee extension motion loss following anterior cruciate ligament reconstruction were referred to physical therapy for treatment. They were treated with drop-out casting and completed a Lower Extremity Functional Scale at baseline, at the time of application of the drop-out casting, and at discharge.

Ulnar collateral ligament reconstruction in major league baseball pitchers.

Background: Ulnar collateral ligament reconstruction is commonly performed in major league pitchers, but little is known about pitching performance after a return to major league play.

Hypothesis: Pitching performance after ulnar collateral ligament reconstruction returns to baseline by the second season after surgery.

Study Design: Cohort study (prognosis); Level of evidence, 2.