Intraoperative Cost Comparison of Endoscopic Carpal Tunnel Release With WALANT Versus MAC Anesthesia.

Background: The cost of endoscopic carpal tunnel release (ECTR) has historically been shown to be significantly higher than the cost of open carpal tunnel release (OCTR). Setting and anesthetic technique drive costs in hand surgery; ambulatory surgical center (ASC) settings demonstrate lower costs when compared to hospital-based settings and local-only anesthetic techniques demonstrate savings over general anesthesia. The purpose of this study is to compare wide awake local-only anesthesia technique (WALANT) to monitored anesthetic care (MAC) for ECTR performed in an ASC setting.

Advances in Dynamization of Plate Fixation to Promote Natural Bone Healing.

The controlled dynamization of fractures can promote natural fracture healing by callus formation, while overly rigid fixation can suppress healing. The advent of locked plating technology enabled new strategies for the controlled dynamization of fractures, such as far cortical locking (FCL) screws or active plates with elastically suspended screw holes. However, these strategies did not allow for the use of non-locking screws, which are typically used to reduce bone fragments to the plate.

Is Timing of Total Hip Arthroplasty and Lumbar Spine Fusion Associated With Risk of Hip Dislocation?

Background: In patients with concomitant hip and lumbar spine disease, the question of which surgery-total hip arthroplasty (THA) or lumbar spine fusion (LSF)-to address first has not been adequately answered. We aimed to evaluate the risk of dislocation after THA in patients with LSF first or after THA.

Methods: Retrospective review utilizing the PearlDiver database querying Current Procedural Terminology codes for LSF in the year prior (LSF first) or in the year after primary or revision THA (THA first).

Technical improvements in preparing 3D printed anatomical models for comminuted fracture preoperative planning.

Preoperative planning of comminuted fracture repair using 3D printed anatomical models is enabling surgeons to visualize and simulate the fracture reduction processes before surgery. However, the preparation of such models can be challenging due to the complexity of certain fractures, particularly in preserving fine detail in bone fragments, maintaining the positioning of displaced fragments, and accurate positioning of multiple bones. This study described several key technical considerations for preparing 3D printed anatomical models for comminuted fracture preoperative planning.

The Effect of a Statewide Policy on High School Emergency Action Plans.

Institutions sponsoring athletics must be prepared for emergencies. Due to this, more governing bodies are requiring a sports-related emergency action plan (EAP). Yet, the effects of these policies are unknown.

Use of Lifesaving Medications by Athletic Trainers.

The athletic trainer's (AT's) emergency management skillset requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training practice for decades, but that list has grown as ATs' practice settings have expanded, increasing the types of emergent conditions that the AT may have to treat. The 2020 Commission on Accreditation of Athletic Training Education (CAATE) curricular standards require that athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low-dose aspirin, bronchodilators, epinephrine using an automated injection device, glucagon, and naloxone.

Pedestrian Safety Among High School Runners: A Case Series.

Background: Participation in high school cross-country and track has increased over the last few decades. At the same time, the rate of pedestrian-involved motor vehicle crashes (MVCs) has also increased. In the context of organized sport, pedestrian safety among runners is often not highlighted, despite the risk of catastrophic injury.

The Operative Treatment of Scapula Fractures: An Analysis of 10,097 Patients.

Background: The indications for operative treatment of scapula fractures have been debated over the past decade. Our purpose was to determine 1) the incidence and trends in the operative treatment of scapula fractures, 2) the incidence of conversion from operative fixation to total or hemi-shoulder arthroplasty (THSA) and 3) rates of associated injuries in scapula fractures. We hypothesized that the operative treatment of scapula fractures is increasing over time and that scapula fractures treated with open reduction and internal fixation (ORIF) would have increased risk for conversion to THSA.

Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty.

Investigate the underlying cellular basis of muscle atrophy (Placebo) and atrophy reduction (essential amino acid supplementation, EAAs) in total knee arthroplasty (TKA) patients by examining satellite cells and other key histological markers of inflammation, recovery, and fibrosis. Forty-one subjects (53-76 yr) scheduled for TKA were randomized into two groups, ingesting 20 g of EAAs or placebo, twice-daily, for 7 days before TKA and for 6 wk after surgery. A first set of muscle biopsies was obtained from both legs before surgery in the operating room, and patients were randomly assigned and equally allocated to have two additional biopsies at either 1 or 2 wk after surgery.

Cost-Benefit of Hiring Athletic Trainers in Oregon High Schools From 2011-2014.

Context: Hiring athletic trainers (ATs) in high schools may lower medical payments by third-party payers such as Medicaid or commercial insurers by reducing injury risks or may increase medical payments due to more referrals to other health care providers. To date, evidence is lacking on the actual financial effect of high school ATs based on an analysis of medical claims.

Objective: To assess the overall cost-benefit of hiring ATs in Oregon high schools based on medical claims data across years.

Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Substantial muscle atrophy occurs after total knee arthroplasty (TKA), resulting in decreased strength and impaired mobility. We sought to determine whether perioperative supplementation with essential amino acids (EAA) would attenuate muscle atrophy following TKA and whether the supplements were safe for ingestion in an older surgical population.

Methods: We performed a double-blind, placebo-controlled, randomized trial of 39 adults (age range, 53 to 76 years) undergoing primary unilateral TKA who ingested 20 g of EAA (n = 19) or placebo (n = 20) twice daily for 7 days preoperatively and for 6 weeks postoperatively.

Foot Kinematics Differ Between Runners With and Without a History of Navicular Stress Fractures.

Background: A navicular stress fracture (NSF) is a common and high-risk injury in distance runners. It is not clear whether there are differences in foot structure and function between runners who have and those who have not sustained an NSF.

Purpose/hypothesis: This study compared foot structure, range of motion, and biomechanics between runners with a history of unilateral NSFs and runners who had never sustained this injury.

Sports-Related Emergency Preparedness in Oregon High Schools.

Background: Best practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders-specifically coaches-trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so.

Hypothesis: Schools with an AT were more likely to have implemented the recommendations.

Dynamic Stabilization of Simple Fractures With Active Plates Delivers Stronger Healing Than Conventional Compression Plating.

Objectives: Active plates dynamize a fracture by elastic suspension of screw holes within the plate. We hypothesized that dynamic stabilization with active plates delivers stronger healing relative to standard compression plating.

Methods: Twelve sheep were randomized to receive either a standard compression plate (CP) or an active plate (ACTIVE) for stabilization of an anatomically reduced tibial osteotomy.

Normalization to Maximal Voluntary Contraction is Influenced by Subacromial Pain.

In this study, we aimed to determine if electromyography (EMG) normalization to maximal voluntary isometric contractions (MVIC) was influenced by subacromial pain in patients with subacromial impingement syndrome. Patients performed MVICs in unique testing positions for each shoulder muscle tested before and after subacromial injection of local anesthetic. In addition to collection of MVIC data, EMG data during an arm elevation task were recorded before and after injection.

Dynamic Stabilization with Active Locking Plates Delivers Faster, Stronger, and More Symmetric Fracture-Healing.

Background: Axial dynamization of fractures can promote healing, and overly stiff fixation can suppress healing. A novel technology, termed active plating, provides controlled axial dynamization by the elastic suspension of locking holes within the plate. This prospective, controlled animal study evaluated the effect of active plates on fracture-healing in an established ovine osteotomy model.

Transcriptional profiling and muscle cross-section analysis reveal signs of ischemia reperfusion injury following total knee arthroplasty with tourniquet.

Total knee arthroplasty (TKA) is the most common and cost-effective treatment for older adults with long-standing osteoarthritis. Projections indicate that nearly 3.5 million older adults will undergo this procedure annually by the year 2030.

Factors influencing high school coaches' adoption of injury prevention programs.

Objectives: Despite documented efficacy of injury prevention programs (IPPs) to reduce sport-related lower extremity injury risk, there is evidence of a lack of widespread IPP adoption by high school coaches. This study identified factors related to non-adoption of IPPs by assessing coaches' knowledge, attitudes, and behaviors related to prevention programs and comparing attitudes between adopter and non-adopter coaches.

Design: Cross-sectional.

Dynamic locking plates provide symmetric axial dynamization to stimulate fracture healing.

Axial dynamization of an osteosynthesis construct can promote fracture healing. This biomechanical study evaluated a novel dynamic locking plate that derives symmetric axial dynamization by elastic suspension of locking holes within the plate. Standard locked and dynamic plating constructs were tested in a diaphyseal bridge-plating model of the femoral diaphysis to determine the amount and symmetry of interfragmentary motion under axial loading, and to assess construct stiffness under axial loading, torsion, and bending.

The effectiveness of a web-based resource in improving postconcussion management in high schools.

Purpose: Because many sports concussions happen during school-sponsored sports events, most state concussion laws specifically hold schools accountable for coach training and effective concussion management practices. Brain 101: The Concussion Playbook is a Web-based intervention that includes training in sports concussion for each member of the school community, presents guidelines on creating a concussion management team, and includes strategies for supporting students in the classroom.

Methods: The group randomized controlled trial examined the efficacy of Brain 101 in managing sports concussion.

Subacromial Injection Results in Further Scapular Dyskinesis.

Background: Scapular kinematic movement patterns between patients with subacromial impingement and healthy controls have been extensively investigated. However, a high degree of variability has been reported in the literature pertaining to differences between these 2 groups.

Purpose: To investigate the influence of subacromial pain on scapular kinematics.

Center of pressure trajectory differences between shod and barefoot running.

This study examined differences in center of pressure (COP) trajectories between shod and barefoot running. Ten habitually shod runners ran continuous laps under both shod and barefoot conditions. The COP trajectory was calculated in the global coordinate system but then transformed to the anatomic coordinate system of the foot.