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  Subjects -> SPORTS AND GAMES (Total: 199 journals)
Showing 1 - 3 of 3 Journals sorted alphabetically
Acta Facultatis Educationis Physicae Universitatis Comenianae     Open Access   (Followers: 3)
Acta Kinesiologiae Universitatis Tartuensis     Open Access   (Followers: 1)
ACTIVE : Journal of Physical Education, Sport, Health and Recreation     Open Access   (Followers: 23)
Advances in Physical Education     Open Access   (Followers: 10)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 5)
Ágora para la Educación Física y el Deporte     Open Access  
Al-Rafidain Journal For Sport Sciences     Open Access  
Al.Qadisiya journal for the Sciences of Physical Education     Open Access  
American Journal of Sports Science and Medicine     Open Access   (Followers: 38)
Annals of Applied Sport Science     Open Access   (Followers: 8)
Arena-Journal of Physical Activities     Open Access   (Followers: 2)
Arquivos em Movimento     Open Access   (Followers: 1)
Arrancada     Open Access  
Asia Pacific Journal of Sport and Social Science     Hybrid Journal   (Followers: 4)
Asian Journal of Sport and Exercise Psychology     Open Access   (Followers: 1)
Australian and New Zealand Sports Law Journal     Full-text available via subscription   (Followers: 7)
Baltic Journal of Sport and Health Sciences     Open Access   (Followers: 2)
Berkeley Journal of Entertainment and Sports Law     Open Access   (Followers: 5)
Biomedical Human Kinetics     Open Access   (Followers: 8)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 34)
Cerdas Sifa Pendidikan : Sport Education     Open Access  
Ciencia y Deporte     Open Access   (Followers: 1)
Citius, Altius, Fortius     Open Access  
Clinical Journal of Sport Medicine     Hybrid Journal   (Followers: 34)
Coaching Psykologi : The Danish Journal of Coaching Psychology     Open Access   (Followers: 3)
College Athletics and The Law     Hybrid Journal   (Followers: 1)
Communication & Sport     Hybrid Journal   (Followers: 7)
Comparative Exercise Physiology     Hybrid Journal   (Followers: 21)
Conexões     Open Access  
Corpoconsciência     Open Access  
Cuadernos de Psicologia del Deporte     Open Access  
Cultura, Ciencia y Deporte     Open Access   (Followers: 1)
Curriculum Studies in Health and Physical Education     Hybrid Journal   (Followers: 9)
Educación Física y Ciencia     Open Access  
Educación física y deporte     Open Access   (Followers: 1)
eJRIEPS : Ejournal de la recherche sur l'intervention en éducation physique et sport     Open Access  
European Journal for Sport and Society     Hybrid Journal   (Followers: 1)
European Journal of Sport Science     Hybrid Journal   (Followers: 65)
Facta Universitatis, Series : Physical Education and Sport     Open Access   (Followers: 4)
FairPlay, Revista de Filosofia, Ética y Derecho del Deporte     Open Access  
Footwear Science     Hybrid Journal   (Followers: 3)
Forum for Idræt, Historie og Samfund     Open Access  
Forum Kinder- und Jugendsport : Zeitschrift für Forschung, Transfer und Praxisdialog     Hybrid Journal  
Frontiers in Sports and Active Living     Open Access   (Followers: 2)
Gelanggang Pendidikan Jasmani Indonesia     Open Access  
German Journal of Exercise and Sport Research : Sportwissenschaft     Hybrid Journal   (Followers: 2)
Indonesian Journal of Sport Management     Open Access   (Followers: 4)
International Journal of Applied Exercise Physiology     Open Access   (Followers: 52)
International Journal of Computer Science in Sport     Open Access   (Followers: 5)
International Journal of Exercise Science     Open Access   (Followers: 24)
International Journal of Golf Science     Open Access   (Followers: 1)
International Journal of Kinesiology and Sports Science     Open Access   (Followers: 16)
International Journal of Performance Analysis in Sport     Full-text available via subscription   (Followers: 22)
International Journal of Recreation and Sports Science     Open Access   (Followers: 4)
International Journal of Science Culture and Sport     Open Access  
International Journal of Sport and Exercise Psychology     Hybrid Journal   (Followers: 36)
International Journal of Sport Communication     Hybrid Journal   (Followers: 6)
International Journal of Sport Policy     Hybrid Journal   (Followers: 11)
International Journal of Sport, Exercise & Training Sciences     Open Access   (Followers: 1)
International Journal of Sports Marketing and Sponsorship     Hybrid Journal  
International Journal of Sports Science     Open Access   (Followers: 24)
International Journal of Sports Science & Coaching     Hybrid Journal   (Followers: 32)
International Journal of the History of Sport     Hybrid Journal   (Followers: 18)
International Review for the Sociology of Sport     Hybrid Journal   (Followers: 21)
International Review of Sport and Exercise Psychology     Hybrid Journal   (Followers: 22)
International Sport Coaching Journal     Hybrid Journal   (Followers: 7)
International Sports Law Journal     Hybrid Journal   (Followers: 3)
International Turfgrass Society Research Journal     Free   (Followers: 1)
Isokinetics and Exercise Science     Hybrid Journal   (Followers: 10)
Jeffrey S. Moorad Sports Law Journal     Open Access   (Followers: 1)
Jendela Olahraga     Open Access  
Journal for the Measurement of Physical Behaviour     Hybrid Journal   (Followers: 1)
Journal of Amateur Sport     Open Access   (Followers: 1)
Journal of Applied Sport Management: Research that Matters     Full-text available via subscription   (Followers: 5)
Journal of Athlete Development and Experience     Open Access  
Journal of Athletic Enhancement     Hybrid Journal   (Followers: 6)
Journal of Exercise Science & Fitness     Open Access   (Followers: 24)
Journal of Global Sport Management     Hybrid Journal   (Followers: 1)
Journal of Hospitality, Leisure, Sport & Tourism Education     Full-text available via subscription   (Followers: 3)
Journal of Human Kinetics     Open Access   (Followers: 15)
Journal of Human Sport and Exercise     Open Access   (Followers: 13)
Journal of Intercollegiate Sport     Open Access   (Followers: 5)
Journal of Motor Learning and Development     Hybrid Journal  
Journal of Orthopaedic & Sports Physical Therapy     Full-text available via subscription   (Followers: 68)
Journal of Physical Activity Research     Open Access   (Followers: 3)
Journal of Physical Education and Human Movement     Open Access  
Journal of Physical Education and Sport Sciences     Open Access   (Followers: 2)
Journal of Physical Education and Sports     Open Access   (Followers: 4)
Journal of Physical Education and Sports Science     Open Access  
Journal of Physical Education Health and Sport     Open Access   (Followers: 1)
Journal of Physical Education, Recreation & Dance     Full-text available via subscription   (Followers: 12)
Journal of Policy Research in Tourism, Leisure and Events     Hybrid Journal   (Followers: 7)
Journal of Science and Cycling     Open Access   (Followers: 9)
Journal of Science and Medicine in Sport     Hybrid Journal   (Followers: 36)
Journal of Science in Sport and Exercise     Hybrid Journal   (Followers: 4)
Journal of Sport & Tourism     Hybrid Journal   (Followers: 7)
Journal of Sport and Health Science     Open Access   (Followers: 23)
Journal of Sport History     Full-text available via subscription   (Followers: 12)
Journal of Sport Psychology in Action     Hybrid Journal   (Followers: 13)
Journal of Sport Sciences and Fitness     Open Access   (Followers: 13)
Journal of Sports Economics     Hybrid Journal   (Followers: 6)
Journal of Sports Media     Full-text available via subscription   (Followers: 4)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Sports Medicine and Therapy     Open Access  
Journal of Sports Science and Medicine     Open Access   (Followers: 22)
Journal of the Philosophy of Sport     Hybrid Journal   (Followers: 6)
Journal of Tourism, Hospitality and Sports     Open Access   (Followers: 3)
Juara : Jurnal Olahraga     Open Access  
Jurnal Abdimas     Open Access  
Jurnal Keolahragaan     Open Access  
Jurnal Sport Science     Open Access   (Followers: 1)
Kinesiology : International Journal of Fundamental and Applied Kinesiology     Open Access  
Kinesiology Review     Hybrid Journal   (Followers: 3)
Laisvalaikio Tyrimai     Open Access   (Followers: 2)
Managing Sport and Leisure     Hybrid Journal   (Followers: 1)
Marquette Sports Law Review     Open Access   (Followers: 1)
Martial Arts Studies     Open Access  
Materiales para la historia del deporte     Open Access  
mensch & pferd international     Full-text available via subscription  
MHSalud : Movimiento Humano y Salud     Open Access  
Movement & Sport Sciences : Science & Motricité     Full-text available via subscription   (Followers: 1)
New Approaches in Sport Sciences     Open Access  
NINE : A Journal of Baseball History and Culture     Full-text available via subscription   (Followers: 4)
Open Access Journal of Sports Medicine     Open Access   (Followers: 14)
Open Sports Sciences Journal     Open Access  
Orthopaedic Journal of Sports Medicine     Open Access   (Followers: 14)
Pace Intellectual Property, Sports & Entertainment Law Forum     Open Access   (Followers: 4)
PALAESTRA : Adapted Sport, Physical Education, and Recreational Therapy     Full-text available via subscription   (Followers: 3)
Perceptual and Motor Skills     Full-text available via subscription   (Followers: 8)
Physical Culture and Sport. Studies and Research     Open Access   (Followers: 8)
Physical Education of Students     Open Access  
Physician and Sportsmedicine     Open Access   (Followers: 6)
Podium Sport, Leisure and Tourism Review     Open Access   (Followers: 2)
Polish Journal of Sport and Tourism     Open Access  
Proceedings of the Institution of Mechanical Engineers Part P: Journal of Sports Engineering and Technology     Hybrid Journal   (Followers: 4)
Qualitative Research in Sport and Exercise     Hybrid Journal   (Followers: 20)
Qualitative Research in Sport, Exercise and Health     Hybrid Journal   (Followers: 18)
Quality in Sport     Open Access  
Quest     Hybrid Journal   (Followers: 3)
RBFF - Revista Brasileira de Futsal e Futebol     Open Access  
RBNE - Revista Brasileira de Nutrição Esportiva     Open Access   (Followers: 1)
Reabilitacijos Mokslai : Slauga, Kineziterapija, Ergoterapija     Open Access   (Followers: 3)
Research on ٍEducational Sport     Open Access  
Research Quarterly for Exercise and Sport     Hybrid Journal   (Followers: 2)
Retos : Nuevas Tendencias en Educación Física, Deportes y Recreación     Open Access  
Revista Andaluza de Medicina del Deporte     Open Access   (Followers: 2)
Revista Brasileira do Esporte Coletivo     Open Access  
Revista de Artes Marciales Asiáticas     Open Access  
Revista de Psicología del Deporte     Open Access  
Revista Iberoamericana de Ciencias de la Actividad Física y el Deporte     Open Access  
Revista Intercontinental de Gestão Desportiva     Open Access  
Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte : International Journal of Medicine and Science of Physical Activity and Sport     Open Access   (Followers: 1)
RICYDE. Revista Internacional de Ciencias del Deporte     Open Access  
Scandinavian Journal of Sport and Exercise Psychology     Open Access   (Followers: 3)
Science and Medicine in Football     Hybrid Journal   (Followers: 1)
Seton Hall Journal of Sports and Entertainment Law     Open Access   (Followers: 3)
SIPATAHOENAN : South-East Asian Journal for Youth, Sports & Health Education     Open Access  
Soccer & Society     Hybrid Journal   (Followers: 10)
Sociology of Sport Journal     Hybrid Journal   (Followers: 12)
Spor Bilimleri Araştırmaları Dergisi     Open Access  
Spor Bilimleri Dergisi / Hacettepe Journal of Sport Sciences     Open Access  
Spor Eğitim Dergisi     Open Access  
Spor ve Performans Araştırmaları Dergisi / Ondokuz Mayıs University Journal of Sports and Performance Researches     Open Access  
Sport and Art     Open Access   (Followers: 1)
Sport and Fitness Journal     Open Access   (Followers: 4)
Sport History Review     Hybrid Journal   (Followers: 10)
Sport i Turystyka : Środkowoeuropejskie Czasopismo Naukowe     Open Access  
Sport in History     Hybrid Journal   (Followers: 10)
Sport Journal     Open Access   (Followers: 12)
Sport Management Education Journal     Hybrid Journal   (Followers: 5)
Sport Science and Health     Open Access   (Followers: 1)
Sport Science Review     Open Access   (Followers: 13)
SPORT TK-Revista EuroAmericana de Ciencias del Deporte     Open Access  
Sport, Business and Management : An International Journal     Hybrid Journal   (Followers: 8)
Sport, Exercise, and Performance Psychology     Full-text available via subscription   (Followers: 11)
Sporting Traditions     Full-text available via subscription   (Followers: 2)
Sportis. Scientific Journal of School Sport, Physical Education and Psychomotricity     Open Access   (Followers: 1)
SPORTIVE : Journal Of Physical Education, Sport and Recreation     Open Access  
Sportphysio     Hybrid Journal  
Sports     Open Access   (Followers: 3)
Sports Coaching Review     Hybrid Journal   (Followers: 3)
Sports Law and Governance Journal     Open Access   (Followers: 1)
Sports Medicine International Open     Open Access   (Followers: 2)
Sports Technology     Hybrid Journal   (Followers: 3)
Sportverletzung · Sportschaden     Hybrid Journal   (Followers: 2)
Sri Lankan Journal of Sports and Exercise Medicine     Open Access  
Strategies : A Journal for Physical and Sport Educators     Hybrid Journal   (Followers: 3)
The Sport Psychologist     Hybrid Journal   (Followers: 7)
Therapeutic Recreation Journal     Full-text available via subscription  
Timisoara Physical Education and Rehabilitation Journal     Open Access   (Followers: 1)
Translational Journal of the American College of Sports Medicine     Hybrid Journal  
Turkish Journal of Sport and Exercise     Open Access  
Türkiye Spor Bilimleri Dergisi / Turkish Journal of Sports Science     Open Access  
Ulusal Spor Bilimleri Dergisi / Journal of National Sport Sciences     Open Access  
UNLV Gaming Research & Review Journal     Open Access   (Followers: 2)
Video Journal of Sports Medicine     Open Access  
Zeitschrift für Sportpsychologie     Hybrid Journal  
Слобожанський науково-спортивний вісник     Open Access  

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Orthopaedic Journal of Sports Medicine
Journal Prestige (SJR): 0.935
Citation Impact (citeScore): 1
Number of Followers: 14  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2325-9671 - ISSN (Online) 2325-9671
Published by Sage Publications Homepage  [1174 journals]
  • Comparison of the Therapeutic Effects Between Isokinetic and Isotonic
           Strength Training in Patients After Total Knee Replacement: A Prospective,
           Randomized Controlled Trial

    • Authors: Yuan-Yang Cheng, Chuan-Ching Liu, Shih-Yi Lin, Cheng-Hung Lee, Shin-Tsu Chang, Shun-Ping Wang
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery stage after TKR.Purpose:To compare the therapeutic effects between isokinetic and isotonic strengthening in patients after TKR.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:From April 2018 to August 2020, 37 patients met the inclusion criteria and were randomly assigned to perform either 4-week isokinetic or isotonic strength training programs. Other components of the rehabilitation program were kept the same between the 2 groups. All cases were evaluated by the Timed Up and Go (TUG) test, peak torque of knee extension and flexion (60 and 120 deg/s), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).Results:After undergoing a 4-week strength training regimen, significant improvements in the TUG test were noted in both groups; however, the time improvement in the isotonic group did not reach the minimal detectable change. All peak torque measurements improved in the isokinetic group but not in the isotonic group for knee flexion at 60 deg/s. The pain subdomain, physical domain, mental domain, total SF-36 score, and WOMAC index all improved significantly in both groups after training. Both training groups improved significantly in peak torque of knee strength, TUG test, and functional scores, but the differences between isokinetic and isotonic training were not statistically significant.Conclusion:The study findings showed that a 4-week strengthening exercise program in the early postoperative stage, involving either isokinetic or isotonic training, resulted in significant improvements in patients undergoing TKR.Registration:NCT02938416 (ClinicalTrials.gov identifier).
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-21T03:58:07Z
      DOI: 10.1177/23259671221105852
      Issue No: Vol. 10, No. 6 (2022)
       
  • SLAP Repair Versus Subpectoral Biceps Tenodesis for Isolated SLAP Type 2
           Lesions in Overhead Athletes Younger Than 35 Years: Comparison of Minimum
           2-Year Outcomes

    • Authors: Lucca Lacheta, Marilee P. Horan, Philip C. Nolte, Brandon T. Goldenberg, Travis J. Dekker, Peter J. Millett
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:It remains unclear if young overhead athletes with isolated superior labrum anterior-posterior (SLAP) type 2 lesions benefit more from SLAP repair or subpectoral biceps tenodesis.Purpose:To evaluate clinical outcomes and return to sport in overhead athletes with symptomatic SLAP type 2 lesions who underwent either biceps tenodesis or SLAP repair.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective analysis of prospectively collected data was performed in patients who underwent subpectoral biceps tenodesis (n = 14) or SLAP repair (n = 24) for the treatment of isolated type 2 SLAP lesions. All patients were aged
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-21T03:30:32Z
      DOI: 10.1177/23259671221105239
      Issue No: Vol. 10, No. 6 (2022)
       
  • Performance and Return to Sport After Meniscal Repair in Professional
           Baseball Players

    • Authors: Brandon J. Erickson, Peter N. Chalmers, John D’Angelo, Kevin Ma, Dana Rowe, Steven B. Cohen, Jeffrey R. Dugas
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Meniscal repair is an effective treatment option for certain meniscal injuries to preserve meniscal function and limit the progression of knee osteoarthritis. Outcomes after meniscal repair in professional baseball players are not well documented.Purposes/Hypothesis:The purposes of this study were to determine performance and return to sport (RTS) in professional baseball players after meniscal repair and compare the results of medial versus lateral meniscal repair. It was hypothesized that there would be a high RTS rate, with no difference in the rate or timing of RTS between players who underwent medial versus lateral meniscal repair.Study Design:Cohort study; Level of evidence, 3.Methods:All professional baseball players who underwent meniscal repair between 2010 and 2017 were identified using the Major League Baseball Health and Injury Tracking System database. Descriptive information and performance data (before and after injury) for each player were recorded. The rate and timing of RTS were then compared between players who underwent medial versus lateral meniscal repair.Results:Included were 31 patients (mean age, 24 ± 3 years). There were 6 players (19%) who had failed repair, underwent subsequent meniscectomy within 2 years of meniscal repair, and were thus excluded from the performance analysis. Of the remaining 31 players, 68% returned to the same or a higher level of play, and 6% of players returned to a lower level of play. Most repair procedures (60%) were performed using the all-inside technique, and 72% of players underwent lateral meniscal repair. The mean time missed was 187 ± 67 days, and the mean time to RTS at full competitive play was 209 ± 84 days. There were no significant differences in the rate or timing of RTS between players who underwent medial versus lateral meniscal repair (P ≥ .999 and P = .574, respectively). Pitchers saw a decrease in usage but no change in performance after meniscal repair. For batters, most metrics were unchanged, but there was a significant decrease in base stealing and on-base percentage after surgery.Conclusion:The RTS rate after meniscal repair in Major League Baseball players was 74% at a mean of 209 days; 19% of players had failed repair and underwent subsequent meniscectomy within 2 years of repair. No difference in the rate or timing of RTS was observed between players who underwent medial versus lateral meniscal repair.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-21T03:18:39Z
      DOI: 10.1177/23259671221101914
      Issue No: Vol. 10, No. 6 (2022)
       
  • Shortening the Return-to-Play Times in Elite Athletes With Unstable
           Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture
           Button: Case Series and Literature Review

    • Authors: Martin Sullivan, Dane Peckston, Bernardino Alpuerto
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Isolated unstable Lisfranc ligament injuries in elite athletes are associated with a lengthy period of rehabilitation and prolonged absence from competition.Purpose:To assess the efficacy of a knotless, interosseous suture button system for repairing isolated unstable ligamentous Lisfranc injuries and its capacity to allow accelerated rehabilitation with earlier weightbearing and return-to-play times in elite athletes.Study Design:Case series; Level of evidence, 4.Methods:The authors retrospectively reviewed data from a prospectively compiled database for elite athletes treated by a single surgeon. All included patients had clinical and magnetic resonance imaging evidence of an unstable isolated complete ligamentous Lisfranc injury requiring surgical reduction and stabilization. All patients underwent surgery using a knotless interosseous suture button to achieve stabilization, followed by a standardized postoperative regimen involving full weightbearing at 4 weeks, and all had a minimum postoperative follow-up of 2 years.Results:Included were 12 patients: 7 National Rugby League (NRL) players, 2 professional dancers, 1 Olympic gymnast, 1 professional wakeboarder, and 1 professional NRL referee. The mean age of the patients was 21.1 years (range, 16-34 years). Ten patients underwent acute surgical stabilization within 3 weeks of the injury, and 2 patients sustained chronic isolated Lisfranc instability that was initially treated nonoperatively. All athletes were able to return to full weightbearing by 4 weeks postoperatively, successfully returned to training by 9 to 12 weeks, and returned to full competition by 12 to 16 weeks. No major complications were reported.Conclusion:Knotless interosseous suture button stabilization was a reliable treatment option for both acute and chronic isolated ligamentous Lisfranc injuries in these elite athletes. This technique does not require hardware removal, allows early weightbearing with accelerated rehabilitation, and may shorten the return-to-play interval.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-21T03:10:36Z
      DOI: 10.1177/23259671221102969
      Issue No: Vol. 10, No. 6 (2022)
       
  • Biomechanical Evaluation of 4 Suture Techniques for Hip Capsular Closure

    • Authors: Yoichi Murata, Naomasa Fukase, Alex W. Brady, Brenton W. Douglass, Anna R. Bryniarski, Grant J. Dornan, Hajime Utsunomiya, Soshi Uchida, Marc J. Philippon
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The most reliable suture technique for capsular closure after a capsulotomy remains unknown.Purpose:To determine which suture technique best restores native stability after a 5-cm interportal capsulotomy.Study Design:Controlled laboratory study.Methods:Ten human cadaveric hip specimens were tested using a 6-degrees-of-freedom robotic arm in 7 states: intact, capsular laxity, 5-cm capsulotomy, standard suture, shoelace, double shoelace, and Quebec City slider (QCS). Rotational range of motion (ROM) was measured across 9 tests: flexion, extension, abduction, abduction at 45° of flexion, adduction, external rotation, internal rotation, anterior impingement, and log roll. Distraction (ie, femoral head translation [FHT]) was measured across a range of flexion and abduction angles.Results:When compared with the native state, the 5-cm capsulotomy state showed the largest laxity increases on all tests, specifically in external rotation ROM (+13.4°), extension ROM (+11.5°), and distraction FHT (+4.5 mm) (P < .001 for all). The standard suture technique was not significantly different from the 5-cm capsulotomy on any test and demonstrated significantly more flexion ROM than the double shoelace suture (+1.41°; P = .049) and more extension ROM (+5.51°; P = .014) and external rotation ROM (+6.03°; P = .021) than the QCS. The standard suture also resulted in significantly higher distraction FHT as compared with the shoelace suture (+1.0 mm; P = .005), double shoelace suture (+1.4 mm; P < .001), and QCS (+1.1 mm; P = .003). The shoelace, double shoelace, and QCS techniques significantly reduced hip laxity when compared with the 5-cm capsulotomy state, specifically in external rotation ROM (respectively, –8.1°, –7.8°, and –10.2°), extension ROM (–6.3°, –7.3°, and –8.1°), and distraction FHT (–1.8, –2.2, and –1.9 mm) (P ≤ .003 for all). These 3 techniques restored native stability (no significant difference from intact) on some but not all tests, and no significant differences were observed among them on any test.Conclusion:Hip capsule closure with the standard suture technique did not prevent postoperative hip instability after a 5-cm capsulotomy, and 3 suture techniques were found to be preferable; however, none perfectly restored native stability at time zero.Clinical Relevance:The shoelace, double shoelace, and QCS suture techniques are recommended when closing the hip capsule.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-21T03:07:58Z
      DOI: 10.1177/23259671221089946
      Issue No: Vol. 10, No. 6 (2022)
       
  • Postoperative Pain and Paresthesia in Labral Repairs of the Shoulder:
           Location Does Matter

    • Authors: Joseph Latif, Ricardo Aveledo, Patrick H. Lam, George A.C. Murrell
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Favorable outcomes have been reported regarding postoperative shoulder pain and function after repair of anteroinferior (Bankart) glenohumeral labral tears. However, the outcomes of patients after repair of isolated superior labral anterior-posterior (SLAP) tears are a contentious topic. The authors have also anecdotally noted that patients evaluated with labral tears complained of numbness and tingling in their ipsilateral hand.Purpose:To determine if there is a difference in the temporal outcomes of shoulder pain and hand paresthesia in patients with SLAP tears versus Bankart tears after arthroscopic repair.Study Design:Cohort study; Level of evidence, 3.Methods:Included were 66 consecutive patients who underwent arthroscopic labral repair at a single institution between August 2018 and February 2021. The prevalence and magnitude of shoulder pain as well as numbness and tingling of the hand were assessed using questions from the L’Insalata Shoulder Questionnaire and the Boston Carpal Tunnel Questionnaire preoperatively and at 1 week, 6 weeks, 12 weeks, and 6 months after surgery.Results:Preoperatively, patients with SLAP lesions reported a higher prevalence of shoulder pain during sleep compared with those with Bankart tears (P < .05). Postoperatively, patients who underwent SLAP repair reported a larger proportion and more severe magnitude of shoulder pain during rest, overhead activities, and sleep compared with those who underwent Bankart repair (P < .05). Only patients who underwent Bankart repair reported improvements in the prevalence and magnitude of their shoulder pain during rest, overhead activities, and sleep by 6 months postoperatively compared with preoperative levels (P < .05). Preoperatively, 30% of patients with Bankart repairs and 40% of patients with SLAP repairs reported hand tingling, while 35% and 50%, respectively, reported hand numbness. The prevalence and magnitude of hand tingling and numbness were not significantly different between groups at any time point.Conclusion:Study results indicated that patients who underwent SLAP repair experienced worse shoulder pain outcomes compared with those who underwent Bankart repair using the same anchor and surgical technique. Only patients who underwent Bankart repair reported improvements in their hand numbness after surgery. Therefore, labral tear location does matter with respect to shoulder pain and hand numbness.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-17T03:24:47Z
      DOI: 10.1177/23259671221105080
      Issue No: Vol. 10, No. 6 (2022)
       
  • Professional Pitchers Display Differences in UCL Morphology and Elbow
           Gapping During Moving Valgus Stress Testing After UCLR: Letter to the
           Editor

    • Authors: Stephen J. Thomas, Ryan W. Paul, John D. Kelly
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.

      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-17T01:55:28Z
      DOI: 10.1177/23259671221103586
      Issue No: Vol. 10, No. 6 (2022)
       
  • Ability to Retension Knotless Suture Anchors: A Biomechanical Analysis of
           Simulated Bankart Lesions

    • Authors: Matthew R. LeVasseur, Michael R. Mancini, Nicholas Williams, Elifho Obopilwe, Mark P. Cote, Katherine J. Coyner, Robert A. Arciero, Paul E. Caldwell, Augustus D. Mazzocca
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Knotless suture anchors are gaining popularity in arthroscopic glenohumeral labral repairs. The ability to retension knotless designs after initial anchor placement has been reported; however, no studies have quantified this claim or investigated the biomechanical consequence of retensioning.Purpose/Hypothesis:To determine whether knotless and knotted suture anchors have biomechanical or anatomic differences with regard to labral repairs and to determine whether retensioning of knotless suture anchors affects capsular tension, labral height, and capsular shift. We hypothesized that retensioning of knotless anchors would result in improved capsular tension compared with conventional knotted suture anchors.Study Design:Controlled laboratory study.Methods:A total of 18 fresh-frozen cadaveric shoulders with a mean age of 56 years were dissected to the capsule and disarticulated at the humeral capsular insertion. The scapula was potted and placed in a custom shoulder simulator to tension the capsule via braided sutures localized to the anteroinferior glenohumeral ligament. Specimens were randomized into 3 groups: (1) Knotted (KT), (2) Knotless with end retensioning (KLend), and (3) Knotless with stepwise retensioning (KLstepwise). All repairs were completed using all-suture anchors placed at the 5-, 4-, and 3-o’clock positions. KLstepwise was used to simulate an intraoperative technique. Resultant mean capsular tension under 5 mm of displacement (subfailure loading) was measured for each anchor placement and retensioning step. Labral height and capsular shift were measured using a MicroScribe digitizer.Results:The intact, defect, 1-anchor, 2-anchor, and 3-anchor tensions were not significantly different between the KT and KLend groups. For the latter, retensioning of all knotless anchors increased capsular tension by 2.1 N compared with its 3-anchor state, although this was not statistically significant (P = .081). The KLstepwise group explored an alternative method to retension the capsule using knotless anchors, with similar final capsular tensions compared with the other groups. All repairs had similar improvements in capsulolabral height and superior capsular shift.Conclusion:Knotted and knotless suture anchors provided similar overall restorations in anteroinferior glenohumeral ligament tension. However, knotless devices were capable of small but statistically insignificant improvements in capsular tension with retensioning.Clinical Relevance:Retensioning of knotless anchors allows the surgeon to tighten regions of the glenohumeral capsule that remain lax after repair.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-16T03:08:06Z
      DOI: 10.1177/23259671221098726
      Issue No: Vol. 10, No. 6 (2022)
       
  • Medical and Biomechanical Risk Factors for Incident Bone Stress Injury in
           Collegiate Runners: Can Plantar Pressure Predict Injury'

    • Authors: Andrew R. Wilzman, Adam S. Tenforde, Karen L. Troy, Kenneth Hunt, Nathaniel Fogel, Megan Deakins Roche, Emily Kraus, Rishi Trikha, Scott Delp, Michael Fredericson
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Bone stress injury (BSI) is a common reason for missed practices and competitions in elite track and field runners.Hypothesis:It was hypothesized that, after accounting for medical risk factors, higher plantar loading during running, walking, and athletic movements would predict the risk of future BSI in elite collegiate runners.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 39 elite collegiate runners (24 male, 15 female) were evaluated during the 2014-2015 academic year to determine the degree to which plantar pressure data and medical history (including Female and Male Athlete Triad risk factors) could predict subsequent BSI. Runners completed athletic movements while plantar pressures and contact areas in 7 key areas of the foot were recorded, and the measurements were reported overall and by specific foot area. Regression models were constructed to determine factors related to incident BSI.Results:Twenty-one runners (12 male, 9 female) sustained ≥1 incident BSI during the study period. Four regression models incorporating both plantar pressure measurements and medical risk factors were able to predict the subsequent occurrence of (A) BSIs in female runners, (B) BSIs in male runners, (C) multiple BSIs in either male or female runners, and (D) foot BSIs in female runners. Model A used maximum mean pressure (MMP) under the first metatarsal during a jump takeoff and only misclassified 1 female with no BSI. Model B used increased impulses under the hindfoot and second through fifth distal metatarsals while walking, and under the lesser toes during a cutting task, correctly categorizing 83.3% of male runners. Model C used higher medial midfoot peak pressure during a shuttle run and triad cumulative risk scores and correctly categorized 93.3% of runners who did not incur multiple BSIs and 66.7% of those who did. Model D included lower hindfoot impulses in the shuttle run and higher first metatarsal MMP during treadmill walking to correctly predict the subsequent occurrence of a foot BSI for 75% of women and 100% without.Conclusion:The models collectively suggested that higher plantar pressure may contribute to risk for BSI.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-15T02:22:54Z
      DOI: 10.1177/23259671221104793
      Issue No: Vol. 10, No. 6 (2022)
       
  • Glenohumeral Hydrodistension for Postoperative Stiffness After
           Arthroscopic Primary Rotator Cuff Repair

    • Authors: Ryan H. Barnes, Anthony V. Paterno, Feng-Chang Lin, Jingru Zhang, David Berkoff, R. Alexander Creighton
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Postoperative stiffness is a known complication after rotator cuff repair (RCR). Glenohumeral hydrodistension (GH) has been a treatment modality for shoulder pathology but has not been used to treat postoperative stiffness after RCR.Purpose/Hypothesis:The purpose of this study was to identify the risk factors for postoperative stiffness after RCR and review outcomes after treatment with GH. Our hypotheses were that stiffness would be associated with diabetes and hyperlipidemia and correlated with the tendons involved and that patients with stiffness who underwent GH would have significant improvement in range of motion (ROM).Study Design:Case series; Level of evidence, 4.Methods:Included were 388 shoulders of patients who underwent primary RCR by a single surgeon between 2015 and 2019. Shoulders with revision RCRs were excluded. Patient characteristics, medical comorbidities, and perioperative details were collected. A total of 40 shoulders with postoperative stiffness (10.3%) received GH injectate of a 21-mL mixture (15 mL of sterile water, 5 mL of 0.5% ropivacaine, and 1 mL of triamcinolone [10 mg/mL]). The primary outcome measure was ROM in forward flexion, internal rotation, external rotation, and abduction. Statistical tests were performed using analysis of variance.Results:Patients with diabetes had significantly decreased internal rotation at final follow-up after RCR as compared with patients without diabetes. GH to treat stiffness was performed most commonly between 1 and 4 months after RCR (60%), and patients who received GH saw statistically significant improvements in forward flexion, external rotation, and abduction after the procedure. Patients with hyperlipidemia had the most benefit after GH. Among those undergoing concomitant procedures, significantly more patients who had open subpectoral biceps tenodesis underwent GH. Patients who underwent subscapularis repair or concomitant subacromial decompression had significant improvement in ROM after GH. Only 1 patient who received GH underwent secondary surgery for resistant postoperative stiffness.Conclusion:Patients with diabetes had increased stiffness. Patients with a history of hyperlipidemia or concomitant open subpectoral biceps tenodesis were more likely to undergo GH for postoperative stiffness. Patients who underwent subscapularis repair demonstrated the most improvement in ROM after GH. After primary RCR, GH can increase ROM and is a useful adjunct for patients with stiffness to limit secondary surgery.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-14T03:22:35Z
      DOI: 10.1177/23259671221104505
      Issue No: Vol. 10, No. 6 (2022)
       
  • Injuries During Return to Sport After the COVID-19 Lockdown: An
           Epidemiologic Study of Italian Professional Soccer Players

    • Authors: Daniele Mazza, Alessandro Annibaldi, Giorgio Princi, Leopoldo Arioli, Fabio Marzilli, Edoardo Monaco, Andrea Ferretti
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The injury rate in professional soccer players may be influenced by match frequency.Purpose:To assess how changes in match frequency that occurred because of coronavirus disease 2019 (COVID-19) influenced training and match injuries in the Italian Serie A league.Study Design:Descriptive epidemiology study. Methods:Three phases in the Serie A league, each 41 days long, were evaluated: phase A was the beginning of the 2019-2020 season; phase B was a period after the COVID-19 lockdown was lifted, when the remaining matches of the season were played with greater frequency; and phase C was the beginning of the 2020-2021 season. All male professional soccer players who were injured during the 3 phases were included. Player age, height, position, injury history, and return to play (RTP) were retrieved from a publicly available website. Training- and match-related injuries during each of the 3 phases were collected and compared. Moreover, match injuries that occurred after the lockdown phase (phase B), in which there were 12 days designated for playing matches (“match-days”), were compared with injuries in the first 12 match-days of phases A and C.Results:When comparing 41-day periods, we observed the injury burden (per 1000 exposure-hours) was significantly lower in phase B (278.99 days absent) than in phase A (425.4 days absent; P < .05) and phase C (484.76 days absent; P < .05). A longer mean RTP period was recorded in phase A than in phase B (44.6 vs 23.1 days; P < .05). Regarding 12–match day periods (81 days in phase A, 41 days in phase B, and 89 days in phase C), there was a significantly higher match injury rate (0.56 vs 0.39 injuries/1000 exposure-hours; P < .05) and incidence (11.8% vs 9.3%; P < .05) in phase B than in phase A and a longer mean RTP period in phase A than in phase B (41.8 vs 23.1 days; P < .05). Finally, the rate and incidence of training-related injuries were significantly higher in phase B (4.6 injuries/1000 exposure-hours and 6.5, respectively) than in phase A (1.41 injuries/1000 exposure-hours and 2.04, respectively) (P < .05).Conclusion:Both training- and match-related injuries were greater during the abbreviated period after the COVID-19 lockdown. These may be linked to the greater match frequency of that period.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-14T03:04:48Z
      DOI: 10.1177/23259671221101612
      Issue No: Vol. 10, No. 6 (2022)
       
  • Predictors of Positive Outcomes and a Scoring System to Guide Management
           After Fasciotomy for Chronic Exertional Compartment Syndrome

    • Authors: Christopher A.J. Trew, Cezary Kocialkowski, Tom Parsons, Tristan Barton
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Chronic exertional compartment syndrome (CECS) of the lower limb usually responds well to fasciotomy in patients with failed nonoperative treatment. Careful history taking and compartment pressure testing are both required to accurately diagnose CECS.Purposes:To evaluate patients with CECS after fasciotomy to establish predictive criteria of positive outcomes and to develop a scoring system to aid clinicians in their management of such patients.Study Design:Case-control study; Level of evidence, 3.Methods:We reviewed data from 28 patients who underwent fasciotomy between 2017 and 2019. All patients had undergone preoperative dynamic intracompartmental pressure (ICP) monitoring. For each patient, subjective preoperative and postoperative pain scores were gained via a questionnaire. The point biserial and Pearson correlation coefficients were used to calculate the association between multiple diagnostic criteria and a reduction in visual analog scale (VAS) pain scores after fasciotomy.Results:A reduction in VAS pain scores was strongly correlated with a peak ICP>40 mm Hg (r = 0.71; P = .0007) and an area under the receiver operating characteristic curve for an intraexercise ICP>22,000 mm Hg·s2 (r = 0.76; P = .0002). A moderate correlation was found between a history of CECS pain (r = 0.61; P = .005), a duration of symptoms of 10 mm Hg (r = 0.60; P = .006). When combined into an objective, weighted scoring system (2 points for factors with r> 0.7; 1 point for r = 0.5-0.7), a score of ≥4 points (of 7) had a strong correlation (r = 0.85; P < .00001) with postoperative improvement in the VAS pain score. Linear regression of this score demonstrated a good fit (R 2 = 0.61; P < .0001), indicating a degree of predictive power.Conclusion:We identified diagnostic criteria in the history and examination of patients with CECS that can be used to help predict positive outcomes after fasciotomy. We propose a scoring system to aid clinicians in their management of such patients. We recommend taking these results forward in prospective trials to test the efficacy of predictive scoring.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-14T02:54:45Z
      DOI: 10.1177/23259671221101328
      Issue No: Vol. 10, No. 6 (2022)
       
  • Assessment of Outcomes After Multisurface Osteochondral Allograft
           Transplantations in the Knee

    • Authors: James L. Cook, Kylee Rucinski, Cory Crecelius, Blake Fenkell, James P. Stannard
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Treatment of multisurface articular cartilage lesions of the knee is a challenging problem.Hypothesis:Large multisurface cartilage defects in the knee can be successfully managed with transplantation of high chondrocyte viability osteochondral allografts (OCAs) to result in statistically significant improvements in patient-reported outcome measures of pain and function.Study Design:Cohort study; Level of evidence, 3.Methods:Patients were prospectively enrolled into a registry to follow outcomes after OCA transplantation. The study included patients who received OCA transplantation for multisurface unipolar defects in 1 knee and had minimum 2-year follow-up data, including patient-reported outcome measures, failures, reoperations, and complications. The OCA transplants had been stored using 2 methods: standard preservation (SP) or Missouri Osteochondral Preservation System (MOPS). Preoperative data were compared with outcomes at 1 year and final follow-up, and risk factors for revision surgery or failure (total knee arthroplasty) were analyzed.Results:The sample included 25 patients with a mean age of 37.2 years (range, 13-51 years), body mass index of 27.7 (range, 18-38), and follow-up of 45.1 months (median, 49 months; range, 24-68 months). OCAs stored using SP were transplanted into 6 patients, and those stored using MOPS were transplanted into 19 patients. The initial success rate was significantly higher for MOPS OCAs (94.7%) than SP OCAs (33.3%). There were statistically significant improvements in all patient-reported outcomes at 1 year and final follow-up in the MOPS cohort (P < .0001 for all). Revision surgery/failure was significantly associated with patients who were nonadherent to the prescribed postoperative restrictions and rehabilitation protocols (P = .038; odds ratio = 13.5) and with OCAs that had a viable chondrocyte density
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-14T02:47:45Z
      DOI: 10.1177/23259671221102452
      Issue No: Vol. 10, No. 6 (2022)
       
  • Changes in Dynamic Postural Stability After ACL Reconstruction: Results
           Over 2 Years of Follow-up

    • Authors: Robert H. Brophy, Kevin A. Schafer, Derrick M. Knapik, John Motley, Amanda Haas, Matthew J. Matava, Rick W. Wright, Matthew V. Smith
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The anterior cruciate ligament (ACL) is crucial for knee proprioception and postural stability. While ACL reconstruction (ACLR) and rehabilitation improve postural stability, the timing in improvement of dynamic postural stability after ACLR remains relatively unknown.Purpose:To evaluate changes in dynamic postural stability after ACLR out to 24 months postoperatively.Study Design:Case series; Level of evidence, 4.Methods:Patients undergoing ACLR were prospectively enrolled, and dynamic postural stability was assessed within 2 days before surgery, at 3-month intervals postoperatively to 18 months, then at 24 months. Measurements were made on a multidirectional platform tracking the patient’s center of mass based on pelvic motion. The amount of time the patient was able to stay on the platform was recorded, and a dynamic motion analysis score, reflecting the patient’s ability to maintain one’s center of mass, was generated overall and in 6 independent planes of motion.Results:A total of 44 patients with a mean age of 19.7 ± 6.2 years completed the study protocol. Overall mean dynamic postural stability improved significantly at 3, 6, 9, and 12 months after surgery, with continued improvement out to 24 months. Notable improvements occurred in medial/lateral and anterior/posterior stability from baseline to 6 months postoperatively, while internal/external rotation and flexion/extension stability declined initially after surgery from baseline to 3 months postoperatively before stabilizing to the end of the study period.Conclusion:Overall dynamic postural stability significantly improved up to 12 months after ACLR. Improvement in postural stability occurred primarily in the medial/lateral and anterior/posterior planes of motion, with initial decreases in the flexion/extension and internal/external rotational planes of motion.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-13T03:34:15Z
      DOI: 10.1177/23259671221098989
      Issue No: Vol. 10, No. 6 (2022)
       
  • Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency
           Departments: Sex- and Age-Based Injury Patterns

    • Authors: Breann Tisano, Aaron J. Zynda, Henry B. Ellis, Philip L. Wilson
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Despite increasing participation rates in youth gymnastics, the majority of epidemiologic literature focuses on older elite athletes or stratifies athletes by level of competition.Hypothesis:The authors hypothesized that sex- and age-based patterns in youth gymnastics–related injuries exist, which are otherwise overlooked in an unstratified population.Study Design:Descriptive epidemiology study.Methods:Publicly available injury data from the National Electronic Injury Surveillance System were collected on pediatric gymnastics injuries presenting to emergency departments in the United States. Participation data from the National Sporting Goods Association were used to calculate national injury incidence rates in 7- to 11-year-olds (childhood) and 12- to 17-year-olds (adolescence) from January 1, 2012, to December 31, 2018. Z tests were conducted for the comparison of injury rates between girls and boys within each age group and for overall injury rate across age groups.Results:Girls participated in gymnastics at a frequency 6.5 times that of boys in childhood and 13.5 times that of boys in adolescence. An estimated 72,542 youth gymnastics–related injuries were reported in US emergency departments each year. A large proportion (61.3%) occurred in childhood, with female predominance in both age groups. Overall, there was no difference in weighted annual injury rate (injuries per 100,000 athlete-days per year) by age group (6.9 [childhood] vs 8.8 [adolescence]; P = .19) or sex (7.4 [girls] vs 8.1 [boys]; P = .65). In adolescence, boys were more likely than girls to experience injury (16.47 vs 8.2; P = .003). Wrist and lower arm fractures were more common in childhood than adolescence (1.07 vs 0.43; P = .002) and specifically in girls (childhood vs adolescence, 1.06 vs 0.37; P = .001). Ankle injuries and concussions were more common in adolescence vs childhood (P = .01 and .0002).Conclusion:Upper extremity injuries predominated among childhood gymnasts, particularly girls. In adolescence, girls and boys experienced increases in concussions and foot and ankle injuries. Although representing a lower overall number of training gymnasts as compared with girls, adolescent boys experience a higher rate of injuries overall.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-13T03:26:28Z
      DOI: 10.1177/23259671221102478
      Issue No: Vol. 10, No. 6 (2022)
       
  • Efficacy of Stem Cell Therapy for Tendon Graft Ligamentization After
           Anterior Cruciate Ligament Reconstruction: A Systematic Review

    • Authors: Hong-De Wang, Zong Li, Xiaoqing Hu, Yingfang Ao
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Sufficient intra-articular graft ligamentization enhances the biomechanical and biological properties of the femur-graft-tibia complex to ensure knee stability after anterior cruciate ligament (ACL) reconstruction using a tendon graft. It remains unclear whether stem cell therapy promotes tendon graft ligamentization.Purpose/Hypothesis:The purpose of this study was to compare tendon graft ligamentization after primary ACL reconstruction with versus without stem cell therapy. It was hypothesized was that stem cell therapy would promote tendon graft ligamentization by enhancing the biomechanical and histological properties of the tendon graft after ACL reconstruction.Study Design:Systematic review.Methods:A systematic review was performed according to the guidelines outlined in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement to identify controlled animal studies that compared tendon graft ligamentization outcomes after primary ACL reconstruction in groups with and without stem cell therapy. Biomechanical and histological outcomes were assessed.Results:A total of 4 studies met the eligibility criteria and were included in this review. Bone marrow–derived mesenchymal stem cells were used in 3 studies, while tendon-derived stem cells were used in 1 study. An intra-articular injection was used to deliver conditioned medium and stem cells in 2 studies, while around-graft application was used to deliver bone marrow–derived mesenchymal stem cells in 2 studies. Stem cell therapy enhanced the biomechanical and histological properties of the tendon graft after ACL reconstruction.Conclusion:This review revealed that stem cell therapy is a promising technique that promotes graft ligamentization by enhancing the biomechanical and histological properties of the tendon graft after ACL reconstruction in animal models. There is a need for future preclinical studies aimed at evaluating the effect of stem cells on graft ligamentization and identifying the optimal method of intra-articular stem cell delivery.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-10T05:22:12Z
      DOI: 10.1177/23259671221098363
      Issue No: Vol. 10, No. 6 (2022)
       
  • Association Between Landing Error Scoring System (LESS) Items and the
           Incidence Rate of Lower Extremity Stress Fracture

    • Authors: Kenneth L. Cameron, Karen Y. Peck, Steven M. Davi, COL(ret) Brett D. Owens, COL(ret) Steven J. Svoboda, Lindsay J. DiStefano, Stephen W. Marshall, Sarah J. de la Motte, COL(ret) Anthony I. Beutler, Darin A. Padua
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Lower extremity stress fracture injuries are a major cause of morbidity in physically active populations. The ability to screen for modifiable risk factors associated with injury is critical in developing injury-prevention programs.Purpose:To determine if baseline Landing Error Scoring System (LESS) scores are associated with the incidence rate of lower extremity stress fracture.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 1772 participants with no history of lower extremity stress fracture were included. At preinjury baseline, the authors conducted a lower extremity movement assessment during a jump-landing task using the LESS. Incident lower extremity stress fractures were identified during a 4-year follow-up period. Potential incident cases were reviewed by 2 sports medicine fellowship–trained orthopaedic surgeons blinded to baseline LESS data. Univariate and multivariable Poisson regression models were used to estimate the association between baseline total LESS scores, individual LESS items, and the incidence rate ratio (IRR) of lower extremity stress fracture.Results:A total of 94 incident lower extremity stress fractures were documented, for a 5.3% (95% CI, 4.3%-6.5%) cumulative incidence. The overall LESS score was associated with the incidence rate of lower extremity stress fracture. For every additional movement error documented at baseline, there was a 15% increase in the incidence rate of lower extremity stress fracture (IRR, 1.15 [95% CI, 1.02-1.31]; P = .025). In univariate analyses, ankle flexion, stance width, asymmetrical landing, and trunk flexion at initial contact, in addition to overall impression, were associated with the incidence rate of stress fracture. After controlling for sex and year of entry into the study cohort, participants who consistently landed flat-footed or heel-to-toe were 2.33 times (95% CI, 1.36-3.97; P = .002) more likely to sustain a lower extremity stress fracture. Similarly, participants who consistently demonstrated asymmetric landing at initial contact were 2.53 times (95% CI, 1.34-4.74; P = .004) more likely to sustain a stress fracture.Conclusion:Components of the LESS may be associated with increased lower extremity stress fracture risk and may be helpful in efficiently assessing high-risk lower extremity biomechanics in large groups.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-09T06:34:48Z
      DOI: 10.1177/23259671221100790
      Issue No: Vol. 10, No. 6 (2022)
       
  • Reliability and Reproducibility of a Novel Grading System for Lesions of
           the Ligamentous-Fossa-Foveolar Complex in Young Patients Undergoing Open
           Hip Preservation Surgery

    • Authors: Vera Maren Stetzelberger, Corinne Andrea Zurmühle, Matthieu Hanauer, Jonathan Laurençon, Darius Marti, Malin Kristin Meier, Vlad Popa, Joseph Michael Schwab, Moritz Tannast
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Several classification systems based on arthroscopy have been used to describe lesions of the ligamentum teres (LT) in young active patients undergoing hip-preserving surgery. Inspection of the LT and associated lesions of the adjuvant fovea capitis and acetabular fossa is limited when done arthroscopically but is much more thorough during open surgical hip dislocation. Therefore, we propose a novel grading system based on our findings during surgical dislocation comprising the full spectrum of ligamentous-fossa-foveolar complex (LFFC) lesions.Purpose:To determine (1) intraobserver reliability and (2) interobserver reproducibility of our new grading system.Study Design:Cohort study (diagnosis); Level of evidence, 3.Methods:We performed this validation study on 211 hips (633 images in total) with surgical hip dislocation (2013-2021). We randomly selected 5 images per grade for each LFFC item to achieve an equal representation of all grades (resulting in 75 images). The ligament, fossa, and fovea were subcategorized into normal, inflammation, degeneration, partial, and complete defects. All surgeries were performed in a standardized way by a single surgeon. The femur was disarticulated using a bone hook, the LT was inspected, documented and resected, then the fossa and fovea were documented with the femoral head in full dislocation using a 70° arthroscope. Six observers with different levels of expertise in hip-preserving surgery independently conducted the measurements twice, and intraclass correlation coefficients (ICC) were calculated to determine (1) intraobserver reliability and (2) interobserver reproducibility of the novel grading system.Results:For intraobserver reliability, excellent ICCs were found in both the junior and the experienced raters for grading the ligament, fossa, fovea, and total LFFC (ICCs ranged from 0.91 to 0.99 for the LFFC score). We found excellent interobserver reproducibility between raters for all items of the LFFC (all interobserver ICCs ≥ 0.76).Conclusion:Our new grading system for lesions of the LFFC is highly reliable and reproducible. It covers the full spectrum of damage more precisely than arthroscopic classifications do and offers a scientific basis for standardized intraoperative evaluation.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-09T03:46:39Z
      DOI: 10.1177/23259671221098750
      Issue No: Vol. 10, No. 6 (2022)
       
  • Comparison of Outcomes Between Nonsmokers and Patients Who Discontinued
           Smoking 1 Month Before Primary Hip Arthroscopy: A Propensity-Matched Study
           With Minimum 2-Year Follow-up

    • Authors: Michael S. Lee, Andrew E. Jimenez, Jade S. Owens, Andrew J. Curley, Olivia A. Paraschos, David R. Maldonado, Ajay C. Lall, Benjamin G. Domb
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Cigarette smoking has been shown to negatively affect outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). The effect of cessation of cigarette smoking before surgery has not been well established.Purposes:(1) To report minimum 2-year patient-reported outcomes (PROs) of former smokers who underwent primary hip arthroscopy for FAIS and (2) to compare these results with those of a propensity-matched control group of nonsmokers.Study Design:Cohort study; Level of evidence, 3.Methods:Data were collected for all patients who underwent primary hip arthroscopy for FAIS between December 2008 and November 2017. Patients were eligible if they indicated that they had previously smoked cigarettes but had quit smoking at least 1 month before surgery and had minimum 2-year postoperative outcomes for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain. The percentage of hips achieving the minimal clinically important difference (MCID) were recorded. The study group was then propensity matched in a 1:1 ratio by age, sex, and body mass index (BMI) to patients who had never smoked.Results:A total of 83 former-smoking patients (84 hips; age, 45.0 ± 13.5 years) were included at a median follow-up of 38.6 months (interquartile range, 27.5-48.2 months); all patients had stopped smoking at a mean ± standard deviation of 14.3 ± 24.5 months preoperatively. Former smokers demonstrated significant improvement from preoperatively to the minimum 2-year follow-up for all recorded PROs (P < .001 for all) and achieved the MCID for the mHHS, NAHS, and VAS at favorable rates (75.0%-81.6%). Logistic regression analysis did not identify a significant relationship between cessation time and rates of achieving MCID for mHHS, NAHS, or VAS. When compared with 84 never-smokers (84 hips), the former smokers demonstrated similar preoperative scores, postoperative scores, and improvement on all recorded PROs (P> .05 for all). Both groups achieved MCID for mHHS, NAHS, and VAS at similar rates and demonstrated similar rates of revision surgery.Conclusion:Former smokers who underwent primary hip arthroscopy for FAIS demonstrated significant improvement in PROs at minimum 2-year follow-up. When compared with a propensity-matched control group of never-smokers, they achieved similar postoperative PROs and rates of achieving psychometric thresholds.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-08T03:43:54Z
      DOI: 10.1177/23259671221097372
      Issue No: Vol. 10, No. 6 (2022)
       
  • Return to Sports After Anterior Cruciate Ligament Reconstruction: Validity
           and Reliability of the SPORTS Score at 6 and 12 Months

    • Authors: Jordan A. Bley, Hiral Master, Laura J. Huston, Shannon Block, Jacquelyn S. Pennings, Rogelio A. Coronado, Charles L. Cox, Jaron P. Sullivan, Kevin M. Dale, Paul M. Saluan, Kurt P. Spindler, Kristin R. Archer
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The Subjective Patient Outcome for Return to Sports (SPORTS) score is a single-item scale that measures athletes' ability to return to their preinjury sport based on effort and performance.Purpose/Hypothesis:The purpose of this study was to examine the psychometric properties of the SPORTS score and a modified score within the first year after anterior cruciate ligament reconstruction (ACLR). The modified version replaced “same sport” with “any sport” in the answer choices. It was hypothesized that both versions of the SPORTS score would have acceptable floor and ceiling effects and internal responsiveness, moderate convergent validity, and excellent test-retest reliability.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:Patients were recruited preoperatively from 2 academic medical centers. The authors collected responses to the 1-item SPORTS scores at 6 and 12 months after ACLR and the Tegner activity scale, Lysholm knee score, Knee injury and Osteoarthritis Outcome Score (KOOS)–sport/recreation subscale, and Marx activity rating scale preoperatively and 6 and 12 months after ACLR. Ceiling and floor effects and responsiveness were assessed using descriptive statistics and cross-tabulations, respectively, at both follow-up time points. Spearman correlations and intraclass correlation coefficients were used to examine convergent validity and test-retest reliability, respectively.Results:Follow-up rates at 6 and 12 months were 100% and 99%, respectively. Test-retest follow-up was 77%. Floor effects for the SPORTS scores were not observed, while ceiling effects at 12 months ranged from 38% to 40%. Cross-tabulation of the SPORTS scores showed that 64% to 66% of patients reported a change in their score from 6 to 12 months, with significant differences noted between the proportions that improved versus worsened for return to any sport. Convergent validity was observed at 6 and 12 months via moderate correlations with the Tegner, Lysholm, KOOS–sport/recreation, and Marx scores (r = 0.31 to 0.47). Fair to good test-retest reliability (intraclass correlation coefficient, 0.58 and 0.60) was found at 12 months after ACLR.Conclusion:The SPORTS score appears to be a reliable, responsive, and valid 1-item scale that can be used during the first year after ACLR. No differences in psychometric properties were found between the SPORTS score and the modified version.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-08T02:22:10Z
      DOI: 10.1177/23259671221098436
      Issue No: Vol. 10, No. 6 (2022)
       
  • Effect of Sectioning of the Anterior Cruciate Ligament and Posterolateral
           Structures on Lateral Compartment Gapping: A Randomized Biomechanical
           Study

    • Authors: Safa Gursoy, Allison K. Perry, Navya Dandu, Harsh Singh, Amar S. Vadhera, Adam Yanke, Robert F. LaPrade, Jorge Chahla
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The contribution of anterior cruciate ligament (ACL) injury to lateral instability under varus stress, particularly compared with posterolateral structures, is not well known.Purpose:To investigate the effect of sectioning the ACL and posterolateral knee structures on lateral compartment gapping under varus stress.Study Design:Controlled laboratory study.Methods:Fourteen nonpaired cadaveric knees were randomized to 1 of 2 groups: sequential sectioning of the ACL, fibular collateral ligament (FCL), popliteus tendon (PLT), and popliteofibular ligament (PFL) (ACL-first group) or sequential sectioning of the FCL, PLT, PFL, and ACL (FCL-first group). Knees were loaded onto a custom jig at a 20° flexion angle. A standardized 12-N·m varus moment was applied to each specimen in the intact state and after each randomized sequential-sectioning state. Lateral compartment opening was measured on radiographs to assess the contribution to the increase in the lateral gap caused by resecting the respective structure. The distance was measured by 3 observers on 15 images (5 testing states each imaged 3 times) per specimen, for a total of 210 radiographs. The articular cartilage surfaces were not included in the measurements.Results:The mean increase in lateral opening after sectioning all structures (ACL and posterolateral corner) was 4.6 ± 1.8 mm (range, 1.9-7.7 mm). The ACL and FCL sectioning contributed the most to lateral knee opening (1.3 ± 0.6 and 2.2 ± 1.3 mm, respectively). In both groups, lateral gapping>3 mm was achieved only after both the ACL and FCL were sectioned. All comparisons of increased mean gapping distances demonstrated a significant difference with subsequent sequential sectioning of structures, except comparisons between the FCL and PLT and the PLT and PFL. When considering the effect of the ACL on lateral opening, no significant difference was found between sectioning the ACL first or FCL first (P = .387).Conclusion:ACL deficiency significantly increased lateral opening under varus stress, regardless of the sequence of injury. The effect of injury to the ACL in addition to the lateral structures should be considered when using varus stress radiographs to evaluate knee injuries.Clinical Relevance:With the current findings, understanding the effect of ACL and posterolateral corner injuries on lateral gapping under varus stress can aid in correctly diagnosing knee injuries and determining appropriate treatment plans.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-06T02:44:11Z
      DOI: 10.1177/23259671221100216
      Issue No: Vol. 10, No. 6 (2022)
       
  • Is Nonoperative Treatment Appropriate for All Patients With Type 1 Tibial
           Spine Fractures' A Multicenter Study of the Tibial Spine Research
           Interest Group

    • Authors: Jilan L. Shimberg, Tomasina M. Leska, Aristides I. Cruz, Henry B. Ellis, Neeraj M. Patel, Yi-Meng Yen, Gregory A. Schmale, R. Justin Mistovich, Peter D. Fabricant, Theodore J. Ganley, Daniel W. Green, Benjamin Johnson, Indranil Kushare, R. Jay Lee, Scott D. McKay, Todd A. Milbrandt, Jason Rhodes, Brant Sachleben, Jessica L. Traver
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Type 1 tibial spine fractures are nondisplaced or ≤2 mm–displaced fractures of the tibial eminence and anterior cruciate ligament (ACL) insertion that are traditionally managed nonoperatively with immobilization.Hypothesis:Type 1 fractures do not carry a significant risk of associated injuries and therefore do not require advanced imaging or additional interventions aside from immobilization.Study Design:Case series; Level of evidence, 4.Methods:We reviewed 52 patients who were classified by their treating institution with type 1 tibial spine fractures. Patients aged ≤18 years with pretreatment plain radiographs and ≤ 1 year of follow-up were included. Pretreatment imaging was reviewed by 4 authors to assess classification agreement among the treating institutions. Patients were categorized into 2 groups to ensure that outcomes represented classic type 1 fracture patterns. Any patient with universal agreement among the 4 authors that the fracture did not appear consistent with a type 1 classification were assigned to the type 1+ (T1+) group; all other patients were assigned to the true type 1 (TT1) group. We evaluated the rates of pretreatment imaging, concomitant injuries, and need for operative interventions as well as treatment outcomes overall and for each group independently.Results:A total of 48 patients met inclusion criteria; 40 were in the TT1 group, while 8 were in the T1+ group, indicating less than universal agreement in the classification of these fractures. Overall, 12 (25%) underwent surgical treatment, and 12 (25%) had concomitant injuries. Also, 8 patients required additional surgical management including ACL reconstruction (n = 4), lateral meniscal repair (n = 2), lateral meniscectomy (n = 1), freeing an incarcerated medial meniscus (n = 1), and medial meniscectomy (n = 1).Conclusion:The classification of type 1 fractures can be challenging. Contrary to prior thought, a substantial number of patients with these fractures (>20%) were found to have concomitant injuries. Overall, surgical management was performed in 25% of patients in our cohort.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-03T06:06:05Z
      DOI: 10.1177/23259671221099572
      Issue No: Vol. 10, No. 6 (2022)
       
  • Epidemiology and Outcomes of Ankle Injuries in the National Football
           League

    • Authors: Sohil S. Desai, Craig S. Dent, Blake H. Hodgens, Michael G. Rizzo, Spencer W. Barnhill, Paul R. Allegra, Charles A. Popkin, Amiethab A. Aiyer
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Traumatic ankle injuries are commonly complicated by persistent symptoms and the development of chronic ankle instability.Purpose:To describe the epidemiology of ankle injuries in the National Football League (NFL) and investigate the effects that ankle injuries have on performance metrics in the years after injury.Study Design:Descriptive epidemiologic study.Methods:Ankle injuries sustained by NFL players during the 2015-2016, 2016-2017, and 2017-2018 seasons were identified using the Pro Football Reference database. Cumulative incidence was calculated, and demographic identifiers were collected for each injury. The return-to-play (RTP) rate was also recorded. For each player who met inclusion for the performance analysis, power rating (PR) was calculated for the preinjury season (Y–1) and 2 postinjury seasons (Y+1 and Y+2) as follows: PR = (offensive yards/10) + (total touchdowns × 6) + (combined tackles) + (sacks × 2) + (interceptions × 2). Mean PRs were calculated for each season as well as the percentage change and mean difference in PR between Y–1 and Y+1 (ΔPR1%, ΔPR1) and between Y–1 and Y+2 (ΔPR2%, ΔPR2). Subgroup analyses of PR were performed by player position, injury type, and years of experience.Results:Overall, 668 ankle injuries were identified, with an average cumulative incidence across the 3 seasons of 11.2% and RTP rate of 91%. Of those injuries, 159 met inclusion criteria for the PR analysis. The mean overall PR (96.95 in Y–1) declined 22% in Y+1 to 76.10 (–20.85 [95% CI, –13.82 to –27.89]; P < .001) and 27% in Y+2 to 70.93 (–26.02 [95% CI, –18.04 to –34.00]; P < .001). The mean PR per game played (6.70 in Y–1) decreased 14% in Y+1 to 5.75 (–0.95 [95% CI, –0.56 to –1.34]; P < .001) and 17% in Y+2 to 5.54 (–1.16 [95% CI, –0.63 to –1.62]; P < .001).Conclusion:It was found that ankle injuries hampered the performance of NFL players, even multiple years after the injury occurred, despite a relatively high RTP rate. There was a decrease in total games played after ankle injuries as well as a decreased performance output per game played.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-03T05:51:54Z
      DOI: 10.1177/23259671221101056
      Issue No: Vol. 10, No. 6 (2022)
       
  • Is There an Association in Young Patients Between Quadriceps or Hamstring
           Strength After ACL Reconstruction and Graft Rupture'

    • Authors: Nicola C. Blucher, Julian A. Feller, Brian M. Devitt, Haydn J. Klemm, Timothy S. Whitehead, Jodie A. McClelland, Kate E. Webster
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Younger patients who sustain anterior cruciate ligament (ACL) ruptures are at high risk for reinjury after ACL reconstruction. Restoring muscle strength before return to sports (RTS) is regarded as an important factor in reducing the reinjury risk, and quadriceps and hamstring strength assessment is commonly included in RTS testing. However, it is not clear whether reduced strength is a risk factor for subsequent graft rupture in this patient population.Purpose:To investigate the association between quadriceps and hamstring strength at 12 months after primary ACL reconstruction and ACL graft rupture in young patients.Study Design:Case-control study; Level of evidence, 3.Methods:The cohort consisted of 210 patients (100 men and 110 women) who were younger than 20 years at the time of primary ACL reconstruction with a hamstring tendon autograft and who had no previous contralateral ACL injury. Isokinetic strength testing (60 and 180 deg/s) of knee flexors and extensors was performed at 12 months postoperatively, and the limb symmetry index (LSI) for each strength outcome was calculated. RTS rates and the incidence of further ACL graft ruptures were recorded.Results:Measures of central tendency (mean and median) of LSI values ranged from 88 to 98. The percentage of patients with LSI ≥90 was 57% to 69% for quadriceps strength and 45% to 47% for hamstring strength. Overall, 19 patients (9%) sustained an ACL graft rupture. No significant differences were found between the patients who sustained an ACL graft rupture and those who did not in terms of quadriceps and hamstring strength at 12 months. No significant associations were found between achieving LSI ≥90 for quadriceps peak torque and subsequent ACL graft rupture.Conclusion:In young patients who underwent an ACL reconstruction, no association was noted between quadriceps and hamstring strength at 12 months postoperatively and subsequent graft ruptures. The role of strength testing as part of the RTS criteria after ACL reconstruction, and specifically the use of limb symmetry thresholds, warrants further investigation and clarification.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-03T05:35:04Z
      DOI: 10.1177/23259671221101003
      Issue No: Vol. 10, No. 6 (2022)
       
  • Sex-Based Differences in Athletes Undergoing Primary Hip Arthroscopy With
           Labral Reconstruction: A Propensity-Matched Analysis With Minimum 2-Year
           Follow-up

    • Authors: Jade S. Owens, Michael S. Lee, Andrew E. Jimenez, David R. Maldonado, Olivia A. Paraschos, Benjamin G. Domb
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:There is a paucity of literature comparing sex-based outcome differences in athletes after primary hip arthroscopy with labral reconstruction for femoroacetabular impingement syndrome (FAIS) and irreparable labral tears.Purpose:To report sex-based differences in clinical characteristics, patient-reported outcome (PRO) scores, and return-to-sports (RTS) rates in athlete who underwent primary hip arthroscopy with labral reconstruction.Study Design:Cohort study; Level of evidence, 3.Methods:Data were reviewed for recreational, organized amateur, high school, collegiate, and professional athletes who underwent primary hip arthroscopy with labral reconstruction for FAIS and irreparable labral tears between July 2014 and May 2019. Inclusion criteria included preoperative and minimum 2-year postoperative PRO scores (modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, International Hip Outcome Tool [iHOT-12], and visual analog scale [VAS] for pain). Exclusion criteria were Tönnis grade>1, hip dysplasia (lateral center-edge angle,
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-03T05:19:21Z
      DOI: 10.1177/23259671221100861
      Issue No: Vol. 10, No. 6 (2022)
       
  • Outcomes and Return-to-Sport Rates for Elite Athletes With Femoral
           Retroversion Undergoing Hip Arthroscopy: A Propensity-Matched Analysis
           With Minimum 2-Year Follow-up

    • Authors: Jade S. Owens, Andrew E. Jimenez, Michael S. Lee, David R. Maldonado, Ajay C. Lall, Benjamin G. Domb
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Return to sports (RTS) and patient-reported outcomes (PROs) for elite athletes with femoral version abnormalities undergoing hip arthroscopy have not been well established.Purposes:To (1) report minimum 2-year PROs and RTS rates in elite athletes with femoral retroversion who underwent primary hip arthroscopy and (2) compare clinical results to those of a propensity-matched control group of elite athletes with normal femoral version who underwent primary hip arthroscopy.Study Design:Cohort study; Level of evidence, 3.Methods:Data were prospectively collected and retrospectively reviewed for elite (professional and collegiate) athletes with femoral version 1, hip dysplasia, and previous ipsilateral hip surgery or conditions. Rates of achieving the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. Athletes with retroversion were propensity matched in a 1:2 ratio to elite athletes with normal femoral version (5°-20°) for comparison.Results:A total of 33 elite athletes (33 hips) with femoral retroversion who underwent hip arthroscopy met the inclusion criteria, and follow-up was available for 30 hips in 30 athletes (90.9%) at an average of 36.1 ± 25.6 months. Elite athletes with femoral retroversion demonstrated significant improvements in all recorded PROs, achieved the MCID and PASS for the HOS-SSS at high rates (86.7%), and returned to sports at a rate of 83.3%. PROs, rates of achieving MCID and PASS for the HOS-SSS, and RTS rates were similar between the study and propensity-matched control group.Conclusion:Elite athletes with femoral retroversion undergoing primary hip arthroscopy demonstrated favorable PROs and high RTS rates at a minimum 2-year follow-up. These results were comparable with those of a propensity-matched control group of elite athletes with normal femoral version.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-03T04:28:52Z
      DOI: 10.1177/23259671221099840
      Issue No: Vol. 10, No. 6 (2022)
       
  • Effect of COVID-19 on Injury Rates and Timing in the National Football
           League

    • Authors: Ali M. Omari, Ryan W. Paul, Brian Fliegel, Alim Osman, Meghan E. Bishop, Brandon J. Erickson, Frank G. Alberta
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:The coronavirus 2019 (COVID-19) pandemic resulted in the cancellation of the 2020 National Football League (NFL) preseason and a decreased preseason roster size. The effect of this disruption on athlete injury rates is unknown.Purpose/Hypothesis:The purpose was to quantify the rates of anterior cruciate ligament (ACL), Achilles tendon, and hamstring tendon injuries in NFL players before and after the COVID-19 pandemic. We hypothesized that injury rates in the 2020 season would be higher than those seen prepandemic.Study Design:Descriptive epidemiology study. Level of evidence, 4.Methods:An online search using publicly available data was carried out to identify all NFL players who sustained an ACL, Achilles tendon, or hamstring tendon injury between April 1, 2017, and March 31, 2021. Data collected included player characteristics as well as career and season of injury workloads.Results:The number of Achilles tendon (27 vs 20; P = .024) and hamstring tendon (186 vs 149; P < .001) injuries, respectively, in the 2020 NFL season were significantly higher than the average of the 2017 to 2019 seasons. However, the number of ACL injuries sustained remained constant (43 vs 46; P = .175). More than half (52.9%) of ACL injuries in the 2017 to 2019 seasons occurred in the preseason, while most of the injuries (34.9%) in the 2020 season occurred in weeks 1 to 4. There was no player characteristic or career workload variable collected that was significantly different for players who sustained an ACL, Achilles tendon, or hamstring tendon injury in the 2020 NFL season compared with the 2017 to 2019 seasons.Conclusion:In the 2020 NFL season, the number of Achilles tendon and hamstring tendon injuries rose while the number of ACL injuries remained constant compared with the 2017 to 2019 seasons. Injuries that occurred during the first 4 games of the 2020 NFL season were consistent, with higher rates of injuries seen in the preseason in previous years.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-02T01:26:52Z
      DOI: 10.1177/23259671221098749
      Issue No: Vol. 10, No. 6 (2022)
       
  • Reducing the Risk of Neurovascular Injury With Posteromedial Plating and
           Laterally Directed Screw Insertion During Opening-Wedge High Tibial
           Osteotomy

    • Authors: Seung Jae Shim, Ho Won Jeong, Sung Bae Park, Yong Seuk Lee
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Neurovascular injury is a serious complication after opening-wedge high tibial osteotomy (OWHTO).Purpose:To evaluate (1) how neurovascular injuries during fixation can be prevented and (2) whether a lateral hinge–directed posteromedial fixation system provides comparable neurovascular safety during OWHTO to conventional and custom-made locking plate systems.Study Design:Cohort study; Level of evidence, 3.Methods:Included were 275 knees that underwent OWHTO from March 2014 to May 2018. The knees were divided into 4 groups based on the type of fixation system used: (1) lateral hinge–directed system (LCfit HTO; LCfit group), (2) TDM decisive wedge locking plate (TDM group), (3) OhtoFix anatomic locking metal block plate (OhtoFix group), and (4) TomoFix titanium locking plate (TomoFix group). Using postoperative computed tomography, the following variables among the groups were compared: screw insertion angle relative to the tibia posterior cortex in the axial plane, length, proximity to neurovascular structures, and safety angle of screw fixation (angle between the most proximal posterior screw insertion line and a line tangent to the popliteal artery from the screw hole). Radiological and clinical outcomes were also compared between groups.Results:The screw angle was significantly smaller and the distance from neurovascular structures to the screw extension line was significantly farther in the LCfit group compared with the other 3 groups (P < .001 for both). The safety angle was also wider in the LCfit group than in the other groups (P < .001). There were no significant differences in radiologic or clinical outcomes between the groups during follow-up.Conclusion:The distance from the neurovascular structures to the screw extension line was significantly farther, and the safety angle was also significantly wider with the laterally directed posteromedial plate system compared with the other systems. There were no neurovascular injuries in any group or significant differences in clinical outcomes or radiological parameters between the LCfit and the other locking plate systems.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-01T02:50:28Z
      DOI: 10.1177/23259671221098421
      Issue No: Vol. 10, No. 6 (2022)
       
  • Treatment Variability and Complications Associated With Pediatric Lateral
           Ankle Injuries: A POSNA Quality, Safety, and Value Initiative Survey

    • Authors: Jennifer J. Beck, Connor M. Carpenter, Nicole West, Meagan J. Sabatino, Henry B. Ellis
      Abstract: Orthopaedic Journal of Sports Medicine, Volume 10, Issue 6, June 2022.
      Background:Isolated pediatric lateral ankle injuries, including ankle sprain (AS) and nondisplaced Salter-Harris type 1 (SH-1) distal fibular fracture, are common orthopaedic sports-related injuries. Variability in treatment is suspected among pediatric orthopaedic surgeons. Complications from medical treatment or lack thereof have not been reported in this population.Purpose:The purpose of this study was to investigate treatment variability and associated complications after pediatric AS and SH-1 via a survey of members of the Pediatric Orthopaedic Society of North American (POSNA).Study Design:Cross-sectional study. Level of evidence, 5.Methods:A voluntary, anonymous survey was distributed to POSNA membership (approximately 1400 members) via email. Survey questions, specific to both grade 1 or 2 AS and nondisplaced or minimally displaced SH-1 injuries in skeletally immature patients, focused on initial evaluation, immobilization, return to sports, and complications. We analyzed variability both in treatment between AS and SH-1 injury and in respondent characteristics. For statistical analysis, chi-square or Fisher exact test was used for categorical variables, and analysis of variance was used for continuous variables.Results:The survey response rate was 16.4% (229/1400). Of the respondents, 27.7% used examination only to distinguish between AS and SH-1, whereas 18.7% performed serial radiography to aid with diagnosis. A controlled ankle motion boot or walking boot was the most common immobilization technique for both AS (46.3%) and SH-1 (55.6%); the second most common technique was bracing in AS (33.5%) and casting in SH-1 (34.7%). Approximately one-third of all respondents recommended either outpatient or home physical therapy for AS, whereas only 11.4% recommended physical therapy for SH-1 (P < .01). Results showed that 81.2% of respondents reported no complications for SH-1 treatment and 87.8% reported no complications for AS treatment. Cast complications were reported by 9.6% for SH-1 and 5.2% for AS. Rare SH-1 complications included distal fibular growth arrest, infection, nonunion, late fracture displacement, and recurrent fracture.Conclusion:Significant variability was found in primary treatment of pediatric AS and SH-1 injuries. Rare complications from injury, treatment, and neglected treatment after SH-1 and AS were reported.
      Citation: Orthopaedic Journal of Sports Medicine
      PubDate: 2022-06-01T02:41:08Z
      DOI: 10.1177/23259671221100223
      Issue No: Vol. 10, No. 6 (2022)
       
 
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