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American Journal of Sports Medicine

Christina D Mack, Elliott B Hershman, Robert B Anderson, Michael J Coughlin, Andrew S McNitt, Rachel R Sendor, Richard W Kent
BACKGROUND: Biomechanical studies have shown that synthetic turf surfaces do not release cleats as readily as natural turf, and it has been hypothesized that concomitant increased loading on the foot contributes to the incidence of lower body injuries. This study evaluates this hypothesis from an epidemiologic perspective, examining whether the lower extremity injury rate in National Football League (NFL) games is greater on contemporary synthetic turfs as compared with natural surfaces...
November 19, 2018: American Journal of Sports Medicine
Michelle M Gosselin, Jacob A Haynes, Jeremy J McCormick, Jeffery E Johnson, Sandra E Klein
BACKGROUND: Ankle sprains are the most common musculoskeletal injury in the United States. Chronic lateral ankle instability can ultimately require operative intervention to decrease pain and restore stability to the ankle joint. There are no anatomic studies investigating the vascular supply to the lateral ankle ligamentous complex. PURPOSE: To define the vascular anatomy of the lateral ligament complex of the ankle. STUDY DESIGN: Descriptive laboratory study...
November 19, 2018: American Journal of Sports Medicine
Xin Tang, Brandon Marshall, Joon Ho Wang, Junjun Zhu, Jian Li, Patrick Smolinski, Freddie H Fu
BACKGROUND: The effect of lateral meniscal posterior root tear and repair-commonly seen in clinical practice in the setting of anterior cruciate ligament (ACL) reconstruction-is not known. PURPOSE/HYPOTHESIS: This study evaluated the effect of tear and repair of the lateral meniscal posterior root on the biomechanics of the ACL-reconstructed knee. It was hypothesized that anterior tibial translation would increase under anterior loading and simulated pivot-shift loading with the root tear of the posterior lateral meniscus, while repair of the root tear would reduce it close to the noninjured state...
November 19, 2018: American Journal of Sports Medicine
R Justin Mistovich, John W Urwin, Peter D Fabricant, J Todd R Lawrence
BACKGROUND: Abnormalities in the trochlea-patella-tibia relationship have been shown to be risk factors for recurrent patellofemoral instability, although no current measurements quantify patellar containment in the trochlea. Standard measurements, such as tibial tubercle-trochlear groove (TT-TG) distance, do not account for the containment of the patella by the trochlea. Our goal was to develop a measurement to assess how well the trochlea contained the extensor mechanism. HYPOTHESIS: A novel measurement describing the amount of the patellar tendon lateral to the lateral trochlear ridge (PT-LTR) would be a reliable measurement and significantly greater among patients with patellofemoral instability...
November 14, 2018: American Journal of Sports Medicine
Adam J Tagliero, Vishal S Desai, Nicholas I Kennedy, Christopher L Camp, Michael J Stuart, Bruce A Levy, Diane L Dahm, Aaron J Krych
BACKGROUND: Studies have shown good and excellent clinical and radiographic results after meniscal repair. Limited published information exists on the long-term outcomes, however, especially in a pediatric and adolescent population. PURPOSE: To determine long-term results of meniscal repair and concomitant anterior cruciate ligament (ACL) reconstruction in a pediatric and adolescent population. Specifically, the aims were to determine the clinical success rate of meniscal repair with concomitant ACL reconstruction, compare results with midterm outcomes, and analyze risk factors for failure...
November 13, 2018: American Journal of Sports Medicine
Kavitha Sivasubramaniyan, Dragos C Ilas, Abhishek Harichandan, Pieter K Bos, Diego L Santos, Peter de Zwart, Wendy J L M Koevoet, Heather Owston, Hans-Jörg Bühring, Elena Jones, Gerjo J V M van Osch
BACKGROUND: Connective tissue progenitors (CTPs) from native bone marrow (BM) or their culture-expanded progeny, often referred to as mesenchymal stem/stromal cells, represents a promising strategy for treatment of cartilage injuries. But the cartilage regeneration capacity of these cells remains unpredictable because of cell heterogeneity. HYPOTHESIS: The harvest technique of BM may highly influence stem cell heterogeneity and, thus, cartilage formation because these cells have distinct spatial localization within BM from the same bone...
November 12, 2018: American Journal of Sports Medicine
David R Maldonado, Itay Perets, Brian H Mu, Victor Ortiz-Declet, Austin W Chen, Ajay C Lall, Benjamin G Domb
BACKGROUND: Hip arthroscopy for the treatment of instability in the setting of borderline dysplasia is controversial. Capsular management in such cases is an important consideration, and plication has been described as a reliable technique, with good midterm outcomes reported when indications are appropriate. HYPOTHESIS: Patients with borderline dysplasia who have a lower lateral center-edge angle (LCEA) and greater age will be at a higher risk of failure after arthroscopic capsular plication...
November 12, 2018: American Journal of Sports Medicine
Felix Dyrna, Florian B Imhoff, B Haller, Sepp Braun, Elifho Obopilwe, John M Apostolakos, Daichi Morikawa, Andreas B Imhoff, Augustus D Mazzocca, Knut Beitzel
BACKGROUND: The synergistic effect of the acromioclavicular (AC) capsule and coracoclavicular (CC) ligaments on AC joint stability has gained recent recognition for its importance. Biomechanical and clinical studies have shown the benefit of combined reconstruction with multiple variations of surgical techniques for AC capsule augmentation. The ideal configuration remains unknown for such capsular repair aimed at achieving optimal stability with anatomic reconstruction. HYPOTHESIS: Primary AC joint stability can be restored by AC capsule augmentation, while position of the additional suture construct is critical...
November 12, 2018: American Journal of Sports Medicine
Duncan P Fransz, Arnold Huurnink, Idsart Kingma, Vosse A de Boode, Ide C Heyligers, Jaap H van Dieën
BACKGROUND: Soccer has a high injury rate, with lateral ankle sprains being a common injury. Therefore, an approach to prevent or at least reduce the occurrence is warranted. Injury prevention can be improved by identifying specific risk factors and individuals at risk. PURPOSE: To assess drop-jump landing performance as a potential predictor of lateral ankle sprain within 3-year follow-up. STUDY DESIGN: Case-control study; Level of evidence, 3...
November 12, 2018: American Journal of Sports Medicine
Felix Dyrna, Philip Zakko, Leo Pauzenberger, Mary Beth McCarthy, Augustus D Mazzocca, Nathaniel A Dyment
BACKGROUND: Bone marrow aspirate is a primary source for cell-based therapies with increasing value in the world of orthopaedic surgery, especially in revision cases of tendon and ligament repairs. However, cells within peritendinous structures, such as the paratenon and surrounding bursa, contribute to the native tendon-healing response and offer promising cell populations for cell-based repair strategies. Therefore, the purpose of this study is to investigate the efficacy of cells derived from human subacromial bursa as compared with the current gold standard, bone marrow stromal cells (BMSCs), for tendon repairs in an established in vivo immunodeficient murine patellar tendon defect model...
November 12, 2018: American Journal of Sports Medicine
Avinesh Agarwalla, Richard N Puzzitiello, Joseph N Liu, Gregory L Cvetanovich, Anirudh K Gowd, Nikhil N Verma, Brian J Cole, Brian Forsythe
BACKGROUND: Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics. PURPOSE: To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs)...
November 12, 2018: American Journal of Sports Medicine
Samir G Tejwani, Heather A Prentice, Ronald W B Wyatt, Gregory B Maletis
BACKGROUND: The femoral tunnel in anterior cruciate ligament reconstruction (ACLR) can be created by the transtibial (TT) or tibial-independent (TI) methods. An anatomically located femoral tunnel can be more consistently achieved by TI methods, which include the anteromedial portal and lateral (outside-in, retrodrill) techniques. Nonanatomic graft placement in ACLR can result in postoperative instability and meniscal or chondral injury. An anatomically located graft is subjected to higher postoperative physiologic forces than one placed nonanatomically...
November 12, 2018: American Journal of Sports Medicine
Charles A Thigpen, Ellen Shanley, Amit M Momaya, Michael J Kissenberth, Stefan J Tolan, John M Tokish, Richard J Hawkins
BACKGROUND: There is an ever-increasing demand for widespread implementation of patient-reported outcomes. However, adoption is slow owing to limitations in clinical infrastructure and resources within busy orthopaedic practices. Prior studies showed the single alpha-numeric evaluation (SANE) score to correlate at a single point in time with the American Shoulder and Elbow Surgeons (ASES) score. However, no study has validated the SANE in terms of test-retest reliability, responsiveness, or clinical utility...
November 12, 2018: American Journal of Sports Medicine
Mengcun Chen, Snehal S Shetye, Julianne Huegel, Corinne N Riggin, Daniel J Gittings, Courtney A Nuss, Stephanie N Weiss, Andrew F Kuntz, Louis J Soslowsky
BACKGROUND: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. HYPOTHESIS: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties...
November 12, 2018: American Journal of Sports Medicine
Itay Perets, Danil Rybalko, Brian H Mu, David R Maldonado, Gary Edwards, Muriel R Battaglia, Benjamin G Domb
BACKGROUND: Revision hip arthroscopy is increasingly common and often addresses acetabular labrum pathology. There is a lack of consensus on indications or outcomes of revision labral repair versus reconstruction. PURPOSE: To report clinical outcomes of labral reconstruction during revision hip arthroscopy at minimum 2-year follow-up as compared with pair-matched labral repair during revision hip arthroscopy (control group) and to suggest a decision-making algorithm for labral treatment in revision hip arthroscopy...
November 12, 2018: American Journal of Sports Medicine
Thomas G Baboolal, Alam Khalil-Khan, Anthony A Theodorides, Owen Wall, Elena Jones, Dennis McGonagle
BACKGROUND: Mesenchymal stem cells (MSCs) have emerged as a promising candidate for tissue regeneration and restoration of intra-articular structures such as cartilage, ligaments, and menisci. However, the routine use of MSCs is limited in part by their low numbers and the need for methods and procedures outside of the joint or surgical field. PURPOSE: To demonstrate feasibility of a technique in which minimally manipulated synovial MSCs can be mobilized during knee arthroscopy, thereby showing proof of concept for the future evaluation and clinical use of native joint resident MSCs in single-stage joint repair strategies...
November 12, 2018: American Journal of Sports Medicine
Blake M Bodendorfer, Austin M Looney, Sloane L Lipkin, Esther C Nolton, Jihui Li, Robert G Najarian, Edward S Chang
BACKGROUND: The modified Jobe technique of ulnar collateral ligament (UCL) reconstruction has previously been biomechanically compared with primary repair augmented with internal bracing. However, the docking technique has not been compared with repair with internal bracing. HYPOTHESIS: Load to failure, gapping, and valgus opening angle are similar under valgus loading at 90° of flexion between repair with internal bracing and the docking technique for the UCL...
November 7, 2018: American Journal of Sports Medicine
Elizabeth A Arendt, Marie Askenberger, Julie Agel, Marc A Tompkins
BACKGROUND: First-time lateral patellar dislocations have historically been treated with a nonoperative approach; a clinical tool to predict patients who are most likely to redislocate may have clinical utility. PURPOSE: (1) To determine if there are discriminating factors present between patients who redislocated their patellas and those who did not after a first-time lateral patellar dislocation and (2) to use this information to develop a model that can predict the recurrence risk of lateral patellar dislocation in this population...
November 6, 2018: American Journal of Sports Medicine
David J Lessley, Richard W Kent, James R Funk, Christopher P Sherwood, Joseph M Cormier, Jeff R Crandall, Kristy B Arbogast, Barry S Myers
BACKGROUND: Concussions in American football remain a high priority of sports injury prevention programs. Detailed video review provides important information on causation, the outcomes of rule changes, and guidance on future injury prevention strategies. PURPOSE: Documentation of concussions sustained in National Football League games played during the 2015-2016 and 2016-2017 seasons, including consideration of video views unavailable to the public. STUDY DESIGN: Descriptive epidemiology study...
November 6, 2018: American Journal of Sports Medicine
Alberto Gobbi, Graeme P Whyte
BACKGROUND: Surgical treatment to repair partial anterior cruciate ligament (ACL) injury without reconstruction has demonstrated inconsistent clinical success. PURPOSE: To examine the long-term clinical outcomes of primary ACL repair combined with biologic healing augmentation in patients with symptomatic partial ACL tears. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: 50 patients (mean age, 29.5 years) with a partial ACL tear and symptomatic knee instability were treated with primary ligament repair in conjunction with marrow stimulation and followed prospectively for a mean duration of 10...
November 6, 2018: American Journal of Sports Medicine
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