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Current Reviews in Musculoskeletal Medicine

Timothy B Griffith, James Kercher, S Clifton Willimon, Crystal Perkins, Xavier A Duralde
PURPOSE OF REVIEW: With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures. RECENT FINDINGS: Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve...
February 14, 2018: Current Reviews in Musculoskeletal Medicine
Alejandro Novoa-Boldo, Lawrence V Gulotta
PURPOSE OF REVIEW: To outline the radiographic and clinical outcomes after a rotator cuff surgery in order to set the expectations with the patient before the surgery to obtain a better outcome, taking into account the factors that can affect the outcome and the technique used for the repair. RECENT FINDINGS: The majority of surgeons use arthroscopic repair. The double-row repair has better biomechanical strength, footprint coverage, and radiographic healing rates...
February 13, 2018: Current Reviews in Musculoskeletal Medicine
Michael D Charles, David R Christian, Brian J Cole
PURPOSE OF REVIEW: The purpose of this review was to establish the foundation of the major biologic adjuvants to rotator cuff repairs and review recent scientific findings. RECENT FINDINGS: Platelet-rich plasma (PRP) overall has no significant impact on functional outcomes and repair integrity, but may be more advantageous in small to medium tears. Further studies should focus on leukocyte-rich versus poor preparations and the use of PRP in patients that are high risk for repair failure...
February 7, 2018: Current Reviews in Musculoskeletal Medicine
Jason L Codding, Jay D Keener
PURPOSE OF REVIEW: In the past several years, there have been significant advances in our understanding of the natural history of rotator cuff disease. Studies have continued to provide valuable insight into the clinical, radiographic, and anatomic features of these atraumatic tears. Our purpose is to summarize the findings and contributions from these recent high-quality studies. RECENT FINDINGS: Current research has continued to describe and provide understanding into the natural history of atraumatic rotator cuff disease, including symptom progression, tear enlargement, and the development of arthritis...
February 6, 2018: Current Reviews in Musculoskeletal Medicine
Terrance A Sgroi, Michelle Cilenti
PURPOSE OF REVIEW: With improvements in surgical techniques and increased knowledge of rotator cuff healing, there was a need to identify a safe progression after rotator cuff repair. The rehabilitation specialist plays an integral role in the care of these patients, and by implementing an evidence and criteria-based model, patients may be able to return to their prior levels of function sooner with fewer complications. RECENT FINDINGS: Timing of progression for rotator cuff patients should align not only with healing but also potential strain on the involved tissue...
February 5, 2018: Current Reviews in Musculoskeletal Medicine
Jacob M Kirsch, M Tyrrell Burrus, Asheesh Bedi
PURPOSE OF REVIEW: Professional football quarterbacks are at particular risk for upper extremity injuries due to the physical demands of their position coupled with the inherent risks associated with professional football. This review sought to evaluate current clinical literature to better characterize the injury profile unique to this athletic population. RECENT FINDINGS: Shoulder injuries are the most prevented upper extremity injury among professional football quarterbacks...
January 23, 2018: Current Reviews in Musculoskeletal Medicine
Thomas R Sellers, Adham Abdelfattah, Mark A Frankle
PURPOSE OF REVIEW: The purpose of this review is to discuss the indications for reverse shoulder arthroplasty (RSA) in the treatment of massive rotator cuff tear (MCT), review the reported outcomes in the literature, and outline our approach and surgical technique for treating these patients. RECENT FINDINGS: While RSA remains a successful and well-accepted treatment for cuff tear arthropathy (CTA), management of MCT in the absence of arthritis is controversial...
January 22, 2018: Current Reviews in Musculoskeletal Medicine
Amit Nathani, Kevin Smith, Tim Wang
PURPOSE OF REVIEW: The purpose of this article is to review the recent literature concerning modern repair techniques related to partial- and full-thickness rotator cuff tears. RECENT FINDINGS: The understanding of rotator cuff pathology and healing continues to evolve, beginning with emerging descriptions of the anatomic footprint and natural history of rotator cuff tears. Significant controversy remains in treatment indications for partial-thickness rotator cuff lesions as well as optimal surgical repair techniques for both partial- and full-thickness tears...
January 22, 2018: Current Reviews in Musculoskeletal Medicine
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
Jacob G Calcei, Venkat Boddapati, David W Altchek, Christopher L Camp, Joshua S Dines
PURPOSE OF REVIEW: This review discusses the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex. RECENT FINDINGS: A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results...
January 17, 2018: Current Reviews in Musculoskeletal Medicine
Michael C Fu, Todd S Ellenbecker, Per A Renstrom, Gary S Windler, David M Dines
PURPOSE OF REVIEW: To review the recent literature regarding the epidemiology of tennis injuries at all levels of play, and to discuss recent findings in injury surveillance by the Association of Tennis Professionals (ATP). RECENT FINDINGS: Following the release of a consensus statement in 2009 calling for standardized documentation and analysis of tennis-related injuries, multiple studies have been published describing longitudinal injury incidences at Grand Slam tournaments and the Davis Cup...
January 16, 2018: Current Reviews in Musculoskeletal Medicine
Nicholas J Clark, Vishal S Desai, Joshua D Dines, Mark E Morrey, Christopher L Camp
PURPOSE OF REVIEW: This review aims to describe the nonreconstructive options for treating ulnar collateral ligament (UCL) injuries ranging from nonoperative measures, including physical therapy and biologic injections, to ligament repair with and without augmentation. RECENT FINDINGS: Nonoperative options for UCL injuries include guided physical therapy and biologic augmentation with platelet-rich plasma (PRP). In some patients, repair of the UCL has shown promising return to sport rates by using modern suture and suture anchor techniques...
January 15, 2018: Current Reviews in Musculoskeletal Medicine
Leigh J Weiss, Dean Wang, Michael Hendel, Philip Buzzerio, Scott A Rodeo
PURPOSE OF REVIEW: Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. RECENT FINDINGS: Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
Joseph N Liu, Grant H Garcia, Anirudh K Gowd, Brandon C Cabarcas, Michael D Charles, Anthony A Romeo, Nikhil N Verma
PURPOSE OF REVIEW: To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. RECENT FINDINGS: Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
Ryan A Mlynarek, Struan H Coleman
PURPOSE OF REVIEW: To discuss the clinical significance of the most common hip and groin injuries in baseball players, as well as an algorithmic approach to diagnosis and treatment of these injuries. RECENT FINDINGS: (a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list...
January 12, 2018: Current Reviews in Musculoskeletal Medicine
Terrance A Sgroi, John M Zajac
PURPOSE OF REVIEW: Throwing places high demands on the human body, and specific characteristics are developed over time unique to these athletes. When returning to throw after injury, it is important to follow a criterion-based progression that allows the body to be prepared appropriately for the stresses that throwing will require. There is currently a void in the literature for criteria-based progression that helps these athletes return to the highest level of play. RECENT FINDINGS: As injury rates continue to rise in baseball, there is increased evidence showing contributions of the core and lower extremity to the baseball pitch...
March 2018: Current Reviews in Musculoskeletal Medicine
Nicholas J Clark, Bassem T Elhassan
PURPOSE OF REVIEW: This review aims to describe the tendon transfer options for treating irreparable rotator cuff tears (RCTs). Options for transfer include latissimus dorsi and lower trapezius transfers for posterior-superior RCTs and pectoralis major and latissimus dorsi transfer for anterior-superior RCTs. RECENT FINDINGS: While the latissimus dorsi tendon transfer has historically been performed for posterosuperior RCTs, the lower trapezius transfer is a more anatomic option and has demonstrated promising results in recent studies...
March 2018: Current Reviews in Musculoskeletal Medicine
Susan C Lee, Danielle Williams, Yoshimi Endo
PURPOSE OF REVIEW: The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications. RECENT FINDINGS: The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months...
March 2018: Current Reviews in Musculoskeletal Medicine
Heath P Melugin, Nels D Leafblad, Christopher L Camp, Stan Conte
PURPOSE OF REVIEW: This review examines recent literature on injury epidemiology and prevention in the sport of baseball from youth to professional levels. RECENT FINDINGS: Overuse is the predominant mechanism of injury in youth baseball players. Newer stretching and exercise protocols may help prevent these injuries. At the professional level, however, overuse has not been proven to correlate with increased injury incidence, but pitch counts are still monitored...
March 2018: Current Reviews in Musculoskeletal Medicine
Kevin C Wall, Alison P Toth, Grant E Garrigues
PURPOSE OF REVIEW: To introduce the challenges in addressing irreparable rotator cuff tears and examine the surgical options, specifically interposition grafting and superior capsule reconstruction. RECENT FINDINGS: Interposition grafting of rotator cuff tears shows promising results in reducing pain and improving function postoperatively and one study demonstrated that it performs significantly better than partial repair alone. Superior capsule reconstruction has become popular rapidly, but given the novelty of the procedure, there is currently a paucity of outcomes data to review...
March 2018: Current Reviews in Musculoskeletal Medicine
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