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Christopher L Camp, Travis G Tubbs, Glenn S Fleisig, Joshua S Dines, David M Dines, David W Altchek, Brittany Dowling
BACKGROUND: Likely due to the high level of strain exerted across the elbow during the throwing motion, elbow injuries are on the rise in baseball. To identify at-risk athletes and guide postinjury return-to-throw programs, a better understanding of the variables that influence elbow varus torque is desired. PURPOSE: To describe the within-subject relationship between elbow varus torque and arm slot and arm rotation in professional baseball pitchers. STUDY DESIGN: Descriptive laboratory study...
August 1, 2017: American Journal of Sports Medicine
Glenn S Fleisig, Alek Z Diffendaffer, Brett Ivey, Kyle T Aune
The purpose of this study was to determine how often flaws in pitching mechanics identified from biomechanical analysis are corrected. The biomechanics of 46 baseball pitchers were evaluated twice, with an average of 12 months (range 2-48 months) between evaluations. Pitchers were healthy at the time of both evaluations, competing at the high school, college, minor league or Major League level. After warming up, each participant pitched 10 full-effort fastballs. Automated three-dimensional motion analysis was used to compute eight kinematic parameters which were compared with a database of elite professional pitchers...
July 25, 2017: Sports Biomechanics
Hiroshi Kinoshita, Satoshi Obata, Daiki Nasu, Koji Kadota, Tomoyuki Matsuo, Glenn S Fleisig
Forces imparted by the fingers onto a baseball are the final, critical aspects for pitching, however these forces have not been quantified previously as no biomechanical technology was available. In this study, an instrumented baseball was developed for direct measurement of ball reaction force by individual fingers and used to provide fundamental information on the forces during a fastball pitch. A tri-axial force transducer with a cable having an easily-detachable connector were installed in an official baseball...
May 10, 2017: Human Movement Science
Connor R Read, Kyle T Aune, E Lyle Cain, Glenn S Fleisig
BACKGROUND: Anterior cruciate ligament (ACL) injuries occur commonly in football. Recent work has reported ACL reconstruction (ACLR) as one of several orthopaedic procedures with unfavorable outcomes for professional athletes. The performance impact to defensive players after surgery has not been quantified. PURPOSE: To quantify the effect of ACLR on the performance of defensive players by comparing them to a cohort of matched controls as well as to measure the effect of ACLR on athletes' career length in the National Football League (NFL)...
July 2017: American Journal of Sports Medicine
Diego A Adrianzen Herrera, Sarah B Fleisig, Benjamin A Gartrell
Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10-15% of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response...
May 2, 2017: Investigational New Drugs
Mathew R Birnbaum, Michelle W Ma, Sarah Fleisig, Stuart Packer, Bijal D Amin, Mark Jacobson, Beth N McLellan
No abstract text is available yet for this article.
May 2017: JAAD Case Reports
E Lyle Cain, Glenn S Fleisig, Brent A Ponce, Hikel A Boohaker, Martha P George, Gerald McGwin, James R Andrews, Lawrence J Lemak, William G Clancy, Jeffrey R Dugas
This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9...
November 28, 2016: Journal of Knee Surgery
Glenn S Fleisig, Alek Z Diffendaffer, Kyle T Aune, Brett Ivey, Walter A Laughlin
BACKGROUND: Weighted-ball throwing programs are commonly used in training baseball pitchers to increase ball velocity. The purpose of this study was to compare kinematics and kinetics among weighted-ball exercises with values from standard pitching (ie, pitching standard 5-oz baseballs from a mound). HYPOTHESIS: Ball and arm velocities would be greater with lighter balls and joint kinetics would be greater with heavier balls. STUDY DESIGN: Controlled laboratory study...
May 2017: Sports Health
Brittany Dowling, Glenn S Fleisig
Determining and understanding baseball batting mechanics at various competition levels may help players and coaches identify key kinematics crucial to being a successful hitter. The purpose of this study was to compare batting kinematics across competition levels. Kinematic and temporal data were analysed for 170 male batters (youth n = 33; high school n = 69; college n = 22; professional n = 46) using 3D motion capture (480 Hz). The results showed differences in angular positions between competition levels during the five phases of the swing, with the greatest differences seen between the youth and professional batters...
September 2016: Sports Biomechanics
Jeffrey R Dugas, Benjamin B Bedford, John S Andrachuk, Anthony J Scillia, Kyle T Aune, E Lyle Cain, James R Andrews, Glenn S Fleisig
PURPOSE: To determine common mechanisms of anterior cruciate ligament (ACL) injury in baseball players and to quantify the rate of return to play after primary surgical reconstruction and review intermediate clinical outcomes. METHODS: Surgical injuries involving the ACL in youth, high school, collegiate, and professional baseball players were queried for an 11-year period (2001 to 2011). Over the study period, 42 baseball players were identified who had undergone arthroscopically assisted primary ACL reconstruction by 1 of 3 attending surgeons...
November 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Glenn S Fleisig, Walter A Laughlin, Kyle T Aune, E Lyle Cain, Jeffrey R Dugas, James R Andrews
Controversy continues whether curveballs are stressful for young baseball pitchers. Furthermore, it is unproven whether professional baseball pitchers have fewer kinematic differences between fastballs and off-speed pitches than lower level pitchers. Kinematic and kinetic data were measured for 111 healthy baseball pitchers (26 youth, 21 high school, 20 collegiate, 26 minor league, and 18 major league level) throwing fastballs, curveballs, and change-ups in an indoor biomechanics laboratory with a high-speed, automated digitising system...
June 2016: Sports Biomechanics
Walter A Laughlin, Glenn S Fleisig, Kyle T Aune, Alek Z Diffendaffer
Swing trajectory and ground reaction forces (GRF) of 30 collegiate baseball batters hitting a pitched ball were compared between a standard bat, a bat with extra weight about its barrel, and a bat with extra weight in its handle. It was hypothesised that when compared to a standard bat, only a handle-weighted bat would produce equivalent bat kinematics. It was also hypothesised that hitters would not produce equivalent GRFs for each weighted bat, but would maintain equivalent timing when compared to a standard bat...
2016: Sports Biomechanics
Jeffrey R Dugas, Brian L Walters, David P Beason, Glenn S Fleisig, Justin E Chronister
BACKGROUND: The number of throwing athletes with ulnar collateral ligament (UCL) injuries has increased recently, with a seemingly exponential increase of such injuries in adolescents. In cases of acute proximal or distal UCL insertion injuries or in partial-thickness injuries that do not respond to nonoperative management, UCL repair and augmentation rather than reconstruction may be a viable option. PURPOSE/HYPOTHESIS: The purpose of this study was to biomechanically compare a new technique of augmented UCL repair versus a typical modified Jobe UCL reconstruction technique...
March 2016: American Journal of Sports Medicine
Kevin E Wilk, Leonard C Macrina, Glenn S Fleisig, Kyle T Aune, Ron A Porterfield, Paul Harker, Timothy J Evans, James R Andrews
BACKGROUND: Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem. PURPOSE: To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012)...
October 2015: American Journal of Sports Medicine
David P Beason, Jay P Shah, James W Duckett, Patrick W Jost, Glenn S Fleisig, E Lyle Cain
BACKGROUND: Humeral fracture following subpectoral biceps tenodesis has been previously reported; however, there are no published biomechanical studies reporting the resulting torsional strength of the humerus. Our purpose was to determine if there is an increased risk of humerus fracture after subpectoral biceps tenodesis with an interference screw and to determine if screw size is also a factor. We hypothesized that limbs receiving the procedure would have reduced failure torque and rotation under external rotation compared to untreated controls and that the larger screw size would result in inferior mechanical properties compared to the smaller...
November 2015: Clinical Biomechanics
Brent A Ponce, E Lyle Cain, Ryan Pflugner, Glenn S Fleisig, Bradley L Young, Hikel A Boohaker, Thomas A Swain, James R Andrews, Jeffrey R Dugas
Purpose The purpose of this study was to identify risk factors for revision surgery following primary anterior cruciate ligament (ACL) reconstruction. Methods A retrospective analysis of 2,965 patients who underwent a primary ACL reconstruction were separated into two groups: those who returned to our center for revision of their reconstruction (n = 67) and those who did not return to our center for revision of their reconstruction (n = 2,898). Patient characteristics assessed at the time of primary reconstruction include age, gender, graft type, graft source, meniscal and/or chondral injury, sport, side of effected extremity, level of competition, and surgeon...
May 2016: Journal of Knee Surgery
Stan A Conte, Glenn S Fleisig, Joshua S Dines, Kevin E Wilk, Kyle T Aune, Nancy Patterson-Flynn, Neal ElAttrache
BACKGROUND: While the high rate of ulnar collateral ligament (UCL) injuries in professional baseball is widely discussed in the media and medical literature, the actual prevalence of UCL reconstruction has not been documented. HYPOTHESIS: The prevalence of UCL reconstruction will be higher among pitchers than nonpitchers, and Major League Baseball (MLB) pitchers will have a higher prevalence than will minor league pitchers. STUDY DESIGN: Descriptive epidemiology study...
July 2015: American Journal of Sports Medicine
H B Fleisig, K R Hukezalie, C A H Thompson, T T T Au-Yeung, A T Ludlow, C R Zhao, J M Y Wong
Reactivation of telomerase reverse transcriptase (TERT) expression is found in more than 85% of human cancers. The remaining cancers rely on the alternative lengthening of telomeres (ALT), a recombination-based mechanism for telomere-length maintenance. Prevalence of TERT reactivation over the ALT mechanism was linked to secondary TERT function unrelated to telomere length maintenance. To characterize this non-canonical function, we created a panel of ALT cells with recombinant expression of TERT and TERT variants: TERT-positive ALT cells showed higher tolerance to genotoxic insults compared with their TERT-negative counterparts...
January 14, 2016: Oncogene
J R Dugas, A M Barrett, D P Beason, M F Plymale, G S Fleisig
Meniscocapsular separations are often seen in knees with other intra-articular pathology. The consequences of these tears with regard to knee contact mechanics are currently unknown, and the biomechanical advantages of repair have not been measured. We hypothesize that tears to the meniscocapsular junction will cause an increase in tibiofemoral contact pressure and a decrease in contact area, with a return to more normal conditions after repair. 10 fresh-frozen cadaver knees each underwent 10 cycles of axial compressive loading in full extension under three different testing conditions: intact, meniscocapsular separation, and repair...
June 2015: International Journal of Sports Medicine
Glenn S Fleisig, Charles E Leddon, Walter A Laughlin, Michael G Ciccotti, Bert R Mandelbaum, Kyle T Aune, Rafael F Escamilla, Toran D MacLeod, James R Andrews
BACKGROUND: A relatively high number of active professional baseball pitchers have a history of ulnar collateral ligament reconstruction (UCLr) on their throwing elbow. Controversy exists in the literature about whether professional baseball pitchers regain optimal performance after return from UCLr. It has been suggested that pitchers may have different biomechanics after UCLr, but this has not been previously tested. HYPOTHESIS: It was hypothesized that, compared with a control group without a history of UCLr, professional pitchers with a history of UCLr would have (1) significantly different throwing elbow and shoulder biomechanics; (2) a shortened stride, insufficient trunk forward tilt, and excessive shoulder horizontal adduction, characteristics associated with "holding back" or being tentative; (3) late shoulder rotation; and (4) improper shoulder abduction and trunk lateral tilt...
May 2015: American Journal of Sports Medicine
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