Sage Orthopaedics

While the preparticipation evaluation (PPE) is widely used by medical practitioners, its overall effectiveness is unknown, in part because there are no standardized or centralized mechanisms to collect and analyze medical historyinformation. While some data in this population are self-evident, we were not aware of the high frequency of past injuries, the magnitude of time lost from sport, the high frequency of past surgery, and the number of participants still symptomatic from injuries. The ePPE is a valuable tool for collecting and analyzing aggregate injury and illness data in athletes, such as the finding that 11% of injuries that were reported were unresolved and still symptomatic.   Click here to read the article.

Five articles from the June 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "The Effect of Trochlear Dysplasia on Patellofemoral Biomechanics: A Cadaveric Study With Simulated Trochlear Deformities," "A Comparative Study on the Biomechanical and Histological Properties of Bone-to-Bone, Bone-to-Tendon, and Tendon-to-Tendon Healing: An Achilles Tendon–Calcaneus Model in Goats," "The Effect of a Combined Glenoid and Hill-Sachs Defect on Glenohumeral Stability: A Biomechanical Cadaveric Study Using 3-Dimensional Modeling of 142 Patients," "Platelet-Rich Plasma Increases Anti-inflammatory Markers in a Human Coculture Model for Osteoarthritis," and "Shoulder Function

Distal biceps brachii tendon repairs performed with a tension slide technique using a cortical button (CB) and interference screw are stronger than those based on suture fixation through bone tunnels (BTs) in biomechanical studies. However, clinical comparison of these 2 techniques is lacking in the literature. Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve.   Click here to read the article.

Five articles from the May 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Association of Equipment Worn and Concussion Injury Rates in National Collegiate Athletic Association Football Practices: 2004-2005 to 2008-2009 Academic Years,” “Prevalence of and Risk Factors for Dislocation Arthropathy Radiological Long-term Outcome of Arthroscopic Bankart Repair in 100 Shoulders at an Average 13-Year Follow-up,” “No Association Between Fibrosis on Magnetic Resonance Imaging at Return to Play and Hamstring Reinjury Risk,” “Relationship Between Knee Mechanics and Time Since Injury in ACL-Deficient Knees Without Signs of Osteoarthritis,” and “Tibial and Femoral Tunnel

The tibial tubercle–trochlear groove (TT-TG) distance and trochlear structure have become important radiographic measurements in the evaluation and management of patients with patellar instability. Many orthopaedic surgeons, however, do not have access to musculoskeletal radiologists and therefore must make such measurements independently. The results of this study suggest that the intra- and interobserver reliability in the MRI measurement of the TT-TG distance and TDI is high for both orthopaedic surgeons and musculoskeletal radiologists. In addition, the TT-TG distance may be lower than previously thought in patients with patellar instability.   Click here to read the article.

Five articles from the April 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes: A Clinical Case-Control Study,” “The Prevalence and Combined Prevalences of Anatomic Factors Associated With Recurrent Patellar Dislocation: A Magnetic Resonance Imaging Study,” “Association Between Ball-Handling Versus Defending Actions and Acute Noncontact Lower Extremity Injuries in High School Basketball and Soccer,” “Does Obesity Affect Outcomes in Hip Arthroscopy?: A Matched-Pair Controlled Study With Minimum 2-Year Follow-up,” and “On-Site Treatment of Exertional Heat Stroke.”  

Recent prospective randomized trials support primary plate fixation of displaced midshaft clavicle fractures. However, the safety and efficacy of this practice have not been well documented in athletes, nor has the time to return-to-sport. The Latarjet procedure can provide satisfactory outcomes, including a low recurrence rate and reliable functional recovery. Defects at the anteroinferior glenoid were restored to nearly normal after coracoid transfer by use of the Latarjet procedure, which is an anatomically matched reconstruction.   Click here to read the article.

Five articles from the March 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “MRI Volume and Signal Intensity of ACL Graft Predict Clinical, Functional, and Patient-Oriented Outcome Measures After ACL Reconstruction,” “Surgical Management of Osteochondritis Dissecans Lesions of the Patella and Trochlea in the Pediatric and Adolescent Population,” “Structural Properties of the Intact Proximal Hamstring Origin and Evaluation of Varying Avulsion Repair Techniques: An In Vitro Biomechanical Analysis,” “Anterior Cruciate Ligament Reconstruction With Contralateral Autogenous Patellar Tendon Graft: Evaluation of Donor Site Strength and Subjective Results,” and “Revisi

Five articles from the February 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "The Impact of Previous Hamstring Strain Injury on the Change in Eccentric Hamstring Strength During Pre-Season Training in Elite Australian Footballers," "The Effect of Donor Age on the Structural and Mechanical Properties of Allograft Tendons," Femoral Nerve Blockade is Associated with Persistent Strength Deficits at Six Months Post ACL Reconstuction in Pediatric and Adolescent Patients," "Factors Affecting Capsular Volume Changes and Association with Outcomes after Bankart Repair and Capsular Shift," and "Correlation of Meniscal and Articular Cartilage Injuries in Children and Ad

Rotator cuff tears are common, and rotator cuff repair represents a major health care expense. While patients often benefit from rotator cuff repair, anatomic failure of the repair is not unusual. In spite of a dramatic increase in the number of publications per year, there is little evidence that the results of rotator cuff repair are improving. The information needed to guide the management of this commonly treated and costly condition is seriously deficient. To accumulate the evidence necessary to inform practice, future clinical studies on the outcome of rotator cuff repair must report important data relating to each patient’s condition, the surgical technique, the outcome in terms of integrity, and the change in patient self-assessed comfort and function.   Click here to read the article.

There has been an increase in minimally invasive surgery for chronic exertional compartment syndrome (CECS), despite the potential for incomplete compartment release and iatrogenic injuries. To our knowledge, no study has examined the effect of the length of fascial release on compartment pressures. This study demonstrates a strong correlation between fasciotomy length and a reduction in intracompartmental pressures in a swine model. Our study suggests that 90% fascial release may represent a possible watershed zone, returning the intracompartmental pressure to a value at or near baseline values.    Click here to read the article.

Five articles from the January 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Epidemiology of Stress Fracture Injuries Among US High School Athletes, 2005-2006 Through 2012-2013,” “Consequences of Tibial Tunnel Reaming on the Meniscal Roots During Cruciate Ligament Reconstruction in a Cadaveric Model, Part 1 The Anterior Cruciate Ligament,” “Arm Pain in Youth Baseball Players A Survey of Healthy Players,” “Analysis of ‘‘Hidden Lesions’’ of the Extra-articular Biceps After Subpectoral Biceps Tenodesis: The Subpectoral Portion as the Optimal Tenodesis Site,” and “Suture Placement Near the Musculotendinous Junction in the Supraspinatus Implications for Rotator C

Ankle sprains are the most common sports-related injury, associated with a high rate of recurrence and societal costs. Recent studies have emphasized the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains. Bracing was found to be the dominant secondary preventive intervention over both neuromuscular training and the combination of both measures.   Click here to read the article.

A Hill-Sachs lesion is a common injury associated with anterior glenohumeral instability, and a Hill-Sachs lesion that engages with the anterior glenoid rim is 1 factor related to recurrent instability. In a cadaveric study in 2007, a new concept, the glenoid track, was proposed to evaluate the risk of engagement of Hill-Sachs lesions with the glenoid. The existence and widths of the glenoid track were confirmed in vivo.   Click here to read the article.

The effect of platelet-rich plasma (PRP) on chondrocytes has been studied in cell and tissue culture, but considerably less attention has been given to the effect of PRP on synoviocytes. Fibroblast-like synoviocytes (FLS) compose 80% of the normal human synovium and produce cytokines and matrix metalloproteinases that can mediate cartilage catabolism. Treatment of synovial cells with LR-PRP and RBCs resulted in significant cell death and proinflammatory mediator production.   Click here to read the article.

The presence of a cam deformity represents a significant risk factor for the development of hip pain. An elevated alpha angle at the 1:30 clock position and decreased internal rotation are associated with an increased risk of developing hip pain. However, not all patients with a cam deformity develop hip pain, and further research is needed to better define those at greater risk of developing degenerative symptoms.   Click here to read the article.

There is a high rate of RTP in professional baseball after UCL reconstruction. Performance declined before surgery and improved after surgery. When compared with demographic-matched controls, patients who underwent UCL reconstruction had better results in multiple performance measures. Reconstruction of the UCL allows for a predictable and successful return to the MLB.   Click here to read the article.

Femoral tunnel enlargement after MPFL reconstruction is common, with patients with patella alta at an increased risk. The influence of tunnel malposition and trochlear dysplasia on this condition requires further research. Recurrent instability and patient-reported outcome scores are not affected by tunnel enlargement.   Click here to read the article.

Five articles from the March 2014 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Treatment of 'Patellofemoral' Cartilage Lesions With Matrix-Assisted Autologous Chondrocyte Transplantation A Comparison of Patellar and Trochlear Lesions," "Comparisons of Retear Patterns for Three Arthroscopic Rotator Cuff Repair Methods," "20 Years of Pediatric Anterior Cruciate Ligament Reconstruction in New York State," "Platelet-Rich Plasma versus Dry-Needling, Combined with Eccentric Exercises, as a Treatment for Patellar Tendinopathy: A Double-Blind Randomized Controlled Trial," and "Risk Factors of Subsequent Operations After Primary Anterior Cruciate Ligament Reconstruction.

Five articles from the February 2014 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Efficacy of Platelet-Rich Plasma for Chronic Tennis Elbow A Double-Blind, Prospective, Multicenter, Randomized Controlled Trial of 230 Patients," "Relationship Between Isokinetic Strength and Tibiofemoral Joint Space Width Changes After Anterior Cruciate Ligament Reconstruction," "Complications After Arthroscopic Knee Surgery,""Comparison of Hamstring Tendon and Patellar Tendon Grafts in Anterior Cruciate Ligament Reconstruction in a Nationwide Population-Based Cohort Study: Results From the Danish Registry of Knee Ligament Reconstruction," and "Increased Risk of Revision with Hams