HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery最新文献

{"title":"Return-to-Sport Testing in Young Athletes After Anterior Cruciate Ligament Reconstruction","authors":"Snehal Patel, W. Marrone, Patrick Vignona","doi":"10.1177/15563316241247202","DOIUrl":"https://doi.org/10.1177/15563316241247202","url":null,"abstract":"Implementing return-to-sport (RTS) testing should be an integral component of rehabilitation for young athletes who have undergone anterior cruciate ligament (ACL) reconstruction, but there are no universally accepted standards for such testing. In this article, we highlight our institution’s use of a structured and evidence-based approach to guide RTS decision-making for athletes, coaches, surgeons, therapists, and parents, with an emphasis on reducing the likelihood of reinjury after ACL reconstruction surgery.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"55 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication note","authors":"","doi":"10.1177/15563316241237567","DOIUrl":"https://doi.org/10.1177/15563316241237567","url":null,"abstract":"","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140653424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strength and Conditioning in the Young Athlete for Long-Term Athletic Development","authors":"Chelsea Long, Stephen Ranellone, Mathew Welch","doi":"10.1177/15563316241248445","DOIUrl":"https://doi.org/10.1177/15563316241248445","url":null,"abstract":"The safety and efficacy of youth strength and conditioning programs depend on proper instruction, coaching, and supervision. Types of training include bodyweight strengthening, resistance bands, medicine balls and weights, agility, plyometrics, and cardiovascular exercise. These should be preceded by a proper warm up using a combination of static stretching, self-myofascial release, dynamic warm-ups, and sport-specific warm-ups. Coaches and trainers should consider the athlete’s age, maturity level, cognitive ability, puberty status, sport volume, and readiness levels in designing and supervising strength and conditioning programs. This review article covers the latest evidence supporting training to improve movement skills and promote long-term athletic development, while also preventing injury, for young athletes.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"46 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140661029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Modified 4-in-1 Stanisavljevic Procedure for Treating Obligatory or Congenital Patellar Dislocations in Children: A Surgical Technique","authors":"R. Gigi, Addy S. Brandstetter, B. Danino, Amit Benady, D. Ovadia, Moshe Yaniv","doi":"10.1177/15563316241244792","DOIUrl":"https://doi.org/10.1177/15563316241244792","url":null,"abstract":"Patellar instability and dislocation pose complex clinical and surgical challenges, especially in children. Congenital (fixed) and obligatory (habitual) dislocations present significant anatomical and etiological complexity, frequently leading to deformities and functional impairments, which can range from walking difficulties to sports limitations. Conservative treatment is often inadequate. We describe a surgical technique for treating congenital or obligatory patellar dislocations in patients with various underlying diagnoses—including Down syndrome, nail-patella syndrome, and skeletal dysplasia—that involves extensive subperiosteal quadriceps realignment, distal realignment (Roux-Goldthwait or tibial tuberosity transfer), and optional medial plication. This modified 4-in-1 technique follows the principles described in 1976 by Stanisavljevic, which involves subperiosteal quadriceps mobilization, thus minimizing muscle damage, bleeding, and postoperative muscular adherences. In 24 patients treated at our institution between 2002 and 2021 (35 knees; age range = 5.5-16.8 years; 13 girls, 11 boys), with a mean follow-up of 8.2 years (2.4-20 years), we achieved satisfactory improvements in patellar stability, range of motion, and quality of life with a modified 4-in-1 Stanisavljevic technique. A total of 9 patients (7 with obligatory dislocations and 2 with congenital dislocations) could engage in recreational or competitive sports. The average postoperative pediatric International Knee Documentation Committee (pedi-IKDC) score was 78.45 ± 22.3 (range = 0-100); a patient with DiGeorge syndrome and 1 with multiple epiphyseal dysplasia had scores of 35 and 48, respectively. We found at our institution that a modified 4-in-1 Stanisavljevic technique produced favorable outcomes in patellar stability, range of motion, and quality of life in pediatric patients with congenital or obligatory patellar dislocation. More study is warranted to determine the procedure’s overall benefits for children with obligatory or congenital dislocations of complex etiology.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140695897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Flow Restriction Training in the Young Athlete","authors":"Adam P. Weaver, Zachary Dunkle, Nicholas Giampetruzzi, J. Prue, Donna Pacicca, Dylan P. Roman","doi":"10.1177/15563316241245700","DOIUrl":"https://doi.org/10.1177/15563316241245700","url":null,"abstract":"Blood flow restriction training (BFRT) is increasing in popularity in the rehabilitation setting due to its believed impact on mitigating muscle atrophy, maintaining muscle mass and improving muscle function after musculoskeletal injury. This intervention has shown to be an effective option for addressing muscle strength and atrophy during earlier phases of rehabilitation when higher loads are not tolerated after injury. Although this intervention appears to be a safe and effective approach in sports medicine environments, there is limited information on the young athlete population. The purpose of this study is to provide a detailed overview of mechanisms, safety considerations, and clinical applications specific to the young athlete after musculoskeletal injury.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"54 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Is a Better Predictor Than Preoperative Electrodiagnostic Findings for Outcomes After Common Peroneal Nerve Decompression for Compressive Neuropathy: A Retrospective Review","authors":"Stephen J. DeMartini, Amanda M. Faust, Nathan P. Olafsen, David M. Brogan, Christopher J. Dy","doi":"10.1177/15563316241243018","DOIUrl":"https://doi.org/10.1177/15563316241243018","url":null,"abstract":"There is increasing interest in the evaluation and management of compressive neuropathy of the common peroneal nerve (CPN). We sought to determine demographic and electrodiagnostic predictors for resolution of symptoms after CPN decompression for compressive neuropathy. We hypothesized that severity of neuropathy (as measured by compound motor amplitudes and active or chronic denervation on electromyography) would be associated with symptom resolution after CPN decompression. We performed a retrospective review of patients who underwent CPN decompression and had preoperative electrodiagnostic (EDX) studies at a single institution from January 1, 2015, to April 30, 2023. We performed independent samples t-test and logistic regression to evaluate demographic and EDX study factors associated with symptom resolution. Of the 44 patients identified, 33 reported resolution of preoperative symptoms, with no differences based on EDX findings. The likelihood of symptom resolution was significantly higher in men than women (OR = 10.62; 95% CI = 1.218, 92.677). Patient demographics were otherwise not predictive of symptom resolution. Three-quarters of our patients reported symptom resolution after CPN decompression for compressive neuropathy. While EDX studies were not predictive of outcomes, our findings suggest that sex-based factors may be contributing to outcomes. This deserves further investigation, as outcomes after surgery may be driven by preoperative characteristics such as surgeon counseling, patient expectations, or other biologic factors.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"165 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin Does Not Inhibit Platelet-Rich Plasma Releasate Efficacy in a Murine Model of Rotator Cuff Tendinopathy","authors":"Matthew L. Magruder, Sarah Caughey, Camila Carballo, Claire D. Eliasberg, Yulei Liu, Janice Havasy, Alex Piacentini, Scott Rodeo","doi":"10.1177/15563316241243371","DOIUrl":"https://doi.org/10.1177/15563316241243371","url":null,"abstract":"Platelet-rich plasma (PRP) has been shown to be a promising treatment for subacromial impingement, and although its interaction with aspirin (ASA) is controversial, many providers ask patients to stop non–steroidal anti-inflammatory drug use before PRP administration. This studied aimed to identify the effect of PRP in a murine model of subacromial impingement and to explore the effect of ASA on PRP treatment. A murine model of subacromial impingement was used, incorporating 48 wild-type C57BL/6 mice. After impingement surgery, mice received either human PRP activated via calcium chloride or saline injected into the subacromial space. The mice received either drinking water with ASA or standard drinking water, creating 4 groups: saline injection, saline injection + ASA, PRP injection, and PRP injection + ASA. All injections occurred at 3 weeks after impingement surgery, and mice were evaluated at 6 weeks. Each mouse underwent gait analysis, biomechanical analysis (N = 10 shoulders), histological analysis (N = 6), and gene expression analysis (N = 8). Biomechanical testing showed increased load to failure in the PRP group compared to the ASA group, and increased stiffness in PRP vs saline, PRP vs ASA, and PRP vs ASA + PRP. Gene expression analysis identified 17 downregulated genes between the ASA + PRP and saline groups. Eight of these differentially expressed genes contribute to collagen biosynthesis and modification, 4 to extracellular matrix (ECM) synthesis, and 4 to ECM degradation. In this preliminary analysis, PRP injections in a murine model of subacromial impingement demonstrated mixed effects on tendon quality and pain, and ASA did not have a consistent effect on the response to PRP.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering International Knowledge Sharing and Clinical Excellence: A Partnership and Inaugural Academic Conference","authors":"Klaus Mieth Alviar, Guillermo Bonilla, Mathias Bostrom, Alberto Carli, Matthew Cunningham, Claire D. Eliasberg, Adolfo Llinás, Jorge Rojas Liévano, Catherine Maclean, William M. Ricci, Laura Robbins","doi":"10.1177/15563316241242368","DOIUrl":"https://doi.org/10.1177/15563316241242368","url":null,"abstract":"","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"179 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140740523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening Burnout in Orthopedic Surgeons Since 2019 and Key Areas of Work life Drivers","authors":"Shuting Lu, Rosie Mc Colgan, Joseph Nguyen, Bryan T. Kelly, D. Fufa","doi":"10.1177/15563316241242129","DOIUrl":"https://doi.org/10.1177/15563316241242129","url":null,"abstract":"In 2019, we assessed rates of burnout in orthopedic surgeons (attendings and trainees) at our institution and found distinct levels and drivers of burnout. Excessive workload had the strongest association with burnout across career stages. We sought to re-examine the rates of burnout in orthopedic trainees and faculty in the same institution several years later and to identify the areas of worklife that correlated with burnout at distinct career stages, comparing 2019 and 2023 responses. From November 2022 to February 2023, we invited 190 orthopedic attending surgeons and trainees to participate in a survey by email. The Maslach Burnout Inventory and Areas of Worklife Scale were used to evaluate burnout and areas of worklife, respectively. Respondents were invited to elaborate on their experiences in free-text boxes. Results were compared to those of our 2019 survey. In 2023, 76 recipients completed the survey, for a 40% response rate, compared with a 79% response rate in 2019. The response rate among residents fell from 93% in 2019 to 28% in 2023. High levels of depersonalization were found in 38% of residents and 21% of attending surgeons. High levels of emotional exhaustion were found in 31% of residents and 33% of attending surgeons. The proportion of attending surgeons reporting symptoms of burnout doubled between 2019 and 2023, whereas rates remained similar in residents. In 2023, 38% of residents reported low personal accomplishment compared with 5% in 2019. Excessive workload and limited job control were the work life areas most strongly correlated with burnout. The results of our 2023 survey suggest that burnout rates increased in academic orthopedic attending surgeons at our institution since 2019. The COVID-19 pandemic has highlighted the importance of institutions continuing to prioritize physician well-being.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"64 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Patterns of Common Injuries in Pediatric and Adolescent Athletes","authors":"Tyler J. Uppstrom, Nicolas Pascual-Leone, Joshua T. Bram, Dylan Bennett, David A. Kolin, Harry G. Greditzer","doi":"10.1177/15563316241233578","DOIUrl":"https://doi.org/10.1177/15563316241233578","url":null,"abstract":"Injuries in pediatric and adolescent athletes continue to rise in the United States, with increases in year-round sports participation, earlier sport specialization, and inadequate access to neuromuscular training programs. In this setting, the use of magnetic resonance imaging (MRI) provides a critical diagnostic tool. This review article describes the utility of MRI in diagnosing common pediatric and adolescent sports injuries and presents imaging findings associated with these pathologies.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"111 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}