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

{"title":"Youth Sport Specialization: Current Concepts and Clinical Guides","authors":"Dai Sugimoto, Kristin E. Whitney, P. d’Hemecourt, A. Stracciolini","doi":"10.1177/15563316241237526","DOIUrl":"https://doi.org/10.1177/15563316241237526","url":null,"abstract":"The concept of youth sport specialization has evolved over the past decade, from a focus on the risk of overuse injury to a broader awareness of its effects on mental health, social well-being, quality of life, growth and maturation, sport performance, and long-term athletic success. This review article considers a recently revised definition of youth sport specialization, as well as guidelines and consensus statements from various sports medicine organizations, with practical applications for young athletes.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140218046","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":"High Rates of Abnormal Patellofemoral Morphology in Adolescents With Anterior Knee Pain: A Retrospective Review","authors":"Julia S. Retzky, Preston W Gross, Shevaun M. Doyle, S. Strickland","doi":"10.1177/15563316241231805","DOIUrl":"https://doi.org/10.1177/15563316241231805","url":null,"abstract":"Background: Anterior knee pain is a common reason for referral to a pediatric orthopedic surgeon. Although previous studies have found that adults with anatomic risk factors for patellofemoral instability (patella dislocation) are predisposed to anterior knee pain, no studies have elucidated the relationship between anatomic risk factors for patellofemoral instability and anterior knee pain in children. Purpose: We sought to characterize common radiographic findings in adolescent patients with a chief complaint of anterior knee pain and to determine the prevalence of abnormal patellofemoral morphology. Methods: We conducted a retrospective review of patients 13 to 18 years old with anterior knee pain at a single tertiary care metropolitan institution from 2016 to 2021. X-rays and magnetic resonance imaging (MRI) were evaluated in those diagnosed with “chondromalacia patellae,” “chondromalacia,” “patellofemoral disorders,” or “anterior knee pain.” Patella alta, tibial tubercle-trochlear groove (TT-TG) distance, tubercle height, Wiberg patella type, patellar tilt, and trochlear dysplasia characterization were recorded. Results: Of the 293 adolescents with anterior knee pain included, 62 had bilateral anterior knee pain. Of the 172 MRIs, 72 (42%) met criteria for patella alta, Caton-Deschamps Index (CDI) >1.3, 35% had a TT-TG distance >15 mm, and 32% had lateral patellar tilt >15°. Magnetic resonance imaging findings included infrapatellar fat pad signal hyperintensity (41%) and patellofemoral dysplasia (23%). Of all 293 adolescents, 74% had images showing abnormal patellofemoral morphology, of which 30% had a history of 1 or more patellar dislocation. Overall, 40% of the adolescents had surgery, most commonly medial patellofemoral ligament (MPFL) reconstruction (18%). Conclusions: In this retrospective review, nearly 3/4 of adolescents with anterior knee pain had images showing abnormal patellofemoral morphology, including patella alta, increased TT-TG distance, trochlear dysplasia, or abnormal lateral patellar tilt; only 18% had MPFL surgery. These findings suggest that primary care providers might consider obtaining X-rays and/or MRIs to evaluate for pathology that warrants orthopedic evaluation.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"31 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226365","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":"Management of Concussion in the Young Athlete","authors":"Meghan A. Lamothe, Jillian Erickson, Kouros Emami","doi":"10.1177/15563316241238014","DOIUrl":"https://doi.org/10.1177/15563316241238014","url":null,"abstract":"Sports-related concussion continues to be a rapidly growing public health concern in nearly all sports, and at all levels, in children and adolescents. Evidence-based clinical guidelines are constantly evolving but those specific to the pediatric population are less robust. There are nuances to treatment of the developing pediatric brain in the context of mild traumatic brain injury (mTBI). The purposes of this review are to (1) analyze the differences in concussion symptom presentation and recovery in children versus adults, (2) describe the role of the physical therapist in management of pediatric concussion, (3) examine current recommendations for return to participation in school and return to sport, and (4) highlight the psychological implications of concussion in the young athlete. We find that additional research is needed in nearly all aspects of concussion in the young athletic population. The current evidence stresses the importance of an active approach to recovery using a stepwise progression.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"153 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140233877","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":"Return to Sports Following Spondylolysis Surgery in Children and Adolescents: A Systematic Review","authors":"Preston W Gross, Michelle Yang, Ruth H. Jones, Shevaun M. Doyle","doi":"10.1177/15563316241234843","DOIUrl":"https://doi.org/10.1177/15563316241234843","url":null,"abstract":"Spondylolysis is common in athletes participating in gymnastics, football, dance, and weightlifting. Few studies have reviewed return to sports (RTS) rates in young athletes after surgical intervention for spondylolysis. We sought to review the literature on RTS frequencies and timing, as well as postoperative treatment, in children and adolescents who underwent spondylolysis surgery. This was a systematic review, using the PubMed, Embase, and Cochrane databases, of primary, peer-reviewed studies published from 2014 to 2022 that investigated child and adolescent RTS after spondylolysis surgery. Each author independently reviewed each study’s design, number of participants, age range, fixation, postoperative course of treatment, frequency of RTS, and reasons for failure of RTS. The initial search produced 106 articles; 25 were reviewed in full and 9 were included in the final analysis, with a combined total of 177 patients. Sample sizes ranged from 5 to 52 participants. The most common fixations were direct repair (6 studies, n = 120), indirect repair (3 studies, n = 22), and fusion (2 studies, n = 35). Five studies mentioned the use of immediate postoperative immobilization. Physical therapy programs were initiated most often at 6 weeks postoperatively. The RTS rate of the 177 athletes (median age younger than 23 years) was 76% to 100%. The most common reason for failure to RTS was lower back pain. This systematic review suggests that young athletes RTS at a high rate following spondylolysis surgery, but more rigorous study is warranted. The review also found varied preferred fixation methodologies and postoperative treatment regimens across the available studies.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"83 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140236270","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":"Variable Guidelines for Pediatric Medial Patellofemoral Ligament Reconstruction Rehabilitation Exists Across PRiSM Member Organizations","authors":"Elliot Greenberg, Joseph Hannon, Nathan Chaclas, Jeffrey Albaugh, Joseph T. Molony, Brendan A. Williams","doi":"10.1177/15563316241233254","DOIUrl":"https://doi.org/10.1177/15563316241233254","url":null,"abstract":"Medial patellofemoral ligament (MPFL) reconstruction, typically used to restore stability to the patellofemoral joint after dislocation, often requires extensive rehabilitation to address acute impairment related to surgical intervention and also underlying non-anatomical deficits that may have contributed to the index injury. Rehabilitation guidelines, including objective functional performance assessment criteria, are lacking in the literature. We sought to summarize the clinical guidelines for rehabilitation and return to activity assessment after MPFL reconstruction as advocated by the member organizations of the Pediatric Research in Sports Medicine (PRiSM) Patellofemoral Research Interest Group (PF-RIG). We obtained and reviewed MPFL rehabilitation guidelines from 11 member organizations of the PRiSM PF-RIG, extracting information on weight-bearing advancement, bracing, use of supplemental strengthening modalities, and any objective criteria for advancing rehabilitation phases. We found highly variable agreement among guideline parameters at each treatment stage, with time-based criteria most widely used for early progression. Although functional metrics like strength or movement tests were more widely used in later phases of rehabilitation, there was substantial variation in testing mode and level of acceptable performance. Our review found that significant variability exists in current practice among PRiSM and PF-RIG member institutions regarding rehabilitation standards after MPFL reconstruction. Although we found broad consensus that objective strength or performance criteria should be employed to establish a better framework for clinical decision-making, most current guidelines lack standardization and sufficient detail to guide ideal clinical practice.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140245639","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":"Squeaking Shoulder Following Arthroscopic Shoulder Surgery: A Case–Control Study","authors":"Si Heng Sharon Tan, V. P. Kumar, Joel Louis Zongwei Lim, R. Manohara, D. Z. Ng, Keng Soon Poh, Hsi Ming Bryan Tan","doi":"10.1177/15563316241236797","DOIUrl":"https://doi.org/10.1177/15563316241236797","url":null,"abstract":"To date, the occurrence of unusual squeaking noises during shoulder movements following shoulder arthroscopic surgeries have been minimally reported. The aim of this study was to report the incidence, natural history, possible risk factors and functional outcomes of patients who reported to have squeaking noises following shoulder arthroscopic procedures. In this 2-year case-control study, all patients who underwent arthroscopic shoulder in a single institution were included. All patients were then evaluated preoperatively and postoperatively for demographics, pathology, surgical factors, and functional outcomes. The possible risk factors and functional outcomes of the patients who experienced squeaking following shoulder arthroscopic surgeries were then compared with those patients who did not experience squeaking following shoulder arthroscopic surgeries. Of the 360 patients included in the study, the incidence of squeaking following arthroscopic shoulder surgeries was 2.23%, and the incidence of squeaking following arthroscopic shoulder labral repair was 3.1%. The age, gender, hand dominance, body mass index, participation in sports, pathology, side of pathology, use of knot-tying versus knotless suture anchors, number of suture anchors, and surgical duration were not significantly different between patients who experienced squeaking and patients who did not. All patients had comparative functional outcomes preoperatively and postoperatively (at the 3-month, 6-month, and 1-year follow-ups). This case-control study provides an analysis of a series of patients with squeaking of the shoulder following arthroscopic shoulder surgeries. No risk factors or etiology of the condition have been identified in the series. However, there is no functional compromise among these patients who experienced squeaking following shoulder arthroscopic surgeries.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140246064","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":"ACL Injury Prevention Education Improves Implementation of Neuromuscular Training Among High School Sports Coaches: A Cross-Sectional Survey Study","authors":"J. Janosky, James Russomano, Connor Duscha, Alexandra Henderson, Alexandra Archer, James J Kinderknecht, Robert G. Marx","doi":"10.1177/15563316241236194","DOIUrl":"https://doi.org/10.1177/15563316241236194","url":null,"abstract":"Neuromuscular training (NMT) programs delivered by trained personnel have demonstrated protective effects against anterior cruciate ligament (ACL) injury among high school sports participants, but few studies have investigated the impact of education on high school sports coaches’ knowledge and incorporation of NMT programs into daily practice sessions. We sought to evaluate changes in knowledge and behavior among high school sports coaches who completed an NMT-based injury prevention training program. High school sports coaches were invited to complete a free online training course in incorporating NMT into daily practice sessions. Anonymized surveys were administered before and after education and at 3 months to evaluate knowledge level and program effectiveness. Of the 13,640 coaches who enrolled in the training course in 2019, 1641 submitted pre- and post-education and 3-month follow-up surveys. Prior to training, 4.4% reported incorporating NMT into daily training sessions and the mean knowledge score was 1.89 ± 1.55. After training, 92.7% of participants reported that they intended to incorporate NMT into their daily training sessions and the mean knowledge score was 4.87 ± 1.11. At 3-month follow-up, 88.9% of participants reported incorporating NMT into daily training sessions. A chi-square test revealed a significant association between pre- and post-education incorporation of NMT into daily practice sessions, and a multiple regression analysis resulted in a significant model with intent to incorporate NMT into daily practice sessions identified as a significant behavior predictor. These survey results show that completion of a training course significantly improved ACL injury prevention knowledge among a cohort of high school sports coaches and likely contributed to the sustained incorporation of NMT into their daily practice sessions.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"2010 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140246306","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":"HSS Journal and Its Commitment to DEI: A Progress Report","authors":"Lauren A. Barber, Joy Jacobson, Charles N. Cornell","doi":"10.1177/15563316241230949","DOIUrl":"https://doi.org/10.1177/15563316241230949","url":null,"abstract":"","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140081050","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":"Injury to the Main Branch of the Saphenous Nerve following Hamstring Tendon Graft Harvesting: A Report of 3 Cases","authors":"Alexandra Flaherty, Cristian Escalera, Heather Haeberle, Stephen Fealy, Steve K. Lee","doi":"10.1177/15563316241230285","DOIUrl":"https://doi.org/10.1177/15563316241230285","url":null,"abstract":"Hamstring tendon grafts are commonly utilized tendon autografts; however, the harvesting procedure can result in saphenous nerve injury due to its proximity to the semitendinosus and gracilis tendons. Injury to the main branch of the saphenous nerve is a less commonly reported and understood injury during these procedures. This case report aimed to identify and present cases of iatrogenic injury to the main branch of the saphenous nerve during hamstring tendon graft harvesting. A retrospective chart review of a tertiary-care hospital over the past 10 years was conducted. The search included clinical notes mentioning “saphenous neuropathy, neuralgia or neuritis” and magnetic resonance imaging (MRI) reports indicating saphenous nerve involvement. Patients with a history of a hamstring graft harvesting procedure and radiographically confirmed injury to the main branch of the saphenous nerve were included. Injury characteristics, symptoms, and sequential treatment were evaluated. Three cases of iatrogenic injury to the main branch of the saphenous nerve during hamstring graft harvesting were identified. Reported symptoms included pain, paresthesia, numbness, hypersensitivity, swelling, and discoloration. All 3 patients had persistent symptoms despite non-operative treatment and therefore underwent surgical intervention, which involved resection and reconstruction using allograft or burial into adjacent musculature. Postoperatively, 2 of 3 patients demonstrated resolution of symptoms. Iatrogenic injury to the main branch of the saphenous nerve is a complication that can occur during hamstring tendon harvesting procedures, leading to severe, persistent symptoms. A better understanding of the mechanism of injury is needed to minimize the risk of iatrogenic injury.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"83 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267232","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":"Tarsal Coalition: Surgical Management in the Young Athlete","authors":"J. Masquijo, Florencia Turazza","doi":"10.1177/15563316241231791","DOIUrl":"https://doi.org/10.1177/15563316241231791","url":null,"abstract":"Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints.","PeriodicalId":253125,"journal":{"name":"HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery","volume":"113 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089597","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}