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Return to High Level Sports After Meniscal Transplant (Arthroscopy 2013)

arthroscopy-150x150 Return to High Level Sports After Meniscal Transplant (Arthroscopy 2013) Journal Club Meniscus | JC Sports Medicine | JC
Chalmers PN, Karas V, Sherman SL, Cole BJ. Return to high-level sport after meniscal allograft transplantation. Arthroscopy. 2013 Mar;29(3):539-44. doi: 10.1016/j.arthro.2012.10.027. Epub 2013 Jan 29. PubMed PMID: 23375179.


In this retrospective review from Arthroscopy, Brian Cole’s group studied 13 patients undergoing meniscal transplant, with a minimum 2 year follow-up. Mean age was 19.8 years, mean follow-up 3.3 years.

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The 13 athletes were a combination of high school, professional, and college athletes who underwent meniscal transplant. Cole’s group followed them longitudinally and collected patient reported outcomes (PROs) to objectively assess their improvement. 77% of the patients returned to their desired activity level, and 70% of those retired to their desired level of play. Patient reported outcomes improved from the preoperative to the postoperative state. 23% of the patients required a revision operation (revision meniscus transplant, menisectomy, or meniscus repair).

The study was limited by a small sample size, relatively short follow-up time, retrospective nature with no control group, Level IV evidence, and lack of second look arthroscopy or routine postoperative advanced imaging.

 

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Dislocation of the Acromioclavicular Joint (JBJS 1987)

Screenshot-2015-05-20-00.12.34-e1432095302195-73x98 Dislocation of the Acromioclavicular Joint (JBJS 1987) Journal Club Shoulder | JC Sports Medicine | JC Upper Extremity | JC
Taft, T. N., Wilson, F. C., & Oglesby, J. W. (1987). Dislocation of the acromioclavicular joint. An end-result study. The Journal of Bone & Joint Surgery, 69(7), 1045. https://doi.org/3654696


In this classic article from JBJS, Taft et al. retrospectively analyzed 127 patients who had been treated both operatively and nonoperatively for acute dislocation of the acromioclavicular joint. Average follow-up was approximately 10 years. Fifty-two of the patients were managed with surgery and 75 were management without surgery.

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Classification system for acromioclavicular injury.

Key findings of operative versus nonoperative management of dislocation of the acromioclavicular joint
  • reduction of the AC joint was not necessary for good results
  • Operative management resulted in more complications than nonoperative management
  • 4 weeks of sling use led to good results (after gradual exercises)
  • In patients with persistent pain and symptoms, distal clavice resection was usually successful
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Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass

Fuller, J. T., Thewlis, D., Buckley, J. D., Brown, N. A. T., Hamill, J., & Tsiros, M. D. (2017). Body Mass and Weekly Training Distance Influence the Pain and Injuries Experienced by Runners Using Minimalist Shoes. The American Journal of Sports Medicine, 363546516682497. https://doi.org/10.1177/0363546516682497


This randomized clinical trial performed in Australia investigated running injury risk in 61 male runners with a mean age of 27 years old. All participants had a rearfoot strike at the beginning of the trial and met minimum training and performance requirements. Participants were randomized to a minimalist shoe or conventional shoe group for the remainder of the study. The minimalist shoe runners were then transitioned from their conventional shoes to minimalist shoes gradually over a 26 week period. Ultimately, 31 runners were allocated to the minimalist shoe group and 30 runners were allocated to the conventional shoe group. Runners completed a visual analog scale (VAS) weekly to assess their pain levels.
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home_cover-73x98 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC   home_cover-1x1 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC   Screenshot-2017-02-04-14.12.35-300x264 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC

Linear fixed-effects model predicted differences in weekly pain between minimalist and conventional shoes relative to weekly training distance.

Key findings of minimalist vs. conventional shoes include:
  • Knee, calf, shin, and ankle pain scores were significantly higher (more self-reported pain) in the minimalist shoe group than the conventional shoe group
  • There were no differences in foot, thigh, or lower back pain scores between groups
  • For runners using minimalist shoes, the risk of injury increased with increasing body mass and with increasing training distance
  • For runners using minimalist shoes, a body mass of 85kg or more correlated with a 68% chance of injury by the end of the 26 week training period
  • For runners using minimalist shoes, a weekly training distance of more than 21.7 miles resulted in a clinically significant increase in calf pain compared to conventional shoes
  • A weekly training distance of more than 24.9 miles resulted in clinically significant increases in shin and ankle pain compared to conventional shoes
  • Runners over 187 lbs were more than 3x as likely to sustain a running injury
  • The study authors concluded that heavier runners should avoid running in minimalist shoes
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Rotator Cuff Surgery is Most Common Upper Extremity Ambulatory Orthopaedic Procedure

Screenshot-2017-01-28-13.07.17-e1485627573337-73x98 Rotator Cuff Surgery is Most Common Upper Extremity Ambulatory Orthopaedic Procedure Journal Club Sports Medicine | JC
Jain, N. B., Higgins, L. D., Losina, E., Collins, J., Blazar, P. E., & Katz, J. N. (2014). Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskeletal Disorders, 15(1), 4. https://doi.org/10.1186/1471-2474-15-4


This study analyzed data from the 2006 National Survey of Ambulatory Surgery to assess which surgeries were most commonly performed in ambulatory surgery centers (outpatient) in the United States. They included only upper extremity surgeries.

Key findings include:
  • Arthroscopic procedures were the most common
  • Arthroscopic rotator cuff surgery was the most common procedure
  • General shoulder arthroscopy, elbow arthroscopy, carpal tunnel release, and wrist arthroscopy were the next most common procedures
  • Rotator cuff repair was more common in males
  • Most shoulder arthroscopy (besides rotator cuff tears) was for impingement or instability (labral tears, etc)
  • The highest incidence of rotator cuff repair was in the 65-74 age range (28.3 per 10,000 persons)
  • Average surgery time for rotator cuff repair was 106 minutes

 

More information on rotator cuff surgeries from a rotator cuff surgeon and shoulder specialist

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NCAA Football Injuries – Most Surgeries are Arthroscopic

2459519 TSUTWFM8 items 1 default ASC http://www.orthoconsult.com/wp-content/plugins/zotpress/ Epidemiologic study of NCAA (collegiate) football injuries across 60 teams over 5 seasons. Most common orthopaedic injuries were lower extremity. This 2016 study utilized information from the NCAA injury surveillance system over 5 seasons. Key findings include: Over 18,000 football injuries 39% were in competition, 56% were in regular practices The highest injury…

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A Prospective Evaluation of Survivorship of Asymptomatic Degenerative Rotator Cuff Tears

Keener JD, Galatz LM, Teefey SA, Middleton WD, Steger-May K, Stobbs-Cucchi G, Patton R, Yamaguchi K. A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears. J Bone Joint Surg Am. 2015 Jan 21;97(2):89-98. doi: 10.2106/JBJS.N.00099. PubMed PMID: 25609434; PubMed Central PMCID: PMC4296477. Location: Shoulder and Elbow Service, Dept. Orthopaedic Surgery, Washington University, St. Louis, Missouri Goals: To better…

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