The American journal of sports medicine
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There is a paucity of published data regarding the management of osteochondritis dissecans (OCD) lesions of the patellofemoral joint in children and adolescents. ⋯ Surgical treatment of patellofemoral OCD in children and adolescents produces a high rate of satisfaction and return to sports. Female sex, prolonged duration of symptoms, and internal fixation may be associated with worse outcomes.
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Humeral head defects such as degenerative disease or avascular necrosis are often treated with stemmed hemiarthroplasty or total shoulder arthroplasty. Despite its historical and clinical significance, stemmed humeral head replacement poses inherent technical challenges to placing spherical implants at the anatomically correct head height, version, and neck-shaft angle. ⋯ Humeral head inlay arthroplasty is effective in providing pain relief, functional improvement, and patient satisfaction. Rather than delaying shoulder arthroplasty to end-stage osteoarthritis, humeral head inlay arthroplasty is a promising new direction in primary shoulder arthroplasty for younger and active patients with earlier stage disease.
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Observational Study
Instrumented mouthguard acceleration analyses for head impacts in amateur rugby union players over a season of matches.
Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (rotational acceleration or strain) have been postulated as the 2 major mechanisms of head-related injuries such as concussion. Although data are accumulating for soccer and American football, there are no published data for nonhelmeted collision sports such as rugby union. ⋯ The acceleration magnitudes and number of head impacts in amateur rugby union players over a season of matches, measured via instrumented mouthguard accelerations, were higher than for most sports previously reported. Mean linear acceleration measured over a season of matches was similar to the mean linear accelerations previously reported for youth, high school, and collegiate American football players but lower than that for female youth soccer players. Mean rotational acceleration measured over a season of matches was similar to mean rotational accelerations for youth, high school, and collegiate American football players but less than those for female youth soccer players, concussed American collegiate players, collegiate American football players, and professional American football players.
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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. ⋯ Plate fixation of displaced clavicle fractures in athletes is a safe procedure resulting in excellent functional outcomes, with an early return to the same level of sports in the majority of patients.
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Patients generally choose to undergo anterior cruciate ligament reconstruction (ACLR) to return to their active lifestyles. However, returning to their previous activity level may result in a retear of their reconstructed knee or an injury to their contralateral anterior cruciate ligament (CACL). ⋯ The 5-year revision-free and CACLR-free survival rate in this study was 95.1% and 95.8%, respectively. Allografts and hamstring autografts had a higher risk of revision ACLR surgery, and BPTB autografts had a higher risk of CACLR. Males were found to have a higher risk of revision ACLR, and females had a higher risk of CACLR. Increasing age and increasing BMI decreased the risk of both revision and CACLR.