The American journal of sports medicine
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In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as an alternative salvage procedure when other, previous reparative treatments have failed. ⋯ Favorable results were shown in both groups with significant improvement of functional scores and excellent survivorship. Despite the higher reoperation rate in the previously treated group, previous subchondral marrow stimulation did not adversely affect the survivorship and functional outcome of OCA transplantation.
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In treatment of distal third clavicle fractures, the Neer classification system, based on the location of the fracture in relation to the coracoclavicular ligaments, has traditionally been used to determine fracture pattern stability. ⋯ Fracture stability determination and the decision to operate had the highest interobserver agreement. Fracture stability was the key determinant of treatment, rather than the Neer classification system or the size of the distal fragment.
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Exertional heat stroke is a devastating condition that can cause significant morbidity and mortality. Rapid cooling is the most effective means of treating heat stroke, but little is published on the safety and logistics of cooling patients on site at a major sporting event. ⋯ On-site treatment of athletes who develop exertional heat stroke appears to be both safe and effective. On-site treatment may decrease the local burden of critically ill patients to emergency departments during large athletic events.
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Meniscal root tears are an increasingly recognized subset of meniscal injury. The menisci are critical secondary stabilizers of the anterior cruciate ligament (ACL). The kinematic effect of lateral meniscus posterior root tear in the setting of ACL injury is not known. ⋯ This study shows that lateral meniscal root injury further destabilizes the ACL-deficient knee and thus advances the concept that the lateral meniscus is a secondary stabilizer of the knee under pivot-shift loading. In the absence of stronger evidence, the study data suggest a rationale for surgical repair of lateral meniscal root tears encountered in the setting of ACL tears.