The American journal of sports medicine
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Several risk factors have been proposed for intervertebral disc degeneration (DD) among adolescent athletes. However, the causes of DD are not well understood, and there have been few prospective studies evaluating DD in adolescents. ⋯ Significant risk factors for DD progression in high school AF players included playing a lineman position, the presence of Schmorl nodes, and disc herniation. Continuing to play AF through 2 years of high school was a risk factor for the onset of LBP.
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Clinical Trial
Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 200 shoulders.
There are few reports in the literature detailing the arthroscopic treatment of unidirectional posterior shoulder instability. ⋯ Arthroscopic capsulolabral reconstruction is an effective, reliable treatment for symptomatic, unidirectional recurrent posterior glenohumeral instability in an athletic population. Overall, 90% of patients were able to return to sport, with 64% of patients able to return to the same level postoperatively. With the incorporation of bone suture-anchors in capsulolabral reconstruction, patients had greater improvements in ASES scores and a higher rate of return to play.
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Case Reports
Operative and nonoperative treatment of cervical disc herniation in National Football League athletes.
Limited evidence exists to guide clinical decision making regarding cervical disc herniations in professional athletes playing for the National Football League (NFL) in the United States. ⋯ Data regarding the treatment of this unique population are limited but suggest that NFL athletes can safely return to sport after the treatment of cervical disc herniations. In the treatment algorithm for this study, cord compression with signal change in the cord on MRI was a consistent operative indication. Discs abutting the cord can be treated nonoperatively but do not allow for return to sport until symptoms have improved and repeat imaging demonstrates no cord compression. Isolated nerve root compression has a more favorable prognosis. It can be treated symptomatically and return to sport allowed when symptoms permit.
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Clinical Trial
Improving the rapid and reliable diagnosis of complete distal biceps tendon rupture: a nuanced approach to the clinical examination.
Diagnosis of complete distal biceps tendon rupture (DBTR) is frequently missed or delayed on clinical examination. No single clinical test, including MRI, has demonstrated 100% efficacy in assessing the integrity of the distal biceps tendon. ⋯ Application in sequence of the hook test, the PFP test, and the BCI test results in 100% sensitivity and specificity when the outcomes on all 3 special tests are in agreement.
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Factors contributing to recurrent dislocation, revision stabilization, and complications requiring reoperation after an initial shoulder stabilization procedure for instability have not been evaluated on a population level. ⋯ The risks of revision stabilization and postoperative (either shoulder) dislocation were most influenced by young age (<20 years) and having had 3 or more preoperative dislocations. Complications requiring surgery are rare.