Sports medicine and arthroscopy review
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The prevalence of rotator cuff tears after traumatic dislocation increases with advancing age, a likely consequence of the age-associated deterioration of the structure and mechanical properties of the tendons of the rotator cuff. These are the effective stabilizers of the glenohumeral joint, compressing the humeral head in the 3-dimensional concavity of the glenohumeral joint. ⋯ A peripheral nerve or a brachial plexus injury can be associated with tendon lesion and instability, developing the "terrible triad" of the shoulder. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion.
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Sports Med Arthrosc · Jun 2011
ReviewManagement of arterial and venous injuries in the dislocated knee.
Although uncommonly encountered, knee dislocation is frequently associated with major vascular injury. Serious injuries resulting in ischemia demand prompt recognition and efficient management to prevent devastating long-term sequelae. ⋯ Appropriate initial management of vascular injuries is crucial and an algorithm for diagnosis and management will be reviewed. We elaborate on the salient points of vascular reconstruction in the context of the dislocated knee: surgical approach, conduct of the procedure, and adjunctive maneuvers are described.
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In the United States, youth interest in sports participation has increased steadily over the past 2 decades. Although such trends are encouraging to the medical community, especially given the concurrent obesity epidemic among American youth, this increase in sports participation is accompanied by an increase in rates of sports injury in the pediatric population. Appropriate diagnosis and treatment of these injuries by primary care and orthopedic providers rests heavily on a fundamental understanding of the epidemiology of such pathologies.
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There has been a significant increase in youth sports participation and athletic activities over the past 3 decades. With the increase in participation, there has been a commensurate rise in the number of sports-related injuries. A majority of these injuries are due to overuse as athletes frequently compete in multiple sports with year round competition and training. ⋯ This review will focus on both overuse and traumatic injuries of the upper extremity in the adolescent athlete. A significant emphasis will be placed on the evaluation and management of soft tissue and bony injuries in the overhead throwing athlete. The review will conclude with a discussion on common wrist and hand injuries seen in this population.
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Postarthroscopic glenohumeral chondrolysis is a devastating, poorly understood, and relatively rare complication. True chondrolysis involves the dissolution of articular cartilage, including the matrix and cellular elements, leading to premature and irreversible articular cartilage loss. Several factors have been implicated in this phenomenon; however, to date, no study has conclusively ascertained the causation. ⋯ To date, several papers have described the phenomenon and the potential associations; however, there is no definitive answer although the use of high-dose bupivacaine as an intra-articular anesthetic seems to be contraindicated. The purpose of this article is to review the basic science regarding chondrolysis and to assess the current literature which focuses on postarthroscopic glenohumeral chondrolysis, as well as innovative treatment alternatives. It is unlikely that postoperative chondrolysis will be clearly understood until controlled studies are available, of which there are currently none.