Recent News

Abstract:

“​Meniscal injuries in athletes present a challenging problem. Surgeons must balance the needs of the healing meniscus with the desire of the athlete to return to play as quickly as possible. Evidence-based rehabilitation protocols are important for ensuring a successful meniscal repair and preventing athletes from returning to play prematurely. Ultimately, however, the return to play determination requires a shared decision-making approach between the physician, the athlete, and the providers involved in the athlete’s rehabilitation process. This decision considers not only the athlete’s ability to meet return-to-play criteria but also their season-specific and career goals.”

To read the full article, please visit the journal website here.

Both former and current members Christine Etzel ’19 and Lauren Ready MD’21 were featured in a Brown Daily Herald article discussing their recent work in the Sports Injury Lab with Brett Owens, MD. With a focus in sports injury prevention, treatment, and recovery, both Brown students have contributed to research that will help athletes (like Etzel, Goalie for the Brown Women’s Soccer team) return to sport.

To read the full article by Gloria Nashed, please go to the Brown Daily Herald website, located here.

Abstract

» Although shoulder instability is well described, there is a paucity of literature examining the differences between women and men with regard to epidemiology, pathophysiology, and treatment of shoulder instability.

» Variability in muscle mass, ligamentous laxity, and overall biomechanics of the glenohumeral joint may cause men and women to experience shoulder instability in different ways. » Additionally, differences in circulating hormones such as relaxin may contribute to increased joint laxity in women compared with men; these differences affect the pathophysiology of instability.

» The presence of increased physiologic laxity, due to these hormone levels, in female patients makes the treatment considerations more complex in that many classification systems do not take sex into consideration (i.e., the Instability Severity Index Score).”

To read the full article, please visit the journal website here.

Abstract

BACKGROUND:

The internet is an easily accessible resource for both providers and patients. Despite this, the internet is not peer reviewed, leaving searches subject to inaccuracies, especially with regards to medical information. The purpose of this study was to review internet images of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) tears using two popular search engines: Google and Bing.

METHODS:

A search query was performed on both Google and Bing for the following terms: ‘ACL tear’, ‘PCL tear’, ‘MCL tear’ and ‘LCL tear’. The first 100 images of each individual search were analyzed by three independent orthopedists.

RESULTS:

The inter-rater reliability was very good for PCL tear on Bing (Cronbach’s alpha = 0.89) and excellent (Cronbach’s alpha > 0.9) for the remainder of the search queries. When comparing Google to Bing, the only significant difference occurred in the ACL group, with Bing returning a significantly greater number of correct images 60%, 95% CI: 53.2 – 66.7%) compared to Google (45% correct, 95% CI: 38.1-51.8%), p = 0.034. With regards to the other ligaments Bing was more accurate than Google for PCL (39% versus 38%), and LCL (32% to 30%). Both sites were 48% accurate for MCL tear.

CONCLUSION:

Ultimately, our study revealed that physicians should take an active role in making high quality, easy to understand medical resources and anatomic diagrams available to their patients to avoid confusion and enhance understanding when querying the internet for additional information regarding their condition.

To read the full article, please go to the journal website located here.

Abstract

Chronic exertional compartment syndrome (CECS) is an overuse injury characterized by increased intracompartmental pressure during exercise. CECS has been described in the foot, thigh, and trunk, but 95% of cases occur in the lower leg. Interestingly, CECS may also affect the upper extremities, and has been best described in the forearms. Unfortunately, due to the rarity of this condition, there is no consensus regarding its diagnosis and treatment. This review seeks to discuss the prevalence, etiology, diagnosis, and treatment of CECS of the forearms, which has been described in the literature.

To read the full article, please go to the journal website located here.

Abstract

BACKGROUND:

Clavicle fractures are a very common injury due to accidental trauma, specifically during athletics. The purpose of this study was (1) to determine the incidence of clavicle fractures presenting to United States emergency departments; (2) to compare the rate of clavicle injuries from 2012 to 2015 to 2002-2005 (3) to determine the most common mechanisms of injury for clavicle fractures.

METHODS:

The National Electronic Injury Surveillance System (NEISS) was queried for the years 2002–2005 and 2012–2015. Examined variables included patient age, sex, and year of admission. Total annual case numbers were estimated using NEISS hospital weights. Annual injury incidence rates by age group and patient sex were calculated based on yearly U.S. Census estimates. Chi square test and logistic regression were used to compare injury rates by sex and age groups. Statistical significance was set at P < 0.05.

RESULTS:

During the 8 years studied, the participating emergency departments (EDs) coded 14,795 fracture exposures. Using weighted estimates, this represent 545,663 injuries nationally (95% CL 425,986-665,339). This resulted in an incidence of 22.4 injuries per 100,000 person years (95% CL 17.5-27.3). The most common causes of injury were bicycles (15.1%), football (10.7%), beds/bedframes (6.8%), stairs (5.4%), and floors (4.0%). Fifty percent of clavicle fractures were due to an athletic activity. There was no significant change in injuries from 2002 to 2005 compared to 2012-2015 (23.1 per 100,000, 95% CL 18.5-27.7, and 22.4 per 100,000 person years (95% CL 17.5-27.3), respectively).

CONCLUSION:

Clavicle fractures continue to occur at similar rates, with athletics accounting for 50% of injuries. Patients most at risk for clavicle fracture was bimodal in nature, with males aged 0-19 being the most common. Females were most at risk between 0 and 9 years old. We found that clavicle fracture continued to occur at similar rates as compared to 10 years prior, especially in active populations participating in collision sports (bicycle, football, and soccer).”

To read the full article, please visit the journal website here.

Abstract

Medial instability of the patellofemoral joint is a rare but known phenomenon; it may result from an incompetent lateral patellofemoral ligament (LPFL). However, biomechanical details of the ligament have not been the subject of scrutiny. The purpose of this study was to describe the biomechanical properties of the LPFL. Ten fresh-frozen human cadaveric knees were dissected to identify the LPFL. The ligament was harvested with a bone plug from the patella and the femoral surface and underwent axial loading to failure. Load to failure and location of failure were recorded. Regression analysis was performed to determine which anatomic variables (midsubstance width, femoral insertion width, patellar insertion width, or percent patellar articular surface of insertion) significantly influenced load to failure. Nine of the 10 specimens failed at the midsubstance of the ligament. The average load to failure was 90±67 N. Logistical regression showed that midsubstance width was most correlated with load to failure, which approached but did not reach significance (P=.09). Studies are warranted to investigate the clinical consequences of medial patellar instability and the best repair or reconstruction techniques available.

 

To read the full article, please go to the journal website located here.