bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healing Rates of Massive Rotator Cuff Tears by Allograft Reconstruction vs Maximal Repair - A Prospective Randomized Controlled Trial
Authors: Tejaswi Purnachandra , Wong Ivan H. 
Published: July 2019

Objectives: To determine the healing rate of rotator cuff reconstruction with an acellular human dermal allograft compared with the current gold standard arthroscopic maximal rotator cuff repair of large, chronic tears of the rotator cuff. Methods: Thirty patients with a two-tendon chronic retracted rotator cuff tear were enrolled in the study and were randomly allocated (15) to each group. All the patients were evaluated for structural integrity of repair using a 1.5 T MRI at an average of 15 months after surgery. Rotator cuff arthropathy (RCA) and acromio-humeral distance (AHD) were graded using X-rays. WORC, DASH, MARX scores, range of motion (ROM) of shoulder were also analyzed. Results: The re-tear rate in reconstruction group was 13% (2 of 15 patients) compared to 67%(10/15) in repair group (p=0.008). Progression of RCA was seen in 7.14%(1/14) and 35.71%(4/14) of patients in reconstruction and repair group; respectively (p=0.006). The change in AHD (preop-postop) was significantly higher in repair (reduced by 2.27 mm) than the reconstruction group (increased by 0.1 mm) (P=0.006). Both groups had significant improvements in patient reported outcome scores. Reconstruction group had statistically significant better forward flexion (p= 0.01) and scapular plane abduction (p=0.03) compared to repair. Conclusion: Rotator cuff reconstruction with a dermal allograft demonstrated favourable structural healing rates and improved range of motion compared to maximal repair in the short term. Moreover, those in the maximal repair group were more likely to develop RCA compared to reconstruction.
Epidemiology of Foot and Ankle Injuries in NCAA Jumping Athletes in the United States from 2009-2014
Authors: Lytle Joseph Benjamin , Parikh Kisan B. , Tarakemeh Armin , Vopat Bryan George , Mulcahey Mary K. 
Published: July 2019

Objectives: The purpose of this study was to describe the epidemiology of foot and ankle injuries in men’s and women’s NCAA basketball, women’s volleyball, and women’s gymnastics during the 2009-2010 through 2013-2014 seasons. Methods: Injury surveillance data was obtained from the NCAA Injury Surveillance Program (ISP) for the 2009-2010 through 2013-2014 seasons. Injuries were examined by mechanism, activity during injury, participation restriction time, and recurrence. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs), and risk ratios (RR) with 95% confidence intervals were calculated. Reported sex differences were calculated for men’s and women’s basketball. All 95% confidence intervals not containing 1.0 were considered statistically significant. Results: During the study period, 1136 players sustained foot and ankle injuries (483 male, 653 female) over 612,680 AEs. In total, these injuries resulted in a combined rate of 1.85/1000 athlete-exposures (AEs; 95% CI 1.75 -1.97). Ankle sprains were the most common injury overall (63.7%), with lateral ligamentous complex (LLC) injuries comprising 77.1% of all ankle sprains. The most common foot injury varied based on sport and sex. Ankle injury rates were higher in male vs female basketball players (IRR=1.33, 95% CI 1.13 -1.57), but foot injury rates did not differ. Foot injuries occurred at half the rate of ankle injuries, but were significantly more likely to be severe (time loss over 30+ days) (IRR=3.37, 95% CI 1.91-5.949). Among basketball and volleyball athletes, player contact was the most common mechanism of injury and occurred most often while engaging in team jumping activities (rebounding, shooting, blocking, spiking). Surface contact was the most common mechanism in gymnasts. Female gymnasts had higher chronic injury rates than all other sports examined (0.485/1000 AEs, 0.304-0.735, p<0.002). Overall, female basketball players were 1.98 times more likely to suffer an overuse injury than male athletes (95% CI 1.14-3.45, p=0.005). Conclusion: Athletes participating in jumping sports have a higher rate of lateral ligamentous complex ankle sprains than other NCAA sports. Deterring player contact during jumping and landing by way of coaching and/or rule changes may reduce injury rates and improve player safety. The increased prevalence of chronic injuries in female collegiate athletes competing in jumping sports necessitates further investigation in order to identify opportunities to reduce injury rates through prevention and training programs. [Table: see text]
Influence of Acetabular Labral Tear Length on Postoperative Clinical Outcomes and Patient Satisfaction following Hip Arthroscopy for Femoroacetabular Impingement Syndrome with Capsular Plication
Authors: Chahla Jorge , Beck Edward , Cancienne Jourdan M. , Nwachukwu Benedict Uchenna , Okoroha Kelechi , Neal William H. , Nho Shane Jay 
Published: July 2019

Objectives: To determine the effect of labral tear length on post-operative outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Methods: Patients undergoing primary hip arthroscopy for FAIS from January 2012 to January 2016 were identified in a prospectively collected database. All patients completed the hip outcome score (HOS)-activities of daily living (ADL), HOS-sports subscale (HOS-SS), modified Harris hip score (mHHS), international hip outcome tool-12 (IHOT-12), and visual analog scales (VAS) for pain and satisfaction. Patients were stratified by labral tear length into small (<2.5 cm) or large (>2.5 cm) labral tear based on the ROC curve analysis. Patient demographics and outcomes were analyzed using parametric and multivariate linear regression analyses to identify predictors of labral tear length. Binary logistic regression analysis was performed to determine whether labral tear length predicted the likelihood of achieving the Minimal Clinically Important Difference (MCID). Results: A total of 747 eligible patients were included in the analysis. Mean age and BMI were 33.5±12.3 years and 25.4±8.6 kg/m2 22, respectively. Mean length of labral tears was 2.7±0.7 cm with 99% occurring in the anterosuperior position. Men had a higher proportion of large tears (>2.5 cm) when compared to women (75% vs 44%; p<0.001). All PROs showed improvement at a minimum of 2-years postoperatively (p<0.05 for all). Independent T-test demonstrated significant differences in two-year outcomes between patients with tears less than and greater than 2.5 cm: HOS-ADL (87.3±16.3 vs. 84.3±18.3, p=0.033), HOS-SS (76.6±23.5 vs. 70.5±27.7, p=0.005), mHHS (82.5±18.0 vs. 78.5±18.2, p=0.009), and satisfaction (83.5±23.4 vs. 77.8±34.9, p=0.026). Multivariate regression analysis demonstrated that labral tear length is an independent predictor of VAS satisfaction, HOS-ADL, -SS, and mHHS. Binary logistic regression analysis demonstrated that patients with small labral tears (<2.5 cm) had a higher likelihood of achieving MCID HOS-SS (OR: 1.61; p-value<0.02) and PASS mHHS (OR:1.56; p-value 0.038) than those with larger tears (more than 2.5 cm). Conclusion: Labral tear length is associated with numerous preoperative factors. These factors were found to be predictive of injury pathology and outcomes following hip arthroscopy for FAIS. Furthermore, patients with smaller tears (< 2.5 cm) had better outcomes and a higher likelihood of achieving a minimal clinically important difference at 2 years follow-up. [Table: see text]
Injury Risk Associated with Sports Specialization in Youth
Authors: Kocher Mininder S. , Field Alison E. , Tepolt Frances 
Published: July 2019

Objectives: Sports specialization has become increasingly common among youth. Our goal was to examine the independent prospective associations of sports specialization and volume of activity with injury risk in youth. Methods: A prospective analysis in 2018 using data collected from 10,138 youth in the Growing Up Today Study, a prospective cohort study of youth throughout the United States, and their mothers. Activity was assessed via questionnaires in 1997, 1998, 1999 and 2001. Sports specialization was defined as engaging in one sport in the fall, winter, and spring. Injury history was provided by participants’ mothers via questionnaire in 2004. The outcome was incident stress fracture, tendinitis, chondromalacia patella or anterior cruciate ligament tear. Results: Females who engaged in sports specialization were at increased risk of injury (females: hazard ratio (HR)=1.31, 95% confidence interval (CI) 1.07 -1.61), but risk varied by sport. In both genders sports specialization was associated with greater volume of physical activity (p<0.0001). Total hours/week of vigorous activity was predictive of developing injury (males: HR=1.04, 95% CI 1.02 -1.06; females: HR=1.06, 95% CI 1.05 -1.08). Among the females even those engaging in 3-3.9 hours per week less than their age were at a significantly increased risk of injury (HR=1.93, 95% CI 1.34-2.77). In males there was not a clear pattern of risk. Conclusion: Sports specialization is associated with higher volume of vigorous sports activity and increased risk of injury. Parents, coaches, and medical providers need to be made aware of the volume threshold above which physical activity is excessive.
Increasing Incidence of Pectoralis Major Ruptures in NFL Players
Authors: Wise Patrick , Gallo Robert A. 
Published: July 2019

Objectives: Pectoralis major ruptures are considered an uncommon injury in football. A previous study showing that only 10 compete ruptures occurred in the NFL between the years 2000-2010. The purpose of the study is to report the incidence of pectoralis ruptures in National Football League (NFL) players from 2010-2017 and identify any characteristics that could have contributed. We hypothesized that incidence of pectoralis major ruptures would increase over the past eight years. Methods: Using publicly available reports from websites such as ESPN.com and NFL.com, pectoralis major injuries in professional football players were identified during the years 2010-2017. Details about age, position played, injury setting, performance enhancing drug (PED) suspensions, and combine performance were obtained from NFL Combine and compared to peers at the same workout. Results: During the eight years analyzed 51 separate NFL players suffered a total of 55 pectoralis major ruptures. Defensive players accounted for 82% (42 of 51) of the injured players. The ruptures happened at the average age of 26±1 years, and 76.4% (42 of 55) of them occurred during games. After the rupture, 87.3% (48 of 55) required surgery, while definitive treatment could not be determined for the remaining seven injuries. For athletes that received playing time before injury and had their rupture occur prior to the most recent 2017 season, 85.4% (41 of 48) returned to play in a game. When comparing athletes at the combine who later ruptured their pectoralis major to peers at their position, those who tore their pectoralis major tendon on-average ranked in the 63 rd percentile for bench press (N=40), 50th percentile for arm length (N=14), and 52nd percentile for 20-yard shuttle (N=20). When the NFL suspension records were examined, only 5.9% (3 of 51) of players with a pectoralis major rupture had been suspended for (performance-enhancing drug) PED use before or after the injury. Conclusion: The total number of pectoralis major ruptures has drastically risen from 10 cases between 2000-2010 to 55 cases from 2010-2017. The reason behind this increase remain uncertain but appears to be independent of relative strength, agility, and arm length, and suspension for PED use.
Early Sports Specialization is Associated with Increased Upper Extremity Injuries and Fewer Games Played in Major League Baseball Players
Authors: Confino Jamie Erica , Irvine James N. , Ahmad Christopher S. , Lynch Thomas Sean 
Published: July 2019

Objectives: Early sport-specialization has been shown to place athletes at risk for increased injuries and decreased sporting performance in various sporting populations. However, the effect of sport-specialization has not been studied in professional baseball. The purpose of this investigation is to determine if single-sport athletes that specialize in baseball at a young age have a greater predisposition to overuse injury, burnout, and decreased performance compared to multiple-sport athletes. We hypothesized that MLB players who played multiple sports in high school would experience fewer injuries necessitating time on the Disabled List (DL), play more games, and have a longer career compared to athletes that played only baseball in high school. Methods: First and second-round MLB draft picks from 2008 to 2016 that played in at least one professional (minor or major league) game were included in this study. Athletes who participated in one or more sports in high school in addition to baseball were considered multi-sport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and MiLB, number of days on the Disabled List (DL) for each injury, number of games played in MLB and MiLB, and whether the athlete was still active were collected from publically available records. Results: Seven hundred forty-seven athletes were included in this study, of which 240 (32%) were multi-sport and 506 (68%) were single-sport athletes. Multi-sport athletes played in significantly more total professional baseball games on average (362.8 vs. 300.8, p < 0.01) as well as more major league games (95.9 vs. 71.6, p = 0.04) than single-sport athletes. Meanwhile, single-sport athletes had a significantly higher number of upper extremity injuries than multi-sport athletes (136 vs. 55, p < 0.01, Table I). Single-sport pitchers also had a higher number of shoulder and elbow injuries than multi-sport pitchers and, once injured, were more likely to have recurrent elbow injuries (86 vs. 27, p < 0.01; 33% vs. 17% recurrence). Conclusion: Professional baseball players who participated in multiple sports during high school played in more MLB games and sustained fewer upper extremity injuries than players who specialized in baseball before high school. Professional pitchers who specialized by the time they were in high school had a significantly higher chance of sustaining recurrent elbow injuries compared to those who were multi-sport athletes in high school. MLB players with a history of multi-sport participation were more likely to avoid overuse injuries and had greater longevity and level of performance compared to those that limited their sport participation to baseball during high school. [Table: see text]
Hypovitaminosis D Is A Risk Factor for Posterior Chain Muscular Injury in NCAA Division I Track And Field Athletes
Authors: Lindsay Adam , Jalali Omid , Korber Shane , Romano Russ , Tibone James E. , Weber Alexander E. , Gamradt Seth C. 
Published: July 2019

Objectives: Currently little information is available in evaluating micronutrient requirements in elite athletes. Despite evidence that groups of NCAA athletes may be deficient in Vitamin D, no study to date has examined Vitamin D levels with respect to their predicative values for injuries to the ‘posterior chain’ musculature. The objective of this study was to evaluate the association between hypovitaminosis D and posterior chain injuries in NCAA Division I track and field athletes. Methods: After IRB approval, we evaluated data for men’s and women’s outdoor track and field teams from 2015-2018 at a large NCAA Division I athletics program. Vitamin D levels were drawn during pre-season annual physicals. The cutoff for hypovitaminosis D was set at 40 nmol/L. Demographic and athletic tenure data were recorded and analyzed, and competitive events were grouped into one of four categories: 1) running events, 2) jumping events, 3) throwing events, and 4) multiple event types. Student T tests, chi-squared tests, and multivariate logistic regression were performed. Results: The analysis consisted of 145 (58% female, 42% male) NCAA Division I track athletes. Eighty-five of the 145 athletes had hypovitaminosis D. A full breakdown of athlete characteristics by vitamin D status can be seen in Figure 1 and Table 1. Of the 145 athletes analyzed, 33 (22.7%) suffered a muscular injury to their posterior chain musculature. Multinomial logistic regression identified hypovitaminosis D as an independent risk factor for posterior chain injury (relative risk ratio: 3.23, p=0.016). Age, BMI, and event type were not predictive of a posterior chain injury. Of note, 4 (4.7%) athletes in the hypovitaminosis D group suffered multiple posterior chain injuries, with 2 (2.4%) athletes suffering 2 separate injuries and 2 (2.4%) athletes suffering 3 separate injuries. None of the athletes in the normal Vitamin D group suffered multiple posterior chain injuries. Conclusion: These results demonstrate that pre-season hypovitaminosis D is an independent risk factor for posterior chain muscular injury in NCAA division I track athletes. These data suggest that early detection of hypovitaminosis D may play a critical role in injury prevention for these athletes. [Table: see text]
Is Brace Immobilization Needed Following Surgical Repair Of Proximal Hamstring Tears?
Authors: Lazaro Lionel E. , Banffy Michael B. 
Published: July 2019

Objectives: Braces are commonly used in Orthopaedic to protect repaired tissue from excessive stress that can compromise the healing process. Some of these braces can become a nuisance, especially the ones commonly used following proximal hamstring repairs. The idea is to limit hip flexion and knee extension to avoid stretching of the hamstrings. However, this immobilization creates discomfort and limitation during the basic daily needs, possibly compromising patient satisfaction. We hypothesis that proximal hamstring repairs can be safely managed, without brace immobilization and allowing partial weight bearing immediately after surgery, and result in excellent outcomes with minimal complications. Methods: We identify 57 patients that underwent surgical repair of proximal hamstring injuries. The repairs were fixed using suture anchors, and the same surgical technique were performed by a single sport medicine fellowship trained Orthopaedic surgeon. During the postoperative period the patient were allowed to bear partial weight with the assistance of crutches for 6 weeks. At the fourth week, light stretches begin with assistance of the physical therapist. Brace immobilization is not utilize at all, instead detail instruction are provide to the patient to avoid simultaneous hip flexion and knee extension. Subjective outcome measures included: the single assessment numeric evaluation (SANE); I-Holt 12 and KJOC hip scores. Clinical data was obtained from the electronic medical records. Results: Mean patient age was 52 years (range 29-69). The injury was chronic (> 6 weeks) in 55% of the patients. Mean length of follow-up was 32 months ( range 14-60). One patient failed repair, requiring revision surgery. The average SANE score were excellent at 97points, and representing a 43 points increase from the preoperative assessment. Similarly, the mean score for the I-Holt 12 and KJOC hip scores were very good with 99 and 83 points, respectively. In 68% of the patient the injury was sport related, and they all return to sport at an average of 7 months. Conclusion: A post-operative protocol that included immediate partial weight bearing and does not utilized immobilization brace can result in excellent subjective outcomes, high rate to return to sport in a timely matter and low failure rates. Based in our findings, brace immobilization following surgical repair of proximal hamstring appear to be excessive and may not provide additional benefit.
Platelet-rich plasma (PRP) Shortens Return to Play in National Football League (NFL) Players with Acute Hamstring Injuries
Authors: Arner Justin W. , Lawyer Tracye J. , Mauro Craig Stephen , Bradley James P. 
Published: July 2019

Objectives: Hamstring injuries are common in professional athletes and subsequent delays in healing are common, costly, and even career ending. The efficacy of platelet-rich plasma (PRP) for augmentation of non-operative treatment of partial musculotendinous hamstring injuries has not yet been established. Methods: NFL players from a single team who sustained acute grade 2 hamstring injuries as diagnosed on MRI by a musculoskeletal radiologist from 2009 to 2017 were retrospectively reviewed. Average days, practices, and games missed were recorded. Players that did and did not receive PRP injections were compared. Those who received PRP did so within 24 to 48 hours after injury. Results: Ninety-four NFL players had MRI evidence of a hamstring injury, while 61 athletes sustained grade 2 injuries. Thirty-one were treated with PRP injections and 30 were not. Average time missed in those treated with PRP injections was 22.4 days, 18.5 practices, and 1.7 games. In those who did not receive PRP injections, time missed was 25.8 days (p = 0.81), 22.2 practices (p = 0.68), and 2.7 games (p < 0.05). Conclusion: PRP injection treatment for acute grade 2 hamstring injuries in NFL players allows for faster return to play with a 1 game overall difference. Due to the possible large financial impact of return to play 1 game sooner, PRP injections for treatment of grade 2 hamstring injuries may be advantageous in professional athletes. Additional evaluation of PRP treatment of acute hamstring injuries in a larger cohort is necessary.