bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 352: Adverse Events and Complications following Primary ACL Reconstruction with Quadriceps Tendon Autograft: A Systematic Review
Authors: Mameri Enzo , McCormick Johnathon , Khan Zeeshan , Verma Nikhil , Chahla Jorge , Jackson Garrett 
Published: August 2023

Objectives: To systematically review the incidence of postoperative complications and adverse events following primary ACLR with quadriceps tendon autograft, while secondarily comparing the reported rates in an all-soft tissue quadriceps tendon (QT) graft relative to quadriceps tendon grafts with a patellar bone plug (QTPB). Methods: Two independent authors conducted a literature search using PubMed, Embase, and Scopus databases using the Preferred Reporting Items for Systematic Meta-Analyses (PRISMA) guidelines. The search strategy included the following keywords combined with Boolean operators: ‘Anterior Cruciate Ligament’, ‘ACL’ ‘Reconstruction’, and ‘Quadriceps Tendon’. Inclusion criteria consisted of level I to IV human clinical studies in English or English-language translation reporting complications and adverse events after primary ACLR using quadriceps tendon autograft. The overall incidence of complications throughout the included studies, as well as the incidence of specific complications were extracted. A 2- proportion z-test was performed to evaluate for potential differences in the incidence of postoperative complications between ACLR with quadriceps tendon with and without a patellar bone plug. Results: A total of twenty studies, consisting of 2,381 patients (2,389 knees) with a mean age of 27 (mean range, 12 - 58) years, consisting of 68.3% males (n=1626/2381), were identified. The mean follow-up was 28.5 (mean range, 6 – 47) months. The total incidence of complications was 10.3% (n = 246/2389 patients), with persistent post-operative knee pain being the most common, as seen in 10.8% (n = 91/843) of knees. Patients who underwent ACL reconstruction with QT graft had increased incidence of persistent knee pain (23.3%) and reoperations (5.9%) when compared to QTPB grafts (8.6% and 3.2%, respectively) (p < .01). Nontraumatic graft ruptures were greater with the QTPB (2.1%) relative to QT (0.5%) (p = 0.01). There was no appreciable difference in total complications, total graft failures, traumatic rupture, ACLR revisions, cyclops lesions, or arthrofibrosis (all, p > 0.05). Patellar fractures occurred exclusively with the QTPB (2.2%). Conclusions: Complications following primary ACLR using quadriceps tendon autograft were recorded in 10.5% of knees, the most common of which is persistent knee pain. No difference was reported in the overall incidence of complications with the use of the QT versus QTPB grafts, however persistent knee pain was 2.7x greater with QT. [Table: see text][Table: see text]
Poster 356: Injury patterns of Achilles tendon ruptures: a systematic video analysis of 80 cases in professional male football
Authors: Gronwald Thomas , Klein Christian , Hollander Karsten , Ueblacker Peter , Rolvien Tim , Hoenig Tim 
Published: August 2023

Objectives: Achilles tendon ruptures are injuries with a high severity. Analyses of underlying biomechanical and situational patterns may promote a better understanding of Achilles tendon ruptures and aid in their management and prevention. However, a systematic biomechanical and situational video analysis of real-life Achilles tendon ruptures has not been performed to date. Methods: Professional male football players with an acute Achilles tendon rupture were identified by using an online database (Transfermarkt.com, Hamburg, Germany). For every in-competition injury, the coinciding football match leading to injury was detected. Video files of the injuries were accessed using Wyscout.com (Wyscout.com, Genova, Italy). Situational patterns and injury biomechanics of the injury frame were independently analyzed by two reviewers using a standardized checklist and a motion analysis software (Kinovea v.0.8.15, www.kinovea.org). Finally, consensus was reached to describe the main injury patterns of Achilles tendon ruptures in professional male football. Results: Overall, 80 injuries were included for video analysis. Most injuries (94%) were indirect or non- contact injuries. The kinematic analysis revealed a knee extension movement and an ankle dorsiflexion movement in most cases. Typical joint positions at the assumed injury frame were hip extension, knee extension and ankle dorsiflexion. Player actions identified as main injury patterns were stepping back, landing, running/sprinting, starting, and jumping. All main patterns were closed-chain movements (that is, fixation of the affected leg to the ground). Conclusions: Most Achilles tendon ruptures share characteristic injury features, that is, Achilles tendon elongation, closed-chain movements, and sudden loading. The findings of this study allow insight into injury mechanisms of Achilles tendon ruptures in professional male football and may support translation towards future development of prevention programs.
Poster 366: EVALUATION OF A DEPRESSION SCREENING PROGRAM IN PEDIATRIC ORTHOPAEDIC SPORTS CLINICS: WHICH PATIENTS ARE IDENTIFIED AS AT RISK?
Authors: Bastrom Tracey , Edmonds Eric , Morillo Reinaldo Colon 
Published: August 2023

Objectives: Universal depression screening of patients ≥12 years of age was instituted at our facility in 2018 in an effort to combat the suicide rate among teenagers. The purpose of this study was to quantify the significance of depression in adolescents being treated within a sports clinic at a pediatric institution and attempt to identify predictors of at risk patients. Methods: A retrospective review was performed to identify all patients, ages 12-21 years, who were administered the Patient Health Questionnaire (PHQ-2/PHQ-9) over a 2-year period within our pediatric orthopaedic sports clinics. Patients were grouped into four broad diagnostic categories; knee instability, knee other, other sports related, or shoulder injury. The rate of a positive screen prompting administration of PHQ9 (PHQ2>3), rate of depression risk (PHQ9≥10), and rate of patients indicating self-harm were evaluated. Multivariate binary logistic regression to identify available demographic and diagnosis predictors of risk of self-harm was performed. Results: There were 3,298 patients screened in orthopedic sports clinics from 2018-2021. The overall rate of positive screens was 4.2% (n=138), rate of depression risk was 1.9% (n=63), and self-harm was 0.9% (n=29). The distribution of these rates for each diagnostic category are seen in Table 1. Self-harm showed a significant difference in the proportion at risk across the four diagnostic categories (p=0.038), with shoulder and knee instability having the highest rate. Black or African American race (OR 3.8, 95% CI 1.3-11, p=0.02), female gender (OR 3 95%CI 1.3-6.9, p=0.01), public/government insurance (OR 3.8, 95% CI 1.3-11, p=0.02), shoulder diagnosis (OR 3.5 95%CI 1.3-9.4, p=0.016), and knee instability diagnosis (OR 2.8 95%CI 1.2-6.5, p=0.02) were associated with increased risk of self-harm. Conclusions: This study demonstrated a 2% rate of depression risk and 1% rate of self-harm risk in this adolescent population being treated within sports clinics. Variability in rate of risk was identified, with the shoulder and knee instability patients having higher risk profiles. Aside from diagnosis groups, gender, race, and insurance were factors that were also independently predictive of patients at risk for depression or self-harm. Knowledge of risk factors can help increase awareness and recognition of potential mental health conditions that may need addressing during the course of treatment for the sports-related injury. [Table: see text]
Poster 393: The Impact of the COVID-19 Lockdown on the Rate of Injuries in the National Basketball Association
Authors: Nguyen Nguyen , Dorsey Harold , Pais Kalaila , Boone Andrew , Wilson Robert , Khanuja Harpal , Singh Sanjum 
Published: August 2023

Objectives: This study aims to assess the impact of the COVID-19 lockdown on injury rates experienced by athletes of the National Basketball Association (NBA). We hypothesized that there would be a change in the incidence rates of sports-related injuries on return to play post-lockdown. Methods: We conducted a retrospective analysis utilizing data retrieved from Pro Sports Transactions Archive. This database records all transactions occurring in the NBA, including injuries, trades, signings, and waivings. Information about all injuries to players in the NBA over the last 10 years were collected. All injury descriptions in the dataset were stratified by key anatomical locations and the dataset was shortened to the eight most common. These specific locations were selected due to higher injury rates overall comparatively to the rest of the body. We then compared basketball players who played after the COVID-19 NBA suspension to a propensity score generated control group before the suspension. They were matched for age, body mass index (BMI), regions of the country and positions played. The study outcome variable was the injuries stratified into 4 different groups. Demographics for every player injured (height, weight, years played, and birth dates) were collected from Basketball Reference, in line with publicly available information from the NBA. Results: We compared 789 players during the post-suspension to 3,945 match controlled pre- suspension players. The mean age of players was 27.1± 5 years, mean BMI was 25.0± 1.2. The eight most common injuries were knee, ankle, back, hamstring, shoulder, calf, groin, and elbow injuries. Prior to propensity score matching, the rates of the three most common were: knee (pre-suspension: 33.79%; postsuspension: 36.88%), ankle (pre: 27.28%; post: 26.62%), back (pre: 18.52%, post: 14.45%) (p-value: 0.022). Following propensity score matching, the results are as follows: knee (pre-suspension: 29.89%; post-suspension: 36.88%), ankle (pre: 27.10%; post: 26.62%), back (pre: 19.06%, post: 14.45%) (p-value: <0.001). Conclusions: Our study concluded that among the three most common injuries, the knee was noted to have a statistically significant increase post the COVID-19 NBA suspension. Moreover, there was a significant decrease in the percentage of players who suffered back and ankle injuries [Table: see text][Table: see text]
Poster 395: Racial Disparities in Utilization and Perioperative Metrics in Rotator Cuff Repair in a US Inpatient Database
Authors: Berlinberg Elyse , Schlacter Jamie , Forlenza Enrico , Mirle Vikranth , Gamsarian Vahram , Cole Brian , Verma Nikhil , Chahla Jorge ,   Forsythe Group
Published: August 2023

Objectives: Previous studies have shown racial disparities in the utilization and perioperative metrics of orthopedic procedures. However, it remains unclear if similar disparities exist in rotator cuff repair (RCR). The purpose of this study was to examine trends in racial disparities between white and black patients with inpatient RCR in the United States (US). Methods: Admissions for inpatient RCR in 2008-2012 were queried from the Healthcare Cost and Utilization Project National Inpatient Sample. The primary outcome was utilization rate, defined by the number of RCRs normalized to the US population per race and year. The effect of race on utilization and perioperative metrics was assessed using a regression model correcting for race and year, with a race- year interaction term to approximate temporal trends in disparities (alpha=0.05, 1-beta>0.90). Results: Overall, 20,363 patients were included in the final analysis, 18,602 identifying as white (91%) and 1,761 (8.6%) as black. On average, white patients undergoing RCR were older (white median=67 [IQR=58-75] years; black median=60 [IQR=52-68] years, P<0.0001) and more likely on Medicare (white: 59%; black: 44%, P<0.0001). Black race was associated with a 6.6/1,000,000 lower utilization rate compared to white race (P<0.0001). Although the utilization gap narrowed over time, this trend was not significant (Ptrend=0.06). Black patients were 4% less likely to be discharged to a facility (P< 0.0001, Ptrend=0.07) and had a 0.23-day longer average length of stay (P=0.047, Ptrend=0.81). When correcting for baseline age and comorbidities, postoperative complications were not significantly different between white and black patients (beta=-2.4%, 95%CI=-13.0%-+8.3%, P=0.60). Conclusions: There is a discrepancy in inpatient RCR utilization between white and black patients. Although this disparity appears to be decreasing over time, this trend was not significant. Further studies are warranted to understand causal factors for these differences, that may serve as targets for future public health interventions. [Table: see text]
Pediatric Knee Arthroscopy: The Basics of Pediatric Knee Arthroscopy from a Collection of Pediatric Sports Medicine Experts
Authors: Kirby Julia , Johnson Benjamin , Millewski Matt , Shea Kevin , Beck Jennifer , Wilson Philip L. , Schmitz Matthew , Milbrandt Todd , Edmonds Eric , Pace Lee , Vandenberg Curt , Tompkins Marc , Gamble James , Yen Yi-Meng , Ganley Ted , Ellis Henry B. 
Published: August 2023

Background/Objective: To share technical pearls of a basic knee arthroscopy in a pediatric patient by presenting tips and tricks used by experienced pediatric arthroscopists. Indications: Knee arthroscopy is a common procedure performed by most orthopedic surgeons. However, technical considerations and equipment should be considered before performing this procedure in a pediatric patient. This video provides information on indications, equipment, and patient positioning, as well as outlining a systematic approach to diagnostic arthroscopy and pertinent pediatric anatomy. Discussion/Conclusion: This video provides an excellent overview as well as specific pathology-dependent considerations for the inexperienced orthopedic surgeon, or the orthopedic surgeon who rarely performs knee arthroscopy. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Lyme borreliosis diagnosis: state of the art of improvements and innovations
Authors: Guérin Mickaël , Shawky Marc , Zedan Ahed , Octave Stéphane , Avalle Bérangère , Maffucci Irene , Padiolleau-Lefèvre Séverine 
Published: August 2023

AbstractWith almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in the world. Transmitted by ticks of the genusIxodesand caused by bacteriaBorrelia burgdorferisensu lato, LB occurs with various symptoms, such as erythema migrans, which is characteristic, whereas others involve blurred clinical features such as fatigue, headaches, arthralgia, and myalgia. The diagnosis of Lyme borreliosis, based on a standard two-tiered serology, is the subject of many debates and controversies, since it relies on an indirect approach which suffers from a low sensitivity depending on the stage of the disease. Above all, early detection of the disease raises some issues. Inappropriate diagnosis of Lyme borreliosis leads to therapeutic wandering, inducing potential chronic infection with a strong antibody response that fails to clear the infection. Early and proper detection of Lyme disease is essential to propose an adequate treatment to patients and avoid the persistence of the pathogen. This review presents the available tests, with an emphasis on the improvements of the current diagnosis, the innovative methods and ideas which, ultimately, will allow more precise detection of LB.
Evaluation of altered starch mutants and identification of candidate genes responsible for starch variation in wheat
Authors: Irshad Ahsan , Guo Huijun , Xiong Hongchun , Xie Yongdun , Jin Hua , Gu Jiayu , Wang Chaojie , Yu Liqun , Wen Xianghui , Zhao Shirong , Liu Luxiang 
Published: August 2023

Abstract
Background
Induction of mutation through chemical mutagenesis is a novel approach for preparing diverse germplasm. Introduction of functional alleles in the starch biosynthetic genes help in the improvement of the quality and yield of cereals.

Results
In the present study, a set of 350 stable mutant lines were used to evaluate dynamic variation of the total starch contents. A megazyme kits were used for measuring the total starch content, resistant starch, amylose, and amylopectin content. Analysis of variance showed significant variation (p < 0.05) in starch content within the population. Furthermore, two high starch mutants (JE0173 and JE0218) and two low starch mutants (JE0089 and JE0418) were selected for studying different traits. A multiple comparison test showed that significant variation in all physiological and morphological traits, with respect to the parent variety (J411) in 2019–2020 and 2020–2021. The quantitative expression of starch metabolic genes revealed that eleven genes of JE0173 and twelve genes of JE0218 had consistent expression in high starch mutant lines. Similarly, in low starch mutant lines, eleven genes of JE0089 and thirteen genes of JE0418 had consistent expression in all stages of seed development. An additional two candidate genes showed over-expression (PHO1, PUL) in the high starch mutant lines, indicating that other starch metabolic genes may also contribute to the starch biosynthesis. The overexpression of SSII, SSIII and SBEI in JE0173 may be due to presence of missense mutations in these genes and SSI also showed overexpression which may be due to 3-primer_UTR variant. These mutations can affect the other starch related genes and help to increase the starch content in this mutant line (JE0173).

Conclusions
This study screened a large scale of mutant population and identified mutants, could provide useful genetic resources for the study of starch biosynthesis and genetic improvement of wheat in the future. Further study will help to understand new genes which are responsible for the fluctuation of total starch.
‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL
Authors: Mingote Álvaro , Zamora Moreno Eloísa , García Díaz Andrés , Chiara Graciani Guillermo , Elbal Sánchez Carlos , Guadalix Sánchez Cristina , Gutiérrez Martínez Diego , García - Fernández Javier , Fornet Ruiz Inocencia 
Published: August 2023

Abstract
Introduction
Epidural infusion with low local anesthetic concentrations with opiates decrease the severity of the motor blockade associated. The present study aims to compare the analgesic efficacy and the motor blockade between two local anesthetic epidural infusions: levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL.

Materials and methods
In a single-blind prospective randomized study, 60 laboring parturient had continuous epidural analgesia as follows: 30 of them received levobupivacaine 0.0625% + fentanyl 2mcg/mL and 30 of them received ropivacaine 0.075% + fentanyl 2mcg/mL and rates of infusion were adjusted to the height. Analgesic, motor blockade and satisfaction records were collected as well as maternal and neonate adverse events.

Results
After 2 h of the catheter placement, patients who received levobupivacaine showed a mean VAS of 3.2 [1.8–4.6] versus 1.8 [1.2–2.5] (p = 0.05) in patients who received ropivacaine. In addition, patients who received levobupivacaine showed a punctuation in Bromage scale of 0.0 [0.0–1.0] versus 0.0 [0.0–0.0] (p = 0.04) in patients who received ropivacaine. Finally, the parturient who received levobupivacaine scored a mean satisfaction index of 8.1 [7.3–8.9] versus 9.3 [8.7–9.8] (p = 0.02) in those who received ropivacaine. We did not register maternal nor neonate adverse events.

Conclusion
Both infusions (levobupivacaine 0.0625% + fentanyl 2mcg/mL and ropivacaine 0.075% + fentanyl 2mcg/mL) are effective for labor analgesia. However, ropivacaine would present a better pharmacodynamic profile with less motor blockade and decreased need for analgesic rescue hence improving patient’s satisfaction.
Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction
Authors: Zou Tianxiao , Yu Shenghua , Ding Guili , Wei Rong 
Published: August 2023

Abstract
Objective
Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone.

Methods
This was a single-center, prospective, randomized, controlled study. A total of 60 children aged 6-24 months who underwent cranial suture reconstruction were randomly divided into two groups: Group A (general anesthesia combined with scalp nerve block) and Group N (general anesthesia). The hemodynamics were recorded preoperatively, at 5 min after incision and at 1, 6 and 12 h after surgery; the pain was scored at 1, 6 and 12 h after surgery, and blood glucose was detected at 1 h after surgery.

Results
The mean arterial pressure and heart rate at 5 min after incision and 1 h after surgery in Group N were higher than those in Group A; the blood glucose and FLACC score in Group N were higher than those in Group A; and the number of postoperative analgesic pump presses were also significantly increased in Group N.

Conclusion
Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.