bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Outcomes of Arthroscopic OS Trigonum Excision in Adolescents
Authors: Chun Liane , Bastrom Tracey P. , Carroll Alyssa N. , Edmonds Eric W. 
Published: May 2022

Background: Outcomes of symptomatic os trigonum excision have been well described as a successful treatment in adults; however, the literature lacks information on standardized longer term functional outcomes in the pediatric population. Hypothesis/Purpose: This study intends to report functional outcomes of arthroscopic os trigonum excision in adolescents who failed conservative management, with the hypothesis that these younger patients would have similar, successful outcomes of adult patients. Methods: A retrospective study was performed on adolescents who underwent arthroscopic os trigonum excision at a single institution between 2011 and 2017. Patient demographic, clinical history, radiographic, and operative data were documented. Outcome measures included the Foot and Ankle Ability Measure (FAAM) score comprised of the Activities of Daily Living (ADL) and Sports subscales, Single Assessment Numeric Evaluation (SANE) score, ability to return to the same level of sport, and any additional foot/ankle surgery. Results: Ten patients (12 ankles) met criteria with a mean age at surgery of 15.4 years (range, 12 to 18 years) and a mean follow-up of 6.5 years (range, 2.8 to 9.1 years). Mean FAAM ADL subscale, Sports subscale, and SANE scores were 91.0 ± 15.5, 76.3 ± 29.1, and 88.6 ± 15.1 respectively. A chronic duration of symptoms prior to surgery was associated with a lower FAAM Sports current level of function score (p=0.032). Four patients (40%) discontinued their sport due to continued ankle issues and reported significantly lower FAAM ADL subscale (p=0.01), Sports subscale (p<0.001), and SANE scores (p = 0.002). Conclusion: Os trigonum syndrome in the adolescent population may not have the same rate of success as that seen in adult athletes over the long term. However, if proven to be refractory to conservative measures and surgical intervention is indicated, patients and their families should be counseled about the risk for persistent ankle symptoms and the possibility that they may not be able to return to their previous level of sport.
Can the Disoid Meniscus Remodel After Saucerization?
Authors: Chan Charles M. , Squiers Monte V. A. , Gamble James G. 
Published: May 2022

Background/Purpose: The discoid meniscus is a congenital variant that is reported to be present in 3-5% of the United States population. Treatment involves partial meniscectomy and saucerization to obtain a more anatomic-appearing meniscus. The immediate post-operative cross-sectional morphology is often squared due to the inherent thickness of the discoid meniscus at the resection margin. The purpose of this study is to determine if the discoid meniscus can remodel and regain the triangular cross sectional configuration of a normal meniscus after surgical intervention. Methods: A retrospective chart review was performed to identify all patients undergoing partial meniscectomy for symptomatic discoid meniscus within the past 3 years at our institution. Patients were included if they had a subsequent knee magnetic resonance imaging (MRI) study. Each MRI study was evaluated by two orthopaedic surgeons independently. The extent of remodeling was graded on the cross-sectional morphology of the saucerized discoid meniscus on coronal and sagittal T1-weighted images of the corresponding knee mri based on the following scheme: 1) complete for a triangular cross-section, 2) partial for a trapezoidal cross-section , and 3) none for a square cross-section. Descriptive means and statistical analysis for intraclass correlation coefficient (ICC) were performed using Microsoft Excel. Results: A total of 11 patients and 14 knees were included in this study. Average age at time of surgery was 10.85. Average time to the follow-up MRI of the same knee was 540.50 +/- 341.84 days. 2 knees required additional surgical intervention following their index surgery. Complete remodeling was identified in 78.5% (11/14) knees. 1 knee had no remodeling and 2 knees had partial remodeling. Our ICC was 0.87 (95% CI: [0.66,0.96]). Conclusion: Our results indicate that the discoid meniscus has the potential to remodel into a “normal” triangular cross-sectional morphology after partial meniscectomy and saucerization. In our series, 21.4% (3/14) knees did not experience complete remodeling. This may have been due to over resection of the discoid meniscus at the index surgery owing to the extent of an existing tears. The remodeling all occurred within a two-year time frame though the exact time is unknown. This study indicates no additional intervention is required at the central resection margin to thin out the thick edge that often results from the meniscal biter.
Accelerated Vs Conservative Rehabilitation Following Meniscus Repair In Pediatric Pateints With Or Without Acl Reconstruction
Authors: Ali Sabah , Ciranna-Truong Alexandra , Kiebzak Gary M. , Stinson Zachary 
Published: May 2022

Background: There are variations in postoperative restrictions following pediatric meniscus repairs, whether they are performed in isolation or at the time of an anterior cruciate ligament reconstruction (ACLR). Hypothesis: We hypothesized that there would be no difference in failure rates when comparing accelerated versus conservative post-operative management following both isolated meniscus repairs and meniscus repairs performed at the time of an ACLR. Methods: A retrospective chart review was performed to investigate pediatric patients who underwent an isolated medial or lateral meniscus repair with or without a combined primary ACLR from January 2010 to January 2019 within a large children’s health system among eight different surgeons who all utilized different rehabilitation protocols. Patient outcomes of a need to return to the operating room secondary to failure of meniscus repair were analyzed with regard to accelerated versus conservative rehabilitation. Accelerated management included early unrestricted weightbearing within 3 weeks, unrestricted range of motion in a brace within 6 weeks, less than 6 weeks of brace use, initiation of outpatient physical therapy within 6 weeks, and returning to play sports earlier than 16 weeks for the isolated meniscus group or earlier than 30 weeks for the combined group. Results: 138 patients aged 14.1 + 2.9 years had an isolated meniscus repair with 24.6 + 16.8 weeks of follow-up and a 17% failure rate, and 190 patients aged 15.5 + 1.6 years had a meniscus repair at the time of an ACLR with follow-up of 42.9 + 27.4 weeks and a 13% failure rate. A binomial logistic regression showed no differences in failure rates for accelerated versus conservative weightbearing restrictions, brace immobilization, physical therapy timing, or return to play timing (Table 1). Conclusion: These findings demonstrate that pediatric meniscus repair failure rates remain similar despite wide variations in postoperative management, whether performed in isolation or at the time of an ACLR. Further investigation should be directed towards determining optimal post-operative management protocols that attempt to strike a balance between protecting the surgical repair and avoiding measures that may be overly burdensome to the patient or add unnecessary treatment costs. [Table: see text]
Higher Rates of Mensical Repair and Rim Preservation in Younger Patients with Discoid Lateral Menisci
Authors: Kemper W. Craig , Adsit Lizzie R. , Cooper Savannah , McKay Scott , Latz Kevin , Shea Kevin , Fabricant Peter , Beck Jennifer , Schmale Gregory , Tenfelde Allison , Gupta Andrew , Green Dan , Albright Jay , Cardelia Marc , Ellis Henry B. ,   the SCORE group
Published: May 2022

Background: Management of discoid meniscus in pediatric patients requires understanding of the presentation, associated risks, and appropriate techniques. Surgical treatment consists of saucerization, meniscus repair, meniscocapular stabilization, and, periodically, subtotal meniscectomy. The type of meniscal treatment is commonly determined during arthroscopy. Thus, surgeons, patients, and their parents/guardians must be prepared for a variety of surgical options. Hypothesis/Purpose: To compare intraoperative arthroscopic findings and treatment of discoid meniscus across pediatric age groups in a large multicenter quality improvement registry. Methods: A multi-center quality improvement registry (16 institutions, 26 surgeons) monitoring the safety of discoid meniscus surgery was reviewed. Audit processes using CPT codes were designed to ensure that all consecutive cases from 2018-2020 were prospectively entered on patients <19 years old into a HIPAA-compliant electronic platform. Patients were grouped into five groups based on age at time of surgery (<7, 7-10, 11-13, 14-16, >16). Demographic characteristics, discoid type, presence and type of tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Chi-Square or Fisher’s exact tests were used for categorical comparisons and a Kruskal-Wallis test for continuous comparisons. Results: 274 patients were identified (mean age 12.4 years, range 3-18; 47.3% females). Complete discoid meniscus and peripheral rim instability were found to be more prevalent in younger age groups (Table 1). Peripheral rim instability was noted in 55.5% of cases, most commonly in the posterior horn (24.8%). While a focal region of instability was most common, the youngest age group was more likely to have either multifocal instability or no instability. Repair was conducted more commonly in the younger cohorts, with a significant decrease in repair percentage (p=0.008) per age group. All-inside was the most common repair technique in all age groups. Partial meniscectomy/debridement beyond saucerization occurred more frequently in older age groups than younger age groups (p=.0002), including 38.4% of cases in the oldest age group (Table 2). Conclusion: Younger patients experienced a greater incidence of complete discoid menisci and meniscus repair in this age group and was more likely to have more than one area of rim instability. However, when meniscal resection beyond a saucerization was required, this was more likely to occur in older patients. [Table: see text][Table: see text]
Influence of Anxiety Sensitivity and Negative Affect on Concussion Outcomes
Authors: Caze Todd , Williams Kimberly , Boucher Sarah , Price August , Abt John , Burkhart Scott 
Published: May 2022

Background: Approximately two million children sustain a concussion annually, with negative mood being associated with elevated initial symptom reporting and longer recoveries. Despite this finding, minimum research has explored the predictive value of a person’s negative mood and propensity to misinterpret internal sensations (anxiety sensitivity) on concussion outcomes. Hypothesis/Purpose: The purpose of this study was to examine how the relationship between anxiety sensitivity, negative affect, and positive affect relate to various concussion outcomes. It was hypothesized that higher anxiety sensitivity, higher negative affect, and lower positive affect would be predictive of higher initial concussion symptom reporting, increased number of total visits, and longer time to medical clearance. Methods: Children aged 8-18 years who sustained a concussion were examined in an acute concussion clinic for diagnosis and treatment of injury. Patients were evaluated within 14 days of injury and remained under clinical care until cleared to return to activity/sport. Patients were administered the Anxiety Sensitivity Index-3 (ASI-3), The International Positive and Negative Affect-Short Form (I-PANAS-SF) and Post-Concussion Symptom Scale (PCSS). Independent t-tests were run for all independent variables. Linear regressions were run to determine potential predictive value of ASI-3 (cognitive, physical, social subscale and total score) and I-PANAS-SF (negative and positive affect) on concussion outcomes (initial visit concussion symptom scores calculated by PCSS, total number of clinical visits, and days till medically cleared). Results: A total of 43 children (age: 15.6±1.6 years) were enrolled. Independent t-tests for all independent variables resulted in females on average having higher ASI-3 subscale and total scores ( p<0.01). Sex was therefore entered as a control variable in the regression models. Higher negative affect was significantly predictive (β = 0.38, p=0.030) of higher initial visit concussion symptom reporting (R2 =0.46, F(5,36)=4.48, p=0.003). More days to clinic (β = 0.88, p≤0.001) and higher ASI-3 physical subscale scores (β = 0.25, p=0.008) were predictive of more days until medical clearance (R2 =0.88, F(5,35)=5.33, p=0.001). Conclusion: Results from this study show that both a person’s negative affect and anxiety sensitivity are not just related to concussion outcomes but also predictive. Negative affect and anxiety sensitivity are easy to measure and amenable to treatment. Targeted interventions on improving negative affect and normalizing symptoms to minimize misinterpretations (anxiety sensitivity), could improve concussion outcomes.
The Impact of sport particiaption on the Health of Adolescents During the CoVID-19 pandemic
Authors: McGuine Timothy , Biese Kevin , Schwarz Alison , Dickman James , Hetzel Scott , Reardon Claudia , Watson Andrew 
Published: May 2022

Background: Since April 2020, some high schools were closed to in-person teaching, and interscholastic and club sports were cancelled in an attempt to slow the spread of COVID-19. While some US adolescents participated in sports since April 2020, other US adolescents did not participate in sports during this time. It is unknown what effect sport participation has had on the health of adolescents. Hypothesis/Purpose: To identify how sport participation during the COVID-19 pandemic impacted the health of adolescents. Methods: Adolescents across the US were recruited via social media to complete an online survey in the spring of 2021. Participants were asked to report their demographics (age, gender, race), whether they participated in school club or school sports since May 2020, type of school they attended (in-person, online, hybrid), and measures of mental health (MH), physical activity (PA) and quality of life (QoL). Assessments included the: General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. Assessment scores were compared for respondents who participated in sports (PAR) with those that did not participate in sports (NoPAR). Univariable comparisons between the groups were made via t-tests or chi-square tests while means for continuous outcome measures were compared between the groups by ANOVA models that controlled for age, gender, race and the type of school attendance. Results: 4,693 adolescents (52% female, Age = 16.1+1.3 yrs., grades 9–12) from 38 states participated in the study with PAR = 4,286 (91%) and NoPAR = 407 (9%). NoPAR participants reported a higher prevalence of moderate to severe levels of anxiety (29.3% vs 21.3%, p<0.001) and depression (40.7% vs 19.8%, p<0.001). NoPAR participants reported lower (worse) PFABS scores (mean 13.2 [95%CI 12.4, 13.9] vs 21.2 [20.7, 21.6] p<0.001) and lower (worse) PedsQL total scores compared to the PAR group (77.9 [76.5, 79.3] vs. 83.2 [82.3, 84.1], p<0.001). Conclusions: Adolescents who did not play a sport during the COVID-19 pandemic reported significantly higher levels of anxiety and depression, as well as lower physical activity and quality of life scores compared to adolescents who did play a school or club sport. Participation in organized sports may offer an important opportunity to improve physical activity and mental health for adolescents during and after the COVID-19 pandemic.
Assessment of Coping Skills in Pediatric Sports Medicine Patients
Authors: Townsend Tracy K. , Coene Ryan P. , Williams Kathryn A. , Pluhar Emily , Ackerman Kathryn E. , Kramer Dennis E. , Stracciolini Andrea , Christino Melissa A. 
Published: May 2022

Background: Psychological variables play integral roles in an athlete’s response to injury recovery, and poor mental coping skills have been shown to have a negative impact. The Athletic Coping Skills Inventory-28 has been demonstrated to have predictive value in identifying pediatric patients who may be at risk for a prolonged recovery. Hypothesis/Purpose: The purpose of this study was to investigate variations in coping skills in pediatric sports medicine patients using the Athletic Coping Skills Inventory-28, and to examine correlations with the following variables: age, gender, individual vs. team sports, and time devoted to sport. Methods: This was a cross-sectional, single institution study, that assessed young sports medicine patients, ages 12-18. A one-time, voluntary, anonymous survey was utilized to assess demographics, primary sport, sport participation patterns, and the validated Athletic Coping Skills Inventory-28 (ACSI, range 0-84). Younger adolescents were considered to be ages 11-14 and older adolescents ages 15-18 for data analysis. Statistical analysis included Fischer’s exact tests, t-tests, Pearson correlations, linear regression analysis, and Wilcoxon rank sum tests. Results: Of 430 eligible patients, 334 (mean±sd age 15.0±1.8 years, 64.7% female, 35.3% male) completed questionnaires, for a 78% response rate. The mean ACSI score was 50.2±10.9. No significant differences were observed in overall ACSI scores between genders. ACSI scores were higher in younger adolescents compared to older adolescents (52.4±10.5 vs 48.9±10.9, p <0.010). Team sport athletes reported higher coping skill scores than individual sport athletes (51.2±10.9 vs 47.2±10.8, p<0.001). Multivariable linear regression revealed that younger team sport athletes demonstrated higher coping skill scores compared to older team sport athletes (55.9 vs 49.8, p<0.001). Younger team sport athletes also scored higher than the younger individual sport athletes (55.9 vs 47.6 p=0.002). In addition, playing >16 hours per week of sports adds 6.36 (95% CI: 3.14, 9.57) units to the total ACSI score compared to participants who play <11 hour per week. Conclusion: Athletic coping skills scores did not significantly differ among genders in adolescent athletes. ACSI scores were higher in younger adolescents and athletes playing team sports. Coping skill scores are also positively correlated with time devoted to playing sports.
No Difference in Patient Reported Outcome Measures for Patients with High Grit Scores
Authors: Mackie Alexandra T. , Pascual-Leone Nicolas , Fabricant Peter D. 
Published: May 2022

Background: The importance of grit on maintaining overall wellness is well described, but less is known about how grit impacts surgical outcomes, specifically among pediatric patients. The pediatric-validated 5-item Grit Scale measures trait-level perseverance and passion for long-term goals. Purpose/Hypothesis: The purpose of this study was to identify whether Grit scores were associated with baseline PROMIS Pain Interference and Pain Intensity scores. The investigators hypothesized that higher Grit would be associated with lower PROMIS Pain Interference and Pain Intensity scores. Methods: Pediatric and adolescent patients who underwent lower extremity sports or trauma surgery between 2018-2020 at a single orthopaedic hospital preoperatively completed the Grit scale along with PROMIS Pain Interference and Pain Intensity questionnaires. Patients were excluded if they underwent multiple surgeries (with the exception of implant removal). Patients were divided into five groups based on their Grit quintile (<20th, 20-40, 40-60, 60-80, >80th). Statistical analysis was run on IBM SPSS version 22. Results: A total of 103 patients were included in analysis with a median preoperative Grit Score of 4.0. Spearman correlation between Grit cohort and PROMIS Pain Interference and Pain Intensity scores demonstrated no associations between higher Grit scores and higher PROMIS baseline Pain Interference and Pain Intensity scores (p = 0.612, 0.981, respectively). Conclusion: This study did not find associations between baseline Grit and PROMIS Pain Interference and Pain Intensity questionnaires. Therefore, Grit may be an independent construct that is not measured in the existing outcome scales and should be further investigated. Although not associated with baseline pain, its associations with postoperative pain improvement should be further studied. [Figure: see text]
Did the Covid-19 Pandemic Affect Psychological Readiness to Return-To-Sport in Young Athletes Undergoing ACL Reconstruction?
Authors: Christino Melissa A. , Majumdar Aditi S. , Coene Ryan P. , Cook Danielle L. , Kocher Mininder S. , Kramer Dennis E. , Micheli Lyle J. , Yen Yi-Meng , Milewski Matthew D. 
Published: May 2022

Background: Return-to-sport (RTS) following anterior cruciate ligament reconstruction (ACLR) is influenced by multiple physical and psychological variables. Psychological readiness has been associated with improved patient reported outcomes as well as RTS rates in young athletes. The COVID-19 pandemic may have altered the typical recovery process for patients undergoing ACLR. Hypothesis/Purpose: To compare 6-month postoperative levels of psychological readiness to RTS in ACLR patients before and during the pandemic. Methods: Patients were prospectively enrolled 6 months after primary ACLR at a single academic sports medicine practice, from December 2018 until May 2021. Patients were categorized into pre-COVID (enrollment prior to March 13, 2020) and COVID groups (March 13, 2020 - May 26, 2021). Demographic information, outcomes scores including the ACL-Return to Sport after Injury Scale (RSI) and PROMIS Psychological Stress Experiences (PROMIS-PSE), and physician RTS clearance were obtained and compared for both groups. Comparisons were performed utilizing Chi-square, Student’s t-tests and linear regression. A matched analysis was conducted between groups controlling for age, sex, and graft type. Results: 231 patients were included in the present study (89 males, 142 females; mean age 16.9 years), with 76% (176/231) in the pre-COVID group and 24% (55/231) in the COVID group. There were no significant differences in age and sex between the two population cohorts. There was a significant difference in time from surgery to enrollment in the COVID group compared to the pre-COVID group (7.1 vs 6.2 months, p<0.001). In the matched cohort (n=126, 37/126 COVID group), the COVID group was cleared earlier by their physician to RTS compared to the pre-COVID group (6.9 months vs 8.5 months, p<0.001). While there was no significant difference between groups in 6 month ACL-RSI scores (63.8 pre-COVID vs 66.6 COVID, p=0.48), both groups yielded globally low scores. There were no significant associations between matched groups in PROMIS-PSE (p=0.71), IKDC (p=0.55), Pedi-IKDC (p=0.15), and Pedi-FABS (p=0.77) scores (Table 1). Conclusion: Young athletes demonstrated similar levels of psychological readiness to RTS at 6 months following ACLR prior to and during the COVID-19 pandemic. Patient-reported outcome scores were similar in pre-COVID and COVID ACLR patients, suggesting that the pandemic may not have played a detrimental role in perceptions of recovery. Psychological readiness may not be fully optimized at 6 months post-ACLR and young athletes may benefit from additional time and training for progressive confidence, muscle strength, and performance. [Table: see text]