Purpose: To assess the effectiveness of a nonopioid pain regimen in controlling postoperative pain as compared to a traditional opioid pain control following primary meniscectomy or meniscal repair.Study design: Level of Evidence: Level I, Prospective Randomized Controlled Trial METHODS: Ninety-nine patients undergoing primary meniscectomy or meniscal repair were assessed for participation. A prospective randomized control trial was performed in accordance with the Consolidated Standards of Reporting Trials 2010 (CONSORT) statement. The two arms of the study included a multimodal non-opioid analgesic protocol and a standard opioid regimen with a primary outcome of postoperative pain level (visual analog scale) for the first 10 days post-operatively. Secondary outcomes included patient reported outcomes, complications and patient satisfaction. Randomization was achieved using a random number generator. Patients were not blinded. Data collection was done by a blinded observer.
Adductor injuries in the National Basketball Association: an analysis of return to play and player performance from 2010 to 2019
Objectives: 1) To evaluate return to play (RTP) timing in National Basketball Association (NBA) athletes following adductor injuries, and 2) to evaluate the effect of adductor injuries on player performance, game availability, and career longevity following RTP.
Methods: Adductor injuries in NBA athletes from the 2009-2010 to 2018-2019 seasons were identified utilizing publicly available records via previously validated methodology. RTP time was calculated, and player performance and game availability were compared pre- vs. post-injury. Additionally, an injury-free control group matched for age, BMI, position, and experience was assembled to allow for comparisons in performance, availability, and career length.
Comparison of Tendon Lengthening With Traditional Versus Accelerated Rehabilitation After Achilles Tendon Repair: A Prospective Randomized Controlled Trial
BACKGROUND: Early weightbearing protocols after Achilles tendon repair promote mobilization, yet little is known about their effect on tendon lengthening.
PURPOSE: To evaluate tendon lengthening after Achilles tendon repair with accelerated rehabilitation.
PURPOSE: The purpose of this study was to determine the correlation between pre- and postoperative opioid use in patients undergoing arthroscopic shoulder labral repair, as well as patient risk factors associated with increased postoperative opioid use following the procedure.
METHODS: A retrospective review of all patients undergoing arthroscopic shoulder labral surgery at a single institution between August 2013 and November 2017 was performed. Patients were stratified as opioid nonusers, acute users, or chronic users based on preoperative consumption. Patient demographics, injury characteristics, surgical interventions, and postoperative opioid use for the first 12 months after surgery were then analyzed.
PROMIS Instruments Correlate Better with Legacy Measures in Knee Cartilage Patients at Post-operative than at Pre-operative Assessment
PURPOSE: To define the psychometric properties of the PROMIS Physical Function (PF), Pain Interference (PI) and Depression Computer Adaptive Test (CAT) in patients undergoing knee cartilage surgeries.
METHODS: The PROMIS PF, PI and Depression CAT were administered preoperatively and at 6 months alongside legacy knee patient-reported outcome measures in patients undergoing knee cartilage surgeries. Statistical analysis consisted of time-to-completion, psychometric analysis for correlative strengths, absolute and relative floor and ceiling effects, and Cohen's effect size.
Return to play and performance after shoulder instability in National Basketball Association athletes
HYPOTHESIS: We hypothesized that players in the National Basketball Association (NBA) who sustained a shoulder destabilizing injury could return to play (RTP) successfully at a high rate regardless of treatment type.
METHODS: We used publicly available data to identify and evaluate 50 players who sustained an in-season shoulder instability event (subluxation/dislocation) while playing in the NBA. Demographic variables, return to NBA gameplay, incidence of surgery, time to RTP, recurrent instability events, and player efficiency rating (PER) were collected. Overall RTP was determined, and players were compared by type of injury and mode of treatment.
BACKGROUND: The economic loss following ulnar collateral ligament reconstruction (UCLR) in Major League Baseball (MLB) pitchers has not been evaluated. The purpose of this study is to quantify the financial impact of UCLR on MLB teams. We hypothesize that MLB teams incur significant losses annually as a result of salaries paid to injured players following reconstruction.
METHODS: Public records were accessed to identify MLB pitchers from January 1, 2004, to December 31, 2014, who had undergone UCLR. Contract terms and time away from competition were used to approximate economic loss. Successful return was considered when a pitcher returned to play in at least 1 Minor League Baseball (MiLB) or MLB game.
How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?
PURPOSE: The purpose of the study was to define the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) thresholds for the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) computerized adaptive test (CAT) instrument in patients undergoing arthroscopic meniscal surgery.
METHODS: The PROMIS PF CAT was administered preoperatively and postoperatively to patients undergoing arthroscopic meniscal surgery. At 6 months postoperatively, patients graded their knee function based on a domain-specific anchor question. A satisfaction anchor question was used to indicate achievement of the PASS. Receiver operating characteristic analysis determined the relevant psychometric values. Cutoff analysis was performed to find preoperative patient-reported outcome scores predicting achievement of clinically significant outcomes (CSOs).
PURPOSE: To determine whether fatigue increases dynamic knee valgus in adolescent athletes, as measured after a standardized exercise protocol and video-based drop-jump test. A secondary aim was to determine whether individual risk factors place certain athletes at increased risk for dynamic knee valgus.
Effect of Fatigue Protocols on Upper Extremity Neuromuscular Function and Implications for Ulnar Collateral Ligament Injury Prevention
BACKGROUND: As the incidence of overuse injuries to the medial elbow in overhead athletes continues to rise, recent evidence suggests a link between these injuries and alterations in biomechanics produced by athlete fatigue. Previous studies have evaluated the effect of fatigue on elbow injuries using a wide array of fatigue protocols/athletic tasks, and, as a consequence, the results have been heterogeneous.
PURPOSE: To determine whether there is a uniform alteration in neuromuscular function or biomechanics as the overhead athlete fatigues. Furthermore, this study sought to determine whether player fatigue should be accounted for in ulnar collateral ligament (UCL) injury prevention programs.