JAAOS

JAAOS, Volume 27, No. 13


Artistic Gymnastics Injuries; Epidemiology, Evaluation, and Treatment

Artistic gymnastics is a physically demanding sport that requires flexibility, agility, and extreme upper and lower body strength. The specific biomechanics of the sport leads to a unique injury profile. Gymnastic skills require intense upper body weight-bearing, placing unusual forces across the upper extremity joints and predisposing them to injury. In addition, the required body control during air aerobatics (tumbling, twisting, flipping) necessitates precise landing techniques to avoid spine and lower extremity injury. Common gymnastic injuries include those of the spine and upper extremity such as spondylolysis, shoulder instability, ulnar collateral ligament injuries, capitellar osteochondritis dissecans, and several wrist pathologies. Understanding the injury etiology, prevention, and treatment protocols is important for a successful recovery and return to sport.

      • Subspecialty:
      • General Orthopaedics

      • Trauma

    Rationale for Biologic Augmentation of Rotator Cuff Repairs

    The structural integrity of rotator cuff repair (RCR) has been a primary focus for shoulder surgeons seeking long-term clinical and functional success. Improvements in surgical techniques have allowed for superior initial biomechanical fixation. However, tendon healing remains a significant clinical problem even after rigid time-zero repair. The lack of long-term healing has led to increased interest in biologic augmentation to improve tendon-to-bone healing. This interest has led to a rise in the investigation of small molecular therapies, cell-based strategies, and tissue-derived treatments offering surgeons a new therapeutic toolbox for potentially improving RCR long-term outcomes. However, the delivery, efficacy, and safety of these treatments remain under investigation. Additional well-designed, high-level studies are of paramount importance in creating evidence-based guidelines for the implementation of new biologic solutions. This review article discusses the current preclinical, translational, and clinical experience with and rationale for biologic augmentation in RCR.

    CMECME

        • Subspecialty:
        • Shoulder and Elbow

      Musculoskeletal-based Patient-reported Outcome Performance Measures, Where Have We Been—Where Are We Going

      While health care evolves from volume to value, there is increasing interest by payors to use patient-reported outcomes (PROs) to determine value and more specifically, quality from the patient's perspective. This article reviews the current state of PROs and discusses future directions. Specifically, this article will review the current history and background of PROs; it will highlight the perspective of the National Quality Forum and review the efforts of the musculoskeletal community related to PROs. Goals, positive aspects, limitations, and barriers related to PROs will be discussed. Additionally, development considerations and strategies will be highlighted. Finally, development recommendations from the American Academy of Orthopaedic Surgery position statement “principles for musculoskeletal based PRO performance measurement development” will be introduced.

      STATUSONLINE-ONLY

          • Subspecialty:
          • General Orthopaedics

        A 46-year Analysis of Gender Trends in Academic Authorship in Orthopaedic Sports Medicine

        Introduction: Participation of women in medicine has increased markedly in recent decades, but gender disparities still exist, particularly in academic medicine. To provide insight into the gender gap, specifically in academic orthopaedic sports medicine, we investigated the relationship between gender and authorship in orthopaedic sports literature from 1972 to 2018.

            • Subspecialty:
            • Sports Medicine

          Insurance Status Affects Complication Rates After Total Hip Arthroplasty

          Introduction: Previous studies have examined the relationship between total hip arthroplasty (THA) and insurance status in small cohorts. This study evaluates the effect of patient insurance status on complications after primary elective THA using the Nationwide Inpatient Sample.

              • Subspecialty:
              • Adult Reconstruction

            Business Modeling of Orthopaedic Trauma in the Emergency Department: An Untapped Revenue Stream

            Introduction: Emergency departments (EDs) and emergency medicine and orthopaedic residencies can be faced with financial challenges while caring for patients. Procedures performed by residents are a potentially viable source of revenue that may make orthopaedic coverage of the ED a financially viable service line.

                • Subspecialty:
                • Trauma

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