The American journal of sports medicine
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Several risk factors have been proposed for intervertebral disc degeneration (DD) among adolescent athletes. However, the causes of DD are not well understood, and there have been few prospective studies evaluating DD in adolescents. ⋯ Significant risk factors for DD progression in high school AF players included playing a lineman position, the presence of Schmorl nodes, and disc herniation. Continuing to play AF through 2 years of high school was a risk factor for the onset of LBP.
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Factors contributing to recurrent dislocation, revision stabilization, and complications requiring reoperation after an initial shoulder stabilization procedure for instability have not been evaluated on a population level. ⋯ The risks of revision stabilization and postoperative (either shoulder) dislocation were most influenced by young age (<20 years) and having had 3 or more preoperative dislocations. Complications requiring surgery are rare.
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Comparative Study Clinical Trial
Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery.
Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown. ⋯ The PROs of the HOOS and iHOT-33 demonstrate psychometric properties that may enable researchers and clinicians to use them with confidence in a population undergoing hip arthroscopic surgery. The psychometric properties of the MHHS, HOS, and some subscales of the HAGOS are reduced, and these PROs may be less valuable in this group.
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In posterolateral corner (PLC) injuries in which the lateral collateral ligament (LCL) is intact, there is controversy about whether reconstructing the popliteus tendon (POP), the popliteofibular ligament (PFL), or both structures (POP + PFL) is required to restore normal external tibial rotation. ⋯ In an LCL-intact PLC injury model, the POP and PFL function as a unit in resisting external rotation. All surgical procedures described and tested were able to reduce the increased external rotational laxity found in the sectioned state. The PFL reconstruction technique was able to restore external rotation to near normal. However, the techniques involving POP reconstruction overconstrained external rotation during laxity testing.
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Case Reports
Operative and nonoperative treatment of cervical disc herniation in National Football League athletes.
Limited evidence exists to guide clinical decision making regarding cervical disc herniations in professional athletes playing for the National Football League (NFL) in the United States. ⋯ Data regarding the treatment of this unique population are limited but suggest that NFL athletes can safely return to sport after the treatment of cervical disc herniations. In the treatment algorithm for this study, cord compression with signal change in the cord on MRI was a consistent operative indication. Discs abutting the cord can be treated nonoperatively but do not allow for return to sport until symptoms have improved and repeat imaging demonstrates no cord compression. Isolated nerve root compression has a more favorable prognosis. It can be treated symptomatically and return to sport allowed when symptoms permit.