Sports Medicine Commons^™

The Major League Baseball Pitch Clock: One Year Position Player Injury Analysis, Troy Puga, Nicholas Scigliano, Mckenna Box, John T. Riehl

North Texas Research Forum 2025

Background In 2023, Major League Baseball (MLB) implemented the pitch clock. The effects of the pitch clock on player injury rates is largely unknown, and some, including the major league baseball players association, have suggested that pitchers may be at an increased risk of injury with its implementation. Position players have received little attention in these discussions, even though they may be at the same theorized risk of injuries. The aim of this study is to determine if implementation of the 2023 MLB pitch clock influenced the incidence of injuries in position players. It is hypothesized that implementation of the …

Trends And Outcomes In Fixation Of Distal Radius Fractures In Elderly Patients: Should Gender Play A Role In Surgical Decision Making?, Rabia Qureshi, Kenny Ling, Sydney Laramie

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Impact Of Teriparatide On Surgical And Medical Outcomes In Osteoporotic Patients Undergoing Multilevel Anterior Cervical Discectomy And Fusion, Samuel Akhnoukh, Uttsav Patel, Kenny Ling, Ivan Zapolsky

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF) are at increased risk of pseudarthrosis and perioperative complications, including higher rates of reoperation compared to non-osteoporotic individuals. Teriparatide, an anabolic agent used in osteoporosis treatment, has shown promise in enhancing fusion and reducing complications in lumbar spine procedures, but its role in multi-level ACDF remains unclear.

Purpose: The purpose of this study was to evaluate the impact of postoperative teriparatide use on outcomes in osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF). Specifically, the study aimed to determine whether teriparatide could reduce long-term complications such as …

Identifying Authenticity In Orthopaedic Residency Applications: Can Selection Committees Detect Ai-Written Personal Statements, Samir Baig, Lekha Yaramada, David E. Komatsu, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Hypertensive Status Predicts 30-Day Postoperative Complications Following Open Reduction Internal Fixation Of Distal Radius Fractures, Nishank Mehta, Emma Smolev, Dorian Cohen, Kenny Ling, Becka Konnayil, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The primary objective of this study was to investigate the association between preoperative hypertension and postoperative complications following open reduction internal fixation of distal radius fractures.

Methods: All patients who underwent open reduction internal fixation (ORIF) for distal radius fractures (DRF) between 2015 to 2021 were queried from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Postoperative complications were reported within 30 days of procedure. We identified a total of 26,138 patients and 31.5% (n=8,225) of patients had hypertension. Hypertension was defined as blood pressure greater than 140/90 as documented in the medical record, requiring …

Femoral Avascular Necrosis And Triptan Therapy: A Multicenter Retrospective Study, Joseph Bisiani, Francisco Martos Jr., Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Aims: Migraines are one of the most common neurological disorders that patients typically suffer from. One of the more common prescription medications for migraines are triptans, which can lead to vasoconstriction throughout the peripheral vasculature as a potential side effect. However, a possible risk of femoral avascular necrosis may arise from these treatments, as it has been well known that a lack of blood flow to the femur can arise due to this peripheral vasoconstriction. Therefore, research is warranted for whether taking anti-migraine medications is associated with a higher risk of developing avascular necrosis within the femur, an area highly …

Extensor Tendon Injuries: Does Repair Technique Influence Re- Rupture Rate?, Rahul Rai, Joseph Bisiani, Athikur Rahman, David Komatsu, Lawrence Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Extensor tendon injuries are common injuries to the hand. When poorly managed, these injuries can have significant long-term effects on a patient’s hand function. There are multiple described repair techniques to repair an injured extensor tendon. The aim of this study was to determine if there was a correlation between extensor tendon repair technique and subsequent re-rupture rate.

Methods: A retrospective analysis was conducted on patients who underwent extensor tendon repair at our institution, utilizing the electronic medical record database of patients with extensor tendon injuries from 2015 to 2024. Data were collected on patient demographics, injury mechanisms, tendon …

Biomechanical Comparison Of Posterolateral Fibula Plating With Independent Syndesmotic Screw Fixation Versus Direct Lateral Plating With Syndesmotic Screw Fixation Through Plate, Dmitriy Butsenko, Zack Bonick, J Gary Bledsoe, Michael E. Doany

Stony Brook Orthopaedic and Musculoskeletal Journal

Syndesmotic fixation has been extensively investigated. Screw size, number, position, orientation, and flexible fixation options have all been investigated at length. There is however a lack of knowledge of any difference between an independent syndesmotic screw versus onethrough a lateral plate. The purpose therefore is to perform a biomechanical assessment of syndesmotic fixation comparing independent screw vs screw through plate combination, analyzing torsional strength of both constructs. To perform this, seven matched cadaveric through tibia-fibula lower leg specimens were prepared by creating an oblique fracture performing surgical syndesmotic disruption. The specimens were then randomized into the direct lateral through plate …

Association Between Glp-1 Agonist Use And Site-Specific Fracture Risk: A Retrospective Cohort Analysis, Nathan Zou, Joseph Bisiani, Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Type 2 diabetes and obesity rates are expected to rise, possibly increasing the usage of Glucagon-like peptide-1 (GLP-1) agonists. Use of these agents for nondiabetic patients for weight loss I s approaching the number prescribed for diabetes. GLP-1 agonists may influence bone metabolism by promoting formation and reducing resorption, but their impact on fracture risk remains unclear. While some studies show no association, others suggest increased vulnerability. Most prior research has examined overall fracture risk without considering specific skeletal sites. This study aimed to compare site-specific fracture rates in adults with T2DM or obesity receiving GLP-1 therapy with those …

All Inside Meniscus Repair - How Close Is Too Close?, Frederick Hance, Kenny Ling, Liam Edwards-Gaherty, Diana Patterson

Stony Brook Orthopaedic and Musculoskeletal Journal

Although rare, neurovascular injuries are major complications. The purpose of this study was to use cadaveric dissection to determine the proximity of medial and lateral meniscus repair to major neurovascular structures in the posterior knee. We hypothesized that repair of the posterior horn of the medial and lateral menisci would be within 1 centimeter proximity of a key neurovascular structure.

The study was performed on 4 fresh-frozen cadaveric specimens that included the full knee joint spanning from the distal femur to proximal tibia and fibula. Following identification and tagging of the key structures, arthroscopic meniscus repair was simulated using Arthrex …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Liv Selection In ‘Tweener’ Patients Treated With Magnetically Controlled Growing Rods Vs. Posterior Spinal Fusion, Brandon Yoshida, Claudia Leonardi, Jacquelyn Valenzuela-Moss, Lindsay M. Andras, Tyler A. Tetreault, John B. Emans, John T. Smith, Joshua M. Pahys, G. Ying Li, Michael J. Heffernan

School of Public Health Faculty Publications

Purpose: The purpose of this study was to compare the LIV selection in ‘tweener’ patients treated with MCGR or PSF. Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8–11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), and the LIV were evaluated. Results: One hundred and fifty-nine patients met inclusion criteria. Preoperative curve magnitude was similar between groups (MCGR 68 …

A New Treatment For Knee Osteoarthritis: Microfragmented Adipose Tissue Injections, Anne Bernot, Elizabeth Colantonio

Physician Assistant Capstones, 2020-current

Objective: Assess the effectiveness of microfragmented adipose tissue injections at lowering knee injury and osteoarthritis outcome scores (KOOS) 6 months post treatment in patients aged 18-75 with symptomatic knee osteoarthritis compared to platelet rich plasma injections. Design: systematic literature review. Methods: A search of PubMed and Google Scholar was performed using the terms “Lipogems”, “adipose tissue injection”, “Micro Fragmented adipose tissue injections”, “Micro Fragmented adipose tissue and PRP”, and “MFAT vs. PRP knee”. The search was limited to randomized controlled trials (RCTs) published in the past ten years. Results: Three randomized control trials (RCTs) met inclusion …

Rates Of Reporting And Analyzing Race And Ethnicity In Athlete-Specific Sports Medicine Research: A Systematic Review, John H. Sonnier, Carlo Coladonato, Irfan A. Khan, Gregory Connors, Ryan W. Paul, Anya T. Hall, Emma E. Johnson, Meghan E. Bishop, Fotios P. Tjoumakaris, Kevin B. Freedman

Rothman Institute Papers

BACKGROUND: Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.

PURPOSE: To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered …

Hip Sideline Emergencies And Hip Injuries In Elite Athletes, Kevin K Chen, Emmanuel N Osadebey, Paul G Shupe, Bonnie P Gregory

Faculty, Staff and Student Publications

Purpose of review: Hip injuries in elite athletes are an increasingly recognized problem and range from chronic overuse injuries, such as adductor strains and labral tears, to acute traumatic injuries such as hip dislocations. In this article, we review common hip pathology experienced by elite athletes and sideline management of emergent hip injuries.

Recent findings: Elite athletes are subject to unique physical and mental stresses and therefore must be evaluated and treated in a unique manner. Hip and groin injuries account for approximately 6% of sport injuries overall and 3-15% of all injuries in professional sports. Hip sideline emergencies were …

Anxiety And Depression Amongst Female Athletes, Dp Golden, Re Obmann, Em Moore

Clinical Practice in Athletic Training

Context: Anxiety (categorized by a feeling of fear, dread, and uneasiness) and depression (mood disorder causing feelings of persistent sadness and loss of interest in things an individual once loved) are two major mental health disorders effecting females considerably who participate in sport. Females are more likely to present with anxiety (55-60%)1 and depression (1.844 times)2 compared to males. The purpose of this study was to examine the prevalence between mental health comorbidities (anxiety and depression), across female athletes aged 18-40. Methods: An anonymous survey was distributed via snowball sampling using social media. Demographic data, Generalized Anxiety Disorder-7 (GAD-7), validated …

Effects Of Sex Hormones And The Menstrual Cycle On Knee Joint Laxity In Physically Active Females: A Critically Appraised Topic, Ae Eicher, Rj Gage, K Park-Braswell

Clinical Practice in Athletic Training

Clinical Scenario: In recent years, females have exhibited increased physical activity and sport participation than ever before. Recent studies have identified a rising incidence rate of ACL injuries and indicate that the risk of ACL tears is greater in females than males. Knee laxity and physiological variation in women during the menstrual cycle have demonstrated increased ligament laxity, therefore, varying hormone concentrations may contribute to changes in ligamentous mechanical properties. Despite these findings, it remains unclear whether fluctuating sex hormone concentrations directly correlate to measurable changes in knee laxity. Clinical Question: How do fluctuations in sex hormones throughout the menstruation …

Individual Goal And Velocity Based Throwing Program For Collegiate Baseball Pitchers With Medial Elbow Injuries, Le Trail, Jm Cline, Ap Jacobsen

Clinical Practice in Athletic Training

Background: A 22-year-old male collegiate baseball pitcher experienced sudden pain in the medial left elbow following feeling a pop when pitching. The pitcher was removed from the competition and was evaluated with a point-of-care ultrasound at the conclusion of the competition. Ultrasound revealed an intact ulnar collateral ligament (UCL) and no edema. Differential Diagnosis: UCL sprain, Wrist flexor strain Treatment: The patient was referred to a primary care sports medicine physician for further evaluation. The physician found no tenderness or laxity at the UCL and ordered an MRI arthrogram for further diagnostic information. MRI revealed a grade II flexor digitorum …

Presentation Of An Accessory Navicular Bone In A Collegiate Women’S Field Hockey Player: A Type 3 Clinical Case Study, N Sutker, J Franco, K Mallory, B Hansberger

Clinical Practice in Athletic Training

Background: The accessory navicular is an extra bone located posterior and medial to the navicular tuberosity. The prevalence of accessory navicular has been reported to be 4 - 21% in the general population though this anatomical variant may often be overlooked during differential diagnosis. This case presents a female collegiate field hockey patient that was initially diagnosed with a midfoot sprain but was later determined to have an accessory navicular bone which required surgical removal. Patient: A 19-year-old female Division I collegiate field hockey patient presented to the athletic training clinic with pain in her left medial foot. The patient …

Changes In Neural Excitability Following 6-Week Of Balance Training In Individuals With Chronic Ankle Instability, Sh Chung, J Freeman, Rs Mccann

Clinical Practice in Athletic Training

Context: Individuals with chronic ankle instability (CAI) often struggle with balance issues due to changes in the central nervous system (CNS). Specifically, difficulties in modulating spinal reflexive excitability and enhancing corticospinal excitability contribute to poor balance, indicating challenges in transferring control to supraspinal centers. A recent study found that a single session of balance training could positively impact the CNS, improving spinal reflexive excitability modulation and corticospinal excitability in CAI patients. However, there is limited research on the effects of long-term balance training on neural excitability in CAI individuals. Therefore, this study aimed to investigate the effects of a 6-week …

Chronic Neck Pain, Vasculopathy, And Pre-Syncope In A Young Adult: A Type 4 Case Study, Tn Crane, K Moore, A Field

Clinical Practice in Athletic Training

Background: The patient is a 23-year-old college female presenting with chronic cervicalgia, bilateral upper extremity neurovascular symptoms, and insidious pre-syncope episodes over the past 3.5 years. Upper extremity neurovascular symptoms include bilateral numbness and tingling into the hands and bilateral throbbing arm pain originating proximal to the elbow and traveling to the fingers, which worsens with cervical rotation bilaterally. The patient has experienced 10 episodes of pre-syncope lasting less than 30 seconds that occur with cervical flexion, extension, or bilateral rotation. Pre-syncope symptoms include lightheadedness, blurry vision, increased neck/arm pain, headache, and malaise. Upon clinical evaluation, no obvious deformity, discoloration, …

Cyclops Lesion In A Collegiate Men’S Lacrosse Player: A Type 4 Clinical Case Study, K Powers, R Moen, G Siarkas

Clinical Practice in Athletic Training

Background: In late July 2023, a 20-year-old male division I lacrosse player reported to the Athletic Training clinic with pain, swelling, and an inability to fully extend his left knee. Evaluation revealed an extension deficit of 5 – 10° during active range of motion (ROM). The patient had previously undergone a double-bundle procedure to repair a torn anterior cruciate ligament (ACL) in his left knee in November 2022. Following this surgery, the patient completed a standard but conservative ACL reconstruction (ACLR) rehabilitation program as prescribed by the sports medicine team but switched to a light strength training regimen on his …

How Comorbidity With Adhd Impacts On Neurocognitive Performance In Adolescents After Sport-Related Concussions: A Scoping Review, T Chiba, Dm Emerson

Clinical Practice in Athletic Training

Context: The number of sport-related concussions (SRCs) is higher in adolescents than in other age groups and accounts for 32% of concussions. Athletes with attention-deficit hyperactivity disorder (ADHD) have a higher risk of previous history of concussion and future concussion risk compared with those without ADHD. People with ADHD present lower baseline scores of neurocognitive performances compared with those without ADHD. Neurocognitive deficits after SRC lead to increase risk of musculoskeletal injuries or another concussion after return to play (RTP) and affect RTP process. There is no consensus regarding the management of SRCs for those with ADHD. This scoping review …

A Qualitative Study Evaluating Athletic Trainers’ Self-Perceived Knowledge And Knowledge Acquisition Of Concussion Biomarkers, Kgs Swindell, T Mccormick, Jm Allen

Clinical Practice in Athletic Training

Context: Rapid movement of the brain caused by a concussion can damage brain cells and create chemical changes within the brain, which may cause lasting neurological, cognitive, and behavioral symptoms. It is suggested that following a trauma, biomarkers can be released which may be useful in accurately diagnosing concussions. Potential biomarkers being studied include β-amyloid peptide 42 [Aβ42], S100 calcium-binding protein B [S100B], glial fibrillation acidic protein [GFAB], microtubule-associated protein 2 [MAP2], and 2’,3’-cyclic-nucleotide 3'- phosphodiesterase [CNPase]. This study focuses on evaluating AT knowledge and awareness of biomarkers, with sub-analyses evaluating ATs’ perception of current knowledge of biomarkers, and the …

An Investigation Of Lower Extremity Injuries In Soccer Athletes Related To Their Playing Environment, Ak Whitlock, K Francis, H Maloney

Clinical Practice in Athletic Training

Context: The goal of this study was to investigate a connection between cleat type, surface type, and increased lower extremity injury rates in soccer athletes. Our hypothesis was that the cleat model, surface type, and facility affected the lower extremity injury rate among soccer athletes. Methods: A review of survey results distributed to the male and female soccer from an NCAA D-I program was completed. The survey investigated athlete injury history related to the specific shoe worn and the field surface information where the injury occurred. Measures of central tendency were calculated. Data was analyzed using a correlation analysis with …

Anaerobic Capacity And Lower Body Strength Deficits Related To Thermal Protective Gear In Rural Volunteer Firefighters, J Diggins, R Shagena, T Patrick, A Catanese

Clinical Practice in Athletic Training

Context: Firefighting is a dangerous job with occupational hazards, strenuous shifts, and increased work- related fatigue that contributes to risk of injury. The weight of thermal protective gear (TPG) may increase neuromuscular challenges while on-duty. The purpose of this study was to investigate the influence of TPG on volunteer firefighters’ anaerobic and lower body strength performance. Methods: Nine healthy males (mean±SD: age= 41±9.3 years; ungeared body mass= 96.47 ± 14.51kg; ungeared height=181.67 ± 4.48cm; VFF experience 8 years) participated in a cross-sectional correlation study during three visits to a university research laboratory. Participants’ TPG included thermal pants, jacket, boots, and …

Athletic Trainers’ Attitudes Towards Concussion Biomarkers And Their Future Use In Concussion Diagnosis, Jm Allen, T Mccormick, Kgs Swindell, T Campbell

Clinical Practice in Athletic Training

Context: Currently, concussions are diagnosed using subjective criteria that typically require baseline measurements to be considered accurate. In some cases, symptoms may not be immediately evident following a brain injury. Recently, studies have begun analyzing the possibility of using biomarkers as a means of objectively diagnosing concussions. However, more research and information on biomarkers are required before implementation of diagnostic methods are possible; therefore, the purpose of our study was to explore and analyze current practicing athletic trainers’ attitudes toward the future implementation of concussion biomarkers in clinical practices. Methods: A phenomenological qualitative research design was used to gather information …

Caffeine Consumption On Sports Performance Measures In College Athletes: A Critically Appraised Topic, Ja Wills, Al Fraley

Clinical Practice in Athletic Training

Focused Clinical Question: How does caffeine (CAF) consumption affect sports performance measures in healthy college athletes? Data Sources: In December 2023, PubMed was utilized to search key terms, including collegiate athlete, caffeine, and performance measures. A publication time frame from 2013-2023 was established. Study Selections: Inclusion criteria consisted of studies investigating collegiate athletes ingesting CAF and its impact on anaerobic, agility, and speed performance measures. Exclusion criteria consisted of participants with current injuries and ingredients consumed in addition to CAF. Data Extraction: Outcomes included sports performance measures such as: vertical jump test, 60- and 100-meter time trials, reaction time, maximum …

Citation Accuracy Of Scholarly Journal Articles In Sports Medicine, Lk Warner, Le Trail, Bj Warner, Sa Cage

Clinical Practice in Athletic Training

Context: Previous research has expounded on the importance of accurate use of references in scholarly manuscripts. A thorough and appropriate use of references allows authors to validate and lend credence to the position they are attempting to take on their subject matter.Reference errors have been well documented in multiple scholarly journals covering healthcare topics. To date, there does not appear to be a description of the accuracy of reference lists in sports medicine scholarly journal articles. Therefore, the purpose of this study was to describe the rate of reference errors in sports medicine literature. Methods: We examined four peer-reviewed sports …

Conflict Management In Athletic Training: The Influence Of Organizational Culture, Cc Emerson

Clinical Practice in Athletic Training

Context: Athletic trainers (ATs) face conflict within the social ecosystem of the organizations in which they practice and arises due to incompatibility of goals and interests. Within athletic departments, the ATs’ role to advocate for health and safety often comes at odds with an organizational culture directed towards maximizing performance and winning. ATs are often evaluated by dominant and powerful members of organizations who may not understand or respect the AT’s role. The purpose of this study was to examine the experience of managing conflict as an AT within the culture of athletics. Methods: This qualitative study explored experiences of …