Sports Medicine Commons^™

Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft In Baseball Players: A Cohort Analysis, Michael C. Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric Didomenico, Harrison S. Fellheimer, Christopher C. Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.

PURPOSE: To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or …

Retrospective Comparison Of Outcomes Of Osteochondral Allograft Transplantation Of The Knee Using Extended Storage Modality Missouri Osteochondral Preservation System Versus Standard Preservation, Henson Destine, Gaston Davis, Harrison S. Fellheimer, Azra Dees, Nathaniel Kern, Bradford Tucker, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Osteochondral allograft (OCA) transplantation is an established surgical intervention for full-thickness chondral defects. Standard preservation (SP) protocols currently allow for OCAs to be stored for a maximum of 28 days after procurement before significant chondrocyte death. An alternative protocol, the Missouri Osteochondral Allograft Preservation System (MOPS), has been shown to allow for grafts to be stored for twice the maximum time allotment as SP.

PURPOSE: To compare clinical outcomes in patients who have undergone OCA transplantation utilizing the extended storage capabilities of the MOPS versus SP protocols.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent …

Modeling Surgeon Belief Updating Under Bias: A Bayesian Simulation In Shoulder Arthroplasty, Mariano Menendez, Michael Moverman, Surena Namdari, Frederick Matsen, David Ring

Rothman Institute Papers

BACKGROUND: Shoulder surgeons often offer markedly different treatment recommendations for a given patient and pathophysiology within the context of a common body of evidence. Prior beliefs and cognitive bias may contribute to this variability. Using Bayesian decision theory informed by principles of behavioral science, we modeled how surgeons with different initial beliefs and degrees of bias update their treatment preferences in response to new evidence comparing anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) when making surgery recommendations for advanced primary glenohumeral osteoarthritis.

METHODS: We developed a Bayesian simulation involving 3 hypothetical surgeons with distinct initial beliefs: …

Return To Sport And Performance Outcomes After Hand Fractures In Professional Baseball Players, Ryan W. Paul, Sean M. Wilson, Gaston Davis, Amit Syal, Steven B. Cohen

Rothman Institute Papers

BACKGROUND: About 7% of injuries in the Major League Baseball (MLB) involve the hand. Fractures of the hand are not uncommon in professional baseball players while fielding or from being hit by a pitch while batting; however, the outcomes of professional baseball players treated both operatively and nonoperatively are unclear.

PURPOSE/HYPOTHESIS: The purpose of this study was to report the return-to-sport (RTS) rate, RTS time, and performance outcomes in professional baseball position players who sustained a hand fracture. The secondary purpose was to compare outcomes between positions and between operatively versus nonoperatively treated players. It was hypothesized that there would …

Academic Productivity At Orthopaedic Surgery Sports Medicine Fellowship Programs In The United States Has A Weak Positive Correlation With Nonresearch Lifetime Industry Earnings, Benjamin Miltenberg, William Johns, Anthony Baumann, Faheem Pottayil, Bradley Richey, Albert Anastasio, Kempland Walley, Christopher Dodson, Sommer Hammoud

Rothman Institute Papers

PURPOSE: To characterize the relationship between academic productivity, as defined by the h-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships.

METHODS: The American Orthopaedic Society for Sports Medicine fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total nonresearch lifetime earnings were obtained from the Centers for Medicare & Medicaid Services website. Academic productivity of each fellowship faculty was assessed via the h-index. Frequency counts and other descriptive statistic measures …

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 …

Chatgpt Can Offer Satisfactory Responses To Common Patient Questions Regarding Elbow Ulnar Collateral Ligament Reconstruction, William Johns, Alec Kellish, Dominic Farronato, Michael G. Ciccotti, Sommer Hammoud

Rothman Institute Papers

PURPOSE: To determine whether ChatGPT effectively responds to 10 commonly asked questions concerning ulnar collateral ligament (UCL) reconstruction.

METHODS: A comprehensive list of 90 UCL reconstruction questions was initially created, with a final set of 10 "most commonly asked" questions ultimately selected. Questions were presented to ChatGPT and its response was documented. Responses were evaluated independently by 3 authors using an evidence-based methodology, resulting in a grading system categorized as follows: (1) excellent response not requiring clarification; (2) satisfactory requiring minimal clarification; (3) satisfactory requiring moderate clarification; and (4) unsatisfactory requiring substantial clarification.

RESULTS: Six of 10 ten responses were …

Physical Examination Versus Ultrasonography For Detection Of Ulnar Nerve Subluxation In Professional Baseball Pitchers, Austin Looney, Hannah Day, Manoj Reddy, Ryan Paul, Levon Nazarian, Steven Cohen

Rothman Institute Papers

Background: Despite the importance of accurately detecting ulnar nerve subluxation in vulnerable athletes, few studies have compared the performance of physical examination and ultrasound in this population. Purpose/Hypothesis: The purpose of this study was to compare the diagnostic validity of physical examination versus ultrasound in detecting ulnar nerve subluxation at the cubital tunnel of the elbow in professional baseball pitchers. It was hypothesized that ultrasound would more sensitively detect ulnar nerve subluxation. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Physical and sonographic examinations for ulnar nerve subluxation were performed on 186 elbows of 95 consecutive male professional …

Does Prehabilitation Before Surgery Affect Return To Sport In Baseball Pitchers With Partial Ulnar Collateral Ligament Tears?, Kourtney Snigar, Ryan W. Paul, Joshua M. Spada, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rothman Institute Papers

BACKGROUND: Purposeful rehabilitation before surgery (prehabilitation) has been researched and implemented in the treatment of anterior cruciate ligament tears. However, it is unclear whether prehabilitation would affect outcomes for baseball pitchers with partial ulnar collateral ligament (UCL) tears.

PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether baseball pitchers with partial UCL tears who completed ≥4 weeks of prehabilitation (prehab group) have different return to play (RTP) outcomes than pitchers with 0 to 3 weeks of preoperative physical therapy (no prehab group). We hypothesized that pitchers in the prehab group would have similar RTP rates compared with pitchers in …

Return To Recreational Sports Participation Following Rotator Cuff Repair In Adults Over 40 Years Of Age: Outcomes And Return To Play Analysis, John Hayden Sonnier, Gregory Connors, Michael P. Campbell, Matthew Sabitsky, Ryan W. Paul, Hayden E. Sando, William D. Emper, Steven B. Cohen, Michael G. Ciccotti, Fotios P. Tjoumakaris, Kevin B. Freedman

Rothman Institute Papers

Background: Despite the high prevalence of rotator cuff (RTC) tears in older adults, there is limited literature evaluating the return to recreational sport after repair. The purpose of this study was (1) to assess the patient-reported outcomes and return to sport rates following rotator cuff repair in patients aged more than 40 years with minimum 2-year follow-up; (2) to compare baseline, preoperative and postoperative outcomes, and level of play following repair of self-reported athletes with nonathletes; and (3) to compare return to sport rates in overhead athletes compared to nonoverhead athletes. Methods: Patients undergoing arthroscopic rotator cuff repair between January …

Beach Chair Versus Lateral Decubitus Surgical Positioning For Arthroscopic Anterior Shoulder Stabilization: A Retrospective Comparison Of Clinical And Patient-Reported Outcomes, Ryan W Paul, Sydney Streicher, Alim Osman, Chuka Ukekwe, Usman Zareef, Kevin B Freedman, Brandon J Erickson, Sommer Hammoud, Meghan E Bishop

Rothman Institute Papers

Background: Surgical positioning can affect both perioperative and postoperative complication rates. It is unclear whether beach-chair versus lateral decubitus positioning affects outcomes in patients undergoing arthroscopic anterior shoulder stabilization surgery.

Purpose: The purpose of this study was to compare recurrent instability, complications, and patient-reported outcomes between patients who underwent arthroscopic anterior shoulder stabilization in the beach-chair versus the lateral decubitus positions. It was hypothesized that recurrent instability, complications, and patient-reported outcomes would not be affected by surgical positioning.

Study Design: Cohort study; Level of evidence, 3.

Methods: The authors reviewed the medical records of patients who underwent shoulder stabilization ( …

Long-Term Sports Participation And Satisfaction After Ucl Reconstruction In Amateur Baseball Players., Robert A Jack, Somnath Rao, Taylor D'Amore, Donald Willier Iii, Robert Gallivan, Steven B. Cohen, Christopher C Dodson, Michael G. Ciccotti

Rothman Institute Papers

Background: While the incidence of ulnar collateral ligament reconstruction (UCLR) has increased across all levels of play, few studies have investigated the long-term outcomes in nonprofessional athletes.

Purpose: To determine the rate of progression to higher levels of play, long-term patient-reported outcomes (PROs), and long-term patient satisfaction in nonprofessional baseball players after UCLR.

Study Design: Case series; Level of evidence, 4.

Methods: We evaluated UCLR patients who were nonprofessional baseball athletes aged(KJOC), the Timmerman-Andrews (T-A) Elbow score, the Mayo Elbow Performance Score (MEPS), and a custom return-to-play questionnaire.

Results: A total of 91 baseball players met the inclusion criteria, and …

Rehabilitation And Return-To-Play Criteria After Fresh Osteochondral Allograft Transplantation: A Systematic Review., Michael Stark, Somnath Rao, Brendan Gleason, Robert A. Jack, Bradford Tucker, Sommer Hammoud, Kevin B. Freedman

Rothman Institute Papers

Background: Fresh osteochondral allograft (OCA) is a treatment option that allows for the transfer of size-matched allograft cartilage and subchondral bone into articular defects of the knee. Although long-term studies show good functional improvement with OCA, there continues to be wide variability and a lack of consensus in terms of postoperative rehabilitation protocols and return to sport.

Purpose: To systematically review the literature and evaluate the reported rehabilitation protocols after OCA of the knee, including weightbearing and range of motion (ROM) restrictions as well as return-to-play criteria.

Study Design: Systematic review; Level of evidence, 4.

Methods: PubMed, EMBASE, Cumulative Index …

Stress Fractures Of The Elbow In The Throwing Athlete: A Systematic Review., Shelby R. Smith, Nirav K. Patel, Alex E. White, Christopher J Hadley, Christopher C. Dodson

Rothman Institute Papers

Background: Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers.

Purpose: To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes.

Study Design: Systematic review; Level of evidence, 4.

Methods: A systematic review was conducted by searching the Scopus, PubMed, and Cochrane Library electronic databases to identify studies reporting on the management and outcomes of stress fractures in …

Injuries In The Chinese Arena Football League: American Versus Chinese Players., Tianwu Chen, Austin Wetzler, Scott Singer, Michael Feldman, David Rubenstein, Gunnar Gillespie, Shiyi Chen, Merrick Wetzler

Rothman Institute Papers

Background: Arena football is an indoor version of American football played in indoor arenas on a smaller field with 8 players per team. Only 1 study has evaluated injury rates in arena football, and no study had compared 2 distinct cohorts of players.

Purpose/Hypothesis: The purpose of this study was to evaluate and compare injury rates in American versus Chinese athletes in the Chinese Arena Football League. Our hypothesis was that the rate of significant injuries (≥7 days of time lost from play) would be statistically significantly higher in Chinese athletes.

Study Design: Cohort study; Level of evidence, 2.

Methods: …