Sports Medicine Commons^™

Using Carrots Not Sticks To Cultivate A Culture Of Safeguarding In Sport, Judith L. Komaki, Yetsa A. Tuakli-Wosornu

Publications and Research

The power-driven, win-at-all-costs milieu of many sport settings can create fertile ground for athlete victimization and abuse (Roberts et al., 2020). Victory can in fact be so sovereign that abusive coaches and staff are enabled and “even rewarded. . . in the name of winning” (Armour, 2020). Athlete abuse prevention therefore requires systemic cultural change (Letourneau et al., 2014; Rhind and Owusu-Sekyere, 2017). Thus far, however, enacting this idea has eluded organizations in sport (Mountjoy et al., 2016; Harris and Terry, 2019; Kerr et al., 2019; Rhind and Owusu-Sekyere, 2020) as well as in other settings (National Academies of Sciences, …

Return To Play Criteria Following Operative Management Of Acromioclavicular Joint Separation: A Systematic Review, Richard J. Gawel, Taylor D'Amore, Md, Peters Otlans, Md, Somnath Rao, Steven B. Cohen, Md, Michael G. Ciccotti, Md

Phase 1

Introduction: Acromioclavicular (AC) joint separation is a leading cause of shoulder injury among athletes. High grade injuries may require operative fixation, and comprehensive return to play guidelines have not yet been established. The purpose of this investigation is to summarize return to play criteria following operative management of AC joint separation.

Methods: A systematic review of the literature was performed to evaluate clinical evidence regarding return to play following operative management of isolated AC joint separation. Studies satisfying inclusion criteria were analyzed for return to play timeline and other factors used to guide return to play following surgery.

Results: Sixty-three …

Allocation Of Anchors During Labral Repair: A Multicenter Cohort Analysis Of Labral Treatment In Hip Arthroscopy., Ryan P Mcgovern, John J Christoforetti, Benjamin R Kivlan, Shane J Nho, Andrew B Wolff, John P Salvo, Dean Matsuda, Thomas J Ellis, Allston J Stubbs, Dominic S Carreira

Ambulatory and Primary Care Articles

BACKGROUND: While previous studies have established several techniques for suture anchor repair of the acetabular labrum to bone during arthroscopic surgery, the current literature lacks evidence defining the appropriate number of suture anchors required to effectively restore the function of the labral tissue.

PURPOSE/HYPOTHESIS: To define the location and size of labral tears identified during hip arthroscopy for acetabular labral treatment in a large multicenter cohort. The secondary purpose was to differentiate the number of anchors used during arthroscopic labral repair. The hypothesis was that the location and size of the labral tear as well as the number of anchors …

When Do Patients Achieve Promis Milestones Following Anterior Cruciate Ligament Reconstruction?, Kareem Elhage, Nikhil R. Yedull, Nabil Mehta, David N. Bernstein, Eric C. Makhni

Medical Student Research Symposium

National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive test (CAT) assessments have become increasingly utilized within sports medicine due to their efficient administration and favorable correlation with traditional patient reported outcome measures (PROMs). One key advantage of CAT forms is the ability to draw from hundreds of item bank questions while utilizing very few questions in order to produce an accurate quantitative health measurement for the patient.



The Computer Adaptive Tests (CAT) algorithm assigns questions based on previous answers by the patient. The purpose of this study is to utilize this feature of the PROMIS …

Can Opioids Be Eliminated After Arthroscopic Meniscus Surgery? A Prospective Randomized Controlled Trial, Muhammad J. Abbas Bs, Toufic R. Jildeh Md, Kelechi R. Okoroha Md, Noah Kuhlmann Bs, Austin Cross Bs, Vasilios Moutzouros Md

Medical Student Research Symposium

Purpose: To compare a multimodal nonopioid pain protocol to traditional opioid medication in controlling postoperative pain following arthroscopic meniscal surgery.

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 10 days. Secondary outcomes included patient reported outcomes, complications and patient satisfaction. Randomization was achieved using a random number …

Effectiveness Of Two Frequently Used Screening Tools In Identifying Depression And Anxiety In Collegiate Athletes, Adriana C. Isacke Do, Amy Haskins Phd, Christina Holt Md, Msc, Williams Dexter Md, Facsm

Journal of Maine Medical Center

Introduction: To determine whether the Electronic Pre-participation Physical Examination (EPPE), a proprietary and frequently used tool, is an effective method for depression and anxiety screening in the collegiate athlete population as compared to the Patient Health Questionnaire-4 (PHQ-4).

Methods: College athletes at a Division III university completed PHQ-4 questionnaires and a proprietary EPPE. Positive reponse rates to depression and/or anxiety for both questionnaires were collected and analyzed with a kappa (κ) statistic.

Results: Among 420 students, we found that 9 (2%) reported depression and/or anxiety via the EPPE. Of the 26 students (6%) who answered positively on the PHQ-4, we …

Epidemiology Of Concussive Injuries In Collegiate Recreational Athletics, Maddison R. Flowers

College of Graduate Studies: Theses & Dissertations

Background: The epidemiology of concussion in collegiate and high school athletes has been extensively researched. Concussive injury in collegiate recreation, a less supervised sample, is limited. This preliminary study retrospectively examined the incidence and prevalence rates of concussive injuries in intramural and club sports at one institution. Methods: Injury reports were analyzed during the 2016-2019 calendar years. Concussion prevalence, incidence, and odds ratios (reported with 95% CIs) were calculated for intramural and club sports. Results: During the study period, a total of 805 injuries were reported between intramural and club sports with 111 injuries being documented as concussions. Intramural sports …

Anterior Cruciate Ligament Injury Incidence Across Sex, Sport, And Level: A Systematic Review And Meta-Analysis, Dana Anderson

Dissertations, Master's Theses and Master's Reports

Well controlled Anterior Cruciate Ligament (ACL) injury prevention neuromuscular training reduces the risk of ACL injury by 50%, but despite the efficacy of these programs, ACL injury rates have not decreased. This lack of decrease in injury incidence may be due in part to limited knowledge on who is most at risk for sustaining an ACL injury, and there is no formal clinical tool available to estimate the personalized or group risk of ACL injury. The purpose of this study was to better understand what groups of athletes are most at risk of sustaining a primary ACL injury, as the …

Measuring Vastus Medialis Cross-Sectional Area With Panoramic Ultrasound Over Time, Kaitlin Minnehan, Elizabeth Scharnetzki, Kaitlyn Chin, Christina Holt, William Dexter

Costas T. Lambrew Research Retreat 2021

Panoramic ultrasound detected a statistically significant decrease in the VM CSA of participants after 70 days of bedrest without exercise.

Symptomatic Combined Thumb Cmc Arthritis And Slac Wrist: Incidence & Treatment Options, Frank Lalezar, Lawrence C. Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Thumb basal joint osteoarthritis and scapholunate advanced collapse are common degenerative wrist disorders. Surprisingly, literature describing the incidence and treatment of these two disorders in the same wrist is limited. This study sought to determine how often these disorders present concurrently, as well as report on outcomes from a new surgical technique devised to treat these cases.

Are Radiographs Over-Utilized In Pediatric Orthopaedic Emergency Room Care?, Brian Lynch, Stephen Bowen, David E. Komatsu, Wesley Carrion

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: There is an estimated $760 to $935 billion in annual cost of waste in the United States healthcare system. $12.8 to $28.6 billion is attributed to wasteful studies/treatments. In an effort to examine current waste in our institution, we examined the use of radiographs in orthopedic patients evaluated in our pediatric emergency department (ED). The pediatric population is largely unable to make decisions for themselves and thus are susceptible to unneeded studies.

Hypothesis/Purpose: We propose that there is a significant amount of waste, in regard to: time, cost, and resources in the ED. Additionally, we believe that unnecessary studies …

Hip Fractures Before And During The Covid-19 Pandemic: Comparative Demographics And Outcomes, Alireza K. Nazemi, Samer M. Al-Humadi, Ryan Tantone, Thomas R. Hays, Stephen N. Bowen, David E. Komatsu, Nicholas Divaris

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: During the height of the COVID-19 pandemic in NY, hip fractures requiring operative management continued to present to Stony Brook University Hospital. Given the novelty of SARS-CoV-2, there is recent interest in the pandemic and its relationship to orthopaedic operative outcomes.

Purpose: This retrospective cohort study compared outcomes for operative hip fractures in patients prior to and during the COVID-19 pandemic at a Level 1 academic center.

Methods: Data were collected from patients age18 years or older who underwent operative management for hip fractures performed from January 21, 2019 to July 1, 2019 (pre-pandemic) and from January 21, 2020 …

Cost-Effectiveness Of Exercise Medicine For Prostate Cancer, Kim Edmunds

Theses: Doctorates and Masters

Background

Androgen deprivation therapy (ADT) is associated with numerous adverse effects that impact on quality of life and contribute further to the cost burden of prostate cancer (PCa) via treatment and supportive care. Exercise medicine is effective in slowing PCa progression, reversing treatment adverse effects and improving quality of life and survival of patients, however, no economic analyses have been conducted to determine whether exercise is cost-effective in this population.

Objectives

Firstly, to examine the adverse effects of ADT for PCa and the evidence supporting the use of exercise medicine in their management. Secondly, to conduct the first economic evaluations …

Is There A Role For Ct Pan-Scans In The Initial Work-Up Of Fragility Fracture Patients?, Eric Lepkowsky, Trevor Simcox, Hunter Rogoff, Shahidul Islam, Omid Barzideh

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: CT pan-scans have become increasingly commonplace as part of the initial diagnostic work-up for patients sustaining traumatic injuries. They have proven effective in improving diagnostic accuracy in those with high energy mechanisms of injury. However, the utility of pan-scans in the geriatric population sustaining low energy traumatic injuries remains unproven. There is no study that assesses the usefulness of CT pan-scans in patients who sustain injuries related to osteoporosis, also known as fragility fractures.

Methods: A retrospective review was conducted of patients who sustained a fragility fracture at a Level 1 trauma center over a 15-month period. Patients underwent …

Effects Of Alcohol Use On Total Knee Arthroplasty Patient Osteoarthritis Severity, Preoperative Pain Scores, And Postoperative Range Of Motion: A Retrospective Study, Christopher Ruland, Samir Baig, Zach Warheit, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Despite the prevalence of significant alcohol use, the effect of alcohol consumption on patients undergoing total knee arthroplasty (TKA) is poorly understood. Other forms of substance abuse, such as narcotic dependence, decrease patient pain tolerance and increase self-reported pain scores, while excessive alcohol consumption has been associated with adverse outcomes following other elective surgical procedures. In the context of TKA, perception of pain is also likely linked to the ability to achieve functional postoperative range of motion (ROM), one of the most important predictive indicators of patient satisfaction. It is not well understood whether heavy alcohol users who are …

Biomechanical Comparison Of Krackow Open Repair And Percutaneous Achilles Repair System For Achilles Tendon Rupture: A Cadaveric And Finite Element Model Study, David R. Swanson, Alireza Nazemi, Bonnie Macaluso, Chaudhry R. Hassan, Megan Paulus, Yi-Xian Qin, David E. Komatsu

Stony Brook Orthopaedic and Musculoskeletal Journal

Achilles tendon ruptures are one of the most common tendon injuries. Numerous surgical procedures have been developed to repair these injuries, but there is no consensus as to which technique is superior. This combined cadaveric and finite element model study was performed to compare directly initial biomechanical integrity between two operative techniques and use these resulting data to validate a finite element model.

Multicenter Studies In Orthopaedic Trauma: Importance, Challenges, And Stony Brook’S Contributions, Amanda C. Pawlak, Nathan Olszewski, Maxwell Alley, Thomas Seaver, Diana Lee, Michael Doany, Paul Tornetta Iii, Stephen A. Kottmeier, Orthopaedic Trauma Research Consortium

Stony Brook Orthopaedic and Musculoskeletal Journal

Historically, research within the field of orthopaedic surgery has largely consisted of small cohort studies or case series, typically produced out of one single center.1 Multicenter studies, however, allow for larger sample sizes and analyses with greater power and improved generalizability.2 Though these collaborative studies present challenges, including time, cost, communication and authorship issues, the value of these types of studies cannot be overstated.2,3 The Orthopaedic Trauma Research Consortium (OTRC) is one of several multi-institution research groups dedicated to furthering the field of orthopaedic trauma research. This manuscript reviews four recent OTRC studies that Stony Brook provided significant contributions to: …

Supervisor Knowledge, Attitudes, And Interventions Methods Of Burnout Among Healthcare Providers, Wendy Deal

College of Graduate Studies: Theses & Dissertations

Context: Burnout is prevalent among healthcare providers. Research has identified evidence-based intervention and preventative methods for use against burnout. There is limited research surrounding perceptions of burnout among those that supervise healthcare providers. Purpose: To explore supervisors’ knowledge, attitudes, and interventions related to burnout of healthcare providers within a hospital or clinic setting. Design: Consensual qualitative research with emergent design Methods: Eight supervisors were interviewed using a semi-structured interview approach via virtual platform. Participants were asked questions that aimed to capture supervisor perceptions of burnout. Interview transcripts were coded based on categories and themes developed through a consensus process …

Sports Under Quarantine: A Case Study Of Major League Baseball In 2020, Kari L.J. Goold, Reynafe N. Aniga, Peter B. Gray

Anthropology Faculty Research

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This case study entailed a Twitter content analysis to address the pandemic-delayed start to Major League Baseball (MLB) in the shortened 2020 season. This case study helps address the overarching objective to investigate how the sports world, especially fans, responded to MLB played during the 2020 COVID-19 pandemic. The methods investigated the common themes and determined who used predetermined Twitter hashtags. We recorded how many times external links, photos, emojis, and the 30 MLB teams were mentioned in the 779 tweets obtained during 39 days of data retrieval. Results showed that …

Microhemorrhages In Professional Motocross Athletes: A Case Series, Brianna Millsaps, Phillip R. Worts, Scott O. Burkhart, David C. Berg

HCA Healthcare Journal of Medicine

Introduction: Motocross is a sport in which riders race 250–450 cc four-stroke dirt bikes and are potentially subjected to a high frequency of head injuries starting at a very young age. The objective of this case series is to present the findings following gradient echo T2-weighted MRI (SWI) upon clinical evaluation after a concussion in 4 young professional motocross racers.

Clinical Findings: Microhemorrhages were found in 2 of 4 riders. Areas of microhemorrhages were not aligned with a previously positive CT finding from a prior concussion in 1 rider.

Conclusions: Microhemorrhages were found in 2 young motocross riders following a …