scholarly journals Outcomes following surgical management of inguinal-related groin pain in athletes: a case series

2020 ◽  
Vol 7 (1) ◽  
pp. 103-108
Author(s):  
Michael Gerhardt ◽  
Josh Christiansen ◽  
Benjamin Sherman ◽  
Alejandro Miranda ◽  
William Hutchinson ◽  
...  
Keyword(s):  
Groin Pain ◽  
Surgical Intervention ◽  
Case Series ◽  
Return To Sport ◽  
Scar Tissue ◽  
Nerve Entrapment ◽  
Return To Play ◽  
Retrospective Case ◽  
Operative Findings

Abstract To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Fifty-one athletes treated surgically for inguinal-related groin pain from 2009 to 2015. Limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement based on intra-operative findings. Ability to return to sport at the same level, time to return to play. Fifty-one athletes were included in the study with an average follow-up of 4.42 years (range 2.02–7.01). The average age was 24.2 years (range 16–49) and consisted of 94.0% males and 6.0% females. Nerve entrapment was demonstrated in 96.2% of cases with involvement of the ilioinguinal in 92.5%, the iliohypogastric in 30.8% and the genitofemoral in 13.2%. Attenuation of the posterior inguinal wall was present and repaired in 79.3% of cases. Scar tissue was present around the adductor origin and required debridement in 56.7% of cases. Forty-nine (96.1%) athletes returned to sport at the same level of play at an average of 5.9 weeks. Two athletes required a revision surgery. High rates of return to sport were achieved after surgery for inguinal-related groin pain that addresses the varying pathology and associated nerve entrapment.

scholarly journals Stretching for Recovery from Groin Pain or Injury in Athletes: A Critical and Systematic Review

2021 ◽  
Vol 6 (3) ◽  
pp. 73
Author(s):  
José Afonso ◽  
João Gustavo Claudino ◽  
Hélder Fonseca ◽  
Daniel Moreira-Gonçalves ◽  
Victor Ferreira ◽  
...  
Keyword(s):  
Groin Pain ◽  
Case Series ◽  
Return To Sport ◽  
Return To Play ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Rehabilitation Protocols ◽  
Recovery Protocols ◽  
Meta Analyses ◽  
Specific Contribution

Stretching is usually used as part of rehabilitation protocols for groin pain or injury, but its specific contribution to and within multimodal recovery protocols is unclear. Our goal was to systematically review the effects of stretching for the recovery from groin pain or injury. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, with eligibility criteria defined according to PICOS: (Participants) athletes with groin pain or injuries; (Interventions) interventions with stretching as the differentiating factor; (Comparators) comparators not applying stretching; (Outcomes) symptom remission or improvement and/or time to return to sport and/or return to play; (Study design) randomized controlled trials. Searches were performed on 26 March 2021, in CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science, with no limitations regarding language or date, and no filters. Of 117 retrieved results, 65 were duplicates and 49 were excluded at the screening stage. The three articles eligible for full-text analysis failed to comply with one or more inclusion criteria (participants, intervention and/or comparators). We then went beyond the protocol and searched for non-randomized trials and case series, but no intervention was found where stretching was the differentiating factor. We found no trials specifically assessing the effects of stretching on recovery or improvement of groin pain or injury in athletes. Currently, the efficacy of these interventions is unknown, and more research is warranted.

scholarly journals Outcomes after Elbow Ulnar Collateral Ligament Reconstruction with the Docking Plus Technique in 163 Athletes

2020 ◽  
Author(s):  
Marc Lubitz ◽  
Benjamin Donohue ◽  
Vadim Molla ◽  
Timothy Kremchek
Keyword(s):  
Case Series ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
High Volume ◽  
Return To Play ◽  
College Level ◽  
Collateral Ligament ◽  
Retrospective Case ◽  
Before And After ◽  
High Level

Abstract Background: This retrospective case series examined 163 athletes who underwent ulnar collateral ligament (UCL) reconstruction (UCLR) from 2015-2018. All cases were by a single surgeon at a high volume center using the Docking Plus Technique. We previously reported outcomes in 324 athletes from 2005-2014 with 88% of patients reporting a Conway score of good or excellent. Purpose/Hypothesis: The purpose of this study was to determine if patients undergoing UCLR with the docking plus technique are able to return to sport and to better characterize the athletes needing this procedure. Our hypothesis was that our cohort would largely be able to return to their previous level of play and be mostly college level pitchers. Methods: Patients who underwent UCLR at our institution from 2015-2018 were identified and surveyed. We were able to reach a total of 163 patients and they were asked for background demographic information and information about their athletic careers before and after UCLR. Results: Our results were largely similar to our previously study with 94.5% of athletes obtaining Conway scores of Good or Excellent. 95% of athletes were male, 91% played baseball, and 83% of baseball players were pitchers. 59% of athletes were in college at the time of their surgery. For 8 athletes, this was a revision procedure, 7 of the revisions were for pitchers. 5 of the 7 pitchers were able to get back to the same level or higher of competition. 98.8% of patients surveyed said they were “satisfied with the outcome of the surgery.” Conclusions: The Docking Plus Technique performed by a single surgeon at a private practice setting leads to reproducible return to play and patient satisfaction. The prototypical patient undergoing UCLR is a high level male baseball pitcher. UCL outcomes data would benefit from more prospective studies and the creation of a nationwide UCLR database to draw conclusions about technique, graft type, risk factors, and many more relevant variables.

TP1-1 Endovascular versus surgical management of pericallosal artery aneurysms, single centre experience

2019 ◽  
Vol 90 (3) ◽  
pp. e10.2-e10
Author(s):  
MS Draz ◽  
AK Toma ◽  
S Bezouich ◽  
P Grover
Keyword(s):  
Surgical Intervention ◽  
Case Series ◽  
Artery Aneurysm ◽  
Endovascular Management ◽  
Single Centre ◽  
Retrospective Case ◽  
Surgical Clipping ◽  
Pericallosal Artery ◽  
Single Centre Experience

ObjectivesComparing surgical versus endovascular management of pericallosal artery aneurysm.DesignRetrospective case series.SubjectsPatients managed in our unit for pericallosal artery aneurysms.MethodsPatients medical and radiological records were reviewed collecting data about presentation, management, complications. Clinical outcome was assessed by mRS at 3,6 and 12 months. Imaging were reviewed to report aneurysm size and treatment outcome.ResultsAverage follow up period 3.3 years SD ±3.5. 38 patients had SAH and 19 were incidentally discovered. Initial CT showed SAH in 21 patients, IVH in 3,ICH in 3 IVH and ICH in 9. 33 patients treated using endovascularly, 13 patients conservatively and 2 by surgical clipping. 33% of endovascular group had stroke caused by approach related complications. 41.3% of the patients had mRS (0–2) at 3 months period. Increased to 46.5% at 12 months. Average imaging follow up was 1.5 years (SD ±1.6). 36.3% of endovascular group showed aneurysm remnant filling or recurrence.ConclusionsPericallosal artery aneurysms are complex in nature and both management modalities are challenging. Complications were high in endovascular group. Surgical intervention should be considered in selected patients where complex intervention is required.

scholarly journals Return to Sport after Surgical Treatment of Lisfranc Injuries in Athletes: A Retrospective Case Series

2019 ◽  
Vol 12 (4) ◽  
pp. 141-145 ◽  
Author(s):  
Bryan G. Vopat ◽  
Matthew L. Vopat ◽  
Pim A.D. Van Dijk ◽  
Sean Hazzard ◽  
Kayla McKinnon ◽  
...  
Keyword(s):  
Open Reduction ◽  
Case Series ◽  
Return To Sport ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Lisfranc Injury ◽  
Vein Thrombosis ◽  
Post Surgery ◽  
Average Pain

Introduction A Lisfranc injury can be a devastating injury in athletes,and if inadequately treated, may lead to chronic pain and lossof function. The purpose of this study was to determine the rate andtime until return to sport after surgical fixation for a ligamentous Lisfrancinjury. We hypothesized that open reduction and screw fixationof a ligamentous Lisfranc injury can be a successful treatment in theathletic population and allow patients to return to sport at close totheir preinjury level of play. Methods All patients who were analyzed underwent repair of aligamentous Lisfranc injury with open reduction and screw fixationby a single surgeon, were between 18 - 40 years old at time of theirfinal follow up, and were identified as being an athlete (either recreationalor competitive). Eligible patients were given a questionnairethat included if they were able to return to sport, time until return tosport, subjective percentage of pre-injury level of play, current pain(0 - 10), and complications. Results Eleven patients were identified as athletes. Ten (91%) wereavailable for follow-up with a mean of 36.5 months (range, 14 - 60).The average age was 25.4 years (range, 15 - 37) at time of surgery.Eighty percent (8/10) were able to return to sport. The average timeuntil return to sport was 29.4 weeks (range, 22 - 52) with an averagesubjective value of their pre-injury level of play of 87% (range, 70 -100%). However, 67% (6/9) of the athletes had occasional pain withsport with an average pain level of 2.1 (range, 0 - 5). Two patientshad complications, a superficial infection and a deep vein thrombosis. Conclusion Most athletes were able to return to sport after undergoingopen reduction and internal fixation of a ligamentous Lisfrancinjury by less than 30 weeks post-surgery with a subjective value of87% of their previous function. However, the majority of the patientsalso experienced some residual pain with their respective sport.These findings suggested that athletes with a ligamentous Lisfrancinjury can have reliably good outcomes with operative repair.

scholarly journals Femur Fractures in Professional Athletes: A Case Series

2015 ◽  
Vol 50 (4) ◽  
pp. 442-448 ◽  
Author(s):  
Robby Sikka ◽  
Gary Fetzer ◽  
Thomas Hunkele ◽  
Eric Sugarman ◽  
Joel Boyd
Keyword(s):  
Case Series ◽  
Return To Sport ◽  
Return To Play ◽  
Professional Athletes ◽  
Retrograde Nailing ◽  
Retrograde Intramedullary Nail ◽  
Femur Fractures ◽  
Previous Level ◽  
Significant Injury

Objective To discuss return to play after femur fractures in several professional athletes. Background Femur fractures are rare injuries and can be associated with significant morbidity and mortality. No reports exist, to our knowledge, on return to play after treatment of isolated femur fractures in professional athletes. Return to play is expected in patients with femur fractures, but recovery can take more than 1 year, with an expected decrease in performance. Treatment Four professional athletes sustained isolated femur fractures during regular-season games. Two athletes played hockey, 1 played football, and 1 played baseball. Three players were treated with anterograde intramedullary nails, and 1 was treated with retrograde nailing. All players missed the remainder of the season. At an average of 9.5 months (range, 7–13 months) from the time of injury, all athletes were able to return to play. One player required the removal of painful hardware, which delayed his return to sport. Final radiographs revealed that all fractures were well healed. No athletes had subjective complaints or concerns that performance was affected by the injury at an average final follow-up of 25 months (range, 22–29 months). Uniqueness As the size and speed of players increase, on-field trauma may result in significant injury. All players returned to previous levels of performance or exceeded previous statistical performance levels. Conclusions In professional athletes, return to play from isolated femur fractures treated with either an anterograde or retrograde intramedullary nail is possible within 1 year. Return to the previous level of performance is possible, and it is important to develop management protocols, including rehabilitation guidelines, for such injuries. However, return to play may be delayed by subsequent procedures, including hardware removal.

scholarly journals The Treatment and Outcomes of Medial Malleolar Stress Fractures

2014 ◽  
Vol 6 (6) ◽  
pp. 527-530 ◽  
Author(s):  
Val Irion ◽  
Timothy L. Miller ◽  
Christopher C. Kaeding
Keyword(s):  
Stress Fracture ◽  
Treatment Options ◽  
Case Series ◽  
Return To Sport ◽  
Stress Fractures ◽  
Return To Play ◽  
Cochrane Library ◽  
Medial Malleolus ◽  
Retrospective Case ◽  
Level Of Evidence

Context: The medial malleolus is considered a high-risk stress fracture and can be debilitating to the highly active or athletic populations. A range of treatment methods have been described with varying outcomes. Currently, there is no gold standard treatment option with optimal results described. Objective: A systematic search of the literature to determine treatment options and outcomes in medial malleolus stress fractures. Data Sources: OVID/Medline, EMBASE, and the Cochrane Library from 1950 to September 2013. Study Selection: Included studies mentioned treatment and outcomes of medial malleolus stress fractures. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: The searches used combinations of the terms stress fracture, medial malleolus, management, and treatment. Two authors independently reviewed the selected articles and created individual tables, which were later compiled into a master table for final analysis. Results: Six retrospective case series were identified (n = 31 patients). Eighty percent (25/31) of patients were men, with an average age of 24.5 years. Ninety percent (28/31) of patients were at least involved in recreational athletics. All patients were able to return to sport. Complications were seen in both groups ranging from minor stiffness to nonunion requiring open reduction internal fixation. Conclusion: Nonoperative and operative interventions have proven to be successful with regard to healing and return to play for medial malleolar stress fractures in the recreational and competitive athlete. However, early operative intervention can possibly create a higher likelihood of early healing, decrease in symptoms, and return to play.

scholarly journals Outcomes after Elbow Ulnar Collateral Ligament Reconstruction with the Docking Plus Technique in 162 Athletes (129)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0027
Author(s):  
Marc Lubitz ◽  
Vadim Molla ◽  
Timothy Kremchek
Keyword(s):  
High School ◽  
Case Series ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
High Volume ◽  
Return To Play ◽  
College Level ◽  
Collateral Ligament ◽  
Retrospective Case ◽  
Elbow Pain

Objectives: This retrospective case series examined 162 athletes who underwent ulnar collateral ligament (UCL) reconstruction (UCLR) from 2015-2018. All cases were by a single surgeon at a high volume center using the Docking Plus Technique. We previously reported outcomes in 324 athletes from 2005-2014 with 88% of patients reporting a Conway score of good or excellent. The purpose of this study was to determine if patients undergoing UCLR with the docking plus technique are able to return to sport and to better characterize the athletes needing this procedure. Our hypothesis was that our cohort would largely be able to return to their previous level of play and be mostly college level pitchers. Methods: Patients who underwent UCLR at our institution from 2015-2018 were identified and surveyed. We were able to reach a total of 162 patients by telephone for a survey. They were surveyed for subjective and objective outcomes and for background demographic information including information about their athletic careers before and after UCLR. Results: Of our 162 respondents, 150 (93%) returned to the same level of play or higher (excellent on Conway classification). 9 did not return to competitive play (6%) while 3 returned to a lower level of play. 5 of those who did not return to competitive play had their surgery senior year of college. Most athletes were in college at the time of surgery (61%), followed by high school (32%). 2 athletes were in middle school, the rest were playing professionally. Baseball pitchers compromised the majority of our respondents (75%). Catchers were 9% of respondents and infielders/outfielders were 3% each. Other athletes participated in cheerleading, lacrosse, track, volleyball, gymnastics, wrestling, and football, though these were far less common. The mean and median ages of survey respondents was 19 (12-31). 61% described an acute “pop” leading to their elbow pain while 39% endorses no acute event but chronic elbow pain leading to presentation. Of the 61% presenting with an acute rupture, 40% endorsed an “acute on chronic,” presentation. 58% of baseball players played more than just baseball in high school while 41% had specialized in just baseball. The average return to competitive play was 12 months, with a range of 4-24. The range for pitchers was 9-24 with an average of around. Conclusions: Overall, our results mirror those of previous studies. 93% of our patients returned to the same level of competition or higher after undergoing UCLR with the docking plus technique. Most of those who did not return were college seniors who graduated. Our typical patient was a college baseball pitcher around 19 years old. Return to play with our set rehab protocol was around 1 year, though faster for non-pitchers. The docking plus technique provides reliable treatment for chronic or acute UCL tears in athletes.

scholarly journals THU0319 DEVELOPMENT AND OUTCOME OF AORTIC COMPLICATIONS DURING TOCILIZUMAB TREATMENT OF GCA AND HISTOPATHOLOGIC EVIDENCE OF RESIDUAL INFLAMMATION-A CASE SERIES.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 388.2-389
Author(s):  
A. Rubbert-Roth ◽  
P. K. Bode ◽  
T. Langenegger ◽  
C. Pfofe ◽  
T. Neumann ◽  
...  
Keyword(s):  
Structural Changes ◽  
Case Series ◽  
Aortic Aneurysms ◽  
Imaging Data ◽  
Limited Data ◽  
Retrospective Case ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Background:Giant cell arteritis (GCA) may affect the aorta and the large aortic branches and lead to dissections and aortic aneurysms. Tocilizumab (TCZ) treatment has the capacity to control aortic inflammation as has been demonstrated by CRP normalization and imaging data. However, limited data are available on the histopathological findings obtained from patients who underwent surgery because of aortic complications during TCZ treatment.Objectives:We report on 5 patients with aortitis who were treated with TCZ and developed aortic complications.Methods:We describe a retrospective case series of patients with GCA treated with TCZ, who presented in our clinic between 2011 and 2019. Three patients underwent surgery. Histopathologic examination was performed in specimen from all of them.Results:Five female patients were diagnosed with GCA (4/5) or Takaysu arteritis (1/5) involving the aorta, all them diagnosed by MR angiography and/or FDG PET CT scan. Three patients (one with aortic aneurysm, one with dissection) underwent surgery after having been treated with TCZ for seven weeks, nine months and four years, respectively. Imaging before surgery showed remission on MRI and/or PET-CT in all cases. At the time of surgery, all patients showed normalized CRP and ESR values. Histopathological evaluation of the aortic wall revealed infiltrates, consisting predominantly of CD3+CD4+ T cells. Enlargement of pre-existing aneuryms was observed in the other two patients 10 weeks and 4 months after discontinuation of TCZ, respectively. Both patients were not eligible for surgical intervention and died during follow-up.Conclusion:Our case series suggests that during treatment with TCZ, regular imaging is necessary in this patient population to detect development of structural changes such as aneurysms or dissections. Despite treatment, residual inflammation might persist which could contribute to eventual aortic complications.Disclosure of Interests:Andrea Rubbert-Roth Consultant of: Abbvie, BMS, Chugai, Pfizer, Roche, Janssen, Lilly, Sanofi, Amgen, Novartis, Peter Karl Bode: None declared, Thomas Langenegger: None declared, Claudia Pfofe: None declared, Thomas Neumann: None declared, Olaf Chan-Hi Kim: None declared, Johannes von Kempis Consultant of: Roche

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2021 ◽  
pp. 107110072199542
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph O’Neil ◽  
Steven Raikin
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Return To Sport ◽  
Osteochondral Lesions ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Additional Surgery ◽  
Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

scholarly journals Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

2021 ◽  
Author(s):  
Gabriele Colo’ ◽  
Mattia Alessio Mazzola ◽  
Giulio Pilone ◽  
Giacomo Dagnino ◽  
Lamberto Felli
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Deformity Correction ◽  
Tibialis Posterior ◽  
Open Wedge ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

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