scholarly journals Performance and Return to Sport After Open Fracture in National Football League Players

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110278
Author(s):  
Michael O. Cotton ◽  
Joseph M. Sliepka ◽  
Derek M. Klavas ◽  
Patrick C. McCulloch ◽  
Joshua D. Harris ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Open Fracture ◽  
National Football League ◽  
Return To Sport ◽  
Open Fractures ◽  
Level Of Evidence ◽  
Paired Samples ◽  
Career Length ◽  
And Control

Background: Open fractures are debilitating injuries for athletes. No prior studies have investigated open fractures in National Football League (NFL) players. Purpose: To compare outcomes after open fracture in NFL players in terms of (1) time to return to sport (RTS), (2) postinjury career length and games played per season, (3) postinjury performance, and (4) postinjury performance compared with matched controls. Study Design: Retrospective comparative series; Level of evidence, 3. Methods: Publicly available records were used to identify NFL players who had sustained an open fracture between 1970 and 2018. Controls were matched to injured players by age, experience, position, and preinjury performance. RTS was defined as playing in at least 1 NFL game after open fracture. Comparisons between injured and control players were made using the paired-samples Student t test. Results: Injuries in 37 players were analyzed (age, 27.2 ± 3.6 years; experience, 4.4 ± 3.6 seasons).  The 3 most common locations for open fracture were the tibia/fibula (n = 16), hand/finger (n = 12), and forearm/wrist (n = 3). A total of 30 (81%) players had a mean time of RTS of 9.3 ± 8.2 months after open fracture; of these players, 4 (13.3%) who sustained hand/finger open fracture did not undergo surgical treatment. There was no difference in postinjury career length or games played per season between control and injured players. Postinjury performance was similar to preinjury performance in injured players, and postinjury performance scores were similar between injured and control players. There were significant differences between players who sustained upper extremity and lower extremity open fractures in RTS time (4.0 ± 4.8 vs 14.6 ± 7.4 months, respectively; P = .00007) and postinjury performance (6.4 ± 4.3 vs 3.3 ± 2.1, respectively; P = .03). Conclusion: RTS after open fracture among NFL players was high. Players who sustained an open fracture had similar games played per season, career length, and performance compared with matched controls. Players who sustained an upper extremity open fracture had a faster RTS time, higher RTS rate, and improved postinjury performance compared with players who sustained a lower extremity open fracture.

scholarly journals Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha
Keyword(s):  
Lower Extremity ◽  
National Football League ◽  
Field Performance ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
And Control

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.

Clinical factors and mortality rates for non-traumatic upper extremity amputations

2021 ◽  
pp. 175319342110427
Author(s):  
Yong-Zheng Jonathan Ting ◽  
An-Sen Tan ◽  
Chi-Peng Timothy Lai ◽  
Mala Satku
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Significant Risk ◽  
Arterial Disease ◽  
Mortality Rates ◽  
Level Of Evidence ◽  
Peripheral Arterial ◽  
Extremity Amputation

Non-traumatic upper extremity amputations are an increasing concern with the rising prevalence of diabetes mellitus. To ascertain the risk factors and mortality rates for these amputations, the demographic information, amputation history, comorbidities and clinical outcomes of 140 patients who underwent non-traumatic upper extremity amputations between 1 January 2004 and 31 October 2017 were studied. Correlations were assessed using Cochran-Armitage chi-squared tests, odds ratios and multivariate binomial logistic regression as appropriate. Diabetes mellitus, coronary artery disease, end-stage renal failure, peripheral arterial disease and prior lower extremity amputation were significant risk factors for multiple upper extremity amputations. One-year, 2-year and 5-year mortality rates were 12%, 15% and 38%, respectively, following first upper extremity amputation. The risk factors for upper extremity amputations correspond with those for lower extremity amputations, comprising mainly diabetes mellitus and its related comorbidities. The mortality rates for non-traumatic upper extremity amputations highlight their significant burden on patients. Level of evidence: III

scholarly journals Performance and Return to Sport After Thumb Ulnar Collateral Ligament Surgery in National Football League Players

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Kyle R. Sochacki ◽  
Robert A. Jack ◽  
Richard Nauert ◽  
Shari R. Liberman ◽  
Patrick C. McCulloch ◽  
...  
Keyword(s):  
National Football League ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
High Rate ◽  
Collateral Ligament ◽  
Postoperative Performance ◽  
Paired Samples ◽  
Significant Difference ◽  
Postoperative Time ◽  
And Performance

Background: Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair of complete tears has yielded excellent results in elite athletes. Methods: National Football League (NFL) players who underwent thumb UCL surgery and matched controls were identified. Demographic and performance data were collected. Performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in at least 1 NFL game after thumb UCL surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Results: Twenty-three players were identified (mean age: 28.8 ± 3.4 years and mean experience in the NFL: 5.9 ± 3.4 years). Twenty-two players (95.7%) were able to return to sport in the NFL at an average of 132.2 ± 126.1 days. The overall 1-year NFL career survival rate of players undergoing thumb UCL surgery was 87.0%. There was not a statistically significant decrease in games per season and career length for any position following surgery. No positions had a significant difference in postoperative performance when compared with preoperative performance, and there was no significant performance difference postoperatively when compared with matched controls. Conclusions: There is a high rate of RTS in the NFL following thumb UCL surgery. Players who underwent thumb UCL surgery played in a similar number of games per season and had similar career lengths in the NFL as controls. No position group had any significant postoperative performance score differences when compared with postindex matched controls.

Performance and Return to Sport After Tommy John Surgery Among Major League Baseball Position Players

2018 ◽  
Vol 46 (7) ◽  
pp. 1720-1726 ◽  
Author(s):  
Robert A. Jack ◽  
Matthew B. Burn ◽  
Kyle R. Sochacki ◽  
Patrick C. McCulloch ◽  
David M. Lintner ◽  
...  
Keyword(s):  
Major League Baseball ◽  
Return To Sport ◽  
High Rate ◽  
Position Change ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Postoperative Performance ◽  
Career Length ◽  
Major League ◽  
Tommy John

Background: The anterior bundle of the medial ulnar collateral ligament (UCL) is the primary restraint to valgus stress at the elbow and is often injured among overhead throwing athletes. Despite prevention strategies, injuries to the elbow UCL are on the rise. Purpose: To determine (1) the return-to-sport (RTS) rate of Major League Baseball (MLB) position players after elbow medial UCL reconstruction, (2) postoperative career length and games per season, (3) pre- and postoperative performance, (4) postoperative performance versus matched control players, and (5) whether position players changed positions after UCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: MLB players who underwent elbow UCL reconstruction were identified (cases). Demographic and performance data were collected for each player. Matched controls were identified. RTS in MLB was defined as playing in at least 1 MLB game after UCL reconstruction. Comparisons between case and control groups and pre- and postoperative time points were made via paired samples Student t tests. Results: Thirty-three players (34 surgical procedures) were identified with a mean ± SD age of 30.2 ± 4.2 years and a mean experience in the MLB of 6.3 ± 3.9 years at the time of surgery. Twenty-eight players (84.8%) were able to RTS in MLB at a mean 336.9 ± 121.8 days. However, players ≥30 years old demonstrated a significantly lower RTS rate (53.3%) than players <30 years old (89.4%; P < .05). Catchers had a significantly shorter postoperative career length (2.8 ± 1.8 years) versus matched controls (6.1 ± 1.9 years; P < .05). Outfielders had a significantly lower wins above replacement postoperatively (0.8 ± 0.7) versus preoperatively (1.5 ± 1.1; P < .05). There were no performance differences between cases and matched controls. Twelve players (48%) returned to a different position postoperatively. Conclusion: The RTS rate for MLB position players after elbow UCL reconstruction is similar to that of pitchers. Catchers had a significantly shorter career length than that of matched controls. Outfielders performed worse postoperatively versus preoperatively. There is a high rate of position change after Tommy John surgery for infielders and outfielders.

scholarly journals Return-to-Sport Criteria After Upper Extremity Surgery in Athletes—A Scoping Review, Part 2: Ulnar Collateral Ligament of the Elbow Procedures

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110218
Author(s):  
Rebecca Griffith ◽  
Ioanna K. Bolia ◽  
Nickolas Fretes ◽  
Iain R. Murray ◽  
John Meyer ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Upper Extremity ◽  
Scoping Review ◽  
English Language ◽  
Physical Therapists ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Meta Analyses

Background: There is a lack of consensus to guide patient return to sport (RTS) after elbow ulnar collateral ligament surgery (eUCLS). Purpose: To describe the reported RTS criteria after eUCLS in the athletic population. Study Design: Scoping review; Level of evidence, 4. Methods: This scoping review was performed by adhering to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Scoping Review) guidelines. We searched 5 electronic databases (MEDLINE, Scopus, SPORTDiscus, Embase, Google Scholar Advanced) and the gray literature for English-language studies that reported at least 1 RTS criterion in athletes after eUCLS. Data were extracted and summarized as frequencies or arithmetic mean and standard deviation. Results: Included were 14 studies and 1335 athletes with a mean age of 21.4 ± 1.1 years. Time from surgery (range, 6-16 months) was the most common RTS criterion used, and it was reported by all 14 of the included articles. RTS criteria reported less often were pain (3/14; 21%), successful completion of a throwing program (3/14; 21%), muscle strength of the forearm muscles (1/14; 7%), and “normal” range of motion and muscle strength of the elbow and shoulder joints on the operated upper extremity (1/14; 7%). All studies used 1 to 5 of the above RTS criteria. Conclusion: Only 14 studies reported 1 or more RTS criteria after eUCLS in athletes, and time was the most common RTS criterion used. Our results highlight the need for a coordinated effort among surgeons, physical therapists, and athletic trainers in order to establish evidence-based RTS criteria after eUCLS in athletes so athletes can safely to sport and prolong their athletic careers.

Clinical Outcomes of Patients With Anterior Shoulder Instability and Glenolabral Articular Disruption Lesions: A Retrospective Comparative Study

2020 ◽  
Vol 48 (14) ◽  
pp. 3472-3477
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Christopher A. Colasanti ◽  
John P. Scanlon ◽  
Mohamed Gaafar ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Return To Sport ◽  
Return To Play ◽  
Anterior Shoulder Instability ◽  
Control Group ◽  
Control Groups ◽  
Level Of Evidence ◽  
Significant Difference ◽  
And Control

Background: Anterior shoulder instability is a common clinical condition that often requires surgical stabilization. Glenoid labral tears are often associated with instability, with glenolabral articular disruption (GLAD) lesions occasionally being identified arthroscopically during repair, particularly in collision athletes. Purpose: To evaluate the clinical outcomes and recurrence rates in patients who had GLAD lesions and underwent arthroscopic Bankart repair (ABR) and compare them with a control group without GLAD lesions. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of patients who underwent ABR with GLAD lesions, by a single surgeon between July 2012 and March 2017, was performed. Additionally, these were pair matched in a 2:1 ratio for age, sex, sport, and level of play with a control group who underwent ABR without GLAD lesions. Return to sport, the level of return, and the timing of return were assessed. The visual analog scale (VAS) for pain score, Rowe score, Shoulder Instability–Return to Sport after Injury (SIRSI) score, and Subjective Shoulder Value (SSV) were evaluated. Results: The study included a total of 66 patients (22 and 44 patients for the GLAD and control groups, respectively), with a mean age of 25.8 years and a mean follow-up of 66 months. Overall, there was no significant difference in any of the clinical outcome scores (VAS, Rowe, SIRSI, and SSV) utilized for the GLAD and control groups ( P > .05 for all). Similarly, there was no significant difference in the total rate of return to play (90.9% vs 88.6%; P > .99) or return at the same/higher level (68.2% vs 72.7%; P = .78). There was no significant difference in timing of return to play (6.3 ± 6.6 months vs 6.4 ± 2.5 months; P = .98). There were 3 cases (13.6%) requiring further surgery (1 revision stabilization, 1 arthroscopic release, and 1 rotator cuff repair) in the GLAD group and 2 cases (4.5%) requiring further surgery (both revision stabilization) in the control group; the difference was not statistically significant ( P = .32). Conclusion: After arthroscopic repair, patients with GLAD lesions had similar midterm outcomes when compared with a control group without GLAD lesions.

scholarly journals Performance and Return to Sport After Forearm Fracture Open Reduction and Internal Fixation in National Football League Players

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 682-688 ◽  
Author(s):  
Kyle R. Sochacki ◽  
Robert A. Jack ◽  
Takashi Hirase ◽  
Patrick C. McCulloch ◽  
David M. Lintner ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
National Football League ◽  
Forearm Fracture ◽  
Return To Sport ◽  
High Rate ◽  
Forearm Fractures ◽  
Postoperative Performance ◽  
Paired Samples ◽  
Significant Difference

Background: Forearm fractures are one of the most common upper extremity injuries requiring surgery in professional football. Surgical fixation of forearm fractures may speed recovery and decrease games missed in football. Methods: National Football League (NFL) players who underwent forearm fracture open reduction and internal fixation (ORIF) were identified. Matched controls (position, age, experience, performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in a single NFL game after surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Results: Thirty-six surgeries were analyzed following ORIF. Thirty-three were able to RTS in the NFL at an average of 152.1 + 129.8 days. Controls had a significantly longer NFL career ( P < .001) and played in significantly more games per season ( P = .026) than players who underwent surgery. There was a significant ( P = .013) decrease in games/season for DBs following surgery. No significant difference was seen in postoperative performance scores compared with preoperative scores among any positions, nor in postoperative and postindex performance scores compared with matched controls. Conclusion: There is a high rate of RTS in the NFL following forearm fracture ORIF. Following surgery, players’ careers were 1 year shorter and played nearly 2 fewer games per season than matched controls. Games per season following surgery was significantly lower among DBs when compared with presurgery. Postoperative performance scores were not significantly different compared with preoperative and when compared with matched controls.

A Review of the Exoskeleton and Human Augmentation Technology

2008 ◽  
Author(s):  
H. Kazerooni
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Dynamic Systems ◽  
Plenary Talk ◽  
Human Power ◽  
Systems And Control ◽  
The Future ◽  
Ann Arbor ◽  
And Control ◽  
Human Augmentation

This paper is written for the plenary talk of 2008 ASME Dynamic Systems and Control Conference in Ann Arbor Michigan and gives an overview of the exoskeleton technology and human augmentation. Human-Robot integration outlines the future of robotics. The technology associated with exoskeleton systems and human power augmentation can be divided into lower extremity exoskeletons and upper extremity exoskeletons. The reason for this was two-fold; firstly, one could envision a great many applications for either a stand-alone lower or upper extremity exoskeleton in the immediate future. Secondly, and more importantly, the reason for the division is that it is unclear if an integrated upper extremity-lower extremity exoskeleton is a scientifically-valid concept in logistical operations (i.e., lifting and carrying heavy objects).

scholarly journals Lower Extremity Compartment Syndrome in National Football League Athletes

2021 ◽  
Vol 13 (2) ◽  
pp. 198-202
Author(s):  
Joseph D. Lamplot ◽  
Dean Wang ◽  
Leigh J. Weiss ◽  
Michael Baum ◽  
Kristina Zeidler ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Compartment Syndrome ◽  
National Football League ◽  
Case Series ◽  
Epidemiological Data ◽  
High Rate ◽  
Return To Play ◽  
Level Of Evidence ◽  
Injury Surveillance System ◽  
Record System

Background: The purpose of this study was to evaluate the incidence of lower extremity compartment syndrome in National Football League (NFL) athletes and report the mechanisms of injury, methods of treatment, and subsequent days missed. We review the existing literature on lower extremity compartment syndrome in athletic populations. Hypothesis: Lower extremity compartment syndrome occurs with a low incidence in NFL athletes, and there is a high return-to-play rate after surgical management of acute compartment syndrome. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of recorded cases of lower extremity compartment syndrome from 2000 to 2017 was performed using the NFL Injury Surveillance System and electronic medical record system. Epidemiological data, injury mechanism, rates of surgery, and days missed due to injury were recorded. Results: During the study period, 22 cases of leg compartment syndrome in 21 athletes were recorded. Of these injuries, 50% occurred in games and 73% were the result of a direct impact to the leg. Concomitant tibial fracture was noted in only 2 cases (9.1%) and there was only 1 reported case of chronic exertional compartment syndrome. Surgery was documented in 15 of 22 cases (68.2%). For acute nonfracture cases, the average time missed due to injury was 24.2 days (range, 5-54 days), and all were able to return to full participation within the same season. Conclusion: NFL athletes with acute leg compartment syndrome treated with surgery exhibited a high rate of return to play within the same season. Clinical Relevance: Although compartment syndrome is a relatively rare diagnosis among NFL players, team physicians and athletic trainers must maintain a high index of suspicion to expediently diagnose and treat this potentially limb-threatening condition.

scholarly journals Epidemiology of Figure Skating Injuries: A Review of the Literature

2018 ◽  
Vol 10 (6) ◽  
pp. 532-537 ◽  
Author(s):  
Julie S. Han ◽  
Ellen T. Geminiani ◽  
Lyle J. Micheli
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Overuse Injury ◽  
Overuse Injuries ◽  
Similar Proportion ◽  
Figure Skating ◽  
Ankle Sprains ◽  
Level Of Evidence ◽  
Acute Injuries ◽  
Extremity Injuries

Context: As the popularity and technical demands of figure skating increase, so will the number of athletes presenting with sport-related problems. Evidence Acquisition: Searches were performed across PubMed from 1980 to 2017. The keywords searched were skating, skaters, incidence, and injuries. The search was limited to English-language articles and human participants. Relevant articles were cross-referenced. Study Design: Clinical review. Level of Evidence: Level 5. Results: Previous studies suggest an increase in incidence of figure skating injuries from 1982 to 2003. When combining all disciplines of figure skating, there is a similar proportion of acute and overuse injuries. Within disciplines, overuse injuries appear to be more common in singles skating, while acute injuries are more common in pairs skating, ice dancing, and synchronized skating. Lower extremity injuries are more common than upper extremity injuries in all disciplines, and pairs skating accounts for the majority of upper extremity injuries. Ankle sprains are the most common skating injury, and patellar tendinitis is the most common overuse injury across all disciplines. Stress fractures are the most common overuse injury in female singles skaters. Conclusion: The predominance of overuse injuries in singles disciplines reflects their increasing technical difficulty, with more difficult jumps and longer training hours. Partner disciplines are more likely to involve acute injuries and upper extremity injuries due to high-risk throws and lifts. Emphasis should be placed on properly fitting skating boots, intrinsic foot and ankle strengthening, and lower extremity flexibility, which may prevent many of the common lower extremity and back injuries in figure skating.

Sign in / Sign up

Export Citation Format

Share Document