Sports Medicine & Arthroscopy Journal Scan

Editor's Pick

Influence of Different Tibial Fixation Techniques on Initial Stability in Single-Stage Anterior Cruciate Ligament Revision With Confluent Tibial Tunnels: A Biomechanical Laboratory Study.

Schliemann B, Treder M, Schulze M, Müller V, Vasta S, Zampogna B, Herbort M, Kösters C, Raschke MJ, Lenschow S.

Arthroscopy. 2015 Sep 11. pii: S0749-8063(15)00575-7. doi: 10.1016/j.arthro.2015.06.044. [Epub ahead of print]

Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather conditions.

Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.

Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments.

Wilderness sports and adventures continue to increase in popularity. Counseling is an essential element of the preparticipation evaluation (PPE) for athletes in traditional sports. This approach can be applied to and augmented for the wilderness athlete and adventurer. The authors reviewed the literature on counseling during PPEs and gathered expert opinion from medical professionals who perform such PPEs for wilderness sports enthusiasts. The objective was to present findings of this review and make recommendations on the counseling component of a wilderness sports/adventure PPE. The counseling component of a PPE for wilderness sports/adventures should take place after a basic medical evaluation, and include a discussion on sport or activity-specific injury prevention, personal health, travel recommendations, and emergency event planning.

PURPOSE:

To determine the effectiveness of proficiency-based progression (PBP) training using simulation both compared with the same training without proficiency requirements and compared with a traditional resident course for learning to perform an arthroscopic Bankart repair (ABR).

METHODS:

In a prospective, randomized, blinded study, 44 postgraduate year 4 or 5 orthopaedic residents from 21 Accreditation Council for Graduate Medical Education-approved US orthopaedic residency programs were randomly assigned to 1 of 3 skills training protocols for learning to perform an ABR: group A, traditional (routine Arthroscopy Association of North America Resident Course) (control, n = 14); group B, simulator (modified curriculum adding a shoulder model simulator) (n = 14); or group C, PBP (PBP plus the simulator) (n = 16).

The Journal of the American Academy of Orthopaedic Surgeons (JAAOS) is the #1 clinical review journal of musculoskeletal education in the world. The peer-reviewed articles presented each month in JAAOS critically evaluate and synthesize current information regarding the diagnosis and management of musculoskeletal conditions and document the current state of orthopaedic practice.

The editorial board of JAAOS represents every subspecialty within orthopaedic medicine: Sports Medicine, Trauma, Pediatric Orthopaedics, Hip and Knee, Spine, Shoulder and Elbow, Hand and Wrist, Foot and Ankle, and Musculoskeletal Oncology, as well as areas of general orthopaedic interest. This diversity of topics is reflected in every issue of the Journal.

Orthopaedic surgeons spend most of their surgical planning thinking about bones and hardware. However, respecting the soft tissues (eg, the skin) is a key factor in promoting healing after orthopaedic surgery, particularly in the setting of trauma or infection. Attending and resident physicians alike often think that they are tying square knots, when in reality they are throwing a series of half hitches in opposite directions, ultimately creating a slip knot. The purpose of this article is to review the nature of a square knot, demonstrate how to tie a square knot, and review the most common error in technique that young surgeons often demonstrate in the operating room.

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