Rotator Cuff Repair Techniques

Posted February 24, 2014 by Orthopaedic Specialists

Your rotator cuff includes your shoulder muscles and tendons that allow your shoulder to move and keep your arm stable.

Sometimes your rotator cuff gets torn, either from an injury, or wear and tear that happens over an extended period of time.

If your rotator cuff is injured, you may need rotator cuff repair. This can involve orthopedic surgery to fix your torn rotator cuff.

What is better for rotator cuff repair? A double row suture bridge (transosseous equivalent) rotator cuff repairs or single row repairs?

At Orthopaedic Specialists, I use a double row suture bridge (transosseous equivalent) repair. The repair gives multiple points of contact between the rotator cuff and the footprint of the (more…)

The High Cost of Hockey Injuries

Posted February 18, 2014 by Orthopaedic Specialists

NHL Injuries Come with High Costs

The fiscal importance of sports injury prevention is emphasized in a recent medical study by Dr. Michael Cusimano at Toronto’s St. Michael’s Hospital. National Hockey League (NHL) teams and their insurance companies paid over $650 million in salary to NHL players who were unable to play due to sports injuries.

Common hockey injuries for the players including sports injuries like concussions. Over a three year period the cost of concussions averaged around $218 million per year. About half of the hockey players missed one NHL game or more due to hockey injuries. (more…)

Louisville Orthopedic Emphasizes Dangers of Concussions in Sports

Posted February 13, 2014 by Orthopaedic Specialists

Concussions in Sports are a Serious Problem

The long term effects of concussions in sports are being recognized and concussion treatment and prevention is being intensively studied. The NFL settled a lawsuit with retired NFL players for 765 million dollars over concussion related brain injuries and the NCAA is currently in mediation regarding the same topic. It is estimated that there are 1.6 to 3.8 million sports-related concussions that occur annually in the United States.

An important study tool was recently developed by Simbex, a company which focuses on research and development in the area of bio-mechanical feedback. The study tool is the Head Impact Telemetry system (HIT). It was developed by Dr. Joseph “Trey” Crisco who is a Professor of Orthopedics and Director of the Bio-engineering Lab at Brown University and Dr. Richard Greenwald, co-founder of Simbex. (more…)

The Societal and Economic Impact of the Anterior Cruciate Ligament Tear

Posted February 11, 2014 by Orthopaedic Specialists

What is the cost in both societal and economic impact of the anterior cruciate ligament tear? Is there a difference in cost when comparing patients who have undergone an ACL reconstruction versus more conservative treatment?

cheerleading and sports injuries like an anterior cruciate ligament tear

An outstanding study published in the October 2013 issue of the Journal of Bone and Joint Surgery compared a cost analysis of an ACL reconstruction versus a structured rehab program. The authors, Drs. Richard Mather et al. found that in the short to intermediate term (6 years) ACL reconstruction was both less costly and more effective than rehab without reconstruction.

In the short term, the ACL reconstruction was $4,503 dollars less than structured rehab and in the long term the surgical group provided a savings of $50,417 dollars.

Effectiveness was expressed as quality – adjusted life years gained. The operative group had an improvement of .72 compared to the rehabilitation group.

Anterior Cruciate Ligament Tear – Reduce Costs Through ACL Reconstruction & ACL Injury Prevention

The authors concluded that the ACL reconstruction is the most cost effective treatment strategy for people suffering from an ACL tear. Based on this research, ACL reconstruction offers a reduction in societal costs when compared to rehabilitation, when indirect fctors including things like the ability to work and individual earnings are taken into consideration.

These findings underscore the substantial cost of an ACL tear over a lifetime. It is advisable that more resources should be directed to creating innovations that help reduce the number of ACL injuries that happen every year. (more…)

Is Exercise a Good Intervention for Some People with Osteoarthritis of the Knee?

Posted February 3, 2014 by Orthopaedic Specialists

A recent medical article published in the International SportMed Journal examined whether exercise was a favorable treatment for knee osteoarthritis. Osteoarthritis of the knee is a common joint condition that happens when the cartilage in a person’s knee wears down. This progressive degenerative condition tends to happen gradually over time and is more common in people as they age. According to the American Academy of Orthopaedic Surgeons (AAOS), osteoarthritis of the knee is the most common type of knee arthritis.

Examining results from 91 different research studies, scientists Dr. Matthew Rogers and Dr. Stuart Semple found that based on the literature, certain types of exercise may be very beneficial for people with osteoarthritis of the knee.

Which Exercises May Benefit People with Osteoarthritis of the Knee?

Exercises that may be good for people with knee osteoarthritis include resistance training, cycling, walking, Tai Chi, balance training, and agility exercises. These activities were found to reduce symptoms and improve overall functioning for people suffering from knee osteoarthritis. (more…)

Diabetes and Shoulder Pain

Posted January 21, 2014 by Orthopaedic Specialists

Why Do People With Diabetes Have Increased Stiffness and Pain with Shoulder Injuries?

The standard theory trying to explain why people with diabetes experience more pain and stiffness from shoulder injuries has been related to the increase in sugar or increased glycosylation of the connective tissue. However, there have been studies that show that increased glycosylation or control of a diabetic patient’s blood sugar has no effect on changing the incidence of adhesive capsulitis in diabetic patients. What is behind the connection between diabetes and shoulder pain?

A study published in the November 2013 issue of the Journal of Shoulder and Elbow looked at the interleukin 1beta levels in the subacromial fluid of people with and without diabetes. Drs. Sui et al. found a statistically significant increase of interleukin 1beta levels in diabetic patients.

This research has opened the door for other studies looking at diabetes and shoulder pain. Future research will focus on determining if a reduction of the interleukin 1 beta levels will help reduce the amount of stiffness and pain that insulin diabetic patients experience with shoulder injuries.

Concussions in Football – Does Type of Helmet or Mouth-Guard Make a Difference?

Posted January 13, 2014 by Orthopaedic Specialists

New data looking at football helmet type and brand disproves the fact that certain helmet companies are claiming that their brand is more likely to prevent concussions than others. Three common helmet brands: Ridell, Schutt, and Xenith were studied by authors Dr. Timothy McGuine et al. at the University of Wisconsin-Madison Health Sports Medicine Center. Results from this research was presented at the American Orthopedic Sports Medicine Annual Meeting in July 2013, in Chicago, Illinois.

Renee Blisard Buddle with the Journal of Orthopedics Today interviewed Dr. Timothy McGuine for the November, 2013 issue. She wrote an outstanding article in which she noted that Dr. McGuine studied three football helmet brands (Ridell, Schutt and Xenith) purchased between the years 2002 and 2012, worn by 1,332 high school football players during the 2012 season. Dr. McGuine’s research group had the players complete a questionnaire answering three questions:

Helmet brand worn
Number of years playing football
Type of mouth guard used (custom vs. off the shelf)

Number of concussions in football and days lost from play were recorded by the athletic trainers. (more…)

Knee Function and Quality of Life after Bilateral ACL Injuries

Posted January 8, 2014 by Orthopaedic Specialists

The ACL injury is very common in certain sports such as soccer, football, and basketball. The data has revealed that 14 percent of patients with a unilateral ACL injury will go on to develop an ACL injury to the other leg. There is an incidence of 32 to 70 ACL injuries per 100,000 people per year. It has been reported as high as 500 to 8,500 per 100,000 people per year among soccer players.

Paterno et al. reported in the February 2012 Clinical Journal of Sports Medicine that 25% of patients who undergo an ACL reconstruction and return to twisting, turning and jumping sports will suffer another ACL injury within 12 months. What is very interesting is that 75% of those injuries occur to the contralateral (other side) knee. (more…)

Torn Meniscus and Meniscal Injury – Comparing Children and Adolescents

Posted January 6, 2014 by Orthopaedic Specialists

More and more children are competing in sports, and with increased participation there is an increase in the number of knee injuries.

A knee injury like a torn meniscus can affect a young athletes knee for the rest of their life. Studies have confirmed early onset osteoarthritis in patients with ACL injuries and meniscal tears.

The meniscus is a very important structure in the knee. There are two in each knee: a medial and lateral meniscus. The meniscus provides shock absorption. It also protects the articular cartilage covering the bones within the knee joint.

Most people suffering from a torn meniscus experience this knee injury in conjunction with other knee injuries such as an ACL injury, chondral injuries, and fractures.

The incidence of meniscal tears in children versus adolescence has not be widely studied.

What is the rate (incidence) of experiencing a torn meniscus in the pediatric vs. the adolescence population?

A study from the Rady Children’s Hospital and Health Center in San Diego published by Dr. Alvin Shieh et al. in the December 2013 American Journal of Sports Medicine researched the meniscal tear pattern in relation to skeletal immaturity. (more…)

Brain Injury from Contact Sports Possible Even Without Concussion

Posted January 2, 2014 by Orthopaedic Specialists

Research suggests that repeated impact to the head, like many contact athletes experience, can cause damage to the brain even without a concussion. Dr. Thomas McAlllister at Indiana University School of Medicine compared a group of college athletes engaged in contact sports like ice hockey and football with those participating in track and field.

The brains of all 159 athletes were scanned before and after the playing seasons. Other tests were also conducted to measure changes in learning. Accelerometers were attached to the helmets of those participating in contact sports to determine how frequently and intensely they experienced blows to the head. (more…)