|
|
|
Thrower's Exotosis Pathophysiology and Management Andrews JR, Dugas JR, Hackel JG, Reinold MM, Wilk KE. Thrower's Exotosis Pathophysiology and Management. Techniques in Shoulder and Elbow Surgery 5(1):44-50, 2004 Methods The thrower’s exostosis or Bennett lesion is a unique finding in throwing athletes with the presentation of an osteophyte found on the posterior inferior rim of the glenoid. The Stryker view is necessary to identify the lesion. In this study, 22 baseball players with a posterior inferior osteophyte on the glenoid rim were followed. Eleven of the 22 had the osteophyte removed because of symptomatic pain while the other ten were treated for internal impingement since the exostosis was asymptomatic. Results Ten of the 11 players were throwing at a level equal to their premorbid level of throwing for greater than one year. An extensive rehabilitation program was started immediately after surgery to regain range of motion. A gradual return to overhead sports was allowed 8-10 weeks after surgery.UCL Reconstruction in High School Baseball Players Petty DH, Andrews JR, Fleisig GS, Cain EL. Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors. The American Journal of Sports Medicine 32(5):1158-1164, 2004 Methods The incidence of ulnar collateral ligament (UCL) injury has increased in baseball, especially at the high school level. Follow-up physical exam and questionnaire data were collected from 27 former high school baseball players at 35 months after UCL reconstruction surgery. Six potential risk factors were evaluated: year-round throwing, seasonal overuse, event overuse, velocity over 80 mph, throwing breaking pitches prior to age 14, and inadequate warm-ups. Results UCL reconstruction had a success rate of 74% (20/27) in the high school baseball players by allowing them to return to baseball at the same level or higher after surgery. These baseball players demonstrated an average of 3.1 presumed risk factors for UCL injury in their throwing histories, with the greatest risk factor being overuse of one type or another. 85% (22/26) were involved with at least one overuse category. Although UCL reconstruction in high school players is shown to have roughly equal results to college and professional baseball players, the earlier these traumatic injuries occur in a player’s career can have a limiting effect if they wish to continue to pursue baseball through their lifetime.
Total Ankle Replacement with Prior Adjunctive Procedures Hurowitz EJ, Gould JS, Fleisig GS, Fowler R. Outcome analysis of agility total ankle replacement with prior adjunctive procedures: two to six year follow-up. Foot & Ankle International 28(3):308-312, 2007. Ankle arthrodesis has traditionally been the most common method for treatment of severe ankle injuries. While this method has proven to decrease the amount of pain for an individual, ankle arthrodesis has been linked to arthritis, dysfunction, and decline of other joints in the foot. As an alternative to fusion, total ankle replacements have been developed. This retrospective study examines the Agility total ankle replacement outcome and possible reasons for failure. This study examined 62 Agility total ankle replacements in 61 different recipients from April 1998 and March 2002. Several parameters regarding the ankle replacement were inspected, the most notable including patient age, prior procedure as part of a staged approach to ankle replacement, and size of the prosthesis used. Each patient and his or her chart and radiographic records were checked from the time of implantation to end point. A Kaplan-Meier survivorship curve was generated using all of the ankles to obtain a 95% confidence interval. Statistical analysis was conducted on all of the data collected to determine whether age was a predictive factor for failure. Comparative statistics such as chi squared testing were also conducted to determine if the type of arthritis and size of the prosthesis could identify the different outcomes of each ankle. The results of the study indicate that patients with rheumatoid arthritis have a significantly higher rate of success. The ability of age to predict failure only showed significance in patients whose end point was the degenerative joint disease osteoarthritis. The size 1 prosthesis showed correlation with a decrease in some rate of failures, but did not prove significant causation. Based on the results from this study, patients who have a prosthesis size 1 and rheumatoid arthritis are positives signs for a better outcome after total ankle replacement. Copyright © 2009,
American Sports Medicine Institute |
