A5005503462- Knee injuries and reconstruction techniques
- Shoulder Injury and Treatment
- Sports injuries and prevention
- Trauma Management and Diagnosis
- Shoulder and Clavicle Injuries
- Osteoarthritis Treatment and Mechanisms
- Total Knee Arthroplasty Outcomes
- Orthopedic Surgery and Rehabilitation
- Cardiovascular Effects of Exercise
- Bone fractures and treatments
- Pediatric Pain Management Techniques
- Tendon Structure and Treatment
- Foot and Ankle Surgery
- Anesthesia and Pain Management
- Opioid Use Disorder Treatment
- Lower Extremity Biomechanics and Pathologies
Boston Children's Museum
2021-2024
Boston Children's Hospital
2019-2024
Children's Healthcare of Atlanta
2021
Campbell Clinic
2021
Cincinnati Children's Hospital Medical Center
2021
Hospital for Special Surgery
2021
Children's Hospital of Philadelphia
2021
Harvard University
2019-2020
Background: The optimal treatment of midshaft clavicle fractures is controversial. Few previous comparative functional outcome studies have investigated these in adolescents, the most commonly affected epidemiologic subpopulation. Purpose/Hypothesis: purpose was to prospectively compare outcomes operative versus nonoperative adolescents with completely displaced fractures. study hypothesis that surgery would yield superior outcomes. Study Design: Cohort study; Level evidence, 2. Methods:...
Background: When stable osteochondritis dissecans (OCD) lesions of the femoral condyle in a skeletally immature patient fail to heal with nonoperative methods, standard care treatment is condylar OCD drilling. Two primary drilling techniques have been described, but no prospective studies compared their relative effectiveness. Purpose/Hypothesis: The purpose this study was compare healing and function after transarticular (TAD) that retroarticular (RAD). It hypothesized there would be...
Quadriceps tendon soft tissue autograft represents an increasingly popular graft option for anterior cruciate ligament reconstruction (ACLR), particularly adolescents, some of whom have open physis, precluding use options with bone plugs.The purpose this study was to quantify return-to-sport performance assessments in adolescents at 6 months after ACLR all-soft quadriceps (ACLR-Q) versus hamstring (ACLR-HS). It hypothesized that ACLR-Q would be associated improved strength and...
Objectives: To compare the clinical, radiographic, and patient-reported outcomes of non-operative operative treatment adolescents with comminuted ‘Z-type’ mid-shaft clavicle fractures. Methods: Design: Prospective observational cohort Setting: Eight tertiary-care pediatric centers Patient Selection Criteria: Patients 10 to 18 years-old who were treated either operatively or non-operatively for a diaphyseal fracture between 2013 2017 screened/enrolled at time injury. The current sub-cohort...
The physeal-sparing iliotibial band (ITB) anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-established technique for treating skeletally immature patients with ACL rupture. However, the long-term implications of procedure on intricacies kinetic and kinematic function knee have not been comprehensively investigated.To assess short-, mid-, effects ITB ACLR parameters functions.Case series; Level evidence, 4.A total 38 who had undergone an as child were recruited to participate...
Background: Small-diameter semitendinosus-gracilis tendon autografts may be encountered intraoperatively during anterior cruciate ligament reconstruction (ACLR); these have been shown to at increased risk of graft rupture. One option that surgeons pursued reduce the theoretical failure rate smaller-diameter grafts is augmenting them with allograft material, thereby forming a larger-diameter hybrid autograft-allograft construct. Purpose/Hypothesis: The purpose this study was compare outcomes...
Objective: The primary objective of this study was to identify differences in the treatment approach for isolated, displaced midshaft clavicle fractures adolescent patients 15–18 years age at adult versus pediatric hospitals. secondary factors associated with surgical these group. Design: Retrospective cohort study. Setting: Two and one tertiary care referral Patients/Participants: Adolescent treated 2 hospitals hospital were identified. A total 214 patients, 105 from 109 hospital, included....
Background: The culture of opioid abuse in the United States has brought attention to prescribing habits, especially as recent studies identify practices within post-operative period a risk factor for development dependence adolescents. current study sought explore concept pain control and use following ACL reconstruction (ACLR), one most common orthopaedic procedures Because adult have suggested that quadriceps tendon autograft, graft choice appears be growing popularity, may associated...
Background: Quadriceps tendon autograft represents an increasingly popular graft option for ACL reconstruction (ACLR). However, there is a paucity of literature regarding the early post-operative effects this technique on functional recovery, particularly in adolescents. Purpose/Hypothesis: To quantify strength, dynamic balance, and hop test performance adolescents 6 months following ACLR with quadriceps (ACLR-Q) compare to adolescent control group who underwent hamstring (ACLR-HS). Methods:...
Objectives: Quadriceps tendon (QT) autograft has emerged as an increasingly popular soft tissue graft alternative to the hamstring (HS) autograph for ACL reconstruction (ACLR). However, utilization of technique is not yet widespread, particularly in population adolescent athletes, whom safety and effectiveness remains under-investigated, despite this being most affected epidemiologic sub-population, with regard primary injury, post-ACLR re-tear, overall complications. The study hypothesis...
Background: Anterior cruciate ligament (ACL) tears are among the most devastating orthopaedic injuries affecting young athletes, especially when they occur in children and adolescents. Growing interest physeal-sparing techniques has prompted various investigations into combined extra-articular/intra-articular modified-Macintosh ACL reconstruction with Iliotibial band autograph (ACLR-ITB), which is often used for younger skeletally immature patients complete ruptures. However, several aspects...
Background: Anterior cruciate ligament reconstruction (ACLR) remains one of the most commonly performed orthopaedic surgeries in adolescents and young adults. However, selection optimal graft for individual patient controversial, considering multiple options, subtle technique differences, wide-ranging bodies evidence each option largely adult populations. epidemiologic studies clearly demonstrate as greatly affected age-based sub-population, with highest rates re-tear global morbidity, due...
Background: While ACL reconstruction (ACLR) in skeletally immature patients was traditionally delayed until physeal closure, the development of techniques that avoid disturbance have allowed surgical intervention with minimization growth compromise. Previous reports shown excellent patient outcomes and functional stability low re-tear rates at short mid-term follow-up one most widely used physeal-sparing techniques, combined extra-articular/intra-articular modified-MacIntosh Iliotibial band...
Objectives: The purpose of this study is to compare the re-tear rates and medium-term functional outcomes in matched cohorts adolescent athletes who underwent primary anterior cruciate ligament reconstruction (ACLR) with patellar tendon/bone-tendon-bone autograft (BTB) versus hamstring tendon (HS). Methods: An initial cohort 731 patients, aged 13-19 years, ACLR-BTB or ACLR-HS between 2003-2015 at a pediatric tertiary care hospital by one 5 surgeons, was identified through comprehensive...
Background: Optimal treatment of midshaft clavicle fractures in adolescents remains a topic controversy. While adolescent have historically been treated nonoperatively, recent randomized controlled trials displaced the adult literature raised question decreased symptomatic nonunion and malunion improved functional outcomes with surgery. Consequently, rates surgical fractures, particularly older age group, has increased, despite paucity high-level evidence to justify this trend....
Background: The most common presentation of knee osteochondritis dissecans (OCD) is a stable lesion on the lateral aspect medial femoral condyle (MFC) in an adolescent or pre-adolescent athlete. Standard care for conservative treatment, include activity modification and weight bearing protection. Failed management often leads arthroscopy drilling lesion. Two different primary techniques have been utilized, but no prospective studies compared their relative effectiveness. Hypothesis/Purpose:...
Background: Progressive displacement of diaphyseal clavicle fractures has been observed in adult patients, at times necessitating a change from non-operative to operative treatment. Whether this occurs adolescent patients not well investigated. Purpose: The purpose study was assess the rate and extent progressive fracture following injury during early stages healing. Methods: This an IRB approved multi-center evaluating prospective data that had previously collected as part larger functional...
Purpose: There has been a recent shift towards operative management of mid-shaft clavicle fractures in adults and adolescents. This largely based on studies the adult population that showed reduced rates nonunion, symptomatic malunion better short-term functional outcomes. For injuries with comminuted “Z-type” fracture pattern, characterized by vertical positioning segmental fragment, it is commonly accepted to treat surgically due concerns about healing bony prominence. The purpose...
Objectives: The most common presentation of knee osteochondritis dissecans (OCD) is a stable lesion on the lateral aspect medial femoral condyle (MFC) in an adolescent or pre-adolescent athlete. standard care for primary treatment non-operative, and includes rest/activity modification often weight bearing protection bracing. Failed conservative management leads arthroscopy drilling lesion. Two different techniques have been utilized, but no prospective studies compared their relative...
Objectives: Operative management of clavicle fractures is increasingly advocated for athletes and young adults. Surgical indications optimal treatment comminuted or severely shortened in adolescent remain unclear. The purpose this study was to evaluate the outcomes non-operatively operatively treated and/or (>25mm) older athletes. Methods: Athletes aged 14 18 years with mid-shaft who had non-operative (NONOP) operative (OP) at one eight participating centers between 2013 2017 were...