On today’s episode we’re focusing on Achilles tendon ruptures with Dr. Bonnie Chien. We have some great articles for you that contribute well to our conversation on the optimal management of Achilles tendon ruptures and the different surgical approaches. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.comWe’ll start off our discussion today with an article from the April 2012 issue of CORR titled “MRI is Unnecessary for Diagnosing Acute Achilles Tendon Ruptures.” Yes, it is an oldie. But we do think it sparks an interesting discussion about the utility of MRI in the setting of a clear Achilles tendon rupture.This study retrospectively compared 66 patients with acute Achilles ruptures and pre-op MRI with a control group of 66 patients without a pre-op MRI who were indicated for surgery by clinical diagnostic criteria alone.Criteria was: (1) an abnormal Thompson test, (2) decreased resting tension and (3) a palpable defect. The authors found that these clinical findings were 100% sensitive for a complete Achilles rupture.It took patients an average of 5 days to obtain the MRI after injury and 12 days for surgical intervention. In comparison, patients in the control group were taken for surgery at an average of 5.6 days after injury. No additional procedures were required in the control group compared to 19 patients in the MRI group.The authors concluded that physical exam was more sensitive than MRI and that MRI is time-consuming, expensive and can lead to treatment delays which may be associated with a need for additional procedures at the time of surgery.Then, from the April 2022 issue of the New England Journal of Medicine, we review an article titled “Nonoperative or Surgical Treatment of Acute Achilles Tendon Rupture.” This multicenter randomized controlled trial compared nonoperative treatment, open repair, and minimally invasive repair in 554 patients with an acute Achilles tendon rupture. The authors concluded that that 12 months post-treatment, surgery was not associated with better outcomes than nonsurgical treatment. However, 11 patients in the nonoperative group sustained a re-rupture compared to 1 patient in the open repair group and 1 patient in the minimally invasive repair group.We are joined today by Dr. Bonnie Chien, a board-certified orthopedic surgeon and Assistant Professor at Columbia University who specializes in foot and ankle conditions. She received her medical degree from Stanford University and then completed her orthopedic residency at Harvard Medical School with Catherine and I. She then went on to complete a foot and ankle fellowship at Mercy Medical Center in Baltimore. Dr. Chien is passionate about global health and has traveled internationally to teach and perform foot and ankle surgeries. She is fluent in Chinese and English and speaks conversational Spanish. Dr. Chien has lectured extensively on the topic of Achilles, so we’re very excited to hear all that she has to share on this topic today.

Today we’re going to give you an update pertaining to one of our favorite topics – ACL. And honestly, it’s been a bit since we done an episode on ACL so we’re excited to dive into this new paper today and talk more about how it will impact our practice. We’re going to review an article from the January issue of AJSM year titled “Risk of Revision and Reoperation After Quadriceps Tendon Autograft ACL Reconstruction Compared with Patellar Tendon and Hamstring Autografts in a US Cohort of 21,973 Patients.”

In this Overtime episode, The Sports Docs discuss the remplissage procedure and will be reviewing an article from the January issue of AJSM year titled “Stabilizing Mechanisms in Patients Treated Using Hill-Sachs Remplissage with Bankart Repair in Abduction–External Rotation Position.”This study was performed by Dr. Fei Zhang and team in Beijing, China and analyzed the biomechanical effects of the remplissage procedure on glenohumeral alignment at rest and with active motion.

Our next poster is titled The Utility of Stress Ultrasound in Identifying Risk Factors for Elbow Ulnar Collateral Ligament Rupture: A Longitudinal Study of 203 Professional Baseball Players. This study was performed by your colleagues at the Rothman Institute and aimed to identify anatomic risk factors on dynamic ultrasound that may predispose players to future UCL injury. The authors found that players who ultimately required UCL reconstruction had greater ulnohumeral joint rest space, higher rates of hypoechoic foci and increased UCL thickness on ultrasound compared to players who did not require UCLR.

Our next poster is titled Primary Latarjet Procedure versus Latarjet in the Setting of Previously Failed Bankart Repair: A Systematic Review. We’ve spoken a lot about shoulder instability on this podcast, most recently with Yoni Rosenblatt last month discussing rehab tips and tricks after various shoulder stabilization surgeries. We also had Dr. Brian Lau on Episodes 48 and 49 to chat about the different surgical options for anterior shoulder instability. So, we’re excited to review this poster today and add some new literature to this discussion.

Our next poster is titled Revision Osteochondral Allograft Transplantation after Failed Autologous Chondrocyte Implantation of the Knee: A Matched Cohort Analysis. Dr. Brian Cole and team at Rush sought to evaluate the clinical outcomes associated with revision OCA after failed ACI as compared with a matched cohort of patients undergoing primary OCA. They concluded that there was no difference in patient reported outcomes, number of reoperations and failure rates.

Our next AAOS 2024 Annual Meeting poster is titled The Statistical Fragility of Platelet-Rich Plasma in Lateral Epicondylitis: A Systematic Review and Simulated Fragility Analysis of Randomized Controlled Trials. Our podcast tries to stay far away from statistical analysis and methodology breakdown; however, this poster draws attention to an important issue. Often in orthopedics we try to use statistically significant findings –defined as those with a p value of less than .05 – from Level I randomized controlled trials to guide our clinical decision making. This poster suggests that is not all we should be looking at, particularly as it pertains to the use of PRP for lateral epicondylitis.

Our next poster is titled Arthroscopic Rotator Cuff Repair with Bioinductive Patch Achieves Equivalent Patient-Reported Outcomes At 1 Year and was performed by Dr. Stephanie Muh and team at Wayne State University and Henry Ford Medical Center. The purpose of this study was to compare patient-reported outcomes, range of motion and complications of patients undergoing arthroscopic rotator cuff repair augmented with a bovine bioinductive patch compared to standard repair.

Our next AAOS 2024 Annual Meeting poster is titled The Influence of Donor Demographics on Outcomes following Knee Osteochondral Allograft Transplantation. This study was performed by Dr. Brian Cole and Dr. Adam Yanke at Rush and aimed to assess the impact of donor sex and age, donor-recipient sex mismatch, and graft storage duration on clinical outcomes and failure rates in knee OCA transplantation. The authors found that in contrast to previous literature, no substantial survival difference was observed for sex- mismatched OCA donors and recipients in terms of reoperation or failure.

Today, we’re kicking off a special series of episodes to recap the new research presented at the American Academy of Orthopaedic Surgeons Annual Meeting, our largest orthopaedic conference. This year, over 20,000 orthopedic professionals gathered at the AAOS meeting in San Francisco to take part.The educational program was comprised of instructional course lectures, video theater, live surgeries, podium presentations and research posters. Over the next several episodes we’re going to be reviewing seven sports medicine posters that were presented at the AAOS meeting. On this podcast we try to review the most updated literature on different sports medicine topics. So, reviewing some of the posters that were just presented at AAOS is particularly exciting for us because this is very new data.  So new that most of this data has not even been published yet.We’re joined by Dr. Meghan Bishop to get her take on these poster presentations. Dr. Bishop is fellowship-trained, board certified orthopaedic sports surgeon at the Rothman Orthopaedic Institute in Philadelphia. After graduating from George Washington University Medical School, she completed her residency in Orthopaedic Surgery at Thomas Jefferson University Hospital. Dr. Bishop then completed a fellowship in Sports Medicine and Shoulder Surgery at Hospital for Special Surgery. She is the orthopedic medical director for the Philadelphia Marathon, Chair of the AOSSM Early Career Members Committee and is a member of the Editorial Board of AJSM and VJSM. She is very active in research, so we are excited to hear her thoughts on these posters over the new few episodes.

Our latest segment addition - “Ask The Sports Docs” - Drs. Logan & Bassett answer listeners' most pressing orthopaedic & sports medicine questions, giving  insight to their opinions and expertise on these topics. On this episode, The Sports Docs will touch on the treatment of various types of meniscus tears - when to repair vs resect vs manage the injury with PT and how surgeons determine if a SLAP tear will necessitate surgery. We appreciate this episodes questions from Peter, a patient from North Carolina, and Tara, a PT from New Jersey. Would you like your question answered by The Sports Docs? Send inquiries to: thesportsdocspod@gmail.com

Today we’re talking about medial meniscus posterior root tears and will be reviewing an article from AJSM last month titled “Medial Meniscus Posterior Root Tears Lead to Changes in Joint Contact Mechanics at Low Flexion Angles During Simulated Gait.” This study was performed by Dr. Sabrina Strickland and her team at HSS. We will also reference an older article from the January 2020 issue of AJSM that nicely compares the different treatment options for medial meniscus root tears. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.com

In this episode, we’re going to continue our discussion with Dr. Yoni Rosenblatt and focus on the rehab of different stabilization surgeries, including arthroscopic Bankart repair, Bankart with the addition of a remplissage procedure, and Latarjet reconstruction. We then wrap up with a discussion on return to play and an important conversation on the psychological aspects of recovery.Our conversation picks back up with an article from the March 2020 issue of Sports Health titled “A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair.” Dr. Nik Verma and team at Rush reviewed 31 PT protocols and found a high degree of variability with regard to exercises and motion goal recommendations. Despite the variability, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols, which may contribute to the earlier return to play metrics identified in the literature for Latarjet compared to Bankart repair.Next, we review an article titled “Functional Rehabilitation and Return to Play After Arthroscopic Surgical Stabilization for Anterior Shoulder Instability” published in the December 2021 issue of Sports Health. In this case series, Dr. Brian Busconi and colleagues at UMass evaluated 62 athletes who underwent arthroscopic Bankart repair and were subsequently cleared to return to sports using both functional and psychological testing. The average time to pass psychological testing was 5 months, while the average time to pass functional testing was 6 months. The re-dislocation rate of 2 years was 6.5%, lower than what is currently published for this population.We finish up today with an article from the October issue of AJSM titled “Relationship of the SIRSI Score to Return to Sports After Surgical Stabilization of Glenohumeral Instability.” Dr. Rossi and colleagues in Argentina reported that patients who returned to sports and those who returned to their preinjury sports level were significantly more psychologically ready than those who did not return. In fact, for every 10-point increase in the SIRSI score, the odds of returning to sports increased by 2.9 times. Furthermore, those who did not achieve their preinjury sports level showed poorer psychological readiness to return to play and SIRSI score results.

On today’s episode we’re focusing on post-op rehab after shoulder stabilization surgery with Dr. Yoni Rosenblatt, a physical therapist at True Sports PT in Baltimore, Maryland. We have some great articles for you that contribute well to our conversation on shoulder instability rehabilitation. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.comWe’ll start off our discussion today with an article from the Journal of Sports Rehabilitation in October 2019 titled “A Clinical Comparison of Home-Based and Hospital-Based Exercise Programs Following Arthroscopic Capsulolabral Repair for Anterior Shoulder Instability.” This prospective study evaluated 54 patients who underwent shoulder stabilization surgery followed by a home-based PT program versus hospital-based PT program starting 4 weeks post-op to 6 months post-op. While they did not report range of motion in this study, the authors reported no difference in patient-reported clinical outcome scores at any timepoint in recovery. The authors concluded that use of a controlled home-based exercise program is as effective as hospital-based rehab after shoulder stabilization surgery. Then, from JSES last month, we review an article titled “Cross-Education Effects on Shoulder Rotator Muscle Strength and Function After Shoulder Stabilization Surgery.” This RCT included 28 patients who underwent arthroscopic shoulder stabilization surgery. Patients were randomly assigned to standard rehab with or without the addition of cross-education. The cross-education group received isokinetic training with the non-operated shoulder focusing on the rotator cuff muscles. At 6 months post-op, patients in the cross-education group demonstrated significantly greater cuff strength but functional outcomes between the groups were equivalent. The authors suggest that cross-education may improve dynamic shoulder stability but not the functional capacity. We wrap up with an article from the 2022 issue of IJSPT titled “The Effect of Blood Flow Restriction Therapy on Shoulder Function Following Shoulder Stabilization Surgery: A Case Series.” The study included 20 military cadets who underwent shoulder stabilization surgery and completed 6 weeks of upper extremity BFR training beginning post-op week 6. While there was no comparison group, the authors reported significant and clinically meaningful improvements in shoulder strength, self-reported function and upper extremity performance following BFR training.  We are joined today by Dr. Yoni Rosenblatt, a physical therapist at True Sports PT in Baltimore, Maryland. Yoni received his Bachelors in Kinesiological Sciences from the University of Maryland in College Park. He went on to complete his doctorate of physical therapy at the University of Maryland in Baltimore. Yoni is the Director of Sports Medicine for Israel National Lacrosse and is a physical therapist for the Israel National Baseball team, competing in the 2017 World Baseball Classic. Yoni also hosts his own sports medicine podcast – the True Sports PT Podcast – which you should definitely check out for all sorts of rehab tips and tricks.

Welcome back to The Sports Docs Podcast!  In this episode, we’re going to continue our discussion with Dr. Andrea Spiker and focus on open surgical treatment for hip preservation, then wrap up with a discussion on post-op rehab and return to play.Our conversation picks back up with an article from the September 2017 issue of AJSM titled “Early Functional Outcomes of Periacetabular Osteotomy After Failed Hip Arthroscopic Surgery for Symptomatic Acetabular Dysplasia.” Bryan Kelly and his team  at HSS investigated the effect of prior arthroscopic hip surgery on clinical outcomes after periacetabular osteotomy or “PAO”. They found that patients who previously underwent hip arthroscopy had inferior functional outcomes at 6 months and 12 months after PAO compared to patients with no prior hip surgery. The authors note that both groups significantly improved post-op and there was no difference in complications or reoperation between the groups.We finish up today with a surgical technique article authored by our guest, Dr. Andrea Spiker, from the August 2022 issue of Arthroscopy Techniques. The article is titled “Treatment of Coxa Profunda with Open Surgical Hip Dislocation, Rim Resection, Cam Resection, and Labral Reconstruction” and describes an open surgical approach to address many of the challenges posed by coxa profunda. For our listeners, coxa profunda is essentially a deep acetabular socket. This differs from acetabular protrusio, in which the femoral head and socket displace into the pelvis. The global acetabular over-coverage associated with coxa profunda makes arthroscopic management very challenging in terms of obtaining adequate hip distraction and concerns for traction injury. For these reasons, an open approach has been proposed.

On today’s episode we’re focusing on hip preservation with Dr. Andrea Spiker. We have some great articles for you that contribute well to our conversation on femoroacetabular impingement or “FAI”, hip dysplasia and the arthroscopic and open surgical treatments for these conditions. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.comWe’ll start off our discussion today with an article from the June 2018 issue of The Lancet titled “Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome.” This multicenter RCT included 348 patients across 28 hospitals in the UK and compared conservative treatment with physical therapy to surgical treatment with hip arthroscopy. The authors reported that while both groups improved after treatment, patients who underwent hip arthroscopy for treatment of FAI demonstrated significantly greater improvement in hip-related quality of life compared to patients who had nonsurgical treatment. Then, from the September issue of AJSM this year, we review an article titled “Progression of Osteoarthritis at Long-term Follow-up in Patients Treated for Symptomatic Femoroacetabular Impingement with Hip Arthroscopy Compared with Nonsurgically Treated Patients.” Aaron Krych and team at the Mayo Clinic reported significantly less progression of arthritic changes in surgical patients compared to non-op. Seven percent of patients in the surgical group ultimately underwent a total hip replacement compared to 12% in the non-op group. Risk factors for failure of non-op treatment included male sex, presence of a CAM morphology, increased age and initial arthritic joint changes at diagnosis.  We are joined today by Dr. Andrea Spiker, a board-certified orthopedic surgeon at the University of Wisconsin-Madison who is dual fellowship trained in sports medicine and hip preservation. She is a team physician for UW Badger Athletics and provides head orthopedic coverage for the UW Men’s and Women’s Basketball teams. She is also the Program Director of the UW Orthopedic Surgery Sports Medicine Fellowship Program. Dr. Spiker is an active member in numerous orthopedic societies including AAOS, AOSSM and AANA, and has published extensively on the topic of hip preservation, so we’re very excited to hear all that she has to share on this topic today.

Happy New Year from The Sports Docs Podcast! 🎆As we reflect on an incredible year of growth for our podcast, we’d like to take a moment to thank our amazing listeners, guests and supporters for making this podcast such a success! 🫶🏻Our podcast has been downloaded in over 60 countries, is in the top 25% of @buzzsprout podcasts and is ranked in the top sports medicine podcasts 📈🎙️ We are very excited to see what 2024 has in store!

Happy New Year from The Sports Docs Podcast! 🎆As we reflect on an incredible year of growth for our podcast, we’d like to take a moment to thank our amazing listeners, guests and supporters for making this podcast such a success!Our podcast has been downloaded in over 60 countries, is in the top 25% of @buzzsprout podcasts and is ranked in the top sports medicine podcasts 📈🎙️ We are very excited to see what 2024 has in store.

Our latest segment addition - “Ask The Sports Docs” - Drs. Logan & Bassett answer listeners' most pressing orthopaedic & sports medicine questions, giving  insight to their opinions and expertise on these topics. On this episode, The Sports Docs will touch on the use of stem cells in sports medicine, our thoughts on open kinetic chain (OKC) exercise after knee surgery, and when ACL repair is recommended.We appreciate this episodes questions from Daniel, orthopedic surgeon in California; Dan, physical therapist in Maryland and Delaware; and an anonymous patient.Would you like your question answered by The Sports Docs? Send inquiries to:thesportsdocspod@gmail.com

Welcome to another episode of the Injury Report! Today, we’re focusing on core muscle injuries in the NFL, also known as “sports hernias”, most recently plaguing lead wide receiver for the Jaguars Christian Kirk. But this injury is quite common in the NFL affecting players from DeSean Jackson, Kareem Hunt, OBJ, Mike Evans, JJ Watt, Adrian Peterson to name a few. So, it’s about time that we cover this injury. As always, our plan today is to start with an overview of the relevant anatomy, discuss the mechanism of injury followed by treatment options for these players, and then wrap up with what you all want to know – when do players typically return to play after this injury and how do they do once they return?