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  • 1
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    Infographic: Biologics in professional and Olympic sport: a scoping review
    British Editorial Society of Bone & Joint Surgery ; 2021
    In:  The Bone & Joint Journal Vol. 103-B, No. 7 ( 2021-07-01), p. 1187-1188
    Details
    In: The Bone & Joint Journal, British Editorial Society of Bone & Joint Surgery, Vol. 103-B, No. 7 ( 2021-07-01), p. 1187-1188
    Type of Medium: Online Resource
    ISSN: 2049-4394 , 2049-4408
    URL: Article
    DOI: 10.1302/0301-620X.103B7.BJJ-2021-0864
    Language: English
    Publisher: British Editorial Society of Bone & Joint Surgery
    Publication Date: 2021
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  • 2
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    Biologics in professional and Olympic sport: a scoping review
    British Editorial Society of Bone & Joint Surgery ; 2021
    In:  The Bone & Joint Journal Vol. 103-B, No. 7 ( 2021-07-01), p. 1189-1196
    Details
    In: The Bone & Joint Journal, British Editorial Society of Bone & Joint Surgery, Vol. 103-B, No. 7 ( 2021-07-01), p. 1189-1196
    Abstract: The aim of this study was to prepare a scoping review to investigate the use of biologic therapies in the treatment of musculoskeletal injuries in professional and Olympic athletes. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews and Arksey and O’Malley frameworks were followed. A three-step search strategy identified relevant published primary and secondary studies, as well as grey literature. The identified studies were screened with criteria for inclusion comprising clinical studies evaluating the use of biologic therapies in professional and Olympic athletes, systematic reviews, consensus statements, and conference proceedings. Data were extracted using a standardized tool to form a descriptive analysis and a thematic summary. Results A total of 202 studies were initially identified, and 35 met criteria for the scoping review; 33 (94.3%) were published within the last eight years, and 18 (51.4%) originated from the USA. Platelet rich plasma was the most studied biologic therapy, being evaluated in 33 (94.3%) studies. Ulnar collateral ligament and hamstring injuries were the conditions most studied (nine (25.7%) studies and seven (20.0%) studies, respectively). Athletes most frequently participated in baseball, soccer, and American football. Only two (5.7%) studies were level 1 evidence, with interpretation and comparison between studies limited by the variations in the injury profile, biologic preparations, and rehabilitation protocols. Conclusion There is diverse use of biologic therapies in the management of musculoskeletal injuries in professional and Olympic athletes. There is currently insufficient high-level evidence to support the widespread use of biologic therapies in athletes. Further research priorities include the development of condition/pathology-specific preparations of biologic therapies, and of outcome measures and imaging modalities sufficiently sensitive to detect differences in outcomes, should they exist. Cite this article: Bone Joint J 2021;103-B(7):1189–1196.
    Type of Medium: Online Resource
    ISSN: 2049-4394 , 2049-4408
    URL: Article
    DOI: 10.1302/0301-620X.103B7.BJJ-2020-2282.R1
    Language: English
    Publisher: British Editorial Society of Bone & Joint Surgery
    Publication Date: 2021
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  • 3
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    Comparing Meniscectomy and Meniscal Repair: A Matched Cohort Analysis Utilizing a National Insurance Database
    SAGE Publications ; 2020
    In:  The American Journal of Sports Medicine Vol. 48, No. 10 ( 2020-08), p. 2353-2359
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 48, No. 10 ( 2020-08), p. 2353-2359
    Abstract: Meniscal repair leads to improved patient outcomes compared with meniscectomy in small case series. Purpose: To compare the reoperation rates, 30-day complication rates, and cost differences between meniscectomy and meniscal repair in a large insurance database. Study Design: Cohort study; Level of evidence, 3. Methods: A national insurance database was queried for patients who underwent meniscectomy (Current Procedural Terminology [CPT] code 29880 or 29881) or meniscal repair (CPT code 29882 or 29883) in the outpatient setting and who had a minimum 2-year follow-up. Patients without confirmed laterality and patients who underwent concomitant ligament reconstruction were excluded. Reoperation was defined by ipsilateral knee procedure after the index surgery. The 30-day postoperative complication rates were assessed using the International Classification of Diseases, 9th Revision, Clinical Modification codes. The cost of the procedures per patient was calculated. Propensity score matching was utilized to create matched cohorts with similar characteristics. Statistical comparisons of cohort characteristics, reoperations, postoperative complications, and payments were made. All P values were reported with significance set at P 〈 .05. Results: A total of 27,580 patients (22,064 meniscectomy and 5516 meniscal repair; mean age, 29.9 ± 15.1 years; 41.2% female) were included in this study with a mean follow-up of 45.6 ± 21.0 months. The matched groups were similar with regard to characteristics and comorbidities. There were significantly more patients who required reoperation after index meniscectomy compared with meniscal repair postoperatively (5.3% vs 2.1%; P 〈 .001). Patients undergoing meniscectomy were also significantly more likely to undergo any ipsilateral meniscal surgery ( P 〈 .001), meniscal transplantation ( P = .005), or total knee arthroplasty ( P = .001) postoperatively. There was a significantly higher overall 30-day complication rate after meniscal repair (1.2%) compared with meniscectomy (0.82%; P = .011). The total day-of-surgery payments was significantly higher in the repair group compared with the meniscectomy group ($7094 vs $5423; P 〈 .001). Conclusion: Meniscal repair leads to significantly lower rates of reoperation and higher rates of early complications with a higher total cost compared with meniscectomy in a large database study.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546520935453
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2063945-4
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  • 4
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    We Need Robust Nomenclature for Orthobiologics: Letter to Editor
    SAGE Publications ; 2020
    In:  The American Journal of Sports Medicine Vol. 48, No. 12 ( 2020-10), p. NP52-NP54
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 48, No. 12 ( 2020-10), p. NP52-NP54
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546520947043
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2063945-4
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  • 5
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    Autologous Bone Grafting
    Elsevier BV ; 2020
    In:  Operative Techniques in Sports Medicine Vol. 28, No. 4 ( 2020-12), p. 150780-
    Details
    In: Operative Techniques in Sports Medicine, Elsevier BV, Vol. 28, No. 4 ( 2020-12), p. 150780-
    Type of Medium: Online Resource
    ISSN: 1060-1872
    URL: Article
    DOI: 10.1016/j.otsm.2020.150780
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2134538-7
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  • 6
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    Biologic Augmentation for the Operative Treatment of Osteochondral Defects of the Knee: A Systematic Review
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 11 ( 2021-11-01), p. 232596712110497-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 11 ( 2021-11-01), p. 232596712110497-
    Abstract: Various surgical treatment options exist for repairing, replacing, or regenerating tissue to fill osteochondral defects. Biologic augmentation has been increasingly studied as an adjunct in the surgical treatment of osteochondral defects of the knee in animal and human models. Purpose/Hypothesis: The purpose of the study was to systematically review use of platelet-rich plasma (PRP) and bone marrow concentrate (BMC) augmentation in the surgical treatment of osteochondral knee defects and to describe the outcomes. It was hypothesized that both PRP and BMC augmentation will result in improved outcomes in osteochondral knee surgery in both animal and human models. Study Design: Systematic review. Methods: PubMed, MEDLINE, and Embase were searched for studies relating to PRP or BMC and treatment of osteochondral defects of the knee, from database inception to February 1, 2020. Included were articles that (1) studied PRP or BMC augmentation; (2) used osteochondral autograft, allograft, or biologic scaffold; and (3) treated osteochondral defects in the knee. Data on use of PRP or BMC, outcomes assessed, and results were recorded for each publication. Results: Of the 541 articles identified initially, 17 were included in the final review. Five articles studied osteochondral grafts in animals, 5 studied biologic scaffolds in animals, and 7 studied scaffolds or allografts in humans; the combined sample size was 202 patients. Of 4 histologic scaffold studies, 3 PRP-augmented scaffold studies identified histologic improvements in regenerated cartilage in animal models, while 1 BMC study demonstrated similar improvement in histologic scores of BMC-augmented scaffolds compared with controls. Three studies associated greater collagen type 2 and glycosaminoglycan content with PRP treatment. Comparative studies found that both augments increase osteogenic proteins, including bone morphogenetic protein–2 and osteoprotegerin. Two of 3 studies on BMC-augmented osteochondral allografts reported no difference in radiographic features postoperatively. Long-term improvement in clinical and radiographic outcomes of PRP-augmented scaffolds was demonstrated in 1 human study. Conclusion: Animal studies suggest that biologics possess potential as adjuncts to surgical treatment of osteochondral knee defects; however, clinical data remain limited.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671211049756
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2706251-X
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  • 7
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    Concomitant Osteotomy Reduces Risk of Reoperation Following Cartilage Restoration Procedures of the Knee: A Matched Cohort Analysis
    SAGE Publications ; 2021
    In:  CARTILAGE Vol. 13, No. 1_suppl ( 2021-12), p. 1250S-1257S
    Details
    In: CARTILAGE, SAGE Publications, Vol. 13, No. 1_suppl ( 2021-12), p. 1250S-1257S
    Abstract: The objective of this study is to compare the (1) reoperation rates, (2) 30-day complication rates, and (3) cost differences between patients undergoing isolated autologous chondrocyte implantation (ACI) or osteochondral allograft transplantation (OCA) procedures alone versus patients with concomitant osteotomy. Study Design Retrospective cohort study, level III. Design Patients who underwent knee ACI (Current Procedural Terminology [CPT] 27412) or OCA (CPT 27415) with minimum 2-year follow-up were queried from a national insurance database. Resulting cohorts of patients that underwent ACI and OCA were then divided into patients who underwent isolated cartilage restoration procedure and patients who underwent concomitant osteotomy (CPT 27457, 27450, 27418). Reoperation was defined by ipsilateral knee procedure after the index surgery. The 30-day postoperative complication rates were assessed using ICD-9-CM codes. The cost per patient was calculated. Results A total of 1,113 patients (402 ACI, 67 ACI + osteotomy, 552 OCA, 92 OCA + osteotomy) were included (mean follow-up of 39.0 months). Reoperation rate was significantly higher after isolated ACI or OCA compared to ACI or OCA plus concomitant osteotomy (ACI 68.7% vs. ACI + osteotomy 23.9%; OCA 34.8% vs. OCA + osteotomy 16.3%). Overall complication rates were similar between isolated ACI (3.0%) and ACI + osteotomy (4.5%) groups and OCA (2.5%) and OCA + osteotomy (3.3%) groups. Payments were significantly higher in the osteotomy groups at day of surgery and 9 months compared to isolated ACI or OCA, but costs were similar by 2 years postoperatively. Conclusions Concomitant osteotomy at the time of index ACI or OCA procedure significantly reduces the risk of reoperation with a similar rate of complications and similar overall costs compared with isolated ACI or OCA.
    Type of Medium: Online Resource
    ISSN: 1947-6035 , 1947-6043
    URL: Article
    DOI: 10.1177/19476035211011515
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2515870-3
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  • 8
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    Comparison of Autologous Chondrocyte Implantation and Osteochondral Allograft Transplantation of the Knee in a Large Insurance Database: Reoperation Rate, Complications, and Cost Analysis
    SAGE Publications ; 2021
    In:  CARTILAGE Vol. 13, No. 1_suppl ( 2021-12), p. 1187S-1194S
    Details
    In: CARTILAGE, SAGE Publications, Vol. 13, No. 1_suppl ( 2021-12), p. 1187S-1194S
    Abstract: To compare (1) the reoperation rates, (2) risk factors for reoperation, (3) 30-day complication rates, and (4) cost differences between autologous chondrocyte implantation (ACI) and osteochondral allograft transplantation (OCA) of the knee in a large insurance database. Design Subjects who underwent knee ACI (Current Procedural Terminology [CPT] code 27412) or OCA (CPT code 27415) with minimum 2-year follow-up were queried from a national insurance database. Reoperation was defined by ipsilateral knee procedure after index surgery. Multivariate logistic regression models were built to determine the effect of independent variables (age, sex, tobacco use, obesity, diabetes, and concomitant osteotomy) on reoperation rates. The 30-day complication rates were assessed using ICD-9-CM codes. The cost of the procedures per patient was calculated. Statistical comparisons were made. All P values were reported with significance set at P 〈 0.05. Results A total of 909 subjects (315 ACI and 594 OCA) were included (mean follow-up 39.2 months). There was a significantly higher reoperation rate after index ACI compared with OCA (67.6% vs. 40.4%, P 〈 0.0001). Concomitant osteotomy at the time of index procedure significantly reduced the risk for reoperation in both groups (odds ratio [OR] 0.2, P 〈 0.0001 and OR 0.2, P = 0.009). The complication rates were similar between ACI (1.6%) and OCA (1.2%) groups ( P = 0.24). Day of surgery payments were significantly higher after ACI compared with OCA ( P = 0.013). Conclusions Autologous chondrocyte implantation had significantly higher reoperation rates and cost with similar complication rates compared with OCA. Concomitant osteotomy significantly reduced the risk for reoperation in both groups.
    Type of Medium: Online Resource
    ISSN: 1947-6035 , 1947-6043
    URL: Article
    DOI: 10.1177/1947603520967065
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 9
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    Relationship of the Medial Patellofemoral Ligament Origin on the Distal Femur to the Distal Femoral Physis: A Systematic Review
    SAGE Publications ; 2021
    In:  The American Journal of Sports Medicine Vol. 49, No. 1 ( 2021-01), p. 261-266
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 49, No. 1 ( 2021-01), p. 261-266
    Abstract: The relationship between the medial patellofemoral ligament (MPFL) and the distal femoral physis has been reported in multiple studies. Purpose: To determine the distance from the MPFL central origin on the distal femur to the medial distal femoral physis in skeletally immature participants. Study Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched for studies investigating the anatomic origin of the MPFL on the distal femur and its relationship to the medial distal femoral physis in skeletally immature participants. Study methodological quality was analyzed with the Anatomical Quality Assessment tool, with studies categorized as low risk, high risk, or unclear risk of bias. Continuous variable data were reported as mean ± SD. Categorical variable data were reported as frequency with percentage. Results: Seven articles were analyzed (298 femurs, 53.7% male patients; mean age, 11.7 ± 3.4 years). There was low risk of bias based on the Anatomical Quality Assessment tool. The distance from the MPFL origin to the distal femoral physis ranged from 3.7 mm proximal to the physis to 10.0 mm distal to the physis in individual studies. Six of 7 studies reported that the MPFL origin on the distal femur lies distal to the medial distal femoral physis in the majority of specimens. The MPFL originated distal to the medial distal femoral physis in 92.8% of participants at a mean distance of 6.9 ± 2.4 mm. Conclusion: The medial patellofemoral ligament originates distal to the medial distal femoral physis in the majority of cases at a mean proximal-to-distal distance of 7 mm distal to the physis. However, this is variable in the literature owing to study design and patient age and sex.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546520904685
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2063945-4
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  • 10
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    Linked Double-Row Equivalent Arthroscopic Rotator Cuff Repair Leads to Significantly Improved Patient Outcomes
    SAGE Publications ; 2020
    In:  Orthopaedic Journal of Sports Medicine Vol. 8, No. 7 ( 2020-07-01), p. 232596712093831-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 8, No. 7 ( 2020-07-01), p. 232596712093831-
    Abstract: Biomechanical studies have demonstrated that arthroscopic rotator cuff repair using a linked double-row equivalent construct results in significantly higher load to failure compared with conventional transosseous-equivalent constructs. Purpose: To determine the patient-reported outcomes (PROs), reoperation rates, and complication rates after linked double-row equivalent rotator cuff repair for full-thickness rotator cuff tears. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients who underwent linked double-row equivalent arthroscopic rotator cuff repair with minimum 2-year follow-up were included. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score at final follow-up. Secondary outcomes included the Simple Shoulder Test (SST), shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, visual analog scale (VAS), reoperations, and complications. Clinical relevance was defined by the minimally clinically important difference (MCID). Comparisons on an individual level that exceeded MCID (individual-level scores) were deemed clinically relevant. Comparisons between preoperative and postoperative scores were completed using the Student t test. All P values were reported with significance set at P 〈 .05. Results: A total of 42 shoulders in 41 consecutive patients were included in this study (21 male patients [51.2%]; mean age, 64.5 ± 11.9 years; mean follow-up, 29.7 ± 4.5 months). All patients (100%) completed the minimum 2-year follow-up. The rotator cuff tear measured on average 15.2 ± 8.9 mm in the coronal plane and 14.6 ± 9.8 mm in the sagittal plane. The ASES score improved significantly from 35.5 ± 18.2 preoperatively to 93.4 ± 10.6 postoperatively ( P 〈 .001). The QuickDASH ( P 〈 .001), SST ( P 〈 .001), and VAS ( P 〈 .001) scores also significantly improved after surgery. All patients (42/42 shoulders; 100%) achieved clinically relevant improvement (met or exceeded MCID) on ASES and SST scores postoperatively. There were no postoperative complications (0.0%) or reoperations (0.0%) at final follow-up. Conclusion: Arthroscopic repair of full-thickness rotator cuff tears with the linked double-row equivalent construct results in statistically significant and clinically relevant improvements in PRO scores with low complication rates (0.0%) and reoperation rates (0.0%) at short-term follow-up.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120938311
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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