Patient Education Apps: Guides to Orthopaedic Surgery

Patient Education Apps from the AAOS website. Easy-to-use apps let you demonstrate anatomy, pathology, and treatment at the point of care. Notation tools let you create personalized education for your patients. In-depth educational videos can be placed on your practice website for patients to view at any time. All apps feature expert content co-developed by AAOS and Visual Health Solutions, a leading medical multimedia company....

Sports Medicine Tips

Each of these single-page, fact sheets have been written and reviewed by top sports medicine professionals and combine easy-to-read text with colorful illustrations to help patients understand the diagnosis, treatment, recovery and prevention of a particular condition or illness. If you’d like to order multiple copies, please visit the Online Store or call 1-877-321-3500 (toll free). Click to view tip...

Sports Medicine Myths vs. Truths

By Matthew Matava, MD, Kevin Farmer, MD, Kevin Shea, MD, Lance LeClere, MD Preventing and recovering from sports injuries is an ongoing issue for athletes of all ages. Below we address some of the misperceptions about some common injuries and their treatment in sports medicine. Myth: Throwing curveballs leads to the highest risk of injury in young pitchers. Truth: Overuse, high pitch counts, and poor mechanics are the highest risk factors for injury. Throwing only fastballs with inappropriate rest and high pitch counts is a significant risk in young arms. Myth: A reconstructed ACL is stronger than the original ACL. Truth: An original ACL is always stronger than one that has been reconstructed from foreign materials. No reconstruction allows an athlete to perform better than the native tissues. Myth: A dislocated finger takes longer to heal than a fractured one. Truth: Fractures are typically worse in terms of prognosis and return to play than ligament injuries such as dislocations. Myth: Both heat and ice should be used immediately following an injury. Truth: Ice should be used after an injury in order to reduce inflammation and inhibit pain. Heat should be used prior to exercise to warm and stretch injured soft tissues. Myth: A patient is able to throw faster following ulnar collateral ligament reconstruction (“Tommy John” surgery). Truth: A common myth about Tommy John surgery is that having surgery when the ligament is not torn will add speed/strength to a player’s pitches. Many players will begin to lose accuracy and speed because of pain, muscle fatigue, and ligament damage before their ligament ruptures completely. Having surgery on a healthy...

ACL Injury 101

by Matthew Panzarella, M.D. Sports participation results in 70 percent of anterior cruciate ligament (ACL) tears and the majority of these occur in 15 to 45 year olds. Approximately 70 percent of ACL injuries are noncontact injuries that occur during a sudden change in direction with a planted foot (i.e., cutting) or stopping rapidly. In the United States there are between 100,000 to 250,000 ACL ruptures annually. The ACL is one of the main stabilizing ligaments of the knee and helps provide the hinge that allows the knee to remain stable while moving. When an ACL tear occurs the athlete often reports hearing a pop and usually cannot walk on the injured limb. During the injury it is common for the knee to partially dislocate, resulting in bruising and sometimes a small fracture at the back of the tibia and on the femur. Also common is a sprain of the medial collateral ligament (MCL) which is located on the inside of the knee. These injuries result in a painful swollen knee that is tender outside and deep within the knee. Female athletes are two to eight times more likely to rupture their ACL than male athletes. This is primarily due to mechanical reasons, such as weaker core muscles and hamstrings. Another factor that can increase the risk of ligament rupture is the interface between the player’s shoes and the playing surface that results in higher friction. For example, longer cleats or more cleats on a shoe resulting in better traction and more friction. High risk sports include soccer, basketball, volleyball, skiing, and football. Prevention programs have been developed based...

Jumper’s Knee: Know Your Limits

by Michael J. Smith, MD Jumper’s knee is a common overuse injury that affects up to 20 percent of athletes who jump with rapid acceleration and deceleration. Typically athletes who play basketball, volleyball, soccer, and track are the individuals most affected. The length and intensity of training and repetitive jumping are well known causes of jumper’s knee (patella tendonitis). 1,2,3 Playing surfaces and footwear can also play a part. There are several body type conditions that have also been investigated as causing the issue, including patella height, malalignment, and muscle imbalance. 1 Initial symptoms are usually pain along the front of the knee that occurs after a sports activity, with specific trauma. Pain may become worse and continue even after the sporting event and training stops. It can also progress into pain with day-to-day activities. Swelling is usually not present. Jumper’s knee is usually managed conservatively. In a high percentage of the cases, most athletes return to their activities and sports. If the condition is treated early, there is a much higher success rate. Nonoperative treatment includes activity restriction and modification, ice, pain medications, and physical therapy. Careful attention to a good stretching and strengthening therapy program and improvement of muscle imbalance across the knee is important. When the pain and inflammation is under control, a gradual training program can be started. Neoprene braces and straps may also be used for comfort. Surgery is a possibility if these measures fail to improve the issue. Surgery for jumper’s knee tends to have a long recovery time—6 to 12 months. 7,9,10 Because of this, several arthroscopic procedures are being studied and...

Common Hip Injuries in Kids

by Kevin Shea, MD Pediatric athletes are subject to several different acute hip injuries. These injuries include problems around the growth plate and around the femur and pelvis. In some cases, acute symptoms can develop in association with previous hip conditions. Two common hip injuries are discussed below. Slipped Capitol Femoral Epiphysis (SCFE) Young athletes may develop significant pain during sports participation. Other athletes may present to a doctor’s office with the chief complaint of pain in the hip, thigh, and/or knee. In patients with open growth plates, fractures may develop. These fractures may be a displaced fracture, where the bone snaps into two or more parts and moves so that the two ends are not lined up straight. In other cases, a fracture may occur on a pre-existing stress fracture of the growth plate. In each of these instances, an evaluation of the hip joint is necessary to ensure there is no evidence of a femur (large leg bone) fracture or SCFE. These athletes may present with sudden onset of pain, limp, or inability to bear weight. In some cases, they may also have a history of previous hip pain/discomfort, and loss of motion in some cases. These injuries require urgent evaluation, and prompt referral to an orthopaedic specialist. Delayed treatment can lead to disruption of the blood supply to the hip, and may predispose the athlete to arthritis in the future. Hip Avulsion A hip avulsion is an injury that occurs when a small chunk of bone that is attached to a tendon or ligament gets pulled away from the main part of the bone. This injury...