Pickleball-Related Fractures in the United States From 2002 to 2022: An Analysis Using the NEISS Database.

Background: Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019. Purpose: To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status. Study Design: Descriptive epidemiology study. Methods: The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission). Results: A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P < .001) and female (n = 273 [69%]; P < .001). Most fractures involved the upper extremity (n = 262 [66%]; P < .001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P < .001) and occurred in the winter months (n = 142 [36%]; P < .001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P < .001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively). Conclusion: Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture.

An osteogenic magnesium alloy with improved corrosion resistance, antibacterial, and mechanical properties for orthopedic applications.

The aim of this study was to develop a novel biodegradable magnesium (Mg) alloy for bone implant applications. We used scandium (Sc; 2 wt %) and strontium (Sr; 2 wt %) as alloying elements due to their high biocompatibility, antibacterial efficacy, osteogenesis, and protective effects against corrosion. In the present work, we also examined the effect of a heat treatment process on the properties of the Mg-Sc-Sr alloy. Alloys were manufactured using a metal casting process followed by heat treatment. The microstructure, corrosion, mechanical properties, antibacterial activity, and osteogenic activity of the alloy were assessed in vitro. The results showed that the incorporation of Sc and Sr elements controlled the corrosion, reduced the hydrogen generation, and enhanced mechanical properties. Furthermore, alloying with Sc and Sr demonstrated a significantly enhanced antibacterial activity and decreased biofilm formation compared to control Mg. Also, culturing Mg-Sc-Sr alloy with human bone marrow-derived mesenchymal stromal cells showed a high degree of biocompatibility (>90% live cells) and a significant increase in osteoblastic differentiation in vitro shown by Alizarin red staining and alkaline phosphatase activity. Based on these results, the Mg-Sc-Sr alloy heat-treated at 400°C displayed optimal mechanical properties, corrosion rate, antibacterial efficacy, and osteoinductivity. These characteristics make the Mg-Sc-Sr alloy a promising candidate for biodegradable orthopedic implants in the fixation of bone fractures such as bone plate-screws or intramedullary nails.

Is Video-Based Analysis a Valid Method for Determining Mechanisms of Ankle Injuries During Gameplay in the National Basketball Association?

Background: In the National Basketball Association (NBA), lower extremity injuries account for over 70% of games missed, with ankle injuries being the most common. High-quality video analysis has been successful for studying injury mechanism. Purpose: To (1) determine the validity of video-based analysis as a method to evaluate ankle injury mechanisms in NBA players and (2) analyze the circumstances associated with injury, games missed due to injury, and associated costs in player salary due to time missed. Study Design: Case series; Level of evidence, 4. Methods: Ankle injuries were identified using an injury report database, and corresponding videos were searched using YouTube.com to access high-quality video evidence of these injuries during the 2015-2020 NBA regular season. We reviewed 822 injuries, of which 93 had corresponding videos (video subset), in our final analysis. Variables including number of games missed, necessity for surgical treatment, and injury recurrence were reported for the entire cohort. In the video subset, the mechanism of injury and other corresponding situational data were evaluated. Results: The most common mechanism of injury occurred via ankle inversion (83.9%; n = 78; P < .001). These injuries were significantly associated with indirect contact with the player's ankle (79.6%; n = 74; P < .001). There were significant differences based on player position, within both the video subset (P = .008) and the entire cohort (P < .001), with guards being injured the most frequently. The average number of games missed due to injury was 7 games in the video subset and 5 games in the entire cohort (P = .14). There were significant differences between the groups in average player salary per game ($133,878 [video subset] versus $87,577 [entire cohort]; P < .001). Conclusion: Despite its low yield of 11.3%, video analysis proved to be a useful tool to determine ankle injury mechanisms as well as the distribution of injuries based on player position. However, this methodology was subject to selection bias, as evidenced by a $50,000 increase in player salary among the video cohort. These findings should be considered when using video analysis in future studies.