Return to sports following distal biceps tendon repair: A current concepts review.

Distal biceps tendon ruptures are relatively rare injuries but tend to occur in active and athletic populations, especially in weightlifting and contact sports. The distal biceps tendon is an important supinator of the forearm and flexor of the elbow, thus an injury to this ligament can be invalidating for athletes. The aim of this review was to determine the ability and the time to return to sports following distal biceps tendon repair in athletes and the level of performance. The literature is scarce about the return to sports among athletes. Most studies include athletes are National Football League (NFL) players, others are weightlifters and a few recreational athletes. The return to play rate after distal biceps tendon repair is high. The performances of the returned players were similar to matched players and most players returned to the same level. Most players-depending on the sport-were not able to return to competition within the same season. In order to manage expectations, it should be discussed preoperatively with the athlete (and their coach) that the return to sports rate is high, but the return will probably be the following season.

Radiographic Predictors for Short-term Functional Outcome after Radial Head Arthroplasty in Patients with Persistent Symptoms after Treatment for Radial Head.

BACKGROUND: Evaluation of the accurate position after radial head arthroplasty remains a challenge for surgeons. Standard radiographs are used to evaluate the position of the implant, however, results regarding radiographic deficiencies on clinical outcome are not consistent. In this retrospective study our main aim was to determine if subtle radiographic deficiencies after radial head arthroplasty can predict functional outcomes measured with the Mayo Elbow Performance Score (MEPS). METHODS: A total of 24 patients, that had a press-fit bipolar radial head arthroplasty because of persistent symptoms after treatment of a radial head fracture, were included. The mean follow-up time was 27 months and the MEPS was assessed at the final follow-up. Three upper extremity orthopaedic surgeons evaluated 12 potential deficiencies on anteroposterior and lateral radiographs in consensus agreement. RESULTS: The median MEPS was 97.5 (Interquartile Range 82.5-100). No association was found between the presence of subtle radiographic deficiencies and MEPS. CONCLUSION: Functional outcome of the elbow after uncemented press-fit bipolar radial head arthroplasty is not associated with subtle radiographic deficiencies. Therefore, surgeons might accept small imperfections on postoperative radiographs.

Hip arthroscopy in obese, a successful combination?

Discussion persists about the outcome and results of hip arthroscopy in obese patients. Hip arthroscopy gained popularity over time. A current discussion is if obese patients can reach similar results after surgery compared with non-obese. To our knowledge, this is the first systematic review of literature about hip arthroscopy and obesity. We searched the Pubmed/Medline databases for literature and included three studies that compared the outcome of hip arthroscopy between different BMI groups. We extracted and pooled the data. For continues data a weighted mean difference was calculated, for dichotomous variables a weighted odds ratio (OR) was calculated using Review Software Manager. Heterogeneity of the included studies was calculated using I(2) statistics. Data were extracted from two studies. In the Obese group, there was significant more conversion to total hip replacement or resurfacing hip replacement (OR = 2.21, 95% CI 1.07-4.56) and more re-arthroscopy (OR = 4.68, 95% CI 1.41-15.45). Any reoperation occurred more often in the obese group (OR = 2.87, 95% CI 1.53-5.38). In the Non Arthritic Hip Score obese scored lower than the non-Obese group [10.9 (-14,6 to 7.1)]. For the modified Harris Hip Score the score is - 6,6, according to the MCID this difference is clinically relevant. For both scores obese show lower outcomes but similar improvement after hip arthroscopy. Regarding a higher chance of needing a re-operation and lower subjective outcome scores obesity appears to have a negative influence on the outcome of hip arthroscopy.

Subxiphoid pericardial window to exclude occult cardiac injury after penetrating thoracoabdominal trauma.

BACKGROUND: An occult cardiac injury may be present in patients with an acute abdomen after penetrating thoracoabdominal trauma. This study assessed the use of a subxiphoid pericardial window (SPW) as a diagnostic manoeuvre in this setting. METHODS: This was a retrospective review of a trauma database (2001-2009). Patients presenting with a penetrating thoracoabdominal injury with an acute abdomen, and in whom there was concern about a potential cardiac injury from the site or tract of the injury, were included. RESULTS: Fifty patients with an indication for emergency laparotomy underwent a SPW for a possible cardiac injury. An occult haemopericardium was present at SPW in 14 patients (28 per cent) mandating, median sternotomy. Nine cardiac injuries (18 per cent) were identified including five tangential injuries and four perforations. The specific complication rate relating to the SPW was 2 per cent. CONCLUSION: The SPW is a useful technique at laparotomy to identify cardiac injuries in patients with penetrating thoracoabdominal injuries.