Imaging changes following surgery for ischiofemoral impingement.

Partial resection of the lesser trochanter (LT plasty) has been increasingly recommended to treat ischiofemoral impingement. However, there is a lack of studies on the imaging findings following LT plasty. The purpose of this study was to assess magnetic resonance imaging (MRI) changes on the lesser trochanter and surrounding musculotendinous structures following LT plasty to treat ischiofemoral impingement. Twenty-one patients (21 hips) were studied. The LT length and cross-sectional area of the iliopsoas muscle were measured on MRI before and after surgery. The MRIs were performed on average 11 months (range, 3 to 25 months) after surgery. The mean ± standard deviation amount of LT resected (difference between pre- and postoperative LT length) was 7.3 mm ± 2.5 mm. The iliopsoas cross-sectional area decreased after the LT plasty in 95% of the hips (20/21) by an average of 35% ± 16%. The reduction in iliopsoas size had no significant correlation with improvement on the modified Harris Hip Score at a mean follow-up of 17 months after surgery (r = -0.13, P = 0.58). The iliopsoas muscle size decreased on average 35% following endoscopic LT plasty. The decrease was not correlated with midterm functional outcomes.

Anterior Cruciate Ligament Injury Prevention and Rehabilitation.

At all levels of American football, knee injuries are common, with injuries to the anterior cruciate ligament (ACL) making up a significant proportion. Historically, ACL injuries were career-altering for professional players, but innovative techniques in surgery and rehabilitation have returned many to the field. While there is a consensus on surgical techniques for ACL reconstruction, significant discrepancies remain on injury prevention and rehabilitation programs. This review article describes the burden of ACL injury on players in the National Football League, best practices in injury prevention and rehabilitation, and evidence-based recommendations for preparing injured athletes to return to play.

Effects of the COVID-19 pandemic on hip fracture volume, disposition, and readmission rates.

Our study aimed to assess the effects COVID had on the incidence of hip fractures. Hip fracture cases (from March 1 to September 1) were compared in 2018, 2019, and 2020. Data were analyzed for surgical volume, discharge location, and readmission rates. There was a statistically significant decrease in hip fractures during 2020 (P < 0.01) and a decrease in patients placed in skilled nursing facilities (P = 0.04), with no increase in 30-day readmission (P = 0.776). Findings suggest that COVID-19 has impacted the volume and composition of hip fracture cases. Although additional research on the subsequent survival impact is necessary, these placement patterns of hip fracture patients into facilities may be an opportunity to optimize cost and care.

Secondary traumatic stress among physiatrists treating trauma patients.

Secondary traumatic stress is a form of posttraumatic stress disorder resulting from exposure to others' acute serious physical harm or death, regardless of mechanism. However, the incidence of secondary traumatic stress among physiatrists remains unexplored. This study examined relationships with secondary traumatic stress among physiatrists. Surveys were distributed to members of the Association of Academic Physiatry and local physiatrists. Surveys included measures of secondary traumatic stress, resilience, personality factors, demographics, and work-related factors. Of 102 surveys returned, 88 were complete and included for analysis. The sample was 42 ± 11 years and included 45 women (51%). Moderate to severe levels of secondary traumatic stress were found in 26 (30%) respondents, and 45% reported clinical levels of at least one symptom cluster. Higher resilience, higher extraversion, and higher emotional stability were associated with significantly lower odds of positive secondary traumatic stress screens and lower symptom severity (all P < 0.023). In conclusion, a third of responding physiatrists reported moderate to severe symptoms of secondary traumatic stress-a rate consistent with previous research among clinicians in a trauma setting and higher than the rate of posttraumatic stress disorder in the general population. Resilience-building interventions for secondary traumatic stress are likely to improve the well-being of physiatrists.