Recovery in Hip Range of Motion in Young Flexibility Athletes 1 Year After Periacetabular Osteotomy.

Background: Periacetabular Osteotomy (PAO) is a well-established surgical intervention for the treatment of hip dysplasia. Purpose: Our primary objective was to assess whether a group of young flexibility athletes who underwent PAO for hip dysplasia recovered their pre-operative hip range of motion (ROM) within 1 year of surgery. Our secondary objective was to compare hip ROM recovery between a group of young flexibility athletes and a group of non-flexibility athletes who underwent PAO for hip dysplasia. Results: In our study, 100% of flexibility athletes regained preoperative hip external rotation at 1-year post-operation. This was also the first plane of motion to return to preoperative motion in flexibility athletes. A significantly higher percentage of non-flexibility athletes regained their preoperative hip internal rotation compared to flexibility athletes (100% compared to 54%; P = .02), but not flexion or external rotation at 1-year post-operation. Conclusion: Our findings may help providers to set expectations regarding the recovery of hip ROM in flexibility athletes who undergo PAO for hip dysplasia.Level of Evidence: Level IV.

Considerations for Athlete Retirement After Sport-Related Concussion.

The recommendation to retire from sport after concussion has evolved with the understanding of concussion. Age, sport, position, level of play, relevant medical and concussion history, severity and duration of symptoms, neuroimaging and neuropsychological testing should all be considered. Susceptibility to injury, persistence of symptoms, psychological distress, and personal values and support may also play a role. Pediatric athletes may require a more conservative approach, given ongoing growth and development. For professional and/or elite athletes, financial or career implications may be considerations. When possible, retirement should be a shared decision among the athlete, the family, and the health care team.

Concussion-Symptom Rating Correlation Between Pediatric Patients and Their Parents.

CONTEXT: Understanding how parents and their children perceive concussion symptoms may provide insights into optimal concussion-management strategies. OBJECTIVE: To examine patient-parent correlations and agreement on concussion-symptom ratings, to identify differences in patient-parent symptom reporting between children (8-12 years of age) and adolescents (13-18 years of age), and to evaluate the correlation between patient and parent initial symptom-severity ratings with symptom duration and return-to-play time. DESIGN: Cross-sectional study. SETTING: Primary care sports medicine clinic. PATIENTS OR OTHER PARTICIPANTS: A total of 267 patients aged 8 to 18 years seen for care within 21 days of sustaining a concussion. Patients were classified as children (n = 65; age = 11.3 ± 1.4 years; age range, 8-12 years) or adolescents (n = 202; age = 15.5 ± 1.4 years; age range, 13-18 years). MAIN OUTCOME MEASURE(S): Each patient and his or her parent (or legal guardian) completed a concussion-symptom-frequency inventory, the Health and Behavior Inventory (HBI), at the initial postinjury examination. Patients were followed until they no longer reported concussion symptoms (symptom-resolution time) and were allowed to return to unrestricted sport participation (return-to-play time). RESULTS: At the initial examination (8.9 ± 5.2 days postinjury), the symptom-frequency correlation between children and their parents was high (rs = 0.88; 95% confidence interval [CI] = 0.80, 0.95). Adolescents' symptom-frequency reports were also highly correlated with those of their parents (rs = 0.78; 95% CI = 0.71, 0.85). However, the child-parent correlation was higher than the adolescent-parent agreement (z = 2.21, P = .03). Greater patient (consolidated child and adolescent) HBI ratings were associated with longer symptom-resolution times (coefficient = 0.019; 95% CI = 0.007, 0.031; P = .002) and longer return-to-play times (coefficient = 0.012; 95% CI = 0.002, 0.022; P = .02), whereas parent HBI ratings were not. CONCLUSIONS: Our findings may help to set expectations regarding concussion-symptom durations and return-to-play timing for pediatric patients and their families. Given the patient-parent correlations in our sample, substantial reporting discrepancies between patients and their parents may be a relevant factor for clinicians to investigate further during concussion evaluations.