Magnetic resonance imaging-documented chondral injuries about the knee in college football players: 3-year National Football League Combine data.

PURPOSE: To evaluate the incidence and risk factors for knee cartilage injury in elite college football players invited to attend the US National Football League (NFL) Scouting Combine over a 3-year period. METHODS: All players entering the NFL Scouting Combine (National Invitational Camp) from 2005 through 2007 were evaluated. "At-risk" knees underwent magnetic resonance imaging (MRI), and the results were evaluated for chondral injuries. RESULTS: During the 3-year period reviewed, a total of 980 players were available for analysis, and a total of 516 players' knee MRI scans were obtained (53% of all players at the Combine). The total number of full-thickness chondral injuries evident on MRI was 197 (20.1%) among all players, or 38.2% of the players who had an MRI scan. Of the players, 30 (3.06% of all players at the Combine, or 5.8% of the players who had an MRI scan) had isolated medial compartment full-thickness chondral injuries, 41 (4.2%, or 7.9%) had isolated lateral compartment full-thickness chondral injuries, 48 (4.9%, or 9.3%) had patellofemoral compartment full-thickness chondral damage, and 78 (7.96%, or 15.1%) had full-thickness chondral injuries in more than 1 compartment. CONCLUSIONS: The epidemiologic and risk assessment data presented in this study offer a cross-section of a young and elite athletic population who were "prescreened" at the NFL Combine over a 3-year period and judged to have at-risk knees. The total number of full-thickness chondral injuries evident on MRI was 197 (20.1%) among all players, or 38.2% of the players who had an MRI scan: 30 players (3.06%, or 5.8%) had an isolated medial compartment full-thickness chondral injury, 41 players (4.2%, or 7.9%) had an isolated lateral compartment full-thickness chondral injury, 48 players (4.9%, or 9.3%) had isolated patellofemoral compartment full-thickness chondral damage, and 78 players (7.96%, or 15.1%) had full-thickness chondral injuries in more than 1 compartment. LEVEL OF EVIDENCE: Level IV, diagnostic study.

Demineralized bone matrix for fracture healing: fact or fiction?

Demineralized bone matrix (DBM) has been touted as an excellent grafting material; however, there are no Level I studies that use DBM alone in humans to back up this claim. DBM functions best in a healthy tissue bed but should be expected to have little impact in an anoxic or avascular tissue bed, a situation often encountered in traumatic orthopaedic pathologies. Moreover, there is some evidence of differential potencies of DBM preparations based on donor variability and the manufacturing process. DBM efficacy may also be related to its formulation and the various carriers used. The fact that DBM is an allogeneic material opens up the potential for disease transmission. In addition, DBM activity may be altered by the hormonal status or nicotine use of a patient. In summary, although DBM has proven effective for bone induction in lower form animals, the translation to human clinical use for fracture healing, and the burden of proof, remains.

A shoulder health survey: correlating behaviors and comorbidities with shoulder problems.

Shoulder pain and loss of shoulder function are common complaints reported by a variety of patients. This article suggests that shoulder pain and loss of function are directly proportional to lifestyle choices, including smoking and obesity. To investigate possible relationships between lifestyle choices and shoulder health, the authors conducted an online survey combining the Oxford Shoulder Questionnaire, the Shoulder Rating Questionnaire, and the Subjective Shoulder Rating System. Data were collected from 166 respondents. Statistical significance was set at P < .05. The data show a statistically significant correlation between decreased shoulder function and cigarette smoking and a similar correlation between decreased shoulder function, elevated cholesterol, and obesity.

Negative pressure wound therapy with reticulated open cell foam-adjunctive treatment in the management of traumatic wounds of the leg: a review of the literature.

Over the last decade, the application of and indications for negative pressure wound therapy with reticulated open cell foam (NPWT/ROCF) as delivered by V.A.C.(R) Therapy (KCI, San Antonio, TX) have grown tremendously. This is particularly true in orthopaedic trauma in the management of injuries to the leg, ankle, and foot. This article reviews the evidence-based medicine in terms of NPWT/ROCF, as a method of reducing bacterial counts in wounds, as a bridge until definitive bony coverage, for treating infections, and as an adjunct to wound bed preparation and for bolstering split-thickness skin grafts, dermal replacement grafts, and over muscle flaps. NPWT/ROCF has been shown to be an adjunct to the mainstays of wound management. No significant complications have been noted in the categories of NPWT/ROCF discussed in this review. In addition, evidence supports a decrease in complex soft tissue procedures in grade IIIB open fractures when NPWT/ROCF is employed. Although more research needs to be done, NPWT/ROCF appears to provide clinical benefit for the treatment of these complex lower extremity wounds.