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Kosko B, Richey B, Cardin S, White K, Youmans DH, Service B, Osbahr DC. Little League Shoulder and Subsequent Proximal Humeral Fracture in the Setting of Human Growth Hormone Use: A Case Report. JBJS Case Connect 2023; 13:01709767-202309000-00036. [PMID: 37556574 DOI: 10.2106/jbjs.cc.22.00612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
CASE A 16-year-old right-hand dominant male baseball player presented with little league shoulder in the setting of recombinant growth hormone utilization for growth hormone deficiency. After a prolonged treatment course, including physical therapy and throwing programs, the patient returned to baseball but suffered an ipsilateral proximal humerus fracture around the growth plate. CONCLUSION The occurrence of such an injury in the context of human growth hormone treatment merits consideration in youth athletes undergoing similar treatment regimens. Clinically, we recommend screening pediatric patients with sports-related epiphysiolysis for current or previous growth hormone use because of the possible prognostic implications of such treatment.
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Affiliation(s)
- Brendan Kosko
- Florida State University College of Medicine, Tallahassee, Florida
| | - Bradley Richey
- University of Michigan Orthopaedic Surgery Residency Program, Ann Arbor, Michigan
| | - Stefano Cardin
- Orlando Health Orthopedic Surgery Residency Program, Orlando, Florida
| | - Krishna White
- The Center for Health and Sports Medicine, Fruit Cove, Florida
| | | | | | - Daryl C Osbahr
- Rothman Orthopaedics Florida at AdventHealth, Orlando, Florida
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Williams C, Bagwell MT, DeDeo M, Lutz AB, Deal MJ, Richey BP, Zeini IM, Service B, Youmans DH, Osbahr DC. Demographics and surgery-related complications lead to 30-day readmission rates among knee arthroscopic procedures. Knee Surg Sports Traumatol Arthrosc 2022; 30:2408-2418. [PMID: 35199185 DOI: 10.1007/s00167-022-06919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The study objectives were (1) to evaluate risk factors related to 30-day hospital readmissions after arthroscopic knee surgeries and (2) to determine the complications that may arise from surgery. METHODS The American College of Surgeons National Surgical Quality Improvement Program database data from 2012 to 2017 were researched. Patients were identified using Current Procedural Terminology codes for knee arthroscopic procedures. Ordinal logistic fit regression and decision tree analysis were used to examine study objectives. RESULTS There were 83,083 knee arthroscopic procedures between 2012 and 2017 obtained from the National Surgical Quality Improvement Program database. The overall readmission rate was 0.87%. The complication rates were highest for synovectomy and cartilage procedures, 1.6% and 1.3% respectively. A majority of readmissions were related to the procedure (71.1%) with wound complications being the primary reason (28.2%) followed by pulmonary embolism and deep vein thrombosis, 12.7% and 10.6%, respectively. Gender and body mass index were not significant factors and age over 65 years was an independent risk factor. Wound infection, deep vein thrombosis, and pulmonary embolism were the most prevalent complications. CONCLUSION Healthcare professionals have a unique opportunity to modify treatment plans based on patient risk factors. For patients who are at higher risk of inferior surgical outcomes, clinicians should carefully weigh risk factors when considering surgical and non-surgical approaches. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Cynthia Williams
- Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA
| | - Matt T Bagwell
- Department of Public Administration, School of Criminology, Criminal Justice and Public Administration, College of Liberal and Fine Arts, Tarleton State University, 10850 Texan Rider Dr., Rm # 336, Fort Worth, TX, 76036-9414, USA.
| | - Michelle DeDeo
- Department of Mathematics and Statistics, College of Arts and Sciences, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA
| | - Alexandra Baker Lutz
- Department of Orthopedic Surgery, University of Maryland, 110 S Paca St, Baltimore, MD, 21201, USA
| | - M Jordan Deal
- Department of Orthopedic Surgery, William Beaumont Hospital, Royal Oak, 3577 W.13 Mile Rd., Suite 402, Royal Oak, MI, 48073, USA
| | - Bradley P Richey
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd 32827, Orlando, FL, USA
| | - Ibrahim M Zeini
- AdventHealth Research Institute
- Orthopedic Institute, 301 E Princeton St, Orlando, FL, 32804, USA
| | - Benjamin Service
- Orlando Health Jewett Orthopedic Institute, 7243 Della Drive, Floor 2, Suite I, Orlando, FL, 32819, USA
| | - D Harrison Youmans
- Rothman Orthopaedic Institute Florida, 410 Lionel Way Suite 201, Davenport, FL, 33837, USA
| | - Daryl C Osbahr
- Rothman Orthopaedic Institute Florida, 410 Lionel Way Suite 201, Davenport, FL, 33837, USA
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Sales E, Gupta S, Daines B, Baker A, Landgrabe M, Zeini IM, Youmans DH, Osbahr DC. Bicompartmental Bucket Handle Meniscal Tear with Chronic ACL Deficiency Causing a Rare Triple PCL and Triple Cruciate Sign: A Case Report. JBJS Case Connect 2021; 11:01709767-202106000-00064. [PMID: 33974600 DOI: 10.2106/jbjs.cc.20.00694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CASE A 16-year-old football player presented with chronic ACL deficiency along with bicompartmental bucket handle meniscal tears. CONCLUSION We present a "triple cruciate" sign in addition to the triple posterior cruciate ligament (PCL) sign seen on Magnetic Resonance Imaging (MRI) to aid in diagnosing this injury.
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Affiliation(s)
- Eric Sales
- Sunshine Valley Pediatrics, Las Vegas, NV
| | - Sunny Gupta
- University of Pennsylvania, Philadelphia, PA
| | - Benjamin Daines
- University of Central Florida College of Medicine, Orlando, Florida
| | - Alexandra Baker
- University of Central Florida College of Medicine, Orlando, Florida
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