John D Polousky

BACKGROUND: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies.

PURPOSE: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: Baseball-related ...

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in regard to the pediatric population. A single study on specimens younger than age 5 years demonstrated the ...

BACKGROUND: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis.

PURPOSE: To evaluate the relationship of the distal femoral physis and the MPFL.

STUDY DESIGN: Descriptive ...

BACKGROUND: Graft selection for anterior cruciate ligament (ACL) reconstructive surgery is a controversial topic. Few studies have compared graft outcomes in adolescents.

PURPOSE: To identify factors related to ACL graft failure in an adolescent cohort.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: After institutional review board approval was obtained, adolescent subjects (age range, 11-18 years) who underwent primary ACL reconstruction surgery at a large tertiary ...

BACKGROUND: Elastic intramedullary nails are commonly the preferred treatment option for operative stabilization of pediatric diaphyseal femur fractures. Increased complication rates have been reported in unstable fractures and older patients treated with TENs (titanium elastic nails). The reported complications have led to a change in management at our institution: limiting the use of TENs and using submuscular plating and trochanteric entry nails as alternatives. The purpose of this ...

BACKGROUND: Understanding the relationship of the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL) to the femoral and tibial physes is important to reducing the risk of physeal injury during surgical reconstruction. The purpose of this study was to identify the location of the attachments of the PCL and LCL in skeletally immature cadaveric knee specimens and to determine their position relative to the physes.

METHODS: Seven skeletally immature cadaveric knee ...

BACKGROUND: The reliability of assessing healing on plain radiographs has not been well-established for knee osteochondritis dissecans (OCD).

PURPOSE: To determine the inter- and intrarater reliability of specific radiographic criteria in judging healing of femoral condyle OCD.

STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 3.

METHODS: Ten orthopedic sports surgeons rated the radiographic healing of 30 knee OCD lesions at 2 time points, a minimum of 1 month apart. First, ...

BACKGROUND: Patellar dislocations are common in skeletally immature athletes, and the medial patellofemoral ligament (MPFL) is an important primary restraint to lateral patellar translation. The relationship between the MPFL femoral origin footprint and femoral physis is unclear. The purpose of this study was to evaluate the MPFL femoral origin footprint and its relationship to the femoral physis in skeletally immature anatomic specimens.

METHODS: Six skeletally immature cadaver knee ...

BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee.

PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis.

STUDY DESIGN: Descriptive laboratory study.

METHODS: Thirty-six cadaveric specimens between 2 and 11 ...

BACKGROUND: Understanding the pathogenesis of osteochondrosis/osteochondritis dissecans and other developmental orthopaedic diseases that are thought to occur secondary to defects in vascular supply to growth/epiphyseal cartilage has been hampered by the inability to image the vasculature in this tissue. This is particularly true in human beings due to limitations of current imaging techniques and the lack of availability of appropriate cadaveric samples for histological ...

BACKGROUND: The anterolateral ligament (ALL) of the knee has been identified as a structure that limits internal rotation, and thus, affects the pivot shift mechanism. It has previously been reported in a high percentage of adult subjects. The purpose of the current study was to evaluate whether the ALL could be identified on pediatric cadaveric knee specimens and compare these findings to previously published reports.

METHODS: Eight skeletally immature cadaver knee specimens were ...

Computer-assisted navigation for total knee arthroplasty provides high technology instrumentation that may improve the technique for restoring the normal lower limb mechanical axis. This study evaluated the use of computer-assisted navigation in 7 patients (9 total knee arthroplasties) with a radiographic femoral extra-articular deformity. Postoperatively, the mechanical axis deviated medially by a mean of 1.3 degrees +/- 0.9 degrees (range, -0.2 degrees to 2.5 degrees ). Early patient ...

BACKGROUND: Several systems have been proposed for classifying osteochondritis dissecans (OCD) of the knee during surgical evaluation. No single classification includes mutually exclusive categories that capture all of the salient features of stability, chondral fissuring, and fragment detachment. Furthermore, no study has assessed the reliability of these classification systems.

PURPOSE: To determine the intra- and interobserver reliability of a novel, comprehensive arthroscopic ...

BACKGROUND: The purpose of this study was to evaluate the medial patellofemoral ligament (MPFL) patellar insertion in skeletally immature anatomic specimens.

METHODS: Nine pediatric cadaveric knee specimens were examined through gross dissection. Metallic markers were placed at the MPFL patellar insertion footprint. Computed tomographic scans for each specimen were analyzed. The MPFL insertion footprint width, patellar height, and patellar width were measured. The distance from the MPFL ...

BACKGROUND: Based on recent evidence of inconsistent outcomes after the closed treatment of adult midshaft clavicle fractures, the management of similar fracture patterns in adolescents is being reevaluated. The primary aim of this study is to report current treatment preferences for adolescent midshaft clavicle fractures among pediatric orthopaedic physicians and to determine if recent adult literature has influenced clinical decision making.

METHODS: An invitation email to a ...