orbidities, specifically depression and anxiety, was independently associated with revision HA and overall HA failure.Level of Evidence III.

Femoroacetabular impingement (FAI), particularly cam-type, is now well accepted as a risk factor for the development of hip osteoarthritis (OA). However, many hips with FAI morphology will never develop hip pain or OA, identifying that our current understanding of FAI disease progression remains limited. The purposes of this retrospective case-control study were to (1) report the patient and disease characteristics of patients with rapidly progressive FAI requiring hip arthroplasty by the age of 40 and (2) to identify patient and imaging factors associated with rapidly progressive FAI.

Cases were retrospectively identified from an arthroplasty registry as patients 40 years old or younger with underlying FAI deformity and end stage OA requiring primary total hip arthroplasty. Patients were excluded for known DDH, AVN, SCFE, inflammatory arthritis, and previous ipsilateral surgery. Controls were identified from a hip preservation database as patients with symptomatic FAI undergoing surgical intervention oves with symptomatic FAI, rapidly progressive cases did not demonstrate major differences in cam deformity magnitude. check details Thus severity of bony deformity may only be one aspect of a multifactorial etiology of hip OA progression in FAI.

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When compared to controls with symptomatic FAI, rapidly progressive cases did not demonstrate major differences in cam deformity magnitude. Thus severity of bony deformity may only be one aspect of a multifactorial etiology of hip OA progression in FAI.Level of Evidence III.

Adjustable-length cortical suspension devices provide technical advantages over fixed-length devices for femoral graft fixation during anterior cruciate ligament (ACL) reconstruction but have shown increased lengthening during cyclic loading in biomechanical studies. The purpose of this study was to prospectively measure graft elongation in vivo along with patient reported outcomes.

Thirty-seven skeletally mature patients diagnosed with anterior cruciate insufficiency who underwent ACL reconstruction using autogenous hamstring graft were included in this study. Thirteen patients received an ACL reconstruction using a fixed loop device (FL) and twenty-four patients were treated with an adjustable-length device (AL) based on surgeon preference. Bilateral knee laxity was measured with a KT1000 Arthrometer before surgery and immediately after surgery with the patient under anesthesia, and at the 6-week, 3-month, and 6-month clinical follow-up appointments. All measurements were made by the same operator with the groups.Level of Evidence IV.

Some NCAA conferences now require a press box-based Medical Observer for all football games to identify injuries missed by on-field providers. The objective of this study was to determine whether a Medical Observer identified injuries missed by the on-field medical personnel.

This was a comparative observational study of injury identification methods which was done at nine NCAA football games. The athletes on a single institution’s varsity football team participated. Eight games and one bowl game were studied. Observers were sports medicine Fellows (Orthopaedic, Primary Care). Injury logs were kept by the Medical Observer to document game day injuries. The athletic training staff collected injury reports in the days following games. These were compared with game day injury logs to identify any injuries that were not reported to the medical staff during competition.

A total of 41 game injuries were identified (4.56 injuries/ game). 29 injuries (29/41; 71%) were identified by both the sideline medical proreated the following day.Level of Evidence II.Background Haemophilus parainfluenzae (H. parainfluenzae) is a gram-negative rod that inhabits the oral cavity. It is a common cause of respiratory tract infections and rarely is responsible for musculoskeletal infections in immunocompetent hosts. We present a case of a 17-year-old male whose postoperative course following arthroscopic all-inside meniscus repair was complicated with H. parainfluenzae septic arthritis. The infection was successfully cleared with two arthroscopic irrigation and debridements and antibiotic therapy. The patient successfully returned to full-contact high school football at five months postoperatively. To our knowledge, this represents the first reported case of H. parainfluenzae infection following an orthopaedic procedure in an adolescent. Level of Evidence IV.

To determine if children with Osteochondritis Dessicans (OCD) lesions of the distal femur are more likely to have a co-morbid diagnosis of Attention Deficit/ Hyperactivity Disorder (ADHD) than age matched controls and to assess the impact of ADHD on OCD outcomes.

A retrospective chart review of patients treated at a single tertiary care hospital between 2000-2012 was performed. Charts were reviewed for a diagnosis of OCD of the distal femur in all skeletally immature patients (males < 16 years and females < 14 years). These were then screened for a comorbid diagnosis of ADHD. Age-matched controls with anterior knee pain without OCD were then reviewed to determine if ADHD was more common in the OCD population. Treatment and outcomes of the OCD lesions were then compared in children with and without ADHD.

The prevalence of ADHD was 23% in patients with OCD lesions and was significantly greater than the 11% found in the anterior knee pain age-matched controls (p<0.05). The average grade of lesions at presentation was similar in both groups (2.2 ADHD vs 2.1 no ADHD) however, at final follow-up, the average OCD grade was significantly worse for children with ADHD (1.4 vs 0.7, p<0.004).

There is a significantly higher prevalence of ADHD in children with OCD lesions compared with age-matched controls. This study suggests children that with osteochondritis dessicans and ADHD may not have as favorable treatment course as children without the hyperactivity disorder.

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There is a significantly higher prevalence of ADHD in children with OCD lesions compared with age-matched controls. This study suggests children that with osteochondritis dessicans and ADHD may not have as favorable treatment course as children without the hyperactivity disorder.Level of Evidence III.