The Use of MotusBASEBALL For Pitch Monitoring and Injury Prevention

Introduction: MotusBASEBALL (MOTUS) has proven to be a reliable and accurate method for evaluating the multifactorial kinesiology involved with pitching. We sought to review the use of MOTUS in assessment of pitching parameters and identify its practicality as an injury prevention tool across the literature. Methods: A systemic review of the literature was preformed, using key words such as MOTUS, baseball, pitcher, sensor and arm sleeve, identifying 77 total articles. Inclusion criteria entailed original articles that used MOTUS and studied baseball pitchers across any level of sport. Results: A total of 13 articles met the inclusion criteria, producing a sample of 493 male athletes with a mean age of 18.7. Uniformly across studies, elbow torque was a primary metric and was observed in relation to a wide range of variables, such as pitch type, height, weight and arm length. Additionally, MOTUS was able to detect several other pitching metrics, such as arm speed, shoulder rotation and arm slot, displaying a wide range of capabilities. Conclusion: We suspect MOTUS technology could become a significant tool for observing pitching mechanics in real time, as well as an injury prevention tool to be used by players, coaches and trainers across all levels of baseball

Can Opioids be Eliminated After Arthroscopic Meniscus Surgery? A Prospective Randomized Controlled Trial

Purpose: To compare a multimodal nonopioid pain protocol to traditional opioid medication in controlling postoperative pain following arthroscopic meniscal surgery. Methods: Ninety-nine patients undergoing primary meniscectomy or meniscal repair were assessed for participation. A prospective randomized control trial was performed in accordance with the Consolidated Standards of Reporting Trials 2010 (CONSORT) statement. The two arms of the study included a multimodal non-opioid analgesic protocol and a standard opioid regimen with a primary outcome of postoperative pain level (visual analog scale) for 10 days. Secondary outcomes included patient reported outcomes, complications and patient satisfaction. Randomization was achieved using a random number generator. Patients were not blinded. Data collection was done by a blinded observer. Results: A total of 61 patients were analyzed with 30 randomized to the opioid regimen, and 31 randomized to the non-opioid regimen. Patients receiving the nonopioid regimen demonstrated non-inferior VAS scores compared to patients who received opioid pain medication (p\u3e0.05) No significant differences were found in preoperative (opioid: 58.9 ± 7.0; nonopioid: 58.2 ± 5.5, p = 0.724) nor postoperative (opioid: 59.8 ± 6.5; nonopioid: 54.9 ± 7.1, p = 0.064) PROMIS-Pain Interference Short Form scores. No difference was found in recorded side effects between both groups: constipation, nausea, diarrhea, upset stomach, and drowsiness (p \u3c 0.05). Conclusion: This study found that multimodal nonopioid pain protocol provided equivalent pain control and patient outcomes following primary meniscus surgery while having an equivalent side effect profile. All patients reported satisfaction with their pain management without requiring emergency opioid analgesia

Career Longevity and Performance Following Shoulder Instability in National Football League Athletes

Purpose: To investigate the career longevity, game utilization and performance of National Football League (NFL) athletes following glenohumeral instability events treated operatively versus nonoperatively. Methods: Public resources identified NFL players who sustained a shoulder instability event from 2000-2019. Players with prior shoulder instability, without NFL experience before injury, or who did not return to play (RTP) after injury were excluded. Demographic information, utilization (games and seasons), and season approximate value (SAV) statistics were recorded one year prior to injury and three years following return to play (RTP). Statistical analysis compared utilization and SAV following RTP for athletes managed operatively versus nonoperatively. Results: Ninety-seven NFL players who sustained their first instability event while playing in the NFL were identified, 91 of whom RTP (93.8%). Quarterbacks were significantly more likely to undergo immediate surgical management compared to other positions (P=.023). Final analysis included 58 players managed operatively and 33 players managed nonoperatively by the end of the index season. Players treated operatively played in significantly more seasons following RTP during their remaining career (4.1±2.7 vs. 2.8±2.5 seasons; P=.015). There were no differences in games played or started, offensive or defensive snap count percentage, or performance (SAV) before and after injury when compared between cohorts (P\u3e.05). Following surgical stabilization, time to RTP (36.62±10.32 vs. 5.43±12.33 weeks, P Conclusions: Athletes who RTP in the NFL following a shoulder instability injury do so with similar workload and performance irrespective of surgical or non-surgical management. While nonoperative treatment is associated with faster return to play, operative management is associated with fewer recurrent instability events, greater time between recurrent instability events, and greater career longevit

Does Hospital Consumer Assessment of Healthcare Providers and Systems survey correlate with traditional metrics of patient satisfaction? The challenge of measuring patient pain control and satisfaction in total joint replacement

Background: Medicare reimbursements have been tied to patient satisfaction measures. Despite these measures' influence on reimbursements, the relationship between pain management and patient satisfaction remains unclear. This study aims to evaluate the relationship between traditional patient perception of pain control and their overall satisfaction after joint replacement. Methods: This study is a retrospective review of consecutive primary total hip and total knee replacements. A total of 286 patients who underwent primary total hip (N = 106) and total knee (N = 196) replacements with completed Hospital Consumer Assessment of Healthcare Providers and Systems surveys were evaluated. Pain control, communication, and hospital satisfaction were stratified into satisfactory or unsatisfactory groups. These 2 groups were compared in terms of visual analog scale (VAS), opioid use in morphine equivalents, length of hospital stay, anesthesia type, and demographics. Results: Average VAS and opioid use did not differ between patient groups for any of the questions evaluated. Those who responded “always” to pain domain questions had a statistically shorter length of stay compared to patients with other response. On average, those who endorsed “always” on communication question were younger. Conclusions: Patients who endorsed satisfactory pain control and communication with staff had shorter lengths of stay. There was no relationship between survey scores and traditional pain control measures such as VAS and opioid use. This questions the relevance of our primary pain measures in assessing patient perception of pain control. Length of stay may be a better surrogate marker for patient satisfaction of pain control. Keywords: Pain management, Total hip, Total knee, Patient-reported outcome

Arthroscopic Femoral Osteochondroplasty With Capsular Plication for Osteochondroma of the Femoral Neck

Osteochondromas of the femoral neck are a rare but challenging problem because of their distal location, which is difficult to access arthroscopically. Traditional methods of osteochondroma resection used invasive open approaches to manage these lesions. More recently, advances in hip arthroscopy have allowed expanded treatment of extra-articular hip conditions with a minimally invasive approach. Reports have described the use of hip arthroscopy for osteochondroma removal; however, surgical techniques for the procedure have yet to be described. We describe a technique for arthroscopic resection of a femoral neck osteochondroma using an extended capsulotomy and osteochondroplasty with subsequent capsular plication. This technique uses contemporary hip arthroscopic techniques and constitutes a safe and effective approach to addressing this rare intra-articular pathology of the hip