Lodbergnorris0506

4054). There was no significant correlation between labral width and the change in preoperative and 2-year postoperative iHOT (R2 = 0.05780), mHHS (R2 = 0.19826), or NAHS (R2 = 0.23543) outcome scores. Those with labral sizes in the upper decile of our cohort showed significantly decreased improvement in the iHOT (p= .0287) and NAHS (p= .0490) when compared to the middle 50% of labral sizes. There was no statistical difference in the rate that the groups achieved MCID or PASS. CONCLUSIONS Hypertrophic labra in the largest 10th percentile demonstrated lower postoperative outcome scores. However, there was no detectable clinical benefit in terms of patient perceived clinical difference or acceptable symptomatic state. For the majority of patients, labral size does not appear to significantly alter patient outcomes or need for arthroplasty. PURPOSE To evaluate outcome data of patients undergoing DeJour sulcus-deepening trochleoplasty with medial patellofemoral ligament reconstruction (MPFLR) for high-grade trochlear dysplasia at a single institution in the United States. METHODS A total of 67 patients (76 knees) with severe trochlear dysplasia and recurrent patellar instability were prospectively enrolled and underwent DeJour sulcus-deepening trochleoplasty with MPFLR from 2011-2019. Inclusion criteria included recurrent lateral patellar instability following failure of conservative treatment with radiographic evidence of severe trochlear dysplasia (DeJour types B or D). Patients were excluded with less than 2-year follow-up. Radiographic analysis, physical examination, clinical follow-up, patient demographics, and patient reported outcome measures were obtained for all patients at each visit. RESULTS Forty patients (44 knees) had complete two-year or longer follow-up and were included. The majority of patients were female (81.8%) with a mean agthis group with many revisions of prior procedures. PURPOSE To assess graft survivorship in patients that underwent autologous chondrocyte implantation (ACI) or osteochondral allograft transplantation (OCA) for the treatment of focal full-thickness cartilage lesions on the medial femoral condyle (MFC) with and without concomitant high tibial osteotomy (HTO), depending on the pre-operative lower extremity alignment. A secondary purpose was to retrospectively evaluate associated factors for ACI and OCA graft failures. METHODS A total of 168 patients who underwent cartilage repair with ACI or OCA with or without HTO for focal chondral defects on the MFC by a single surgeon between March 2007 and February 2018 were included. Clinical notes, operative reports and radiographic imaging were reviewed for each patient. Detailed Kaplan-Meier analyses were performed based on patient's mechanical axis alignment. In a sub-analysis, failures and non-failures in patients treated with ACI or OCA were comparatively evaluated. RESULTS In ACI, neutral mechanical alignment resulted in a significantly longer graft survival compared to slight valgus alignment (p = 0.003 and p = 0.05, respectively). No significant differences in survivorship were seen based on mechanical axis alignment in OCA patients (p > 0.05). Patients that were considered failures after ACI presented significantly more often with valgus alignment (p = 0.002), whereas failures in the OCA group were more often female and smokers (p = 0.025; p = 0.034). CONCLUSION In summary, the results of this study suggest that neutral mechanical axis alignment, regardless if physiologic or through HTO, improves survivorship in patients undergoing medial compartment ACI. Neutral alignment also showed a trend towards improved survivorship in patients after OCA, but this did not reach statistical significance. PURPOSE To determine if postsurgical pain, measured by visual analogue scale (VAS), following common orthopedic sports procedures could be managed effectively with a nonopioid multimodal analgesic protocol. METHODS This prospective study evaluated a custom multimodal non-opioid pain protocol in patients undergoing common orthopedic sports procedures by a single fellowship trained Orthopaedic Sports surgeon from May 2018 to December 2018. Procedures included anterior cruciate ligament reconstruction, rotator cuff repair, arthroscopic partial meniscectomy, and labrum repair. The non-opioid pain protocol consisted of preoperative analgesics, intraoperative local infiltration analgesia, and a postoperative pain regimen. Patient pain was immediately reported after surgery and 1 week postoperatively using the VAS, while rescue opioids (oxycodone 5 mg) used were recorded using a prescription opioid journal. Statistical analysis of patient VAS scores, demographic correlations, and comparison between opioid rescue use results suggest a non-opioid alternative to pain management following common orthopedic sports procedures. PURPOSE The purpose of this study was to compare the biomechanical differences between quadriceps tendon (QT) repair with high-strength suture (HSS) versus suture tape (ST) with varying number of suture passes. METHODS 28 fresh-frozen QTs were randomized into two groups i) HSS; or ii) ST; specimens were then further randomized into subgroups of either four or six suture passes. Specimens were secured within a materials testing system and a 150 N preload was applied 10s followed by a cyclic loading protocol between 50N and 250N for 1000 cycles. Video was utilized to follow tracking markers used to calculate the magnitude of tendon displacement. Two-way univariate ANOVA was used to determine the effect of suture type and passes on the displacement after preloading and mixed repeated-measures ANOVA was used to determine the effect of suture type and passes on displacement following cyclic loading. see more RESULTS There were large increases in displacement following the preload across all conditions (7.82±3.64 mm), with no statistically significant differences between groups. There was a significant difference in the mean (±SD) displacement between the ST (5.24±2.82 mm) and HSS (7.93±2.91 mm) starting at 200 cycles, which became more pronounced with successive testing out to 1000 cycles (p=0.0≤21). There were no significant difference with respect to the number of suture or tape passes.results CONCLUSIONS Following preloading at 150N, significant displacement occurred in both quadriceps tendon repair groups. ST demonstrated significantly less displacement than HSS under cyclic loading and had greater ultimate failure loads.conclusion CLINICAL RELEVANCE When performing quadriceps tendon repair, emphasis should be placed on appropriate pre-tensioning of sutures to at least 150N prior to knot-tying. Additionally, where available, suture tape should be utilized over high-strength suture to reduce further cyclic elongation and improve ultimate failure loads. OBJECTIVES Ultrasound research on speech production in normal speakers has long used quantitative measurements in different languages. However, no studies in this area have been conducted in the Persian language. This study investigated Persian speaking children scores on two single curve measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging. METHODS This is a cross-sectional study conducted on four 7-8 years old Persian speaking children. The data for analysis was collected using an ultrasound machine in 2018-2019. The stimuli included a range of consonants including/p/,/t/,/f/,/k/and/s/in consonant-vowel sequences, with the vowels/a/and/i/. The measures do not require head stabilization. Statistical analyses were done using Linear mixed models in lmer software package of R version 3.6.2. The results were performed by Chi-squared and Tukey post hoc tests in R. RESULTS In all of the consonants, the mean of two single curve measures in the context of/i/was greater than the context of/a/. However, there was no significant effect of the vowel context on one measure for the/k/. Also, these measures were significantly different in each of the Persian consonants and they showed consistent patterns across all of the participants (P less then 0.001). CONCLUSION It seems the single curve measures are the valid value of tongue dorsum excursion for Persian speaking children. link2 This study showed that measures of single curves are reliable for distinguish between consonants in vowel contexts and created robust results on lingual coarticulation of the consonants without the use of head stabilization. Acute vestibular syndrome is most often caused by vestibular neuritis or stroke, although demyelinating diseases may be responsible for 4% of all AVS episodes. The authors present the case of a previously healthy 17-year-old female patient complaining of spontaneous vertigo and right-sided hearing loss. Otoneurological examination suggested a peripheral vestibular cause and video head impulse test revealed a reduced vestibulo-ocular reflex gain. The presence of sensorineural hearing loss raised the suspicion of a central cause and prompted imaging evaluation. link3 A brain MRI evidenced demyelinating lesions in the right middle cerebellar peduncle and the patient was ultimately diagnosed with Multiple Sclerosis. OBJECTIVE Our objective was to compare the diagnostic characteristics of sonographic estimated fetal weight (SEFW) done within 7 versus 8-14 days before delivery for detection of fetal macrosomia (birthweight ≥ 4500 g). STUDY DESIGN We performed a multicenter, retrospective cohort study of all non-anomalous singletons with SEFW ≥ 4000 g by Registered Diagnostic Medical Sonographers conducted within 14 days of delivery. Cohorts were grouped by time interval between ultrasound and delivery 0-7 days versus 8-14 days. The detection rate (DR) and false positive rate (FPR) for detection of birthweight (BW) ≥ 4500 g were compared between groups with subgroup analysis for diabetic women. Area under the receiver operator curve (AUC) was calculated to analyze all possible SEFW cutoffs within our cohort. RESULTS A total of 330 patients met inclusion criteria with 250 (75.8 %) having SEFW within 7 days and 80 (24.2 %) with SEFW 8-14 days prior to delivery. The rate of macrosomia was 15.1 % (N = 51). The DR for macrosomia was significantly higher when SEFW was performed within 7 days of delivery compared to 8-14 days among non-diabetic (73.0 % vs 7.1 %; p less then 0.001) and diabetic women (76.5 % vs 16.7 %; p = 0.02). There was no significant change in FPR in either group. The AUC for detection of macrosomia was significantly higher when SEFW was performed within 7 days versus 8-14 days (0.89 vs 0.63; p less then 0.01). CONCLUSION With SEFW ≥ 4000 g, the detection of BW ≥ 4500 g is significantly higher when the sonographic examination is within 7 days of birth irrespective of maternal diabetes. Love wave propagation in periodically domain-inverted lithium niobate substrate with a homogeneous zinc oxide waveguide layer is theoretically investigated. Much attention is devoted to the effect of initial stress on the band gap and dispersion behavior of Love wave in the layered structure. The results reveal a strong dependency of the band structure on the waveguide layer. In particular, as the waveguide layer gradually thickens, the band gap shifts into a lower frequency range remarkably. Additionally, the initial stress has a significant influence on the location of the band gap, but a small effect on the bandgap width. This separate effect provides the potential to actively tune the surface acoustic waves by the stress.