The Opioid Epidemic in America: Pandemic Impacts.

There is still an ongoing epidemic of opioid abuse in the United States. It has resulted in a major healthcare crisis and led to an alarming number of daily overdose deaths. Strong interventions from the medical community and the government had made progress toward control. Tragically, the COVID-19 pandemic made the death rate dramatically worse. The purpose of this article is to reexamine the origins of this situation and provide updates from the pandemic period. The authors review the medical-legal risks physicians face when prescribing pain-relieving medications for their orthopaedic patients. Methods for providing responsible pain management plans for patients are suggested.

The Opioid Epidemic: Risk Evaluation and Management Strategies for Prescribing Opioids.

Abuse of opioids has had and continues to have a devastating impact on public health and safety in the United States, and the use of opioids has increased dramatically in the last two decades. The purpose of this chapter is to examine the roots of this tragic state of affairs and what may be done about it moving forward. The authors review the medical-legal risks physicians face when prescribing pain relieving medications for their patients. Strategies are offered for staying out of trouble while providing quality pain management for patients.

Latissimus dorsi and teres major tears in professional baseball pitchers: a case series.

BACKGROUND: Latissimus dorsi and teres major tendon tears are uncommon injuries. Only a few case reports exist, mainly in high-level athletes. PURPOSE: To describe a series of latissimus dorsi and teres major tendon tears in professional baseball pitchers. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Injury data from 3 Major League Baseball clubs were collected over a total of 10 seasons. Any baseball player who sustained an injury to either the latissimus dorsi or teres major identified on magnetic resonance imaging (MRI) was included. All injured players were treated nonoperatively with a goal of returning to full velocity throwing at 3 months from the time of injury. RESULTS: Ten players sustained injuries to the latissimus dorsi and/or the teres major during pitching. The MRI findings documented 5 isolated latissimus dorsi tears, 4 isolated teres major tears, and 1 combined injury. All athletes returned to pitching, and all but 1 player returned to baseball at the same level of competition in the same season. Nine of 10 players returned at 3 months from the time of their injury. One recurrence was seen 6 months after returning to throwing; however, this healed with further nonoperative treatment, and the player returned to competition at the same level 6 weeks later. One player had continued shoulder symptoms and retired at the end of the season. CONCLUSION: Although uncommon, tears of the latissimus dorsi and teres major occur in professional baseball players. Acute injuries are demonstrated on standard shoulder MRI, although larger field-of-view images are required to accurately assess the injury. Most heal successfully with nonoperative treatment, and most players are able to return to the same level of competition in 3 months.