Performance and return to sport after injury in professional mixed martial arts.

BACKGROUND: Mixed Martial Arts (MMA) is an increasingly popular combat sport incorporating striking and grappling that results in a high incidence of injuries. OBJECTIVES: The purpose of this study was to analyze the impact of injuries on the return to sport and post-injury performance of professional MMA athletes. We hypothesize that increased age is associated with lower probability of return to sport and diminished post-injury performance. METHODS: Publicly available data (obtained from ESPN.com/MMA, UFC.com, Rotowire.com/MMA) from professional MMA fighters who resigned from fight cards due to injury from 2012 to 2014 were analyzed. Injury history, match history and outcomes, and duration of time to return to professional fighting were recorded and compared to a cohort consisting of uninjured opponents. RESULTS: 454 fighters were included in the analysis. The mean age at the time of injury was 30.0±3.9 years. 94.4% of injured athletes were able to return to professional MMA, and athletes required a mean duration of 6.8±6.7 months between injury and their next professional fight (range 0.3-58 months). There was no significant difference in winning percentage in the post-injury period between the injured group and the uninjured group (p = 0.691). Increased age at the time of injury was associated with the odds of being able to return to professional fighting after injury (OR = 0.822, p = 0.001). CONCLUSION: In this analysis of publicly available injury data on MMA fighters, there was a high rate of return to professional sport and no evidence of an associated decline in performance following major injury requiring withdrawal from a fight card. Older age at the time of injury was associated with decreased odds of being able to return to professional fighting. With increasing popularity of combat sports, sport-specific prognostic information will help guide and treat specific injuries associated with MMA participation.

Opioid Stewardship in Orthopaedic Surgery: Principles and Practice.

The abuse of prescription opioid pain medication has contributed to the U.S. opioid crisis. Opioid stewardship programs ensure that our patients receive the safest and most effective opioid regimens. Opioid stewardship programs involve a multidisciplinary team, including pharmacists, orthopaedic surgeons, nurses, pain management personnel, and anesthesiologists. All of these stakeholders work together to formulate the best evidence-based use of these medications.

Hemispheric differences in relational reasoning: novel insights based on an old technique.

Relational reasoning, or the ability to integrate multiple mental relations to arrive at a logical conclusion, is a critical component of higher cognition. A bilateral brain network involving lateral prefrontal and parietal cortices has been consistently implicated in relational reasoning. Some data suggest a preferential role for the left hemisphere in this form of reasoning, whereas others suggest that the two hemispheres make important contributions. To test for a hemispheric asymmetry in relational reasoning, we made use of an old technique known as visual half-field stimulus presentation to manipulate whether stimuli were presented briefly to one hemisphere or the other. Across two experiments, 54 neurologically healthy young adults performed a visuospatial transitive inference task. Pairs of colored shapes were presented rapidly in either the left or right visual hemifield as participants maintained central fixation, thereby isolating initial encoding to the contralateral hemisphere. We observed a left-hemisphere advantage for encoding a series of ordered visuospatial relations, but both hemispheres contributed equally to task performance when the relations were presented out of order. To our knowledge, this is the first study to reveal hemispheric differences in relational encoding in the intact brain. We discuss these findings in the context of a rich literature on hemispheric asymmetries in cognition.