Board of Directors Names Clare L. Ardern Next JOSPT Editor-in-Chief.

The JOSPT/Movement Science Media (MSM) Board of Directors is pleased to announce its appointment of the first woman Editor-in-Chief (EIC) of the Journal, Clare L. Ardern, PT, PhD. Dr Ardern succeeds J. Haxby Abbott, DPT, PhD, FNZCP, who held this position for 2 years from January 2016 through December 2017. Beginning July 1, 2018 and for the next year, Dr Ardern will work collaboratively as EIC Elect with Guy G. Simoneau, PT, PhD, ATC, FAPTA, who is currently serving as Interim EIC and previously served as JOSPT EIC for 14 years. J Orthop Sports Phys Ther 2018;48(7):517-518. doi:10.2519/jospt.2018.0106.

Assessment of Distal Radioulnar Joint Stability After Reconstruction With the Brachioradialis Wrap.

BACKGROUND: The brachioradialis (BR) wrap technique is an option to restore the stability of the distal radioulnar joint (DRUJ). The technique capitalizes on the BR's advantageous insertion point on the radial styloid and the ability of the BR to be harvested with minimal to no deficit. The tendon can then be wrapped around the radius and ulna, tunneling under the pronator quadratus and extensor compartments and secured back into its insertion to provide stability. In this cadaveric study, we used micro-computed tomography (CT) to assess the stability restored by this procedure. METHODS: Axial CT scans were taken of cadaveric specimens (n = 10) in 3 different positions (neutral, 60° pronation, and 60° supination) to establish the baseline measurements of each DRUJ. Surgical disruption of the dorsal and volar ligaments of each DRUJ then simulated a destabilizing injury and the specimens were scanned again. The specimens then underwent the BR wrap procedure and were scanned once more. Degree of ulnar subluxation with respect to the Sigmoid notch was determined using the modified radioulnar line method. RESULTS: The mean percentages of subluxation in the neutral position for the normal, injured, and reconstructed DRUJ were 22.4±4.9%, 56.2±12.9%, and 29.0±6.5%, respectively. In 60° pronation, these values were 15.4±4.7%, 53.5±15.0%, and 36.5±11.8%, respectively. In 60° supination, these values were 18.6±2.5%, 69.7±20.5%, and 31.9±8.7%, respectively. CONCLUSIONS: Values differed significantly between normal and injured conditions in all positions. No significant difference was noted between normal and reconstructed conditions, suggesting reconstruction improves DRUJ biomechanics and more closely approximates normal stability.

JOSPT Experiences Tremendous Growth, Change in 14 Years With Editor-in-Chief Simoneau in Charge.

As Editor-in-Chief, Dr Guy G. Simoneau and his editorial board have taken JOSPT from an acceptable US-based journal to a highly influential worldwide force behind contemporary orthopaedic and sports physical therapy research and practice. Today, the bridge Dr Simoneau constructed spans the orthopaedic and sports physical therapy globe for the betterment of clinical practice and research. His work fully supports JOSPT's latest strategic plan to provide value-added knowledge translation, develop a broader authorship and readership, increase global marketing of the JOSPT brand, and expand current relationships to new partners and stakeholders. The bridge places JOSPT on very firm footing, tying its rich history to the promise of an exciting and successful future.

JOSPT's Board names Dr Haxby Abbott editor-in-chief elect.

On behalf of JOSPT's Board of Directors, President John A. Nyland is pleased to announce that J. Haxby Abbott, DPT, PhD, FNZCP, has accepted the position of editor-in-chief for JOSPT. He succeeds Guy G. Simoneau, PT, PhD, ATC, who has served in this role since the January 2002 issue.

A formal reception improves orthopaedic surgery residency program applicant perceptions of the interview experience.

Orthopaedic surgery residency program (OSRP) applicant selection is an essential part of program success. The perceived quality that applicants place on an OSRP may influence whether or not they apply. Efforts are being made in Kentucky to recruit the best possible applicants for residency programs. This study evaluated the relationship between the pre-interview reception structure and applicant perceptions of the interview process. A retrospective study of prospectively collected data from all OSRP applicants interviewed between 2001 and 2006 was performed. Applicants interviewed between 2002 and 2006 received an informal reception without direct faculty involvement. Applicants interviewed between 2000 and 2001 received a formal reception with direct faculty involvement. The overall response rate was 86.4% (178 of 206 interviewees). Applicants who participated in the formal reception developed a more positive perception of the interview process (Fisher's Exact Test = 7.71, P = 0.035). Presenting a positive image of the OSRP as an important marketing tool. The formal reception generated a more positive applicant perception.

Orthopedic trauma from recreational all-terrain vehicle use in central Kentucky: a 6-year review.

BACKGROUND: All-terrain vehicle (ATV) crashes and injuries have become an increasing concern for the medical community. After the expiration of federal guidelines in 1998, the United States Consumer Product Safety Commission has tracked an increasing incidence of usage and injury. This retrospective review of data from a Level I trauma center presents ATV crash-related injury prevalence, type, and location sustained in central Kentucky and compares the data with previous reports. METHODS: Patient demographics, helmet and alcohol use, insurance type, injury type and location, Injury Severity Score (ISS), Glasgow Coma Scale (GCS) score, Functional Independence Measure (FIM), duration of hospital stay, days in an intensive care unit (ICU), internal disposition, and discharge destination were analyzed among individuals who had sustained ATV crash-related injuries between January 1998 and December 2003. RESULTS: Patients were primarily male (85.4%), white (98%), resided in a rural county (85.1%), and relied on commercial insurance (36.2%) or self-pay (31.4%) for medical expenses. Alcohol use before injury was documented for 25% and 85.5% were not wearing a helmet. Rollover was the primary ATV crash mechanism (63.3%) and 52.1% of patients lost consciousness. Of 707 total injuries, 319 (45.1%) were fractures or dislocations with the spine (26%), ribs (24.1%), clavicle (6%), radius-ulna (5.3%), and tibia-fibula (4.7%) being the most common locations. Admitted patients were hospitalized for 8.1+/-12.7 days (range=0-127 days), 42% were transferred to the standard care ward, 28.2% spent 8.4+/-7.7 days (range=1-34 days) in the ICU, and 18.6% were taken directly to the operating room. At discharge 78.2% of patients went home, 12.8% were transferred to a rehabilitation facility, 4.8% died, and 3.2% were transferred to another hospital. Patients who never lost consciousness or who were discharged to home had lower ISSs and greater composite and component GCS and FIM scores. CONCLUSION: Almost half of all patients sustained one fracture or joint dislocation with the spine being the most prevalent location. Injury severity, the low number referred to rehabilitation facilities, and predominantly rural residence locations suggests that many may not be accessing needed healthcare services. Prospective longitudinal outcome studies are needed to assess patient functional independence, quality of life, and health care system effectiveness.

Prehabilitation before knee arthroplasty increases postsurgical function: a case study.

Conditioning the body to undergo physical stress such as joint arthroplasty has been termed prehabilitation. This case study examined the effect of a 4-week prehabilitation intervention on functional outcomes after total knee arthroplasty (TKA). Two female subjects completed baseline strength and functional assessments before TKA. Subjects were randomized to either a 4-week prehabilitation intervention (ES) aimed at increasing strength and range of motion or a usual care condition (CS). After 4 weeks of training, subjects were reassessed and underwent TKA. Subjects completed a final assessment 12 weeks after TKA. Functional outcomes included 6-minute walk, number of times up from a chair in 30 seconds, proprioception, and self-reported function and pain using the Western Ontario and McMaster Universities Osteoarthritis Index. The data suggest that 4 weeks of prehabilitation had a positive effect on functional task performance and knee proprioception before surgery. After surgery, the ES continued to exhibit higher levels of functioning and less pain compared with the CS. Prehabilitation before TKA may contribute to improved recovery after surgery.

Recreational all-terrain vehicle injuries among children: an 11-year review of a Central Kentucky level I pediatric trauma center database.

BACKGROUND: A database review of 238 admissions for recreational all-terrain vehicle (ATV) accident-related injuries treated over an 11-year period at a level I pediatric trauma center in Central Kentucky was performed. METHODS: Descriptive statistical analysis of patient demographics (age and sex), helmet use, county of residence, county of ATV accident, injury mechanism, injuries sustained, days of hospitalization, days in the intensive care unit, Glasgow Coma Scale (GCS) score, Injury Severity Score, Functional Independence Measure (FIM) score, and discharge disposition was performed. RESULTS: All-terrain vehicle accident-related admissions increased approximately 4.7 times, and overall fracture number increased 4 times over the study period. Most injuries were sustained in the county of residence (81.1% [193 of 238]). The single largest group of patients resided and sustained injuries (48.3% [115 of 238]) in a level I county (metropolitan area population, > or =1 million). Mean Injury Severity Score was 7.3 +/- 5.6, and average hospitalization was 4.3 +/- 4.0 days. Most patients (84% [201 of 238]) were not wearing a helmet, and 18.1% (43 of 238) were admitted to the intensive care unit. Patients were aged 11.4 +/- 3.6 years, predominantly boys (70% [166 of 238]), between the age of 11 and 15 years (59.7% [142 of 238]), and 63% (150 of 238) sustained at least 1 fracture. The lower extremity (32.4% [66 of 204]), upper extremity (25% [51 of 204]), and face-skull (25% [51 of 204]) were the most common fracture sites. The femur (45.5% [30 of 66]) and tibia-fibula (42.4% [28 of 66]) were the most common lower extremity fracture sites. The radius-ulna (39.2% [20 of 51]) and humerus (25% [13 of 51]) were the most common upper extremity fracture sites. Nine patients (4.4% of total fractures) sustained spinal fractures. Most patients (93.7% [223 of 238]) were discharged home, 6.3% (15 of 238) were discharged to a rehabilitation facility or to another hospital. Helmet use was related to higher component GCS and FIM communication scores, and patients with higher component GCS and FIM scores were more likely discharged to home. CONCLUSIONS: Hospital admissions and fractures concurrently increased over the study period, with the greatest increase occurring between 1998 and 1999, shortly after expiration of the 1988 Consent Decrees between the Consumer Product Safety Commission and the ATV industry.

Evaluation of cruciate and slot auxiliary screw head design modifications for extracting stripped screw heads.

Slotted and cruciate auxiliary screw head design modifications for "salvaging" a stripped hexagonal head screw were studied. Thirty screws were divided into 3 groups: Group 1 = control without modification, Group 2 = auxiliary cruciate design modification and Group 3 = auxiliary slot design modification. Screws were inserted into adhesive filled high-density synthetic bone tunnels using a hexagonal driver. Group 1 screws were removed using a hexagonal driver. Group 2 and group 3 screws were removed using drivers that matched their respective auxiliary design modifications. All group 1 and group 3 screws (100%) were effectively extracted. Three of 10 (30%) group 2 screws could not be effectively extracted. Group 2 screws displayed greater stripping and deformation than the other groups. The auxiliary slot design modification withstood comparable extraction torques as control screws without significant deformation. Screws with a cruciate design modification displayed more frequent failure, greater stripping and deformation.

Scapular thickness--implications for fracture fixation.

The purpose of this study was to measure and map scapula osseous thickness to identify the optimal areas for internal fixation. Eighteen (9 pairs) scapulae from 2 female and 7 male cadavers were used. After harvest and removal of all soft tissues, standardized measurement lines were made based on anatomic landmarks. For consistency among scapulae, measurements were taken at standard percentage intervals along each line approximating the distance between two consecutive reconstruction plate screw holes. Two-mm-diameter drill holes were made at each point, and a standard depth gauge was used to measure thickness. The glenoid fossa (25 mm) displayed the greatest mean osseous thickness, followed by the lateral scapular border (9.7 mm), the scapula spine (8.3 mm), and the central portion of the body of the scapula (3.0 mm). To optimize screw purchase and internal fixation strength, the lateral border, the lateral aspect of the base of the scapula spine, and the scapula spine itself should be used for anatomic sites of internal fixation of scapula fractures.

Knee flexor function 2 years after anterior cruciate ligament reconstruction with semitendinosus-gracilis autografts.

PURPOSE: This retrospective study evaluated the knee flexor function of 20 patients at 25.8 +/- 5 months after anterior cruciate ligament reconstruction with use of a semitendinosus-gracilis (STG) autograft. METHODS: Clinical examinations included instrumented isometric testing, conventional and prone isokinetic testing, hop testing, knee arthrometry, modified visual analog scale leg sensation evaluation, and International Knee Documentation Committee (IKDC) Subjective Knee and Current Health Evaluations. Paired t tests were used to evaluate side-to-side differences, and multiple regression analysis related these findings to knee function (P < .05). RESULTS: Involved side active knee flexion was decreased by 8.2 degrees +/- 5 degrees. Involved side isokinetic knee flexor work was decreased by 76.7 +/- 118 J at 60 degrees/sec during conventional testing and was decreased by 94.4 +/- 107 J and 86.3 +/- 115 J at 60 degrees/sec and 180 degrees/sec, respectively, during prone testing. Isometric testing at 90 degrees and 120 degrees flexion in internal and neutral tibial rotation, respectively, revealed decreased involved side knee flexor torque > or = 13.2 +/- 12 Nm. Sensation scores revealed a mean 24% difference from the uninvolved side (range, 0% to 80%). Multiple regression revealed that instrumented isometric testing at 90 degrees knee flexion with neutral tibial rotation and the role physical score predicted 62% (R2 = .62) of involved side forward hop capability (P < .0001). Self-reported activity level and isokinetic work (60 degrees/sec) predicted 69% (R2 = .69) of involved side lateral hop capability (P < .0001). Sensation, role physical score, and prone isokinetic peak torque (180 degrees/sec) predicted 80% (R2 = .80) of involved side medial hop capability (P < .0001). CONCLUSIONS: Two years after surgery, functionally significant knee flexor strength deficits remain. Prone isokinetic knee flexor work at 60 degrees /sec, isometric knee flexor torque at 90 degrees flexion-neutral tibial rotation, and sensation score were related to patient function 2 years after anterior cruciate ligament reconstruction with an STG autograft. LEVEL OF EVIDENCE: Level IV, therapeutic case series.