Patterns of mouthguard utilization among atom and pee wee minor ice hockey players: a pilot study.

OBJECTIVE: To determine if youth hockey players wear their mouthguards properly, and if not, why? DESIGN: Descriptive cross-sectional study. SETTING: Tecumseh Shoreline Minor Hockey Association, Tecumseh, Ontario, Canada, during the 2007-2008 season. PARTICIPANTS: Subjects were 180 travel hockey players of the Tecumseh Shoreline Minor Hockey Association at the Atom or Pee Wee level (aged 9-12 y) or their competitors. ASSESSMENT OF RISK FACTORS: Players were asked to complete a survey addressing mouthguard wear under their coach's supervision. MAIN OUTCOME MEASURES: The type of mouthguard, whether mouthguards were worn at all and worn properly, and the reasons for noncompliance. The incidence of concussion and association to mouthguard-wearing tendencies were also assessed. RESULTS: Sixty-eight percent [95% confidence interval (CI), 60.4%-74.5%] of subjects always wore their mouthguards, but only 31.7% (95% CI, 25.0%-39.0%) wore them properly during games and 51.1% (95% CI, 43.6%-58.6%) during practice. Custom-made mouthguards were most likely to be worn properly, followed by boil-and-bite and stock-type guards. Younger players wore mouthguards more consistently than older players (P < 0.01). Reasons for not wearing the guard included the following: 43.0% (95% CI, 35.4%-50.4%) of subjects felt it made talking difficult, 27.4% (95% CI, 20.9%-34.3%) felt it uncomfortable, 23.9% (95% CI, 17.9%-30.8%) felt it made breathing difficult, and 12.4% (95% CI, 8.3%-17.9%) thought it did not fit correctly. The incidence of concussion was 17.8%, but the study was underpowered for any association with mouthguard type. CONCLUSIONS: Even when mouthguards are mandated to be worn in a children's travel hockey league, young players self-report that they routinely fail to wear them properly.

Raman spectroscopy of synovial fluid as a tool for diagnosing osteoarthritis.

For many years, viscosity has been the primary method used by researchers in rheumatology to assess the physiochemical properties of synovial fluid in both normal and osteoarthritic patients. However, progress has been limited by the lack of methods that provide multiple layers of information, use small sample volumes, and are rapid. Raman spectroscopy was used to assess the biochemical composition of synovial fluid collected from 40 patients with clinical evidence of knee osteoarthritis (OA) at the time of elective surgical treatment. Severity of knee osteoarthritis was assessed by a radiologist using Kellgren/Lawrence (K/L) scores from knee joint x rays, while light microscopy and Raman spectroscopy were used to examine synovial fluid (SF) aspirates (2 to 10 microL), deposited on fused silica slides. We show that Raman bands used to describe protein secondary structure and content can be used to detect changes in synovial fluid from osteoarthritic patients. Several Raman band intensity ratios increased significantly in spectra collected from synovial fluid in patients with radiological evidence of moderate-to-severe osteoarthritis damage. These ratios can be used to provide a "yes/no" damage assessment. These studies provide evidence that Raman spectroscopy would be a suitable candidate in the evaluation of joint damage in knee osteoarthritis patients.

Proximal row carpectomy with capitate resection and capsular interposition for treatment of scapholunate advanced collapse.

Proximal row carpectomy with capitate head resection and dorsal capsular interposition was performed in 8 patients with stage II and III scapholunate advanced collapse (SLAC). Mean patient age was 58.5 years (range, 50-79 years). One year postoperatively, range of motion and grip strength were not significantly changed from preoperative values. Mean postoperative Disabilities of the Arm, Shoulder, and Hand questionnaire score was 27. Pain improved from 8.8 preoperatively to 4.3 postoperatively on a scale of 0-10. Pain levels were highly inversely correlated with final range of motion (r=-0.94, P=.0004). Proximal row carpectomy with capitate leveling and capsular interposition for stage II and III SLAC wrist provides reasonable pain relief in 75% of patients. Patients should be counseled that 25% of cases may demonstrate progression of radiocapitate degeneration, necessitating further intervention.