Prevalence and Treatment Outcomes of Hand and Wrist Injuries in Professional Athletes: A Systematic Review.

BACKGROUND: Injuries to the hand and wrist constitute up to 25% of all athletic injuries, yet not much information is available on the effects of such injuries on the careers of professional athletes. Understanding whether elite athletes can return to sport and at what level has value for athletes, coaches, managers, and others, including athletes at other levels of play. QUESTIONS/PURPOSES: The purpose of this study was to systematically review the literature on injuries of the hand and wrist in professional athletes to determine the prevalence and types of injuries sustained in professional sports, the management and clinical outcomes of such injuries, and the statistics regarding return to play. METHODS: A systematic review was conducted of PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials to identify all studies reporting on hand and wrist injuries in professional athletes that were published between January 1970 and April 2019. Inclusion criteria were injuries of the upper extremity distal to the elbow that occurred in professional athletes during athletic competition, English language, and a study cohort consisting of four or more subjects. Details of injury sustained, sport, treatment, clinical outcome, and return to sport were extracted. RESULTS: We identified 32 nonoverlapping studies involving a total of 4299 hand and wrist injuries. The most common sport studied was baseball (eight studies), followed by football (seven), boxing (six), and basketball (five). Specific injury type was included in 29 of 32 studies and totaled 792 injuries. Metacarpal fractures were the most common injuries (n = 273; 34.5%), followed by thumb collateral ligament injuries (n = 110; 13.9%), phalangeal fractures (n = 87; 11.0%), and scaphoid fractures (n = 56; 7.1%). The overall operative rate was 18.3% (n = 708 of 3867). One-half of the studies reported the return to play (average, 2.8 months; range, 0.5 to 9 months). Seven studies reported sport-specific objective performance measures, with six describing consistent return to preinjury levels of performance among athletes. CONCLUSIONS: Based on the available evidence, a large majority of hand and wrist injuries in professional athletes are treated conservatively. Athletes frequently return to preinjury levels of performance after surgery. Additionally, return to play after a hand injury appears to be faster than that after other bony injuries. Further research is needed into the impact of these injuries on athletic performance, as well as how surgical intervention affects validated patient-reported outcome measures in professional athletes.

Level of Evidence and Publication Rates of Abstracts Presented at the American Society for Surgery of the Hand Annual Meetings: Comparison Over 23 Years.

PURPOSE: The primary aims of this study were to determine how level of evidence and publication rates of American Society for Surgery of the Hand (ASSH) abstracts presented at the national meeting have changed over the past 23 years. METHODS: Abstracts presented at the ASSH annual meeting from 1992 to 2014 were reviewed. Level of evidence (LoE) and publication status for each abstract were recorded. We calculated annual and overall LoE, publication rates, average time to publication, and top journals of publication for abstracts presented from 1992 to 2014. The LoE was categorized into level 1 or 2 studies, levels 3 to 5 studies, or nonclinical study. RESULTS: A total of 1,757 abstracts were presented at ASSH meetings from 1992 to 2014; 942 abstracts were published in peer-reviewed journals for an overall publication rate of 53.6%. There was a significant increase in the proportion of levels 1 to 2 LoE abstracts over time (18% in 2007-2014 vs 11% in 1999-2006 and 2% in 1992-1998). There was also a significantly higher percentage of abstracts published over time (62% in 2007-2014 vs 52% in 1999-2006 and 47% in 1992-1998). Levels 1 to 2 LoE studies were associated with higher publication rates than nonclinical or levels 3 to 5 LoE studies. CONCLUSIONS: This research provides historical trends on the LoE of abstracts presented at the ASSH annual meetings. Our study shows there are increasing numbers of levels 1 to 2 studies as well as higher publication rates of abstracts presented at more recent ASSH annual meetings. Levels 1 to 2 studies are more likely to be published than nonclinical or levels 3 to 5 studies. CLINICAL RELEVANCE: Although not all questions can be feasibly answered with level 1 or level 2 studies, authors should continue to search for ways to strengthen study designs, producing more valid and comparable results with increased likelihood of publication driving forward the quality of hand surgery research. Higher recent publication rates may be partially due to the increased number of available journals for publication.

Adult Reconstruction Hip and Knee Fellowship Program Content and Accessibility.

BACKGROUND: The objective of the study was to assess the accessibility and content of accredited adult reconstruction hip and knee fellowship program websites. METHODS: Using the online database of the American Association of Hip and Knee Surgeons (AAHKS), we compiled a list of accredited adult hip and knee/tumor reconstruction fellowship programs. A full list of adult reconstruction hip and knee fellowship programs was gathered from the AAHKS website. The program website links they provided were evaluated. A Google search was conducted to identify program websites and analyzed for accessibility and content in 3 domains: program overview, applying/recruitment, and education. RESULTS: At the time the study was conducted, there were 78 accredited adult reconstruction hip and knee fellowship programs identified through the AAHKS program directory. Three of the 78 programs identified had a functional link on the AAHKS fellowship program directory; however, Google search identified 60 websites. Eighteen programs did not have a website and were not evaluated for content. Data analysis of content in the domains of program details, application process/recruitment, and education revealed that most websites included a program description and director name with contact information. However, they were not as comprehensive in the application process/recruitment and education domains. CONCLUSIONS: AAHKS provides a reasonable method of identifying programs. Yet, most programs can readily be identified using a Google search (76.9%). Although most fellowship program websites contained program details, there is still paucity of information for fellowship candidates.

Characteristics of Orthopedic Publications in High-Impact General Medical Journals.

Orthopedic studies are occasionally published in high-impact general medical journals; these studies are often given high visibility and have significant potential to impact health care policy and inform clinical decision-making. The purpose of this review was to investigate the characteristics of operative orthopedic studies published in high-impact medical journals. The number of orthopedic studies published in high-impact medical journals is relatively low; however, these studies demonstrate methodological characteristics that may bias toward nonoperative treatment. Careful analysis and interpretation of orthopedic studies published in these journals is warranted. [Orthopedics. 2017; 40(3):e405-e412.].

Publication Rates of Podium Presentation Abstracts at the Arthroscopy Association of North America Annual Meetings 2004-2012.

PURPOSE: To determine the publication rates of podium presentation abstracts at the Arthroscopy Association of North America (AANA) annual scientific meetings from 2004 to 2012. METHODS: A database of podium presentation abstracts at the annual meetings of the AANA was compiled. Abstract presentations that reached manuscript publication were determined by a PubMed search of the MEDLINE database and Google Scholar. The journal and publication date were then recorded for all identified published abstracts. RESULTS: A total of 658 abstracts were selected for podium presentations at AANA annual meetings from 2004-2012 (range, 53-102 per year). Of these 658 abstracts, 443 (67.3%) went on to eventual publication in peer-reviewed journals. The mean time from the meeting to publication was 20.0 months. Most abstracts were published within 3 years of the meeting (n = 380, 85.8%), with a significant number of published abstracts reaching publication before the time of the meeting (n = 41, 9.3%). Published abstracts were most frequently published in Arthroscopy (n = 186, 42.0%), The American Journal of Sports Medicine (20.3%), and The Journal of Bone and Joint Surgery (6.1%). CONCLUSIONS: The overall publication rate of podium presentations at AANA annual meetings (67.3%) was similar to publication rates for other major orthopaedic annual meetings. Most published abstracts (85.8%) were published within 3 years, and the mean time to publication was 20.0 months. CLINICAL RELEVANCE: The rates of publication of podium presentations at AANA annual meetings show the impact and importance of these meetings in the advancement of orthopaedic research.

Authorship Trends in 30 Years of the Journal of Arthroplasty.

BACKGROUND: While various studies have investigated trends in characteristics of authors in other medical literature, no study has examined these characteristics in the field of arthroplasty. METHODS: A database was created of all articles published in The Journal of Arthroplasty in 1986, 1990, 1995, 2000, 2005, 2010, and 2015. Degree(s) of authors, number of authors, number of references, and region of institution were recorded. RESULTS: A total of 1343 original articles were assessed over the study period. There was a significant increase in the number of authors per publication from 3.45 in 1986 to 4.98 in 2015 (P < .001) and number of references per article from 17.36 to 29.76 (P < .001). There was a significant increase in proportion of first authors with a bachelor's degree (P = .001), MD/PhD (P < .001), and MD/MBA (P = .016), with a significant decrease in first authors with an MD degree only (P < .001). There was a significant increase in number of last authors with an MD/PhD (P = .001) and MD/MBA (P = .003). There has been a significant growth in papers from outside North America (P = .007), with a decrease in articles from the UK/Ireland (P = .003) and an increase in contributions from the Far East (P < .001). CONCLUSION: Trends of authorship characteristics in the arthroplasty literature largely mirror those seen in other medical literature including increased number of authors per article over time, changes in author qualifications, and increased contributions from international author groups.