<p>PDF file - 1353K, Supplementary Table S1. Patient and tumor characteristics from the 22 bevacizumab-resistant versus 22 bevacizumab-na�ve glioblastomas from whom paired pre-treatment tissue was available. Supplementary Table S2. Altered transcripts in 15 bevacizumab-resistant glioblastomas compared to before treatment. Supplementary Table S3. Altered transcripts in 15 bevacizumab-resistant glioblastomas compared to before treatment. Supplementary Table S4. Altered transcripts in bevacizumab-naive recurrent glioblastomas compared to their paired glioblastomas at diagnosis. Supplemetary Table S5. FISH Results. Supplementary Table S6. Patient and tumor characteristics from 22 bevacizumab-na�ve recurrent glioblastomas (control group) from whom paired pre-treatment tissue was available.</p>
The purpose of this study was to compare recurrent instability and return to play (RTP) in young athletes who underwent clearance to full activity based on a validated return-to-sport (RTS) test to those who underwent time-based clearance following primary posterior labral repair.This was a retrospective review of athletes with posterior shoulder instability who underwent primary arthroscopic posterior labral repair from 2012 to 2021 with minimum 1-year follow-up. Patients who underwent RTS testing at a minimum of 5 months postoperatively were compared to a historic control cohort of patients who underwent time-based clearance.There were 30 patients in the RTS cohort and 67 patients in the control cohort (mean follow-up 32.1 and 38.6 months, respectively). Of the 30 patients who underwent RTS testing, 11 passed without failing any sections, 10 passed while failing 1 section, and 9 failed the RTS test by failing 2+ sections. No differences were found between the RTS and control cohort in the incidence of recurrent instability (6.7% vs. 9.0%), overall RTP (94.7% vs. 94.3%), RTP at the same level as before injury (84.2% vs. 80.0%), recurrent pain/weakness (23.3% vs. 25.4%), or revision surgery (0% vs. 3.0%), respectively.While RTS testing in young athletes after posterior labral repair did not reduce recurrence or improve return to play compared to time-based clearance, two-thirds of athletes who underwent testing failed at least 1 section, indicating some functional deficit. Thus, RTS testing may help guide postoperative rehabilitation following posterior stabilization.
Background: Arthroscopic remplissage is an effective adjunct for anterior shoulder stabilization in patients with large engaging Hill-Sachs lesions (HSLs) and without significant glenoid bone loss or on-track HSLs with high risk of recurrence. Indications: The arthroscopic remplissage shown was performed in a patient with a high-risk profile for recurrence (age <25, near track) following a first-time traumatic anterior dislocation event. In this specific case, the remplissage was used to fill a near-track HSL, a significant risk factor for recurrence. Technique Description: Following diagnostic shoulder arthroscopy, the anterior labral repair is started with placement of the most inferior anchor and passage of the suture around the labrum and capsule. This anchor is not tightened to allow visualization and access to the posterior humeral head. Posterior labral work is then performed if there is a posterior labral tear extension. Next, for the remplissage, 2 double loaded suture anchors are placed spanning the HSL and passed through the capsule/infraspinatus without tightening. The prior placed anterior inferior anchor is then tightened. The remaining anterior labrum is then completed with capsulorraphy using additional 3 knotless suture anchors. Finally, the remplissage is completed using a double pulley method to pull the posterior capsule into fill the HSL. Results: Based on literature and the author's experience, addition of a remplissage for arthroscopic anterior stabilization in patients with anterior glenohumeral instability and either off-track HSL, or on-track HSL with high risk of recurrence can significantly reduce rates of recurrent instability when compared to arthroscopic Bankart repair alone. Discussion/Conclusion: Arthroscopic remplissage is an effective adjunct for arthroscopic anterior instability in patients with off-track HSLs or on-track HSLs with high risk of recurrence that is efficient with low surgical complication risk when performed with proper technique. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
<p>PDF file - 1353K, Supplementary Table S1. Patient and tumor characteristics from the 22 bevacizumab-resistant versus 22 bevacizumab-na�ve glioblastomas from whom paired pre-treatment tissue was available. Supplementary Table S2. Altered transcripts in 15 bevacizumab-resistant glioblastomas compared to before treatment. Supplementary Table S3. Altered transcripts in 15 bevacizumab-resistant glioblastomas compared to before treatment. Supplementary Table S4. Altered transcripts in bevacizumab-naive recurrent glioblastomas compared to their paired glioblastomas at diagnosis. Supplemetary Table S5. FISH Results. Supplementary Table S6. Patient and tumor characteristics from 22 bevacizumab-na�ve recurrent glioblastomas (control group) from whom paired pre-treatment tissue was available.</p>
Background: Despite increasing use of quadriceps tendon (QT) autograft in anterior cruciate ligament (ACL) reconstruction (ACLR), limited data exist regarding its outcomes in high-risk adolescent athletes. Purpose: To (1) report the outcomes after QT ACLR in adolescent athletes and (2) identify patient-related and surgery-related factors that may influence failure rates after QT ACLR. Study Design: Case series; Level of evidence, 4. Methods: All patients aged 14 to 17 years who underwent primary anatomic, transphyseal, single-bundle QT ACLR between 2010 and 2021 with a minimum 2-year follow-up were included for analysis. Demographic and surgical data as well as preoperative International Knee Documentation Committee (IKDC) and Marx activity scores were collected retrospectively. All patients were also contacted to assess postoperative patient-reported outcomes (PROs), including IKDC and Marx activity scores, and return-to-sports (RTS) data. Outcomes of interest included rates of revision ACLR and ipsilateral complications, contralateral ACL tears, difference in pre- and postoperative PROs, and rates of RTS. Patient and surgical characteristics were compared between groups who required revision ACLR versus those who did not. Results: A total of 162 patients met inclusion criteria, of which 89 adolescent athletes (mean age 16.2 ± 1.1 years, 64% female) were included for analysis at mean follow-up of 4.0 years. Postoperative IKDC scores were significantly higher than preoperative scores (88.5 vs 37.5; P < .001), whereas Marx activity scores decreased postoperatively (14.3 vs 12.2; P = .011). Successful RTS occurred in 80% of patients at a mean time of 9.7 ± 6.9 months, and 85% of these patients returned to the same or higher level of sports. The most common reasons for failure to RTS included lack of time (n = 7, 70%) and fearing reinjury in the operative knee (n = 5, 50%). The overall revision ACLR rate was 10% (n = 9), and contralateral ACL tears occurred in 14% (n = 12) of patients. The overall ipsilateral knee reoperation rate was 22.5% (n = 20). No statistically significant differences in patient or surgical characteristics were observed between patients who underwent revision ACLR and those who did not. Conclusion: At a minimum 2-year follow-up after QT ACLR, adolescent athletes experienced significantly improved postoperative IKDC scores, high rates of RTS, and low rates of graft failure, despite a relatively high ipsilateral reoperation rate. Surgeons may utilize this information when identifying the optimal graft choice for adolescent athletes who have sustained an ACL injury and wish to return to high level of sporting activities.
