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  1. Article: Adolescent Clavicle Fractures: Is There a Role for Open Reduction and Internal Fixation.

    Pandya, Nirav K

    Current reviews in musculoskeletal medicine

    2019  Volume 12, Issue 2, Page(s) 228–232

    Abstract: Purpose of review: Over the past ten years, there has been a change in the management of adolescent clavicle fractures. Utilizing data from the adult population, clinicians have become more aggressive in terms of surgical fixation. The purpose of this ... ...

    Abstract Purpose of review: Over the past ten years, there has been a change in the management of adolescent clavicle fractures. Utilizing data from the adult population, clinicians have become more aggressive in terms of surgical fixation. The purpose of this paper is to critically analyze the recent literature in regard to adolescent clavicle fractures, and to determine the role of open reduction and internal fixation.
    Recent findings: Although there have been many case series that demonstrate that open reduction and internal fixation can be done safely and with predictable healing, studies which compare operative versus non-operative intervention suggest there may not be functional outcome differences between the two treatment options. Further study is necessary to determine the specific indications for fixation of clavicle fractures in the adolescent population. Shared decision-making between patient, family, and clinicians is essential to determine the specific fracture patterns and patients who might benefit from fixation to improve functional outcome.
    Language English
    Publishing date 2019-03-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407827-X
    ISSN 1935-9748 ; 1935-973X
    ISSN (online) 1935-9748
    ISSN 1935-973X
    DOI 10.1007/s12178-019-09553-7
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  2. Article: Adolescent Tibial Tubercle Fracture: Review of Outcomes and Complications.

    Reyes, Chloe Delos / Wu, Wei / Pandya, Nirav K

    Current reviews in musculoskeletal medicine

    2023  Volume 16, Issue 9, Page(s) 392–397

    Abstract: Purpose of review: Fractures of the tibial tubercle are a relatively uncommon injury, representing 3% of all proximal tibia fractures and < 1% of all physeal fractures, primarily seen in the adolescent demographic. While recognition of the injury and ... ...

    Abstract Purpose of review: Fractures of the tibial tubercle are a relatively uncommon injury, representing 3% of all proximal tibia fractures and < 1% of all physeal fractures, primarily seen in the adolescent demographic. While recognition of the injury and its management is being more widely reported in the literature and recognized in the hospital setting, reports of its outcomes and complications have still been limited. This article provides an updated review of the outcomes and complications of tibial tubercle fractures.
    Recent findings: Current research shows both radiographic outcomes, specifically osseous union, and functional outcomes, such as return to play and full knee range of motion, are excellent in patients treated either operatively or nonoperatively. Complication rates overall remain relatively low, with the most common complication being bursitis and hardware prominence and the most common associated injuries being patellar tendon avulsions and meniscus tears. With appropriate management, tibial tubercle fractures have an excellent overall outcome and a low complication rate. Although complications are uncommon, treating providers should be vigilant and recognize the signs of devastating complications resulting from acute vascular injuries or compartment syndrome. Further research should aim to analyze patients' experiences and satisfaction following treatment of this injury and examine the long-term functional and patient-reported outcomes.
    Language English
    Publishing date 2023-07-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407827-X
    ISSN 1935-9748 ; 1935-973X
    ISSN (online) 1935-9748
    ISSN 1935-973X
    DOI 10.1007/s12178-023-09849-9
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  3. Article: Hip Pain in Adolescent Patients.

    Swarup, Ishaan / Makarewich, Christopher / Blumberg, Todd J / Pandya, Nirav K

    Instructional course lectures

    2023  Volume 73, Page(s) 471–486

    Abstract: Hip pain is a common complaint in adolescents. There are several causes for hip pain in this population, with dysplasia and impingement being the most common; however, other conditions such as extra-articular impingement, torsional disorders, labral ... ...

    Abstract Hip pain is a common complaint in adolescents. There are several causes for hip pain in this population, with dysplasia and impingement being the most common; however, other conditions such as extra-articular impingement, torsional disorders, labral tears, and osteochondral lesions also require consideration. Many of these conditions are related to underlying anatomic abnormalities and increased activity in this age group. An understanding of the common pathologies of the adolescent hip is integral to the evaluation, diagnosis, and treatment of these patients.
    MeSH term(s) Humans ; Adolescent ; Hip ; Pain/diagnosis ; Pain/etiology ; Arthralgia/etiology ; Arthralgia/complications ; Hip Joint ; Femoracetabular Impingement/complications ; Femoracetabular Impingement/diagnosis ; Arthroscopy/adverse effects
    Language English
    Publishing date 2023-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 802490-x
    ISSN 0065-6895
    ISSN 0065-6895
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    In stock of ZB MED Cologne/Königswinter

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  4. Article ; Online: Allograft Medial Patellofemoral Ligament Reconstruction in Adolescent Patients Results in a Low Recurrence Rate of Patellar Dislocation or Subluxation at Midterm Follow-Up.

    Allahabadi, Sachin / Pandya, Nirav K

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2021  Volume 38, Issue 1, Page(s) 128–138

    Abstract: Purpose: To evaluate rates of recurrent instability in adolescent patients with medial patellofemoral ligament (MPFL) reconstruction with allograft and associations of anatomic risk factors with complications.: Methods: A retrospective review ... ...

    Abstract Purpose: To evaluate rates of recurrent instability in adolescent patients with medial patellofemoral ligament (MPFL) reconstruction with allograft and associations of anatomic risk factors with complications.
    Methods: A retrospective review identified patients of a single surgeon who underwent MPFL reconstruction with allograft for recurrent patellar instability with minimum 2-year follow-up. Surgical management was recommended after a minimum 6 weeks of nonoperative management and included MPFL reconstruction with gracilis allograft using a double-bundle technique. Preoperative radiographs were evaluated to assess physeal closure, lower-extremity alignment, trochlear morphology, and Insall-Salvati and Caton-Deschamps ratios. Magnetic resonance images were reviewed to evaluate the MPFL, trochlear morphology, and tibial tubercle trochlear groove distance (TT-TG). Descriptive statistics were used to characterize data. The primary outcome was recurrent instability.
    Results: 20 patients (24 knees; 18 knees in 14 females and 6 knees in 6 males; average age 15.7 years; range 11.5 to 19.6) underwent MPFL reconstruction with allograft (mean ± standard deviation follow-up 5.2 ± 1.7 years; range 2.2 to 8.1). Physes were open in 9 knees. The Insall-Salvati ratio was 1.09 ± 0.16, and the Caton-Deschamps index was 1.17 ± 0.15. Preoperatively, 19 patients were noted to have trochlear dysplasia, and TT-TG was 15.3 ± 3.9 mm. Three of 4 knees (16.7%) with non-hardware-related complications had open physes: 3 (12.5%) had recurrent instability, 2 of which underwent subsequent operation, and 1 sustained a patella fracture after a fall, requiring open reduction and internal fixation. The average Insall-Salvati ratio of these 4 patients was 1.21 ± 0.20, Caton-Deschamps index was 1.18 ± 0.17, and TT-TG was 17.5 ± 3.3 mm, none of which were statistically different from the group without complications. There were no clinically noted growth disturbances postoperatively.
    Conclusions: MPFL reconstruction using allograft tissue may be performed safely in the pediatric and adolescent population with good outcomes at midterm follow-up, few complications, and a low rate of recurrent instability.
    Level of evidence: IV, case series.
    MeSH term(s) Adolescent ; Adult ; Allografts ; Child ; Female ; Follow-Up Studies ; Humans ; Joint Instability/surgery ; Ligaments, Articular ; Male ; Patellar Dislocation/diagnostic imaging ; Patellar Dislocation/surgery ; Patellofemoral Joint/diagnostic imaging ; Patellofemoral Joint/surgery ; Recurrence ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2021-05-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2021.05.005
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2046: Show issues Location:
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  5. Article: Association of Insurance Status With Treatment Delays for Pediatric and Adolescent Patients Undergoing Surgery for Patellar Instability.

    Allahabadi, Sachin / Halvorson, Ryan T / Pandya, Nirav K

    Orthopaedic journal of sports medicine

    2022  Volume 10, Issue 5, Page(s) 23259671221094799

    Abstract: Background: Health care disparities have been highlighted in pediatric sports medicine, but the association between insurance status and delayed care for patients undergoing surgery for patellar instability has not been defined.: Purpose: To ... ...

    Abstract Background: Health care disparities have been highlighted in pediatric sports medicine, but the association between insurance status and delayed care for patients undergoing surgery for patellar instability has not been defined.
    Purpose: To determine whether there is an association between insurance status and delays in care in pediatric and adolescent patients undergoing surgery for patellar instability.
    Study design: Cohort study; Level of evidence, 3.
    Methods: This was a retrospective case series at a safety-net tertiary referral center of pediatric and adolescent patients undergoing surgical treatment for patellar instability. Insurance status was classified as public or private. We calculated the times from injury to clinical evaluation, injury to magnetic resonance imaging (MRI), injury to surgery, clinical evaluation to MRI, and clinical evaluation to surgery. Comparisons were made between insurance groups.
    Results: Included were 78 patients (38 public, 40 private insurance) who underwent surgery for patellar instability. The public insurance group was older (
    Conclusion: Significant delays were seen for pediatric and adolescent patients with patellar instability and public insurance (approximately 6 times longer to clinical evaluation, more than 5.5 times longer to obtain MRI, and 4.5 times longer to surgery) relative to injured patients with private insurance. Even after adjusting for delays to clinical evaluation, publicly insured patients had a delay from clinic to surgery that was triple that of privately insured patients.
    Language English
    Publishing date 2022-05-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2706251-X
    ISSN 2325-9671
    ISSN 2325-9671
    DOI 10.1177/23259671221094799
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  6. Article: ACL Tears in the National Football League From 2013 to 2020: Analysis of the 2020 Season After Delays and Schedule Changes From the Early COVID-19 Pandemic Relative to Prior Seasons.

    Allahabadi, Sachin / Gatto, Andrew P / Pandya, Nirav K

    Orthopaedic journal of sports medicine

    2022  Volume 10, Issue 2, Page(s) 23259671221076045

    Abstract: Background: The impact of fatigue and preseason preparation on anterior cruciate ligament (ACL) tears in the National Football League (NFL) are not well described. The 2020 NFL season did not include the standard preseason in response to changes ... ...

    Abstract Background: The impact of fatigue and preseason preparation on anterior cruciate ligament (ACL) tears in the National Football League (NFL) are not well described. The 2020 NFL season did not include the standard preseason in response to changes secondary to the coronavirus disease-2019 (COVID-19) pandemic.
    Purpose: To evaluate the association of game play on ACL tears in NFL athletes and to determine if differences in ACL tear epidemiology were present based on season of play from 2013 to 2020.
    Study design: Descriptive epidemiology study.
    Methods: ACL tears in NFL athletes were identified using publicly available data. Games played and snap counts at the time of injury were recorded for each athlete sustaining game-related injuries. Tear rates were determined, and injuries were also calculated per 1000 athlete-exposures. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated.
    Results: Overall, 379 ACL tears were identified, including 256 (67.6%) during game play and 118 (31.1%) during practice. Practice-based injuries were significantly higher in the preseason versus the remainder of the season. Games and snaps at the time of injury did not differ by year. The incidence rate of preseason injuries was significantly greater relative to in-season injuries (IRR = 2.68; 95% CI, 2.18-3.29;
    Conclusion: There was an increased proportion of in-season ACL tears in the 2020 NFL season relative to 2014 to 2019; this is attributable to a frameshift in the consistent trend of injuries in the 1st month to return of competitive play, with 2020 being in the regular season in September as opposed to the preseason in August.
    Language English
    Publishing date 2022-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2706251-X
    ISSN 2325-9671
    ISSN 2325-9671
    DOI 10.1177/23259671221076045
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  7. Article: Adolescent elbow osteochondral lesions following prior elbow fracture pinning.

    Padaki, Ajay S / Allahabadi, Sachin / Pandya, Nirav K

    Journal of children's orthopaedics

    2022  Volume 16, Issue 6, Page(s) 475–480

    Abstract: Purpose: Pinning of pediatric elbow fractures has been shown to be a safe procedure with a low complication profile. This study identified patients who underwent cartilage surgery for elbow osteochondral lesions or osteochondritis dissecans who had ... ...

    Abstract Purpose: Pinning of pediatric elbow fractures has been shown to be a safe procedure with a low complication profile. This study identified patients who underwent cartilage surgery for elbow osteochondral lesions or osteochondritis dissecans who had prior ipsilateral elbow pinning.
    Methods: Records of patients who underwent ipsilateral cartilage surgery for osteochondritis dissecans and prior percutaneous pinning for elbow fractures were identified. Demographics were compiled and the clinical, radiographic, and surgical results were tabulated for patients with at least 1-year of follow-up from initial presentation.
    Results: In total, 6/52 (11.5%) pediatric patients from 2012 to 2021 who underwent isolated elbow osteochondritis dissecans surgery (mean age at surgery 13.4 ± 1.5 years) had a history of ipsilateral elbow pinning (mean age at surgery 6.9 ± 2.4 years). Of these, five had a history of a supracondylar fracture while one patient sustained a lateral condyle fracture. Overall, three of six patients had mechanical symptoms at presentation and three had abnormal radiographs. All patients underwent pre-operative magnetic resonance imaging and the five patients with an osteochondritis dissecans lesion <1cm
    Conclusion: This study demonstrates that the history of elbow fracture pinning may predispose patients to future elbow chondral injuries in adolescence. Although patients appear to do well following consequent osteochondritis dissecans surgery, patients and parents may be advised of possible association of elbow pinning and elbow osteochondral lesions.
    Level of evidence: III, case-control study.
    Language English
    Publishing date 2022-10-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2279410-4
    ISSN 1863-2548 ; 1863-2521
    ISSN (online) 1863-2548
    ISSN 1863-2521
    DOI 10.1177/18632521221133814
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    Zs.A 6613: Show issues Location:
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  8. Article: Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review.

    McLellan, Maddison / Allahabadi, Sachin / Pandya, Nirav K

    Orthopaedic journal of sports medicine

    2022  Volume 10, Issue 11, Page(s) 23259671221129594

    Abstract: Background: Limited data are available on the long-term consequences of early sports specialization in high-level athletes.: Purpose: To evaluate the existing literature on the effects of sports specialization among professional, Olympic, and other ... ...

    Abstract Background: Limited data are available on the long-term consequences of early sports specialization in high-level athletes.
    Purpose: To evaluate the existing literature on the effects of sports specialization among professional, Olympic, and other elite athletes.
    Study design: Systematic review; Level of evidence, 3.
    Methods: We performed a systematic review of studies from 1990 to 2021 on youth sports specialization in professional, elite, and/or Olympic athletes following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An elite athlete was defined as one who performed at the highest level of his or her sport, beyond college level. Data were summarized according to 6 objectives: (1) definitions of specialization, age at specialization, and participation in other sports; (2) motivation for specialization; (3) athlete perspectives on specialization; (4) performance data; (5) specialization and injury risk; and (6) career longevity.
    Results: From 8756 articles, 29 studies were included, of which 17 (58.6%) were survey-based studies. Of the 8 articles that commented on injury risk, all demonstrated reduction in injury risk in athletes who delayed specialization. Performance benefits were apparent with later specialization in 7 of 9 articles; the remaining 2 showed benefit with earlier specialization in marathon runners and soccer players. There were less definitive results on career longevity, with 5 of 9 articles finding no association between career longevity and sports specialization.
    Conclusion: Although current data on sports specialization in elite, professional, and Olympic athletes are mostly retrospective and survey-based evidence, most sports demonstrate better performance after youth multisport engagement, and youth sports specialization was linked with increased injury risk in athletes at the highest levels of competition.
    Language English
    Publishing date 2022-11-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2706251-X
    ISSN 2325-9671
    ISSN 2325-9671
    DOI 10.1177/23259671221129594
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  9. Article: Failure of Surgery for Osteochondral Injuries of the Elbow in the Pediatric and Adolescent Population.

    Chen, Eric / Pandya, Nirav K

    Current reviews in musculoskeletal medicine

    2020  Volume 13, Issue 1, Page(s) 50–57

    Abstract: Purpose of review: With an increase in single-sport specialization, elbow injuries have become increasingly common in the pediatric and adolescent population. Osteochondritis dissecans (OCD) of the capitellum frequently requires intervention yet can be ... ...

    Abstract Purpose of review: With an increase in single-sport specialization, elbow injuries have become increasingly common in the pediatric and adolescent population. Osteochondritis dissecans (OCD) of the capitellum frequently requires intervention yet can be difficult to treat given high patient activity demands. The purpose of this paper is to review treatment options, understand failure rates, and provide strategies for successful revision surgery.
    Recent findings: Patients at high risk for the development of this condition are involved in high-demand upper extremity activity such as baseball or gymnastics. Treatment options include non-operative management, drilling, fixation, loose body removal/microfracture, osteochondral autograft, and osteochondral allograft. Cartilage preservation procedures (i.e., osteochondral autograft) have a significant advantage in terms of clinical and radiographic healing compared with fixation or microfracture. Capitellar OCD lesions afflict a large number of adolescent athletes today and will likely continue increasing in number from sports-related injuries. It is critical to recognize and treat these lesions in a timely and appropriate fashion to optimize clinical outcomes. When faced with failure of healing, surgeons must critically analyze reasons for failure including post-operative compliance, return to high-demand sporting activity, fixation of non-viable fragments, utilization of microfracture, alignment, and concomitant pathology.
    Language English
    Publishing date 2020-01-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407827-X
    ISSN 1935-9748 ; 1935-973X
    ISSN (online) 1935-9748
    ISSN 1935-973X
    DOI 10.1007/s12178-020-09606-2
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  10. Article: Anterior Cruciate Ligament Re-tear and Revision Reconstruction in the Skeletally Immature Athlete.

    Garcia, Steven / Pandya, Nirav K

    Current reviews in musculoskeletal medicine

    2020  Volume 13, Issue 3, Page(s) 369–378

    Abstract: Purpose of review: With an increase in high-demand sporting activity, the rate of pediatric and adolescent anterior cruciate ligament (ACL) reconstruction is increasing. Yet, the failure rates after reconstruction are much higher than the adult ... ...

    Abstract Purpose of review: With an increase in high-demand sporting activity, the rate of pediatric and adolescent anterior cruciate ligament (ACL) reconstruction is increasing. Yet, the failure rates after reconstruction are much higher than the adult population. The purpose of this paper is to understand failure rates, reasons for graft failure, and strategies for successful revision surgery.
    Recent findings: A complete understanding of the failure etiology is essential for the clinician treating this population prior to revision. This begins with an assessment of post-operative patient compliance and sporting activity. Surgical technique must then be scrutinized for non-anatomic tunnel placement and poor graft size/type. Concurrent bony deformity must also be addressed including lower extremity valgus alignment and tibial slope abnormalities. Meniscus and chondral injury must be aggressively treated. Furthermore, imaging must be examined to look for missed posterolateral corner injury. Lateral extra-articular tenodesis (in the setting of ligamentous laxity or rotational instability) may be also indicated as well. The surgeon can then choose a graft type and surgical technique that optimizes outcome and respects skeletal growth. Prior to surgical intervention, the clinician must also counsel patients in regard to the guarded prognosis and outcomes in this setting. Prolonged rehabilitation protocols/return-to-play timing as well as sporting activity modification in the post-operative period after revision are critical. There is limited literature on revision ACL reconstruction in the skeletally immature athlete. An understanding of all the risk factors for failure is essential in order to achieve treatment success.
    Keywords covid19
    Language English
    Publishing date 2020-04-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407827-X
    ISSN 1935-9748 ; 1935-973X
    ISSN (online) 1935-9748
    ISSN 1935-973X
    DOI 10.1007/s12178-020-09627-x
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