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Article: The History and Evolution of the Open Labral Repair with Capsular Shift for Shoulder Instability.

Inclan, Paul M / Rodeo, Scott A

Current reviews in musculoskeletal medicine

2024

Abstract: Purpose of review: The purpose of this review is to describe the evolution of the open labral repair with capsular shift, including the current role of this procedure in the treatment of shoulder instability.: Recent findings: Currently, a subset of ... ...

Abstract	Purpose of review: The purpose of this review is to describe the evolution of the open labral repair with capsular shift, including the current role of this procedure in the treatment of shoulder instability. Recent findings: Currently, a subset of patients - high-level collision/contact sport athletes, patients with significant inferior or multi-directional instability, and individuals with failed arthroscopic Bankart repair without bone loss - may experience benefit from undergoing open Bankart repair with capsular shift. Surgeons performing open stabilization can benefit from instrumentation and anchors developed to assist with arthroscopic techniques. Understanding the history and evolution behind the procedure not only allows the surgeon to appreciate principles behind an arthroscopic approach, but also permits the utilization of an open approach when required by patient pathology and risk factors.
Language	English
Publishing date	2024-04-29
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/s12178-024-09901-2
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Article ; Online: Revision anterior cruciate ligament reconstruction.

Inclan, Paul M / Brophy, Robert H

The bone & joint journal

2023 Volume 105-B, Issue 5, Page(s) 474–480

Abstract: Anterior cruciate ligament (ACL) graft failure from rupture, attenuation, or malposition may cause recurrent subjective instability and objective laxity, and occurs in 3% to 22% of ACL reconstruction (ACLr) procedures. Revision ACLr is often indicated to ...

Abstract	Anterior cruciate ligament (ACL) graft failure from rupture, attenuation, or malposition may cause recurrent subjective instability and objective laxity, and occurs in 3% to 22% of ACL reconstruction (ACLr) procedures. Revision ACLr is often indicated to restore knee stability, improve knee function, and facilitate return to cutting and pivoting activities. Prior to reconstruction, a thorough clinical and diagnostic evaluation is required to identify factors that may have predisposed an individual to recurrent ACL injury, appreciate concurrent intra-articular pathology, and select the optimal graft for revision reconstruction. Single-stage revision can be successful, although a staged approach may be used when optimal tunnel placement is not possible due to the position and/or widening of previous tunnels. Revision ACLr often involves concomitant procedures such as meniscal/chondral treatment, lateral extra-articular augmentation, and/or osteotomy. Although revision ACLr reliably restores knee stability and function, clinical outcomes and reoperation rates are worse than for primary ACLr.
MeSH term(s)	Humans ; Anterior Cruciate Ligament/surgery ; Anterior Cruciate Ligament Reconstruction/methods ; Knee Joint/surgery ; Anterior Cruciate Ligament Injuries/surgery ; Reoperation/methods
Language	English
Publishing date	2023-05-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B5.BJJ-2022-1064.R1
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Article ; Online: Popliteus Avulsion Fracture After Unicompartmental Arthroplasty: A Case Report.

Inclan, Paul M / Barrack, Robert L / Matava, Matthew J

JBJS case connector

2023 Volume 13, Issue 1

Abstract: Case: An active 64-year-old patient presented with new-onset lateral knee pain 42 days after an uncomplicated medial unicompartmental knee arthroplasty (UKA). Magnetic resonance imaging and diagnostic injection of local anesthetic identified an avulsion ...

Abstract	Case: An active 64-year-old patient presented with new-onset lateral knee pain 42 days after an uncomplicated medial unicompartmental knee arthroplasty (UKA). Magnetic resonance imaging and diagnostic injection of local anesthetic identified an avulsion fracture of the popliteus tendon as the source of discomfort. Repair of the tendon to its native footprint was performed with suture anchor fixation. The patient was pain-free and returned to work without restrictions at 12 weeks. Conclusion: We identify a unique cause of knee pain after UKA-avulsion of the popliteus tendon. Successful management of this condition included anatomic repair of the tendon with suture anchor fixation.
MeSH term(s)	Humans ; Middle Aged ; Fractures, Avulsion/diagnostic imaging ; Fractures, Avulsion/etiology ; Fractures, Avulsion/surgery ; Knee Joint/surgery ; Arthroplasty, Replacement, Knee/adverse effects ; Arthroplasty, Replacement, Knee/methods ; Muscle, Skeletal/surgery ; Tendons/surgery
Language	English
Publishing date	2023-01-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	e22.00477
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Article ; Online: How to Treat Distal Radius Fractures: Right Patient, Right Care, Right Time, and Right Cost.

Inclan, Paul M / Dy, Christopher J

Hand clinics

2021 Volume 37, Issue 2, Page(s) 205–214

Abstract: Operative intervention for distal radius fractures is typically reserved for patients with displaced fractures that may result in bothersome compromises in function, although patient-specific factors (age, activity level, and preference) are considered. ... ...

Abstract	Operative intervention for distal radius fractures is typically reserved for patients with displaced fractures that may result in bothersome compromises in function, although patient-specific factors (age, activity level, and preference) are considered. Operative intervention is associated with earlier improvement in function but exposes the patient to the risk of anesthesia and surgery. Although surgery is associated with an initial increase in cost of care, the benefits of earlier return to activity may offset these increases. Efforts to contain cost through implant selection, use of ambulatory surgical centers, and judicious referrals for postoperative therapy can aid surgeons in delivering high-value care.
MeSH term(s)	Bone Plates ; Fracture Fixation, Internal ; Humans ; Radius Fractures/surgery ; Treatment Outcome
Language	English
Publishing date	2021-04-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1315374-2
ISSN	1558-1969 ; 0749-0712
ISSN (online)	1558-1969
ISSN	0749-0712
DOI	10.1016/j.hcl.2021.02.003
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Article ; Online: Environmental and genetic risk factors associated with total knee arthroplasty following cruciate ligament surgery.

Inclan, Paul M / Brophy, Robert H / Saccone, Nancy L / Ma, Yinjiao / Pham, Vy / Yanik, Elizabeth L

The bone & joint journal

2024 Volume 106-B, Issue 3, Page(s) 249–255

Abstract: Aims: The purpose of this study is to determine an individual's age-specific prevalence of total knee arthroplasty (TKA) after cruciate ligament surgery, and to identify clinical and genetic risk factors associated with undergoing TKA.: Methods: This ...

Abstract	Aims: The purpose of this study is to determine an individual's age-specific prevalence of total knee arthroplasty (TKA) after cruciate ligament surgery, and to identify clinical and genetic risk factors associated with undergoing TKA. Methods: This study was a retrospective case-control study using the UK Biobank to identify individuals reporting a history of cruciate ligament surgery. Data from verbal history and procedural codes recorded through the NHS were used to identify instances of TKA. Patient clinical and genetic data were used to identify risk factors for progression from cruciate ligament surgery to TKA. Individuals without a history of cruciate ligament reconstruction were used for comparison. Results: A total of 2,576 individuals with a history of cruciate ligament surgery were identified, with 290 (11.25%) undergoing TKA. In patients with prior cruciate ligament surgery, prevalence of TKA was 0.75% at age 45 years, 9.10% at age 65 years, and 20.43% at age 80 years. Patients with prior cruciate ligament surgery were 4.6 times more likely to have undergone TKA by age 55 years than individuals without prior cruciate ligament surgery. In the cruciate ligament surgery cohort, BMI > 30 kg/m Conclusion: Patients with a history of prior cruciate ligament surgery have substantially higher risk of TKA and undergo arthroplasty at a relatively younger age than individuals without a history of prior cruciate ligament surgery. Physically demanding work and obesity were associated with higher odds of TKA after cruciate ligament surgery, but no SNP was associated with risk of TKA.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects ; Retrospective Studies ; Case-Control Studies ; Osteoarthritis, Knee/genetics ; Osteoarthritis, Knee/surgery ; Anterior Cruciate Ligament/surgery ; Risk Factors
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.106B3.BJJ-2023-0425.R2
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Article ; Online: Treatment Trends in Meniscal Pathology in the Setting of Concomitant ACL Injuries in Pediatric and Young Adult Patients: An Insurance Database Study.

Block, Andrew M / Eisenberg, Matthew T / Inclan, Paul M / Nepple, Jeffrey J

The American journal of sports medicine

2022 Volume 50, Issue 9, Page(s) 2367–2373

Abstract: Background: Meniscal pathology is commonly encountered in the setting of anterior cruciate ligament (ACL) rupture and is increasingly common in the pediatric and adolescent population. Studies have shown that over half of individuals presenting with ACL ...

Abstract	Background: Meniscal pathology is commonly encountered in the setting of anterior cruciate ligament (ACL) rupture and is increasingly common in the pediatric and adolescent population. Studies have shown that over half of individuals presenting with ACL rupture will have concurrent meniscal pathology. Purpose: To define trends in the utilization of meniscal procedures (ie, meniscus repair vs partial meniscectomy) and short-term complications in pediatric and young adult patients with meniscal pathology in the setting of a concurrent ACL reconstruction. Study design: Cohort study; Level of evidence, 3. Methods: The IBM MarketScan Commercial Database was utilized to identify ACL reconstruction procedures performed between 2006 and 2018 for individuals aged 5 to 30 years. Annual proportions of meniscectomy and meniscal repair were analyzed, and short-term complications were compared between pediatric/adolescent patients (aged 5-17 years) and young adults (aged 18-30 years). Results: An overall 40,736 records of individuals <18 years old with ACL tears were included. The pediatric/adolescent population had a significantly lower proportion of concomitant meniscal procedures (56.8%; 23,149/40,736) than the young adult population (59.7%; 33,764/56,515; Conclusion: From 2006 to 2018, the proportion of patients receiving ACL reconstruction with concomitant meniscal repair increased (20.1% to 35.1%) while the proportion with meniscectomy decreased (34.4% to 21.3%) in the pediatric/adolescent population. Meniscal repair was not associated with a higher 180-day rate of reoperation for repeat meniscal repair or meniscectomy than meniscectomy in the setting of ACL reconstruction.
MeSH term(s)	Adolescent ; Anterior Cruciate Ligament Injuries/complications ; Anterior Cruciate Ligament Injuries/surgery ; Child ; Cohort Studies ; Humans ; Insurance ; Menisci, Tibial/surgery ; Meniscus/surgery ; Retrospective Studies ; Tibial Meniscus Injuries/complications ; Tibial Meniscus Injuries/surgery ; Young Adult
Language	English
Publishing date	2022-06-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465221098141
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Article ; Online: Early-Career Sports Medicine Surgeons Perform a Large Volume of Non-Sports Medicine Procedures: American Board of Orthopaedic Surgery (ABOS) Part-II Data Regarding Orthopaedic Surgeons Specializing in Sports Medicine.

Inclan, Paul M / Wright, Rick W / Smith, Matthew V / Brophy, Robert H

The Journal of bone and joint surgery. American volume

2022 Volume 104, Issue 22, Page(s) e97

Abstract: Background: The purpose of this study was to utilize the American Board of Orthopaedic Surgery (ABOS) Part-II Case List database to (1) define the practice patterns of sports medicine-trained ABOS Part- II Oral Examination Candidates and (2) describe ... ...

Abstract	Background: The purpose of this study was to utilize the American Board of Orthopaedic Surgery (ABOS) Part-II Case List database to (1) define the practice patterns of sports medicine-trained ABOS Part- II Oral Examination Candidates and (2) describe the frequency and practice patterns of individuals who are dual fellowship-trained sports medicine candidates. Methods: The ABOS Part-II Case List database was utilized to define all cases submitted by 3,298 applicants indicating completion of a sports medicine fellowship between January 1, 2003, and January 1, 2020. Cases were classified by subspecialty category and case type. The frequency and practice patterns of candidates pursuing additional fellowship training (i.e., "dual fellowship-trained") were recorded. Descriptive statistical methods were used to describe the annual and overall procedure volume and candidate case mix. Trends in the relative frequency of cases performed and fellowship training patterns were determined using linear regression analysis. Results: On average, sports medicine-trained candidates submitted 100.6 cases for review during the 6-month case collection period: 59.0 (58.6%) sports medicine/arthroscopy cases, 29.3 (29.1%) trauma/general cases, 4.5 (4.5%) adult reconstruction cases, and 7.8 (7.8%) "other" cases per candidate. Although candidates performed fewer total (r 2 = 0.84, p < 0.001) and sports medicine/arthroscopy (r 2 = 0.85, p < 0.001) cases over the study period, the proportion of sports medicine/arthroscopy cases did not change over the study period (p = 0.18). Dual fellowship training was indicated by 333 individuals (10.1%). The number of dual fellowship-trained candidates pursuing additional fellowship training in pediatrics and adult reconstruction increased over the study period, and the number of dual fellowship-trained candidates pursuing additional fellowship training in trauma decreased over the study period. Conclusions: Early-career sports medicine candidates are likely to perform >40% of cases outside of the sports medicine subspecialty. Sports medicine trainees are increasingly likely to pursue a second fellowship in pediatrics or adult reconstruction. Level of evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Adult ; United States ; Humans ; Child ; Orthopedic Surgeons/education ; Orthopedics/education ; Sports Medicine/education ; Fellowships and Scholarships ; Arthroscopy/education
Language	English
Publishing date	2022-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.21.01129
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Article ; Online: Factors Associated with the Success and Timing of Orthopaedic Surgery Resident Research Thesis Project Publication.

Kuhn, Andrew W / Inclan, Paul M / Brogan, David M / Aleem, Alexander W / Brophy, Robert H

JB & JS open access

2023 Volume 8, Issue 1

Abstract: Scholarship and research are important aspects of orthopaedic surgery training. Many orthopaedic surgery residency programs have developed dedicated research curricula, often culminating in a capstone thesis project with the intended goal of peer- ... ...

Abstract	Scholarship and research are important aspects of orthopaedic surgery training. Many orthopaedic surgery residency programs have developed dedicated research curricula, often culminating in a capstone thesis project with the intended goal of peer-reviewed publication. However, data on the success of these programs are scarce. The purpose of the current study was to determine the success rate and time to publication of resident research thesis projects at our own institution while evaluating factors associated with these outcomes. Methods: Resident research thesis projects performed over the past 15 years were aggregated and reviewed. Additional data regarding the projects and former trainees who performed them were collected using public resources which included measures of current academic aptitude (i.e., H-index and number of publications) as well as project and publication characteristics. Cox and linear regression analyses were conducted to assess the relation between numerous predictor variables and the success and time to publication. All analyses were conducted at the 95% confidence interval (CI) level. Results: Sixty-eight (n = 68; 83%) resident research thesis projects were published an average of 2,582.8 days, or roughly 7 years from the start of their residency training. Graduate adjusted H-index was associated with increased success and decreased time to publication (hazard ratio 1.183 [95% CI: 1.059-1.322], p = 0.003). A lower journal impact factor was associated with taking significantly shorter time to reach publication ( Discussion/conclusion: Over the past 15 years, 83% of orthopaedic resident research thesis projects at our institution were published. A higher adjusted H-index was associated with greater completion and faster timing to publication. A lower journal impact factor was also associated with quicker publication. These data highlight the publication metrics of a formalized resident research program and identify factors associated with success and timing of publication.
Language	English
Publishing date	2023-01-12
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2472-7245
ISSN (online)	2472-7245
DOI	10.2106/JBJS.OA.22.00072
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Article: Inside-out Medial Meniscal Repair: Improved Surgical Exposure With a Sub-semimembranosus Approach.

Pace, J Lee / Inclan, Paul M / Matava, Matthew J

Arthroscopy techniques

2021 Volume 10, Issue 2, Page(s) e507–e517

Abstract: Inside-out meniscal repair is considered the gold standard for reparable tears of the medial and lateral menisci despite the recent popularity of all-inside devices. Accurate suture passage is required to perform a stable repair as well as to prevent ... ...

Abstract	Inside-out meniscal repair is considered the gold standard for reparable tears of the medial and lateral menisci despite the recent popularity of all-inside devices. Accurate suture passage is required to perform a stable repair as well as to prevent inadvertent neurovascular injury from the suture needles. Placement of a deep soft-tissue retractor is necessary to identify and retrieve these needles prior to tying the sutures. Several authors have recommended placement of this retractor in the interval anterior to the gastrocnemius muscle belly and above the semimembranosus tendon. However, we have noted that the needles often pass distal to the retractor when it is placed in this interval owing to the reorientation of the joint line that occurs with the knee in a relatively extended position during suture placement. We describe a modified technique in which the retractor is placed inferior to the semimembranosus, which puts it directly in line with the needles' trajectory. This modification makes inside-out medial meniscal repair safer and more efficient.
Language	English
Publishing date	2021-01-16
Publishing country	Netherlands
Document type	Journal Article
ISSN	2212-6287
ISSN	2212-6287
DOI	10.1016/j.eats.2020.10.032
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Article ; Online: Use of Publicly Obtained Data in Sports Medicine Research: A Systematic Review and Bibliometric Analysis.

Inclan, Paul M / Kuhn, Andrew W / Troyer, Stockton C / Solomon, Gary S / Matava, Matthew J

The American journal of sports medicine

2023 Volume 52, Issue 5, Page(s) 1367–1373

Abstract: Background: Publicly obtained data (POD) have recently been utilized frequently by sports medicine researchers to describe injury patterns, risk factors, and outcomes in elite athletes. The relative ease of this type of research that is based solely on ... ...

Abstract	Background: Publicly obtained data (POD) have recently been utilized frequently by sports medicine researchers to describe injury patterns, risk factors, and outcomes in elite athletes. The relative ease of this type of research that is based solely on internet and media sources has resulted in a near exponential increase in the number of these POD studies. Purpose: To systematically review the sports medicine literature for studies based solely on POD. Study design: Systematic review and bibliometric analysis; Level of evidence, 4. Methods: A systematic review of POD studies published since 2000 was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies of interest were those relying on publicly available injury reports or online media for data acquisition in collegiate, semiprofessional, and professional athletes. Results: There were 209 POD studies published between 2000 and 2022, with 173 (82.8%) of these studies published after 2016. Studies were published most frequently on athletes participating in North American professional leagues: National Football League (n = 69 [28.4%]), Major League Baseball (n = 56 [23.0%]), National Basketball Association (n = 37 [15.2%]), and National Hockey League (n = 33 [13.6%]). The most common injuries assessed were head injuries/concussions (n = 43 [21.1%]), anterior cruciate ligament injuries (n = 33 [16.2%]), and ulnar collateral ligament injuries (n = 23 [11.3%]). One-quarter of the studies (n = 53 [25.4%]) reported only 1 POD source, and 1 study (0.5%) reported no source. Additionally, 65 studies (31.1%) listed nonspecific POD resources or solely cited previous literature to describe the POD search methodology and data acquisition. Conclusion: POD studies are exponentially increasing in number, particularly across major North American professional sports leagues, with significant variability in the injury of interest, search methodology, and number of data sources. The accuracy of the conclusions reached based on the POD methodology appears highly variable. Given the potential impact of these publications as both contributors to current knowledge and drivers of future research, the sports medicine community should be aware of the inherent biases and limitations of POD injury studies.
MeSH term(s)	Humans ; Athletic Injuries/etiology ; Sports Medicine ; Brain Concussion/complications ; Football/injuries ; Bibliometrics
Language	English
Publishing date	2023-06-12
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231177054
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