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The best treatment for type II superior labral anterior posterior (SLAP) tears in overhead athletes is not well defined. The purpose of this study was to examine post-surgical outcomes in overhead athletes under the age of 35 who underwent primary biceps tenodesis for an isolated type II SLAP tear. We hypothesized that these patients would have high rates of return to play, as well as recovery of range of motion (ROM) and strength after surgery.  Patients were between the ages of 18 and 35, had a primary isolated type II SLAP tear confirmed on magnetic resonance imaging (MRI), and were injured performing overhead activities. All patients underwent biceps tenodesis using an arthroscopic suprapectoral approach. Patients underwent standard postoperative rehabilitation lasting up to one year. Function and outcomes were measured at baseline, three months, six months, one year, and two years using range of motion, strength testing, and patient-reported outcomes (PROs) (Western Ontario Shoulder Instability Index (WOSI), Kerlan-Jobe Orthopedic Clinic Score (KJOC), American Shoulder and Elbow Surgeons Assessment Form (ASES), and Single Assessment Numeric Evaluation (SANE)).  Five patients were included in the case series. There was consistent improvement at each time point on PROs: WOSI, p=0.01; KJOC, p=0.04; SANE, p=0.02; and ASES, p=0.03. Range of motion increased from baseline to each time point with a significant improvement in forward flexion (p=0.03). In strength testing, there were improvements in all exercises and a significant improvement in abducted external rotation between years 1 and 2 (p<0.01).  This study demonstrated that biceps tenodesis in overhead athletes under the age of 35 provides improved outcomes, ROM, and strength.

Background: Kickoffs in the National Football League (NFL) are historically one of the most dangerous plays during an NFL game, with high levels of injuries. In 2024, the NFL introduced new rules aimed at reducing injuries during kickoffs, enhancing player safety, and increasing the frequency of kick returns. Purpose: To evaluate whether the NFL kickoff rule changes in 2024 had any effect on the incidence of injuries, particularly with a focus on concussions. Study Design: Descriptive epidemiology study. Methods: Injuries on kickoffs were identified for the 2022, 2023, and 2024 NFL seasons using the transcribed game book for each game on the official NFL website. Injury type was confirmed using the injury report on each team's website for the following week. If an injury was unreported on the subsequent injury report, it was listed as an unspecified injury. Injuries were defined as neuromusculoskeletal complaints documented in the game book for kickoffs and confirmed in the subsequent week's injury report. The injury rate was calculated annually for each injury category by analyzing injury incidence relative to the number of kickoffs and returns, with each analyzed separately. The incidence rate ratio (IRR) was calculated by dividing the IRR of one season by that of another season. Also, 95% CIs for the IRR were calculated, and P values were determined using the exact Poisson method. Results: This epidemiological study found that a comparison of the 2024 versus 2022 season showed a statistically significant increase in the overall number of injuries (IRR, 1.10 [95% CI, 1.08-1.11]); P < .001), upper extremity injuries (IRR, 6.74 [95% CI, 6.30-7.21]; P < .001]), and lower extremity injuries (IRR, 2.20 [95% CI, 2.14-2.26]; P < .001), when analyzed by the number of kickoffs. This study found that a comparison of the 2024 versus 2022 season showed a statistically significant increase in the overall number of injuries (IRR, 1.25 [95% CI, 1.23-1.27]; P < .001), upper extremity injuries (IRR, 7.69 [95% CI, 7.20-8.23]; P < .001), and lower extremity injuries (IRR, 2.51 [95% CI, 2.44-2.58]; P < .001), when analyzed by the number of returns. However, when comparing the 2024 and 2022 NFL seasons, 2024 saw a statistically significant decrease in the incidence of concussions when analyzed by both kickoffs (IRR, 0.77 [95% CI, 0.74-0.80]; P < .001) and returns (IRR, 0.88 [95% CI, 0.84-0.92]; P < .001). When compared with the 2023 NFL season, the 2024 NFL season showed a statistically significant rise in overall injuries (IRR, 1.59 [95% CI, 1.56-1.61]; P < .001), lower extremity injuries (IRR, 2.57 [95% CI, 2.49-2.64]; P < .001), upper extremity injuries (IRR, 2.24 [95% CI, 2.15-2.34]; P < .001), and concussions (IRR, 3.85 [95% CI, 3.59-4.13]; P < .001) when analyzed by kickoffs. When the 2023 NFL season was compared with the 2024 NFL season, it showed a statistically significant rise in overall injuries (IRR, 1.05 [95% CI, 1.03-1.07]; P < .001), lower extremity injuries (IRR, 1.70 [95% CI, 1.65-1.75]; P < .001), upper extremity injuries (IRR, 1.49 [95% CI, 1.43-1.55]; P < .001), and concussions (IRR, 2.25 [95% CI, 2.38-2.74]; P < .001) when analyzed by returns. When the 2023 season was compared with the 2022 season, there was a statistically significant decrease in the number of concussions when analyzed by both kickoffs (IRR, 0.20 [95% CI, 0.19-0.21]; P < .001) and returns (IRR, 0.31 [95% CI, 0.29-0.34]; P < .001). Conclusion: Our study showed that after the 2024 NFL kickoff rules were implemented, there was a significant increase in overall, lower extremity, and upper extremity injuries compared with the previous 2 seasons, as measured by the number of kickoffs and returns per year. The overall effect of the 2024 NFL kickoff rules on the incidence of concussions remains unclear when compared with the previous 2 seasons, as there was an increase in the incidence of concussions compared with 2023 and a decrease in the incidence of concussions compared with 2022. The kickoff remains an essential component of the game and still presents a challenge, as it is a play with a high injury rate.

Background: Every 4 years, the Winter Olympics occurs in the middle of the National Hockey League (NHL) season. The NHL allowed its players to participate in the Olympics during the 2002, 2006, 2010, and 2014 editions. The added game load, travel, and intense exertion over a short period of time may increase players’ risk of sustaining injuries. Purpose: To compare the injury rates between a normal NHL season and an Olympics-interrupted season and to compare the rates of different types of injuries, games missed due to injury, and the incidence of multiple injuries in NHL players. Study Design: Descriptive epidemiology study. Methods: The study retrospectively evaluated NHL injuries that occurred between 2000 and 2023. Injured players were identified from publicly available online databases: tsn.ca, capfriendly.com, cbssports.com, and sportsforecaster.com. Information regarding the number and characteristics of the injuries was categorized for each season. Injury rates were compared between Olympic and non-Olympic seasons. To evaluate the effect of the Olympics on injuries, multivariate regression models were used, adjusting for position. Results: No significant difference was found in overall injury rates in Olympic years compared with regular NHL seasons (P = .94). The proportion of forwards injured during Olympic seasons increased significantly (P = .041). After adjusting for position, the authors noted significantly increased odds of players sustaining multiple injuries (odds ratio [OR], 1.12; P = .002), knee injuries (OR, 1.71; P < .001), and muscle injuries (OR, 1.65; P < .001) during Olympic years. The mean injury rate was 0.671 in Olympic players compared with 0.905 in non-Olympic players during these seasons (P = .083). Conclusion: The study demonstrated no significantly increased rate of injuries overall to NHL players during Olympic seasons compared with regular NHL seasons. However, within Olympic seasons, an increase was noted in certain categories of injuries to players on Olympic rosters versus those who were not. The current findings may help in future discussions for policies on players’ participation in the Olympics and/or to help develop awareness and safeguards from injuries during Olympic years.

Duchenne muscular dystrophy (DMD) is caused by mutations in the dystrophin gene that cause it to be prematurely terminated or not fully transcribed. A lack of dystrophin in the muscle sarcolemma leads to progressive muscle degeneration. Definitive treatment of DMD will require dystrophin to be restored in all affected skeletal muscles, using cell therapy, gene therapy, or a combination of the two. Interestingly, a very small fraction of muscle fibers are able to produce dystrophin-positive fibers, called revertant fibers through natural exon skipping, indicating that increasing the number of the revertant fibers, may be a possible therapeutic approach for DMD. Using viral expression vectors carrying an inactivated Crispr/Cas9 system, called dCas9, fused to different transcriptional activators, we were able to cause 10T½ fibroblasts to induce transcription of the endogenous full-length dystrophin. We also used this model to investigate what effect transcribing extremely large genes like dystrophin has on the cell cycle of these cells. These findings open the possibility of using this technology to increase transcription of full-length dystrophin in dystrophic cells through natural exon skiping and ultimately increasing the amount of these revertant fibers for DMD therapy, as well understanding these cells on a molecular level.