Answorth A Allen

• MD
• Hospital for Special Surgery

Objectives Lateral extraarticular tenodesis (LET) has been shown to decrease failure rate in settings of revision anterior cruciate ligament (ACL) reconstruction in young, high-demand patients. However, there is a paucity of literature comparing clinical outcomes and return to sports after patients who undergo revision ACL reconstruction LET compar...

Background Accurate assessment of lateral knee radiographs is crucial for evaluating knee biomechanics and guiding treatment decisions. However, manual evaluation is time-consuming and subject to variability. This study aims to develop a machine learning model that can automatically classify lateral knee X-rays, paving the way for automated measure...

Background Primary anterior cruciate ligament (ACL) repair has gained renewed interest in select centers for patients with proximal or midsubstance ACL tears. Therefore, it is important to reassess contemporary clinical outcomes of ACL repair to determine whether a clinical benefit exists over the gold standard of ACL reconstruction (ACLR). Purpos...

Background Women’s Rugby-7’s continues to experience growth in its player involvement and subsequent popularity in the United States. Objective Evaluate the medical cost and severity profile associated with player injuries in U.S. Women’s Rugby-7’s. Design Prospective epidemiological study. Setting U.S. Women’s Rugby-7’s regional tournaments bet...

Objective Rugby-7s is gaining popularity in the U.S. among the university population. The aim was to quantify the incidence and causes for concussions among U.S. university rugby-7s players. Design Prospective, descriptive, epidemiological study. Setting USA rugby-sanctioned tournaments (2011–2016). Participants 4458 university-level athletes (m...

Objective To determine the head, neck, and face (HNF) match injury rates in US rugby-7s. Design Prospective descriptive epidemiology study. Setting USA Rugby-sanctioned tournaments (2010–2016). Participants 42,054 adult U.S. players (3,481 teams and 7,673 rugby-7s matches). Assessment of Risk Factors Match injury rates, site, type, and severity...

Objective To investigate the medical diagnosis and procedural coding cost of concussions in U.S. rugby-7s. Design Prospective descriptive epidemiological study. Setting USA Rugby rugby-7s geographic union tournament series (79 tournament-days, 2010–2015). Participants Tournament players (n=164; female=27%; male=73%) sustaining acute head injurie...

Objective To identify the differences in risk-factors between sexes and age in US rugby-7s. Design Logistic regression. Setting USA Rugby tournaments (U-19 to Elite; 2010–2016). Participants 1,307 (68%=men, 31%=women) injured U.S. Rugby-7s players. Assessment of Risk Factors A cross-sectional analysis using the RISERugby Injury Registry. Anthro...

Objectives Bone-patellar tendon-bone (BTB) autograft has historically been regarded as the gold standard for anterior cruciate ligament reconstruction (ACLR). Despite widespread utilization of BTB autografts, multiple complications following BTB harvest have been reported, including anterior knee pain, difficulty kneeling, patellar tendon rupture,...

Technical considerations of the rotator cuff repair remain of great importance as retear rates remain high. The double-row (DR) rotator cuff repair was designed to better restore the native enthesis footprint to maximize healing. The DR repair features a medial and lateral row of suture anchors. Anatomical and cadaveric studies have demonstrated im...

Background The interscalene nerve block provides analgesia for shoulder surgery. To extend block duration, provide adequate analgesia, and minimize opioid consumption, the use of adjuvants such as dexamethasone as well as the application of perineural liposomal bupivacaine have been proposed. This randomized, double-blinded, noninferiority trial hy...

The outside-in technique of meniscus repair is useful for treating tears amenable to repair within the anterior horn and body. As our understanding of the biomechanical consequences of meniscal deficiency has improved, a detailed understanding of this surgical option is essential to preserve meniscal function. This chapter provides information on t...

Background: Analyzing outcomes and the minimal clinically important difference (MCID) after anterior cruciate ligament reconstruction (ACLR) is of increased interest in the orthopaedic literature. The purposes of this study were to report outcomes after ACLR at medium to long-term follow-up, identify the threshold preoperative outcome values that...

Background Head and neck injuries are a collision sport concern, however there is a lack of Rugby-7s injury data, particularly in emerging Rugby nations. Objective To determine the head, neck, and face (HNF) match injury rates and characteristics in US Rugby-7s. Design Prospective descriptive epidemiology study. Setting USA Rugby-sanctioned tour...

Background Previous studies have highlighted the prevalence of head, neck, and face (HNF) injuries among male and female rugby-15s players; however, differences in risk-factors between sexes and age have not yet been examined in Rugby-7s. Objective To identify risk factors of HNF injuries and sex risk differences among Rugby-7 players by age-group...

Background There are limited injury data for Rugby-7s, and even less data analysed by participation level or days return-to-sport after injury. O Bjective To describe injury incidence, severity, and injury burden for three levels of Rugby-7s competition. Design Prospective descriptive epidemiology study. Setting U.S. Rugby-7s tournaments/serie...

Background: Understanding specific risk profiles for each patient and their propensity to experience clinically meaningful improvement after anterior cruciate ligament reconstruction (ACLR) is important for preoperative patient counseling and management of expectations. Purpose: To develop machine learning algorithms to predict achievement of the...

Background: Numerous studies have reported the incidence and outcomes of injuries in the men's and women's National Basketball Association (NBA and WNBA, respectively). Purpose: To synthesize published data regarding the incidence and outcomes of all injuries in the NBA and WNBA in a comprehensive review. Study design: Systematic review; Level...

Objectives Over the past decade, there have been advances in arthroscopic-assisted approaches for coracoclavicular (CC) reconstruction with less surgical morbidity and enhanced visualization while also allowing for the treatment of concomitant glenohumeral pathology. Previous studies reporting outcomes using both open and arthroscopic-assisted tech...

Background Anterior cruciate ligament (ACL) injuries are occurring with increasing frequency in the adolescent population. Outcomes after ACL reconstruction (ACLR) are inconsistently reported in homogeneous patient populations. Purpose/Hypothesis To evaluate outcomes after bone–patellar tendon–bone (BTB) autograft ACLR in competitive high school–a...

Purpose To evaluate the quality of orthopaedic cost-effectiveness analyses (CEAs) in accordance with the 2016 recommendations by the Second Panel on Cost-Effectiveness in Health and Medicine. Methods A systematic review of all CEAs from 9/2017-9/2019 in the ten highest impact orthopaedic surgery journals was performed. Quality scoring utilized the...

Purpose To report clinical and functional outcomes including return to pre-injury activity level following arthroscopic-assisted coracoclavicular (CC) ligament reconstruction (AA-CCR) and to determine associations between return to pre-injury activity level, radiographic outcomes and patient-reported outcomes following AA-CCR. Methods A institutio...

Purpose To perform a network meta-analysis of randomized controlled trials in order to determine which interventions optimize clinical outcomes in adhesive capsulitis. Methods A systematic review was conducted of all clinical trials on adhesive capsulitis published since 2008. Patient cohorts were grouped into treatment categories and data collect...

Background: There is a lack of injury data for the new Olympic sport of Rugby-7s, particularly for involved youth. Objective: To determine injury rates and characteristics for players participating in U.S. Rugby-7s U19 (under 19 years of age) tournaments. Methods: Injury data were collected, using the Rugby Injury Survey & Evaluation report me...

Background: The purpose of this comprehensive review was to investigate risk factors associated with prolonged opioid use after orthopaedic procedures. A comprehensive review of the opioid literature may help to better guide preoperative management of expectations as well as opioid-prescribing practices. Methods: A systematic review of all stu...

Purpose To evaluate the in vitro effects of corticosteroid injections (CSIs) on rotator cuff tendon (RCT). Methods A systematic review of the MEDLINE database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for all studies reporting on adverse biochemical and biomechanical effects of CSIs on...

Objectives: 1) To evaluate return to play (RTP) timing in National Basketball Association (NBA) athletes following adductor injuries, and 2) to evaluate the effect of adductor injuries on player performance, game availability, and career longevity following RTP. Methods: Adductor injuries in NBA athletes from the 2009-10 to 2018-19 seasons were ide...

Introduction: Understanding and meeting the patients' preoperative expectations for anterior cruciate ligament (ACL) reconstruction (ACLR) is critical for achieving successful patient-centered outcomes. There is currently no standardized method to assess preoperative expectations of ACLR based on the patient-derived methods. The purpose of this st...

Purpose The purpose of this study was to develop and validate a standardized patient satisfaction measurement tool for adult patients undergoing primary anterior cruciate ligament reconstruction. Methods A four-phase iterative process that included item generation and pilot survey development, item reduction, survey readability, and survey validat...

Purpose: To assess adverse effects of pre-operative corticosteroid injections (CSIs) in patients with rotator cuff disease, especially prior to rotator cuff repair (RCR). Methods: A systematic review of the MEDLINE database was performed according to PRISMA guidelines for all studies reporting on adverse clinical effects of CSIs on rotator cuff...

Purpose: To critically review recent literature on outcomes following primary surgical repair of the anterior cruciate ligament (ACL). Methods: In December 2018, a search of the MEDLINE database was conducted for English language articles reporting clinical outcomes of ACL repair from 2003 to 2018. Included studies were evaluated for patient dem...

What we already know about this topic: Interscalene nerve block is commonly used for shoulder surgery for anesthesia and postoperative analgesiaUnfortunately, interscalene blocks commonly result in hemidiaphragmatic paralysis WHAT THIS ARTICLE TELLS US THAT IS NEW: When interscalene block was compared with superior trunk block, less frequent hemid...

Background: Variables affecting return to sport after anterior cruciate ligament reconstruction (ACLR) are multifactorial. The nonphysical factors germane to successful return to play (RTP) are being increasingly recognized. Purpose: To (1) evaluate the available evidence base for psychological factors relating to RTP after ACLR, (2) identify ps...

Introduction The purpose was to investigate if surgical arthroscopic decompression or ultrasound‐guided aspiration of a paralabral cyst would result in suprascapular nerve recovery from axonal regeneration based on electrodiagnostic testing. Methods Nine patients with pre‐operative electromyography evidence of suprascapular neuropathy due to paral...

Objectives: There is a paucity of reporting on surgical outcomes of isolated posterior cruciate ligament reconstruction (PCLR). We hypothesize that isolated PCL injuries failing nonoperative treatment achieve good outcomes and are able to return to sport following PCLR. Methods: A retrospective analysis was performed to identify patients with isola...

Purpose: The purpose of this study was to perform a population-level analysis to evaluate the effect of socioeconomic markers on the use of meniscus surgery in patients with meniscus tears. Methods: We queried all hospital-based clinic visits from 2011 to 2014 in the Statewide Planning and Research Cooperative System database, which also contain...

Background As the use of biologic therapies for the management of knee pathology continues to expand, it is more likely that patients will turn to the Internet to gather information on this topic. Given the lack of scientific consensus on the use of biologics, care providers must understand what information is available online. Questions/Purposes...

Background and objectives: The need for hospital-based acute care following outpatient surgical procedures is expensive and measured as marker for quality. However, little information is available about events leading to emergency department visit or inpatient admission after ambulatory anterior cruciate ligament (ACL) surgery. Methods: We studi...

Background: A greater emphasis on providing high-value orthopaedic interventions has resulted in increased health economic reporting. The contingent-valuation method (CVM) is used to determine consumer valuation of the benefits provided by healthcare interventions. CVM is an important value-based health economic tool that is underutilized in ortho...

Arthroscopic superior capsular reconstruction's promising results using fascia lata autograft have made this technique a viable alternative to reverse shoulder arthroplasty in the treatment of irreparable massive rotator cuff tears. Autologous fascia lata graft has been used in several medical fields, with good results reported in the literature. T...

Background: There is increased interest in understanding the preoperative determinants of postoperative outcomes. Return to play (RTP) and the patient-reported minimal clinically important difference (MCID) are useful measures of postoperative outcomes after anterior cruciate ligament reconstruction (ACLR). Purpose: To define the MCID after ACLR...

This commentary will be a discussion of the rehabilitation and return to play for athletes following anterior cruciate ligament reconstruction. There is a real concern that patients who have underwent an anterior cruciate ligament reconstruction are potentially not being restored to their previous levels of athletic ability, or being prematurely cl...

Objectives The purpose of this study was to investigate the role of pre-operative outcome scores for predicting minimal clinically important difference (MCID) and return to play (RTP) after anterior cruciate ligament reconstruction (ACLR). Methods Patients enrolled as part of a prospective institutional ACL registry were eligible for this study. 2...

Current rotator cuff repair commonly involves the use of single or double row suture techniques, and despite successful outcomes, failure rates continue to range from 20-95%. Failure to regenerate native biomechanical properties at the enthesis is thought to contribute to failure rates. Thus, the need for technologies that improve structural healin...

Background: Return to play and patient satisfaction after anterior cruciate ligament reconstruction (ACLR) have been inconsistently studied. The purposes of this study were to (1) investigate rates and predictors of return to play after ACLR, (2) evaluate patient satisfaction after ACLR, and (3) analyze the relationship between return to play and...

ABSTRACT Objectives: To investigate return to play (RTP) and functional performance after anterior cruciate ligament reconstruction (ACLR) in National Basketball Association (NBA) players and to perform a systematic review of the literature to understand RTP after ACLR in professional basketball. Methods: NBA players undergoing ACLR between 2008 a...

Objectives: Minimal clinical ly important difference (MCID) and other measures of minimum clinical importance are increasingly recognized as important clinical considerations for evaluating the efficacy of an intervention. As our interpretation of clinical outcome evolves beyond statistical significance, psychometric properties such as MCID will be...

Background: In the past 16 years, the number of prescription opioids sold in the United States, as well as deaths from prescription opioids, has nearly quadrupled. However, the overall amount of pain reported by patients has not changed significantly. Specific information about opioid prescriptions in the perioperative period is lacking. Of the st...

Background Rugby-7s an emerging sport in the United States (US) encounters concussions, a growing public concern. Objective To report incidence of concussions in US Rugby-7s. We hypothesized that concussive injuries would occur with frequency in US Rugby-7s similar to international cohorts. Design Prospective descriptive epidemiology study. Sett...

Background Rugby-7s is growing in popularity, however there is a comparative lack of injury data. Objective To report incidence of contact and non-contact causes of US Rugby-7s injuries. Design Prospective descriptive epidemiology study. Setting The study encompassed U19 to elite players in USA Rugby tournaments (2010–2014). Participants A tota...

Background Rugby-7s growth in the United States predominantly seen in the amateur population, has very little youth rugby injury data. Objective To report incidence and causes for US youth Rugby-7s match injuries. Design Prospective descriptive epidemiology study. Setting The study encompassed Under-19 players in USA Rugby sanctioned tournaments...

Background There are limited data on Rugby-7s, an emerging sport in the United States (US), which debuted in the 2016 Olympics. Objective To report incidence and causes for US Rugby-7s. We hypothesized that match injuries would be frequent and patterns of injuries would be similar in the US population to international cohorts. Design Prospective...

Background Reconstruction of the anterior cruciate ligament (ACL) is one of the most common orthopaedic operations in the United States. The long-term impact of ACL reconstruction is controversial, however, as longer term data have failed to demonstrate that ACL reconstruction helps alter the natural history of early onset osteoarthritis that occur...

Purpose: To investigate differences between sport types for patient-reported outcome after anterior cruciate ligament reconstruction (ACLR). Methods: Included patients were enrolled as part of a prospective institutional ACL registry. Inclusion criteria were preoperative self-identification as a competitive athlete, maximum score on the preopera...

Category Sports. Introduction/Purpose Proximal fractures (Zones II and III) of the fifth metatarsal are common in the elite athlete population with basketball players being especially prone to developing these injuries. Fractures in Zones II and III of the fifth metatarsal can be difficult to treat due to tendency toward delayed union, nonunion, o...

Purpose: There is a comparative lack of concussion incidence data on the new Olympic sport Rugby 7s. This study aimed to determine the incidence (number of concussions per 1000 playing hours [ph]), mean and median severity (days absence), and cause of concussive injuries. Methods: This is a prospective epidemiology study, amateur to elite/national...