Joshua S Dines

Joshua S Dines
Hospital for Special Surgery · Department of Orthopaedic Surgery

MD

About

402
Publications
103,022
Reads
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8,334
Citations
Additional affiliations
August 2007 - present
Hospital for Special Surgery
Position
  • Orthopedic Surgeon, Sports Medicine & Shoulder Service
July 2006 - July 2007
Kerlan-Jobe Orthopaedic Clinic
Position
  • Fellow, Sports Medicine
August 1997 - June 2001
Weill Cornell Medical College
Position
  • PhD Student
Education
September 1997 - June 2001
Weill Cornell Medical College
Field of study
  • Medicine
September 1992 - June 1996
Dartmouth College
Field of study
  • Government

Publications

Publications (402)
Article
Objectives The timing for initiation of a throwing program following shoulder or elbow surgery in an overhead throwing athlete is dependent on a variety of factors, including surgical procedure performed, time from surgery, level of competition, and successful progression through a physical therapy program. Determining when it is safe for an athlet...
Article
Objectives Though contralateral trunk tilt has been frequently studied in baseball pitchers, the phenomena of excessive ipsilateral trunk tilt has not been explored as a potential correlate with throwing arm kinetics. Excessive ipsilateral trunk tilt is often observed during earlier portions of the pitch cycle. High school pitchers with excessive c...
Article
Background Electronic methods have been implemented to collect patient reported outcome measures (PROM) to try to increase follow-up rates following surgery. There is a paucity of studies evaluating differences between people who respond to automated electronic methods, and those who need manual hard copy mailings. The aims of this study are: 1) to...
Article
Background Reverse total shoulder arthroplasty is often performed to treat rotator cuff tear arthropathy with irreparable rotator cuff tears. Patients with full thickness tears involving the posterior cuff and teres minor specifically lose active external rotation of the humerus, limiting activities of daily living. A latissimus dorsi transfer has...
Article
Full-text available
Background: The physical and mental health benefits of golf are well recognized, and as a moderate-intensity activity, it is an ideal sport for patients after joint arthroplasty. Purpose: To assess the rate and timing of returning to golf and the factors associated with these after hip, knee, or shoulder arthroplasty. Study Design: Meta-analysis;...
Article
Background Biomechanical predictors of pitching accuracy are underevaluated in baseball research. It is unclear how pitchers with higher accuracy differ in terms of kinematics and upper extremity kinetics. Purpose To differentiate high- and low-accuracy professional pitchers by full-body kinematic and upper extremity kinetic parameters. Study Des...
Article
Background Temporal variations during the pitch have demonstrated significant impacts on the kinetic chain, and as such, have implications in injury risk. Purpose To determine the effect of varying chronological orders of maximum joint and segment velocities on ball velocity and upper extremity kinetics. Methods Professional baseball pitchers (n=...
Article
Purpose To compare kinematic and kinetic parameters between a cohort of fully recovered professional pitchers with prior shoulder injury treated conservatively compared to a cohort with no prior shoulder injury. Methods Twenty-six fully recovered professional baseball pitchers with a history of shoulder injury treated conservatively pitched 8-10 f...
Article
Background: Inefficient energy transfer from the pelvis and trunk has been shown to increase compensation at the level of the shoulder. Kinetic chain sequencing of the core segments is underexamined in professional baseball pitchers, especially as it relates to changes in upper extremity kinetics. Purpose: To evaluate elbow and shoulder kinetics...
Article
Background Aseptic loosening from implant-associated osteolysis in reverse shoulder arthroplasty (RSA) may contribute to premature implant failure. While articular side polyethylene (PE) damage has been well-documented in the literature, no studies to date have investigated backside wear in RSA. The aims of this investigation were to: (1) document...
Article
Full-text available
Objectives Completion of an interval throwing program (ITP) is a common benchmark for return to full competition following an injury to the dominant extremity of an overhead throwing athlete. While workload management for overhead athletes has evolved, the general structure of the ITP remains relatively unexamined. Furthermore, the daily and cumula...
Article
Background: The coronavirus disease 2019 (COVID-19) pandemic has been accompanied by significant reductions in patient volumes for non-COVID-19-related conditions ranging from acute coronary syndrome to ischemic strokes to acute trauma. However, the impact of the COVID-19 pandemic on patient volumes for a broad range of orthopedic conditions remai...
Article
Background The purpose of this study was to determine if postoperative patient-reported outcomes improved over time following anatomic (TSA) and reverse (RTSA) total shoulder arthroplasty. Methods A retrospective analysis was performed on prospectively collected, patient-reported outcomes from our institution’s registry between 2008 and 2018 (n =...
Article
Background Understanding the relationship between the temporal phases of the baseball pitch and subsequent joint loading may improve our understanding of optimal pitching mechanics and contribute to injury prevention in baseball pitchers. Purpose To investigate the temporal phases of the pitching motion and their associations with ball velocity an...
Article
Full-text available
A Correction to this paper has been published: https://doi.org/10.1007/s12178-021-09711-w
Article
While the performance metric ball velocity has often been associated with increased kinetics at the upper extremity and risk of injury in baseball pitchers, it is unclear if the performance metric pitch location consistency has any positive/negative associations with pitching kinetics. Professional pitchers subdivided into high(Hcon) and low(Lcon)...
Article
Background Increased sagittal plane trunk tilt is thought to increase drive in the anterior direction towards home plate, transferring energy from the trunk to the distal upper extremity, ultimately generating greater ball velocity. Increased sagittal trunk tilt has also been implicated in risk of upper extremity joint loading in baseball pitchers...
Article
Professional basebal pitchers (n =315) were divided into quartiles based on increasing stride length and random intercept linear mixed-effect models were used to correlate stride length with ball velocity, pelvis and trunk rotation at foot contact, and throwing arm kinetics. Average stride length among all pitchers was 78.3±5.3%body height (%BH). F...
Chapter
This chapter presents a case scenario of a 52‐year‐old male laborer who presents with chronic, dominant shoulder pain. Magnetic resonance imaging demonstrates a massive rotator cuff tear with retraction of the rotator cuff tendon medial to glenoid, and grade 3 Goutallier atrophy. Double row rotator cuff repair (RCR) is more costly than single row R...
Article
Full-text available
Purpose (1) Identify most recent national trends in the usage of open vs. arthroscopic approaches for DCE from 2007 to 2017, (2) to identify and compare the complication rates for both approaches, and to identify patient-specific risk factors for complications, (3) to identify and compare the revision rate for both approaches and (4) to identify an...
Article
At many institutions, the pendulum has swung toward reverse total shoulder arthroplasty (RTSA). Good results have been reported for patients older than 65 years with glenohumeral osteoarthritis with an intact rotator cuff, leading to questioning of the role of anatomic total shoulder arthroplasty (TSA) in the elderly. The purpose of this study was...
Article
Full-text available
Objectives High school baseball pitch count limits vary widely by state; however, it is unknown how these variations impact cumulative elbow varus torque (EVT) throughout a season. Specifically, pitch count limits are a popular method for preventing overuse in youth baseball players, but rest day requirements for different pitch count limits are of...
Article
Full-text available
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...
Article
Full-text available
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...
Chapter
Ulnar nerve injuries are not uncommon among throwing athletes. The anatomy of the ulnar nerve and the course in which it travels through the upper extremity make it susceptible to injury, especially when the elbow is loaded in the extremes that come with throwing sports such as baseball pitching. In addition to occurring in isolation, ulnar nerve s...
Chapter
Surgical reconstruction of the ulnar collateral ligament (UCL) is an effective procedure that restores valgus elbow stability, while allowing most overhead athletes to return to a previous or higher level of competition in less than 1 year. Despite the majority of patients having such excellent results, complications do occur. Rerupture is one such...
Chapter
In the overhead athlete, medial ulnar collateral ligament (MUCL) insufficiency can develop from repetitive valgus loads across the elbow during the throwing motion. This injury can be potentially career ending for the athlete. Treatment options include conservative care or potential surgical intervention with ligament reconstruction. Given the prol...
Chapter
Overhead athletes frequently sustain injuries to their dominant elbow secondary to the high valgus and extension forces inherent to the throwing motion. The relatively unnatural motion of throwing can produce a number of pathological stresses on the structures about the elbow, namely tensile stresses medially, compression stresses laterally, and sh...
Chapter
The ulnar collateral ligament (UCL) is the primary restraint to valgus stress at the elbow particularly during the late cocking and early acceleration phases of throwing. Injuries to this ligament are being recognized earlier and in younger overhead throwing athletes. These patients represent a different cohort of patients than later career patient...
Chapter
Prior to Jobe’s description of a reconstruction technique for ulnar collateral ligament (UCL) insufficiency, the injury was career ending. Despite successful results in about 70% of cases, concerns with elevation of the flexor-pronator mass, ulnar nerve complications, and relatively large bone tunnels in the medial epicondyle of the humerus led to...
Article
Introduction: The coronavirus disease 2019 (COVID-19) heralded an unprecedented increase in telemedicine utilization. Our objective was to assess patient satisfaction with telemedicine during the COVID-19 era. Methods: Telemedicine visit data were gathered from Stanford Health Care (Stanford) and the Hospital for Special Surgery (HSS). Patient sat...
Chapter
The anterior bundle of the ulnar collateral ligament (UCL) is the primary stabilizer against valgus stress in the elbow. However, when the UCL is compromised, the flexor-pronator mass becomes the primary dynamic valgus stabilizer of the elbow. Combined UCL and flexor-pronator mass injuries are a subset of medial elbow injuries sustained by overhead...
Article
Background The relationships between shoulder abduction and external rotation with peak kinetic values at the shoulder and elbow in professional baseball pitchers are not well established. Methods Professional pitchers ( n = 322) threw 8–12 fastballs under 3D motion analysis (480 Hz). Pitchers were stratified into quartiles by shoulder abduction a...
Article
Full-text available
Purpose of Review General guidelines exist for return to sport after injury. The goal of these guidelines is to outline phases of recovery that will minimize the risk of reinjury and promote an optimal return to function for the athlete. This paper analyzes the current research pertaining to interval return to play programs with a special focus on...
Article
Background The association between ball velocity and elbow varus torque has shown differences when evaluating within a single pitcher and among a cohort. The impact of increasing ball velocity to additional throwing arm kinetics, in particular shoulder distraction forces, with intra versus inter-pitcher evaluations have not been evaluated, even tho...
Article
Background: Patients often have moderate to severe pain after rotator cuff surgery, despite receiving analgesics and nerve blocks. There are many suggested ways to improve pain after rotator cuff surgery, but the effects of adopting a pathway that includes formal patient education, a long-acting nerve block, and extensive multimodal analgesia are...
Article
Full-text available
Background Social media posts regarding ulnar collateral ligament (UCL) injuries and reconstruction surgeries have increased in recent years. Purpose To analyze posts shared on Instagram and Twitter referencing UCL injuries and reconstruction surgeries to evaluate public perception and any trends in perception over the past 3 years. Study Design...
Article
Full-text available
Purpose of Review Weighted baseball throwing programs have gained significant attention recently. They have been promoted as proven option for pitchers wishing to increase their throwing velocity and improve throwing mechanics. However, there is some concern that, if not applied properly, they may increase injury risk. In this review, we aim to (1)...
Article
Background The primary objective of the present study was to investigate how preoperative imaging modalities including 3D computed tomography (CT) scans with preoperative planning software affect implant choice for shoulder arthroplasty. Methods X-ray, uncorrected 2D CT scans, and 3D CT scans from 21 patients undergoing primary arthroplasty were r...
Article
Full-text available
Purpose To investigate the clinical outcomes following the arthroscopic removal of proximal humerus locking plates for symptomatic hardware after open reduction and internal fixation (ORIF) of proximal humerus fractures. Methods Patients who underwent arthroscopic removal of hardware (ROH) with capsular release due to pain and/or immobility after...
Preprint
BACKGROUND The coronavirus disease 2019 (COVID-19) heralded an unprecedented increase in telemedicine utilization. OBJECTIVE Assess patient satisfaction with telemedicine during COVID-19 METHODS Telemedicine visit data were gathered from two separate institutions (Stanford Health Care (Stanford) and the Hospital for Special Surgery (HSS)). Patien...
Article
The glenohumeral joint (GHJ) allows for a wide range of motion, but is also particularly vulnerable to episodes of instability. Anterior GHJ instability is especially frequent among young, athletic populations during contact sporting events. Many first time dislocators can be managed non-operatively with a period of immobilization and rehabilitatio...
Article
Diabetic patients have impaired wound repair due to decreased fibroblast infiltration, growth factor production, and angiogenesis. Decellularized human amnion/chorion placental connective tissue matrix (PCTM) has high levels of extracellular matrix components, is rich in growth factors that promote angiogenesis, and has anti-inflammatory properties...
Article
Background Success of superior capsule reconstruction (SCR) using both fascia lata (FL) and human acellular dermal allograft (ACD) grafts have been reported. One possible explanation for a discrepancy in outcomes may be attributed to graft thickness. SCR with commercially available 3mm thickness ACD is not biomechanically equivalent to FL. Our hypo...
Book
Now in a fully revised and expanded second edition, this practical text presents the current state of the art and latest advancements in the biomechanics, assessment, diagnosis and management of UCL injury in the elbow. In the years since this book’s initial publication, significant developments have occurred on multiple fronts relating to elbow UC...
Article
Full-text available
Background: Although the monitoring of a pitcher’s throwing arm workload has become a hot topic in both research and the pitching world, the impact of mound height and distance still remains unclear. Purpose: To compare the kinetics and kinematics between pitches from a mound and flat ground at 2 different distances. Study Design: Descriptive labor...
Article
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...
Article
The goal of this study was to investigate the level of play that can be expected in a young, athletic population after biceps tenodesis and transfer. The authors hypothesized that both return to play rates and clinical improvement would be high after biceps tenodesis and transfer among young athletes. They conducted a retrospective review of patien...
Article
Full-text available
The COVID-19 crisis has forced a sudden and dramatic shift in the way that clinicians interact with their patients, from outpatient encounters to telehealth visits utilizing a variety of internet-based videoconferencing applications. Although many aspects of pre–COVID-19 outpatient sports medicine care will ultimately resume, it is likely that tele...
Article
The purpose of this study was to determine the association between time from the diagnosis of rotator cuff tear to repair and the rate of subsequent revision surgery for re-tear. A national insurance database was queried from 2007 to 2016 for patients who underwent arthroscopic rotator cuff repair after a diagnosis of rotator cuff tear with minimum...
Article
Background Patients frequently undergo interventions prior to shoulder arthroplasty, including injections and arthroscopy. While the potential impact of injections on postoperative outcomes such as infection has been well studied, it is less clear whether prior arthroscopy has an impact on infection rates following shoulder arthroplasty. The purpos...
Article
The recent study by Mihata et al., [10] “Five-year follow-up of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears” (J Bone Joint Surg Am. 2019;101:1921–1930), was the first case series published examining long-term clinical and radiographic outcomes of superior capsule reconstruction (SCR) for irreparable rotator cuff...
Article
Full-text available
Purpose of review: Injuries to the elbow ulnar collateral ligament (UCL) are especially common in the overhead throwing athlete. Despite preventative measures, these injuries are occurring at increasing rates in athletes of all levels. UCL reconstruction techniques generally require a prolonged recovery period and introduce the potential for intra...
Article
Full-text available
Purpose of review: To review the current technology available for the prevention and treatment of shoulder and elbow injuries in the overhead athlete. Recent findings: Shoulder and elbow injuries are common in recreational and high-level overhead athletes. Injury prevention in these athletes include identifying modifiable risk factors, offering...
Article
Full-text available
Background The number of rotator cuff repairs (RCRs) is increasing each year. Total shoulder arthroplasty (TSA) is a successful treatment option for patients with glenohumeral osteoarthritis with a functioning rotator cuff. Purpose/Hypothesis The purposes of this study were to report the outcomes of TSA in patients with ipsilateral RCR and determi...
Article
Background: There has been an increase in the use of electronic systems to collect patient-reported outcome measures. There is limited data on the added value of electronic reporting on increasing patient response proportions and little knowledge of which patients are more likely to respond. Questions/purposes: (1) What proportion of patients co...
Article
Background Instability arthropathy is a known cause of glenohumeral osteoarthritis (OA) among patients with and without prior shoulder stabilization. This study aims to compare the clinical, radiographic, and patient-reported outcome measure (PROM) scores among total shoulder arthroplasty (TSA) patients with and without a history of shoulder stabil...
Article
Full-text available
Background The optimal surgical approach for recurrent-anterior shoulder instability remains controversial, particularly in the face of glenoid and/or humeral bone loss. The purpose of this study was to utilize a contingent-behavior questionnaire (CBQ) to determine which factors drive surgeons to perform bony procedures over soft tissue procedures...
Article
Full-text available
Purpose of review: The purposes of this review are to describe the epidemiology, treatment options, and clinical outcomes of revision medial ulnar collateral ligament reconstruction in baseball pitchers. Recent findings: Rates of revision UCL range from 1 to 15% and have slowly increased over the past several years. Revision UCL procedures are a...
Article
Full-text available
Purpose of review: The purpose of this review article is to discuss the evolution of surgical reconstruction of the anterior bundle of the UCL, otherwise known as Tommy John surgery, from Dr. Jobe's initial description in 1986 to present day. In particular, the unique changes brought forth by each new surgical technique, and the reasons that these...
Article
Full-text available
Purpose of review: There has been a marked increase in the number of ulnar collateral ligament reconstructions performed annually and an associated increase in the amount of recent literature published. It is paramount that surgeons remain up to date on the current literature, as modern indications and surgical techniques continue to improve clini...
Article
PURPOSE: To describe the national rates of failed primary rotator cuff repair (RCR) requiring revision repair, utilizing numerous patient characteristics previously defined in orthopaedic literature, including smoking history, diabetes mellitus, hyperlipidemia, vitamin-D deficiency, and osteoporosis to determine which factors independently affect t...
Article
Background: Scapular fractures following reverse total shoulder arthroplasty (RSA) are devastating complications with substantial functional implications. The role of the coracoacromial ligament (CAL), which is often transected during surgical exposure for RSA, is not fully known. We hypothesized that the CAL contributes to the structural integrit...
Article
Ulnar collateral ligament (UCL) injuries continue to be a major source of morbidity in baseball players. The throwing motion creates nearly supraphysiological levels of valgus stress on the medial elbow, placing these athletes at high risk of UCL injury. The incidence of injury continues to rise at an alarming rate, especially among adolescent base...
Chapter
Transient brachial plexopathies, also referred to as “stingers” and “burners,” are common athletic injuries, especially in collision athletes. There are multiple proposed etiologies of stingers, with trauma to the upper brachial plexus or cervical nerve roots being the most important causative factor. Athletes with a stinger typically present with...
Article
Background Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would...
Article
Background Reverse shoulder arthroplasty (RSA) is a common treatment of a variety of disabling shoulder conditions. The purpose of this study was to determine revision-free survivorship after RSA using a medialized glenoid and lateralized onlay-type humerus implant and to identify etiologies of revision. Methods All RSAs performed using the Compre...