Claude T Moorman's research while affiliated with Institute for Orthopaedic Surgery and other places
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Publications (144)
Background
Bicortical suspension device (BCSD) fixation treats proximal tibiofibular joint (PTFJ) instability in both the anterolateral and posteromedial directions. However, biomechanical data are lacking as to whether this technique restores the native stability and strength of the joint.
Purpose
To test (1) if BCSD fixation restores the native...
Patients with a body mass index over 30 do not have a significant increase in postoperative arthrofibrosis after multiple-ligament knee injury (MLKI) reconstruction compared with patients with a body mass index under 30. However, although this may be associated with the severity of injury, recent research has shown that patients who undergo externa...
Purpose:
Instability of the proximal tibiofibular joint (PTFJ) can be treated with bicortical suspension (BCS) fixation. However, the ideal location, orientation, and configuration to apply one or two BCS devices are not clear.
Methods:
A finite-element model of the PTFJ was created from a female adult's CT dataset. Anterior and posterior ligame...
Introduction
A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented.
Materials and methods
9 patients were retrospectively identified who underwent poster...
Background
Focal cartilage lesions of the knee remain a difficult entity to treat. Current treatment options include arthroscopic debridement, microfracture, autograft or allograft osteochondral transplantation, and cell-based therapies such as autologous chondrocyte transplantation. Osteochondral transplantation techniques restore the normal topog...
Introduction:
To compare subjective and objective outcomes of fibular and combined tibial-fibular (TF)-based posterolateral corner (PLC) reconstruction.
Methods:
A systematic review of literature reporting outcomes of posterolateral corner reconstruction was conducted including outcome studies of surgically treated PLC injuries with a minimum 1-...
Background
The use of “orthobiologics” or regenerative therapies in orthopaedic surgery has grown in recent years. Particular interest has been raised with regard to platelet-rich plasma, bone marrow aspirate, adipose-derived cells, and amniotic cells. Although studies have analyzed outcomes after orthobiologic treatment, no study has analyzed how...
Purpose
To determine the rate of intraoperative and early postoperative (90-day) complications of multiligamentous knee reconstruction surgeries, both medical and surgical, and associated variables from the 15-year experience of a single academic institution.
Methods
Patients treated at a single academic institution between 2005-2019 who underwent...
Introduction:
Investigations are rapidly increasing into products referred to as orthobiologics and their utility in the nonsurgical and surgical treatment of diverse orthopaedic pathology.
Methods:
Members (599) of the American Orthopaedic Society for Sports Medicine were sent a survey that assessed their usage, motivation for use, and perceive...
Background
The purpose of this study was to identify and report on the rate at which leaders in orthopaedic surgery are encountering GTM, their treatment methods and to identify whether these clinicians’ demographics or techniques correlate with their GTM incidence and/or treatment algorithms.
Methods
A survey was sent to identify the rate at whic...
Background:
Some NCAA conferences now require a press box-based Medical Observer for all football games to identify injuries missed by on-field providers. The objective of this study was to determine whether a Medical Observer identified injuries missed by the on-field medical personnel.
Methods:
This was a comparative observational study of inj...
Background:
There are multiple causes of posterior knee pain and radicular symptoms. A symptomatic fabella is a rare cause but should be considered in the differential diagnosis.
Purpose:
Physicians should consider a symptomatic fabella as a diagnosis when common treatments for posterior knee pain have not alleviated the symptoms.
Study design:...
Background
Revision anterior cruciate ligament (ACL) reconstruction can be potentially devastating for a patient. As such, it is important to identify prognostic factors that place patients at an increased risk for graft failure. There are no data on the effects of patellar tendinopathy on failure of ACL reconstruction when using a bone–patellar te...
The author would like to correct the following errors in the publication of the original article.
Purpose:
To investigate the influence of injury and treatment factors on clinical/functional outcomes in multiligament knee injuries (MLKI).
Methods:
Thirty-nine consecutive patients with confirmed and surgically treated MLKI who met inclusion criteria were scheduled for a follow-up visit to obtain: SF-12 and subjective feeling of normalcy betwe...
Objectives
Revision ACL reconstruction can be potentially devastating for a patient. As such, it is important to identify prognostic factors placing patients at increased risk for re-rupture. There are no data on the effects of patellar tendonopathy on failure of ACL reconstruction when using bone-patellar tendon-bone (BPTB) autograft. The purpose...
Background
There is an association between throwing activity and glenohumeral internal rotation deficit (GIRD). An 18° to 20° deficit has been adopted as the standard definition of pathological GIRD, but specific findings as to how GIRD relates to an injury are inconsistent.
Purpose
To systematically review the literature to clarify the definition...
A technique for proximal tibiofibular joint stabilization using an adjustable loop, cortical fixation device is presented. A standard diagnostic arthroscopy is performed to exclude intra-articular pathology. After arthroscopy, a 5-cm posterior-based curvilinear incision is made over the fibular head with dissection of the fascia and decompression o...
Purpose:
To perform a systematic review aimed to determine (1) if the postural stability deficit represents a risk factor for ankle sprains; (2) the most effective postural stability evaluation to predict ankle sprains and (3) eventual confounding factors that could influence postural stability and ankle sprain risk.
Methods:
A systematic electr...
The treatment of mild to moderate osteoarthritis can be a challenging problem for orthopaedic surgeons. As new research and treatment strategies have emerged, stem cell therapy has risen in popularity for the management of degenerative joint conditions. In this article, we describe a stepwise technical approach with tips and pearls to performing ad...
Surgical interventions for knee osteoarthritis (OA) have markedly different procedure attributes and may have dramatic differences in patient desirability. A total of 323 patients with knee OA were included in a dual response, choice-based conjoint analysis to identify the relative preference of 9 different procedure attributes. A model was also de...
Superior labral anterior to posterior (SLAP) tears are a pathology seen in the athletic population with greater frequency in the overhead athlete. Treatment is guided to some degree based on the type of the SLAP tear. In degenerative conditions, conservative treatment or debridement back to a stable base is indicated. In the case where the biceps-l...
Objectives
Alterations in joint mechanics contribute to the onset and progression of cartilage degeneration. While shoulder kinematics have been investigated through range-of-motion activity with minimal loads, less is known about shoulder function during weight-bearing exercise, specifically in terms of cartilage deformation. This study used magne...
Background:
There are currently limited human in vivo data characterizing the role of the meniscus in load distribution within the tibiofemoral joint. Purpose/Hypothesis: To compare the strains experienced in regions of articular cartilage covered by the meniscus to regions of cartilage not covered by the meniscus. We hypothesized that in response...
The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. The anterior cruciate ligament (ACL) is the most commonly injured ligament in conjunction with the MCL. Most MCL injuries can be treated nonoperatively, whereas the ACL often requires reconstruction. A good physical examination is essential for diagnosis, wherea...
Altered cartilage loading is believed to be associated with osteoarthritis development. However, there are limited data regarding the influence of normal gait, an essential daily loading activity, on cartilage strains. In this study, 8 healthy subjects with no history of knee surgery or injury underwent magnetic resonance imaging of a single knee p...
Introduction: The meniscus plays a variety of roles in knee biomechanics, such as distributing loads in the knee, absorbing shock, enhancing knee stability, and providing lubrication to cartilage surfaces [1]. Although the function of the meniscus has been investigated with animal and cadaver models, there are currently limited in vivo data charact...
Objective:
Detail the imaging findings in patients with proximal tibiofibular instability treated with surgical stabilization.
Methods:
Retrospective analysis of preoperative imaging in patients with clinically confirmed tibiofibular instability.
Results:
Operative fixation of the 16 patients was as follows: 11 using a fiberwire suture constru...
Purpose:
To evaluate the safety for neurovascular structures and accuracy for tunnel placement of the posterolateral portal tibial tunnel drilling technique in posterior cruciate ligament (PCL) reconstruction.
Methods:
Fifteen fresh-frozen human cadaveric knees were used. The tibial tunnel for the PCL was created using a flexible reamer from the...
The purpose was to evaluate which meniscal repair technique for radial tears of the midbody of the lateral meniscus demonstrates the best biomechanical properties. An electronic literature search was conducted using PubMed, EMBASE, CINAHL, and ScienceDirect databases. Biomechanical studies investigating the repair characteristics of radial tears in...
Objectives:
The effectiveness of sustained acoustic medicine to alleviate pain and improve function in subjects with elbow or Achilles tendinopathy was evaluated through a level IV case series study. Subjects were trained to self-apply the wearable, long-duration, low-intensity ultrasonic device on their affected body part at home for 4 hours a da...
Posterior cruciate ligament (PCL) reconstruction using the transtibial drilling or arthroscopic tibial-inlay technique has a risk of injury to the popliteal neurovascular bundle because a pin is drilled anterior to posterior. Intraoperative fluoroscopy is used to decrease the risk of neurovascular injury. In addition, graft passage in the transtibi...
To determine whether force-time integral (FTI) and maximum force (MF) are significantly different between genders when performing an unanticipated side cut on FieldTurf.
Thirty-two collegiate athletes (16 men and 16 women) completed 12 unanticipated cutting trials, while plantar pressure data were recorded using Pedar-X insoles.
Controlled Laborato...
No standardized return-to-activity or sport guidelines currently exist after anterior cruciate ligament (ACL) reconstruction. Isokinetic testing and unilateral hop testing, which have construct validity, are often used to make the determination of when a patient is ready to return to sport. Neither of these measures has been reported to be predicti...
Meniscal tears are common injuries, and while partial meniscectomy is a frequent treatment option, general meniscus loss is a risk factor for the development of osteoarthritis. The goal of this study was to measure the in vivo tibiofemoral cartilage contact patterns in patients with meniscus tears in relation to biomarkers of cartilage catabolism i...
A high tibial osteotomy (HTO) can provide relief of symptoms for the group of chronic posterior cruciate ligament (PCL)-deficient patients who have arthrosis so advanced that reconstruction is no longer recommended and are too young and active for knee arthroplasty. The ideal candidate for an osteotomy is young, active, without patellofemoral sympt...
Objectives:
In competitive athletes, return to play (RTP) and return to pre-injury levels of performance are the main goals of anterior cruciate ligament (ACL) surgery. RTP has been studied in several athletic populations, such as the National Football League. However, to our knowledge, RTP has not been comprehensively evaluated in Division 1 colle...
Context:
Injuries of the first metatarsophalangeal (hallux MP) joint can be debilitating in the athletic population. Turf toe and plantar plate injuries are typically diagnosed similarly. However, variance in injury mechanism as well as compromised integrity of soft tissue and ligamentous structures make it difficult to accurately diagnose specifi...
Clavicular fractures are common, representing 2.6% to 4% of all fractures and 44% of those in the shoulder girdle1,2. Midshaft fractures, which account for approximately 80% of clavicular fractures, historically were treated nonoperatively, even in the presence of substantial displacement2,3. Recent studies have shown that the rate of nonunion with...
Purpose/background:
The Upper Quarter Y Balance Test (YBT-UQ) was developed as a way to identify upper extremity and trunk mobility in the open kinetic chain in the reaching limb as well as midrange limitations and asymmetries of upper extremity and core stability in the closed kinetic chain on the stabilizing limb. Performance on the YBT-UQ is si...
Background:
For competitive athletes, return to play (RTP) and return to preinjury levels of performance after anterior cruciate ligament (ACL) reconstruction are the main goals of surgery. Although outcomes of ACL surgery are well studied, details on factors influencing RTP in elite college football players have not been evaluated thoroughly.
Pu...
Contact and collision sports such as American football expose the athlete to a wide array of potential injuries. Knee injuries garner much of the attention, but spinal injuries are potentially catastrophic and all levels of medical coverage of football must be knowledgeable and prepared to attend to an athlete with a neck injury. Of the other possi...
Background:
Articular cartilage damage of the knee is common, causing significant morbidity worldwide. Many adult tissues contain cells that are able to differentiate into multiple cell types, including chondrocytes. These stem cells have gained significant attention over the past decade and may become frontline management for cartilage defects in...
Multiligament knee injuries account for <0.02% of all orthopaedic injuries, and 16% to 40% of these patients suffer associated injury to the common peroneal nerve (CPN). The proximity of the CPN to the proximal fibula predisposes the nerve to injury during local trauma and dislocation; the nerve is highly vulnerable to stretch injury during varus s...
Objective
Obesity is an important risk factor for osteoarthritis (OA) and is associated with changes in both the biomechanical and inflammatory environments within the joint. However, the relationship between obesity and cartilage deformation is not fully understood. The goal of this study was to determine the effects of body mass index (BMI) on th...
This study sought to determine the role of the coracoacromial ligament and related arch structures in glenohumeral joint stabilization. Eight fresh-frozen cadaver specimens were tested at multiple angles of glenohumeral abduction and rotation for translations (in the direction of and perpendicular to a 50-N force) in intact, vented shoulders and af...
Hamstring strains are one of most common sports injuries. The purpose of this literature review is to summarize studies on hamstring strain injury rate, mechanism, and risk factors in the last several decades with a focus on the prevention and rehabilitation of this injury. Hamstring injury commonly occurs in sporting events in which high speed spr...
Shortcuts for throwing 3 alternating reversed half-hitches on alternating posts (RHAPs), in which the post is switched by alternating strand tension to "flip" the knot, have been advocated but never validated in a biomechanical study.
Shortcut tying techniques will affect knot security or loop security.
Controlled laboratory study.
A single surgeon...
Variation in swing mechanics between golfers of different skill levels has been previously reported. To investigate if differences in three-dimensional wrist kinematics and the angle of golf club descent between low and high handicap golfers.
A descriptive laboratory study was performed with twenty-eight male golfers divided into two groups, low ha...
We conducted a retrospective, single-center (tertiary referral center with associated level I trauma center) review to evaluate the outcome of open reduction and internal fixation (ORIF) with intramedullary (IM) clavicle pin of displaced clavicular fractures. Sixty-eight displaced midshaft clavicle fractures in 68 patients underwent ORIF with IM cl...
Anatomically placed grafts are believed to more closely restore the function of the ACL. This study measured the effect of femoral tunnel placement on graft orientation and length during weight-bearing flexion. Both knees of twelve patients where the graft was placed near the anteroproximal border of the ACL and ten where the graft was placed near...
Achilles tendon rupture is a frequent injury in athletes and the general public. Cases of chronic rupture or poor tendon quality secondary to tendinopathy are challenging to repair primarily. Commercially available extracellular matrix materials have been utilized in recent years to augment tendon repair.
Augmentation of Achilles tendon with extrac...
An MRI diagnosis of the Wrisberg variant discoid lateral meniscus should be considered in patients presenting with an anteriorly flipped posterior horn fragment without a definable peripheral rim. We present four cases discovered on arthroscopy that were thought to resemble bucket-handle tears on preoperative MRI. Posterior hypermobility poses a su...
The long-term survival rate of total shoulder arthroplasty (TSA) is comparable to hip and knee arthroplasty. Although TSA is considered a safe and effective procedure with low complications in patients with osteoarthritis and rheumatoid arthritis (RA), data are lacking on perioperative complications. Complication rates and hospital disposition diff...
Similar subjective outcomes have been reported for tenotomy or tenodesis of the long head of the biceps. Few studies have reported on postoperative strength and endurance.
Biceps tenodesis results in superior subjective outcomes, strength, and endurance compared with tenotomy.
Cohort study; Level of evidence, 3.
Participants completed isokinetic st...
Hyperconcavity of the lumbar spine has been found in a disproportionate percentage of college football lineman evaluated at the National Football League (NFL) Combine compared with age-matched controls.
College football linemen with hyperconcavity of the lumbar spine are more likely to play in the NFL and to have a longer career in professional foo...
Shoulder arthroplasty is being performed with increasing frequency, and patients' athletic participation after shoulder arthroplasty is on the rise. However, little data exist regarding appropriate long-term activity restrictions. We hypothesize that European and North American surgeons both recommend increasing long-term activity restrictions, mov...
BACKGROUND.: Although rare in occurrence, a dorsal dislocation of the 1st metatarsophalangeal (MTP) joint has been successfully treated using surgical and/or non-operative treatment. No descriptions of conservative intervention following a dorsal dislocation of the MTP joint in an athlete participating in a high contact sport are present in the lit...
There are only a few reports about intramuscular injury to the triceps brachii, offering the surgeon limited clinical options and estimates of prognosis. This is a case report of a patient with a traumatic closed tear of his triceps brachii who was treated surgically. This report presents the initial surgical management and data throughout 64 month...
Chronic exertional compartment syndrome is an entity that typically fails nonoperative management and requires operative treatment with fasciotomies for return to activity. Fasciotomies performed through single or multiple incisions may fail to totally release the fascia of the afflicted compartment(s) and may result in injury to neurovascular stru...
The strength and endurance of the contralateral biceps muscle can serve as a useful comparison for the operative limb following distal biceps repairs, mid-substance repairs, or tenotomy or tenodesis of the long head. There are limited data available on the effect of handedness on biceps strength and endurance.
The dominant upper extremity has great...
Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are two viable surgical treatment options for glenohumeral osteoarthritis. Recent systematic reviews and randomized trials suggest that TSA, while more costly initially, may have superior outcomes with regard to pain, function and quality of life with lower revision rates. This study compa...
The purpose of this study was to compare cruciate ligament forces between the forward lunge with a short step (forward lunge short) and the forward lunge with a long step (forward lunge long).
Eighteen subjects used their 12-repetition maximum weight while performing the forward lunge short and long with and without a stride. EMG, force, and kinema...
Although weight bearing lunge exercises are frequently employed during anterior cruciate ligament and posterior cruciate ligament rehabilitation, cruciate ligament tensile forces are currently unknown while performing forward and side lunge exercises with and without a stride.
Eighteen subjects used their 12 repetition maximum weight while performi...
The hamstrings group is made up of three two-joint muscles whose unique anatomy and functional properties during movement make this group particularly susceptible to muscle stain injury along the extensive muscle-tendon junctions, particularly during high-speed activities like sprinting. Proximal strains injury to the hamstring can also occur from...
A motion system collected 120-Hz data from 14 baseball adult hitters using normal and choke-up bat grips. Six swings were digitized for each hitter, and temporal and kinematic parameters were calculated. Compared with a normal grip, the choke-up grip resulted in 1) less time during stride phase and swing; 2) the upper torso more opened at lead foot...
We propose that learning proper hitting kinematics should be encouraged at a young age during youth baseball because this may help reinforce proper hitting kinematics as a player progresses to higher levels of baseball in their adult years. To enhance our understanding between youth and adult baseball hitting, kinematic and temporal analyses of bas...
To compare patellofemoral compressive force and stress during the one-leg squat and two variations of the wall squat.
Eighteen subjects used their 12 repetition maximum (12 RM) weight while performing the wall squat with the feet closer to the wall (wall squat short), the wall squat with the feet farther away from the wall (wall squat long), and th...
Purpose: To compare cruciate ligament forces during wall squat and one-leg squat exercises.
Methods: Eighteen subjects performed the wall squat with feet closer to the wall (wall squat short), the wall squat with feet farther from the wall (wall squat long), and the one-leg squat. EMG, force, and kinematic variables were input into a biomechanical...
Controlled laboratory biomechanics study using a repeated-measures, counterbalanced design.
To compare patellofemoral joint force and stress between a short- and long-step forward lunge both with and without a stride.
Although weight-bearing forward-lunge exercises are frequently employed during rehabilitation for individuals with patellofemoral jo...
Hamstring muscle strain injury is one of the most commonly seen injuries in sports such as track and field, soccer, football, and rugby. The purpose of this study was to advance our understanding of the mechanisms of hamstring muscle strain injuries during over ground sprinting by investigating hamstring muscle-tendon kinematics and muscle activati...
Although weight bearing lunge exercises are frequently employed during patellofemoral rehabilitation, patellofemoral compressive force and stress are currently unknown for these exercises.
Eighteen subjects used their 12 repetition maximum weight while performing forward and side lunges with and without a stride. EMG, force platform, and kinematic...