This special edition podcast highlights the top 10 articles of 2019  that caught the most public attention based on their Altmetric scores.

1. Platelet-Rich Plasma for Patellar Tendinopathy: A Randomized Controlled Trial of Leukocyte-Rich PRP or Leukocyte-Poor PRP Versus Saline

2. Evidence-Based Best-Practice Guidelines for Preventing Anterior Cruciate Ligament Injuries in Young Female Athletes: A Systematic Review and Meta-analysis

3. Activity Modification and Load Management of Adolescents With Patellofemoral Pain: A Prospective Intervention Study Including 151 Adolescents

4. Exposure to American Football and Neuropsychiatric Health in Former National Football League Players: Findings From the Football Players Health Study

5. Higher Rates of Lower Extremity Injury on Synthetic Turf Compared With Natural Turf Among National Football League Athletes: Epidemiologic Confirmation of a Biomechanical Hypothesis

6. Comparative Efficacy and Safety of Nonsurgical Treatment Options for Enthesopathy of the Extensor Carpi Radialis Brevis: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

7. Implementation of the FIFA 11+ Injury Prevention Program by High School Athletic Teams Did Not Reduce Lower Extremity Injuries: A Cluster Randomized Controlled Trial

8. A 6-Week Transition to Maximal Running Shoes Does Not Change Running Biomechanics

9. A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months

10. Coper Classification Early After Anterior Cruciate Ligament Rupture Changes With Progressive Neuromuscular and Strength Training and Is Associated With 2-Year Success: The Delaware-Oslo ACL Cohort Study

Previous studies have shown that runners demonstrate elevated T2 and T1ρ values on magnetic resonance imaging (MRI) after running a marathon, with the greatest changes in the patellofemoral and medial compartment, which can persist after 3 months of reduced activity. Additionally, marathon running has been shown to increase serum inflammatory markers. Hyaluronic acid (HA) purportedly improves viscoelasticity of synovial fluid, serving as a lubricant while also having chondroprotective and anti-inflammatory effects.

Increased T2 and T1ρ relaxation times have been observed in marathon runners, suggesting early cartilage injury. The addition of intra-articular HA did not significantly affect relaxation times in all areas of the knee when compared with an NS control.

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Five articles from the December 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "The Association Between Tibial Slope and Revision Anterior Cruciate Ligament Reconstruction in Patients ≤21 Years Old: A Matched Case-Control Study Including 317 Revisions", "Risk Factors Associated With a Noncontact Anterior Cruciate Ligament Injury to the Contralateral Knee After Unilateral Anterior Cruciate Ligament Injury in High School and College Female Athletes: A Prospective Study", "Functional Results and Outcomes After Repair of Partial Proximal Hamstring Avulsions at Midterm Follow-up", "The Effect of Sport-Related Concussion Injuries on Concussion Symptoms and Health-Related Quality of Life in Male and Female Adolescent Athletes: A Prospective Study", and "Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Outcomes for Quadriceps Tendon Autograft Versus Bone-Patellar Tendon-Bone and Hamstring-Tendon Autografts".

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This special edition podcast highlights the 2019 Systematic Review Award winning article.

An infection after anterior cruciate ligament (ACL) reconstruction is a relatively rare but challenging complication. There are no meta-analyses comparing the incidence of infections after ACL reconstruction with the various available graft choices.

The findings of this meta-analysis demonstrate a significantly lower incidence of deep infections after ACL reconstruction with BPTB autografts compared with hamstring autografts but not compared with allografts.

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Limited in vivo kinematic information exists on the effect of clinical-based partial medial and lateral meniscectomy in the context of anterior cruciate ligament (ACL) reconstruction.

Before ACL reconstruction, partial medial meniscectomy increased AP laxity at 30° and 90° and lateral meniscectomy increased dynamic PS laxity with respect to intact menisci. Anatomic single-bundle ACL reconstruction decreased laxities, but a residual anterior translation of 1.3 mm at 90° remained in patients with partial medial meniscectomy, with respect to those with intact menisci.

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Five articles from the November 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Symptomatic Venous Thromboembolism After Achilles Tendon Rupture", "Humeral Retroversion and Injury Risk After Proximal Humeral Epiphysiolysis
(Little Leaguer’s Shoulder)", "Location of the Glenoid Defect in Shoulders With Recurrent Posterior Glenohumeral Instability", "Changes of Supraspinatus Muscle Volume and Fat Fraction After Successful or Failed Arthroscopic Rotator Cuff Repair", and "Defining Minimal Clinically Important Difference and Patient Acceptable Symptom State After Isolated Endoscopic Gluteus Medius Repair."

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Lower extremity injuries are common in high school sports and are costly, and some have poor outcomes. The FIFA 11+ injury prevention program has been shown to decrease injuries in elite athletes by up to 72%.

This study did not demonstrate a reduction in lower extremity injuries in schools randomized to use the FIFA 11+ program compared with schools using their usual prepractice warm-up program. Coach-reported compliance with performing the FIFA 11+ program at least twice a week was low.

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Five articles from the October 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Portal Placement and Biomechanical Performance of Endoscopic Proximal Hamstring Repair", "Nonabsorbable Suture Knot on the Tendon Affects Rotator Cuff Healing: A Comparative Study of the Knots on Tendon and Bone in a Rat Model of Rotator Cuff Tear", "Increased Chondrocytic Gene Expression Is Associated With Improved Repair Tissue Quality and Graft Survival in Patients After Autologous Chondrocyte Implantation", "The Number of Injury Events Associated With the Critical Size of Bipolar Bone Defects in Rugby Players With Traumatic Anterior Shoulder Instability", and "Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets."

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Studies on the effect of partial- and full-thickness chondral damage of the hip on outcomes and the ability to achieve meaningful clinical outcomes are limited.

Patients with grade IV chondral defects experienced worse functional outcomes, lower satisfaction, and increased pain when compared with both patients without chondral damage or grade I-III chondromalacia at 2-year follow-up. Several predictors were associated with achieving clinically significant function in patients undergoing hip arthroscopic surgery for FAIS.

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Five articles from the September 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Single-Stage Multiple-Ligament Knee Reconstructions for Sports-Related Injuries: Outcomes in 194 Patients", "Surgeon Ability to Appropriately Address the Calcified Cartilage Layer: An In Vitro Study of Arthroscopic and Open Techniques", "Ankle Sprains in the National Basketball Association, 2013-2014 Through 2016-2017", "Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations", and "Predictors of Unsuccessful Nonoperative Management of Capitellar Osteochondritis Dissecans."

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The ability of lateral meniscal allograft transplantation (MAT) to improve knee stability and the meniscal load-bearing function in patients after meniscectomy is critical for surgical success.

Lateral MAT partially restored medial translation of the tibia, and the resultant forces in the meniscal allograft were only 50% to 60% of the intact lateral meniscus forces in the cadaver model. In the majority of testing conditions, no significant changes of the in situ force in the anterior cruciate ligament were observed. Surgeons should consider the potential benefits of lateral MAT when deciding the appropriate treatment for symptomatic patients after lateral meniscectomies. Both lateral MAT techniques functioned similarly.

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Five articles from the August 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Lower signal intensity of the anterior talofibular ligament (ATFL) is associated with a higher rate of return to sport after ATFL repair for chronic lateral ankle instability", "Epidemiology and Video-Analysis of Achilles Tendon Ruptures in the National Basketball Association", "The Use of Particulated Juvenile Allograft Cartilage for the Repair of Porcine Articular Cartilage Defects", "Biomechanical Comparison of Onlay Distal Biceps Tendon Repair: All-Suture Anchors versus Titanium Suture-Anchors", and "In which arm position is a Hill-Sachs lesion created?"

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Nearly three-quarters of anterior cruciate ligament (ACL) injuries occur as “noncontact” failures from routine athletic maneuvers. Recent in vitro studies revealed that repetitive strenuous submaximal knee loading known to especially strain the ACL can lead to its fatigue failure, often at the ACL femoral enthesis.

The authors found evidence of accumulated damage to collagen fibrils and fibers at the ACL femoral enthesis at the time of surgery for noncontact ACL failure. This tissue damage was similar to that found in donor knees subjected in vitro to repetitive 4 times–body weight impulsive 3-dimensional loading known to cause a fatigue failure of the ACL.

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The effect of platelet-rich plasma (PRP) on the risk of meniscal repair failure is unclear. Current evidence is limited to small studies without comparison between isolated repairs and meniscal repairs with concomitant anterior cruciate ligament (ACL) reconstruction. It is also unclear whether the efficacy of PRP differs between preparation systems in the setting of meniscal repair.

Both PRP preparations used in the current study had a substantial protective effect in terms of the risk of isolated meniscal repair failure over 3 years. In the setting of concomitant ACL reconstruction, PRP does not reduce the risk of meniscal repair failure.

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Five articles from the July 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Performance and Return to Sport After Open Reduction and Internal Fixation of the Olecranon in Professional Baseball Players","Adaptation of Running Biomechanics to Repeated Barefoot Running", "Multiplanar Loading of the Knee and Its Influence on Anterior Cruciate Ligament and Medial Collateral Ligament Strain During Simulated Landings and Noncontact Tears" , "Pathoanatomy of Shoulder Instability in Collegiate Female Athletes" and "Severe Bone Marrow Edema Among Patients Who Underwent Prior Marrow Stimulation Technique Is a Significant Predictor of Graft Failure After Autologous Chondrocyte Implantation."

 Click here to read the articles.

Five articles from the June 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Is It Safe to Inject Corticosteroids Into the Glenohumeral Joint After Arthroscopic Rotator Cuff Repair?", "Osteochondral Allograft Transplantation of the Femoral Condyle Utilizing a Thin Plug Graft Technique", "Secondary Meniscal Tears in Patients With Anterior Cruciate Ligament Injury: Relationship Among Operative Management, Osteoarthritis, and Arthroplasty at 18-Year Mean Follow-up" , "Is Microfracture Necessary? Acetabular Chondrolabral Debridement/Abrasion Demonstrates Similar Outcomes and Survival to Microfracture in Hip Arthroscopy: A Multicenter Analysis" and "Allograft Augmentation of Hamstring Anterior Cruciate Ligament Autografts Is Associated With Increased Graft Failure in Children and Adolescents."

 Click here to read the articles.

Five articles from the May 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "5-year Outcomes and Return to Sport in Runners Undergoing Hip Arthroscopy for Labral Tears With or Without Femoroacetabular Impingement", "Predictors of Healing Ligament Size and MR Signal Intensity at 6 months after Bridge-Enhanced ACL Repair", "The effect of ankle bracing on kinematics in simulated sprain and drop landings: A double-blind, placebo-controlled study" , "Arthroscopic repair of the isolated subscapularis full-thickness tear: single-row versus double-row suture-bridge technique" and "Do Outcomes or Subsequent Injuries Differ After Ulnar Collateral Ligament Reconstruction Using Palmaris vs. Hamstring Autograft?."

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Traumatic anterior shoulder instability is a common condition affecting sports participation among young athletes. Clinical outcomes after surgical management may vary according to patient activity level and sport involvement. Overhead athletes may experience a higher rate of recurrent instability and difficulty returning to sport postoperatively with limited previous literature to guide treatment

Primary arthroscopic anterior shoulder stabilization in overhead athletes is associated with a low rate of recurrent stabilization surgery. Return to overhead athletics at short-term follow-up is lower than that previously reported for the general athletic population.

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The purpose of the study was to identify (1) the proportion of opioid-naïve patients undergoing elective shoulder surgery, (2) the rates of postoperative opioid use among these patients, and (3) the risk factors associated with long-term postoperative opioid use.

Most patients were opioid naïve before elective shoulder surgery; however, among opioid-naïve patients, 1 in 7 patients were still using opioids beyond 180 days after surgery. Among all variables, a history of mental illness most significantly increased the risk of long-term opioid use after elective shoulder surgery.

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Five articles from the April 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Ulnar Collateral Ligament Repair With Collagen-Dipped FiberTape Augmentation in Overhead-Throwing Athletes", "Long-term, Prospective, Multicenter Study of Isolated Bankart Repair for a Patient Selection Method Based on the Instability Severity Index Score", "Ivy League – Big Ten Epidemiology of Concussion study: a Report on Methods and First Findings" , "Prospective Evaluation of the Patient Acceptable Symptom State (PASS) to Identify Clinically Successful Anterior Cruciate Ligament Reconstruction (ACLR)" and "Correlation between Magnetic Resonance Imaging and Surgical Exploration of the Anterolateral Structures of the Acutely Anterior Cruciate Ligament Injured Knee."

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Five articles from the March 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Short-term Changes After Corticosteroid Injections Into the Normal Tendons of Rabbits: A Controlled Randomized Study", "Acute anterior cruciate ligament rupture: repair or reconstruction? Two-year results of a randomized control trial", "The Development Process of Bipolar Bone Defects From Primary to Recurrent Instability in Shoulders With Traumatic Anterior Instability" , "Ankle Lateral Ligament Augmentation Versus the Modified Brostrom-Gould Procedure: A 5-Year Randomized Controlled Trial" and "Predictors of Persistent Postoperative Pain at Minimum 2 Years After Arthroscopic Treatment of Femoroacetabular Impingement."

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To evaluate the capability of conventional glenoid bone loss measurement techniques to provide an adequate estimation of the actual biomechanical effect of glenoid defects.

Current glenoid bone loss measurements are unable to provide an adequate estimation on the actual biomechanical effect of glenoid defects because (1) the relation between the glenoid defect size and its biomechanical effect is nonlinear and (2) patients with shoulder instability have constitutional biomechanically relevant glenoid concavity shape differences

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Five articles from the February 2019 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full.

The featured articles for this month are, "Superior Capsule Reconstruction for Reinforcement of Arthroscopic Rotator Cuff Repair Improves Cuff Integrity", "Bone Marrow Aspirate Concentrate Does Not Improve Osseous Integration of Osteochondral Allografts for the Treatment of Chondral Defects in the Knee at 6 and 12 Months", "The Role of Calcaneofibular Ligament Injury in Ankle Instability: Implications for Surgical Management" , "Comparison of Clinical and Radiographic Outcomes of Vertical Simple Stitch Versus Modified Mason-Allen Stitch in Arthroscopic Bankart Repair: A Prospective Randomized Controlled Study" and "Platelet-Rich Plasma Versus Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis."

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To evaluate the effect of the estrogen-deficient state on tendon-to-bone healing after rotator cuff repair in an ovariectomized rat model.

The estrogen-deficient state by ovariectomy, compared with control rats, led to decreased biomechanical properties and poor development of chondroid tissue that influenced the repair of the tendon insertion after surgery.

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