Publications by authors named "Jesse A Goodrich"

14 Publications

  • Page 1 of 1

Exposure to Perfluoroalkyl Substances and Glucose Homeostasis in Youth.

Environ Health Perspect 2021 Sep 1;129(9):97002. Epub 2021 Sep 1.

Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.

Background: Exposure to per- and polyfluoroalkyl substances (PFAS), a prevalent class of persistent pollutants, may increase the risk of type 2 diabetes.

Objective: We examined associations between PFAS exposure and glucose metabolism in youth.

Methods: Overweight/obese adolescents from the Study of Latino Adolescents at Risk of Type 2 Diabetes (SOLAR; ) participated in annual visits for an average of . Generalizability of findings were tested in young adults from the Southern California Children's Health Study (CHS; ) who participated in a clinical visit with a similar protocol. At each visit, oral glucose tolerance tests were performed to estimate glucose metabolism and function via the insulinogenic index. Four PFAS were measured at baseline using liquid chromatography-high-resolution mass spectrometry; high levels were defined as concentrations percentile.

Results: In females from the SOLAR, high perfluorohexane sulfonate (PFHxS) levels () were associated with the development of dysregulated glucose metabolism beginning in late puberty. The magnitude of these associations increased postpuberty and persisted through 18 years of age. For example, postpuberty, females with high PFHxS levels had higher 60-min glucose (95% CI: ; ), higher 2-h glucose (95% CI: ; ), and 25% lower function () compared with females with low levels. Results were largely consistent in the CHS, where females with elevated PFHxS levels had higher 60-min glucose (95% CI: ; ) and higher 2-h glucose, which did not meet statistical significance (95% CI: ; ). In males, no consistent associations between PFHxS and glucose metabolism were observed. No consistent associations were observed for other PFAS and glucose metabolism.

Discussion: Youth exposure to PFHxS was associated with dysregulated glucose metabolism in females, which may be due to changes in function. These associations appeared during puberty and were most pronounced postpuberty. https://doi.org/10.1289/EHP9200.
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http://dx.doi.org/10.1289/EHP9200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409228PMC
September 2021

The importance of lean mass and iron deficiency when comparing hemoglobin mass in male and female athletic groups.

J Appl Physiol (1985) 2020 10 3;129(4):855-863. Epub 2020 Sep 3.

Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado.

Hemoglobin mass (Hbmass) is important for athletes because it helps determine maximal aerobic power. This study examined how lean mass, iron deficiency (ID), and sex influence Hbmass in athletic and nonathletic groups. NCAA Division I student athletes (21 men, 75 women; altitude: 1,625 m) were recruited from six athletic teams; 14 male and 12 female full-time students (non-varsity athletes) served as control subjects. Hbmass, body composition, and iron homeostasis parameters, including ferritin, soluble transferrin receptor (sTfR), hepcidin, erythroferrone, and 10 inflammatory cytokines, were measured two to four times across a competitive/training season. ID was defined as ferritin < 25 ng/mL. Hbmass was more closely related to lean mass ( = 0.90) than body mass ( = 0.69, < 0.01). Compared with female subjects, male subjects had 19.9% higher Hbmass relative to body mass (Hbmass) but only 7.5% higher Hbmass relative to lean mass (Hbmass) (both < 0.001). Prevalence of ID was higher in female than male subjects (47% vs. 9%, < 0.01) but did not vary between groups. Hbmass was 5% lower in ID vs. non-ID female subjects; Hbmass was not different. ID was associated with lower hepcidin, elevated sTfR, and elevated erythroferrone but not with differences in inflammatory cytokines. Hbmass varied significantly between athletic groups and across sex, but the majority of these differences are explained by differences in lean mass. ID was common in female subjects and was associated with lower Hbmass and hepcidin but not with differences in Hbmass or inflammatory cytokines. Hbmass relative to lean mass seems advantageous when monitoring iron deficiency. Differences in hemoglobin mass (Hbmass) between groups and across sex are primarily due to differences in lean mass. Iron deficiency (ID) independently decreases Hbmass; this effect is best characterized with Hbmass relative to lean mass. ID is common in females and is associated with lower hepcidin and elevated erythroferrone but not with differences in inflammatory cytokines. Hbmass relative to lean mass accurately quantifies hematological alterations secondary to iron deficiency.
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http://dx.doi.org/10.1152/japplphysiol.00391.2020DOI Listing
October 2020

Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Am J Sports Med 2021 01 17;49(1):249-260. Epub 2020 Apr 17.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are 2 nonoperative treatment options for knee osteoarthritis (OA) that are supposed to provide symptomatic relief and help delay surgical intervention.

Purpose: To systematically review the literature to compare the efficacy and safety of PRP and HA injections for the treatment of knee OA.

Study Design: Meta-analysis of level 1 studies.

Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify level 1 studies that compared the clinical efficacy of PRP and HA injections for knee OA. The search phrase used was . Patients were assessed via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and Subjective International Knee Documentation Committee (IKDC) scale. A subanalysis was also performed to isolate results from patients who received leukocyte-poor and leukocyte-rich PRP.

Results: A total of 18 studies (all level 1) met inclusion criteria, including 811 patients undergoing intra-articular injection with PRP (mean age, 57.6 years) and 797 patients with HA (mean age, 59.3 years). The mean follow-up was 11.1 months for both groups. Mean improvement was significantly higher in the PRP group (44.7%) than the HA group (12.6%) for WOMAC total scores ( < .01). Of 11 studies based on the VAS, 6 reported PRP patients to have significantly less pain at latest follow-up when compared with HA patients ( < .05). Of 6 studies based on the Subjective IKDC outcome score, 3 reported PRP patients to have significantly better scores at latest follow-up when compared with HA patients ( < .05). Finally, leukocyte-poor PRP was associated with significantly better Subjective IKDC scores versus leukocyte-rich PRP ( < .05).

Conclusion: Patients undergoing treatment for knee OA with PRP can be expected to experience improved clinical outcomes when compared with HA. Additionally, leukocyte-poor PRP may be a superior line of treatment for knee OA over leukocyte-rich PRP, although further studies are needed that directly compare leukocyte content in PRP injections for treatment of knee OA.
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http://dx.doi.org/10.1177/0363546520909397DOI Listing
January 2021

The "Outside-In" Lesion of Hip Impingement and the "Inside-Out" Lesion of Hip Dysplasia: Two Distinct Patterns of Acetabular Chondral Injury.

Am J Sports Med 2019 10 6;47(12):2978-2984. Epub 2019 Sep 6.

University of Colorado School of Medicine, Department of Orthopedics, Aurora, Colorado, USA.

Background: Femoroacetabular impingement (FAI) and acetabular dysplasia lead to acetabular cartilage damage that commonly results in the chondral flaps seen during hip arthroscopy.

Purpose: To compare the acetabular chondral flap morphology seen during hip arthroscopy ("outside-in" vs "inside-out") with clinical and radiographic parameters underlying FAI and hip dysplasia.

Study Design: Cohort study; Level of evidence, 3.

Methods: Patients who underwent hip arthroscopy by the senior author between 2013 and 2017 with a finding of Outerbridge grade IV acetabular chondral flap were included. Each procedure was retrospectively reviewed on video and chondral flaps were categorized as inside-out or outside-in. An inside-out designation was made for flaps exhibiting an intact chondrolabral junction with a detached sleeve of chondrolabral tissue from the central acetabulum, and an outside-in designation was made for centrally anchored flaps exhibiting a break in the chondrolabral junction. Radiographic markers of hip impingement/dysplasia were noted for each patient during assignment into 1 of 2 radiographic groups: group 1, lateral center edge angle (LCEA) >20 with FAI, and group 2, LCEA ≤20 with or without cam FAI. Associations between chondral flap morphology and clinical diagnosis were tested using a chi-square test.

Results: Overall, 95 patients (103 hips) were included (group 1, 78 hips; group 2, 25 hips). Among hips in group 2, 24 had concurrent cam FAI. There was a significant relationship between chondral flap type and radiographic diagnosis ( < .001). Among group 1 hips, 78% exhibited outside-in type chondral flaps, 12% exhibited combined outside-in and inside-out flaps, and 10% exhibited inside-out flaps. Group 2 hips showed 72% inside-out type chondral flaps, 16% combined, and 12% outside-in. Hips exhibiting outside-in type flaps were significantly more likely to be in group 1 (positive predictive value [PPV], 91%; negative predictive value [NPV], 69%). Similarly, hips exhibiting inside-out type flaps were significantly more likely to be in group 2 (PPV, 56%; NPV, 95%). Altogether, 90% of group 1 hips exhibited an outside-in lesion and 88% of group 2 hips exhibited an inside-out lesion.

Conclusion: Acetabular chondral flap type visualized during hip arthroscopy correlates with radiographic markers of hip impingement and hip instability. Outside-in flaps are highly predictive of FAI, whereas inside-out flaps are highly predictive of acetabular dysplasia.
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http://dx.doi.org/10.1177/0363546519871065DOI Listing
October 2019

Effects of Hip Arthroscopy Without a Perineal Post on Venous Blood Flow, Muscle Damage, Peripheral Nerve Conduction, and Perineal Injury: A Prospective Study.

Am J Sports Med 2019 07 24;47(8):1931-1938. Epub 2019 May 24.

University of Colorado School of Medicine, Department of Orthopedics, Aurora, Colorado, USA.

Background: Prior reports of hip arthroscopy using a perineal post have established the risks of groin soft tissue injury, sexual dysfunction, and altered lower extremity neurovascular function. These parameters have not been investigated for hip arthroscopy without the use of a perineal post.

Purpose: To evaluate the effects of postless hip arthroscopy on lower extremity venous blood flow, nerve conduction, muscle tissue damage, and perineal injury.

Study Design: Case series; Level of evidence, 4.

Methods: Patients between the ages of 18 and 50 years undergoing an elective unilateral or simultaneous bilateral hip arthroscopy were enrolled. Creatine phosphokinase (CPK)-MM levels and D-dimer levels were obtained preoperatively, immediately postoperatively, and 7 to 12 days postoperatively. Bilateral Doppler ultrasonography of the common femoral vein (CFV) and popliteal vein were conducted intraoperatively. Somatosensory evoked potentials (SSEPs) and transcranial motor evoked potentials (TcMEPs) were measured intraoperatively for the lower limbs. Perineal injury was assessed at 7 to 12 days postoperatively.

Results: 35 patients underwent a total of 40 hip arthroscopies. No significant differences were found in venous blood flow between the operative and nonoperative legs for either the CFV or popliteal vein. SSEP monitoring of the peroneal nerve showed no significant reduction when traction was applied to the operative leg, 90.8%, compared with final measurement just before it was removed, 72.4% ( = .09). For TcMEPs measured in the muscles outside of the traction boots, no significant changes were seen in the percentage of cases with abnormal measurements throughout the procedure. CPK-MM levels preoperatively, immediately postoperatively, and 7 to 12 days after surgery were on average 112, 190, and 102 IU/L, respectively (normal, <156 IU/L). No significant relationship was found between abnormal venous flow and altered D-dimer levels. No clinical evidence of nerve or vascular injury was encountered, and no groin soft tissue complications were observed during the study period.

Conclusion: Postless hip arthroscopy is safe, without a notable reduction of venous blood flow or alteration of nerve function in the operative leg. Muscle tissue damage is subclinical, transient, and reduced compared with distraction with a post. No cases of perineal injury were observed during the study period.
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http://dx.doi.org/10.1177/0363546519849663DOI Listing
July 2019

Increased Prevalence of Femoroacetabular Impingement in Patients With Proximal Hamstring Tendon Injuries.

Arthroscopy 2019 05 12;35(5):1396-1402. Epub 2019 Apr 12.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.. Electronic address:

Purpose: To determine the prevalence of clinically diagnosed femoroacetabular impingement (FAI) in a consecutive series of patients presenting with proximal hamstring tendon injury and to correlate this with pelvic anatomic factors.

Methods: The prevalence of clinically symptomatic cam-, pincer-, and mixed-type and overall FAI was calculated among a consecutive series of patients presenting to a hip preservation clinic with a confirmed clinical and radiographic diagnosis of proximal hamstring tendon injury between 2012 and 2017. The presence of a cam lesion was determined by an alpha angle > 50° on radiographs and computed tomography radial sequences of the head-neck junction and a femoral head-neck offset ratio < 0.18. Clinical diagnoses of osseous impingement were determined according to accepted pathomorphologic signs and measurements. A diagnosis of FAI was confirmed by imaging findings of acetabular overcoverage for pincer-type FAI and the presence of an anterior or lateral cam lesion for cam-type FAI.

Results: Overall, 120 hips in 97 patients (mean age, 45 years) were included in this study. A clinical diagnosis of FAI was noted in 70.8% of hips (pincer-type 9.2%, cam-type 40.8%, mixed-type 20.8%), an approximate 2- to 7-fold increased prevalence in comparison with the general population from prior studies.

Conclusions: The prevalence of FAI is high in patients with symptomatic proximal hamstring tendon pathology. Because FAI results in restriction of hip range of motion and altered pelvic tilt, future studies are warranted to investigate whether the presence of FAI acts as a predisposing factor for injury to the hamstring muscle complex.

Level Of Evidence: Level IV, case series.
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http://dx.doi.org/10.1016/j.arthro.2018.11.037DOI Listing
May 2019

Combined Lateral Osseolabral Coverage Is Normal in Hips With Acetabular Dysplasia.

Arthroscopy 2019 03 4;35(3):800-806. Epub 2019 Feb 4.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.

Purpose: To compare the lateral osseolabral coverage between groups of patients with different degrees of acetabular bony coverage using a magnetic resonance imaging parameter known as the combined lateral center-edge angle (cLCEA).

Methods: The cLCEA was measured among a consecutive series of patients presenting to a dedicated hip preservation surgeon with a magnetic resonance imaging scan. The cLCEA was measured using a coronal T1 or proton density image and was defined as the angle subtended by (1) a line through the center of the femoral head and orthogonal to the transverse line passing through the teardrops of both hips and (2) an oblique line drawn from the center of the femoral head to the free edge of the lateral acetabular labrum. The average difference between the lateral center-edge angle (LCEA) and the cLCEA was calculated and compared between groups based on acetabular bony coverage: dysplasia (LCEA <20°), borderline dysplasia (LCEA 20°-24.9°), normal coverage (LCEA 25°-39.9°), and overcoverage (LCEA ≥40°).

Results: In total, 341 patients (386 hips) were included. There were no significant differences in cLCEA between hips with normal acetabular coverage and dysplasia (P = .10) or borderline dysplasia (P = .46). Despite the large difference in mean LCEA between dysplasia (14.8° ± 3.9°) and acetabular overcoverage (43.1° ± 2.8°), the mean cLCEA values exhibited only a modest difference (44.7° ± 4.9° vs 52.7° ± 4.5°, respectively). Concordantly, hips with dysplasia exhibited the largest difference between mean LCEA and cLCEA (delta = 29.9° ± 4.7°) and hips with acetabular overcoverage had the smallest difference between measures (9.6° ± 5.2°).

Conclusions: With decreasing acetabular bony coverage, there is increasing labral size such that the total osseolabral coverage, measured by the combined LCEA, remains equivalent between hips with normal acetabular coverage versus dysplasia.

Level Of Evidence: Level III, retrospective comparative study.
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http://dx.doi.org/10.1016/j.arthro.2018.10.133DOI Listing
March 2019

The Influence of Oxygen Saturation on the Relationship Between Hemoglobin Mass and VO max.

Sports Med Int Open 2018 Jul 6;2(4):E98-E104. Epub 2018 Sep 6.

Department of Integrative Physiology, University of Colorado Boulder, Boulder, United States.

Hemoglobin mass (tHb) is a key determinant of maximal oxygen uptake (VO max). We examined whether oxyhemoglobin desaturation (ΔS O ) at VO max modifies the relationship between tHb and VO max at moderate altitude (1,625 m). Seventeen female and 16 male competitive, endurance-trained moderate-altitude residents performed two tHb assessments and two graded exercise tests on a cycle ergometer to determine VO max and ΔS O . In males and females respectively, VO max (ml·kg ·min ) ranged from 62.5-83.0 and 44.5-67.3; tHb (g·kg ) ranged from 12.1-17.5 and 9.1-13.0; and S O at VO max (%) ranged from 81.7-94.0 and 85.7-95.0. tHb was related to VO max when expressed in absolute terms and after correcting for body mass (r=0.94 and 0.86, respectively); correcting by ΔS O did not improve these relationships (r=0.93 and 0.83). Additionally, there was a negative relationship between tHb and S O at VO max (r=-0.57). In conclusion, across a range of endurance athletes at moderate altitude, the relationship between tHb and VO max was found to be similar to that observed at sea level. However, correcting tHb by ΔS O did not explain additional variability in VO max despite significant variability in ΔS O ; this raises the possibility that tHb and exercise-induced ΔS O are not independent in endurance athletes.
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http://dx.doi.org/10.1055/a-0655-7207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225968PMC
July 2018

Standardizing the Prearthritic Hip Joint Space Width: An Analysis of 994 Hips.

Arthroscopy 2018 07 2;34(7):2114-2120. Epub 2018 May 2.

Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, U.S.A.. Electronic address:

Purpose: The purposes of this study were (1) to define a normal prearthritic hip joint space width (JSW) in symptomatic and asymptomatic patients with various degrees of acetabular coverage based on the lateral center edge angle (LCEA) and (2) to determine predictors of JSW using patient-specific variables.

Methods: In a consecutive series of patients presenting to a hip preservation clinic between July 2012 and April 2016, a standard weight-bearing anteroposterior pelvic view was obtained. JSW was defined as the distance between the bony contour of the acetabular rim and femoral head in 2 locations (lateral and medial weight-bearing zone). Hips with severe anatomic deformity, a Tönnis grade >0, or a lateral or medial JSW <2.5 mm were excluded. A linear mixed model analysis was performed in order to determine which variables (age, sex, side, height, weight, symptomatic/asymptomatic, LCEA, and clinical diagnosis) were significantly related to JSW.

Results: A total of 994 hips were included. LCEA was found to be a significant predictor of both the lateral and medial JSW, with a decreased JSW associated with increasing degrees of acetabular bony coverage (P < .02). A mean 0.9 mm (20%) difference in medial JSW was found between patients with frank dysplasia (LCEA <20°) compared with those with pincer-type FAI (LCEA ≥40°). There was no difference between symptomatic and asymptomatic hips, either for lateral (asymptomatic: 4.51 ± 0.83 mm; symptomatic: 4.52 ± 0.85 mm; P = .58) or medial JSW (asymptomatic: 4.02 ± 0.96 mm; symptomatic: 3.97 ± 0.84 mm; P = .49).

Conclusions: The LCEA is a significant predictor of hip JSW, with the mean JSW decreasing with increasing degrees of acetabular bony coverage. Joint space is not a major factor in symptomatology in adults with prearthritic hip pain.

Level Of Evidence: Level III, retrospective comparative study.
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http://dx.doi.org/10.1016/j.arthro.2018.02.036DOI Listing
July 2018

Quadriceps Tendon Autograft for Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review of Comparative Studies With Minimum 2-Year Follow-Up.

Arthroscopy 2018 05 5;34(5):1699-1707. Epub 2018 Apr 5.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.

Purpose: To systematically review the literature in an effort to compare outcomes of patients undergoing primary anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) autograft versus a bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autograft.

Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to locate studies (Level of Evidence I-III) comparing the clinical outcomes of the QT autograft versus the BPTB or HT autograft in patients undergoing primary ACLR. Patients were evaluated based on graft failure rate, examination of knee laxity, and patient-reported outcome scores.

Results: Eight studies (1 Level II, 7 Level III) were identified that met inclusion criteria, including a total of 368 patients undergoing primary ACLR with a QT autograft, 225 with a BPTB autograft, and 150 with an HT autograft. The average follow-up duration for all patients was 2.9 years. Overall, 2.8% of patients (17/603) experienced graft failure. Within the studies that compared the QT versus BPTB autograft, no study found a significant difference in graft failure rate between groups, and the odds ratio for graft failure between QT and BPTB was found to be 1.58 (95% confidence interval: 0.49-5.07; P = .44). Within the studies that compared graft failure rate between the QT and HT autograft, none found significant differences between groups, although a meta-analysis was not performed because of a low number of trials. Two studies found significantly greater postoperative knee laxity in HT patients compared with QT patients (P < .05), although there were no significant differences found in laxity measurements between QT and BPTB patients.

Conclusions: Patients undergoing primary ACLR with either a QT, BPTB, or HT autograft can all be expected to experience improvement in clinical outcomes. QT patients experienced less knee laxity postoperatively compared with HT patients, although no significant differences were found in graft failure rate between groups.

Level Of Evidence: Level III, systematic review of Level II and III studies.
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http://dx.doi.org/10.1016/j.arthro.2018.01.047DOI Listing
May 2018

Hip Distraction Without a Perineal Post: A Prospective Study of 1000 Hip Arthroscopy Cases.

Am J Sports Med 2018 Mar 15;46(3):632-641. Epub 2017 Dec 15.

Melbourne Orthopaedic Group, Melbourne, Australia.

Background: Hip arthroscopy has traditionally been performed with a perineal post, resulting in various groin-related complications, including pudendal nerve neurapraxias, vaginal tears, and scrotal necrosis.

Purpose: To assess the safety of a technique for hip distraction without the use of a perineal post.

Study Design: Case series; Level of evidence, 4.

Methods: We prospectively analyzed a consecutive cohort of 1000 hips presenting to a dedicated hip preservation clinic; all patients had hip pain and were subsequently treated with hip arthroscopy. Demographic variables, hip pathology, and lateral center edge angle were recorded for each case. In the operating room, the patient's feet were placed in traction boots in a specifically designed distraction setup, and the operative table was placed in varying degrees of Trendelenburg. With this technique, enough resistance is created by gravity and friction between the patient's body and the bed to allow for successful hip distraction without the need for a perineal post. In a subset of 309 hips (n = 281 patients), the degrees of Trendelenburg as well as the distraction force were analyzed.

Results: The mean ± SD Trendelenburg angle used among the subset of 309 hips was 11° ± 2°. The mean initial distraction force necessary was 90 ± 28 lb, which decreased to 65 ± 24 lb by 30 minutes after traction initiation ( P < .0001). The most important variables in determining initial force for this cohort of patients were, in order of magnitude, sex ( P < .0001), weight ( P < .0001), and lateral center edge angle ( P < .01). No groin-related complications occurred among the entire cohort of patients, including soft tissue or nerve-related complications. The rate of deep venous thrombosis was 2 in 1000.

Conclusion: The use of the Trendelenburg position and a specially designed distraction setup during hip arthroscopy allows for safe hip distraction without a perineal post, thereby eliminating groin-related soft tissue and nerve complications. Certain patient variables can be used to estimate the required distraction force and inclination angle with this method.
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http://dx.doi.org/10.1177/0363546517741704DOI Listing
March 2018

The Iliofemoral Line: A Radiographic Sign of Acetabular Dysplasia in the Adult Hip.

Am J Sports Med 2017 Sep 13;45(11):2493-2500. Epub 2017 Jun 13.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.

Background: Several radiographic parameters utilized for the diagnosis of acetabular dysplasia in adults suffer from poor reproducibility and reliability.

Purpose: To define and validate a novel radiographic parameter (the iliofemoral line [IFL]) for the detection of frank and borderline hip dysplasia and to compare the sensitivity and specificity of this radiographic marker to those of previously validated qualitative parameters.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A consecutive cohort of 222 adult patients (436 hips) undergoing hip preservation surgery was included. The IFL, which extends from the lateral femoral neck through the inner cortical lip of the iliac crest, intersects the femoral head in cases of dysplasia. Percent medialization of the IFL was defined as the horizontal distance of the exposed femoral head lateral to the IFL, relative to the horizontal femoral head width at the center of the femoral head.

Results: Percent medialization of the IFL was strongly correlated to the lateral center edge angle ( P < .0001). Values of percent medialization ranging from 15% to 22% predicted the presence of borderline hip dysplasia with a sensitivity of 62% and specificity of 89%, while values exceeding 22% predicted the presence of frank acetabular dysplasia with a sensitivity of 77% and specificity of 94%. By comparison, abnormality of the Shenton line demonstrated a sensitivity of 3.7% and specificity of 97% for the detection of borderline dysplasia and a sensitivity of 16% and specificity of 99% for the detection of frank acetabular dysplasia. Compared with the Shenton line, percent medialization of the IFL was significantly more sensitive for the detection of both borderline and frank acetabular dysplasia (both P < .0001). The intraobserver and interobserver reproducibility of the horizontal difference outside the IFL were 0.99 and 0.96, respectively.

Conclusion: Percent medialization of the IFL is a reliable and accurate radiographic marker of frank acetabular dysplasia and, to a lesser extent, borderline dysplasia. The use of this radiographic parameter as an additional tool may enable the earlier detection of borderline and frank hip dysplasia in young adults presenting with hip pain.
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http://dx.doi.org/10.1177/0363546517708983DOI Listing
September 2017

Beneficial Effects of Cooling during Constant Power Non-steady State Cycling.

Int J Sports Med 2017 Feb 16;38(2):141-149. Epub 2016 Dec 16.

Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.

This study compared the effects of cooling on the energetic and associated physiological and perceptual responses to constant power, non-steady state cycling. Twelve males cycled at their lactate threshold power for 60 min or until exhaustion under 3 conditions: wearing a cooling vest and sleeves (COOL), a synthetic shirt embedded with an active particle technology claimed to facilitate evaporative heat loss (EVAP), and a standard synthetic shirt (CON). When adjusted for time, the increase in gastrointestinal temperature from baseline was reduced during COOL and EVAP compared to CON (1.44±0.45 and 1.52±0.43 vs. 1.66±0.45°C, p<0.05). Sweat rate was reduced during COOL compared to EVAP and CON (1 312±331 vs. 1 525±393 and 1 550±548 mL·h, p<0.01). Gross efficiency decreased over time across conditions (p<0.01), but COOL attenuated this decrease by 22% compared to CON (p<0.05). The rating of perceived exertion was reduced during COOL and EVAP compared to CON (p<0.01). In conclusion, cooling using a vest and sleeves or wearing an active particle technology shirt reduced the rise in gastrointestinal temperature and rating of perceived exertion compared to a standard synthetic shirt. Cooling using a vest and sleeves also reduced the decrease in gross efficiency and sweat rate compared to wearing the standard synthetic shirt.
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http://dx.doi.org/10.1055/s-0042-119030DOI Listing
February 2017

Haemoglobin mass alterations in healthy humans following four-day head-down tilt bed rest.

Exp Physiol 2016 05 24;101(5):628-40. Epub 2016 Mar 24.

Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.

New Findings: What is the central question of this study? Is haemoglobin mass (Hbmass) decreased following 4 days of head-down tilt bed rest (HDTBR), and does increased red blood cell (RBC) destruction mediate this adaptation? What is the main finding and its importance? Haemoglobin mass was increased immediately following HDTBR, before decreasing below baseline 5 days after return to normal living conditions. The transient increase in Hbmass might be the result of decreased RBC destruction, but it is also possible that spleen contraction after HDTBR contributed to this adaptation. Our data suggest that the decreased Hbmass 5 days following HDTBR resulted from decreased RBC production, not increased RBC destruction. Rapid decreases in haemoglobin mass (Hbmass) have been reported in healthy humans following spaceflight and descent from high altitude. It has been proposed that a selective increase in the destruction of young red blood cells (RBCs) mediates these decreases, but conclusive evidence demonstrating neocytolysis in humans is lacking. Based on the proposed triggers and time course of adaptation during spaceflight, we hypothesized that Hbmass would be reduced after 4 days of -6 deg head-down tilt bed rest (HDTBR) and that this would be associated with evidence for increased RBC destruction. We assessed Hbmass in seven healthy, recreationally active men before (PRE), 5 h after (POST) and 5 days after (POST5) 4 days of HDTBR. The concentration of erythropoietin decreased from 7.1 ± 1.8 mIU ml(-1) at PRE to 5.2 ± 2.8 mIU ml(-1) at POST (mean ± SD; P = 0.028). Contrary to our hypothesis, Hbmass was increased from 817 ± 135 g at PRE to 849 ± 141 g at POST (P = 0.014) before decreasing below PRE to 789 ± 139 g at POST5 (P = 0.027). From PRE to POST, the concentration of haptoglobin increased from 0.54 ± 0.32 to 0.68 ± 0.28 g l(-1) (P = 0.013) and the concentration of bilirubin decreased from 0.50 ± 0.24 to 0.32 ± 0.11 mg dl(-1) (P = 0.054), suggesting that decreased RBC destruction might have contributed to the increased Hbmass. However, it is possible that spleen contraction following HDTBR also played a role in the increase in Hbmass at POST, but as the transient increase in Hbmass was unexpected, we did not collect data that would provide direct evidence for or against spleen contraction. From PRE to POST5, the concentration of soluble transferrin receptor decreased from 20.7 ± 3.9 to 17.1 ± 3.3 nmol l(-1) (P = 0.018) but the concentrations of ferritin, haptoglobin and bilirubin were not significantly altered, suggesting that the decrease in Hbmass was mediated by decreased RBC production rather than increased RBC destruction. Peak oxygen uptake decreased by 0.31 ± 0.16 l min(-1) from PRE to POST (P = 2 × 10(-4) ) but was not significantly altered at POST5 compared with PRE. Overall, these findings indicate that 4 days of HDTBR does not increase RBC destruction and that re-examination of the time course and mechanisms of Hbmass alterations following short-term spaceflight and simulated microgravity is warranted.
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http://dx.doi.org/10.1113/EP085665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851582PMC
May 2016
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