Health care disparities and racial health inequities significantly influence health care delivery and patient outcomes, including for people with injuries of the anterior cruciate ligament (ACL). This narrative review explores factors that may influence the management of ACL injuries. Studies that have discussed potential social barriers to treatment such as socioeconomic status (SES), insurance status, educational level, and cost of treatment were identified by searching databases such as EBSCO Host, PubMed, and Galileo for the index years from 2008 to 2020. The influence of health care inequities on ACL injury management was explored. Twelve studies met inclusion criteria and described a total of 219,708 participants. Barriers to surgical management of ACL injury were higher cost of surgery, greater time to evaluation and treatment, lower SES, lack of private insurance, and being identified as a racial minority. In addition, surgical environment, whether within a private or community-based health care system, and access to care affected postsurgical complication rates. Finally, risk of revision, lack of physical therapy access, and odds of additional injuries to include chondral and meniscal derangement were higher in racial minority, lower SES, and government insurance populations. These findings suggest health disparity and inequity exist in the care of ACL injury for patients with lower SES and without commercial insurance, and in minority populations. These patients appear to have a significantly reduced ability to access timely care, which can impact healing and ability to return to preferred activities of daily life or sport.

Distal biceps tendinopathy is an uncommon but increasingly diagnosed condition in persons with elbow pain. When traditional treatments are unsuccessful, practitioners have performed ultrasound (US)-guided tendon injections in this region using an anterior approach. Although success has been reported with this technique, this approach may lead to neurovascular injury. This case report is the first in the literature to describe a US-guided distal bicep tendon injection using a posterior approach. The patient had an excellent clinical outcome with no adverse events. This outcome suggests that a US-guided posterior percutaneous tendon injection might be a safe, viable, nonsurgical option for recalcitrant distal biceps tendinopathy.

No abstract

No abstract

Long bone non-union is a detrimental, yet common condition that affects many individuals after injury. It can lead to significant pain and weakness that may impact lifetime productivity and quality of life. This report describes a patient who suffered from greater than two years of a distal humerus fracture non-union along with an ulnar nerve transection that failed traditional surgical management and underwent a percutaneous injection with bone marrow aspirate concentrate, platelet-rich plasma, and platelet lysate, demonstrating subsequent fracture resolution and strength improvement.