Surgical treatment for chondral defects of the knee in competitive running and jumping athletes remains controversial. This study evaluated the performance outcomes of professional basketball players in the National Basketball Association (NBA) who underwent microfracture. Data from 24 professional basketball players from 1997 to 2006 was obtained and analyzed. NBA player efficiency ratings (PER) were calculated for two seasons before and after injury. A control group of 24 players was used for comparison. Study group and control group demographics including age, NBA experience, and minutes per game demonstrated no statistical difference. Mean time to return to an NBA game was 30.0 weeks from the time of surgery. The first season after returning to competition PER and minutes per game decreased by 3.5 (P < 0.01) and 4.9 min (P < 0.05), respectively. The 17 players who continued to play two or more seasons after surgery, the average reduction in their PER and minutes per game was 2.7 (P > 0.05) and 3.0 min (P < 0.26), respectively. A multivariant comparison versus controls demonstrated that power rating during the 2 years after surgery decreased by 3.1 (P < 0.01); while minutes per game decreased by 5.2 (P < 0.001). Twenty-one percent (n = 5 of 24) of the players treated with microfracture did not return to competition in an NBA game. On return to competition player performance and minutes per game are diminished.

Anterior shoulder surgery, using open or arthroscopic technique, places subcoracoid neurovasculature at risk. This study examines the relationships of the brachial plexus and axillary artery to four bony landmarks and provides clinical correlations for anterior shoulder surgery. The musculocutaneous nerve (MN), posterior cord (PC), lateral cord (LC), and axillary artery (AA) were identified in 27 shoulders. Minimum distances (mm) were measured between neurovasculature and the coracoid tip, anterior midglenoid, inferior surface of the midclavicle, and anteromedial aspect of the acromioclavicular joint. Average distances from the coracoid to the MN, PC, LC, and AA were 69.7 6 31.6, 50.5 6 9.2, 41.8 6 9.4, and 60.0 6 8.0 mm, respectively; from the glenoid equator to the MN, PC, LC, and AA were 61.5 6 38.5, 37.0 6 6.1, 35.2 6 8.7, and 45.2 6 7.1 mm, respectively; from the midclavicle to the MN, PC, LC, and AA were 114.1 6 33.9, 62.0 6 13.6, 56.0 6 19.7, and 69.9 6 7.8 mm, respectively; and from the AC joint to the MN, PC, LC, and AA were 112.7 6 36.5, 87.9 6 10.6, 84.0 6 12.0, and 100.9 6 1.0 mm, respectively. The lateral cord was the closest structure to each bony landmark. The musculocutaneous nerve was the furthest structure from each bony landmark. Open procedures using a deltopectoral approach with the shoulder in the anatomical position, such as the Neer capsular shift and Warner capsular reconstruction, can use these results to prevent direct or retraction injuries. Results indicate a potential safe zone of 30 mm in diameter around the anteromedial coracoid tip for anteroinferior portal placement. Clin. Anat. 23:815-820, 2010. V V C 2010 Wiley-Liss, Inc.

No abstract