Even at young ages, ice hockey players have a greater prevalence of α angles associated with cam FAI than do skier-matched controls. Properties inherent to ice hockey likely enhance the development of a bony overgrowth on the femoral neck, leading to cam FAI.

During the sprint start, youth ice hockey players position their hips in a manner that can cause impingement of the femoral neck against the acetabulum and potentially lead to labral tears and/or articular cartilage damage. This knowledge could be applied to assist in the prevention of overuse injuries of the hip as youth hockey players mature and increase in skill level.

No abstract

Study Design. Retrospective cohort review. Objective. The objective of this study was to identify depression using the Mental Component Score (MCS-12) of the Short Form-12 (SF-12) survey and to correlate with patient outcomes. Summary of Background Data. The impact of preexisting depressive symptoms on health-care related quality of life (HRQOL) outcomes following lumbar spine fusion is not well understood. Methods. Patients undergoing lumbar fusion between one to three levels at a single center, academic hospital were retrospectively identified. Patients under the age of 18 years and those undergoing surgery for infection, trauma, tumor, or revision, and less than 1-year follow-up were excluded. Patients with depressive symptoms were identified using an existing clinical diagnosis or a score of MCS-12 less than or equal to 45.6 on the preoperative SF-12 survey. Absolute HRQOL scores, the recovery ratio (RR) and the percent of patients achieving minimum clinically important difference (MCID) between groups were compared, and a multiple linear regression analysis was performed. Results. A total of 391 patients were included in the total cohort, with 123 (31.5%) patients reporting symptoms of depression based on MCS-12 and 268 (68.5%) without these symptoms. The low MCS-12 group was found to have significantly worse preoperative Oswestry disability index (ODI), visual analogue scale back pain (VAS Back) and visual analogue scale leg pain (VAS Leg) scores, and postoperative SF-12 physical component score (PCS-12), ODI, VAS Back, and VAS Leg pain scores (P < 0.05) than the non-depressed group. Finally, multiple linear regression analysis revealed preoperative depression to be a significant predictor of worse outcomes after lumbar fusion. Conclusion. Patients with depressive symptoms, identified with an MCS-12 cutoff below 45.6, were found to have significantly greater disability in a variety of HRQOL domains at baseline and postoperative measurement, and demonstrated less improvement in all outcome domains included in the analysis compared with patients without depression. However, while the improvement was less, even the low MCS-12 cohort demonstrated statistically significant improvement in all HRQOL outcome measures after surgery. Level of Evidence: 3

No abstract

Background: The pectineus muscle has been reported to function primarily as a hip flexor and secondarily as a hip internal rotator; the piriformis muscle has been reported to function as an abductor and external rotator of the hip. The recruitment and activations of these muscles during hip rehabilitation exercises have not been detailed. Hypothesis: The authors hypothesized that they would measure the highest pectineus activation during exercises involving hip flexion, with moderate pectineus activation during exercises with hip internal rotation. They also hypothesized that they would measure the highest piriformis activation during exercises involving hip abduction and/or external rotation. Study Design: Descriptive laboratory study. Methods: Ten healthy volunteers completed 13 hip rehabilitation exercises with electromyography (EMG) electrodes inserted under ultrasound guidance into the pectineus and piriformis muscle bellies. The EMG signals were recorded and exercise activation levels were reported as a percentage of a maximum voluntary contraction (MVC). Results: Both the highest peak pectineus activation (62.8% ± 26.6% MVC) and the highest mean pectineus activation (33.1% ± 17.4% MVC) were measured during the supine hip flexion exercise. Moderate activation was found during the single- and double-legged bridge and both phases of the stool hip rotation exercise. The highest peak piriformis activation was observed in the single-legged bridge (MVC, 35.7% ± 25.7%), and the highest mean piriformis activation was observed in the prone heel squeeze (MVC, 24.3% ± 8.2%). Similar moderate activation levels were found for single-legged hip abduction and resisted hip extension. Conclusion: The pectineus was highly activated during hip flexion exercises and moderately activated during exercises requiring rotational hip stabilization in either direction, rather than with internal hip rotation only. The piriformis was most activated during static external rotation and abduction while the participants’ hips were in slight extension. These observations indicate that the pectineus and piriformis are both muscles that contribute to hip stabilization. Clinical Relevance: The findings indicate that the pectineus and piriformis function as hip-stabilizing muscles and can be used to specifically address pectineus and piriformis muscle rehabilitation. The authors believe that strengthening and conditioning of these muscles should aid in the restoration of hip function and stability after injury or arthroscopic surgery.

Level III, comparative series.

Background: Currently, no studies have assessed what effect the presence of both anxiety and depression may have on patient-reported outcome measurements (PROMs) compared to patients with a single or no mental health diagnosis.Methods: Patients undergoing 1-to 3-level lumbar fusion at a single academic hospital were retrospectively queried. Anyone with depression and/or anxiety was identified using an existing clinical diagnosis in the medical chart. Patients were separated into 3 groups: no depression or anxiety (NDA), depression or anxiety alone (DOA), and combined depression and anxiety (DAA). Absolute PROMs, recovery ratios, and the percentage of patients achieving minimal clinically important difference (% MCID) between groups were compared using univariate and multivariate analysis.Results: Of the 391 patients included in the cohort, 323 (82.6%) were in the NDA group, 37 (9.5%) in the DOA group, and 31 (7.9%) in the DAA group. Patients in the DAA group had significantly worse outcome scores before and after surgery with respect to Short Form-12 mental component score (MCS-12) and Oswestry Disability Index (ODI) scores (P ,.001); however, the change in PROMs, recovery ratio, % MCID were not found to be significantly different between groups. Using multivariate analysis, the DAA group was found to be an independent predictor of worse improvement in MCS-12 and ODI scores (P ¼ .026 and P ¼ .001, respectively).Conclusions: Patients with combined anxiety and depression fared worse with respect to disability before and after surgery compared to patients with a single diagnosis or no mental health diagnosis; however, there were no significant differences in recovery ratio or % MCID.Level of Evidence: 3. Clinical Relevance: Combined anxiety and depression may predict less improvement in MCS-12 and ODI after lumbar arthrodesis compared with single or no mental health diagnosis.