Effect of Achilles Tendon Rupture on Player Performance and Longevity in Women\u27s National Basketball Association Players

Background: Women\u27s National Basketball Association (WNBA) players have a greater incidence of lower extremity injury compared with male players, yet no data exist on functional outcomes after Achilles tendon rupture (ATR). Purpose: To evaluate the effect of Achilles tendon repair on game utilization, player performance, and career longevity in WNBA athletes. Study Design: Cohort study; Level of evidence, 3. Methods: WNBA players from 1997 to 2019 with a history of ATR (n = 12) were matched 1:2 to a healthy control group. Player characteristics, game utilization, and in-game performance data were collected for each athlete, from which the player efficiency rating (PER) was calculated. Statistical analysis was performed comparing postinjury data to preinjury baseline as well as cumulative career data. Changes at each time point relative to the preinjury baseline were also compared between groups. Results: Of the 12 players with ATR, 10 (83.3%) returned to play at the WNBA level at a mean (+/- SD) of 12.5 +/- 3.3 months. Four players participated in only 1 WNBA season after injury. There were no differences in characteristics between the 10 players who returned to play after injury and the control group. After return to play, the WNBA players demonstrated a significant decrease in game utilization compared with preinjury, playing in 6.0 +/- 6.9 fewer games, starting in 12.7 +/- 15.4 fewer games, and playing 10.2 +/- 9.1 fewer minutes per game (P \u3c .05 for all). After the index date of injury, the players with Achilles repair played 2.1 +/- 1.2 more years in the WNBA, while control players played 5.35 +/- 3.2 years (P \u3c .01) Additionally, the players with Achilles repair had a significant decrease in PER in the year after injury compared with preinjury (7.1 +/- 5.3 vs 11.0 +/- 4.4; P = .02). The reduction in game utilization and decrease in PER in these players was maintained when compared with the matched controls (P \u3c .05 for both). Conclusion: The majority of WNBA players who sustained ATR were able to return to sport after their injury; however, their career longevity was shorter than that of healthy controls. There was a significant decrease in game utilization and performance in the year after return to play compared with healthy controls

Synthesis and X-ray crystal structure of a dinuclear platinum hydride complex of tetracyanobiimidazole

Reaction of the diacid form of tetracyanobiimidazole via oxidative addition with two equivalents of Pt(PPh3)4 produces a dinuclear complex whose structure is solved by X-ray analysis. The presence of dihydride is confirmed by observation of IR shift of a deuterium-labelled compound.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26946/1/0000512.pd

Pain Assessment After Anterior Cruciate Ligament Reconstruction: Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft.

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. PURPOSE: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone-patellar tendon-bone (BTB) versus hamstring tendon (HS) autograft. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate. The primary outcome of the study was postoperative pain levels (visual analog scale), which were collected immediately after surgery and for 3 days postoperatively. Secondary outcome measures included opioid consumption (intravenous morphine equivalents), hours slept, patient satisfaction, reported breakthrough pain, and calls to the physician. RESULTS: Patients treated with BTB had increased pain when compared with those treated with HS in the acute postoperative period (mean ± SD: day 0, 6.0 ± 1.7 vs 5.2 ± 2.0 [P = .066]; day 1, 5.9 ± 1.7 vs 4.9 ±1.7 [P = .024]; day 2, 5.2 ± 1.9 vs 4.1 ± 2.0 [P = .032]; day 3, 4.8 ± 2.1 vs 3.9 ± 2.3 [P = .151]). There were also significant increases in reported breakthrough pain (day 0, 76% vs 43% [P = .009]; day 1, 64% vs 35% [P = .003]) and calls to the physician due to pain (day 1, 19% vs 0% [P = .041]) in the BTB group. There were no significant differences in narcotic requirements or sleep disturbances. Overall, the BTB group reported significantly less satisfaction with pain management on days 0 and 1 (P = .024 and .027, respectively). CONCLUSION: A significant increase in acute postoperative pain was found when performing ACL reconstruction with BTB compared with HS. Patients treated with BTB were more likely to have breakthrough pain, decreased satisfaction with their pain management, and to contact their physician due to pain. These findings suggest a difference in early postoperative pain between the 2 most common graft options for ACL reconstruction. Patients should be informed of the differences in acute postoperative pain when deciding on graft choice with their physician

Role of pathophysiology of patellofemoral instability in the treatment of spontaneous medial patellofemoral subluxation: a case report

<p>Abstract</p> <p>Introduction</p> <p>Medial patellar subluxation is usually seen after lateral retinacular release. Spontaneous medial subluxation of the patella is a very rare condition. There are few reports in the literature on the pathophysiology of iatrogenic medial patellar subluxation. To our knowledge, there are no reports of the pathophysiology of non-iatrogenic medial patellar subluxation in the English literature. In this study we present a case of spontaneous medial patellar instability that is more prominent in extension during weight bearing. We also try to define the treatment protocol based on pathophsiology.</p> <p>Case presentation</p> <p>We report the case of a 21-year-old Turkish man with spontaneous medial patellar instability. He had suffered right knee pain, clicking and popping sensation in the affected knee for three months prior to presentation. Clinical examination demonstrated medial patellar subluxation that is more prominent in extension during the weight bearing phase of gait and while standing. Increased medial tilt was observed when the patella was stressed medially. Conventional anterior to posterior, lateral and Merchant radiographs did not reveal any abnormalities. After three months of physical therapy, our patient was still suffering from right knee pain which disturbed his gait pattern. Throughout the surgery, medial patellar translation was tested following the imbrication of lateral structures. He still had a medial patellar translation that was more than 50% of his patellar width. Patellotibial ligament augmentation using an iliotibial band flap was added. When examined after surgery, the alignment of the patella was effectively corrected.</p> <p>Conclusions</p> <p>Chronic imbalance between the strengths of vastus lateralis and vastus medialis results in secondary changes in passive ligamentous structures and causes additional instability. Physical therapy modalities that aim to strengthen the vastus lateralis might be sufficient for the treatment of spontaneous medial instability. There would be no need for any surgical intervention if spontaneous medial instability was recognized before the additional instability occured. If necessary, lateral imbrication followed by lateral patellotibial ligament augmentation can be performed, and these would effectively correct spontaneous medial patellofemoral instability.</p

Electron donors and cyanoimidazole acceptors: Cyclic voltammetry and molecular orbital study

Voltammetric measurements on a series of cyanoimidazoles and their metal complexes are reported and compared with those for various donors and acceptors measured under the same conditions. LUMO energies from extended Huckel calculations correlate well with reduction potentials of cyanoimidazoles. Extended Huckel calculations also give insights into the interaction of the metal complexes of tetracyanobiimidazole and the nature of molecular stacking.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27187/1/0000190.pd

Anisotropic Conductors Based On Tetracyanobiimidazole Complexes Of Iridium.

Mixed valence metal chain compounds based on the monoanion (Ir(CO)\sb 2Tcbiim) \sp- were investigated. (Tcbiim = 4,4\sp\prime,5,5\sp\prime-tetracyano-2,2\sp\prime-biimidazole, a dianion) These compounds were prepared by inert atmosphere electrochemical oxidation with a variety of alkyl ammonium cation based electrolytes. Synthetic details are presented for the preparation of several asymmetric alkyl ammonium cations, and the subsequent electrolyte salt preparation. Technique for electrochemical oxidation is described in detail. Single crystal X-ray Solutions are presented for three complex Ir(I) salts; {\rm NEt\sb 3 Me\lbrack Ir(CO)\sb 2 Tcbiim\rbrack}, {\rm NEt\sb 2 Me\sb 2\lbrack Ir(CO)\sb 2Tcbiim\rbrack,} and a dication salt {\rm NEt\sb 2 Me(CH\sb 2)\sb 4NEt\sb 2 Me\lbrack Ir(CO)\sb 2}Tcbiim) \sb 2. The first of these crystallizes in the space group Pnnm with a = 6.918A, b = 22.223A, c = 15.101A, and Z = 4. A final agreement of R = 4.25% for 133 parameters with 972 retained data was obtained. The second crystallized in the space group P2\sb{1}2\sb{1}2 with a = 7.074A, b = 19.698A, c = 15.336A, and Z = 4. Here, the obtained final agreement was R = 3.94% for 236 parameters with 1505 retained data. The dication structure was refined in the nonstandard space group P22\sb 1 2\sb 1 with a = 15.751A, b = 7.233A, c = 19.135A, and Z = 4. For this compound, a final agreement of R = 5.1% for 130 parameters with 789 retained data was concluded. Solid state packing for this series of compounds is discussed. Packing diagrams reveal molecular interactions responsible for earlier observations of thermochromic behavior. A series of insoluble mixed valence compounds formulated as \lbrack{\rm cat\rbrack\sb 5\lbrack Ir(CO)\sb 2}Tcbiim) \sb 6(an) where (cat) (an) denotes included supporting electrolyte were prepared. Conductivity data are presented. A similar, soluble compound, formulated as \lbrack{\rm cat\rbrack\sb 4\lbrack Ir(CO)\sb 2Tcbiim\rbrack\sb 6} was studied by ESR and UV-VIS during the course of its preparation. A reaction of (cat) \sb 4(Ir(CO)\sb 2Tcbiim) \sb 6 with an isoelectronic analog of the stacking unit, (Pt(CN)\sb 2Tcbiim) \sp{--} produced a unique one dimensional alloy in single crystal form. This compound, (NEt\sb 3Me) \sb 3(Ir(CO)\sb 2Tcbiim) \sb 2(Pt(CN)\sb 2Tcbiim) crystallized in the space group P2\sb 1 with a = 13.412A, b = 6.874A, c = 13.409A, and $\beta$ = 111.21\sp\circ. Since Z = 2, the stacking units are disorderd along the stack. Perspective plots clearly reveal a metal atom chain. Final agreement of R = 4.01% was observed for 223 parameters with 2227 retained data.Ph.D.Inorganic chemistryPure SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/128058/2/8720294.pd