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Purpose: To evaluate the quality and characteristics of systematic reviews, including meta-analyses, in the clinical orthopaedic sports medicine literature from 2015 to 2019 and to compare the results to previous findings from a similar analysis from 2009 to 2013. Methods: All clinical orthopaedic sports medicine and meta-analyses published from 2015 to 2019 published in The American Journal of Sports Medicine, Arthroscopy, The Journal of Bone and Joint Surgery, Knee Surgery, Sports Traumatology, Arthroscopy, and Sports Health were reviewed. These were evaluated according to guidelines from Oxford Centre for Evidence-Based Medicine, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Assessment of Multiple Systematic Reviews tool. Results were compared to the quality of publications from 2009 to 2013. Results: A total of 516 systematic reviews and meta-analyses were included in this study. Of these, 17.1% of studies included Level I or II evidence only, whereas 79.1% included Level IV or V studies. When compared to the previous study from 2009 to 2013, which demonstrated 32% of Level I or II evidence studies and 53% Level IV or V, there was a significant decrease in the level of evidence in the more recent study period (P < .001). The average Preferred Reporting Items for Systematic Reviews and Meta-Analyses scores were 81% and the average Assessment of Multiple Systematic Reviews scores 56%, which are declines from 87% and 73%, respectively (P < .001, P < .001). Conclusions: There has been a significant increase in the volume of systematic reviews and meta-analyses published in orthopaedic sports medicine. This has coincided with significant declines in the level of evidence, as well as declines in methodologic and reporting quality. Clinical Relevance: Clinicians increasingly use systematic reviews to drive their treatment decisions. Therefore, the quality of systematic reviews in orthopaedic sports medicine merits assessment.

Objectives: Despite successful return to sport (RTS) outcomes after posteromedial osteophyte resection, one possible consequence of removing this osteophyte is increased stress on the ulnar collateral ligament (UCL), leading to a UCL injury. It is currently unknown how often overhead athletes who have an isolated posteromedial osteophyte resection progress to require UCL reconstruction (UCLR). Therefore, the purpose of this study was to report outcomes following arthroscopic resection of posteromedial osteophyte in overhead athletes and determine if baseball pitchers who underwent arthroscopic posteromedial osteophyte resection for posteromedial impingement went on to require UCL surgery. Methods: All patients who underwent elbow arthroscopy from 2010-2020 were reviewed. Patients were included if they underwent isolated arthroscopic posteromedial osteophyte resection without concomitant UCL surgery, were overhead athletes at the onset of posteromedial impingement symptoms and had no history of prior elbow surgery. Primary outcomes included RTS rate, complications, subsequent shoulder and elbow injury/surgery and several patient-reported outcome measures (Kerlan-Jobe Orthopaedic Clinic score, Timmerman-Andrews Elbow score, Conway-Jobe score). Results: Overall, 36 overhead athletes were evaluated at 5.1 years post-operatively, including 28 baseball pitchers, 3 baseball catchers, 3 softball players, 1 tennis player, and 1 volleyball player. 77% of overhead athletes RTS and had a mean KJOC score of 70, with 89% of athletes having either an excellent (73%) or good (16%) Conway-Jobe score at long-term follow-up. Subsequent UCLR was required in 18% (n=5) of baseball pitchers at a median of 13 months post-op. Three of the five UCLR were performed shortly after posteromedial osteophyte resection (6, 7, and 13 months post-op), while the other two UCLRs were performed at 6.2 and 7.5 years post-op. Conclusions: Following arthroscopic posteromedial osteophyte resection, 77% of athletes were able to RTS. Baseball pitchers who undergo arthroscopic posteromedial osteophyte resection have an 18% risk of subsequent UCLR.

Background: The coronavirus disease–2019 (COVID-19) pandemic led to disruptions in care for orthopaedic patients who underwent surgery just before the outbreak, rendering some unable to participate in standard postoperative care. Many of these patients underwent clinical follow-up and physical therapy via telehealth. Purpose: To evaluate the methods of postoperative care in patients who underwent arthroscopic rotator cuff repair (RCR) and had follow-ups during the height of the pandemic versus those who received prior standard of care. We aimed to compare the 1-year outcomes between these cohorts. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was used to identify patients who underwent primary RCR in February and March 2020 (COVID cohort) and the same period in 2019 (control cohort) at a single institution. Excluded were patients who underwent revision RCR, used workers’ compensation, or were incarcerated or deceased. The included patients reported the postoperative care received, their satisfaction with care, physical therapy appointment type (in person, home based, telehealth, or self-guided), satisfaction with physical therapy, and minimum 1-year postoperative American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Penn Shoulder Score (PSS) outcomes. Results: Overall, 428 patients were included for final analysis—–199 in the COVID cohort and 229 controls. Follow-up data were collected for 160 patients in the COVID group (80.4%) and 169 control patients (73.8%). In the COVID group, 110 patients (68.8%) had ≥1 clinical visit conducted via telehealth, compared with zero in the control group. There were no differences between the COVID and control groups in the ASES (84.2 ± 16.5 vs 86.5 ± 17; P = .27 ), SANE (83.9 ± 15.4 vs 84.8 ± 17.5; P = .66), PSS (84.8 ± 15.3 vs 87.1 ± 15.1; P = .22), or patient satisfaction with the care received (81.7 ± 22.6 vs 86.3 ± 23.5; P = .09). Satisfaction with physical therapy was significantly higher in the control group (88.3 ± 18.9 vs 81.9 ± 22.5; P = .01). Conclusion: Despite disruptions in care, RCR patients had comparable 1-year outcomes during the pandemic versus before the pandemic. Telehealth clinical follow-up appointments did not adversely affect patient-reported outcome measures and may be appropriate for RCR patients beyond the pandemic.