Objectives: Although dislocation of the knee is rare, the high-energy nature of most injuries often results in high morbidity and sometimes limb-threatening injury. Literature regarding knee dislocations tends to focus upon management. There is a lack of research investigating quality of life for patients having undergone multi-ligament knee reconstruction. The purpose of our study was to review quality of life and functional outcomes as well as examine preoperative variables that may affect these outcomes for patients having undergone multi-ligament knee reconstruction. Methods: Retrospectively, we identified a total of 31 patients who underwent a standardized method of surgical reconstruction for multi-ligament knee injuries since 2006 at a single institution. A single surgeon performed all operations. A total of 28 knees (26 patients) were included in the final analysis. We contacted patients at a minimum of 12 months postoperatively (mean: 40.5 months; range: 12-111 months) and administered the Multi-ligament Quality of Life Questionnaire (ML-QOL), 2000 International Knee Documentation Committee Subjective Knee Form (IKDC), and Lysholm Knee Scoring Scale. We performed independent two-sample t-tests to examine the difference in quality of life and functional measures for the following factors: age (≤ 40 vs. > 40), sex, mechanism of injury, time to surgery ( 3 weeks), vascular injury, nerve injury, concomitant fracture, other injuries, Schenk classification for knee dislocation, manipulation, surgical release, previous knee ligament surgery, and subsequent revision. We then performed ageadjusted multivariable linear regression analysis, including factors that we found to be statistically significant in univariate analysis. A p-value of 0.05 was used for statistical significance and all analysis was performed using STATA (College Station, TX). Results: For ML-QOL, we found that patients who had undergone previous knee ligament surgery had significantly worse mean scores relative to patients who had not undergo previous knee ligament surgery (122.9 vs. 80.2; p = 0.001) (higher score indicates worse quality of life). All other differences in ML-QOL scores were not statistically significant. IKDC and Lysholm scores did not differ significantly with regards to the studied variables. After stratifying patients by history of previous knee ligament surgery (7 vs. 21), we found that patients with Schenk classifications of III or IV had significantly worse mean ML-QOL scores relative to patients with Schenk classifications of I or II (91.3 vs. 62.1; p = 0.0152). Conclusion: To our knowledge, our study is the first to investigate both quality of life and functional outcome measures for patients undergoing multi-ligament reconstruction after knee dislocation. We found that patients with a previous history of knee ligament surgery had a significantly worse quality of life relative to those with no history of knee ligament surgery. Among patients with no history of knee ligament surgery, higher Schenk classification was ass...

BACKGROUND Fellowship directors (FDs) in sports medicine influence the future of trainees in the field of orthopaedics. Understanding the characteristics these leaders share must be brought into focus. For all current sports medicine FDs, our group analyzed their demographic background, institutional training, and academic experience. AIM To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position. METHODS Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories. The demographic and educational background data for each FD was gathered via author review of current curriculum vitae (CVs). Any information that was unavailable on CV review was gathered from institutional biographies, Scopus Web of Science, and emailed questionnaires. To ensure the collection of as many data points as possible, fellowship program coordinators, orthopaedic department offices and FDs were directly contacted via phone if there was no response via email. Demographic information of interest included: Age, gender, ethnicity, residency/fellowship training, residency/fellowship graduation year, year hired by current institution, time since training completion until FD appointment, length in FD role, status as a team physician and H-index. RESULTS Information was gathered for 82 FDs. Of these, 97.5% ( n = 80) of the leadership were male; 84.15% ( n = 69) were Caucasian, 7.32% ( n = 6) were Asian-American, 2.44% ( n = 2) were Hispanic and 2.44% ( n = 2) were African American, and 3.66% ( n = 3) were of another race or ethnicity. The mean age of current FDs was 56 years old (± 9.00 years), and the mean Scopus H-index was 23.49 (± 16.57). The mean calendar years for completion of residency and fellowship training were 1996 (± 15 years) and 1997 (± 9.51 years), respectively. The time since fellowship training completion until FD appointment was 9.77 years. 17.07% ( n = 14) of FDs currently work at the same institution where they completed residency training; 21.95% ( n = 18) of FDs work at the same institution where they completed fellowship training; and 6.10% ( n = 5) work at the same institution where they completed both residency and fellowship training. Additionally, 69.5% ( n = 57) are also team physicians at the professional and/or collegiate level. Of those that were found to currently serve as team physicians, 56.14% ( n = 32) of them worked with professiona...

Objective: With the growth and popularity of the internet, physician review websites are being utilized more frequently by patients to learn about and ultimately select their provider. These sites allow patients to comment on the care they received in a public forum for others to see. With outcome and "quality" measures being used to dictate reimbursement formulas; online patient reviews may affect a physician's compensation in the near future. Therefore, it is of paramount importance for physicians to understand how best to portray themselves on social media and other internet sites. Methods: In this retrospective study, we identified 145 arthroplasty surgeons via the AAHKS database. Then, surgeon data was collected from Healthgrades (HG) and Vitals (V). We identified if the surgeon had social media (SM) accounts by using google search. The number of ratings and comments, overall rating, reported wait-times and physician SM presence were analyzed with univariate, bivariate and multivariate analyses. Results: 64% of surgeons had a SM presence, and younger surgeons with SM had lower distribution of wait-times. A SM presence correlated with significantly higher frequency of total ratings and comments. Both review sites showed that younger physicians with a SM presence had increased frequency of ratings and comments and a quicker office wait-times. SM presence did not impact the overall scores on either website. Conclusion: Having SM presence is correlated with increased number of ratings and comments on physician review sites, possibly revealing an increased likelihood of these physicians encouraging their patients to engage with them via the internet. SM presence did not correlate with higher review scores, displaying that there are many complex factors that go into a physician score outside of SM and internet appearance. Future studies should explore patient comments on these sites to understand additional factors that may optimize a patient's experience.

Previous literature has also reported that complete excision is an ideal procedure for PVNS of TMJ, but temporalis rotational flap use has been rare. This case and previously reported cases in the literature are also reviewed.

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