Sports Surgery Clinic Podcast: Recent Episodes
Sports Surgery Clinic
Sports Surgery Clinic (SSC) located in Santry, Dublin is a Private Hospital specialising in Orthopaedic Surgery and Sports Medicine.
Welcome to 'On the Table' - Sports Surgery Clinic's orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.
The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.
In Episode Seven, we are delighted to speak to Mr Michael Kelleher Consultant Neurosurgeon and Mr Eoin Fenton Consultant Neurosurgeon at Sports Surgery Clinic.
This episode focuses on the topic of back pain and the management of radiculopathy and leg referral of pain and what to watch out for in cauda equina.
Shownotes: 04:14 Back pain is an incredibly common condition with huge morbidity caused with both time off in from work, lack of activity and pain, can you talk us through some of the epidemiology? 05:35 Can you talk us through some of the anatomical features in the back which can be associated with injury and pain? 08:15 How important is imaging of the spine in helping the patient and making the diagnosis? 12:20 Hesitancy and asymptomatic prevalence in MRI, how does use the scan to support the understanding rather than head to surgery? 14:40 The importance of strength and conditioning in back pain? 15:30 How long can rehabilitation of the back take? 16:16 If the patient cannot tolerate a strength intervention due to radiculopathy, what next? 18:50 What types of guided injection can be of help in a patient with pain and what are the differences between transiting and exiting nerve roots? 22:00 When is the indication to progress to consider microdisc surgery? 23:13 What actually happens in a microdiscetomy, and what differs when you have bony overgrowth from the facet joint? 24:30 What does the post-operative management look like? 27:00 If there was a recurrence of symptoms after surgery what options remain? And what are the risks of surgery? 29:04 What is Cauda equina syndrome, and what do we do? 32:00 How important is patient understanding in terminology? 33:00 Is digital rectal examination still important for rectal tone?
Neurospine Contact Details:
Suite: 10 Sports Surgery Clinic, Santry, Dublin 9. Phone: +353 1 526 2227 Fax: +353 1 526 2232 Email: info@neurospine.ie
Welcome to 'On the Table' - Sports Surgery Clinic's orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.
The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.
In Episode Eight, we are delighted to speak to Mr Ray Moran, Consultant Orthopaedic Surgeon and Medical Director at Sports Surgery Clinic.
This episode focuses on the topic of decision making around the Anterior Cruciate Ligament (ACL), the evolving techniques into ACL graft selection and the rehabilitation and post-operative management and Ray's latest paper on ACL outcomes.
Shownotes:
O4:15 What is an ACL ligament?
06:28 Can you talk me through the decision making regarding surgical repair with the patient?
08:29 What about the debate on conservative non-operative management of ACL rupture?
10:20 How important is a timeline for the patient?
12:24 The outcome of your recent paper in AJSM shows a very low re-injury rate in a big series?
14:20 What are the critical time points postoperatively in management?
16:53 The paper showed that bone patellar bone was prefered for a lower re-injury rate, but the Hamstring graft did ok, too, what makes that decision?
21:01 There is always a new version of the operation, the Australians suggested using Kangaroo tail, we went through a phase of LARS repair, and the follow up suggested these really were not that good, but they are reappearing and now the Quad tendon repair - why the continual quest to change?
24.40 Bertrand Sonnery-Cottet from Lyon has published some work on assisted ligament repair of proximal ACL's is this something that might come to SSC in the future?
27:40 How important is graft tension to a successful outcome?
29:22 Biomechanical analysis has led to a low re-injury rate, how important is this and if re-injury does occur what then?
Papers mentioned in the podcast
Factors Influencing Return to Play and Second Anterior Cruciate LigamentInjury Rates in Level 1 Athletes After Primary Anterior Cruciate LigamentReconstruction: 2-Year Follow-up on 1432 Reconstructions at a Single Center. King E, Richter C, Jackson M, Franklyn-Miller A, Falvey E, Myer GD, Strike S, Withers D, Moran R.Am J Sports Med. 2020 Mar;48(4):812-824.
ACL or ACL. Reider B.Am J Sports Med. 2020 Feb;48(2):281-284.
ACL rupture in the immediate build-up to the Olympic Games: return to elite alpine ski competition 5 months after injury and ACL repair. Praz C, Kandhari VK, Saithna A, Sonnery-Cottet B.BMJ Case Rep. 2019 Mar 15;12(3):e227735.
Mr Ray Moran's rooms are located in Suite 5 at the Sports Surgery Clinic in Santry.
Welcome to 'On the Table' - Sports Surgery Clinic's orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.
The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.
In Episode Six, we are delighted to speak to Miss Ann-Maria Byrne, Consultant Orthopaedic Surgeon at the Sports Surgery Clinic and specialist in elbow, hand and wrist surgery.
This episode focuses on the topic of decision making around the biceps and common extensor origin injuries and surgical indications.
Shownotes:
5:09 Distal biceps ruptures certainly seem to be increasingly common, anecdotally one always thinks anabolic steroid use, but the mechanism is more varied?
8:10 Is there commonly tendinopathy or avulsion?
11:38 What is the mechanism of injury in rupture?
13:04 How do you go about the clinical assessment is this something you use to differentiate between partial and complete tears? What are the decision making steps in deciding to operate?16:58 Does MRI help or hinder decision making?
18:38 What does biceps surgery involve?
23:12 And what does the post-operative period look like?
27:17 When can they lift heavy again?
29:09 What are the complications of surgery
32:02 When does contact sport come back?
33:51 Common Extensor Origin tendinopathy, what does the evidence suggest?
37:41 What are the differential diagnosis before surgery?
44:52 When can surgery assist?
45:22 Matache published a protocol for a sham RCT of arthroscopic release using DASH (Disability of Shoulder and Hand) and Mayo Elbow Performance Score (MEPS) not all our listeners will be familiar with DASH and MEPS are these well accepted PROMS that can use to track improvement?
Papers mentioned in the podcast
Platelet-Rich-Plasma Injections in Treating Lateral Epicondylosis: a Review of the Recent Evidence. Murray DJ, Javed S, Jain N, Kemp S, Watts AC. J Hand Microsurg. 2015 Dec;7(2):320-5. doi: 10.1007/s12593-015-0193-3. Epub 2015 Jul 8. Review.
Matache BA, Berdusco R, Momoli F, Lapner PL, Pollock JW. A randomized, double-blind sham-controlled trial on the efficacy of arthroscopic tennis elbow release for the management of chronic lateral epicondylitis. BMC Musculoskelet Disord. 2016;17:239. Published 2016 Jun 1. doi:10.1186/s12891-016-1093-9
Ms Ann-Maria Byrne's clinic is based in Sports Surgery Clinic's Northwood Suite in Santry.
Her secretary is Niamh Kennedy Phone: +353 1 5262345 Email:ambyrneadmin@sportssurgeryclinic.com
Welcome to ‘On the Table’ – Sports Surgery Clinic’s first orthopaedic advances podcast hosted by Dr Andy Franklyn- Miller, Consultant Sports & Exercise Medicine Physician at SSC.
The purpose of the podcast is to explore the reasons behind deciding to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.
In Episode Two, we are delighted to speak to Ms Ruth Delaney, Consultant Orthopaedic Surgeon and Assistant Clinical Professor, University College Dublin.
This episode focuses on the topic of acromioclavicular joint injury and clavicular fractures.
Shownotes:
3:42 The epidemiology of AC joint disruption, the anatomy of the joint, and how it is injured.
5:08 Talk us through imaging and how radiologists like to give these a graded score and referrers often get confused both about what the grading means and the imaging to make that grading, can you explain it and is it useful?
10:51 What do write on the X-Ray referral form to make an appropriate assessment?
12:02 What does conservative management mean to you?
13:35 When does an AC joint need stabilisation surgery and what does that entail?
14: 47 What complications of surgery exist?
18:37 How do you manage pain in the ACJ further down the line, When does excision of the distal clavicle play a part?
21:26 Clavicular fractures, management is tricky; how do you approach it? What re the risks of NSAIDS? What are the surgical options for repair?
25:30 The post-operative surgical timeline is predictable, talking through the return to sport protocols
29:00 Different approaches to clavicular management
Selected papers from Ms Delaney
Complications of the Latarjet procedure. Gupta A, Delaney R, Petkin K, Lafosse L. Curr Rev Musculoskelet Med. 2015 Mar;8(1):59-66.
Neer Award Paper: neuromonitoring the Latarjet procedure. Delaney RA, Freehill MT, Janfaza DR, Vlassakov KV, Higgins LD, Warner JJ. J Shoulder Elbow Surg. 2014 Oct;23(10):1473-80.
Immobilisation in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation. Vavken P, Sadoghi P, Quidde J, Lucas R, Delaney R, Mueller AM, Rosso C, Valderrabano V. J Shoulder Elbow Surg. 2014 Jan;23(1):13-9.
Durability of partial humeral head resurfacing. Delaney RA, Freehill MT, Higgins LD, Warner JJ. J Shoulder Elbow Surg. 2014 Jan;23(1):e14-22. Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies.Müller AM, Sadoghi P, Lucas R, Audige L, Delaney R, Klein M, Valderrabano V, Vavken P. J Shoulder Elbow Surg. 2013 Aug;22(8):1146-52.. Review.
Utilisation of the safe surgical dislocation approach of the hip to retrieve a bullet from the femoral head. Delaney R, Albright M, Rebello G. Case Rep Orthop. 2011;2011:160591.
Ms Ruth Delaney has personal website www.dublinshoulderinstitutecom, and you can follow Ruth on twitter @RDShoulder
Sports Surgery Clinic is Ireland's leading orthopaedic private hospital at www.sportssurgeryclinic.com
Welcome to 'On the Table' - Sports Surgery Clinic's first orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.
In Episode One, we are delighted to speak to Mr Hannan Mullet, Consultant Orthopaedic Surgeon and Honorary Senior Lecturer at The Royal College of Surgeons Ireland.
This episode focuses on the topic of shoulder dislocation and the best practice evidence in its management.
Shownotes:
1:30 Shoulder dislocation is pretty common in contact sports, can you tell us about the epidemiology of it?
2:18 What factors do you take into account when making the clinical assessment?
10:30 What does an MRI add to the assessment?
12:01 Good et all in 2005 "Traumatic shoulder dislocation in the adolescent athlete: advances in surgical treatment." Highlights a poor outcome in adolescents who dislocate in terms of stability, is that what you find? Is the evidence convincing?
16:45 What is the surgical stabilisation procedure? What are the risks of the surgery afterwards?
22:26 Postoperatively can you talk us through the stages of what happens?
24:20 Sling position, post-surgery, has generated some controversy originally from the Japanese group recommending external rotation to improve post-surgical mobility, is that debate still ongoing?
26:24 Contact sport athletes often re-injury the shoulder–what options do you have at that point, is a repeat operation an option?
28:24 What advances might we see in the future?
Papers mentioned in this podcast
Video Analysis of Shoulder Dislocations in Rugby: Insights Into the Dislocating Mechanisms. Montgomery C, O'Briain DE, Hurley ET, Pauzenberger L, Mullett H, Moran CJ. Am J Sports Med. 2019 Dec;47(14):3469-3475. Doi: 10.1177/0363546519882412. Epub 2019 Nov 11.
Long-term outcomes of the arthroscopic Bankart repair: a systematic review of studies at 10-year follow-up. Murphy AI, Hurley ET, Hurley DJ, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2019 Nov;28(11):2084-2089. doi: 10.1016/j.jse.2019.04.057. Epub 2019 Jul 13.
Return to Play After the Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review. Hurley ET, Montgomery C, Jamal MS, Shimozono Y, Ali Z, Pauzenberger L, Mullett H. Am J Sports Med. 2019 Oct;47(12):3002-3008