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Examines the use of judicial discretion on resolving antitrust disputes by the Supreme Court in the United States based on the Thurgood Marshall Papers released by the Library of Congress. Decision in `Matsushita Electric Industrial Co. v. Zenith Radio Corp.'; Factors that influence the exercise of discretion; Relevance to predicting resolutions of antitrust disputes.

This paper evaluates a congestion management concept involving conversion of two existing general-purpose freeway lanes per direction on an 8-lane freeway (with 4 lanes per direction) to priced lanes offering free access for high-occupancy vehicles, in conjunction with cash payments to incentivize a sufficient number of commuters to travel as passengers in transit, carpools or vanpools such that congestion on the remaining free lanes would be no worse than it was before the conversion. Building on prior research, we use a refined modeling process to explore the viability of implementation of the concept on the eastern segment of the Capital Beltway in the Washington, DC metro area. The results of the analysis suggest that the strategy can benefit users of shared travel modes and toll-payers, improve travel speeds on toll-free general-purpose lanes, generate significant surplus revenues to support capital investments and operating subsidies for shared travel modes, and can absorb traffic growth through 2040. [ABSTRACT FROM AUTHOR]

The article introduces the latest issue of Public Works Management and Policy, which covers a range of topics related to infrastructure and public policy. The first paper examines corruption in infrastructure development and proposes measures to mitigate it. The second paper focuses on how coastal counties in the southeastern United States are planning for sea level rise, emphasizing the importance of robust risk management. The third paper analyzes New Orleans' Adopt-A-Catch Basin Program and highlights the need for better communication and stakeholder involvement. The fourth paper explores the perceptions of farmers who have experience with automated technology and their implications for autonomous vehicles. The final paper evaluates a congestion management concept for the Capital Beltway in Washington, DC. The issue concludes with a book review. [Extracted from the article]

Objectives: The baseball pitching motion is one of the most complex movements in sports and stresses the elbow joint with substantial amounts of force. Over the past two decades the incidence of elbow injury and the need for surgical intervention in baseball pitchers has been on the rise. This multifactorial problem has stimulated the implementation of pitch count limits, advising against early pitching specialization, and increased the focus on proper pitching biomechanics to improve injury prevention. A majority of pitching biomechanics research has focused on upper extremity kinematics, however research concerning the contribution of the lower extremities to the overall pitching motion requires further understanding. To minimize the risk of injury to the elbow while maximizing performance, a pitcher must be able to efficiently transfer energy through the lower extremities up through their throwing arm. Of particular interest in this paper is understanding the implications of stride position on pelvic rotation, elbow varus moment, and ball velocity. The purpose of this study was to investigate the affect of stride position and pelvic kinematics on the elbow varus moment and ball velocity in collegiate level pitchers. It was hypothesized that pitchers that land in a crossed-over stride position would reduce their ability to achieve maximum pelvic rotation range of motion, leading to an increase in elbow varus moment and decreasing fastball velocity. Methods: Pitchers were recruited from NCAA Division I and Division III college baseball teams and were included in this study if they were actively pitching for their collegiate team. Pitchers were excluded if they had experienced an injury that caused them to miss one game or practice within the preceding 6 months. Each participant pitched a total of seven of each pitch type they were comfortable throwing in a game setting from a regulation indoor mound towards a pitching target 60 feet 6 inches away. Data for this study were limited to fastball data only. Motion data were collected at 250Hz using a 12 camera Vicon 512 motion analysis system (Vicon, Oxford, UK). Kinematic data were calculated using a 16- segment biomechanical model based on Euler's equations of motion, and upper extremity joint kinetics were calculated using standard inverse dynamic techniques. Stride cross-over was defined as when the pitcher's lead stride foot landed more towards third base if they were a right-handed pitcher or more towards first base if they were a left-handed pitcher (Figure 1). Other predictor variables included pelvic angular velocity (°/sec), pelvic rotation at ball release (°), and pelvic range of motion (°). Statistical analyses were performed using a mixed effects random intercept regression model to determine associations among the variables of interest. Results: A total of 99 baseball pitchers were recruited with a mean age of (20.7 ± 1.3 years), height of (1.8 ± 0.7 m), and weight of (88.6 ± 13.5kg). No pitchers were excluded from this analysis. Regression analysis demonstrated that for every 100°/sec increase in pelvis angular velocity the elbow varus moment increased by 5.6Nm (p=0.00) and ball velocity increased by 0.43mph (p=0.00). Additionally, it was noted that for every 10° increase in pelvis rotation at ball release and 10° increase in total pelvic range of motion, the elbow varus moment increased by 0.4Nm and 0.2Nm respectively (p=0.036, p=0.02) and ball velocity increased by 1.8mph and 1.1mph respectively (p=0.03, p=0.01). Pitchers that achieved greater pelvis range of motion experienced a 0.26% increase in elbow varus moment accompanied by a 1.6% increase in ball velocity. Additionally, pitchers that demonstrated greater pelvis rotation at ball release experienced a 0.53% increase in elbow varus moment and 2.55% increase in ball velocity. Although not statistically significant a quartile analysis demonstrated that pitchers who landed in a cross-over stride position had the largest elbow varus moments accompanied by relatively low-ball velocity compared to pitchers that landed in an open stride position, who tended to have low elbow varus moments with relatively high ball velocity (Figure 2). Conclusions: The results of this study indicated that stride position during pitching was associated with both elbow varus moment and ball velocity. Pitchers that landed in a more crossed-over position experienced greater elbow varus moment and lower fastball velocity compared to those that landed in an open stride position. It is theorized that an open stance stride position allowed the pelvis to achieve full range of motion, thus leading to an efficient energy transfer to the throwing arm. This was supported by the finding that pitchers who achieved greater pelvic range of motion experienced smaller elbow varus moments compared to pitchers with less pelvic range of motion. Additionally, pitchers who demonstrated greater pelvic rotation at ball release and greater pelvic range of motion experienced an almost two mile per hour and one mile per hour increase in fastball velocity, respectively. These results can aid pitching coaches and trainers in understanding the implications of incorrect lower extremity pitching mechanics on elbow injury risk reduction and performance in baseball pitchers. [ABSTRACT FROM AUTHOR]

Background: Although religious involvement tends to be associated with improved mental health, additional work is needed to identify the specific aspects of religious practice that are associated with positive mental health outcomes. Our study advances the literature by investigating how two unique forms of religious social support are associated with mental health. Purpose: We explore whether support received in religious settings from fellow congregants or religious leaders is associated with participants' mental health. We address questions that are not only of interest to religion scholars, but that may also inform religious leaders and others whose work involves understanding connections between religious factors and psychological outcomes within religious communities. Methods: We test several hypotheses using original data from the "Mental Health in Congregations Study (2017–2019)", a survey of Christian and Jewish congregants from South Texas and the Washington DC area (N = 1882). Surveys were collected using both paper and online surveys and included an extensive battery of religious and mental health measures. Results: Congregant support has more robust direct associations with mental health outcomes than faith leader support. Increased congregant support is significantly associated (p < 0.001) with fewer symptoms of psychological distress (β = − 0.168), anxiety (β = − 0.159), and anger (β = − 0.190), as well as greater life satisfaction (β = 0.269) and optimism (β = 0.283). However, faith leader support moderates these associations such that congregant support is associated with better mental health only in cases where faith leader support is also high. When leader support is low, congregant support and mental health are not associated. Conclusions and Implications: At the conceptual level, our study adds to an extensive literature on the relationship between religious social support and mental health. Additionally, our work may provide important insights to religious leadership in terms of communications strategies, services, and resources that might enhance overall congregant mental health and well-being. [ABSTRACT FROM AUTHOR]

Background: Public education reforms, such as expanded school choice, have become a critical lever for remaking urban landscapes. These reforms often aim to attract and retain affluent and White families in urban schools, so scholars have examined how these parents navigate the perceived risk of choosing these schools for their children. Purpose: This paper extends this scholarship to understand how other families experience these reforms in gentrifying landscapes. We ask: (1) How do Black parents navigate school selection in a gentrifying and expansive education marketplace? (2) How do Black parents' perceptions of schooling shape their approach to school selection? (3) How do parents' positionalities (e.g., gender, class, place attachments, and tenure in the city) influence their experiences? Research Design: We leverage a qualitative meta-analysis design that pools data from three separately conducted studies of gentrification in Washington, D.C. For this analysis, we center on 34 Black parents' experiences as they navigate school selection. We reanalyzed data through the lens of critical spatial and racial theories. We paid particular attention to participants' attachments to place, their perceptions of their choices, the school and neighborhood attributes participants valued, and how they navigated school selection. Findings: Parents considered a broad range of school and neighborhood characteristics as they constructed their choice sets. As they searched for schools, Black parents made a series of racialized compromises to find schools they perceived to be racially, physically, and socially safe for their children. Parents, for example, negotiated their desire for academic rigor with their perception of schools' social climates and their perceptions that schools would be racially affirming and inclusive. Place and space were essential to parents' choice set construction. Schools' physical locations and perceptions of safety influenced whether parents viewed schools as viable options for their children. Conclusion: Our study underscores the multiple factors that bound choice set construction. Critically, Black parents' experiences as they navigated school selection suggest that the expansive educational marketplace offered a "chance, not a choice" at high-quality educational opportunities. [ABSTRACT FROM AUTHOR]

The rape law reform movement in the U.S. has made significant progress since the 1970s. All fifty U.S. states and the District of Columbia have now made changes to their rape statutes. Nonetheless, the incidence of reported rape has increased substantially since the 1970s, and rape conviction rates have remained frustratingly low. Such statistical evidence suggests that amending legal statutes has not proven sufficient to curb endemic sexual violence in the U.S. Effective prevention requires a deeper understanding of rape culture, the conglomeration of discourses, ideologies, and practices that normalize sexual assault. Of particular interest here are mass mediated representations of rape, and their power to authorize or critique sexual violence, its root causes, and its consequences. This paper interrogates and seeks to disrupt rape culture by critically analyzing three media texts with narratives based on real-world cases of sexual violence and secondary victimization, the films Anatomy of a Murder, 1959 and The Accused, 1988 and the Netflix miniseries Unbelievable, 2019. With roughly thirty years between these texts, they provide snapshots of shifting attitudes and practices around sexual violence and secondary victimization in the U.S., from the pre-reform era to the #MeToo era. The analysis reveals some heartening changes but also some disturbing continuities in the real-world ideas and practices that media texts reflect and amplify. [ABSTRACT FROM AUTHOR]

Retirement plans can create strong financial incentives that have important labor market implications, and many states have adopted alternative plan designs that significantly change these incentives. The authors use longitudinal data to investigate the impact of Washington State's 1996 introduction of a hybrid retirement plan on late-career attrition. The unique setup of Washington's plans allows them to provide empirical evidence on the influence of financial incentives created by statutory retirement eligibility thresholds. Findings show that despite facing very different financial incentives, teachers enrolled in the hybrid and traditional plans respond similarly to reaching a key retirement eligibility threshold. The authors hypothesize that teachers are anchoring to the eligibility thresholds, muting the influence of the financial incentives. They also provide evidence that, in the presence of bright-line eligibility thresholds that can anchor workers' separation behavior, commonly used structural models may overpredict workers' responsiveness to the financial incentives embedded in retirement plans. [ABSTRACT FROM AUTHOR]

This article traces D.C. White business leaders' advocacy of (low-income) Black suburban relocation and White upper-class resettlement in D.C.'s central neighborhoods in the 1960s and 1970s. By examining the organizational papers and memos of meetings and policy documents from the Federal City Council, a D.C. nonprofit advocacy organization for the city's leading business and real estate leaders, I document how predominantly White business leaders appropriated fair housing and regional fair share political stances to articulate revanchist desires. These leaders' revanchist rhetoric depicted the Black poor—especially the single Black mother with children—as the primary figure of neighborhood blight and domestic deviance. In the wake of these revanchist politics, low-income Black mothers remained principal victims of pro-mobility policies and gentrification agendas that forced them to continually move to support demolition or redevelopment. This article affirms low-income Black mother activists' political support for placemaking and low-cost, family-friendly, and well-maintained communities. [ABSTRACT FROM AUTHOR]

Objectives: Tranexamic acid (TXA) use has become common in Orthopedic surgeries. Despite the growing number of publications related to its use, no recent systematic reviews have been published examining TXA use in foot and ankle surgery. The aim of this review article is to provide a summary of the current available literature regarding TXA use in foot and ankle surgery and to further the understanding of its safety and efficacy. Methods: This was a systematic review following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as outlined on the PRISMA checklist. Databases utilized included PubMed, Ovid, CINAHL, Clinical Key, Medline, and Embase, and the search was conducted through May 21, 2022. Key words used in the search included: "tranexamic acid," "TXA," "foot," "ankle," "calcaneal," and "surgery." The outcomes within the studies analyzed included measures of perioperative blood loss (intra-operative blood loss, 24-hour postoperative blood loss, blood loss from hour 24 to hour 48, postoperative hemoglobin (Hgb), and postoperative hematocrit (Hct)), as well as wound complications and vascular events. Wound complications and vascular events were defined as infection, hematoma formation, necrosis, dehiscence, DVT, PE, myocardial infarction (MI), acute coronary syndrome (ACS), cardiovascular event (CVA), limb ischemia (LI), gastrointestinal hemorrhage (GIH), nerve damage, and any other conditions specified as wound complications or vascular events within individual studies. The Cochrane Collaboration's Risk of Bias 2 (RoB2) tool was used to assess the risk of bias in the studies included. The quality of the studies included was scored using a modified Coleman methodology score (MCMS). Primary treatment outcomes having data from three or more studies available were summarized in forest plots using RevMan 5.4.1 software (The Cochrane Collaboration, Copenhagen, Denmark). Random-Effects models were used to calculate mean differences with 95% confidence intervals for each outcome measure. Heterogeneity of studies was assessed using Tau2, Chi2, and I2 statistics. Statistical significance was set at a=0.05 for all comparisons. Results: The literature search produced 1125 papers. The full texts of 16 studies were assessed using inclusion and exclusion criteria and seven studies met preliminary inclusion criteria. Upon further inspection, five met full inclusion criteria for the meta-analysis. All groups receiving TXA had statistically significantly lower blood loss values at 24 hours. One study found a statistically significant increase in blood loss from 24-48 hours in their A group (TXA) versus non-TXA. Three study groups demonstrated statistically significantly higher values of postoperative hemoglobin in patients receiving TXA versus patients not receiving TXA. Three study groups demonstrated statistically significantly higher values of postoperative hematocrit in patients receiving TXA versus patients not receiving TXA. No studies found statistically significant differences in wound complications between TXA and non-TXA groups. Conclusions: Despite a growing amount of literature on the topic, there is still a paucity of literature published on TXA use in foot and ankle surgery. Additional literature is required to determine the best strategy for TXA use to optimize patient outcomes. Current literature suggests that foot and ankle surgery patients treated with TXA may have reduced 24-hour postoperative blood loss, increased postoperative hemoglobin and hematocrit when compared to similar patients not receiving TXA. The use of TXA in foot and ankle surgery did not lead to increased thromboembolic complications. [ABSTRACT FROM AUTHOR]

Recent research has increasingly documented the adverse effects of ADHD on physical health in addition to its well-known effects on emotional health. Responding to this concern, CHADD organized a summit meeting of health care providers, governmental and other health-related organizations, and health care payers. A White Paper generated from the meeting reviewed the adverse health outcomes, economic burden and public health implications of unmanaged ADHD. Here we summarize the resulting Calls to Action to the various stakeholder groups including: increased awareness and education of providers; development of professional guidelines for diagnosis and treatment; insurance coverage of the relevant services; support of research targeting the role of ADHD in the etiology and treatment of physical illness; and public education campaigns. [ABSTRACT FROM AUTHOR]

In the late-2000s, Washington, DC achieved national notoriety for its embrace of market accountability in public schools and support for a steadily expanding charter sector. At the same time, the DC government pursued a concerted effort to attract new residents and investment to the city, a project that bore fruit in the form of some of the highest levels of gentrification in the country. Most of the research exploring intersections between charterization and gentrification has focused on the school choice decisions of gentrifier parents and school enrollment patterns. This paper illuminates the geography of opening and closing schools in DC—both charter and District-operated—between 1997 and 2017 and describes the intersection of those processes with patterns of gentrification and neighborhood change across the city. A detailed description of how this played out in one gentrifying neighborhood supplements the citywide analysis. [ABSTRACT FROM AUTHOR]

This paper presents qualitative findings associated with the experiences of those tasked with enforcing laws within a novel environment of cannabis legalization. Research partner agencies and participants included local, state, and tribal law enforcement agencies in Washington and bordering areas of Idaho. Semi-structured interviews explored the pre- and post-legalization experiences of 92 police professionals (ranging from first-line officers to agency leadership). Findings suggest that law enforcement authorities in Washington felt insufficiently prepared for cannabis legalization, are now concerned about greater exposure of youth to cannabis as a result of legalization, and broadly believe that cannabis-related impaired driving has increased markedly and poses a major public safety problem for them. These issues, alongside pressing needs in the areas of agency staffing, training, and equipment related directly to dealing with cannabis legalization outcomes, necessitate attention by policymakers to mitigate major operational challenges. These same or similar issues are likely to arise in other states moving toward the commercialization and regulation of cannabis. [ABSTRACT FROM AUTHOR]

A housing restoration trend—called “brownstoning” in New York, and urban pioneering or the back-to-the-city trend in other cities—had a noticeable impact in several major U.S. cities from the late 1950s onwards. Nowhere was the trend more influential than Washington, D.C. In key “intown” residential areas such as Georgetown, Capitol Hill, and Dupont Circle, the popularity of housing restoration was catalyzed by a very active set of neighborhood preservation and restoration groups. Focusing on the Capitol Hill area, this paper explores the organizational and publicity apparatus that drove the restoration process as well as the cultural politics and racial tension that accompanied it. [ABSTRACT FROM PUBLISHER]

The author describes how sociological and philosophical discussions of agency tend to center questions of how or why people are agentic rather than who or what is agentic. In contrast, the author poses questions about the agency of things, the agency of non-humans, and the agency of dead humans, using three examples of historical traces—Washington's refusal of a third term, Jenner's development of the smallpox vaccines, and Smith's publication of The Wealth of Nations —as historical examples to examine how non-humans and non-living-humans leave traces that can experienced as agentic. The author then analyzes six theories of agency that might provide explanations for these actions (actants, affordances, switchmen, residue, repression, and ghosts) before turning to his earlier work on the concept of "external authorities." [ABSTRACT FROM AUTHOR]

As Indigenous-led education mandates proliferate globally, understanding how educators teach Indigenous perspectives and sovereignty remains urgent. Learning and integrating such knowledge proves difficult for non-Native teachers, given their lengthy participation in settler colonial schooling and society. What does learning to implement Native sovereignty curriculum entail? Codesigned with eight Native education leaders, this qualitative study examines five non-Native K–12 teachers' learning processes with Washington's Since Time Immemorial curriculum across three schools, using interviews, observations, and other data. Findings indicate six themes of learning supporting meaningful implementation, one potential catalyst for overall growth, and two distinct learning trajectories that suggest outward, rather than inbound, directionality. Implications for teacher education and educational leadership clarify needed steps for teacher learning and curriculum implementation. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: In 2022, 1 in 6 households with children experienced food insecurity (FI) in the United States. The negative impact of FI on child health is well documented and pediatric clinicians are encouraged to actively screen and intervene in clinical settings. This study aims to evaluate the feasibility and impact of a FI management protocol implemented in 2017 at a pediatric primary care health network serving patients who are Medicaid-eligible in Washington, DC. Methods: In 2019, an 18-item electronic survey was sent to a convenience sample of 42 pediatric clinicians within the health network to understand their knowledge, attitudes, and behaviors surrounding implementation. Both quantitative and qualitative responses were collected and analyzed. We report frequencies of the Likert-type responses, including perceived compliance with protocol components and intervention efficacy. We evaluated the relationship between FI knowledge level and rates of clinician documentation compliance by chi square and Cramer's V statistic for effect size. Open-ended responses were reviewed, and common themes were identified and used to provide context for quantitative results. Results and Conclusions: Out of 42 clinicians invited to complete the survey, 35 completed responses. All respondents reported universal screening for FI (100%) at routine examinations, 80% reported frequently electronically documenting FI in medical records, and 91% of clinicians reported frequently referring families who screened positive for FI to at least one FI resource, with 24% reporting that resources met families' needs. Open-ended responses revealed increased awareness of FI prevalence and of patient experiences in households experiencing FI, increased satisfaction with clinical management of FI, but also concerns around having limited clinical time to do the protocol and the usefulness and accessibility of referred resources. In conclusion, implementing this pilot FI protocol was feasible, but clinicians perceived limited impact of the protocol on alleviating FI and desired more robust intervention options. Further improvements include shifting the burden of performing the protocol away from the clinician, such as by streamlining the protocol or identifying a resource staff member, and establishing more accessible and effective FI interventions such as "Food as Medicine" offerings in partnership with community organizations. [ABSTRACT FROM AUTHOR]

The Oval Office, the White House locus of the president's formal office, is one of the most well-known interiors in the world. It is part of a living museum, where rules and tradition often dictate the placement of furniture and objects, yet the décor changes as each president and spouse guide its decoration in their attempts to create or reinforce a particular political identity as a part of a strategy referred to as political branding. This paper will examine the Oval Office for over 76 years and will discuss the manner in which décor and politics have joined and created four patterns established in this research as branding strategies over time. This particular time period was chosen because it covers the inception of the Oval Office in its permanent location through the present. The methodology of this paper is qualitative. Each of the 13 presidential administrations' use of furniture, color, window treatments, rugs, and emblems is examined to reveal the four patterns identified in this research as branding strategies. These four branding strategies are classified as either symbolic, static, personal or expunged, and propose a new framework to view the décor of the 13 Oval Offices. [ABSTRACT FROM AUTHOR]

The article offers information on conference papers at the Spring Meeting of American Psychoanalytic Association (APA) held in Washington D.C. on June 13, 2011. Panelist Eric Marcus discussed the use of structural model in understanding near psychotic and psychotic illness through symbolic representations. Identified by panelist Andrew Lotterman were seven techniques and five principles centered on psychoanalytic work. Michael Garret discussed the cognitive behavioral therapy (CBT) technique.

This paper focuses on two regions in the United States that have emerged as high-technology regions in the absence of major research universities. The case of Portland's Silicon Forest is compared to Washington, DC. In both regions, high-technology economies grew because of industrial restructuring processes. The paper argues that in both regions other actors—such as firms and government laboratories—spurred the development of knowledge-based economies and catalysed the engagement of higher education institutions in economic development. The paper confirms and advances the triple helix model of university–government–industry relationships and posits that future studies have to examine degrees of university-region engagement. [ABSTRACT FROM AUTHOR]

By concentrating on building leadership and management capacity in the middle ranks of the organization, government services will be enhanced and public trust increased. While this proposition makes intuitive sense, it is difficult to verify. However, the District of Columbia government offers an interesting case study in trying to achieve this goal. This paper outlines the history, rationale, and current status of an innovative leadership development strategy for a complex municipal environment. It specifically reviews an assessment of the Program for Excellence in Municipal Management--a training program of the District of Columbia government which meets the criteria of the Certified Public Manager program, implemented by The George Washington University Center for Excellence in Municipal Management. The paper presents lessons learned from the experience to assist government organizations in their transformational efforts. While government training programs are not unique, the DC case is different in that the delivery, of the training is conducted through a public-private partnership, is organized for middle management, and the explicit purpose of the training is to enhance public service delivery by giving public managers the tools necessary to work with and through the bureaucracy, and organizations of government. [ABSTRACT FROM AUTHOR]

In the late 1960s and early 1970s, the proposed Three Sisters Bridge over the Potamac River became one of the most prominent controversies in the national debate over urban freeway construction. Because of the District Columbia's unique federals status, both highway advocates and opponents saw the bridges as a matter of national importance. Previous accounts of the bridge's defeat and of other highway protests have focused on street demonstrations and grassroots organizations. This article highlights the role of elite highway protestors, who not only fought the bridge with lawsuits and studies but who also penetrated the Kennedy, Johnson, and Nixon administrations, creating a freeway revolt within the federal government. Their actions defeated the Three Sisters Bridge and helped move federal transportation policy away from inflexible insistence on urban freeways. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Planning Education & Research is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We contextualize the magnitude of teacher attrition during the pandemic, including from the 2020–2021 school year to the 2021–2022 school year, using longitudinal data on teachers in Washington since the 1984–1985 school year. The teacher attrition rate after the 2020–2021 school year (7.3%) increased by almost one percentage point from the attrition rate after the 2019–2020 school year (6.4%), but these rates are well within the range of turnover rates observed during pre-pandemic years. The increase in turnover during the pandemic was also smaller than pre-pandemic differences in turnover between high- and low-poverty classrooms in the state, and these inequities in turnover between high- and low-poverty classrooms decreased during the pandemic relative to pre-pandemic years. [ABSTRACT FROM AUTHOR]

Objectives: Spin is a reporting bias that misrepresents research. Ultimately it can impact surgeon decision making and patient care. Anterior Cruciate Ligament (ACL) reconstruction is common; however debate continues over the optimal graft choice. The quadriceps tendon has become an increasingly popular graft. The purpose of this study was to identify the prevalence of spin in meta-analysis and systematic review abstracts regarding the treatment of ACL injuries with quadriceps tendon graft. Methods: Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were searched for meta-analyses and systematic reviews regarding the treatment of ACL tears with quadriceps tendon graft. The key words used for searches included (ACL or Anterior Cruciate Ligament) and (Quad or Quadricep or Quadriceps). All meta-analyses and systematic reviews that contained analysis for quadriceps tendon graft for ACL reconstruction were included. The nine most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Further evaluation included year of publication, number of citations, journal impact factor, and AMSTAR-2 score. Results: The electronic database search resulted in 986 articles, of which 13 met our inclusion criteria. After review of these papers, it was found that 53.8% (7/13) of the included articles contained one of the nine most severe forms of spin. Of the types of spin evaluated, type 3 spin (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention) was found to be the most prevalent (4/13, 30.8%). The other common types of spin found included type 5: conclusion claims the beneficial effect of the experimental treatment despite high risk of bias in primary studies (2/13, 15.4%); and type 9: conclusion claims the beneficial effect of the experimental treatment despite reporting bias (2/13, 15.4%). A detailed accounting of the prevalence of each type of spin can be found in Table 1. There was no relationship between the presence or total types of spin when comparing the publication year, journal impact factor, number of citations per year for the article, or the A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) rating. Conclusions: This study demonstrated the presence of spin in a significant portion (53.8%) of metaanalysis and systematic review abstracts pertaining to quadriceps tendon graft for ACL reconstruction. Orthopedic surgeons should learn to recognize spin as they review articles when deciding the treatment course for ACL injuries. Additionally, strict criteria should be considered to reduce the prevalence of spin in orthopedic literature. [ABSTRACT FROM AUTHOR]

Researchers have found that gentrification is less likely in Black neighborhoods than in White or Latinx neighborhoods, and that gentrification looks different in Black neighborhoods. For example, researchers have found that Black neighborhoods experience marginal gentrification—changes in the educational level but not the income of residents. This study uses Census and National Historical Geographic Information System (NHGIS) data to explore the relationship between gentrification and racial change in Washington, DC between 2000 and 2019. We measure gentrification using four distinct but related measures: change in home value, rent, average educational level, and household income. The results show a positive association between changes in the percentage of residents with college degrees and the percentage of White residents in neighborhoods that were majority Black in 2000. We also find a positive association between changes in the percentage of Latinx residents and the average rent. We do not find a significant relationship between racial change and changes in home value and average income. Our findings point to the importance of including race in models of gentrification as well as using different measures of gentrification to capture it more fully. [ABSTRACT FROM AUTHOR]

Poster No. 66 Abstract ID No. 1499427 The tale of an aortic thrombus I Nichole E. Brunton, DO, Ana Casanegra, MD i I Mayo Clinic i I Background: i Aortic thrombus is rare in patients without aneurysm or atherosclerosis, usually occurring in young patients with prothrombotic disorders. Poster No. 105 Abstract ID No. 1496248 Two strokes of luck: a case of descending thoracic aneurysm in an elderly patient with multip... I Julianne Marie E. Yamamoto, Flordeliz F. Lontok, Ronald S. Reodica, Fabio Enrique B. Posas, Marvin Martinez, Precious Samonte, Arvinjay Bautista i I St. Luke's Medical Center - Bonfacio Global City i I Background: i Treating a patient with aneurysms in multiple segments of the aorta and its branches is a challenge, especially in the elderly with a history of open surgical repair of abdominal aorta aneurysm. I Conclusions: i The variability of CHD and aneurysm presentations in patients with NOTCH-related disease indicate that these genes should be included in any aortopathy or arterial disease gene testing strategy. In patients with underlying connective tissue disease, such as Loeys-Dietz syndrome, vascular Ehlers-Danlos syndrome, and Marfan syndrome, dissecting pseudoaneurysm should be considered in the differential diagnosis. Abstract ID No. 1494785 Venous inflammation might be one of the features of VEXAS syndrome and associated thrombosis I Hazan Karadeniz SP 1 sp , Mahinur Cerit SP 1 sp , Seyma Yildiz SP 1 sp , Abdurrahman Tufan SP 2 sp , Yogen Kanthi, MD SP 3 sp SP 1 sp Gazi University Faculty of Medicine, SP 2 sp National Human Genome Research Institute/NIH, SP 3 sp National Institutes of Health i I Background i : VEXAS syndrome is an often fatal, X-linked disease characterized by hematological dysplasia overlapping with severe autoinflammatory manifestations. [Extracted from the article]

Washington, DC's Opportunity Scholarship Program (OSP), the only federally funded school voucher program in the United States, has provided private school scholarships to low-income students in DC since 2004. From its inception, the program has received significant attention in national debates and has been the subject of rigorous evaluations mandated by Congress. We conduct an experimental evaluation of the effect of the OSP on college enrollment by comparing the college enrollment rates of students offered a scholarship in lotteries held in 2004 and 2005 with those of students who applied but did not win a scholarship. Students who won scholarships to attend private schools were not significantly more or less likely to enroll in college than students who did not. [ABSTRACT FROM AUTHOR]

The article reports about plans for the Fifth World Congress of Sociology, sponsored by the International Sociological Association, to be held in Washington D.C. between September 2 and 8, 1962. The major topics to be discussed are, "Sociologists, Policy Makers and the Public," "The Sociology of Development," "The Nature and Problems of Sociological Theory." The general plan is to have the main paper on each of the three major themes published in advance in two volumes of the "Transactions." The World Congress will follow immediately upon the meetings of the American Sociological Association and will also be held in the Shoreham. Two generous grants have been made in support of the Congress, one of $50,000 from the ACLS-SSRC Committee administrating a Ford Foundation grant, and one of $25,000 from the National Science Foundation. These monies will be largely used to defray the travel cost of foreign scholars who are preparing papers. It has been hoped that the presence of scholars from abroad may be facilitated teaching opportunities in American universities either before or after the Congress.

Background/Context: The stakes are getting higher for teachers daily as more and more states adopt hiring, firing, and tenure-granting policies based on teacher evaluations. Even more concerning is the limited discussion about whether or not high-stakes teacher evaluation can meet the intended outcome of improved student achievement, and at what cost. These high-stakes decisions are based on the rationale that firing ineffective teachers (as primarily measured by observation data and value-added scores) will improve student achievement. This premise is challenged by various variables and assumptions (e.g., reliability, validity, percentage fired, and turnover) that, if not met, could result in a number of possible unintended consequences. Focus of Study: This paper examines the history of high-stakes teacher evaluation and the ways in which teacher evaluation data are being used in today's schools to make human capital decisions. The intended consequences and unintended consequences are explored in great detail. Research Design: This paper is an analytic essay. Conclusions/Recommendations: There is no evidence that high-stakes teacher evaluation can produce a more effective teacher workforce and improve student achievement. Even if basic requirements and assumptions are met (e.g., highly reliable and valid measures, retention of effective teachers, and highly effective hires), gains in student achievement may be short lived, insignificant, or practically meaningless. The possible unintended consequences could result in worse, rather than better, student achievement outcomes and increase the gap in opportunity to learn for students attending the most and least affluent schools. [ABSTRACT FROM AUTHOR]

This article presents a notice concerning the 1957 annual meeting of the American Sociological Association to be held at the Shoreham Hotel, Washington D.C. on August 27-29. Joint sessions will be held with the American Anthropological Association, the Rural Sociological Society, and the Society for the Study of Social Problems. The various sections and respective chairmen for them are Talcott Parsons of Harvard University for Sociological Theory, Paul L. Lazarsfeld of Columbia University for Methodology, Conrad M. Arensberg of Columbia University for Industrial Sociology, S.M. Lipset of University of California, Berkeley for Political Sociology and Samuel A. Stouffer of Harvard University for Consumer Behavior. Each section chairman will present an analytic overview of what he takes to be the most significant problems in the field under examination. Members of the society have been directed to submit their papers to the respective chairmen of the sections and to the program committee alternatively. These papers will complement the usual papers presenting reports on researches.

Shares the author's experience in his participation in the 1970 White House Conference on Children in December 1970 in Washington D.C. Privilege of the author to serve on one of the 25 forums, which were charged with responsibility of planning the meeting for one segment of the conference and preparing a position paper and other materials; Participation of distinguished laymen in the Developmental Child Care Forum; Excellence of the delegates who attended Forum 17 on Developmental Child Care in their attendance and interest and demonstration of considerable competence and experience in the area of child care.

This article describes proceedings from a meeting of the National Multiple Sclerosis Society (NMSS) Task Force on Clinical Disability Measures (the TF). The TF was appointed by the NMSS Research Programs Advisory Committee with the goal of pooling and analyzing existing datasets to explore the utility of novel disability outcome measures based on the Multiple Sclerosis Functional Composite (MSFC) approach. The TF seeks to determine the suitability of the MSFC approach as a primary clinical outcome measure for registration trials in MS. The TF met in Washington, DC, Dec. 14 and 15, 2011, and provided unanimous support for a collaborative approach involving representatives from academic medicine, the pharmaceutical industry, regulatory agencies, the NMSS and the Critical Path Institute. There was also unanimous agreement that analysis of existing datasets would be useful in making progress toward the objective. The TF placed high value on determining the clinical meaning of individual component measures for the MSFC, and in establishing optimal analysis methods for MSFC so that scores would be more interpretable than the originally recommended z-score method. The background for a collaborative project aimed at developing an improved disability outcome measure is described in this paper. [ABSTRACT FROM AUTHOR]

This paper reviews methods for analyzing both individual preferences and choices about where to live, and the implications of these choices for residential patterns. Although these methods are discussed in the context of residential choice, they can be applied more broadly to individual choices in a range of social contexts where behavior is interdependent. We also discuss specific problems with residential mobility data, including the treatment of one’s current location as a potential choice, the aggregation of units and the need to take into account variations in neighborhood size, the problem of very large choice sets, and the link between residential mobility and patterns of neighborhood change. [ABSTRACT FROM PUBLISHER]

Background: Literature reviews have identified recruitment as the single most challenging obstacle in conducting pediatric trials. This paper describes a paradigm shift in recruitment design, developed from experience with grassroots campaigns through the DRINK study (Decreasing the Rates of Illness in Kids). The objective of this study was to explain a new method for recruiting in clinical trials based on lessons learned from grassroots political campaigning. Methods and findings: The study described is a randomized controlled trial of 638 3-6 year olds from the Washington, DC Area. The design involved a comparison between new recruiting approaches modeled after grassroots campaigns and traditional techniques. Traditional techniques for the purpose of this paper are defined by the use of physician referral, mass media such as radio and television advertisements, along with posters in public places like the subway. Grassroots approaches alternatively developed and utilized community contacts and employed targeted small market media community. The main outcome measures were the percentage of budget used and the number of eligible participants recruited. Conclusions: The results showed that the grassroots recruitment approach saved 30% of the budget, recruited 638 kids in 4 months and retained over 90% for the 90 day trial. New techniques need further exploration as community studies are stressed. [ABSTRACT FROM AUTHOR]

In September 2006, the Institute for Justice published a report entitled Designing Cartels: How Industry Insiders Cut Out Competition (Carpenter). The stated purpose was to examine "titling laws, using the interior design industry as the focus, to stimulate further research in this area and to illustrate what titling laws are and how they function" (p. 1). However, the focus of the report, in concert with the Institute for Justice's lawsuits against existing interior design regulation in New Mexico and Texas, appears to be an attack on the interior design profession. This paper is a research-supported rebuttal that analyzes Carpenter's findings within two major constructs: 1) interior decoration is not interior design, and 2) the purpose of regulation. The evidence of the Institute for Justice report is examined via principal topics that include the definition of interior design; the relationship of interior design to the health, safety, and welfare of the public; the framework of interior design regulation; the ideology of consumerism; the function of the Better Business Bureau (BBB) as a measurement tool of industry quality; and the idea of "profession" as a construct. This rebuttal found that Designing Cartels has not succeeded in presenting findings and conclusions that support its intended purpose. It is unfortunate for the public and the interior design profession that this report has been so widespread and used as a way to bolster litigation against the public interest without being examined more closely. Suggestions of the Institute for Justice, if implemented, could compromise the public's health, safety, and welfare. [ABSTRACT FROM AUTHOR]

Various current union proposals for a guaranteed annual wage assume that, during periods of unemployment, employees covered by the guarantee will be eligible for benefits under state unemployment compensation laws. Some of the legislative and administrative implications of this assumption are discussed in this paper by William Papier who is director of the Division of Research and Statistics of the Bureau of Unemployment Compensation of the State of Ohio. [ABSTRACT FROM AUTHOR]

Presents updates related to science communication as of June 2001. Overview of the meeting of the Association for Education in Journalism and Mass Communication in Washington D.C.; Conference on practices for communication of science and technology in Washington D.C.; Information on the book `A Grain of Truth: The Media, the Public, and Biotechnology,' by Susanna Hornig Priest.

Parental access to useful information about schools continues to be a structural barrier that limits the equity potential of school choice programs. While "information interventions" or simplified and readable knowledge resources show promise for counteracting information disparities between families, this line of research has provided limited insight on the particular preferences and needs of parents or the value of person-to-person interpretive assistance in school decisions. This exploratory study uses qualitative methods to investigate parent-school collaboration for the purpose of school selection in Washington, D.C. Drawing on a social capital framework, this study analyzes information transactions from parents' perspectives to clarify ways in which school personnel currently function as liaisons of choice. Findings from this study indicate future opportunities for districts to improve the outcome of school choice through better training of school and district personnel. [ABSTRACT FROM AUTHOR]

Objectives: The Goutallier grading scheme is widely used to assess the chronicity of rotator cuff (RC) tears, predict the likelihood of surgical repair, and provide prognostic information to the expected functional outcomes associated with repair. The limitations of the Goutallier grading scheme are well described and pertain to low rates of interobserver reliability, an inability to distinguish between extramuscular fat replacement and intramuscular fat infiltration (Fig. 1), and an exclusive focus on the supraspinatus. Therefore, a novel 3D magnetic resonance imaging (MRI)-based assessment has been designed to offer a more comprehensive characterization of the chronicity and severity of RC pathology. The Volumetric Score (VS) consists of three measurements of the RC unit: 1. Muscle Size Score (MSS), representing an average z-score of every patient's normalized muscle volume compared to a control population; 2. Relative Contribution Score (RCS), using the weighted average of each of the RC muscle's relative volume to produce a single score for all RC muscles; and 3. Fat Infiltration Score (FIS), averaging fat infiltration for each RC muscle weighted by all RC muscles' relative volume contribution. Objectives (1) Describe the correlation between the Goutallier grade and VS for supraspinatus muscle changes in RC tears, (2) Characterize the chronicity of RC tears in terms of muscle changes using the collective VS measurements, and (3) Compare the Goutallier grade and VS to determine which method most closely corresponds with preoperative functional patient reported outcomes (PROs). Methods: Patients with a history of primary arthroscopic RC repair performed at a single institution and preoperative MRI available for 3D assessment were included. For the MRI-based analysis, the four RC muscles, their respective intramuscular fat, and three upper extremity bones (scapula, clavicle and humerus) were segmented from T1 MRI scans using 3D Slicer and volumized. Segmentation engineers were blinded to all other preoperative, patient-specific variables. To account and normalize for variation in patient sizes, muscle volumes were divided by scapula volume and compared to age-matched controls. Measurements included: (1) muscle size via the MSS; (2) relative muscle volume via the RCS; and (3) intramuscular fat infiltration via the FIS. For each of the four RC muscles, three volumetric measures were obtained (MSS, RCS and FIS), resulting in a total of 12 volumetric scores. All MRIs were assessed independently by two fellowship trained Orthopaedic surgeons according to the Goutallier grading scheme. Patients' preoperative function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) instrument. PROMIS physical function (PF) and pain interference (PI) T-scores were recorded. A univariate and multivariate linear regression was performed to analyze the correlation between MSS, RCS and FIS with the Goutallier grades on evaluation of the supraspinatus. A linear regression was performed to compare the Goutallier grades with preoperative PROMIS PF and PI T-scores, and a multivariate backwards linear regression model was used to determine which of the 12 VS measurements most closely correlated with PROMIS PF and PI preoperative PROs (Fig. 2). Results: Eighty-seven patients were included in the final analysis. The mean age was 54.8 ± 8.6 years with 56 male (64%) and 31 (36%) females. Goutallier grades ranged from grade 0 (n=36, 41.3%), grade 1-2 (n=45, 51.7%) and grade 3-4 (n=6, 6.89%). The univariate linear correlation coefficient (r) demonstrated a strong negative correlation between the supraspinatus MSS (r=-0.73, p<0.001) and RCS (r=-0.73, p<0.001) when compared to the Goutallier grade, while the FIS score (r=0.24, p=0.03) had a moderate positive correlation with the Goutallier grade (Fig. 3). On multivariate linear analysis of all three supraspinatus volumetric measurements, the RCS (p<0.001) most strongly correlated with the Goutallier grade (r=0.73, p<0.001). Very weak correlations were observed between Goutallier grade and both PROMIS PF and PROMIS PI (r=0.08, p=0.45 and r=0.06, p=0.58, respectively) (Fig. 4). On multivariate analysis, the RC muscle volumetric measurements that most strongly correlated with PROMIS PF and PI included the supraspinatus MSS (p<0.05), with a moderate positive correlation with preoperative PROMIS PF, and the supraspinatus RCS (p<0.05), with a moderate negative correlation in predicting preoperative PROMIS PF. The final multivariate linear regression for the volumetric measures to PROMIS PF resulted in a correlation of r=0.27 (p=0.18). The subscapularis MSS (p<0.05) and teres minor RCS (p<0.05) were moderate negative predictors of preoperative PROMIS PI. The final multivariate linear regression for the volumetric measures to PROMIS PI resulted in a correlation of r=0.37 (p=0.06). Conclusions: A strong correlation between the VS and Goutallier grades were observed in evaluation of the supraspinatus. However, although considered the gold standard in evaluation of RC pathology, Goutallier grade demonstrated almost no correlation with preoperative PROMIS PF and PI scores. The 3D MRI-based VS measurements demonstrated a stronger correlation with preoperative PROMIS PF and PI scores. The supraspinatus correlated more closely with PROMIS PF scores, while the subscapularis correlated more closely with preoperative PROMIS PI scores. These findings suggest that this novel 3D volumetric measurement modality, through a more holistic assessment of the RC unit, may provide a more accurate preoperative assessment of RC pathology and global shoulder function. Future research should be focused on assessing the prognostic utility of these novel assessments on postoperative PRO measures. [ABSTRACT FROM AUTHOR]

Objectives: OBJECTIVES: Biochemical joint tissue changes are associated with the development of posttraumatic osteoarthritis (PTOA). Serial assessments of serum biomarkers related to cartilage degradation are predictive of symptomatic progression of idiopathic knee OA but have not been explored in patients with symptomatic PTOA following anterior cruciate ligament (ACL) injury. Both serum and synovial biomarker profiles of inflammation and cartilage degradation post-ACL injury and ACL reconstruction (ACLR) have been associated with deleterious changes of magnetic resonance imaging markers of tibiofemoral cartilage composition (i.e., lower proteoglycan density and poor collagen organization) which precede radiographic PTOA development. However, it is unclear if biochemical changes post-ACL injury and ACLR are also associated with clinically relevant knee OA symptoms. The purpose of this study was to determine if changes in biochemical biomarker profiles preoperatively to 6-months post-ACLR were associated with clinically relevant knee symptoms related to PTOA at 12-months post-ACLR. Methods: METHODS: Participants with a primary history of ACL injury who were planning on undergoing ACLR with a bone-patellar tendon-bone autograft were included in the prospective, longitudinal cohort study. Serum was collected from participants at three separate study visits: i) preoperatively within 15 days of ACL injury; ii) 6 months post-ACLR; and iii) 12 months post-ACLR. Blood samples from the antecubital fossa were collected in 5 mL serum separation tube vacutainers, centrifuged at 3000 rpms and -4°C, and stored in aliquots at -80°C both preoperatively and 6 months post-ACLR. At 12 months post-ACLR, participants completed the Knee Injury and Osteoarthritis Outcome survey. Upon completion of the study, serum samples were batch processed using commercial enzyme-linked immunosorbent assays (ELISA) to determine biomarker concentrations of monocyte chemoattractant protein 1 (sMCP-1), cartilage oligomeric matrix protein (sCOMP), matrix metalloproteinase 3 (sMMP-3), and type-II collagen degradation to synthesis ratio (sC2C:sCPII) which assess inflammation, cartilage breakdown, cartilage degradation, and cartilage turnover, respectively. KOOS subscale scores were calculated on a scale of 0-100. Participants were classified as Symptomatic or Asymptomatic based on Englund et al. cut off scores for each KOOS subscale which were previously validated in patients with radiographic and symptomatic knee OA after a traumatic knee injury. A K-means cluster analysis was used to determine serum biochemical biomarker profiles based on z-score changes in sMCP-1, sCOMP, sMMP-3, sC2C:sCPII preoperatively to 6 months post-ACLR. One-way ANOVAs were used to determine statistically significant differences between biochemical biomarker changes and characterize the profiles of each group. Independent t-tests were used to assess differences in KOOS subscale scores between each group profile and P-values were Bonferroni corrected for multiple comparisons (p<0.0125). Cohen's d effect sizes were calculated to determine the magnitude of differences between groups. Odds ratios (OR) and 95% confidence intervals (CIs) were also calculated to determine the odds of being classified as Symptomatic and reporting clinically relevant, OA-related symptoms. Results: RESULTS: Thirty-six participants completed all study visits and were dichotomized into groups based on changes in biochemical biomarker profiles over 6 months post-ACLR (Table 1). Group 1 (n=15) was characterized by increases in sMCP-1 and sCOMP preoperatively to 6-months post-ACLR (sMCP-1: p<0.001, d=1.75, 95% CI=[0.96-2.52] and sCOMP: p<0.001, d=1.45, 95% CI=[0.70-2.20]) and Group 2 (n=21) was characterized by decreases in sMCP-1 and sCOMP preoperatively to 6-months post-ACLR (Figure 1). No statistically significant differences were found for changes in sMMP-3 (p=0.18, d=0.46, 95% CI=[-0.22-1.13]) or sC2C:sCPII (p=0.10, d=-0.57, 95% CI=[-1.25-0.11]) preoperatively to 6-months post-ACLR between groups. Group 1 characterized by serum biochemical biomarker profiles with increasing sMCP-1 and sCOMP preoperatively to 6-months post-ACLR did not demonstrate statistically significant differences in self-reported knee pain (p=0.72, d=-0.12, 95% CI=[-0.79-0.54]), symptoms (p=0.96, d=0.02, 95% CI=[-0.64-0.68]), activities of daily living (p=0.89, d=-0.05, 95% CI=[-0.71-0.62]), sport (p=0.99, d=0.01, 95% CI=[-0.66-0.67]), or quality of life (p=0.99, d=0.00, 95% CI=[-0.66-0.67) at 12 months post-ACLR (Figure 2) compared to Group 2 characterized by serum biochemical biomarker profiles with decreasing sMCP-1 and sCOMP preoperatively to 6-months post-ACLR. There were no statistically significant associations between serum biochemical biomarker groups and symptomatic OA status (OR=2.13, 95% CI=0.51-9.01). Conclusions: CONCLUSION: Pre-operative and post-ACLR changes in biochemical biomarker sampling revealed a group of ACLR patients with increased biomarker concentrations associated with inflammation (sMCP-1) and cartilage breakdown (sCOMP). Serum biomarker changes from the pre-operative to the 6-month post-ACLR time points had no predictive value with respect to patient reporting of clinically relevant knee OA symptoms 12 months post-ACLR. Therefore, serum biochemical changes post-ACLR may play a role in worsening knee joint health as reported in prior studies, but not poor symptom development related to PTOA. Future research is needed to assess the mechanistic role of biochemical changes in symptomatic PTOA development. [ABSTRACT FROM AUTHOR]

Objectives: Osteochondritis dissecans (OCD) is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis. There are limited evidence-based guidelines to predict which lesions will heal with non-operative treatment. Therefore, this study primarily aims to design and train a classification algorithm to determine whether a patient with OCD of the knee will heal with non-operative treatment from intake visit characteristics. Methods: The Research in OsteoChondritis of the Knee (ROCK) cohort is the largest repository of OCD subjects, which has collected data on over 1400 subjects with OCD knee lesions. It is a longitudinal study at 23 participating institutions. It is registered with ClinicalTrials.gov (NCT02771496). The cohort size and fine level of detail permit optimal algorithm development and allow the present study to consider whether anatomic, image-based, or demographic factors play a role in a lesion's nonoperative healing capacity. The ROCK cohort included all patients seeking care for OCD lesions at any of the participating institutions, except those specified by the following exclusion criteria: (1) diagnosis of a focal chondral defect, (2) patients 26 years or older at the time of enrollment, (3) patient records missing data regarding OCD lesion location, (4) patient records with an incomplete or unverified screening form, and (5) patient records with an incomplete or unverified initial visit form. Subjects were further excluded from the study if data were missing for any feature required for model development. Additional inclusion criteria were that each patient meets the necessary definitions for failure or success of nonoperative management. Failure of nonoperative management was defined as the crossover from nonoperative management to surgery at any point at or beyond three-month follow-up. Successful healing was defined as complete healing on imaging with full return to sports participation. To replicate previous studies examining the healing potential of OCD lesions with logistic regression (Wall et al., JBJS, 2008; Krause et al., AJSM, 2013) a multivariate logistic regression model was developed to ascertain the effects of age, normalized lesion dimensions, and isolated pain or mechanical symptoms on the likelihood of the success of nonoperative management. A second model added sex, race, lesion plane on sagittal and coronal MRI, and lesion anatomical location (lateral femoral condyle, medial femoral condyle, or trochlea) as additional features. Next, a suite of machine learning algorithms, including a random forest classifier, a neural network, linear and radial-kernel support vector machines, a k-nearest-neighbor classifier, and a generalized boosted classifier, was developed using all available features. Each model type was hyperparameter tuned with five-fold cross-validation repeated ten times to select the best model. The raw classification accuracy and area under the receiving operating curve (AUC) were recorded. Results: The current study population includes 81 subjects. The average age in the study cohort was 12.10 years and 38.3% of subjects were female. 72.8% of lesions occurred in the medial femoral condyle, 18.5% in the lateral femoral condyle, and 6.2% in the trochlea. A full description of relevant cohort characteristics is included in Table 1. The logistic regression model developed by previous studies had a cross-validated accuracy of 65.3% and an AUC of 0.645. Only normalized lesion width was associated with an increased likelihood that a lesion would heal nonoperatively (OR = 1.16, CI = 1.04-1.31, p = 0.013). The extended regression model had a cross-validated accuracy of 71.2% and an AUC of 0.750. In this model, coronal lesion location in the lateral or medial-most zone (OR = 0.02, CI = 0.00-0.31, p = 0.012) and sagittal lesion location in the posterior zone (OR = 0.03, CI = 0.00-0.018, p < 0.001) on MRI were associated with an increased likelihood of successful nonoperative treatment. By contrast, increased normalized lesion width was associated with an increased likelihood of nonoperative failure (OR = 1.67, CI = 1.30-2.32, p<0.001). Table 2 compares the effect sizes, odds ratios, and significance for predictors included in the two logistic regression models. A hyperparameter-tuned generalized boosted classifier had the highest cross-validated accuracy and AUC of any model at 74.8% and 0.762, respectively. Regarding the importance of predictor variables: normalized lesion width was the most important variable in the generalized boosting model, followed by lesion location in the posterior sagittal zone, age, the presence of mechanical symptoms, and normalized lesion length. Other variables were not used to determine whether lesions would heal nonoperatively. Table 3 compares the performance characteristics of the three models. Conclusions: Machine learning models can predict which OCD lesions will heal with nonoperative management. Canonical models such as logistic regression can determine risk factors for nonoperative failure and serve as a clinician decision-aid with acceptable sensitivity and specificity profiles following the first encounter with a patient. Advanced machine learning algorithms, such as generalized boosted classifiers, can produce better predictive accuracy for clinical use. Normalized lesion width, lesion location in the posterior sagittal zone, patient age, the presence of mechanical symptoms, and normalized lesion length were the most important variables for successful lesion classification in the best-performing model. In the future, model performance should be tested on new, prospective patient data and compared to clinician decision-making to validate its performance. [ABSTRACT FROM AUTHOR]

Objectives: Contextualizing patient-reported outcomes (PROs) can help to differentiate meaningful outcomes. Measures such as patient acceptable symptom state and minimum clinically important difference have been increasingly investigated in recent years. Assessment of patients' perception of being "completely better" (CB) after hip arthroscopy has not been studied and may be of particular value for this rapidly growing field. The purpose of this study was to assess the rate of patient-reported CB status 2 years after hip arthroscopy and determine associations with PROs. Methods: An orthopaedic registry at a single institution was retrospectively analyzed. All patients who underwent hip arthroscopy from 2015 to 2020, and had 2 year follow up data were included in this study. Patients were administered Patient-Reported Outcomes Measurement Information System (PROMIS) in six domains, Numeric Pain Score, Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) expectations domains and Surgical Satisfaction Questionnaire (SSQ8) preoperatively and at 2 years postoperatively. Patients completed a CB anchor question at 2 years after surgery. Threshold values for PRO scores associated with achieving a CB status were identified with 90% specificity. Variables were selected a posteriori for inclusion into multivariable analysis based off Area Under Curve (AUC) greater than 0.80 on a receiver operating characteristic (ROC) curve. Results: Overall, 29 of the 62 patients (46.8%) reported their condition CB at 2 years postoperatively. There were no differences in demographics of age, sex, BMI, race, prior hip surgery, pre-op opioid use, or smoking status between the CB and non-CB groups (Table 1). The 2-year and change in PROMIS Physical Function, Pain Interference, Social Satisfaction, Fatigue, and Anxiety, and MODEMS Met Expectations, and SSQ8 PROs were significantly better in the CB group than in the non-CB group (Table 2). Numeric Pain Score in the operative hip was significantly better at 2 years in the CB group. There were no differences in preoperative expectations between groups. Thresholds of 2-year PROMIS PF ≥51.3, change in PROMIS PF ≥12, 2-year PROMIS PI ≤46.6, change in PROMIS PI ≤-12.2, 2- year Numeric Pain Score - operative hip ≤1.0, MODEMS Met Expectations ≥ 95.0, and 2-year SSQ8 ≥ 87.5 were the best predictors of achieving CB status (Table 3). Multivariate analysis of CB status demonstrated that SSQ8 and change in PROMIS Physical Function were independent predictors of CB status when controlling for potential confounding variables (Table 4). Conclusions: Almost half of hip arthroscopy patients reported being completely better 2 years after surgery. Multiple PROs including physical function, pain, and satisfaction were significant associated with CB status. Improvement in PROMIS Physical Function and two-year satisfaction were independent predictors of CB status. This is the first study to assess CB status 2 years after hip arthroscopy and provides contextualization to PROs for orthopaedic surgeons and researchers. [ABSTRACT FROM AUTHOR]

Objectives: To report midterm outcomes following primary meniscal allograft transplantation (MAT) from a single surgeon in an adolescent population. Methods: A retrospective review was performed to identify adolescent patients <18 years old at the time of primary MAT from 1999-2016. International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, and Lysholm scores were collected preoperatively and at 1-year, 2-years, and a minimum of 5-years follow-up. Results: Forty-four (female n=33; male n=11) of 62 identified patients (71%) met inclusion criteria with a mean follow-up of 9.5 ± 3.8 years (range: 5.0-17.7). Isolated MAT was performed in 27 (61.3%) patients. Common concomitant procedures included osteochondral allograft transplantation (OCA) (n=14, 31.8%), autologous chondrocyte implantation (ACI) (n=8, 18.1%), and anterior cruciate ligament reconstruction (ACLR) (n=6, 13.6%) (Table 1). Eleven patients (25%) required a reoperation an average 5.9 ± 4.5 years (range: 0.8 - 14.0) post-transplant. Three (6.8%) patients met criteria for failure, requiring revision MAT an average of 3.8 ± 1.1 years (range: 2.84.9) post-transplant. Graft survivability at 1, 2, 5, and 10 years was 100.0%, 100.0%, 93.2%, and 93.2%, respectively (Figure 1). When compared to preoperative scores, significant increases in Lysholm, IKDC, and KOOS subscales were observed at 1-year, 2-year, and most recent follow-up (Figure 2 and Supplemental Table 1). 90% of patients reported satisfaction with their current physical status. Conclusions: At midterm follow-up, primary MAT in the adolescent population resulted in predictable improvements in functional outcomes. These improvements were maintained at an average follow-up of 9.5 years. The meniscal reoperation rate was 25% with a 71.3% probability of being reoperation free at 5 years while graft survivability was 93.2% at 5 years. When compared to extant literature profiling MAT in the adult population, adolescents who undergo MAT demonstrate similar functional outcomes and graft survivability. [ABSTRACT FROM AUTHOR]

Objectives: A double button technique using a cortical button on both the humeral and ulnar sides of the UCLR for fixation has recently been proposed, with advantages including greater control over graft tensioning and decreased risk of bone tunnel fracture. This double cortical button technique was recently evaluated biomechanically and found to be non-inferior to the traditional docking technique regarding strength, joint stiffness, and graft strain. However, clinical outcomes have not been compared between the double cortical button technique and standard UCLR techniques such as the docking technique. Therefore, the purpose of this study was to determine whether baseball players who underwent UCLR with a double cortical button (double button) technique have similar return to sport (RTS) rates, time to RTS, and subjective outcomes compared to baseball players who underwent UCLR with the traditional docking (Docking) technique. Methods: Competitive baseball players that underwent primary UCLR from 2011-2020 at across two institutions were identified using the CPT code 24346. Patients were excluded if they were not baseball players or if they did not undergo UCLR with the double button or docking technique. Included patients were contacted via RedCap to complete a follow-up survey evaluating reoperations, RTS, functional outcome scores, and patient satisfaction. Functional outcome surveys include the Kerlan-Jobe Orthopaedic Clinic (KJOC) score, Conway-Jobe score, Andrews-Timmerman (AT) elbow score, and the Single Assessment Numeric Evaluation (SANE) score. Results: Overall, 78 male baseball players (age: 18.9 ± 2.4 years) with an average follow-up of 3.1±2.4 years were evaluated, with 73 of the players being baseball pitchers and 55 (71%) of players completing the functional outcome surveys. Players in the double button group more frequently received palmaris longus autografts (78% vs. 30%) and less frequently received both gracilis autografts (22% vs. 58%) and allografts (0% vs. 13%) compared to players in the docking group (p=0.001); however, all other demographic factors were similar between groups (Table 1). All post-operative and patient-reported outcomes were also similar between groups. All players in the double button group (100%) were able to RTS in 11.1±2.6 months, while 96% of players in the docking group were able to RTS in 13.5±3.4 months (p>0.05). All other post-operative outcomes and patient-reported outcomes were statistically similar between groups, and remained similar after isolating pitchers only and after separating partial-thickness from full-thickness UCL tears (all p>0.05) (Tables 1-3). Two complications were observed in the docking group, with one player experiencing pain at elbow extension due to nerve neurolysis and another player developing an elbow stress fracture during rehabilitation, while no double button players experienced a complication. Conclusions: Post-operative outcomes were similar between baseball players who underwent UCLR with the double button technique and the docking technique. These findings provide the first clinical outcomes in support of a recent cadaveric study which showed the double button technique to provide similar elbow strength, joint stiffness, and graft strain compared to the docking technique. Larger comparative studies are necessary before a clear clinical recommendation can be made regarding the utilization of double button UCLR for baseball players. [ABSTRACT FROM AUTHOR]

Objectives: Glenoid bone loss in the setting of recurrent shoulder instability remains a challenging surgical problem. The coracoid process and iliac crest currently serve as primary autograft options for glenoid reconstruction. With regards to allograft alternatives, the distal tibia, first described in 2007, has good midterm outcomes when used during an index surgery and in cases of failed prior Latarjet reconstruction. While the distal tibia performs well in reconstructing the glenoid bony defect, it is a nonanatomic reconstruction and does not match the glenoid radius of curvature (ROC) in the anterior to posterior (AP) plane. No prior work has evaluated and described the utilization of the dorsal articular portion of the distal radius as an allograft reconstruction option for recurrent instability with glenoid bony deficiency. The purpose of this study was to evaluate distal radius fresh frozen allograft as a potential match for glenoid reconstruction through assessment of graft ROC and bone mineral density (BMD). Distal tibia allograft was utilized as the primary comparison group with both cadaveric and Computerized Tomography (CT) analysis. Methods: Eighteen fresh-frozen human cadaveric specimens (6 shoulder, 6 wrist, and 6 tibia) were utilized for this study. Specimens without osteoarthritis or prior surgical procedures were included. CT scans were obtained of all specimens to confirm the absence of osteoarthritis, significant joint deformity, or evidence of prior surgical procedure. Specimens were dissected free of all soft tissues except for the glenoid labrum of the shoulder and dorsal wrist ligaments of the distal radius. The ROC for each specimen were independently measured by two fellowship trained shoulder surgeons in both the superior to inferior (SI) and AP planes. Graft length in the SI plane was also assessed. A thirty percent defect was then created in all glenoid specimens and both distal tibia and distal radius grafts were harvested to assess graft fit post-fixation [Figure 1]. CTs were also analyzed to assess bony ROC and BMD for each specimen. Results: On cadaveric analysis, the mean SI graft length of the glenoid was 39.7 mm compared to 36.8 mm for the distal radius and 30.0 mm for the distal tibia [Table 1A]. Average ROC in the SI plane was 29.0 +/- 5.3 for the glenoid, 37.8 +/- 4.9 for the distal radius and 24.0 +/- 3.7 for the distal tibia; in the AP plan average ROC was 39.6 +/- 6.6 for the glenoid, 30.4 +/- 18.6 for the distal radius and 126.3 +/- 9.5 for the distal tibia [Table 1B]. On CT analysis, average ROC in the SI plane was 30.4 +/- 1.5 for the glenoid, 30.3 +/- 5.6 for the distal radius and 24.5 +/- 9.4 for the distal tibia; in the AP plane average ROC was 30.8 +/- 2.0 for the glenoid, 19.1 +/- 2.3 for the distal radius and 46.7 +/- 21.7 for the distal tibia [Table 2A]. Mean BMD was 226.3 +/- 79.0 for the glenoid, 228.5 +/-94.7 for the distal radius, 235.0 +/- 96.2 for the coracoid process, and 235.1 +/-84.6 for the distal tibia [Table 2B]. Conclusions: Given fresh frozen allograft supply and cost constraints, exploration of additional graft options is necessitated. This study presents distal radius allograft as a novel reconstruction option for patients with anterior glenoid bone loss in the setting of recurrent glenohumeral instability. Compared with the distal tibia allograft, the distal radius had greater graft length in the SI plane providing possible utilization in cases of larger bony defects. The distal radius also has a more acute ROC in the AP plane (closer to that of the glenoid) compared with the distal tibia allograft providing a greater potential buttress to anterior humeral translation. Furthermore, the distal radius also has potential to employ the dorsal radio-carpal ligaments to perform an anterior capsular repair following allograft fixation. Finally, compared to currently utilized grafts (coracoid process and distal tibia), the distal radius BMD was not significantly diminished on CT analysis. This study presents the distal radius as a novel allograft reconstruction option in the setting of glenoid bone loss; further biomechanical and clinical investigation is indicated. [ABSTRACT FROM AUTHOR]

Objectives: Acetabular coverage has significant implications in both acetabular dysplasia and femoroacetabular impingement syndrome (FAIS), with both undercoverage (dysplasia) and overcoverage (pincer-type FAIS) contributing to symptoms, labral tears, and degenerative joint changes. Measurements of acetabular coverage inferred from 2D imaging have been shown to be unreliable, and they provide a limited view of complex 3D morphology. Consequently, there is a need 1) for a consistent technique to allow for accurate, repeatable measurement of acetabular coverage and 2) to determine whether and to what degree 2D radiographic measures of acetabular coverage are related to 3D measures. Thus, the objectives of this study were to utilize novel 3D modeling techniques to 1) compare 3D acetabular coverage between patients undergoing HA followed by periacetabular osteotomy (PAO) for combined dysplasia and FAIS to patients undergoing HA alone for FAIS and 2) evaluate the association between 2D radiographic measures of acetabular coverage--lateral center edge angle (LCEA) and Tönnis angle (TA, acetabular index)--and acetabular coverage as measured on 3D osseous models. Methods: An IRB-approved retrospective review of all patients who underwent HA+PAO from a large orthopedic practice from 2017-2021 was conducted. Included patients had a preoperative anteroposterior (AP) pelvic radiograph and CT scan of the full pelvis and bilateral proximal femurs. HA+PAO patients were matched 1:1 by sex, age, and body mass index (BMI) to patients who underwent HA alone. LCEA and TA were measured on AP pelvic radiographs. Dysplasia subgroups were defined as severe (LCEA < 15°), moderate (LCEA 15°-19.9°), mild/borderline (LCEA 20°-24.9°), and normal/non- dysplastic (LCEA 25°-39.9°). 3D osseous models of the femur and acetabulum were reconstructed from CT scans (Materialise Mimics v24.0) and uploaded into 3D modeling software (Materialise 3-matic v16.0). Acetabular coverage of the femoral head was measured by projecting the acetabular surface onto the femoral head surface as delineated by the acetabular rim profile. A coronal, transverse, and sagittal plane were made. The coronal plane was established by first defining a reference plane using points on both anterior superior iliac spines and the pubic tubercle on the affected side. A parallel plane was then created that passed through the affected femoral head center (FHC). The transverse plane was created by making a true horizontal plane passing through the FHC. Finally, the sagittal plane was established as a plane perpendicular to both the coronal and transverse planes and passing through the FHC. Total coverage was evaluated as the percentage coverage of the superior half of the femoral head (above the transverse plane), which was further divided by the coronal and sagittal planes into quadrants: anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL). Percentage coverage of these quadrants was also quantified. 3D acetabular coverage, demographic characteristics, and 2D radiographic measurements were compared between the HA+PAO and HA groups using independent samples t-tests. Correlation and linear regression analyses were performed among all 52 patients. Correlations between 2D LCEA and TA versus 3D acetabular coverage were evaluated using Pearson correlation coefficients. Linear regression was performed evaluating the relationship between 2D LCEA and TA and 3D acetabular coverage. Significance was established using an a priori a of 0.05. Results: Twenty-six dysplastic patients (9 severe, 12 moderate, 5 borderline) who underwent HA+PAO were matched to 26 non-dysplastic controls who underwent HA alone. There were no significant differences in sex, age, or BMI between the groups (p > 0.9). Preoperative 2D LCEA and TA were significantly lower in the HA+PAO group (p < 0.001). 3D acetabular coverage was significantly decreased in the HA+PAO group globally and in the AM, AL, and PL quadrants (p < 0.001). The largest difference in mean coverage between the HA+PAO and HA groups was seen in the AL quadrant (12.8%), followed by the PL quadrant (-11.3%, Figure 1, Figure 2). There was no significant difference in 3D acetabular coverage in the posteromedial quadrant (p = 0.117, Table 1, Figure 2). There were significant correlations of fair to very high strength between both 2D LCEA and TA and 3D coverage globally and in all quadrants (p < 0.001). The strongest correlations by quadrant were between 2D LCEA and 3D coverage anterolaterally (r = 0.835) followed by posterolaterally (r = 0.716). Upon linear regression analysis, 2D LCEA was a significant predictor of 3D coverage globally and in all quadrants (p ≤ 0.025), whereas 2D TA was not (p ≥ 0.4). Conclusions: This study utilized novel 3D modeling techniques to demonstrate that patients with acetabular dysplasia as defined by 2D LCEA have decreased 3D acetabular coverage globally and in each quadrant except the posteromedial quadrant. The decrease in coverage is most pronounced in the AL quadrant, followed by the PL quadrant. The study also demonstrated that both 2D LCEA and TA correlate significantly with 3D acetabular coverage; however, only LCEA is a significant predictor of 3D acetabular coverage globally and in all quadrants. The correlation between 2D LCEA and 3D coverage is strongest in the AL followed by the PL quadrant. These findings suggest that only 2D LCEA, not TA, is a useful radiographic measure of 3D coverage, and it is most useful for predicting coverage laterally, particularly anterolaterally. The further use of 3D modeling to uncover significant anatomical differences in multiple dimensions that are not apparent with 2D radiographic measures alone may have important impacts on patient selection, treatment modalities, surgical planning, and postoperative assessment. [ABSTRACT FROM AUTHOR]

Objectives: Overhead throwing athletes, notably pitchers, subject the elbow to tremendous valgus stress, and numerous studies have demonstrated an increasing incidence of ulnar collateral ligament of the elbow (UCL) injury. However, surgical reconstruction has transformed this injury from career-ending to career-interruptive. Two primary techniques exist for UCL reconstruction (UCLR): 1) the Modified Jobe and 2) the Modified Docking techniques. Prior biomechanical comparisons have reported equivalent ulnohumeral stability. Systematic reviews of clinical studies have suggested that the Docking technique may result in improved rates of return to play (RTP) and fewer complications, but these comparisons have been indirect and complicated by changes in technique. Our objective was to perform the first prospective, randomized comparison of UCLR utilizing the Modified Jobe or Modified Docking technique as measured by Kerlan-Jobe Orthopaedic Clinic (KJOC) score, Andrews-Timmerman score, and Conway-Jobe score. As secondary outcomes, we sought to compare pre- and postoperative imaging characteristics, required tourniquet times, rate of complications, and RTP data. We hypothesized that no difference exists between the two techniques with regard to any of the above outcomes. Methods: This study was a single-surgeon, prospective, randomized trial comparing the Modified Jobe and Modified Docking techniques for primary UCLR. Patients were eligible if they had clinical and radiographic evidence of UCL injury and participated in overhead sports. Patients were excluded if they were not an overhead athlete, lacked clinical and radiographic evidence of a UCL tear, or had a history of previous elbow surgery. An a priori power analysis was performed utilizing historic data from both techniques to generate a sample size of 80 (40 in each group). All patients were randomized to one of the two techniques for UCLR using a standardized, contralateral gracilis autograft. All patients underwent the same postoperative rehabilitation protocol including throwing and batting progressions. Patient reported outcomes (PROs; KJOC score, Andrews-Timmerman score, and Conway-Jobe score) were obtained preoperatively and at 6 months, 1 year, 18 months, and 2 years postoperative. Pre- and post-operative imaging including both stress ultrasound (SUS) and magnetic resonance (MRI/MRA) were obtained. Additional information including demographics, intraoperative data, complications, and RTP data were collected. T-tests or Mann-Whitney U tests were used to calculate differences between continuous data. Chi-Square or Fisher's Exact were used for categorical data. Results: There were 40 patients (38M/2F) enrolled in the Jobe group and 40 patients (39M/1F) enrolled in the Docking group. Demographics including sex ratio, age, time between injury and surgery, and sport and level of play were similar between groups. Detailed patient demographic data is given in Table 1. Six patients in the Jobe group and eight patients in the Docking group underwent concomitant anterior subcutaneous UNT (p=0.769). Gracilis autograft harvest and closure required similar mean tourniquet time in both groups (28.7 minutes in Jobe group vs 28.3 minutes in Docking group; p=0.721). However, UCLR required significantly longer upper extremity tourniquet time in the Jobe group (101.0 minutes vs. 92.0 minutes; p=0.008). Preoperatively, patients reported similar levels of function via all PROs. Postoperatively at 6 months, 1 year and 18 months, both groups reported similar PROs. At two years, patients reported similar scores in terms of Andrews Timmerman and Conway Jobe scores, however the Docking group reported significantly higher mean KJOC scores (75.0 vs 85.0; p=0.025). Following surgery, both groups took a similar mean time to swing a bat, to begin tossing, and to begin a mound program. Of the patients that returned for two year follow up in clinic, 28/32 in the Jobe group returned to play at a mean of 13.4 months, compared to 27/27 in the Docking group who returned to play at 14.3 months (p=0.166). Detailed patient outcome data is given in Table 2. All grafts were intact and showed progressive healing on MR and SUS at final radiographic follow-up. There were no significant differences in the rate of complications. One patient in the Docking group required reoperation with revision ulnar nerve decompression with transposition for persistent ulnar nerve symptoms. No patient in the Jobe group required reoperation. Conclusions: This study is the first and only prospective, randomized trial evaluating the outcomes of the Modified Jobe and Modified Docking techniques for UCLR. The study identified high rates of good-to-excellent results with equivalent RTP rates and time to RTP for both techniques. Surgeons should continue to utilize the technique with which they are most comfortable, but the Docking technique demonstrated reduced tourniquet times and superior KJOC scores at 2 years. [ABSTRACT FROM AUTHOR]