HSS which is nationally ranked No. 1 in orthopedics (for the 13th consecutive year), by U.S. News & World Report (2022-2023) will provide MLP athletes with access to the industry’s best clinicians for sports medicine and its related disciplines at each tournament throughout the year. Joshua S. Dines, MD, will serve as the league’s Medical Director and oversee the coordination of all physician and clinical staffing, and the management of player health throughout the season. 

“At HSS, we are proud to offer Major League Pickleball the same dependable and high-quality care that the athletes at all levels have consistently trusted”, said Dr. Dines, a sports medicine surgeon in the HSS Sports Medicine Institute. “Injuries are inevitable; therefore, we will work with the athletes to effectively identify risk factors and introduce injury prevention and recovery tactics into their routines during the league’s first full season.” 

HSS is among four new corporate sponsors for the league, and it will receive branding through signage and product display at all MLP events as the league’s official hospital. HSS will also have opportunities for content, fan engagement, and other experiential activations throughout the season. The one-year deal includes an option to extend past the 2023 campaign. 

“Major League Pickleball is honored to partner with HSS for the 2023 season,” Brian Levine, Interim CEO of Major League Pickleball says. “HSS is a distinguished leader in the healthcare industry and having them as a partner will provide our athletes with world class support both in terms of injury prevention and recovery.” 

For its first year, the MLP schedule will be divided into two “seasons”, which consist of three events each season, in 2023. The league is broken into two levels. In the MLP Premier Level, 12 teams will compete, and those rosters will be comprised of the first 48 drafted players into the league. The next 48 players drafted will play in the MLP Challenger Level, and those rosters will consist of two men and two women. After the first season is complete, teams will flip levels and there will be a re-draft for the second season. The MLP is offering up to $5 million in both prize money and pay outs to all players in 2023 following the league’s expansion to 24 teams. 

About Major League Pickleball:

Major League Pickleball (MLP) is the premier team league and the standard-bearer for the fastest-growing sport in the United States. MLP is committed to perpetuating the sport's larger role in society and permeating every facet of pickleball’s business, marketing, and community relations. With iconic team owners, a co-ed team format, an innovative draft, easy to understand scoring, groundbreaking broadcast quality, and the highest prize money events in pro pickleball, MLP’s goal is to elevate and grow the sport in everything it does. 

In December 2022, MLP named its first-ever title sponsor, Margaritaville, branding the league MLP by Margaritaville. A global lifestyle brand inspired by Jimmy Buffett, Margaritaville, has served more than 20 million travelers and consumers every year to change their latitude and attitude with Margaritaville. For more information, visit margaritaville.com. 

For more information on Major League Pickleball, visit MajorLeaguePickleball.net and follow Major League Pickleball on Facebook, Twitter, Instagram, TikTok and YouTube.

The results were published in the Orthopaedic Journal of Sports Medicine on December 10, 2020.

“This is an important topic as we continuously look to refine and develop evidence-based injury-prevention and recovery guidelines for baseball pitchers,” said Joshua S. Dines, MD, sports medicine surgeon at HSS and senior author. “Creating data-driven programs requires us to have a better understanding of the kinetic and kinematic implications of a variety of throwing programs.”

Both elbow and shoulder injuries such as ulnar collateral ligament (UCL) tears continue to be on the rise in all baseball players but especially those at the high school level. UCL treatment (also known as Tommy John surgery) has increased sixfold over the last 20 years among this age group. To try to combat this, coaches and clinicians monitor workload, making constant adjustments to keep players healthy.

While workload has been a highly researched topic, the effects of mound height and distance to home plate have not been studied.

“As we’re monitoring pitchers’ workloads, we need to be aware of the stress being placed on the throwing arm elbow during training and rehabilitation in order to make the right adjustments to that individual pitcher’s training regimen,” added Dr. Dines.

Twenty-one healthy high school pitchers wore a sensor arm sleeve while pitching from four different conditions. The sensor and a radar gun were used to record data such as arm speed, arm slot, shoulder rotation, elbow varus torque and ball velocity. The results showed that there is no statistically significant difference between these variations.

“In the past, it has been assumed that throwing from flat ground was safer than throwing off of a mound due to increased elbow torque,” said study co-author Kathryn D. McElheny, MD, primary sports medicine physician at HSS. “Our study findings did not support this notion. Furthermore, we saw that elbow stress and ball velocity may not have a perfect correlation.”

The researchers concluded that pitchers were using similar mechanics (arm speed, shoulder rotation, elbow varus torque) whether throwing from the mound or flat ground, so this knowledge can be factored into player workload calculations.

A new retrospective study from Hospital for Special Surgery (HSS) evaluated 72 patients who underwent arthroscopic SCR with dermal allograft to treat symptomatic irreparable rotator cuff tears. All patients were operated on at HSS between 2012 and 2017. Nearly 42% of the patients had a history of failed rotator cuff repair.

After surgery, the overwhelming majority of patients demonstrated significant improvements in forward elevation, abduction and external rotation through their pre- and post-operative active range of motion. At follow-up appointments, patients completed various patient-reported outcome surveys including Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angeles (UCLA). Patient scores were high, averaging 80%, 78% and 85%, respectively.

Five patients required a second operation – no other complications were recorded.

“This technique has proven to be effective for patients with irreparable tears,” said Joshua S. Dines, MD, HSS sports medicine surgeon and senior study author. “As we continue to do more outcomes research, we become more precise at predicting the best candidates for each technique. While not for everyone, this has emerged as a great option for patients who may not be right for a reverse shoulder replacement.”

The authors look to perform future research evaluating the long-term outcomes and results.

This study is available online as part of the AAOS 2020 Virtual Education Experience.

Abstract Title: Clinical Outcomes following Arthroscopic Shoulder Superior Capsular Reconstruction

Authors: Daniel Hurwit, MD, Justin Chan, Michael Fu, MD, John Apostolakos, MD, Stephen Fealy, MD, Frank Cordasco, MD, David Dines, MD, Lawrence Gulotta, MD, Joshua Dines, MD.

Reconstruction is the current standard of care surgical treatment for tears of the anterior cruciate ligament (ACL). This procedure typically uses a graft, or a piece of tissue, placed in the knee minimally invasively, using small incisions. About 300,000 ACL reconstructions are performed annually in the United States with well documented rates of success.

ACL repair is an older technique that involved suturing (sewing) torn ACL tissue, not rebuilding it with a graft. ACL repair was performed in the 1970s at select institutions, including Hospital for Special Surgery, but was abandoned due to unacceptably high failure rates of up to 50%.

Today, ACL repair has been modernized and can be performed through a minimally invasive approach. Proponents suggest that modern ACL repair techniques may be performed safely and may lead to a quicker recovery than ACL reconstruction. However, the limited studies to date raise questions that must be discussed in detail with your surgeon.

1. It is critically important to get ACL surgery right the first time.

When ACL surgery fails, surgeons must do a revision procedure to correct or revise the problems that were not fully addressed the first time. Revision requires reconstructive ACL surgery with a graft. (ACL repairs cannot be done as revisions.) Redoing ACL surgery may result in higher rates of failure, lower rates of return to sports, and increased risk of osteoarthritis.

The importance of successful initial ACL surgery holds true for people of all ages, but it is particularly critical for young athletes, for whom a failed surgery can have devastating consequences, including years lost from sport in the short term as well as chronic pain and loss of function in the long term.

2. Failure rates for ACL repair appear to be significantly higher than those for ACL reconstruction in people of all ages.

Current studies suggest that modern ACL repair techniques have a failure rate that may be five to ten times higher than that of ACL reconstruction^1,2,3. One major recent study in a prominent sports medicine journal found that arthroscopic ACL repair has unacceptable outcomes in young athletes, with short-term failure rates of close to 50%².

It has been suggested that ACL repair may be appropriate for older adults who have a type of ACL tear called a proximal avulsion and who do not participate in “cutting and pivoting” sports such as basketball, volleyball, and soccer. For these patients, failure rates in the short term appear to be much higher than ACL reconstruction in this age group^1,2,3.

3. There is still much we don’t know about ACL repair.

There has been no scientific evidence that shows a difference in postoperative pain between ACL repair and reconstruction. Rehabilitation and return-to-play protocols for ACL repair have not yet been established. Proper guidelines for rehabilitation and return to sports are essential to keep people safe from re-injury.
 

Andrew D. Pearle, MD

Chief, HSS Sports Medicine Institute

Bryan T. Kelly, MD

HSS Surgeon-in-Chief and Medical Director

Answorth A. Allen, MD

David W. Altchek, MD

Struan H. Coleman, MD, PhD

Frank A. Cordasco, MD, MS

David M. Dines, MD

Joshua S. Dines, MD

Stephen Fealy, MD

Andreas H. Gomoll, MD

Lawrence V. Gulotta, MD

Jo A. Hannafin, MD, PhD

Anne M. Kelly, MD

John D. MacGillivray, MD

Robert G. Marx, MD, MSc, FRCSC

Michael J. Maynard, MD

Moira M. McCarthy, MD

Danyal H. Nawabi, MD, FRCS

Stephen J. O’Brien, MD, MBA

Anil S. Ranawat, MD

Scott A. Rodeo, MD

Howard Anthony Rose, MD

Beth E. Shubin Stein, MD

Sabrina M. Strickland, MD

Karen M. Sutton, MD

Samuel A. Taylor, MD

Russell F. Warren, MD

Thomas L. Wickiewicz, MD

Riley J. Williams III, MD

References

1. Jonkergouw A, van der List J, DiFelice G. Arthroscopic primary repair of proximal ACL tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing. Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):21-28.

2. Gagliardi AG, Carry PM, Parikh HB, Traver JL, Howell DR, Albright JC. ACL repair with suture ligament augmentation is associated with a high failure rate among adolescent patients. Am J Sports Med. 2019 Mar;47(3):560-566.

3. Wright RW et al. Risk of tearing the intact ACL in the contralateral knee and rupturing the ACL graft during the first 2 years after ACLR: A prospective MOON cohort study. Am J Sports Med. 2007 Jul;35(7):1131-4.

For more information visit https://www.hss.edu/condition-list_torn-acl.asp.

This year, HSS will co-sponsor the 17th Winter Meeting of the Ranawat Orthopaedic Conference (ROC) "Advances & Techniques in Joint Replacement Surgery & Arthroscopy".

The three-day annual conference will include sports- and arthroplasty-focused educational sessions with topics such as recent developments in robotic surgery, computerized navigation, cementless total knee replacement, and unicondylar knee replacement.

"HSS is proud to co-sponsor the Ranawat Orthopaedic Conference, an impactful educational conference that advances the field of musculoskeletal medicine through knowledge-sharing and education," said Laura Robbins, DSW, senior vice president, HSS Education Institute.

The conference is presented by HSS and the Ranawat Orthopaedic Center in New York, NY, and is co-directed by HSS hip and knee surgeons, Chitranjan S. Ranawat, MD, and Amar S. Ranawat, MD; and HSS sports medicine surgeon, Anil S. Ranawat, MD.

This year’s conference will include presentations and clinical case discussions by Drs. Anil and Amar Ranawat, HSS hip and knee surgeon, Jose A. Rodriguez, MD; HSS sports medicine surgeon, Joshua S. Dines, MD; and HSS anesthesiologist David H. Kim, MD.

The conference will take place on February 21-23, 2019 at Hotel Pullman, Aerocity in New Delhi, India and will also be live streamed.

For the past 50 years, Dr. Chitranjan S. Ranawat has performed hip and knee replacements at HSS, dedicating his professional life to the education and training of residents, fellows, and surgeons. He developed the first total knee replacement prosthesis in the early 1970s and has played an integral role in solidifying HSS as an innovator of joint replacements. In 2016, HSS presented Dr. Ranawat with the Lifetime Achievement Award.

"The Ranawats are honored and excited to continue our family’s tradition of teaching surgical education in the latest trends and techniques in arthroplasty and sports medicine in India," said Dr. Anil Ranawat. "We now have a partner in HSS to continue our tradition so we can advance as global leaders in surgical education. As Indian-Americans it gives us great pride to see India Rising."

The Ranawat Orthopaedic Research Foundation has supported orthopaedic research and education in the United States and Asia. With Dr. Ranawat as chairman, the foundation collaborates with pioneers around the world to promote the goal of training orthopaedic surgeons in joint reconstruction surgery and delivering high-value care to patients.

In a recent podcast episode of 'Sideline Data', they interview Joshua S. Dines, MD, sports medicine surgeon at HSS, to gain a better understanding of shoulder and elbow fatigue.

"We’re trying to do better at determining what’s an appropriate amount for a given athlete to throw. Not every 15-year-old is the same, and not every professional baseball player is the same. If you take a reliever who is used to throwing 20 throws and make him throw 100 throws, his shoulder or elbow will break down because they’re not used to that," explains Dr. Dines.

"We’ve started to shift to this acute versus chronic workload ratio and it’s been popular in other sports such as rugby and soccer. It’s not just looking at throwing, you can use it for any muscle or body part. What it does is come up with a better way to quantify how much work an athlete is doing over the short term relative to what they’re typically doing over a longer period of time," adds Dr. Dines.

Listen to the full interview at LeagueApps.com.

Dr. Dines explains that the most common sports injuries that he sees are in the shoulder and knee (particularly shoulder dislocations, ACL tears and meniscus tears). He notes that those are surgical issues and athletes also frequently have minor issues that come and go such as tendonitis, tweaks, and sprains. 

They discuss how some of those injuries - especially ACL tears - used to be career ending but now athletes are returning to sport.

Dr. Dines says that patients used to be in the hospital for a week after an ACL repair and now the recovery is much shorter. Surgical techniques have improved - such as performing surgeries arthroscopically instead of creating a big incision.

As we look to the future, Dr. Dines notes three areas that are progressing: minimally invasive surgical techniques, the use of biologics and improving rehabilitation.

"It's not a one size fits all," he says, explaining the importance of tailoring surgery to each patient's individual anatomy. 

Listen to the full podcast at StarTalkRadio.net.

Dr. Dines explains how since the game itself has become more demanding, the types of injuries have changed. "What used to be tennis elbow, overuse shoulder injuries and rotator cuff tendonitis, now we're seeing a lot more lower body, back, and hip injuries."

Jim Courier was also interviewed and shared his own experience with biceps tendonitis. 

This aired during the November 23, 2018 broadcast.

He interviews Joshua S. Dines, MD, sports medicine surgeon at HSS, who has not treated Sanchez, who explains that debridement is a minor procedure since it's more of a cleanup.

"If you are not repairing anything after surgery, you can get a lot more aggressive quickly because you are not depending on anything to heal," he explained.

Read the full article at NYPost.com. This also appeared in the November 9, 2018 print edition.
 

Dr. Dines explained that it typically takes a year for an athlete to recover from the surgery. He added that if they are throwing harder after recovering, "it's because the athlete did a great job post-operatively in their recovery process".

"Each step of the way has been trying to better recreate the anatomy while being less traumatic to the patient in terms of easing their recovery and improving outcomes," he noted while discussing the evolution of the surgery.

Listen to the full interview at soundcloud.com.

Dr. Dines explained that treating patients at HSS provides him an advantage to staying on top of the latest sports medicine research. "I think by being [at HSS] you're around the latest in research, people who are doing things in a very current way, people who are teaching the rest of the world. So by being there and contributing, you stay ahead of the curve and you become the people who are teaching others," he said.

When asked how to prevent injuries in all sports, Dr. Dines recommended gradually building up to participating in a sport and dedicating time to stretching.

Listen to the full segment at soundcloud.com.

Dr. Dines explains that sports have become year-round activities for young kids, leading to overuse injuries that didn't used to occur in the past in this age group. 

Bert and Dr. Dines discuss how young athletes are bouncing back after ACL tears as well as undergoing Tommy John surgery which used to only be performed in elite athletes.

"Over the last ten years, if you look at the data, probably a majority of them are being done in unfortunately not professionals but more teenagers", says Dr. Dines who explains that these ligaments are breaking down at an earlier age.

They also cover shoulder injuries which can be separations or dislocations (usually in football, lacrosse and hockey), as well as overuse injuries such as in baseball players or swimmers.

Listen to the full segment on YouTube.com.

Dr. Dines, who did not treat the athletes, said that recovery from an ACL injury typically takes nine months.

"If the [ACL] surgery is done appropriately…  there's no reason to expect that [the player] won't be back to his previous level of play," Dr. Dines noted.

Additionally, Dr. Dines explained the importance of building relationships with patients and prioritizing their safety as a professional team physician.

Listen to the full segment at soundcloud.com. This also aired during the September 28, 2018 broadcast.

HSS sports medicine surgeon Joshua S. Dines, MD, who did not treat Westbrook, said "any time you've had three or four clean ups, each time you go in there, there's sort of less cartilage. So at some point, you get to a point where it's almost an arthritis situation."

In terms of recovery, Dr. Dines noted "the quicker [athletes] get the swelling out of there, the quicker their quad strength is going to come back, and they'll be safe enough to return."

Dr. Dines added that new data and treatment could emerge to help athletes with knee ailments, similar to how PRP injections have proven beneficial for arthritis sufferers.

Read the full article at newsok.com [subscription required]. This also appeared in the September 14, 2018 print issue.

Dr. Dines, who did not treat Trout, explained that the two common causes of wrist pain in baseball players.

"One is during the follow-through when swinging the bat, with the momentum of the bat on the back end of the swing torquing the wrist in a sometimes-unnatural position…. The second cause is from sliding into a base and jamming the wrist on the bag or the ground," wrote Dr. Dines.

To treat wrist inflammation, Dr. Dines recommended icing, anti-inflammatories and steroid injections.

Read the full article at forbes.com.

Dr. Dines explained the importance of youth football players staying in shape in the offseason. "All of these youth sports have become such high-level endeavors where when the first official practices start, they expect you to be in midseason form. The people who aren't are behind and set themselves up for a higher risk for injury," he said.

"Playing different sports is great because you're using different muscles, so it makes you a better athlete," Dr. Dines added.

Read the full article at blogs.usafootball.com.

Dr. Dines, who did not treat Ohtani, wrote "the UCL is the main ligament on the medial (inner) aspect of the elbow, and it provides the main resistance to the stresses the elbow is exposed to during throwing. Injuries to the UCL are happening with alarming frequency, likely due in part to how hard pitchers are throwing these days."

Prior to surgery, Dr. Dines pointed out that treatment options typically include rest, PRP and biologics injections.

Read the full article at forbes.com.

Additional Coverage:

• Forbes: Rockets' Chris Paul Is Out For Game 6; Will He Be Ready For A Potential Game 7?
• Forbes: Don't Worry, Egypt: Mohamed Salah's Shoulder Injury Shouldn't Keep Him Out Of World Cup
• Forbes: Concussion May Explain Soft Goals Allowed By Liverpool's Loris Karius

"It really is a multi-faceted approach to kind of diagnosing the injuries and coming up with an appropriate timeline to return to play," said Dr. Dines, who noted that he works with the player, physical therapists and trainers throughout the rehabilitation process. 

He added that "not everybody recovers at the same rate, not all injuries are the same. It's really a day-to-day process checking in and making sure they are progressing well."

This segment aired during the May 20, 2018 broadcast.
 

Dr. Dines pointed out that once a shoulder dislocates, it's important to put it back in place as soon as possible.

"The pain from the injury typically dissipates relatively quickly. After the pain subsides and an athlete regains their full range of motion and strength, they can return to play," wrote Dr. Dines.

Read the full article at forbes.com

Additional Coverage:

• Forbes: Another Year, Another Injury For Dodgers' Clayton Kershaw: How Long Will Biceps Injury Sideline Him?
• Forbes: Dodgers' Corey Seager Learns The Hard Way That Tommy John Surgery Isn't Just For Pitchers

The two-day annual symposium will provide clinicians with guidance on how to care for athletes of all levels. Topics to include: the athlete’s elbow, shoulder instability, the rotational athlete, multiligament knee, concussion management, the female athlete, the athlete’s hip, tendonopathy, and the young athlete’s knee.

The symposium is provided by HSS Office of Continuing Medical Education, Department of Rehabilitation and HSS Sports Medicine, and is co-directed by HSS sports medicine surgeon, Anil S. Ranawat, MD, and HSS physical therapist and certified athletic trainer John Cavanaugh, PT, MEd, ATC, SCS.

"At HSS, we treat over 400 elite athletes a year from over 80 professional teams and over 100 Division 1 programs," said Cavanaugh. "We have a front seat to all of the unique injuries that occur as well as the cutting-edge research performed in our labs. This symposium is a way for us to share our expertise with medical professionals who may be in an outpatient setting and not have the same exposure."

The symposium will take place on March 23-24, 2018 at the Richard L. Menschel Education Center at HSS (535 East 70th Street, 2nd floor, New York, NY 10021) and will also be live streamed online.

Consisting of 3 main sessions, 4 concurrent sessions, 3 mini courses, 8 concurrent workshops, and a new lunch & learn option, this year’s symposium includes a keynote address from Gilles Walch, MD, acclaimed shoulder surgeon from Hopital Privé Jean Mermoz in France, on his surgical approach to shoulder instability.

There will also be a live surgery of an anterior shoulder stabilization performed by Joshua S. Dines, MD, sports medicine surgeon at HSS, as well as two optional instructional courses.

The session The Female Athlete will cover gender differences in sports medicine, graft choice for ACL reconstruction, stress fractures, training considerations and sports psychology. The session is moderated by Lisa R. Callahan, MD, primary care sports medicine physician at HSS. Presentations will be made by members of the Women’s Sports Medicine Center:

• Ellen Casey, MD
• Karen M. Sutton, MD
• Marci A. Goolsby, MD
• Polly de Mille, RN, MA, RCEP, CSCS, USAT
• Deborah N. Roche, PhD

HSS serves as the official hospital and team physicians and rehabilitation specialists for over 20 professional and collegiate teams and organizations and is one of only three hospitals in the nation appointed a FIFA Medical Centre of Excellence.

CONTACTS:

Sherry Randolph / Monique Irons / Tracy Hickenbottom

Hospital for Special Surgery

mediarelations@hss.edu

212-606-1197

Dr. Dines, who did not treat Woods, explained that the two most common back surgeries performed for golfers are lumbar discectomy and lumbar fusions. He noted that lumbar fusions help prevent the irritation of nerves that cause severe leg and back pain.

"A benefit, particularly as it relates to golfers, of performing the fusion via an anterior approach is that it spares the large muscles of the back that are critical to the golf swing, which potentially makes the recovery for athletes a bit easier," wrote Dr. Dines.

"Throughout the recovery period after surgery, stretching and core/low-back strengthening are critical," he added.

Read the full article at forbes.com

Additional Coverage:

• Forbes: Marcus Smart Needs Celtics To Make Deep Playoff Run If He Is Going To Play Again This Season
• Forbes: Removing A Wire From Kyrie Irving's Knee Will Make Him Unlikely For Start Of Playoffs
• Forbes: Stephen Curry And Salvador Perez Are Out With Similar MCL Injuries, But Timetables Look Different

Today, researchers from Hospital for Special Surgery (HSS) presented study findings comparing the two leading techniques, Docking and the Modified Jobe, at this year’s annual meeting for the American Academy of Orthopaedic Surgeons (AAOS). This cadaver study has important clinical implications as both techniques are currently widely used by surgeons.

"While our results following Tommy John surgery are good, they’re not perfect," said Joshua S. Dines, MD, sports medicine surgeon at HSS and senior author. "Two ways that outcomes can be improved are through surgical techniques and post-operative rehabilitation - this study focuses on perfecting the surgical technique."

Some known reasons for why UCL reconstructions may fail include inadequate healing at the bone-tendon interface and bony fracture through drill tunnels.

The HSS study set out to determine how the two different reconstruction techniques affect intra-osseous blood flow to the medial epicondyle (ME) and sublime tubercle (ST), the critical sites for ligament graft healing. Additionally, the study looked to quantify vascular disruption caused by tunnel drilling in both techniques.

In the controlled laboratory experiment, eight matched pairs of upper extremities were assigned one of the two techniques, with the other paired elbow acting as a control.

After the surgeries, imaging (both MRI and CT) and statistical analysis revealed that drilling of the ulnar tunnels had a minimal impact on the intra-osseous vascularity of the ulna in both techniques.

However, blood flow to the ME was reduced by 14 percent with the Docking technique and 60 percent with the Modified Jobe, creating a mean difference of 46 percent. After the reduction, the Docking technique maintained 86 percent of blood flow while the Modified Jobe maintained only 40 percent.

"While the ideal amount of blood flow for optimal graft healing is unknown, we do know that more blood supply to the area is better," said Dr. Dines. "Our results showed that the Docking technique has the advantage over the Modified Jobe when it comes to vascularity. The more blood we can get to the affected area, the better the outcomes will be."

These findings can be applied in the operating room, not only for primary procedures, but for revisions as well.

The cause of failure after UCL reconstruction, in many cases, is multifactorial including returning to throwing too soon, poor throwing mechanics and inappropriate postoperative rehabilitation. Surgical factors may also contribute to the need for revision surgery if tendon to bone healing doesn’t occur to the extent that it should after the first procedure. Anything that can be done surgically to remove tendon to bone healing as a potential cause for surgical failure should be investigated further with the hopes that we continue to improve outcomes for Tommy John surgeries overall.

"We’re looking at each different part of the procedure to see how it can be improved. If, with each slight modification, we can increase the return to sport rate by 1 percent, then that’s a victory," said Dr. Dines who added that the research team is also looking at different ways to fix the graft to allow for better healing.

Dr. Dines, who did not treat Butler, wrote about treatment for a meniscus injury and the likelihood of Butler's recovery in time for the NBA playoffs.

"Treatment for meniscus tears depends on severity, location and the underlying disease within the joint. Some individuals can treat their meniscus tears conservatively without operation by using anti-inflammatory medications and physical therapy. Unfortunately, for individuals who are involved in physically demanding work or sports, surgery is often necessary," Dr. Dines noted.

Additionally, Dr. Dines explained that the recovery process involves physical therapy to strengthen the muscles surrounding the knee.

"The goal of recovering for the playoffs is plausible, though; if Butler undergoes hours of rehabilitation each day, he could potentially return to practice within a few weeks," he wrote.

Read the full article at forbes.com

Additional Coverage:

• Forbes: Neymar's Broken Foot May Shatter The Hopes Of Paris Saint Germain And Brazil 

As part of the three-year sponsorship, HSS will receive on-court signage, TV inventory and will provide a Tour Medical Director to provide musculoskeletal consulting services to the athletes participating in each event. Hospital for Special Surgery will be designated the "Official Hospital of the Invesco Series". HSS physician Joshua Dines, MD, of New York, N.Y. will serve as Tour Medical Director.

"As an avid tennis fan, I’ve always had a passion for caring for tennis players, who I see frequently in my practice. I believe it’s important for elite athletes to be treated by physicians who understand the sport and can truly be advocates for the athlete while upholding our medical ethical standards," said Dr. Dines. "I know I speak for my HSS sports medicine colleagues when I say that we are looking forward to providing the highest level of player care for the Invesco Series."

Dr. Dines is a sports medicine surgeon at HSS, specializing in conditions of the shoulder, elbow, knee and ankle. With an interest in arthroscopic surgery, Dr. Dines has developed novel techniques to improve surgical results. He has long-standing relationships treating elite athletes and is currently an assistant team physician for the New York Mets, an orthopedic sports medicine consultant for the New York Rangers and a consultant for the Los Angeles Dodgers. Additionally, Dr. Dines is a consultant for USA Tennis and previously served as a doctor for the U.S. Davis Cup tennis team.

HSS is a world leader in orthopedics, rheumatology and rehabilitation – ranked No. 1 in orthopedics by U.S. News & World Report – and has a longstanding connection to world-class athletes, including many Olympic athletes. HSS is the Official Hospital of the New York Giants, New York Knicks, New York Mets, New York Red Bulls, Brooklyn Nets, USA Basketball, UFC and New York Road Runners for the TCS New York City Marathon. Physicians and rehabilitation specialists from HSS also work closely with many collegiate and other athletic organizations.

"We are excited to add HSS as an Invesco Series sponsor," said Jim Courier, co-founding partner of InsideOut Sports and Entertainment and the Invesco Series. "Tennis has become more and more of a physical sport at all levels with players of all ages so the services and information provided by HSS are vital not only to our Invesco Series player but to the millions of tennis players of all ages around the world."

The 2018 Invesco Series will kick off on April 7 in Charleston, S.C. with ten events including a first-ever event in Hawaii. The series of one-night tournaments, featuring two one-set semifinal matches and a one-set final-round match played between tennis legends, will feature for a fourth straight year players making their own line-calls with the assistance of electronic line-calling.

The full 2018 schedule will be announced March 1. Each Invesco Series event features special VIP experiences, including hit-with-the-pros opportunities and special back-stage access. All ticket, experience and event information can be found at www.PowerSharesSeries.com.

In 2017, the year-long points championship was decided in the final match of the season when Andy Roddick defeated James Blake in the Los Angeles final at the Sherwood Country Club.  Roddick, the 2003 U.S. Open champion and world No. 1, won four Invesco Series titles in all in 2017, winning in Birmingham, Ala., Chicago, Lincoln, Neb., and Los Angeles.  Blake, the former world No. 4 and former U.S. Davis Cup star, won Invesco Series titles in Charleston, S.C., Winston-Salem, N.C. and in Lynchburg, Va.

In 2016, Mark Philippoussis won the Invesco Series points title with 1600 points and tournament titles in Memphis, Tulsa, Newport, Winston-Salem and New Haven. Roddick finished in second place, also earning 1600 points but losing the head-to-head tiebreaker with Philippoussis 5-2, while winning titles in Charleston, St. Louis, Los Angeles and Orlando. Blake finished in third place with 1100 points and tournament titles in Chicago, Portland and Brooklyn.

In 2015, Roddick won the Invesco Series points title in his second year of competing on the series with 1,600 points. Roddick won a record eight events Los Angeles, Lincoln, Chicago, Austin, Little Rock, Dallas, Richmond and Minneapolis. Blake finished second in the points rankings with 1,200 points, winning events in Boston and Cincinnati. Philippoussis finished in third with 1,100 points, winning titles in Salt Lake City and Vancouver. The year before in 2014, McEnroe won the points title for the first time in the nine-year history of Champions Series tennis by winning events in Kansas City, Indianapolis, Nashville and Charlotte.

About InsideOut Sports + Entertainment 
InsideOut Sports + Entertainment is a Los Angeles based producer of proprietary events and promotions founded in 2004 by former world No. 1 and Hall of Fame tennis player Jim Courier and former SFX and Clear Channel executive Jon Venison. In 2005, InsideOut launched its signature property, the Champions Series, a collection of tournaments featuring the greatest names in tennis over the age of 30. In addition, InsideOut produces many other successful events including "Legendary Night" exhibitions, The World Series of Beach Volleyball and numerous corporate outings. Since inception, InsideOut Sports + Entertainment has raised over $4 million for charity. In 2014, InsideOut Sports + Entertainment merged with Horizon Media, the largest privately held media services agency in the world.  For more information, please log on to www.InsideOutSE.com or www.powersharesseries.com or follow on Facebook, Twitter and YouTube.

About Horizon Media
Horizon Media, Inc. is the largest and fastest growing privately held media services agency in the world. The company was founded in 1989, is headquartered in New York and has offices in Los Angeles, San Diego, and Chicago. Horizon Media was chosen as 2011 Independent Media Agency of the Year by Mediapost, 2010 U.S. Media Agency of the Year by Adweek, Brandweek, and Mediaweek as well as by Ad Age and as one of the world’s ten most innovative marketing and advertising companies by Fast Company in 2011. In 2012, Bill Koenigsberg, President, CEO and Founder, was honored by Advertising Age as Industry Executive of the Year. Most recently, in 2014, Bill Koenigsberg was named 4As Chair of the Board and is the first person from a media agency to hold this prestigious position in the 100 year history of the 4As, the marketing industry’s leading trade association. The company’s mission is “To create the most meaningful brand connections within the lives of people everywhere.” By delivering on this mission through a holistic approach to brand marketing, Horizon Media has become one of the largest and fastest-growing media agencies in the industry, with estimated billings of over $5.3 billion and over 1,200 employees. The company is also a founding member of Columbus Media International, a multi-national partnership of independent media agencies. For more information, please visit horizonmedia.com.

HSS sports medicine surgeon Joshua S. Dines, MD, who did not treat Curry, explained that a stress reaction occurs when repeated movements cause stress on a bone and can be a precursor to a fracture.

"Even if it's not fractured, a stress reaction may need to be treated the same way as a fracture with surgery to stabilize the bone," added Dr. Dines.

Additionally, Dr. Dines said it could take professional athletes more than three months to fully recover and return to the sport.

Read the full article at sportsday.dallasnews.com

Dr. Dines explains that there are many factors contributing to the rise in sports injuries in children and adolescents including: specialization in the same sport year-round and playing on multiple teams simultaneously.

According to Dr. Dines, it's important to find a balance between playing enough to stay in shape and prevent injury, and playing too much and causing injury.

He also explains the kinetic chain and how you are only as strong as the weakest link. "If your back breaks down, you start altering your motions [while pitching] and that can cause a breakdown in your elbow or shoulder," he said. "Kids and parents need to be aware of this… and rest and listen to your body. If it hurts, stop."

Dr. Dines often puts things into perspective for young athletes who may be afraid to miss a game and has found that patient (and parent) education is very important.

He notes that some studies have shown that if a young athlete undergoes an ACL reconstruction in high school, he or she has a 50 percent chance of injuring the same or other knee in college. "They may have pre-disposing risk factors, so even if you just treat the ACL and get them back to play, they're still going to have those same risk factors."

The key is working with good physical therapists who can help address those other problems.

Listen to the full segment at iHeart.com. This aired on February 4, 2018.

Dr. Dines notes how times have changed over the years, as young athletes used to play three different sports throughout the year and now may only focus on one sport year-round.

He frequently sees young athletes come in with overuse injuries because they have subjected their body to the same stresses for long periods of time.

"We're seeing a lot more overuse injuries that were typically reserved for older athletes - college and professionals - that we're now seeing in much younger, even high school and middle school athletes," said Dr. Dines.

Dr. Dines explains how pitching is not a normal motion for an arm - and pitchers can throw up to 75-100 times a game. And the good pitchers subject themselves to more stresses as they are often showcased because of their talent. 

"Sports have got to be fun," added Dr. Dines who underlined the importance of kids having fun and playing sports for the right reasons. Even if a young athlete enjoys a sport, if they play it too much (which can lead to overuse injuries), some of the fun may start to go away.

Listen to the full segment at ThisMorningWithGordonDeal.com (starting at the 7:32 mark). The segment aired on February 3, 2018.

Dr. Dines, who did not treat Harden, explained that hamstring injuries are one of the most common injuries in sports that involve sprinting.

"The mechanism of injury is usually traumatic, and often occurs when athletes are at rest and begin sprinting suddenly," he noted.

Initial treatment involves icing the area to decrease swelling, followed by conditioning exercises to build the athlete's strength and mobility.

"Injections of stem cells or platelet-rich plasma (PRP) are often used for injuries such as these. Even if they don't speed up the recovery, biologics may decrease the amount of scar formed during the healing process which could potentially decrease future injury risk," wrote Dr. Dines.

Read the full article at forbes.com

Additional Coverage:

• Forbes: DeMarcus Cousins' Achilles Injury: A Simple Surgery With A Long, Difficult Recovery
• Forbes: Will Your New Year's Resolution Put You On The Disabled List?
• Forbes: Why Rafael Nadal's Injury Is Likely The First Of Many To Top Tennis Players This Year