Abstract
This is a visual representation of the abstract.
Video Transcript
Hello I’m Mike Freehill from Stanford University, and I’m going to talk to you a little bit about how to make an article for the Video Journal of Sports Medicine (VJSM).
Making an article for VJSM can be challenging. The most common mistake is realizing near the end or after a case that this would have been a great one to highlight and submit. Technique videos on the internet have become extremely popular on a variety of available websites. The American Orthopedic Society for Sports Medicine has launched VJSM with the strength of this source being peer reviewed. Thus, viewers can enjoy the video article and be assured the content is appropriate from an audio/video quality standpoint and with transparency about literature support and to what degree. Our aim in this short editorial is to outline strategic steps to allow a thorough, well-rounded video submission.
A basic template for a VJSM submission includes identifying a specific case or topic, obtaining the video, creating the submission, and finishing touches.
The first step is identifying a specific topic or case. This can be anything, including a condition which is managed non-operatively, to a diagnosis with complex or controversial physical examination maneuvers. Articles such as these are certainly welcomed. By nature, more commonly a topic of interest may be a complex case requiring surgical treatment, or new and emerging surgical techniques. The strength of this platform is that the foundation of any given article will be primarily video, rather than text or PowerPoint.
For a nonsurgical case, this typically begins with a case presentation, highlighting the unique components of the case and summarizing controversial literature. The bulk of the submission will focus on a particular physical examination maneuver or in-office procedure; it is important to capture multiple video angles to demonstrate proper patient positioning and practitioner technique. If applicable, post-treatment video is often helpful. It is key to err toward having too much video and editing down.
For a surgical case, this typically begins with a case presentation. It is then important to include ample preoperative footage showing either special or relevant physical examination maneuvers, and operating room setup. For surgical video, obtaining footage inside and outside for an arthroscopic technique is critical. This should highlight as much detail as possible for complete education of the viewer. Landmarks and portal locations are an example. Plan on recording the whole case. It is easier to edit and exclude content not needed than to not have the material. This is the greatest pitfall of submissions! Poor video quality which appears to have been piecemealed together after the fact, and possibly missing important aspects of the case. The more video to work with from the start, the better!
Next is creating your submission. Obtain footage in a 16:9 aspect ratio. This is standard for most smart phones in horizontal recording mode and corresponds to the wide screen slide layout on PowerPoint. Otherwise, video can be cropped using standard video editing software. Begin editing footage together, being conscious of time constraints.
References are limited, to 10 per submission. Thus, in this particular case a systematic review or meta-analysis on the topic may be a better reference to cite. If reporting a newer cutting-edge technique or topic, this may not apply. Following creation of the video content, record your audio. Do this in a quiet spot and make a concerted effort to not speak too quickly; try to avoid the need to rush. A well-thought-out script will guide the presentation. The script is needed for submission, so the clearer and stronger the better!
Submission on the Scholar One platform requires a compressed video of less than 350 MB. The author’s preferred compression software may be used. Otherwise, the Handbrake application is recommended, as a trusted free and open-source application.
To briefly summarize the video compression process using HandBrake, the first step is to download the application for Mac or Windows. Then drag and drop the video. Select the proper preset parameters, with the recommended settings shown here. Finally, start the encoding and when complete, confirm the video and that the size is <350 MB.
Finally, for finishing touches, be sure to reference the VJSM submission requirements, found on the website and shown here. These include a title page, the compressed-format video, a thumbnail image with 16:9 aspect ratio, the written manuscript, financial disclosures, institutional review board (IRB) approval, and once accepted, the fully rendered video.
Next, we will present a sample case of recalcitrant adhesive capsulitis of the shoulder.
The patient is a 53-year-old right-hand-dominant woman with a chief complaint of left shoulder pain and stiffness. Her symptoms were of insidious onset 7 to 8 months prior to presentation. She was initially seen by her primary care physician and prescribed physical therapy, which provided no benefit.
At this point, she is limited in activities of daily living, has night pain, and is unable to raise the arm above shoulder level. Her pain is up to a 9/10, and she rates her shoulder at 20% subjectively.
On examination, she has a normal cervical examination, no atrophy, and mild scapular dyskinesia. She is tender to palpation at the biceps groove. On motion testing, she has significantly limited motion to all planes, with passive forward elevation to only 95° compared with 160°, and external rotation at the side to -5° compared with 65°. Strength testing shows trace weakness to the supraspinatus, otherwise intact.
She underwent a glenohumeral injection, as well as a home exercise program; however, she continued to have no improvement over 1 year.
Radiographs are unremarkable and show no significant arthritis.
Magentic resonance imaging (MRI) findings include thickened inferior capsule, intact rotator cuff with tendinosis, and a degenerative labrum. The capsular thickening is best seen on the coronal projection, with a slit like appearance of the axillary recess.
At this point, she has failed 2 years of conservative therapy and is indicated for left shoulder arthroscopy, capsular release, and extensive debridement.
Moving onto surgical management, this is done in the beach chair position with a mechanical arm holder, and we begin with an examination under anesthesia.
Motion is tested to all planes and is visibly limited. A manipulation is not performed at this point.
Portals are established starting with a standard posterior viewing portal, and an accessory anterior portal under direct spinal needle visualization.
Following thorough diagnostic arthroscopy, we begin with release of the rotator interval using a combination of shaver and electrocautery. Densely thickened tissue is encountered, and care is taken to preserve the subscapularis, anterior labrum, and long-head biceps. The release is taken back to a point where the coracoid is visualized, to the right of the screen here.
We then move onto the inferior capsule. The release is extended inferiorly with electrocautery. The axillary pouch is visualized and again shows densely thickened capsule and synovitis. At this point, a straight or angled meniscal biter can also be used to extend the release to the 6 o’clock position.
We then move onto the posterior capsule. Viewing is switched to the anterior portal where we again encounter significant synovitis and densely thickened capsular tissue. The posterior capsular release is then performed in a similar manner.
To complete the debridement, the subacromial space is addressed. Dense hyperemic bursal tissue is encountered. This is then released systematically. Care is taken to visualize and protect the rotator cuff. Following release of the pathologic thickened bursal tissue, a limited acromioplasty is then performed.
Following completion of the debridement, a gentle manipulation is performed. During rotational manipulation, care is taken to shorten the applied lever arm to prevent iatrogenic fracture. Motion is restored to the shoulder joint, and a standard closure is then performed.
Physical therapy is started on postoperative day 1 for maintenance of motion. The postoperative sling is weaned typically by 3 to 5 days.
In summary, here are the key steps to a successful VJSM submission: identifying an interesting topic or case, operative or nonoperative. Obtaining the video, knowing that quality video is the essential lifeblood of the submission, taking care to obtain more video to edit down, and to include footage both inside and out for arthroscopic cases. In creating the submission, be conscious of time, use the proper layout, and create a compressed video file. And finally, be sure to follow the VJSM author guidelines as listed online.
We are upon a new frontier in orthopedic literature and surgical technique education. We hope that these strategic steps will help with your successful submission to VJSM. Thank you.
