Current Reviews in Musculoskeletal Medicine最新文献

{"title":"The Role of Virtual Physical Therapy in the Management of Musculoskeletal Patients: Current Practices and Future Implications.","authors":"Maureen Suhr, Madelyn Keese","doi":"10.1007/s12178-025-09964-9","DOIUrl":"10.1007/s12178-025-09964-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The rapid evolution of virtual technology and artificial intelligence (AI), combined with physical distancing limitations imparted by the COVID- 19 pandemic, has hastened the shift of healthcare toward digitally enabled practitioners. As physical therapy embraces virtual care, its impact is far-reaching across stakeholders, affecting patients, providers, and payors. This article seeks to explore the role of virtual physical therapy (VPT) in managing patients with musculoskeletal (MSK) conditions and its impact on healthcare and patient outcomes.</p><p><strong>Recent findings: </strong>While research on VPT is growing, high-quality studies remain limited due to challenges in conducting blinded, randomized controlled trials, sponsor bias, and the diversity of digital solutions that complicate comparative studies. Nevertheless, general literature trends show that VPT, particularly when guided by a physical therapist, can yield improvements in pain and function comparable to in-person therapy. VPT demonstrates fair to excellent reliability and validity across key assessment areas, successfully identifying MSK diagnoses and delivering outcomes similar to conventional treatment for pain, function, and quality of life across multiple MSK disorders. Additionally, VPT addresses adherence issues by reducing travel, costs, and exposure risks, while technology enhancements foster patient engagement and communication with therapists. By increasing access and adherence to PT, VPT has the potential to optimize outcomes and curb long-term healthcare costs by preventing progression to more expensive interventions. Virtual care harnesses technology to advance musculoskeletal care by improving access, enhancing patient-provider communication and connection, and optimizing patient engagement and outcomes. VPT moves beyond replication of the in-person experience to an enhanced patient journey. This journey taps into technological advancements to deliver a more integrated experience that engages and supports the patient. VPT offers a sophisticated model of care from the therapist, emphasizing evidence-based practice and critical thinking.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"289-301"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Health Care Disparities in Shoulder Arthroplasty.","authors":"Victoria A Oladipo, Cristobal E Lopez, Ian M Marigi, Kelechi R Okoroha, Gabriella E Ode, Erick M Marigi","doi":"10.1007/s12178-025-09965-8","DOIUrl":"10.1007/s12178-025-09965-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Shoulder arthroplasty (SA) is an effective surgical procedure to treat advanced degenerative conditions of the shoulder as well as tumors or fractures of the proximal humerus. Utilization of SA is increasing in the United States as indications have expanded, however, health care disparities around utilization and clinical outcomes following SA also exist. This review examines current literature on patient related health care disparities in SA.</p><p><strong>Recent findings: </strong>Within SA, patient related health care disparities are highly influenced by race, ethnicity, socioeconomic status, geography, and patient sex. Short term clinical outcomes show that Non-White patients experience lower utilization of SA, longer hospital stays, higher complications, and increased readmissions. Sex related disparities demonstrate that female patients have a longer interval between initial consultation and surgery. Additionally, females experience lower functional scores and higher rates of perioperative fractures than males. In the current era of value-based care, wide disparities in early postoperative outcomes increase the cost of healthcare to both patients and health systems. Disparities in SA remain underexplored compared to other health topics. Existing literature highlights suboptimal outcomes in racially, ethnically, or socially disadvantaged groups. Active awareness and recognition of healthcare disparities are required to renew and strengthen initiatives to deliver more equitable care after SA.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"302-310"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return To Sport Following ACL Reconstruction.","authors":"Aidan Foley, Jamie Confino, Ryan Halvorson, Kyla Petrie, Anisa Torres, Brian Feeley","doi":"10.1007/s12178-025-09989-0","DOIUrl":"https://doi.org/10.1007/s12178-025-09989-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Outcomes after anterior cruciate ligament reconstruction (ACLR) are generally favorable, yet the timing and extent of return to sport vary widely and are influenced by numerous factors. This review examines the principal pre-operative, intra-operative, and post-operative considerations that influence return to sport following ACLR.</p><p><strong>Recent findings: </strong>Successful return to sport depends on many crucial elements during the pre-operative, intra-operative, and post-operative periods. Recent developments for adjunctive rehabilitation modalities-such as blood flow restriction, hyperbaric oxygen therapy, cryotherapy, and photo-biomodulation-may further enhance recovery for some patients. Additionally, psychological readiness has emerged and continues to grow as a key predictor of both the timing and success of return to sport. A criteria-based strategy that integrates physical performance, sport-specific skills, and psychological preparedness offers the most reliable framework for tailoring rehabilitation and maximizing retorn-to-sport outcomes following ACL reconstruction.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications, Technique, and Outcomes of Patient Specific Instrumentation for Osteotomy About the Knee.","authors":"Harmon S Khela, Monty S Khela, Varun Sriram, Grant G Schroeder, Ian Hollyer, Seth L Sherman","doi":"10.1007/s12178-025-09987-2","DOIUrl":"https://doi.org/10.1007/s12178-025-09987-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteotomies around the knee are well-established techniques used to correct lower-extremity malalignment. While osteotomies of the proximal tibia and distal femur have traditionally been performed free-hand, the advent of Patient-Specific Instrumentation (PSI) in the form of custom 3D printed cutting guides and implants offers surgeons a greater ability to individualize surgical corrections to a patient's unique bony anatomy. This review aims to investigate the current state of the literature surrounding the use and outcomes of PSI for knee osteotomies and the benefits and drawbacks of PSI compared to traditional techniques.</p><p><strong>Recent findings: </strong>Recent studies have demonstrated the potential benefits of PSI in knee osteotomy, including improvements in the accuracy of planned corrections, reductions in operative time and fluoroscopy exposure, and similar patient-reported outcomes. While increased costs and lead time represent drawbacks to the use of PSI, the technology continues to evolve such that these areas may improve over time. For osteotomy of the distal femur and proximal tibia, PSI offers surgeons an opportunity to improve surgical precision intra-operatively, with similar outcomes and complication rates as compared to traditional osteotomy techniques.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Results for Meniscus Repair.","authors":"Brandon Cabarcas, Emily Peairs, Sanathan Iyer, Jason Ina, Mario Hevesi, Adam J Tagliero, Aaron J Krych","doi":"10.1007/s12178-025-09966-7","DOIUrl":"10.1007/s12178-025-09966-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Meniscus tears are some of the most commonly managed orthopedic injuries that affect a wide variety of patient populations. Traditionally, meniscus tears were treated either conservatively or with partial meniscectomy. However, recent technological innovations have generated a rapid evolution in the modern evaluation and treatment of meniscus tears. The primary objective of this review is to provide a detailed overview of long-term results of meniscus repair after greater than five to ten years follow up, highlighting modern surgical techniques, clinical and radiologic outcomes, rates of failure and revision surgery, as well as emerging insights and future directions.</p><p><strong>Recent findings: </strong>Advancements in arthroscopic implants and techniques helped establish meniscus repair as the preferred approach for treating many meniscal tears due to its ability to preserve native knee kinematics and decrease the risk of osteoarthritic progression. In properly indicated patients, long-term clinical data supports performing meniscus repair over traditional treatments, such as partial meniscectomy, to preserve overall knee function and longevity. The impact of tear morphology on healing rates, potential for biologic augmentation, and optimal postoperative rehabilitation are substantial areas of active research. Undertaking a comprehensive, individualized approach evaluating careful patient selection, sound surgical technique, and ideal rehabilitation strategies is critical to guiding treatment decisions and achieving long-term successful outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"229-245"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Humeral Avulsion of the Glenohumeral Ligament Injuries: Indications, Treatment Strategies, and Outcomes.","authors":"Nathan H Varady, Julia Retzky, Rajiv P Reddy, Harry G Greditzer, Adam J Tagliero, Joshua S Dines","doi":"10.1007/s12178-025-09963-w","DOIUrl":"10.1007/s12178-025-09963-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to synthesize current knowledge on humeral avulsion of the glenohumeral ligament (HAGL) lesions, emphasizing clinical presentation, operative indications, and surgical outcomes.</p><p><strong>Recent findings: </strong>HAGL lesions play an important role in shoulder instability, occurring in 7.5%-9.4% of surgically treated cases, with a high propensity to cause recurrent instability if left untreated. The sensitivity of magnetic resonance imaging for detecting HAGL lesions remains imperfect (50%- 83%), making arthroscopy the diagnostic gold-standard. Primary instability is the most common surgical indication (up to 82% of cases). Surgical repair, whether open or arthroscopic, yields excellent outcomes, with return to sport (RTS) rates of 81%- 100% and recurrent instability rates as low as 0%- 5.6%. Athletes may not always RTS at the same level (44%- 80%), however, and recurrent instability rates are higher in collision athletes (up to 21%). Limited data suggest a high incidence of recurrent instability in nonoperatively managed cases (up to 90%), although data on ideal indications for nonoperative management are lacking. HAGL lesions are an important yet often under-recognized cause of shoulder instability. Surgery is indicated in most cases due to its positive results, though comparative data between arthroscopic and open approaches are limited. Future research should refine imaging accuracy, directly compare arthroscopic versus open approaches, and enhance rehabilitation to improve pre-injury RTS rates.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"281-288"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evidence-Based Approach to Indication for Remplissage.","authors":"Nathan Graden, Jason Ina, Brandon Cabarcas, Erick Marigi, Jonathan D Barlow, Christopher L Camp, Joshua D Dines, Adam J Tagliero","doi":"10.1007/s12178-025-09969-4","DOIUrl":"10.1007/s12178-025-09969-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Treatment of anterior shoulder instability (ASI) is complex with many factors contributing to surgical decision making. The remplissage is an adjunct surgical technique that can be added at the time of arthroscopic labral repair or glenoid bone block reconstruction to decrease the recurrence rate of ASI post-operatively. The purpose of this review is to highlight the history, indications, and outcomes of remplissage when used for anterior shoulder instability.</p><p><strong>Recent findings: </strong>Prior studies have demonstrated that remplissage, when used in addition to an arthroscopic labral repair, can significantly reduce the rate of recurrent instability in patients with both off-track and near-track Hill Sachs lesions. There remains concern that addition of remplissage will negatively affect post-operative range of motion (ROM). However, recent literature suggests no difference observed in ROM when comparing remplissage plus arthroscopic labral repair to arthroscopic labral repair alone. While the addition of a remplissage has promising rates of return to sport, these results are less favorable when a remplissage is performed in an overhead athlete. The remplissage is a powerful surgical tool to utilize in addition to an arthroscopic labral repair or glenoid bone block reconstruction in patients with anterior instability. An understanding of appropriate indications and its influence on post-operative outcomes can assist the surgeon with providing the best possible outcome for each individual patient.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"267-280"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Current Review of Generative AI in Medicine: Core Concepts, Applications, and Current Limitations.","authors":"Pouria Rouzrokh, Bardia Khosravi, Shahriar Faghani, Mana Moassefi, M Moein Shariatnia, Parsa Rouzrokh, Bradley Erickson","doi":"10.1007/s12178-025-09961-y","DOIUrl":"10.1007/s12178-025-09961-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to offer a foundational overview of Generative Artificial Intelligence (AI) for healthcare professionals without an engineering background. It seeks to aid their understanding of Generative AI's current capabilities, applications, and limitations within the medical field.</p><p><strong>Recent findings: </strong>Generative AI models, distinct from discriminative models, are designed to create novel synthetic data. Key model families discussed include diffusion models for generating images and videos, Large Language Models (LLMs) for text, and Large Multimodal Models (LMMs) capable of processing multiple data types. Recent applications in healthcare are diverse, encompassing general uses like generating synthetic medical images, automating clinical documentation, and creating synthetic audio/video for training. More specialized applications include leveraging Generative AI models as backbones for diagnostic aids, enhancing information retrieval through Retrieval-Augmented Generation (RAG) pipelines, and coordinating multiple AI agents in complex workflows. Generative AI holds significant transformative potential in medicine, enhancing capabilities across imaging, documentation, education, and decision support. However, its integration faces substantial challenges, including models' knowledge limitations, the risk of generating incorrect or uncertain \"hallucinated\" outputs, inherent biases from training data, difficulty in interpreting model reasoning (\"black box\" nature), and navigating complex regulatory and ethical issues. This review offers a balanced perspective, acknowledging both the promise and the hurdles. While Generative AI is unlikely to fully replace physicians, understanding and leveraging these technologies will be crucial for medical professionals navigating the evolving healthcare landscape.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"246-266"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frugal Innovations in Orthopaedics.","authors":"Shravya Kakulamarri, Charlotte F Wahle, Lacey Smith, Sanjeev Sabharwal","doi":"10.1007/s12178-025-09985-4","DOIUrl":"https://doi.org/10.1007/s12178-025-09985-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Frugal innovations prioritize low-cost interventions, while keeping in mind efficacy, accessibility and scalability. Despite a scientific culture that often celebrates major financial investment and cutting-edge technologies, frugal innovations can be just as important in both low-income countries where resources are scarce as they are high income countries where the health needs of aging populations may be outpacing economic growth. We sought to comprehensively review the current state of frugal innovations in orthopaedic surgery, as well as to identify next steps as the importance of these low-cost interventions continues to grow.</p><p><strong>Recent findings: </strong>Frugal innovation is particularly relevant in orthopaedic care as musculoskeletal interventions such as prosthetics, orthotics and surgery demand significant materials, skilled labor, and frequent follow-up. There have been numerous innovations in the recent years, including the development of low-cost intramedullary nails, bioabsorbable implants, negative-pressure wound therapy systems made from aquarium pumps, repurposed Foley catheters and nasogastric tubes for use in surgeries, among many more. Frugal innovations in orthopaedic surgery are becoming more relevant and rapidly evolving in all health-care settings as a tool to deliver value-based care to the growing needs of the population. Though many of these projects are performed on a local scale, when considered collectively, they demonstrate powerful efforts to move the needle in enhancing access to high-quality orthopaedic surgical care and reduce the burden of global musculoskeletal disability. Frugal innovations offer immense promise in reducing costs and closing the gap of access to high-quality orthopaedic care worldwide.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language Barriers in the Delivery of Musculoskeletal Care and Future Directions.","authors":"Edgar Garcia-Lopez, Jamieson O'Marr, Rachel Gottlieb, Katherine Rebecca Miclau, Nirav Pandya","doi":"10.1007/s12178-025-09986-3","DOIUrl":"10.1007/s12178-025-09986-3","url":null,"abstract":"","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}