Current Reviews in Musculoskeletal Medicine最新文献

{"title":"Acromial Stress Fractures in Reverse Total Shoulder Arthroplasty: Diagnosis, Prevention, and Treatment.","authors":"Lauren J Hsue, Mathangi Sridharan, Kushagra Tewari, Nicole J Newman-Hung, Nicole M Truong, Edward C Cheung","doi":"10.1007/s12178-026-10054-7","DOIUrl":"https://doi.org/10.1007/s12178-026-10054-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review critically evaluates the literature on acromial stress fractures (ASFs) following reverse total shoulder arthroplasty (rTSA), with a focus on risk factors, prevention, and treatment. By synthesizing contemporary evidence and highlighting areas of ongoing debate, this review aims to provide clinicians with an updated understanding of these complications and identify priorities for future research.</p><p><strong>Recent findings: </strong>ASFs have an approximate incidence of 3-5% following rTSA. Preoperative risk factors include female sex, acromial morphology, rheumatologic disease, chronic systemic steroid use, and intra-articular steroid use within three months of arthroplasty. Intra-operative risk factors include implant positioning parameters such as excessive distalization, as well as prominence of posterior superior baseplate screws, and resection of the coracoacromial ligament. While nonoperative management is the first line of treatment for many ASFs, displaced fractures are commonly treated operatively. Operative intervention facilitates fracture union but does not consistently improve functional outcomes. Intranasal calcitonin is currently being studied as an adjuvant therapy. The impact of implant design features and placement decisions addressing distalization and lateralization are areas of ongoing study. ASFs remain a challenging complication of rTSA with limited treatment success, highlighting the need for better risk identification, bone health optimization, thoughtful intraoperative decision-making, and evaluation of early interventions to improve prevention and progression.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789331","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":"Instability After Reverse Shoulder Arthroplasty: Evaluation, Diagnosis, Management.","authors":"Brett D Haislup, Nicholas Farrar, Jason C Ho, Vahid Entezari, Eric T Ricchetti, Charles J Cogan","doi":"10.1007/s12178-026-10053-8","DOIUrl":"10.1007/s12178-026-10053-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>To address the concurrent escalation in shoulder instability revision procedures for reverse shoulder arthroplasty (RSA), an operation that has seen significantly expanded utilization over the past two decades due to broader surgical indications and improved implant designs.</p><p><strong>Recent findings: </strong>Prosthetic instability remains a prevalent and challenging complication following RSA. Current observations show a wide variance in reported dislocation rates, which are driven by a diverse array of newly identified patient, technical, and neurological risk factors. A comprehensive clinical and radiographic workup is required to identify the specific underlying etiology of prosthetic instability-such as loss of compression, loss of containment, impingement, or implant loosening. Determining this precise root cause is essential to effectively guide subsequent revision surgery and optimize patient outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677493","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":"Arthroscopy for the Painful Shoulder Arthroplasty: Indications, Outcomes, and Technical Considerations.","authors":"Garrett R Jackson, Sean Koetting, Justin T Childers, Keith Kenter, Matthew J Smith","doi":"10.1007/s12178-026-10052-9","DOIUrl":"10.1007/s12178-026-10052-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Persistent pain, stiffness, or suspected infection following shoulder arthroplasty remains a challenging clinical problem. Arthroscopy has emerged as a minimally invasive diagnostic and therapeutic tool in selected patients with painful anatomic total shoulder arthroplasty, reverse shoulder arthroplasty, or hemiarthroplasty. This review summarizes the current evidence regarding indications, outcomes, complications, and technical considerations for arthroscopy in the setting of pain following prior shoulder arthroplasty.</p><p><strong>Recent findings: </strong>Shoulder arthroscopy after arthroplasty has been described for glenoid component loosening, polyethylene wear, rotator cuff pathology, biceps tendon disease, postoperative stiffness, impingement, and suspected periprosthetic joint infection. Reported outcomes suggest that arthroscopy may improve pain and function in selected patients, particularly after glenoid component removal, biceps procedures, capsular release, and lysis of adhesions. Arthroscopic tissue biopsy also demonstrates greater diagnostic utility than aspiration or serum inflammatory markers for suspected periprosthetic shoulder infection. Technical strategies, including initial subacromial evaluation and controlled glenohumeral entry through the rotator interval, may reduce iatrogenic implant damage during arthroscopic evaluation. Arthroscopy can be both diagnostic and therapeutic in well-selected patients with painful or stiff shoulder arthroplasty. Although it is not a substitute for revision surgery in cases of clear implant failure, instability, or massive cuff insufficiency, it may help clarify the diagnosis, treat focal pathology, and delay or avoid open revision in selected patients.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590636","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":"When an Isolated Bankart Repair is Not Enough: Comparing Latarjet Versus Augmentation with Remplissage.","authors":"Nicolas Pascual-Leone, Tyler Khilnani, Joshua R Eskew, Christopher M Brusalis, Joshua S Dines","doi":"10.1007/s12178-026-10041-y","DOIUrl":"10.1007/s12178-026-10041-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Increased recurrence rates following isolated arthroscopic Bankart repair, particularly in young, high-risk athletes, have prompted adoption of adjunctive surgical strategies. Two commonly utilized techniques are arthroscopic Bankart repair with Remplissage and the Latarjet procedure. Despite widespread use of both options, the optimal indications remain debated. This review synthesizes contemporary evidence regarding indications, clinical scenarios and outcomes, recurrence risk, return to sport and complication profiles following these procedures.</p><p><strong>Recent findings: </strong>Both arthroscopic Bankart repair with remplissage and Latarjet demonstrate excellent outcomes, providing return to sport rates exceeding 80% with recurrence rates ranging from 5 to 10% and 0-5% for the remplissage and Latarjet, respectively [1-3]. Overall complication rates following remplissage have been reported at approximately 1.6% of cases, whereas complication rates range from 5.1 to 16.1% following Latarjet procedures [4, 5]. Recurrent instability following labral repair with remplissage is over 6-fold more likely than following Latarjet when glenoid bone loss exceeds 15% [6]. When addressing patients with recurrent shoulder instability, glenoid and humeral bone loss must be critically analyzed. In patients with subcritical glenoid bone loss who remain at elevated risk for recurrent instability, particularly young, high-demand athletes, arthroscopic Bankart repair with remplissage provides durable stabilization with recurrence rates comparable to Latarjet. However, in the setting of critical glenoid bone loss or true bipolar off-track pathology, the Latarjet procedure confers superior mechanical stability and significantly reduces the risk of recurrence and revision surgery.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469502","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":"Concussion: A Comprehensive Review of Current Evidence.","authors":"Kalvis Hornburg, Claire E Cassianni, Shaheed M Muhammad, Juan E Muñoz Eusse, R Conner Dixon","doi":"10.1007/s12178-026-10051-w","DOIUrl":"10.1007/s12178-026-10051-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Concussion is a common form of mild traumatic brain injury affecting nearly two million people yearly, costing the US nearly 19 billion dollars annually. In light of such significant prevalence and disease burden, tools and interventions aimed at improving diagnosis, recovery, and management are constantly evolving. This narrative review synthesizes literature from PubMed, Scopus, and Google Scholar (2015-2025), prioritizing systematic reviews, randomized trials, and consensus guidelines with the goal of summarizing current best-practices based on up-to-date data and expert opinion.</p><p><strong>Recent findings: </strong>Concussion remains a clinical diagnosis supported by tools such as the SCAT6, though limitations persist. Biomarkers demonstrate high sensitivity for intracranial injury, but limited utility for diagnosing uncomplicated concussion. Recovery is heterogeneous, influenced by initial symptom burden, patient factors, and mechanism of injury. Management has shifted toward early, symptom-guided activity and targeted, multimodal rehabilitation. Persistent symptoms reflect multifactorial etiologies that require individualized care. Concussion care is transitioning toward more objective assessment and personalized management, though gaps remain in diagnostic precision and in predicting prolonged recovery.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419331","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":"Correction to: Hip Arthroscopy After Total Hip Arthroplasty: A Current Review of Indications, Techniques, and Outcomes.","authors":"Justin Harrington, Patrick Castle, Nicholas Morriss, Brian Giordano","doi":"10.1007/s12178-026-10050-x","DOIUrl":"10.1007/s12178-026-10050-x","url":null,"abstract":"","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374910","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":"Parsing Through the Data on Achilles Tendon Rupture Management, Rehab and Sports Return Criteria: a Current Literature Review.","authors":"Lambert T Li, Ansh Shah, Greta Wilker, Morgan W Rice, Shana Miskovsky","doi":"10.1007/s12178-026-10043-w","DOIUrl":"10.1007/s12178-026-10043-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and discuss controversies that have arisen as management of acute and chronic Achilles tendon ruptures continues to evolve. Areas of debate include operative versus nonoperative treatment, best repair or reconstruction techniques, timing of post-op weightbearing protocols, and newer functional rehabilitation interventions. With the incidence of Achilles tendon ruptures increasing, the goal of this review is to provide a resource in determining best treatment options.</p><p><strong>Recent findings: </strong>Evidence demonstrates that operative and nonoperative management yield comparable long-term functional outcomes. However, surgical repairs offer lower rerupture rates and earlier return to activity. There is a trend towards minimally invasive techniques for primary repairs, favored due to reduced wound complications and faster recovery. Earlier surgical intervention after injury shows improved functional outcomes. For chronic ruptures, flexor hallucis longus tendon transfer is the workhorse of secondary reconstruction. Early functional rehabilitation has been shown to be safe and effective across treatment strategies. The management of Achilles tendon injuries remains a complex clinical challenge that demands a comprehensive understanding of the tendon biomechanics, and distinct pathophysiological differences between acute and chronic presentations. Selection between operative and non-operative management requires individualized consideration, while adhering to evidence-based rehabilitation protocols is paramount to successful functional outcomes. Navigating these patient specific treatment options for various patient populations promotes optimal recovery in the short and long term.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359895","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":"Perioperative Management of Patients Undergoing Periacetabular Osteotomy: An Evidence-Based Review.","authors":"Conor Dolson, Ira Zaltz, Alex L Gornitzky","doi":"10.1007/s12178-026-10049-4","DOIUrl":"10.1007/s12178-026-10049-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Periacetabular osteotomy (PAO) is an established and effective surgical treatment for symptomatic acetabular dysplasia in adolescents and young adults with healthy articular cartilage. While outcomes and technical surgical considerations are well described, perioperative management practices vary significantly across institutions. The purpose of this narrative review was to synthesize current literature on evidence-based best practices for perioperative management of patients undergoing PAO and to identify knowledge gaps for future investigation.</p><p><strong>Recent findings: </strong>A comprehensive review of the literature was performed focusing on perioperative care across four phases: preoperative, intraoperative, acute postoperative, and rehabilitation. Areas of emphasis included laboratory evaluation and nutritional optimization, mental health screening, patient education, blood loss mitigation strategies, pain control, venous thromboembolism and heterotopic ossification (HO) prophylaxis, and postoperative rehabilitation protocols. Strong evidence exists to support specific intraoperative practices such as tranexamic acid administration, controlled hypotension, and fascia iliacus blocks for pain control. Conversely, limited or heterogeneous evidence exists regarding preoperative laboratory testing, psychosocial interventions, standardized opioid prescribing, venous thromboembolism prophylaxis regimens, and rehabilitation protocols. Psychosocial health and preoperative educational interventions appear underutilized despite growing evidence of their impact on outcomes. Significant gaps remain, particularly regarding preoperative optimization and rehabilitation strategies. Continued high-quality research is needed to establish standardized, evidence-based perioperative care pathways to further improve outcomes following PAO.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337907","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":"Osteonecrosis of the Femoral Head: Evolution of Contemporary Management Strategies.","authors":"Tyler Sharp, Nathan Davies, Justin J Greiner","doi":"10.1007/s12178-026-10048-5","DOIUrl":"10.1007/s12178-026-10048-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteonecrosis of the femoral head (ONFH) is a progressive condition disproportionately affecting young adults and is a leading indication for total hip arthroplasty in young adults. This review aims to provide a contemporary overview of ONFH with emphasis on treatment strategies aimed to prevent femoral head collapse and disease progression as supported by recent clinical research from the past five years.</p><p><strong>Recent findings: </strong>The 2019 revised ARCO classification has emerged as the most clinically applicable staging system, guiding treatment selection based on lesion size, location, and collapse status. Core decompression remains the surgical mainstay for pre-collapse disease. Recent evidence supports the addition of hip arthroscopy to improve clinical outcomes and increase native hip survival rates. Augmentation strategies including bone marrow aspirate concentrate (BMAC), mesenchymal stem cells (MSCs), bone grafting, and hip arthroscopy have demonstrated the most promising results when combined with core decompression in early-stage disease. Pharmacologic agents, including bisphosphonates and denosumab, have shown meaningful benefit in slowing disease progression but remain adjunctive. Total hip arthroplasty continues to demonstrate excellent long-term outcomes for post-collapse stages, even in younger patient populations. Management to prevent collapse and disease progression of ONFH remains a challenge. Joint preservation through early surgical intervention with augmentation strategies, such as addition of hip arthroscopy, bone grafting, and biologic regenerative biologic therapies represent promising advancements in ONFH management. However, the existing literature remains limited by heterogeneous study designs, small sample sizes, and inconsistent outcome reporting.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337925","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":"To Trim or Not to Trim: Revisiting Acetabuloplasty During Hip Arthroscopy for Femoroacetabular Impingement and Acetabular Overcoverage.","authors":"Jacob D Mikula, Rakan R Alshaibi, John J Kelly, Aaron J Krych, Mario Hevesi","doi":"10.1007/s12178-026-10045-8","DOIUrl":"10.1007/s12178-026-10045-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Acetabuloplasty is a common component of hip arthroscopy for pincer-type and mixed femoroacetabular impingement (FAI), yet the optimal degree of correction remains controversial. Historically, rim trimming has often been guided by radiographic normalization, particularly of the lateral center-edge angle (LCEA). The purpose of this review is to synthesize current evidence regarding acetabular morphology, radiographic assessment, clinical outcomes related to the degree of acetabular correction, and intraoperative strategies that support optimal correction during acetabuloplasty.</p><p><strong>Recent findings: </strong>Recent literature suggests that acetabular overcoverage should not be viewed as a uniform indication for [aggressive] rim resection. Although the LCEA remains a useful measure of acetabular coverage, it incompletely captures focal versus global overcoverage, acetabular version, and dynamic impingement. Mid-term studies have demonstrated favorable outcomes after hip arthroscopy for pincer morphology, with no consistent relationship between postoperative LCEA normalization and patient-reported outcomes. In addition, patients with residual postoperative overcoverage may achieve outcomes comparable to those with normalized coverage and may actually demonstrate lower rates of conversion to arthroplasty. At the same time, excessive rim resection risks iatrogenic undercoverage, instability, edge loading, and accelerated degeneration. Current evidence supports a patient specific rather than radiographically uniform approach to acetabuloplasty. Successful treatment appears to depend on restoring functional femoroacetabular clearance while preserving sufficient acetabular coverage for joint stability and load distribution. Incremental resection, dynamic intraoperative reassessment, labral preservation, and balanced correction of acetabular- and femoral-sided pathology are central to this strategy. Future studies should emphasize three-dimensional assessment, standardized reporting, and longer-term evaluation of joint preservation.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"19 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301247","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}