Current Reviews in Musculoskeletal Medicine最新文献

{"title":"The Treatment of Hip Dysplasia in Adolescent Patients.","authors":"Alicia Asturias, Sara Kiani, Ryan Sadjadi, Ishaan Swarup","doi":"10.1007/s12178-025-09953-y","DOIUrl":"10.1007/s12178-025-09953-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Adolescent hip dysplasia represents a unique challenge for pediatric orthopaedic surgeons. The disease spectrum is broad and the complications of untreated disease can be severe. The purpose of this review is to provide a framework for understanding and treating adolescent hip dysplasia and when to consider nonoperative versus operative interventions.</p><p><strong>Recent findings: </strong>Combined hip arthroscopy and periacetabular osteotomy may be considered for patients with concomitant symptomatic labral tears, which is often diagnosed by history and advanced imaging. Hip dysplasia in adolescent patients is an important diagnosis. There are various clinical and radiographic parameters and the most important ones are lateral center edge angle, Tonnis grade, and joint congruency. Management is based on symptoms and radiographic findings. Nonoperative management is typically recommended for patients with symptomatic borderline dysplasia. Surgical management includes periacetabular osteotomy for patients with symptomatic hip dysplasia that have failed nonoperative treatment. Concomitant hip arthroscopy may be considered for patients with symptomatic labral tear, but is generally not recommended in isolation if there is evidence of dysplasia. Outcomes are generally good after operative management of hip dysplasia in adolescent patients.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"217-227"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556022","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":"Outcomes after Surgical Management of Large Joint Manifestations in Ehlers Danlos Syndrome and Hypermobility Conditions in Sports Medicine: a Systematic Review.","authors":"Caitlin Svendsen, Prushoth Vivekanantha, Doris Braunstein, Sneha Raja, Vireshwar Jagdeo, Andrew Duong, Nicole Simunovic, Olufemi R Ayeni","doi":"10.1007/s12178-025-09979-2","DOIUrl":"https://doi.org/10.1007/s12178-025-09979-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Joint hypermobility can increase complications in surgical management of musculoskeletal conditions. The purpose of this review is to 1) summarize clinical outcomes in patients undergoing various Orthopedic sports medicine surgical procedures by joint, and 2) compare outcomes in patients with and without hypermobility.</p><p><strong>Recent findings: </strong>A total of 38 studies consisting of 144,609 patients and 144,860 joints were included (140,625 shoulders, 2,043 hips, 1,499 knees, 689 ankles, and four elbows). Notable heterogeneity exists within the literature regarding outcomes in hypermobile patients undergoing Orthopedic sports medicine procedures. In general, outcomes for hypermobile patients undergoing procedures of the shoulder, elbow, hip, and knee demonstrated similar or slightly worse outcomes across various patient reported outcomes measures (PROMs) and in terms of recurrent instability or dislocation. There were consistently worse outcomes (e.g. higher rates of post-operative recurrent instability, PROMs) in studies evaluating hypermobile patients undergoing surgery for chronic lateral ankle instability (CLAI) compared to non-hypermobile controls. Patients with joint hypermobility tend to have similar or worse outcomes following Orthopedic sports medicine procedures related to the shoulder, knee, hip, and elbow, and consistently worse outcomes for the ankle. Future studies are encouraged to focus on the effect of hypermobility on elbow and wrist sports pathologies.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110025","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":"Surgical Management of the Discoid Lateral Meniscus: a Systematic Review of Outcomes.","authors":"Prushoth Vivekanantha, Rhea Thomas, Gabriel Kaplan, Matthew Ho, Darren de Sa, Jeffrey Kay","doi":"10.1007/s12178-025-09980-9","DOIUrl":"https://doi.org/10.1007/s12178-025-09980-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The discoid lateral meniscus is an abnormal variant that can lead to pain and mechanical symptoms. This review aims to summarize the clinical outcomes after surgical management of the discoid lateral meniscus. Procedures included saucerization/meniscectomies, repair, or meniscus allograft transplantation.</p><p><strong>Recent findings: </strong>A total of 52 articles were included, consisting of 4,503 patients (4,784 knees). Weighted preoperative and postoperative Lysholm scores were 57.8 and 88.6, respectively, with 100% of studies (27/27) finding a significant improvement in scores postoperatively. Weighted preoperative and postoperative IKDC scores were 59.6 and 87.3, respectively, with 88.9% of studies (8/9) finding a statistically significant improvement in scores. Weighted preoperative and postoperative Tegner scores were 4.8 and 7.3, respectively, with 100% of studies (5/5) finding a statistically significant improvement in scores postoperatively. Weighted preoperative and postoperative VAS scores were 5.3 and 3.2, respectively, with 100% of studies (5/5) finding a statistically improvement in scores postoperatively. Amongst patients with reported values, 209 (6.6%; range 0-23.7%) suffered retears, while there were 290 reoperations (6.0%; range: 0-36.7%). Complications included persistent pain, mechanical symptoms, or swelling (n = 115; 2-4%). Studies to date have reported good outcomes overall following surgical management of the discoid lateral meniscus, with significant improvements in PROMs. However, retear and reoperation rates within the literature have been reported to be as high as 23.7% and 36.7%, respectively.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093158","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":"Patient-Reported Outcomes Measures in Spine Surgery.","authors":"Brynn Charron, Maia Ross, Patrick Thornley","doi":"10.1007/s12178-025-09981-8","DOIUrl":"https://doi.org/10.1007/s12178-025-09981-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Patient-reported outcome measures (PROMs) represent a valuable means of assessing the impact of spine surgery on various aspects of patient function and quality of life. This review highlights the most common and contemporary PROMs used in degenerative cervical and lumbar spine conditions, adolescent idiopathic scoliosis, and adult spinal deformity.</p><p><strong>Recent findings: </strong>Available PROMs differ in their comprehensiveness, flexibility, and ease of use, as well as their ability to provide prognostic information. Condition-specific PROMs such as the Scoliosis Research Society-22 and Modified Japanese Orthopedic Association offer the benefit of prompts tailored to capture the unique considerations for a particular disease state, while more generalized metrics such as the Short-Form 36 facilitate widespread PROM standardization permitting comparison between disease states and interventions. Newer PROMS such as the Patient Reported Outcomes Measurement Information System and the Patient Generated Index offer benefits due to their generalizable yet adaptable format, conferring them the potential to capture condition-specific factors while still permitting comparison between diseases. However, these instruments require further adaptations and validation prior to widespread implementation to fully realize these advantages. Many PROMs are available for use in the spine surgery population, each with unique benefits and drawbacks, necessitating careful evaluation when selecting PROMs for research use.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085971","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":"The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care.","authors":"Andrew Gatto, Kevin Liu, Nesa Milan, Stephanie Wong","doi":"10.1007/s12178-025-09978-3","DOIUrl":"https://doi.org/10.1007/s12178-025-09978-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The global rise in obesity and type 2 diabetes mellitus (T2DM) presents significant challenges in musculoskeletal care, contributing to increased perioperative complications, impaired bone health, and compromised muscle function. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for glycemic control in T2DM, have demonstrated substantial benefits in weight reduction and metabolic regulation. The purpose of this review is to understand the musculoskeletal biologic and clinical implications of GLP-1RAs.</p><p><strong>Recent findings: </strong>Evidence suggests that GLP-1RAs may impact musculoskeletal health through anti-inflammatory effects, bone metabolism modulation, and alterations in muscle composition. GLP-1RAs may promote osteoblastogenesis while dampening osteoclast activity to maintain bone mineral density. The result on fracture risk is unclear. Additionally, while GLP-1RAs cause lean mass loss, GLP-1RAs appear to preserve skeletal muscle, reduce fatty infiltration, and enhance fiber formation and function. Further, GLP-1Rs are present in synovial tissue and cartilage, demonstrating downregulation of inflammatory molecules and chondrocyte apoptotic pathways, though clinical studies show variable effects in the setting of osteoarthritis. Overall, the heterogeneity in findings underscores the need for further research to delineate the long-term musculoskeletal effects of GLP-1RAs. Understanding the musculoskeletal impact of GLP-1RAs is critical for optimizing their integration into orthopedic practice. This review explores the orthopedic implications of GLP-1RAs, highlighting their biologic mechanisms and clinical effects on obesity-related joint inflammation and arthropathy, bone mineral density and fracture risk, and skeletal muscle preservation.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076463","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":"Management of Posterior Shoulder Instability Among Football Players.","authors":"Kira L Smith, Luc Fortier, Andrew Moyal, John M Apostolakos, Jacob G Calcei, James E Voos","doi":"10.1007/s12178-025-09976-5","DOIUrl":"https://doi.org/10.1007/s12178-025-09976-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Football players are at an increased risk for posterior shoulder instability compared to other sports due to certain sport-specific motions that involve posteriorly directed force on the shoulder in a vulnerable position. Management of posterior instability, both nonoperative and operative, is aimed at preventing recurrent instability. Regardless of treatment, timing of return to play revolves around avoiding reinjury and prioritizing player safety. This article provides a review of the current treatment modalities of posterior shoulder instability and the return to play criteria that must be met prior to releasing the player to competition.</p><p><strong>Recent findings: </strong>Posterior shoulder instability was traditionally thought to occur predominately in offensive linemen. However, recent literature suggests it can also commonly be found in other players, including defensive linemen and quarterbacks. Current research reports high return to play rates for athletes that undergo arthroscopic posterior capsulolabral repair. Whereas, there is limited literature regarding return to play rates after posterior bony augmentation and management of reverse Hill-Sachs lesions. Rehabilitation and return to play protocols have been recommended but are nonspecific to American football. Posterior shoulder instability has the potential to sideline young athletes for an extended time and presents a complex challenge to both the athlete and the treating physician. Although the ultimate goal is to facilitate return to play, the physician must balance this with minimizing the risk of re-injury.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076460","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":"Sports Injuries in Female and Non-Binary Athletes: A Systematic Review.","authors":"Leah N Nairn, Amar Aziz, Lana Moayad, Lauren A Gyemi, Nicole Simunovic, Kim Madden, Marko Simunovic, Olufemi R Ayeni","doi":"10.1007/s12178-025-09974-7","DOIUrl":"https://doi.org/10.1007/s12178-025-09974-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>The main purpose of this review was to summarize the current evidence on treatment and outcomes of sports injuries requiring surgical intervention in female and non-binary athletes and identify key gaps in the related literature concerning sports injuries requiring surgical intervention to guide future research.</p><p><strong>Recent findings: </strong>Of the 59 included studies, all focused on biological sex or sex-based differences, while none of the studies discussed gender or the inclusion of non-binary and transgender individuals. Most of the studies (47/59, 80%) focused on ACL reconstruction (37%), hip arthroscopy (27%) or rotator cuff repair (15%). Important sex-based differences were seen with these injuries including differences in fears regarding recovery after ACL injury and pre- and post-operative pain scores following rotator cuff injury. Despite increasing recognition of the role of biologic sex in the treatment and outcomes of sports injuries, very little is known about the impact of gender in sports injuries. Previous sociological literature suggests that gender may play an important role in one's athletic experience, and thus their injury experience. With most of the included studies focused on only three injury types, the experiences of female and non-binary athletes with all other sports injuries are poorly characterized. The lack of gender-inclusive sports injuries research means that the complete experiences of female, non-binary and transgender athletes are not comprehensively captured in the current literature. Future research should aim to characterize the effect of gender on the treatment and outcomes on all sport-related injuries, with the goal of providing inclusive surgical care for all athletes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958731","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":"Current Rehabilitation Principles Following Meniscus Repairs.","authors":"Jill K Monson, Luke V Tollefson, Christopher M LaPrade, Robert F LaPrade","doi":"10.1007/s12178-025-09967-6","DOIUrl":"https://doi.org/10.1007/s12178-025-09967-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to synthesize current science on meniscus anatomy and biomechanics and repair techniques to create an empirical foundation for postoperative rehabilitation precautions and guidelines, including timelines, clinical and performance-based criteria for return to activity, to maximize both meniscal healing potential and patient recovery.</p><p><strong>Recent findings: </strong>Recent literature has focused on meniscus repair rather than debridement, and rehabilitation protocols should be designed to optimize healing. Complex, unstable tears, like root and radial tears, disrupt hoop stress and warrant a more conservative protocol including 6 weeks of non-weightbearing; however, more stable tears, like ramp and vertical tears, can often weight bear immediately after surgery. All protocols should emphasize early protected joint motion. Return to activity guidelines remain ill-defined but this review explores evidence-based recommendations for timelines, strength and performance testing. Patients typically should wait ≥ 4 months for a return to activity and the presence of joint line tenderness or effusion could be a sign of delayed/failed healing. It is essential for therapists to know the size, type, and location of a meniscus repair to optimize patient outcomes. Guidelines for weight bearing, range of motion, strength training, and return to activity should vary per tear type and repair technique and recovery should be both time- and criteria-based. Return to activity should align with healing time, objective clinical and performance testing, and clinical and imaging exam findings. Future research should aim to optimize repair techniques and rehabilitation protocols, specifically further study on the timing to initiate weightbearing, early motion, and return to activity.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988971","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":"Virtual Reality Simulation in Orthopedic Surgery Education Improves Immediate Procedural Skill and Knowledge Acquisition, But Evidence on Cost-Effectiveness and Skill Retention Remains Lacking.","authors":"Francesca R Coxe, Taylor P Stauffer, Michael P Ast","doi":"10.1007/s12178-025-09973-8","DOIUrl":"https://doi.org/10.1007/s12178-025-09973-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training.</p><p><strong>Recent findings: </strong>Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986004","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":"Evaluation and Management of Rotator Cuff Tears Following Shoulder Dislocation.","authors":"Natalie K Kucirek, Jamie E Confino, Brian Feeley, Michael R Davies","doi":"10.1007/s12178-025-09970-x","DOIUrl":"https://doi.org/10.1007/s12178-025-09970-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to summarize the epidemiology, associated pathology, and treatment options for rotator cuff tears following shoulder dislocations and to provide a treatment algorithm for these complex injuries.</p><p><strong>Recent findings: </strong>Rotator cuff tears after shoulder dislocations most often occur in patients older than 40 and may be more prevalent in women. Up to 50% of these patients may have concomitant Bankart lesions. Patients treated nonoperatively generally have worse functional outcomes and higher pain scores than those who undergo rotator cuff repair. However, further studies are needed to elucidate when the rotator cuff can be repaired in isolation versus in combination with capsulolabral stabilization. Reverse total shoulder arthroplasty is a viable treatment option for elderly patients with irreparable cuff tears after dislocation or post-instability arthropathy. Patients who sustain a shoulder dislocation should be evaluated for a rotator cuff tear, particularly if older than 40. Those with post-instability full-thickness rotator cuff tears benefit from surgical treatment. Further research is needed to clarify when additional stabilization procedures should be performed alongside rotator cuff repair.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984760","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}