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":"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":"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":"A Review of Syndesmosis Injuries and Preferred Treatment in Football Players.","authors":"Scott Tucker, Indigo Milne, Michaela Pitcher, Christian Benedict, Samantha N Olson, Ashlee MacDonald, Michael Aynardi","doi":"10.1007/s12178-025-09954-x","DOIUrl":"10.1007/s12178-025-09954-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Syndesmotic injuries are common football injuries. The unique demands of football athletes create large magnitude rotational moments about the ankle, even during low impact maneuvers. This review explores the structure and function of the syndesmosis, assesses recent data in football athletes at the professional and collegiate levels regarding epidemiology, describes available treatment options, and provides example cases from the authors' institution. The review concludes with clinical and surgical pearls for the evaluation and treatment of syndesmotic injury.</p><p><strong>Recent findings: </strong>In general, flexible syndesmotic fixation has demonstrated similar clinical outcome scores as rigid fixation. Flexible fixation has demonstrated benefit over rigid fixation in terms of implant failure, hardware removal, and local irritation. Both flexible and rigid fixation remain viable options for treatment of syndesmotic injuries yet the indications for selecting a construct are often subjective. Certain cases of high-risk football players such as linemen may warrant careful consideration of rigid fixation options despite the clinical advantages of flexible fixation. During fixation, direct visualization techniques with open or arthroscopic assistance for reduction of the syndesmosis remain superior and enable diagnosis of chondral defects. Flexible and rigid syndesmotic fixation techniques are viable for treatment of unstable syndesmotic injuries in athletes. Recent literature favors flexible fixation. However, at-risk football athletes or those with length unstable fibula fractures may benefit from rigid or supplemental flexible fixation as opposed to traditional flexible fixation. We recommend direct visualization of reduction at the syndesmosis during surgical treatment of unstable ankle injuries.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"190-200"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413720","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":"Upper Extremity and Musculoskeletal Injuries Related to Videogame and Augmented Reality Game Usage: A Narrative Review Article.","authors":"Christopher M Belyea, Gregory Rummel, Nathan Lanham, Kevin P Krul","doi":"10.1007/s12178-025-09956-9","DOIUrl":"10.1007/s12178-025-09956-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Since the introduction of videogames and augmented reality technology, injuries associated with e sports have garnered increased attention from researchers and healthcare professionals. This review articles examines the spectrum of injuries associated with videogames and augmented reality and describes the nuances of the diagnoses associated with gaming injuries.</p><p><strong>Recent findings: </strong>Videogames changed architecture from a sedentary style of playing to a more interactive console with the introduction of technologies such as the Wii or Pokémon Go. This new style of gaming increased the range of musculoskeletal injuries to include lower energy injuries and more severe high energy trauma because of the introduction of mobility causing distraction and a neglect for safety. The previous sedentary nature of gaming lends itself to prolonged periods of static posture contributing to long-term effects and potential health implications in the future. This review article presents current literature on the specific injury types and increasing need for awareness of videogame-related injuries to further highlight preventative measures needed to mitigate injury risk and promote healthy gaming habits and ergonomic awareness.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"201-206"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406251","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":"Evaluation and Management Anterior Shoulder Instability Among Football Players.","authors":"Nathan S Lanham, Ian Davidson, Brad Graefe, Gary Updegrove","doi":"10.1007/s12178-025-09957-8","DOIUrl":"10.1007/s12178-025-09957-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Anterior glenohumeral instability is a common injury among football players. The purpose of this review is to provide a summary of existing literature on the evaluation and management of anterior glenohumeral instability in football players.</p><p><strong>Recent findings: </strong>The incidence and treatment of anterior glenohumeral instability varies by injury type, position, and time during the season. Shoulder instability represents a spectrum of pathologies. Important differences exist along this spectrum which affect treatment, rehabilitation, return to play, and outcomes. Current research demonstrates effective treatments and good return to play rates. There are currently no consensus guidelines for return to play after anterior glenohumeral instability for football. Successful RTP and future performance can be achieved with both non-operative and operative treatment.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"207-216"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491162","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}