Current Reviews in Musculoskeletal Medicine最新文献

{"title":"Return to Sport Following Anterior Cruciate Ligament Reconstruction: A Scoping Review of Criteria Determining Return to Sport Readiness.","authors":"Elisa Kodama, Sina Tartibi, Robert H Brophy, Matthew V Smith, Matthew J Matava, Derrick M Knapik","doi":"10.1007/s12178-024-09934-7","DOIUrl":"10.1007/s12178-024-09934-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Provide a concise review of currently utilized functional metrics and patient reported outcomes measures (PROMs) determining appropriate return to sport following anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Recent findings: </strong>When determining return to sport following ACLR, a limb symmetry index (LSI) ≥ 90% when compared to the contralateral extremity is the most commonly reported functional metric. LSI is most commonly assessed using isokinetic quadriceps strength, followed by single-leg vertical hop and cross-over hop test. A minimum ACL-Return to Sport Index (ACL-RSI) score of 68.2 was reported, as well as a mean International Knee Documentation Committee (IKDC) score of 88.3%. A minimum Knee Injury and Osteoarthritis Outcome Score-Quality of Life (KOOS-QoL) of 62.5% was reported in a single investigation. There remains limited data on reported metrics guiding return to sport following ACLR. Evaluation of LSI when compared to the contralateral extremity is the most commonly reported functional measure, with ACL-RSI, IKDC and KOOS-QoL also being reported. Further investigations examining return to sport rate and the incidence of recurrent injury, factoring in differences in sex, competition level, and the presence or absence of concomitant meniscal injuries, based on functional metrics and PROMs is warranted to better understand which outcome measures are predictive of successful return to sport following ACLR.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675333","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":"Hip Arthroscopy for Labral Tears and FAI is Associated with a High Rate of Return to Play for Professional American Football Athletes, A Literature Review.","authors":"Teron A Nezwek, Austin Witt, Dakota Doucet, Mark S Muller","doi":"10.1007/s12178-024-09936-5","DOIUrl":"10.1007/s12178-024-09936-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Femoroacetabular impingement (FAI) with labral tear is an increasingly recognized source of hip pain and lost playing time in elite athletes, yet data pertaining to professional American football athletes remains scarce. Prognostic recommendations are largely limited to single-institution cohort studies. To date, no large-scale literature review of surgical treatment of FAI in elite American football athletes has been performed. This review article reports the prevalence, return to play, performance outcomes, and career longevity following hip arthroscopy in professional American football athletes across all orthopedic literature between 2004-2024. We hypothesize high rates of return to sport (> 85%) to the same competition level and no differences in career longevity or postoperative performance.</p><p><strong>Recent findings: </strong>In the last 20 years, 8 studies have reported outcomes following hip arthroscopy in NFL athletes; no outcomes have been reported since the 2017 season. Return to play ranged from 79-93% and time to return ranged between 6.0-7.4 months. Offensive lineman returned at the lowest rate among all position groups. There were no differences in postoperative performance or career length compared to age-matched controls. There is high rate of return to professional American football after hip arthroscopy for labral tear and/or FAI with no differences in performance or career longevity compared to control groups. Offensive lineman undergoing hip arthroscopy return to same-level competition at a lower rate compared to other football positions.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"6-16"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767290","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":"Treatment Options, Return to Play, and Functional Performance after Operatively and Non-operatively Managed Acute Scaphoid Fractures.","authors":"Mark L Dunleavy, Nicholas Pilla, Michael Darowish","doi":"10.1007/s12178-024-09935-6","DOIUrl":"10.1007/s12178-024-09935-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Scaphoid fractures are commonly encountered injuries in the athletic population. Conservative management is pursued for incomplete fractures and those involving the distal pole. Operative management is indicated for displaced fractures, unstable fractures, and those involving the proximal pole. Complete non-displaced scaphoid waist fractures can be treated operatively or non-operatively based on patient and surgeon preference. The purpose of this article is to discuss the treatment, rehabilitation, and return to play guidelines for scaphoid injuries.</p><p><strong>Recent findings: </strong>CT scan is critically important to determine fracture displacement (which influences treatment choices) and healing (which influences return to activity determination). Nondisplaced scaphoid waist fractures can be treated with casting with 99.4% healing rate. Surgical treatment can hasten return to activities; newer surgical constructs have been suggested including dual screw fixation, plating, and staples. Outcomes of scaphoid fractures are generally favorable, as long as the selected treatment achieves a united, well-aligned scaphoid. In the athletic population specifically, there are high return to play rates and functional performances seen after these injuries. Each athlete is unique with regard to chosen sport, level of play, fracture type, and timing of the injury. Treatment options and return-to-play must be determined in a case-by-case manner to ensure an optimal clinical outcome.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"17-25"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784430","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 Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.","authors":"William Berrigan, Frances Tao, Joel Kopcow, Anna L Park, Isabel Allen, Peggy Tahir, Aakash Reddy, Zachary Bailowitz","doi":"10.1007/s12178-024-09922-x","DOIUrl":"10.1007/s12178-024-09922-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This study aims to systematically review platelet dosage in platelet rich plasma (PRP) injections for common musculoskeletal conditions.</p><p><strong>Recent findings: </strong>Notable heterogeneity exists in the literature regarding platelet dosage. Clinical studies indicate that a higher dosage may lead to improved outcomes concerning pain relief, functional improvement, and chondroprotection in knee osteoarthritis (OA). However, the impact of dosing on other musculoskeletal pathologies remains uncertain. Our investigation identifies a potential dose-response relationship between platelet dose and PRP effectiveness for knee OA treatment, pinpointing an optimal threshold of greater than 10 billion platelets for favorable clinical outcomes. Notably, this effect appears more pronounced for functional outcomes than for pain relief. For other conditions, a lower dosage may suffice, although the existing literature lacks clarity on this matter. PRP dosage may significantly influence treatmentoutcomes, particularly in knee OA. Further research is warranted to elucidate optimal dosages for varying conditions.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"570-588"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343323","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":"Osteoporosis Management for Shoulder Surgeons.","authors":"Kelsey M Healy, Jacob Ritter, Emily Barr, Jessica L Churchill, Nicholas A Trasolini, Brian R Waterman, Alan W Reynolds","doi":"10.1007/s12178-024-09927-6","DOIUrl":"10.1007/s12178-024-09927-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The aim of this review is to aggregate currently available literature as it pertains to treating surgical shoulder pathology in patients with osteoporosis.</p><p><strong>Recent findings: </strong>Emerging data surrounding perioperative use of anti-osteoporosis medications for patients undergoing shoulder surgery have not shown definitively favorable or unfavorable outcomes. Similar evaluations in animal studies have shown promising results as a biologic augment to tendon and bone healing, especially with newer, anabolic agents. The mainstay of bone health management remains pre-operative evaluation, using opportunistic radiographic and CT based validated measurements, along with optimization of risk factors. Surgical techniques continue to incorporate implants that perform well in osteopenic bone. Promising pre-clinical studies have identified anabolic anti-osteoporosis medications as viable biologic augments to shoulder surgery, which has not been borne out in any clinical studies at this time.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"559-569"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281707","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":"Borderline Hip Dysplasia - Best Treated with Hip Arthroscopy or Periacetabular Osteotomy?","authors":"Erin S Wilson, Kyle R Wagner, Andrea M Spiker","doi":"10.1007/s12178-024-09928-5","DOIUrl":"10.1007/s12178-024-09928-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>As the field of hip preservation evolves, the diagnosis of borderline dysplasia (defined as a lateral center edge angle between 18°-25°) has shown itself to be one of the more challenging diagnoses to treat. As the nuances of acetabular coverage have come to light, the question of whether borderline hip dysplasia is best treated with isolated hip arthroscopy, periacetabular osteotomy, or whether a combined procedure is best, is now top of mind. The goal of these procedures is to not only improve patient symptoms, but to correct underlying pathology and ideally slow the development of hip osteoarthritis. The purpose of this review is to summarize the recent literature and clinical findings regarding both isolated hip arthroscopy and periacetabular osteotomy in the surgical management of borderline hip dysplasia.</p><p><strong>Recent findings: </strong>Current research demonstrates improved postoperative clinical outcome scores for both patients who had isolated hip arthroscopy in the setting of borderline hip dysplasia and for those patients who underwent periacetabular osteotomy. Mid-term outcomes for patients in both groups have showed low rates of conversion to total hip arthroplasty. No gold standard in the surgical management of borderline hip arthroscopy exists. Improved clinical outcomes have been seen postoperatively in patients who undergo hip arthroscopy and in patients who undergo periacetabular osteotomy. Successful clinical outcomes seem to rely on treatment of the underlying clinical pathology and are largely based on the appropriate surgical indications and appropriate surgical techniques. Surgical decision making in this patient population should be individualized based on a comprehensive evaluation of the patient.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"538-547"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343322","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":"Humeral Stem Design in Reverse Total Shoulder Arthroplasty.","authors":"Andrew C Lehman, Favian Su, Brian T Feeley","doi":"10.1007/s12178-024-09931-w","DOIUrl":"10.1007/s12178-024-09931-w","url":null,"abstract":"<p><strong>Purpose of the review: </strong>There have been tremendous modifications to the humeral component since Paul Grammont first introduced the reverse total shoulder arthroplasty in 1985. The purpose of this article is to review historical design features and their drawbacks and to summarize the clinical outcomes of modern designs.</p><p><strong>Recent findings: </strong>Decreasing the neck-shaft angle and increasing humeral lateralization have helped address problems of scapular notching and limited internal and external rotation that were common with traditional designs. Advancements in proximal porous coatings have also facilitated the development of short-stem and stemless implants, which decreases the need for cement fixation and allows preservation of bone stock. Moreover, a reduction in stem length with smaller metaphyseal and diaphyseal filling ratios may limit stress shielding. Current humeral implants have an aseptic loosening rate less than 1%. Despite promising results, many of these new humeral design features do not have long-term data and continued surveillance of their performance is necessary. The humeral stem design significantly influences clinical and radiographic outcomes. Surgeons should be mindful of these design variables to increase impingement-free range of motion, minimize scapular notching, reduce stress shielding, and improve implant survivorship.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"616-624"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767293","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":"Advanced Non-Operative Interventions for Anterior Knee Pain.","authors":"Nicole B Katz, Nicholas Tsitsilianos, Andrew S Nowak, Stephanie R Douglas, Adam S Tenforde, Joanne Borg-Stein","doi":"10.1007/s12178-024-09930-x","DOIUrl":"10.1007/s12178-024-09930-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review presents evidence for advanced non-operative interventions, including extracorporeal shockwave therapy (ESWT), prolotherapy, platelet-rich plasma (PRP), adipose tissue-derived cells, bone marrow aspirate concentrate, various additional non-corticosteroid injectates, and needle-based interventions for common causes of anterior knee pain in the adult population. These etiologies include osteoarthritis of the knee, patellofemoral pain syndrome, chondromalacia patella, Hoffa fat pad impingement syndrome, patellar/quadriceps tendinopathy, and prepatellar bursitis. This review discusses patient care options using a case-based understanding of interventions by condition while recognizing strength of evidence.</p><p><strong>Recent findings: </strong>ESWT and PRP are the most robustly studied and have greatest evidence for treating tibiofemoral osteoarthritis and for long-term benefit in treating patellar tendinopathy. PRP may have evidence for treatment of chondromalacia and prolotherapy for management of tibiofemoral arthritis; both have limited evidence. Botulinum neurotoxin type A has strong evidence to support use in treating patellofemoral pain syndrome. There is limited evidence to support the use of viscosupplementation, percutaneous needle tenotomy, and medicinal signaling cell-based therapies beyond platelet-rich plasma for anterior knee pain. There is limited research on the management of quadriceps tendinopathy, prepatellar bursitis, patellofemoral osteoarthritis, and Hoffa's fat pad impingement syndrome. Further research and standardization of protocols are necessary to fully assess these treatments' efficacy. ESWT, cell-based, and needle-based interventions, may serve as effective treatment options for patients with anterior knee pain. Selection of each intervention requires understanding the evidence, level of risk, and appropriate application based on a patient's level of activity to enable clinicians to enhance patient outcomes and quality of life.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"589-615"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616429","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":"Ultrasound Evaluation of the Hip.","authors":"Samuel I Rosenberg, Steven B Soliman, Alex L Gornitzky, Ira Zaltz, Matthew J Hartwell","doi":"10.1007/s12178-024-09929-4","DOIUrl":"10.1007/s12178-024-09929-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Non-arthritic hip pain is a common presentation among the general population, with many possible contributing etiologies. While radiographs, computed tomography, and magnetic resonance imaging are all within the standard diagnostic workup, ultrasonography has emerged as a facile tool given its low cost, lack of radiation, and dynamic application. This article reviews the utility of ultrasound (US) in evaluation of non-arthritic hip pain and its ability to detect pathology both statically and dynamically in comparison and as an adjunct to standard imaging modalities.</p><p><strong>Recent findings: </strong>Current research highlights applications of US to commonly treated hip pathologies including femoroacetabular impingement, labral tears, hip microinstability, and various other extra-articular phenomena. While static evaluation seems to add similar value to that of radiography, several novel protocols have been developed that allow for dynamic evaluation of joint biomechanics, including extent and onset of impingement and femoral head translation, that cannot be assessed with more standard imaging modalities.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"548-558"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544282","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":"Disparities in Musculoskeletal Oncology.","authors":"Abigail Koons, Elyse Smith, Jeffrey C Stephens, Natilyn H McKnight, Jennifer Barr, Izuchukwu K Ibe","doi":"10.1007/s12178-024-09925-8","DOIUrl":"10.1007/s12178-024-09925-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Disparities within the healthcare system serve as barriers to care that lead to poor outcomes for patients. These healthcare disparities are present in all facets of medicine and extend to musculoskeletal oncology care. There are various tenets to health disparities with some factors being modifiable and non-modifiable. The factors play a direct role in a patient's access to care, time of presentation, poor social determinants of health, outcomes and survival.</p><p><strong>Recent findings: </strong>In musculoskeletal oncologic care, factors such as race, socioeconomic factors and insurance status are correlated to advanced disease upon presentation and poor survival for patients with a sarcoma diagnosis. These factors complicate the proper delivery of coordinated care that is required for optimizing patient outcomes. Healthcare disparities lead to suboptimal outcomes for patients who require musculoskeletal oncologic care in the short and long term. More research is required to identify ways to address the known modifiable and non-modifiable factors to improve patient outcome.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"527-537"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307338","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}