Journal of orthopaedics最新文献

{"title":"Predictors of survey non-response two years after hip arthroscopy: Results from an institutional prospective registry","authors":"Dominic J. Ventimiglia,&nbsp;Zachary Clark,&nbsp;Antoan Koshar,&nbsp;Michael A. McCurdy,&nbsp;Alexandra Baker Lutz,&nbsp;Michael S. Rocca,&nbsp;R. Frank Henn III,&nbsp;Sean J. Meredith","doi":"10.1016/j.jor.2025.02.005","DOIUrl":"10.1016/j.jor.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Survey-based studies are inherently subject to non-response bias. A comprehensive understanding of the factors contributing to non-response is important for minimizing attrition bias and ensuring generalizability of results. The purpose of this study was to determine the preoperative factors associated with survey non-response 2 years after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Patients undergoing hip arthroscopy at a single center between October 2015 and March 2020 were approached for enrollment in a prospective registry. Patients were emailed an electronic survey at baseline and at 1 and 2 years postoperatively. The primary outcome was response to the 2-year postoperative survey. Patients who failed to complete any part of the 2-year postoperative survey after a series of standardized email, text message, and phone call reminders were considered non-responders. Baseline sociodemographics and patient-reported outcomes (PROs) were compared between the groups using Pearson Chi-Squared or Wilcoxon Rank-Sum tests. Logistic regression was used to identify predictors of non-response.</div></div><div><h3>Results</h3><div>Ninty-nine patients were enrolled and completed the baseline survey. There were 25 non-responders (25 %) at 2 years. Non-responders demonstrated a higher proportion of patients who were male, identified as non-white, and did not respond to the 1-year postoperative survey. There were no differences in baseline PROs between responders and non-responders. When controlling for age and sex, patients who did not identify as white (OR = 4.3, 95 % CI [1.3, 14.4]) and patients who did not respond to the 1-year postoperative survey (OR = 4.5, 95 % CI [1.5, 13.8]) were more likely to be non-responders at 2 years.</div></div><div><h3>Conclusion</h3><div>Not responding to 1 year postoperative survey and non-white race are independent predictors of non-response at 2 years after hip arthroscopy. Baseline PROs do not differ between responders and non-responders.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 45-50"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteotomy across arcuate line in ilium needs prudence in curved periacetabular osteotomy","authors":"Kazuki Orita ,&nbsp;Koji Goto ,&nbsp;Yutaka Kuroda ,&nbsp;Toshiyuki Kawai ,&nbsp;Yaichiro Okuzu ,&nbsp;Yugo Morita ,&nbsp;Shuichi Matsuda","doi":"10.1016/j.jor.2025.02.001","DOIUrl":"10.1016/j.jor.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to measure the optimal osteotomy angle and length, as well as the available width of the osteotomy site in the posterior column for the safe performance of periacetabular osteotomy.</div></div><div><h3>Methods</h3><div>Fifty-six hips in 41 patients who underwent curved periacetabular osteotomy were evaluated. Computed tomography data were subjected to multiplanar reconstruction to measure parameters in two reference planes: the functional pelvic plane and the anterior pelvic plane. The optimal osteotomy angle, osteotomy length, and available width of the posterior column were defined. We assessed the possible factors affecting the optimal osteotomy angle.</div></div><div><h3>Results</h3><div>The functional pelvic plane showed an average and maximum anterior pelvic tilt of 7.8° and 16.4°, respectively, from the anterior pelvic plane. The optimal osteotomy angles had comparable dispersions in the functional pelvic plane and anterior pelvic plane reference planes. Furthermore, as the rotation angle of the reconstructed axial views increased, i.e., the osteotomy site became closer to the arcuate line of the pelvis, the available width of the osteotomy site narrowed, and the length of the osteotomy site increased. We found significant correlations between the optimal osteotomy angle and sex, height, weight, body mass index, head lateralization index, and acetabular anteversion in all planes. The multiple regression analysis revealed that acetabular anteversion was significantly correlated with the optimal osteotomy angle in all planes, while height, weight, BMI, center edge angle, acetabular roof obliquity, and head lateralization index were correlated in some planes.</div></div><div><h3>Conclusions</h3><div>Osteotomies near the arcuate line of the pelvis are considered particularly risky because long-distance osteotomies must be performed within a narrow width. The optimal osteotomy angle is affected by many factors, including acetabular anteversion, which varies from case to case.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 51-57"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A propensity matched cohort analysis: Cemented vs press fit humeral stem fixation in anatomic total shoulder arthroplasty","authors":"Amogh I. Iyer,&nbsp;Ryan M. Dopirak,&nbsp;Louis W. Barry,&nbsp;Benjamin L. Brej,&nbsp;Akshar V. Patel,&nbsp;Erryk Katayama,&nbsp;Gregory L. Cvetanovich,&nbsp;Julie Y. Bishop,&nbsp;Ryan C. Rauck","doi":"10.1016/j.jor.2025.02.003","DOIUrl":"10.1016/j.jor.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Historically, humeral stems were cemented for anatomic shoulder arthroplasty (aTSA). However, cementless, or press-fit, fixation has been increasingly used. This study aims to compare outcomes and revision rates between cemented and press-fit humeral stems.</div></div><div><h3>Methods</h3><div>Institutional records were searched to identify all patients who underwent aTSA with cemented humeral fixation or press-fit fixation between 2009 and 2021. A 3:1 propensity match based on age, sex, pre-op forward elevation and external rotation was conducted. Mean functional measurements were compared using a 2-Sample <em>t</em>-Test, ordinal variables via Wilcoxon-Mann Whitney test, and categorical variables via the Chi-squared test.</div></div><div><h3>Results</h3><div>There were 35 cemented humeral fixation shoulders matched with 105 humeral press-fit shoulders included in the final cohort. Both groups had similar characteristics at baseline regarding age, sex, body mass index, Charlson Comorbidity Index, mean follow-up, ROM, and strength measurements. Average age at surgery was 61.88 ± 6.68 years with an average follow-up time of 5.61 ± 2.86 years. Post-operatively, press-fit fixation demonstrated significant improvement in all ROM testing: external rotation (ER), forward elevation (FE), internal rotation (IR)-and all strength testing: ER, FE, and IR. Cement fixation demonstrated significant improvement in all ROM testing but only in FE strength testing. Inter-group post-op ROM and strength testing comparisons revealed superior external rotation (p = 0.007) and forward elevation (p = 0.047) ROM in the press-fit group with similar internal rotation ROM values and similar strength testing. There were higher revision rates in the cement fixation cohort (Cement: 11.4 % vs press-fit: 3.8 %; p = 0.036).</div></div><div><h3>Conclusion</h3><div>The results of this analysis showcase that press-fit fixation is a viable option for aTSA. Press-fit fixation shoulders had better ROM in terms of external rotation and forward elevation as well a better survival time to revision compared to cement fixation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 109-113"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcome and correlation with ultrasound gap size of Achilles tendon rupture treated non-operatively with boot and wedges","authors":"Rohit Ravindran Nair ,&nbsp;Suzanne Lane,&nbsp;Brijesh Ayyaswamy,&nbsp;Pradeepsyam Prasad,&nbsp;Anoop Anand,&nbsp;Nithin Babu,&nbsp;Adersh Gopinathannair","doi":"10.1016/j.jor.2025.01.038","DOIUrl":"10.1016/j.jor.2025.01.038","url":null,"abstract":"<div><h3>Background</h3><div>The need for surgical management of Achilles tendon ruptures has been decreasing due to a better understanding of their non-operative management. The primary aim of our study was to assess the functional outcome of Achilles tendon ruptures treated with fixed angle walking boots with wedges (FAWW) and its relationship with gap size, functional scores, single leg heel raise height difference (HHD) and calf circumference difference (CCD). The secondary aim was to look at the complication rates.</div></div><div><h3>Methods</h3><div>34 patients (29 males and 5 females), who presented with acute Achilles tendon ruptures to Blackpool Teaching Hospitals NHS Foundation Trust from October 2020 to April 2022, were treated with an equinus slab for 2 weeks followed by a fixed angle boot, with wedges being sequentially removed every 2 weeks. They were reviewed at 3, 6 and 12 months. At each visit, Achilles Tendon Rupture score (ATRS), HHD and CCD were measured. Any complication, such as deep vein thrombosis (DVT) or re-rupture, was recorded.</div></div><div><h3>Results</h3><div>The mean age group of patients was 50 years (28–87 years). The average ATRS at 3, 6 and 12 months were 29.84, 61.68 and 76, respectively. The mean HHD was 8.9 centimetres (cm) at 3 months, 3.79 cm at 6 months and 2.4 cm at 12 months. The mean CCD was 1.31 cm at 3 months, 0.88 cm at 6 months and 1.07 cm at 12 months. We did not find a significant correlation between Achilles tendon gap size measured by ultrasound and ATRS, HHD and CCD in our study.</div></div><div><h3>Conclusions</h3><div>Non-operative management of Achilles tendon ruptures with boot and wedges gives a good functional outcome, which has no relationship with tendon gap size at the time of initial rupture.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 105-108"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of posterior tibial slope measurements: Accuracy and reliability of radiographs and CT","authors":"Shuhei Hiyama ,&nbsp;Reuben P. Rao ,&nbsp;Feng Xie ,&nbsp;Tsuneari Takahashi ,&nbsp;Katsushi Takeshita ,&nbsp;Hemant Pandit","doi":"10.1016/j.jor.2025.01.037","DOIUrl":"10.1016/j.jor.2025.01.037","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the accuracy and reliability of posterior tibial slope (PTS) measurements obtained from radiographs and CT. PTS, particularly its differences in medial and lateral measurements, plays a crucial role in knee alignment, and inconsistencies in measurement techniques across different imaging modalities have raised concerns about accuracy.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included data from 98 Japanese patients legs and 324 Chinese patients legs. PTS was measured on long-leg and short-leg radiographs and CT. Two independent surgeons assessed the measurements, and the inter- and intra-observer reliability were evaluated. The primary outcome was the comparison of medial and lateral PTS measurements, while the secondary aim was to assess the impact of tibial length on measurement accuracy.</div></div><div><h3>Discussion</h3><div>The study revealed that lateral PTS was consistently smaller than medial PTS, with an average difference of 1.2°–1.9°. Shorter leg radiographs tend to underestimate PTS compared to full-length tibial measurements. The correlation between measurements from short and long leg radiographs showed that PTS measurements were more prone to errors, which may be due to anatomical factors such as tibial bowing. Inter- and intra-observer reliability were good for medial PTS but poor to moderate for lateral PTS, especially when using radiographs.</div></div><div><h3>Conclusion</h3><div>For accurate measurement of both medial and lateral PTS, surgeons should consider using additional examination methods such as CT and MRI. If PTS is to be measured on radiographs, the focus should be on the medial PTS, as it tends to provide more reliable results.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 62-67"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can intraoperative opioid use in hip and knee arthroplasty be reduced further without negatively affecting pain control: A case controlled study","authors":"Adnan Asif ,&nbsp;Sam Aktas ,&nbsp;Baraniselvan Ramalingam ,&nbsp;Hasitha Pananwala ,&nbsp;Janna Maier ,&nbsp;Femi E. Ayeni ,&nbsp;Sol Qurashi S","doi":"10.1016/j.jor.2025.01.035","DOIUrl":"10.1016/j.jor.2025.01.035","url":null,"abstract":"<div><h3>Background</h3><div>Whilst forming the backbone of perioperative analgesic regimes in joint replacement surgery, the negative side effect profile of opioids is well known. Common impediments to a smooth running Enhanced Rapid Recovery model of care are often altered cognitive function and postoperative nausea and vomiting (PONV), both related to opioid use.</div><div>This study focuses on evaluating whether further reductions in intraoperative opioid use during joint arthroplasty can be safely achieved with minimal impact of such reductions on pain control and postoperative outcomes including opioid requirements and the incidence of PONV and ability to mobilise.</div></div><div><h3>Method</h3><div>Case controlled review of prospectively collected data assessing intraoperative opioid use, postoperative analgesic requirement, incidence of PONV and cognitive status as well as day 0 mobility postoperatively. 50 patients were randomized in the study and control groups.</div></div><div><h3>Results</h3><div>The study group received statistically significant lower dose of intraoperative opioids equivalent to 24.18 mg of Morphine compared to control group with equivalent to 69.58 mg of Morphine (p &lt; 0.001). There was no statistically significant increase in analgesia requirement postoperatively and no negative influence on PONV or ability to follow immediate postoperative rehabilitative protocols.</div></div><div><h3>Conclusion</h3><div>Opioid use intraoperatively can be reduced even further without any compromise of postoperative pain control and PONV and may further reduce impediments to efficiency in rapid recovery models of care.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 40-44"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response of Miller ME and Ayoub to Letter to the Editor by Schatzman and BS Miller reading article: Increased blood 1,25 dihydroxyvitamin D levels in infants with metabolic bone disease of infancy in contested cases of child abuse. Journal of orthopaedics. 2024 Oct 29;63:81","authors":"","doi":"10.1016/j.jor.2025.01.019","DOIUrl":"10.1016/j.jor.2025.01.019","url":null,"abstract":"","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 93-95"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct anterior total hip arthroplasty after hip arthroscopy: A retrospective review","authors":"Matthew Pate ,&nbsp;Joshua Gira ,&nbsp;Carl Wierks","doi":"10.1016/j.jor.2025.01.017","DOIUrl":"10.1016/j.jor.2025.01.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited studies have investigated outcomes of total hip arthroplasty (THA) after ipsilateral hip arthroscopy, with mixed conclusions. There is need to provide clarity on potential risks/complications associated with this sequence of operations.</div></div><div><h3>Methods</h3><div>This is a retrospective single surgeon cohort study, evaluating patients from 01/01/2012–01/01/2020 undergoing direct anterior THA for osteoarthritis, with minimum 90-day follow-up. There were two groups: previous hip arthroscopy plus THA (THA+) and isolated THA (control) without previous hip arthroscopy. All THA + patients had undergone one previous hip arthroscopy prior to THA. Quantitative variables were evaluated using the Mann-Whitney-U test or a two-tailed unpaired <em>t</em>-test. Nominal variables were evaluated using the chi-square or Fisher's Exact test. Significance was assessed at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Seventy-one patients were included, 38 patients in the THA + group, and 33 patients in the control group. Surgery duration was longer in the THA + group (74 min THA + [SD = 9.5], 60 min control [SD = 11.3], p &lt; 0.0001). The only secondary outcome with significance was average estimated blood loss (400 mL THA+, 275 mL control, p = 0.009). Only one THA + patient required postoperative transfusion (p = 1.0). There were no postoperative deep infections requiring debridement, intra-operative fractures requiring fixation, or postoperative dislocations in either group. The THA group had one post-operative fracture requiring surgery. The THA + group was younger (average) than the control group (52 THA + [SD = 9.9], 58.4 control [SD = 8.8], p = 0.0062).</div></div><div><h3>Conclusion</h3><div>This study highlights increased operative time and estimated blood loss after previous ipsilateral hip arthroscopy. Surgeons should recognize implications on time management, and assist surgeons when deciding to perform a THA at a surgery center vs hospital. These results contribute to a growing body of literature indicating no increase in major complication rate of THA after ipsilateral hip arthroscopy.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 68-71"},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of augmented reality surgical navigation reduces intraoperative fluoroscopic imaging in anterior total hip arthroplasty with equivalent accuracy for component positioning","authors":"Gloria Coden ,&nbsp;Mikhail Kuznetsov ,&nbsp;Lauren Schoeller ,&nbsp;James Patti ,&nbsp;Andrew Grant ,&nbsp;James Penn Miller ,&nbsp;Carl Talmo","doi":"10.1016/j.jor.2025.01.031","DOIUrl":"10.1016/j.jor.2025.01.031","url":null,"abstract":"<div><h3>Background</h3><div>Computer-assisted surgical navigation was designed to reduce the rates of acetabular component malpositioning, a common cause for revision following primary total hip arthroplasty (THA). We compared intraoperative measures such as radiation exposure, radiographic acetabular cup placement, and outcomes of patients who underwent a THA using computer-assisted surgical navigation with augmented reality (AR) compared to those who underwent traditional manual THA with fluoroscopic assistance (FA).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 115 hips who underwent primary direct anterior THAs using the intraoperative AR surgical navigation system between 3/30/2021 and 12/30/2022. These were compared to a matched cohort of 115 primary THAs performed with FA through a direct anterior approach during the same time period. Patients were matched based on age, gender, American Society of Anesthesiologists score (ASA), and BMI. Goal inclination and anteversion were set to 42° (°) and 22°, respectively.</div></div><div><h3>Results</h3><div>THA with AR patients had decreased intraoperative radiation exposure (mean 2.0 versus 3.2 mGy, p &lt; 0.001) and radiation time (mean 0.2 versus 0.4 min, p &lt; 0.001). Deviation from the preoperative plan was similar between AR and FA for both radiographic inclination and anteversion. There was no difference in the operative time, estimated blood loss, or reoperations, all of which were for infection (1.7 versus 0.0 %, p = 0.5).</div></div><div><h3>Conclusion</h3><div>AR surgical navigation in primary THA has similar radiographic, operative and clinical results as THA with intraoperative FA. However, AR surgical navigation is associated with decreased intraoperative fluoroscopic radiation and time. Further research is needed to evaluate accuracy of acetabular component positioning and complications.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 15-19"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of distal biceps tendon and triceps tendon injuries in National Football League players from 2009 to 2022","authors":"Ashwin R. Garlapaty ,&nbsp;Molly Jones ,&nbsp;John Baumann ,&nbsp;Christian Gunn ,&nbsp;James L. Cook ,&nbsp;Steven F. DeFroda","doi":"10.1016/j.jor.2025.01.033","DOIUrl":"10.1016/j.jor.2025.01.033","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study is to determine the incidence and impact of distal biceps and triceps tendon injuries in the National Football League (NFL) from the 2009-10 to the 2022-23 seasons. This study explores the impact that player and injury characteristics have on injury risk, return-to-play, and player performance.</div></div><div><h3>Methods</h3><div>Data from the 2009-10 to the 2022-23 NFL seasons were analyzed for players with distal biceps or triceps tendon tears. Return-to-play (RTP) and performance metrics were recorded for each player during the season before and first two post-injury seasons. Data were analyzed to determine statistically significant differences in proportions using chi-square, Fisher's exact, or McNemar tests. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Fifty tendon ruptures (26 biceps, 24 triceps) were identified. Biceps injuries were more common in defensive players (73.1 %), while triceps injuries predominantly affected offensive players (58.3 %). Significant risk factors for biceps injuries included BMI ≥31 (p = 0.0008) and ≥4 seasons of experience (p = 0.031, OR = 2.7). Triceps injuries were associated with BMI ≥31 (p = 0.01), age ≥26 (p &lt; 0.0001), and ≥4 seasons of experience (p = 0.006). RTP rates were 73.1 % for biceps and 70.8 % for triceps injuries. However, only 52.6 % and 41.2 % of players with biceps and triceps injuries, respectively, returned to pre-injury performance levels. Younger players (&lt;26 years) and those with fewer years of experience (≤4 years) were more likely to achieve prior performance levels.</div></div><div><h3>Conclusion</h3><div>Distal biceps and triceps tendon injuries are typically season-ending for NFL players. Significant risk factors include BMI ≥31, ≥4 years of NFL experience, and game exposure, with age ≥26 being an additional risk factor for triceps tendon injuries. RTP rates exceed 70 %, indicating a strong potential for athletes to return to the NFL post-injury.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 20-26"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}