Orthopaedic Journal of Sports Medicine最新文献

{"title":"Patellofemoral Joint Chondral Defects Treated With Third-Generation Matrix-Induced Autologous Chondrocyte Implantation on Porcine Collagen Membrane: Minimum 2-Year Follow-up.","authors":"Guilherme M Palhares, Julia S Retzky, Francesca Coxe, Paige Hinkley, Morgan E Rizy, Ava G Neijna, Andreas H Gomoll, Sabrina M Strickland","doi":"10.1177/23259671251341474","DOIUrl":"10.1177/23259671251341474","url":null,"abstract":"<p><strong>Background: </strong>Third-generation autologous chondrocyte implantation (ACI), also known as matrix-induced ACI (MACI), was approved for clinical practice in December 2016. Studies specifically investigating outcomes of MACI for complex patellofemoral chondral lesions are limited.</p><p><strong>Purpose: </strong>To report patient-reported outcome measures (PROMs), complications, and failure rates after MACI for patellofemoral chondral defects at a minimum follow-up of 2 years.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>For this retrospective review of prospectively collected data, the authors identified patients who underwent treatment with MACI for focal chondral defects in the knee between August 2017 and September 2020. PROMs, including International Knee Documentation Committee (IKDC) score, Kujala score for patellofemoral disorders, and the Veterans RAND 12-item Health Survey (VR-12) score, were obtained preoperatively and a minimum of 2 years postoperatively. The percentage of patients who met the minimal clinically important difference (MCID) for each PROM was reported. Failure was defined as (1) graft failure on follow-up magnetic resonance imaging or second-look arthroscopy, (2) revision MACI or other chondral procedure, or (3) conversion to unicompartmental or total knee arthroplasty.</p><p><strong>Results: </strong>A total of 50 patients (34 female; mean age, 32.43 ± 7.33 years; mean follow-up, 2.71 ± 0.79 years) remained after application of the exclusion criteria. There was a significant increase in all PROMs from preoperatively to postoperatively, including the IKDC (43.39 vs 68.58; <i>P</i> < .001), Kujala (58.93 vs 77.07; <i>P</i> < .001), VR-12 Mental (53.12 vs 57.90; <i>P</i> = .002), and VR-12 Physical (40.40 vs 49.89; <i>P</i> < .001) scores, with 5 (10%) failures. The MCID was achieved by 77.8% of patients in IKDC score and 69.0% in the Kujala score. Kaplan-Meier survival analysis showed survival probabilities of 98.0%, 96.0%, and 85.7% at 1, 2, and 4 years, respectively. MACI for patellofemoral bipolar lesions (n = 11) showed significant improvement in IKDC (50.06 vs 74.07; <i>P</i> = .008) and Kujala (69.33 vs 84.33; <i>P</i> = .046) scores, and 2 (18.2%) failures. Kaplan-Meier survival analysis with log-rank test demonstrated no significant differences in survival distributions between unipolar and bipolar patellofemoral lesions (<i>P</i> = .387).</p><p><strong>Conclusions: </strong>Third-generation ACI (MACI) is a successful and effective treatment method for difficult-to-treat patellar, trochlear, and bipolar patellofemoral chondral defects.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251341474"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periacetabular Osteotomy Often Results in Inpatient Stay: A Tertiary Referral Institution's Experience Supporting This Common Postoperative Course.","authors":"Fabien Meta, Sean C Clark, Karen Gomez-Ruiz, Robert T Trousdale, Rafael J Sierra, Emmanouil Grigoriou, Mario Hevesi","doi":"10.1177/23259671251341913","DOIUrl":"10.1177/23259671251341913","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) is a complex procedure historically requiring inpatient stay. However, there is increased emphasis for other complex orthopaedic procedures (eg, arthroplasty) to be performed on an outpatient basis by insurance companies. Increasing resistance to insurance approval of inpatient listing for PAO patients at the participating institution suggests that this changing tide is affecting PAO surgery.</p><p><strong>Purpose: </strong>To (1) investigate the proportion of PAOs various surgical listing classifications (outpatient, outpatient-overnight, inpatient, etc), (2) determine the incidence of subsequent denial/request for additional documentation for approval of inpatient stay after PAO, and (3) characterize the accuracy of preoperative patient listing classification as well as mean length of stay (LOS) and incidence of successful same-day discharge after PAO at a single institution.</p><p><strong>Study design: </strong>Case series; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective chart review was performed to identify all PAOs, performed by 4 participating surgeons, at a single academic institution over a 2-year period. The initial listing status as an outpatient-overnight or inpatient procedure was identified. Whether a preoperative peer review was required for approval of inpatient listings as well as if additional documentation was necessary to convert outpatient-overnight listings to inpatient stays were also recorded.</p><p><strong>Results: </strong>A total of 140 PAOs among 117 patients were performed with 25 (17.9%) initially listed as an inpatient stay and 115 (82.1%) listed as outpatient-overnight. Of the 25 PAOs listed as inpatient, 2 (8.0%) required a preoperative peer review process to justify or clarify listing status. The mean LOS was 1.9 ± 1.4 days with 55.7% (78/140) of PAOs staying ≥2 nights in the hospital. Only 6 PAOs (4.3%) went home the same day as surgery. Patients who underwent PAO with concomitant hip arthroscopy stayed on average 2.4 ± 1.2 days in comparison with 1.6 ± 1.4 days for those who underwent PAO alone (<i>P</i> < .001). Of the 115 PAOs listed as an outpatient-overnight, 53 (46.1%) converted to an inpatient stay, all of which required service documentation to support conversion to inpatient status.</p><p><strong>Conclusion: </strong>Over half of PAOs performed resulted in an inpatient stay with patients spending ≥2 nights in the hospital. Additionally, all conversions from outpatient-overnight to inpatient required additional service documentation to support status conversion. Understanding trends in postoperative hospitalizations and LOS may allow for better informed partnerships between surgeons and insurance companies creating more efficient preauthorizations, billing practices, and expected patterns of patient care and discharge.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251341913"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence of Posterolateral Tibial Plateau Fractures in the Setting of Knee Dislocations.","authors":"Alexander Korthaus, Paul Marx, Philipp-Johannes Braun, Sebastian Colcuc, Peter Behrendt, Michael Hoffmann, Tobias Drenck, Ralph Akoto, Karl-Heinz Frosch, Christian Schoepp, Matthias Krause","doi":"10.1177/23259671251338795","DOIUrl":"10.1177/23259671251338795","url":null,"abstract":"<p><strong>Background: </strong>Acute knee dislocations are devastating injuries that can be challenging for surgeons to treat. The bony integrity of the tibial plateau and the lateral femoral condyle has a fundamental meaning for translational and rotational knee joint stability. Posterolateral tibial plateau depression fractures (PLTPFs) and lateral femoral condyle impaction fractures (LFCIFs) can influence clinical outcomes, but their frequency and characteristics in the setting of acute knee dislocations are unknown.</p><p><strong>Purpose: </strong>To report the incidence of PLTPFs and LFCIFs in acute knee dislocations as well as to describe concomitant soft tissue lesions associated with these bony injuries.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>In this retrospective multicenter study, acute knee dislocations (at least bicruciate ligament injuries) were identified from hospital information systems based on diagnosis-related group coding as well as operation and procedure classification coding at 5 participating level 1 trauma centers from 2018 to 2022. The knee dislocations were categorized according to the Schenck classification. Soft tissue injuries were assessed on magnetic resonance imaging within 2 weeks of the trauma. PLTPFs and LFCIFs were categorized on magnetic resonance imaging and computed tomography according to the Menzdorf and Bernholt classifications.</p><p><strong>Results: </strong>A total of 157 knee dislocations were identified, comprising 106 men and 51 women with a mean age of 39.3 ± 15.1 years. A PLTPF was detected in 42 (26.8%) knee dislocations, with the highest frequency in Schenck type III medial dislocations. Of these 42 cases, 26 (61.9%) PLTPFs were rated as high-grade fractures, theoretically requiring reduction and fixation. An LFCIF was found in 31 (19.7%) of the cases.</p><p><strong>Conclusion: </strong>A PLTPF was observed in one-quarter, and an LFCIF in one-fifth, of acute knee dislocations. They occurred particularly in knee dislocations with medial collateral ligament ruptures. Almost two-thirds of all PLTPFs presented as high-grade fractures according to the Menzdorf or Bernholt classification, potentially requiring a surgical intervention.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251338795"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Stress Tests for Diagnosing Little League Shoulder and Determining the Timing of Return to Sports.","authors":"Takahiko Uchino, Yasunori Shimamura, Taichi Saito, Ryo Nakamichi, Toshifumi Ozaki","doi":"10.1177/23259671251331055","DOIUrl":"10.1177/23259671251331055","url":null,"abstract":"<p><strong>Background: </strong>The primary etiology of Little League shoulder (LLS) is rotational torque caused by repetitive throwing motion. However, there are few reports on the assessment of rotational torque during physical examination.</p><p><strong>Purpose: </strong>To investigate the usefulness of the resisted external rotation test (RERT) and the resisted internal rotation test (RIRT) in diagnosing LLS and determining the time to return to sports (RTS).</p><p><strong>Study design: </strong>Case series (diagnosis); Level of evidence, 4.</p><p><strong>Methods: </strong>In total, 101 patients were diagnosed with LLS by proximal humeral physeal widening on radiography and tenderness on palpation over the lateral aspect of the proximal humerus, and the RERT and the RIRT were performed. During the 2 tests, the examiner lifted the patient's elbow joint with one hand toward the humeral shaft and held the patient's wrist joint with the other hand. In the RERT/RIRT, the patient was instructed to apply a maximal force of external/internal rotation from neutral alignment. The examiner resisted the force of external/internal rotation and maintained the setting position while holding the wrist joint. These test results were positive if either or both tests elicited shoulder pain. Positive test results and their association with radiographic findings were examined. In case of positive test results, the time to achieve negative test results and the time to RTS were investigated.</p><p><strong>Results: </strong>The RERT and RIRT were correlated with severity of LLS. The sensitivity of RERT/RIRT for LLS was 94.1%/36.6%, respectively. In RIRT, patients with advanced-stage LLS were more likely to have positive results than those with early-stage LLS (67.4% vs 10.9%; <i>P</i> < .001). The mean time to achieve negative RERT and RIRT results was 6.7 and 4.7 weeks, respectively (<i>P</i> = .01). Patients with advanced-stage LLS had a longer mean time to achieve negative RERT results than those with early-stage LLS (6.7 vs 4.7; <i>P</i> < .001). The time to RTS was 8.8 weeks in the group that resumed throwing after achieving negative RERT, while the group that resumed throwing before RERT became negative took 12.7 weeks (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>The RERT may be useful in determining the presence of LLS and when RTS can be allowed.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251331055"},"PeriodicalIF":2.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cognitive Dual Task Alters Dynamic Tibiofemoral Movements During Jump-Landing Assessments in Healthy Participants.","authors":"Tom Vendrig, Michèle N J Keizer, Reinoud W Brouwer, Han Houdijk","doi":"10.1177/23259671251340996","DOIUrl":"10.1177/23259671251340996","url":null,"abstract":"<p><strong>Background: </strong>Many sports situations impose high cognitive demands on athletes, requiring them to divide their attention across multiple tasks and leading to landing mechanics associated with an increased anterior cruciate ligament (ACL) load and injury risk.</p><p><strong>Purpose: </strong>To investigate the influence of a cognitive dual task on dynamic tibiofemoral movements (ie, dynamic anterior tibial translation [ATTd] and dynamic internal tibial rotation [ITRd]) during jump-landing assessments in healthy participants.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 20 healthy participants performed the side hop for distance, single-leg hop for distance, and triple hop for distance. Each assessment was performed under 2 conditions: once with a dual task (serial subtraction) and once without a dual task, while jumping distance remained consistent across both conditions. ATTd and ITRd were measured using a 3-dimensional motion capture system from 0.25 seconds before initial contact (IC) to 0.75 seconds after IC. Additionally, dynamic knee flexion angle, knee valgus angle, maximal knee flexion moment, and foot angle at IC were measured.</p><p><strong>Results: </strong>While performing a dual task during the side hop for distance, there was less ATTd during the flight phase and more ITRd during the landing phase (maximal difference [MD], 1.65 mm and 2.07°, respectively; <i>P</i> < .001), accompanied by a greater foot angle at IC (MD, 2.71°; <i>P</i> < .002), resulting in a more pronounced toe landing. During the triple hop for distance, there was more ATTd and less ITRd around IC while performing a dual task (MD, 1.92 mm and 1.42°, respectively; <i>P</i> < .001), accompanied by a decreased knee valgus angle (MD, 0.54°; <i>P</i> < .001) and a reduced foot angle (MD, 1.75°; <i>P</i> < .05), resulting in a flatter heel landing. No effects of the dual task were observed during the single-leg hop for distance.</p><p><strong>Conclusion: </strong>Incorporating a cognitive dual task during jump-landing assessments had variable influences on tibiofemoral movements, depending on the assessment. The observed increases in ATTd and ITRd during the landing on certain assessments suggest an increased ACL load and injury risk.</p><p><strong>Clinical relevance: </strong>The incorporation of cognitive dual tasks in ACL injury screening and prevention programs should be considered to potentially reduce the risk of injuries.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251340996"},"PeriodicalIF":2.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Rehabilitation Characteristics Among High, Average, and Low Performers on Return-to-Sport Testing in Athletes After ACL Reconstruction.","authors":"William H Suits, Olivia N Roe, Luke J Voss, Corey M Snyder","doi":"10.1177/23259671251339827","DOIUrl":"10.1177/23259671251339827","url":null,"abstract":"<p><strong>Background: </strong>Athletes who undergo an anterior cruciate ligament (ACL) reconstruction (ACLR) typically follow supervised rehabilitation before returning to sport. Return-to-sport (RTS) readiness is partially determined by RTS testing. It is not known how characteristics of the supervised rehabilitation episode of care relate to performance on RTS testing.</p><p><strong>Purpose: </strong>To compare high, average, and low performers on RTS testing among athletes after ACLR in regard to characteristics of their rehabilitation episode of care.</p><p><strong>Study design: </strong>Case-control study; Level of evidence 3.</p><p><strong>Methods: </strong>Data from 262 athletes after ACLR (age 20.7 ± 6.7 years; 131 females) who underwent supervised rehabilitation and elective RTS testing were analyzed. Demographic data including the ACL Return-to-Sport Inventory (ACL-RSI) were gathered. RTS testing data included triple-hop symmetry, single-leg vertical jump symmetry, and an assessment of a repeated change-of-direction task for time, the Lower Extremity Functional Test. Athletes were classified as high or low performers if they were in the top (high performers) or bottom quartile (low performers) of at least 2 of the 3 performance measures. Episode of care characteristics included total supervised rehabilitation encounters, episode length, number of unique rehabilitation providers, and frequency of encounters in each quartile. Analyses of covariance with Bonferroni corrections were performed to assess between-group differences with age and sex as covariates.</p><p><strong>Results: </strong>Of the 262 athletes analyzed, 52 were classified as high performers and 46 were classified as low performers. Compared with high performers, low performers had a lower frequency of rehabilitation encounters in the third quartile (-0.39 visits per week; 95% CI, -0.60 to -0.18; <i>P</i> < .01) and fourth quartile (-0.34 visits per week; 95% CI, -0.54 to -0.14; <i>P</i> < .01). Compared with average performers, low performers had a lower frequency of rehabilitation encounters in the third quartile (-0.20 visits per week; 95% CI, -0.36 to -0.03; <i>P</i> = .04). The ACL-RSI score of the high performers was higher than that of average performers (+10.65; 95% CI, 4.17 to 17.12; <i>P</i> < .01) and low performers (+14.82; 95% CI, 6.70 to 22.95; <i>P</i> < .01).</p><p><strong>Conclusion: </strong>Athletes who performed well on RTS tests after ACLR had a significantly higher frequency of rehabilitation encounters during the second half of their rehabilitation episode. Supervised care during the later stages of rehabilitation may have contributed to the more favorable outcomes on RTS tests. Clinicians and patients should consider the timing and distribution of rehabilitation encounters when creating and modifying a plan of care.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251339827"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Analysis After Anterior Cruciate Ligament Reconstruction at the Return-to-Sport Time Point.","authors":"Saud M Alarifi, Lee C Herrington, Omar W Althomali, Faisal Alenezi, Bodor Bin Sheeha, Richard K Jones","doi":"10.1177/23259671251340302","DOIUrl":"10.1177/23259671251340302","url":null,"abstract":"<p><strong>Background: </strong>Biomechanical alterations after anterior cruciate ligament reconstruction (ACLR) may increase the risk of knee reinjury. Furthermore, individuals may experience persistent biomechanical differences in the lower limbs after finishing the rehabilitation program and being ready to return to sport, which may lead to an increase in the risk of reinjury. Limited data exist on individuals after ACLR and biomechanical alterations during running in elite athletes.</p><p><strong>Purpose: </strong>To measure kinetic and kinematic data during overground running 6 to 8 months after ACLR in an elite sports cohort.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Three-dimensional motion capture tested the running gait of the participants. A total of 34 elite sports professionals who underwent ACLR and were cleared to return to sport and 34 noninjured high-level athlete participants matched by age and sex participated as the control group in this study.</p><p><strong>Results: </strong>A significant reduction was identified in internal knee extensor moment and knee flexion angles between the ACLR limb and the contralateral side (<i>P</i> = .01, .02) and between the ACLR limb and the control limb (<i>P</i> = .01, .01). The external knee adduction moment was increased significantly between the ACLR and control limbs (<i>P</i> = .01). No other differences were seen in the knee or hip kinetics and kinematics.</p><p><strong>Conclusion: </strong>After ACLR, the elite participants demonstrated altered knee joint kinematics and kinetics at the time of being cleared to return to sport. These biomechanical deficits suggest that, despite being cleared, the athletes may not have been fully prepared for a safe return to sport, potentially increasing the risk of knee reinjury.</p><p><strong>Clinical relevance: </strong>Alterations in kinematics and kinetics in the sagittal plane of the ACLR knee observed during running may predispose participants to joint-related issues, such as patellofemoral pain. Similarly, increased knee adduction moments in the affected limb may indicate unresolved biomechanical deficits. These findings suggest that the elite population may not be fully prepared to resume high-level activity within the 6-month time frame outlined in current rehabilitation protocols. A longer recovery period may be necessary to restore joint kinematics and kinetics to levels more consistent with a safe return to sport.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251340302"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spanish Translation and Cross-Cultural Adaptation of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (Spanish HSS Pedi-FABS).","authors":"Ruth H Jones, Akshitha Adhiyaman, Preston W Gross, Sofia Hidalgo Perea, Daniel W Green, Peter D Fabricant","doi":"10.1177/23259671251340987","DOIUrl":"10.1177/23259671251340987","url":null,"abstract":"<p><strong>Background: </strong>Language barriers during clinical care are a cause for particular concern for individuals from diverse linguistic backgrounds, especially the Hispanic and Latino US population, who comprise >19% of the American population and speak Spanish, the second most spoken language globally. Ensuring the inclusion of these patients in pediatric sports medicine and rehabilitation research is critical in minimizing bias and necessitates the development of patient-reported outcome measures available for use in Spanish. The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) quantifies activity levels, developed for children and adolescents.</p><p><strong>Purpose: </strong>To validate a Spanish-translated and cross-culturally adapted version of the HSS Pedi-FABS questionnaire (Spanish HSS Pedi-FABS).</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 2.</p><p><strong>Methods: </strong>Phase I consisted of the development and pretesting of the Spanish HSS Pedi-FABS for content validity. Phase II consisted of administering the English and Spanish versions to bilingual children and adolescents aged 10 to 18 years for construct validity and reliability. Participant demographic data and questionnaire responses were recorded. Internal consistency reliability was tested using Cronbach α. Construct validity was assessed by calculating a 2-way random-effects model of intraclass correlation coefficient (ICC) between the total scores and each item of the English and Spanish questionnaires. Floor and ceiling effect testing was performed by calculating the proportion of minimum and maximum overall scores in the cohort, respectively, to ensure they did not exceed a 15% threshold.</p><p><strong>Results: </strong>The study included 50 patients with a mean age of 14.1 ± 2.0 years, of whom 52% were female. Internal consistency reliability of the Spanish HSS Pedi-FABS was excellent (Cronbach α = 0.92). Construct validity testing demonstrated excellent agreement between the English and Spanish questionnaires (ICC = 0.91). No floor or ceiling effects were demonstrated by either scale, as the minimum score was observed only twice (4%) in each scale and the maximum score was not observed.</p><p><strong>Conclusion: </strong>This study demonstrated that the Spanish HSS Pedi-FABS questionnaire is a valid and reliable tool that physicians can use to quantify physical activity levels in Spanish-speaking pediatric and adolescent populations. The validation of the Spanish HSS Pedi-FABS questionnaire is an important step in ensuring the inclusion of Spanish-speaking patients in pediatric sports medicine and rehabilitation research.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251340987"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoration of Hip Kinematics After Arthroscopy for Femoroacetabular Impingement Syndrome: A 1-Year Evaluation of Gait and Stair Performance.","authors":"Edgar Garcia-Lopez, Ryan T Halvorson, Aidan J Foley, Alan L Zhang, Stephanie E Wong","doi":"10.1177/23259671251339777","DOIUrl":"10.1177/23259671251339777","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) is common in athletes, and the effect of biomechanics and biomechanical alterations after hip arthroscopy continues to be investigated. This study aimed to assess the effect of hip arthroscopy on biomechanical function in patients with FAIS during gait, stair ascent, and stair descent.</p><p><strong>Hypothesis: </strong>Patients with FAIS would exhibit decreased motion preoperatively compared with contralateral asymptomatic hips, but these differences would be corrected postoperatively and these changes would correlate to improvements in patient-reported outcome measures (PROMs).</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Ten patients undergoing hip arthroscopy for FAIS were included and completed PROMs as well as kinematic assessment at baseline and 1 year postoperatively. 3D motion tracking was performed using a 10-camera system while patients performed gait, stair ascent, and stair descent. Joint kinematic parameters were calculated in the sagittal, coronal, and transverse planes for the symptomatic and contralateral side. Peak and valley angles for each joint during each task were compared between limbs using linear mixed-effects models. Significant changes in kinematics were correlated to PROMs.</p><p><strong>Results: </strong>Preoperatively, the symptomatic hip demonstrated significant deficits in gait and stair ascent compared with the contralateral hip. During gait, hip kinematics increased compared with before surgery with respect to flexion (+7.7°± 7.3°), abduction (+2.4°± 3.2°), and external rotation (ER) (+3.0°± 4.9°) (<i>P</i> < .01). During stair ascent, hip abduction (+2.8°± 1.7°) and ER (+2.8°± 5.7°) were significantly increased (<i>P</i> < .01). During stair descent, hip flexion (+2.5°± 6.4°), extension (+3.9°± 8.3°), abduction (+2.3°± 2.6°), and ER (+4.8°± 4.3°) were significantly increased (<i>P</i> < .01). Significant improvements were seen in patient-reported outcomes, but these did not correlate to hip kinematics.</p><p><strong>Conclusion: </strong>Hip arthroscopy for FAIS improved hip flexion, abduction, and ER during dynamic tasks such as gait, stair ascent, and stair descent comparable with the contralateral extremity. Additionally, patients reported significant improvement in function and pain at 1 year postoperatively, but these improvements did not correlate with improvements in hip kinematics.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251339777"},"PeriodicalIF":2.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Elbow Joint Morphology Changes in Surgically Treated Osteochondritis Dissecans of the Capitellum: Clinical Implications.","authors":"Satoshi Miyamura, Ko Temporin, Yuji Miyoshi, Ryoya Shiode, Toru Iwahashi, Seiji Okada, Kunihiro Oka, Hiroyuki Tanaka, Tsuyoshi Murase, Kozo Shimada","doi":"10.1177/23259671251339180","DOIUrl":"10.1177/23259671251339180","url":null,"abstract":"<p><strong>Background: </strong>Capitellar osteochondritis dissecans (OCD) frequently results in radial head enlargement. However, due to the elbow joint's complex anatomy, deformities likely extend beyond just the radial head.</p><p><strong>Hypothesis/purpose: </strong>It was hypothesized that in patients with OCD treated with surgery, imbalances in bone morphology during growth would affect the entire joint, leading to postoperative clinical symptoms. The purpose of this study was to test this hypothesis through a 3-dimensional evaluation of morphological changes.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>After retrospective identification, this study enrolled 47 patients who had undergone surgery, with a mean postoperative follow-up of 6.8 years. After in-person evaluation and bilateral computed tomography scanning, 3-dimensional bone models of the affected and contralateral elbows were created. The bone morphology of the radial head, the distal humerus, and the proximal ulna at the anatomic points were evaluated and compared between affected and contralateral sides. These measurements were correlated with clinical symptoms, and risk factors for these changes were identified.</p><p><strong>Results: </strong>The mean age at examination was 20.6 ± 3.3 years and at surgery was 13.9 ± 1.3 years, with a mean follow-up of 6.8 ± 3.2 years. In the radial head, morphological enlargement was observed for radioulnar diameter (26.3 ± 1.9 vs 22.9 ± 1.5 mm; <i>P</i> < .001) and dorsovolar diameter (26.5 ± 1.9 vs 24.2 ± 1.5 mm; <i>P</i> < .001). In the humeral trochlea, enlargement was noted at the lateral trochlea (28.2 ± 1.7 vs 25.0 ± 1.3 mm; <i>P</i> < .001), trochlear groove (20.4 ± 1.7 vs 17.9 ± 1.6 mm; <i>P</i> < .001), and medial trochlea (30.5 ± 2.1 vs 25.5 ± 1.6 mm; <i>P</i> < .001) as well as the ulnar trochlear notch (28.2 ± 1.7 vs 25.0 ± 1.3 mm; <i>P</i> < .001). Restricted elbow flexion was associated with radial head enlargement in radioulnar and dorsovolar diameters (<i>R</i> = 0.60, <i>P</i> < .001; <i>R</i> = 0.44, <i>P</i> = .002). Lesion size was identified as a risk factor for these changes (odds ratio [OR], 1.36; <i>P</i> = .019), as was development of OCD during skeletal growth (OR, 0.82; <i>P</i> = .006).</p><p><strong>Conclusion: </strong>Over mid- to long-term follow-up, the entire elbow joint underwent cylindrical-like morphological changes, leading to restricted motion. Enlargement typically developed during skeletal growth, with larger lesions resulting in more severe enlargement. Awareness of these natural postoperative changes is crucial, and it is clinically important to provide appropriate treatment during skeletal growth when treating OCD.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251339180"},"PeriodicalIF":2.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}