Orthopaedic Journal of Sports Medicine最新文献

{"title":"Return to Sport and Performance Outcomes After Hand Fractures in Professional Baseball Players.","authors":"Ryan W Paul, Sean M Wilson, Adeeb Jacob Hanna, Gaston Davis, Amit Syal, Steven B Cohen","doi":"10.1177/23259671251371302","DOIUrl":"10.1177/23259671251371302","url":null,"abstract":"<p><strong>Background: </strong>About 7% of injuries in the Major League Baseball (MLB) involve the hand. Fractures of the hand are not uncommon in professional baseball players while fielding or from being hit by a pitch while batting; however, the outcomes of professional baseball players treated both operatively and nonoperatively are unclear.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to report the return-to-sport (RTS) rate, RTS time, and performance outcomes in professional baseball position players who sustained a hand fracture. The secondary purpose was to compare outcomes between positions and between operatively versus nonoperatively treated players. It was hypothesized that there would be a high RTS rate (>80%) after hand fractures, with no significant decline in offensive performance after RTS.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The MLB Health and Injury Tracking System database was queried for all Major League and Minor League position players who sustained a metacarpal fracture or phalangeal fracture of any digit from 2011 to 2022. The primary outcomes of interest were RTS rate, RTS time from injury, and offensive performance statistics such as batting average and on-base percentage up to 1 year after injury. RTS outcomes were compared based on player position and operative versus nonoperative treatment.</p><p><strong>Results: </strong>There were 801 professional baseball position players included, with 156 (19.5%) players treated operatively. Overall, 654 of 801 (81.6%) players were able to RTS at a mean of 58 ± 47 days from injury. Outfielders, infielders, and catchers were able to RTS at similar rates (84% vs 81% vs 80%; <i>P</i> = .440) and in a similar amount of time (58 vs 58 vs 56 days; <i>P</i> = .893). Players treated operatively versus nonoperatively were able to RTS at similar rates (83% vs 82%; <i>P</i> = .740); however, players treated operatively required more time to RTS (86 vs 51 days; <i>P</i> < .001). No significant differences in performance were observed when comparing preinjury to 1 year after injury.</p><p><strong>Conclusion: </strong>Players treated operatively did require more time to RTS (86 vs 51 days); however, RTS rate did not differ between operatively versus nonoperatively treated players. At 1 year after injury, players performed similarly compared to preinjury baseline regardless of player position or type of treatment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251371302"},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040970","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":"Pitch Clock Increases Tolerated Workload Before Ulnar Collateral Ligament Injury: A Retrospective Cohort Study of Major League Baseball.","authors":"Ryan K Card, Brendan J Liakos, John T Schwartz, Alexander Baur, Jonathan Pettegrew, Michael B Purnell, Eric Giang, Eric G Huish","doi":"10.1177/23259671251366422","DOIUrl":"10.1177/23259671251366422","url":null,"abstract":"<p><strong>Background: </strong>In 2023, Major League Baseball (MLB) implemented a pitch clock (PC) to reduce game duration. Concerns have emerged regarding its effect on injury rates, particularly ulnar collateral ligament (UCL) tears, by reducing recovery time between pitches.</p><p><strong>Purpose: </strong>To assess the correlation between the MLB PC and UCL injury.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>UCL tear incidence was compared between pre-PC (PPC) (2021-2022) and PC (2023-2024) eras. Data on UCL injuries were collected from publicly available databases. Variables collected included player demographics, advanced pitching metrics, total pitches, innings pitched, and games played. The primary outcome was UCL tear incidence per 1000 innings pitched. Secondary outcomes included UCL tears per innings pitched in the season of injury (preinjury workload innings [PIWi]) and UCL tears per pitches thrown in the season of injury (preinjury workload pitches [PIWp]), pitch count per season, fastball velocity, and pitch selection.</p><p><strong>Results: </strong>There was no significant difference in UCL tear incidence between PPC (0.63) and PC (0.67) eras (<i>P</i> = .73). However, PIWp was significantly higher in the PC era (n = 721) compared with the PPC era (n = 442) (<i>P</i> = .009), and PIWi was significantly higher in the PC (45.7) era compared with the PPC era (26.5) (<i>P</i> = .003). Pitchers in the PC group were significantly younger (28.4 vs 31.0) (<i>P</i> = .0002), threw more pitches per season (710 vs 441) (<i>P</i> = .02), and averaged more pitches per game (54.9 vs 35.5) (<i>P</i> = .0005).</p><p><strong>Conclusion: </strong>The PC had no observed effect on overall UCL tear incidence but was associated with a higher preinjury workload. These findings challenge fatigue-related injury theories and suggest potential protective effects of the PC.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251366422"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041011","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":"Differences in Pitching Kinetics and Kinematics During Various Effort Level Pitching.","authors":"Jakob H Wolf, Sam Kinney, Brian R Waterman, Garrett S Bullock, Kristen Nicholson","doi":"10.1177/23259671251356631","DOIUrl":"10.1177/23259671251356631","url":null,"abstract":"<p><strong>Background: </strong>After a pitching injury, players must go through a return to sports protocol to enable them to get back to competition. However, this should be done while reducing the risk of reinjury. In the early stages of the return to sports protocol, it is important to minimize kinetics while ideally working on pitching mechanics, which may be achieved through interval throwing progressions.</p><p><strong>Purpose: </strong>To assess the differences in kinetics and kinematics during reduced effort pitching.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Collegiate-aged pitchers (n = 19) throw 5 fastballs at each effort level, including 60%, 70%, 80%, 90%, and 100%. Kinetics and kinematics were recorded. Variables of interest included elbow varus torque, shoulder rotation at maximum external rotation (MER), elbow flexion at MER, maximum resultant shoulder force, peak pelvis rotation velocity, peak trunk rotation velocity, peak shoulder internal rotation velocity, peak elbow extension velocity, shoulder abduction at MER, maximum shoulder horizontal abduction, and maximum hand velocity. Once the data were extracted from the Kinatrax database, separate analyses of covariance tests were performed on each set of data, followed by a Tukey Honest Significant Difference post hoc test when the analysis of variance test returned a statistically significant <i>P</i> value (<i>P</i> < .05).</p><p><strong>Results: </strong>Only elbow varus torque was found to have statistically significant differences between effort levels, and only a statistically significant difference between 100% and 60% effort levels was found. At 100% effort level, elbow varus torque showed a mean value of 92.5 N·m, while 60% effort level pitching showed a mean elbow varus torque of 73.2 (<i>P</i> = .017).</p><p><strong>Conclusion/clinical relevance: </strong>These results suggest that players can throw at close to half effort to reduce their elbow kinetics while maintaining kinematics that would be occurring at 100% effort pitching.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251356631"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040975","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":"Interportal Capsulotomy Closure Does Not Improve the Results After Hip Arthroscopy at 1-Year Follow-up: A Prospective Randomized Controlled Study.","authors":"Bjarne Mygind-Klavsen, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Torsten G Nielsen, Lene Lindberg Miller, Marc Philippon, Christian Dippmann","doi":"10.1177/23259671251363604","DOIUrl":"10.1177/23259671251363604","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Management of the capsulotomy at termination of hip arthroscopic procedures in the treatment of femoroacetabular impingement syndrome (FAIS) is debated. Clinical outcomes in favor of capsular closure were demonstrated in a retrospective study; nonetheless, this finding could not be confirmed in a recent randomized, controlled trial comparing capsular closure with unrepaired capsulotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;This randomized, controlled multicenter trial aimed to evaluate the effect of capsular closure on subjective postoperative outcomes and revision rates in patients undergoing hip arthroscopy for FAIS. It was hypothesized was that capsular closure would result in better patient-reported outcome scores compared with no closure of the interportal capsulotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Randomized controlled clinical trial; Level of evidence, 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All eligible patients with FAIS from 4 surgical centers in Denmark, referred for hip arthroscopy (n = 200), were randomly assigned to either closure or no closure of the interportal capsulotomy at termination of the arthroscopic procedure. The capsular closure was performed with 2 to 3 absorbable sutures, using the \"Quebec City Slider\" knot technique. The primary outcome was the Copenhagen Hip and Groin Outcome Score (HAGOS) Sport/Recreation subscale. The secondary outcomes were the other HAGOS subscales, International Hip Outcome Tool (iHOT-12), Hip Sports Activity Scale (HSAS), pain during rest and activity measured on a numerical rating scale (NRS), and a measure of the overall well-being by the European Quality of Life-5 dimensions (EQ-5D). Furthermore, the rate of revision procedures and the rate of conversion to total hip replacement were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline epidemiological and morphological characteristics were comparable between the treatment groups, except for a higher percentage of women in the capsular closure group (65% vs 48%; &lt;i&gt;P&lt;/i&gt; &lt; .05). Both cohorts had significantly improved scores 1 year after surgery, with no difference between the 2 groups, except for the HSAS: HAGOS-Pain (&lt;i&gt;P&lt;/i&gt; = .19), HAGOS-Symptoms (&lt;i&gt;P&lt;/i&gt; = .33), HAGOS-Activities of Daily Living (&lt;i&gt;P&lt;/i&gt; = .21), HAGOS-Sport/Recreation (&lt;i&gt;P&lt;/i&gt; = .52), HAGOS-Physical Activity (&lt;i&gt;P&lt;/i&gt; = .59), HAGOS-Quality of Life (&lt;i&gt;P&lt;/i&gt; = .16), iHOT-12 (&lt;i&gt;P&lt;/i&gt; = .15), HSAS (&lt;i&gt;P&lt;/i&gt; = .03), EQ-5D (&lt;i&gt;P&lt;/i&gt; = .12), NRS-rest (&lt;i&gt;P&lt;/i&gt; = .20), and NRS-activity (&lt;i&gt;P&lt;/i&gt; = 0.23). Five patients received revision hip arthroscopy after 1 year-1 in the unrepaired versus 4 in the repaired cohort. No patients had conversion to total hip replacement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This randomized, controlled multicenter trial showed no effect on clinical outcomes (HAGOS, iHOT-12, EQ-5D, and NRS) 1 year after hip arthroscopy for FAIS of closure of the interportal capsulotomy at termination of surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;R","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251363604"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015948","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":"Association between Meniscal Injuries at the Time of an Anterior Cruciate Ligament Reconstruction and Lower Return-to-Sport Rates: An Analysis at 5 Years of Follow-up of the MERIscience Cohort.","authors":"Clément Cazemajou, Thibault Marty-Diloy, Nicolas Graveleau, Pierre Laboudie, Nicolas Bouguennec","doi":"10.1177/23259671251358394","DOIUrl":"10.1177/23259671251358394","url":null,"abstract":"<p><strong>Background: </strong>While meniscal tears, particularly when treated by meniscectomy concurrent with anterior cruciate ligament reconstruction (ACLR), are known to increase the risk of osteoarthritis and lead to poorer outcomes, their effects on return to sport (RTS) have been little studied so far.</p><p><strong>Purpose: </strong>To assess the effect of meniscal tears on RTS in the context of ACLR depending on the affected meniscus.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors conducted a retrospective analysis based on data from a prospective cohort single-center study involving 504 patients who received the same postoperative follow-up for a minimum of 3 years between April 2015 and December 2019. The preinjury Tegner Activity Scale score was collected preoperatively, and the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) score was collected 6 months after surgery. At the last follow-up, information such as RTS levels, return to the same sport and same athletic level, Self Knee Value, International Knee Documentation Committee score, ACL-RSI score, Tegner score, graft failure, contralateral rupture, and reintervention was collected. Isolated ACLR was compared with ACLR involving medial meniscus (MM), lateral meniscus (LM), and bi-menisci (BM) injuries, and then meniscal repair and meniscectomies were compared for MM and LM injuries.</p><p><strong>Results: </strong>A total of 504 patients were included with a mean follow-up of 4.9 ± 1.2 years; 6 patients were lost to follow-up. The mean postoperative Tegner score was significatively lower for ACLR with MM injuries than for isolated ACLR (5.4 ± 2.0 vs 6.0 ± 2.0; <i>P</i> = .01). Compared with isolated ACLR (93.9%), the RTS rate was significantly lower for MM injuries (85.1%) and BM injuries (84.1%) (<i>P</i> = .02). Outcomes were similar in ACLR with LM and in isolated ACLR. MM repairs significantly increased the mean Tegner score compared with MM meniscectomies (5.8 ± 1.9 vs 4.7 ± 2.1; <i>P</i> < .001). No other significant differences were found on RTS.</p><p><strong>Conclusion: </strong>MM tears encountered at the time of ACLR led to a lower Tegner score and a lower RTS rate. Patients undergoing MM repair had higher postoperative activity levels than those undergoing meniscectomy. These findings highlight the importance of repairing MM tears whenever possible at the time of ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251358394"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015963","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":"Factors Affecting the Health-Related Quality of Life in Taiwanese Adolescent Baseball Players: A Prospective Longitudinal Study.","authors":"Po-Cheng Chen, Hou-Tsung Chen, Kuan-Ting Wu, Yu-Chi Huang, Nai-Lun Lee, Chi-Fa Hung, Wen-Yi Chou","doi":"10.1177/23259671251343236","DOIUrl":"10.1177/23259671251343236","url":null,"abstract":"<p><strong>Background: </strong>Adolescent baseball players often experience throwing arm complaints from the repetitive activity of baseball, which can affect performance and overall well-being. More focus is needed on their psychological and social challenges in order to achieve better treatment outcomes.</p><p><strong>Purpose: </strong>To investigate changes in the health-related quality of life (HRQOL) among adolescent baseball players in Taiwan and identify the factors that influence HRQOL.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Taiwanese adolescent baseball players (12-18 years old) of all positions from junior and senior high schools were surveyed every 3 months for 1 year (starting in August 2022). Data on demographic characteristics, training volume, throwing arm injury history, and Functional Arm Scale for Throwers (FAST) scores (1 measurement of HRQOL for baseball players) were collected and analyzed using mixed-effects regression models.</p><p><strong>Results: </strong>The study included 299 adolescent baseball players (mean age, 14 years; range, 12-18 years). Pitchers and outfielders exhibited higher FAST total scores than infielders and catchers (mean ± SE, 14.74 ± 16.60 and 14.24 ± 18.76 vs 8.92 ± 9.77 and 9.52 ± 9.56, respectively; <i>P</i> = .027), which indicated more physical disability and psychological impact. In the mixed-effects regression model for FAST total scores, injury history (estimate for mild injury, 7.18 ± 1.25; moderate injury, 18.28 ± 3.00; severe injury, 22.94 ± 3.76 vs healthy), player position (pitcher 4.20 ± 1.97 vs infielder), and months of follow-up (estimate for 3 months, -4.86 ± 1.33; 6 months, -4.55 ± 1.48; 9 months, -4.27 ± 1.85; 12 months -5.84 ± 2.28 vs 0 months). Training volume did not significantly affect HRQOL scores (<i>P</i> = .629).</p><p><strong>Conclusion: </strong>Our study demonstrated significant differences in most FAST total and subscale scores among player positions. Pitchers and outfielders exhibited higher FAST scores than the other positions, indicating more physical disability and psychological impact. Furthermore, the severity of throwing arm injury history significantly influenced FAST scores, with more severe injuries correlating with poorer outcomes. However, training volume did not significantly impact FAST scores. These data may help in future studies integrating patient-reported outcomes and HRQOL to evaluate athlete's' well-being beyond just physical parameters.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251343236"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015979","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":"Increases in Ball Weight and Size Decrease Elbow Varus Torque During Baseball Pitching.","authors":"Glenn S Fleisig, Jonathan S Slowik, J Bradford Hall, David P Beason, E Lyle Cain","doi":"10.1177/23259671251368999","DOIUrl":"10.1177/23259671251368999","url":null,"abstract":"<p><strong>Background: </strong>The rates of ulnar collateral ligament injury and surgery continue to rise in baseball. Increased ball velocity and elbow varus torque may correlate with the increased risk of injury.</p><p><strong>Hypothesis: </strong>Increased ball weight and/or size correlate with decreased elbow varus torque during pitching.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Motion capture data of 20 healthy professional and high-level collegiate baseball pitchers pitching fastballs with 4 types of baseballs were collected. The baseballs were 5 oz (standard weight) or 6 oz, with a circumference of 9 inches (standard size) or 5% larger. Five kinetic parameters, 25 kinematic parameters, and 7 ball movement parameters were calculated. Differences for each parameter were compared using 2-factor (ball weight × size) repeated-measures analysis of variance (<i>P</i> < .05).</p><p><strong>Results: </strong>As hypothesized, elbow varus torque decreased with increased ball weight and with increased ball circumference. Ball velocity, shoulder internal rotation velocity, elbow extension velocity, and shoulder kinetics also decreased with increased ball weight and/or increased ball circumference. Ball break decreased with increased ball weight, while ball location as it crossed home plate was also affected by ball weight and/or size. There were no clinically important differences in pitching kinematics with the different baseballs.</p><p><strong>Conclusion: </strong>Increasing the weight of baseballs from 5 oz to 6 oz and/or the circumference by 5% may reduce elbow varus torque. Future research in league play or simulated play is warranted.</p><p><strong>Clinical relevance: </strong>As elbow varus torque has been staassociated with UCL injury risk, increasing ball weight and/or size may reduce the rate of injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251368999"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015917","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":"Patient Perception of Autograft Options in ACL Reconstruction Using a Validated Online Survey Marketplace.","authors":"Robert S Dean, Tanner Hafen, Ryan McNassor, Collin Braithwaite, Kevin X Farley, Robert F LaPrade, Joseph H Guettler, James Bicos","doi":"10.1177/23259671251362631","DOIUrl":"10.1177/23259671251362631","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) is a common surgery performed with a variety of different autograft options. While there is much research that highlights the benefits and drawbacks of each of these options, there is little known about the knowledge of the general population regarding these options and how patient education may influence their choice.</p><p><strong>Purpose: </strong>To evaluate the general population's perception of commonly utilized autografts in ACLR.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Using an online marketplace, a random selection of participants from the general population were asked about demographic data and preferences for autograft type. All respondents then participated in a survey sent in August 2024, reviewed information from an evidence-based sheet, and completed a posteducation test. Participants were again asked about graft preferences. Participants were asked whether they would change their preference based on surgeon recommendation and what factors influenced their decisions. Statistical analysis was performed using Shapiro-Wilks test to determine normality, and Student paired <i>t</i> test was used for comparison.</p><p><strong>Results: </strong>There were 491 participants with a mean age of 39.9 (range, 19-72). Before participant education regarding graft types, 19.3% preferred bone-patellar tendon-bone (BPTB), 18.7% preferred quadriceps tendon (QT), 12.6% preferred hamstring tendon (HT), and 53.4% had no preference. Following education, a significantly greater number of participants chose each graft type; 37.7% (<i>P</i> < .01) preferred BPTB, 21.6% (<i>P</i> < .01) preferred QT, and 13.8% (<i>P</i> < .01) preferred HT. Significantly fewer participants had no preference (26.9%; <i>P</i> < .01). Among the most important factors in patient preference was surgeon preference (n = 357; 72.7%), as 424 (86.4%) participants said they would switch their graft preference if their surgeon recommended it.</p><p><strong>Conclusion: </strong>The findings of this study imply that informed patients can participate in medical decision making with respect to their graft choices in ACLR and that providing educational information can help surgeons and patients work together to optimize patient care.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251362631"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963551","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":"Effect of Different Footwear on the Knee Joint: Biomechanical Analysis and Acute T2 Relaxation Time Changes After Walking in Minimalistic and Neutral Footwear.","authors":"Jan Malus, Victor Casula, Jan Urbaczka, Dominik Vilimek, Miika Nieminen, Joe Hamill, Veronika Horka, Marketa Rygelova, Jaroslav Uchytil","doi":"10.1177/23259671251346985","DOIUrl":"10.1177/23259671251346985","url":null,"abstract":"<p><strong>Background: </strong>Walking in minimalistic footwear (MF) increases mechanical loading on the knee joint, exposing it to acute stresses that may heighten the risk of early onset of knee osteoarthritis. This type of footwear can modify walking patterns in the lower limbs, further intensifying joint stress and contributing to the deterioration of articular surfaces.</p><p><strong>Purpose: </strong>First, to evaluate the differences in kinetic variables associated with the early onset of knee osteoarthritis between MF and neutral footwear (NF) during walking; second, to determine the extent of acute cartilage loading in the knee joint, particularly footwear after 45 minutes of walking in an urban environment, using magnetic resonance imaging (T2 relaxation times [T2RTs] and percentage change of loading) in weightbearing zones.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Knee forces and knee moments were obtained during walking trials of 20 healthy participants using statistical parametric mapping. The analysis focused on alterations across specific intervals of the stance phase, expressed as percentages of the gait cycle. T2RT values of cartilage were quantified using a 1.5 T magnetic resonance imaging at baseline and immediately after 45 minutes of walking in each condition.</p><p><strong>Results: </strong>Significant differences were observed in knee force during the stance phase: (1) in the sagittal plane, greater values were between 2% and 9% and between 90% and 100%, and lower values were between 18% and 40% and between 62% and 85% in MF; (2) the frontal plane showed lower values between 7% and 14% and 98% in MF, and greater values were between 7% and 14% and 98% in MF; and (3) the transversal plane showed greater values between 0% and 9% and between 54% and 78%, and lower values were between 25% and 40% and between 81% and 100% in MF. Knee adduction moment showed significantly lower values between 0% and 8%, 32% and 90%, and >92% and 100%. Knee flexion moment showed significantly lower values between 3% and 5%, 25% and 69%, and >7% and 19% in MF. The main effect of loading in NF of cartilage showed significantly lower T2RT values in all superficial femur parts and significantly greater T2RT values in deep central tibia. MF showed significantly lower T2RT values in the superficial anterior-posterior femur in the medial cartilage compartment.</p><p><strong>Conclusion: </strong>Increased knee moments in all planes reflect the effect of an acute change to particular footwear. NF reveals a greater response to loading in weightbearing knee cartilage zones. The superficial layers appeared to be more sensitive to loading after 45 minutes of walking.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251346985"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963849","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 Relationship of Meniscal Extrusion to Subchondral Bone Density in Medial Knee Osteoarthritis.","authors":"Taku Ebata, Koji Iwasaki, Tomoya Sato, Yoshiaki Hosokawa, Masanari Hamasaki, Dai Sato, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki","doi":"10.1177/23259671251366424","DOIUrl":"10.1177/23259671251366424","url":null,"abstract":"<p><strong>Background: </strong>The hoop function of the meniscus plays a crucial role in stress distribution across the knee joint. While medial meniscal extrusion is known to contribute to the progression of medial knee osteoarthritis (OA) by altering load distribution within the knee joint, its exact effect on living humans remains unclear.</p><p><strong>Purpose: </strong>To investigate the influence of meniscal extrusion on subchondral bone density distribution in patients with medial knee OA.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective study included 59 patients with medial knee OA (OA group) and 19 control participants (non-OA group). Radiographic parameters, including the hip-knee-ankle angle (HKA) and meniscal extrusion ratio (MER), were assessed. The subchondral bone density was evaluated using computed tomography-osteoabsorptiometry to analyze the high-density area (HDA) in the medial and lateral compartments on the articular surface of the proximal tibia. Correlations between these parameters were assessed using single and multiple regression analyses, with subgroup analysis conducted in OA patients with and without meniscal tears.</p><p><strong>Results: </strong>In the OA group, the HKA, medial MER (MMER), and the ratio of the medial compartment HDA to the total HDA (medial ratio) were -7.4°, 64.8%, and 81.8%, respectively. In the non-OA group, these values were -2.1°, 12.5%, and 62.0%. Simple regression analysis showed that, in the OA group, the medial ratio was correlated with HKA (<i>R</i> ² = 0.216; <i>P</i> < .001) and MMER (<i>R</i> ² = 0.307; <i>P</i> < .001). Among non-OA participants, only MMER was correlated with the medial ratio (<i>R</i> ² = 0.217; <i>P</i> = .045). The multivariable regression analysis demonstrated an adjusted <i>R</i> ² value of 0.38 (<i>P</i> < .001) in the OA group. The standardized coefficients were 0.465 for MMER and -0.340 for HKA. Subgroup analysis further indicated that meniscal injury in OA patients amplified the effect of extrusion on subchondral bone density distribution, with an adjusted <i>R</i> ² of 0.54 in the meniscal tear group.</p><p><strong>Conclusion: </strong>MMER had a greater influence on the mediolateral distribution of subchondral bone density in patients with medial knee OA than lower limb alignment, suggesting that the hoop function of the meniscus plays a more important role in altering stress distribution than leg alignment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251366424"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963796","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}