Orthopaedic Journal of Sports Medicine最新文献

{"title":"Combined Periacetabular Osteotomy and Hip Arthroscopy Results in High Return to Sport Rates in Contact and Noncontact Athletes With Hip Dysplasia.","authors":"Zachariah Whiting, Bhargavi Maheshwer, Marsalis Brown, Michael Salata, Robert Wetzel","doi":"10.1177/23259671261466470","DOIUrl":"10.1177/23259671261466470","url":null,"abstract":"<p><strong>Background: </strong>Prior studies of patients with hip dysplasia have documented 70% to 90% return to sport (RTS) with arthroscopy alone, 75% to 92% RTS with periacetabular osteotomy (PAO) alone, and approximately 82% to 86% RTS with combined PAO and hip arthroscopy.</p><p><strong>Purpose: </strong>To investigate the RTS rate in patients with hip dysplasia after combined PAO and hip arthroscopy.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This was a retrospective single-institution review of all patients who underwent a combined PAO and hip arthroscopy between 2016 and 2023. Inclusion criteria were hip dysplasia with a lateral center-edge angle (LCEA) <25° and documented participation in a sport or athletic activity undergoing a combined PAO and hip arthroscopy. Patients were excluded if they had follow-up for <6 months. Demographic data, modified Harris Hip Score (mHHS), RTS, and time to RTS were documented. Preoperative and postoperative radiographs were reviewed with documentation LCEA, extrusion index, acetabular index, and alpha angle.</p><p><strong>Results: </strong>A total of 103 athletic hips in 84 patients were included with a mean age and body mass index of 20.3 ± 6.9 years and 23.9 ± 4.5, respectively. Mean LCEA and AI were 20.8°± 5.4° and 11.9°± 4.8°, respectively. Mean preoperative and postoperative alpha angles were 61.5° and 40.1°, respectively. Mean postoperative follow-up was 514.9 ± 326.5 days. From this cohort, 89.3% of hips returned to sport at a mean of 297.5 days. There was no significant association between RTS rates and any demographics, diagnoses, or preoperative and postoperative measurements. There was no significant association between RTS and mHHS. There was no significant association between degree of dysplasia and RTS. Contact athletes had an 82.5% RTS and noncontact athletes had a 93.7% RTS.</p><p><strong>Conclusion: </strong>This study showed that a combination hip arthroscopy and PAO for the treatment of hip dysplasia exhibited high levels of RTS at 89.3%. There were high rates of RTS in patients with severe dysplasia and those participating in contact sports, specifically. Combined procedures appear to be a very successful option for patients with hip dysplasia hoping to RTS at a high level.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261466470"},"PeriodicalIF":2.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977625","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":"Recovery Trajectory of Range of Motion and Its Association With Patient Factors During Early Postoperative Stiffness After Arthroscopic Rotator Cuff Repair.","authors":"Yunjong Choi, Sanghyeon Lee, Sang-Jin Shin","doi":"10.1177/23259671261477946","DOIUrl":"10.1177/23259671261477946","url":null,"abstract":"<p><strong>Background: </strong>Postoperative shoulder stiffness may influence functional recovery after arthroscopic rotator cuff repair. However, predictors for progression to persistent shoulder stiffness have not been clearly established.</p><p><strong>Purpose: </strong>To identify factors associated with persistent stiffness and describe range of motion (ROM) recovery trajectory after arthroscopic repair of full-thickness rotator cuff tears.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>We retrospectively reviewed 352 patients who underwent arthroscopic complete repair. Stiffness was defined as forward flexion <120°, external rotation <30°, or internal rotation below L3. ROM, visual analog scale (VAS) score, American Shoulder and Elbow Surgeons score, Constant score, and tendon integrity were assessed, and patients reported the primary barrier to rehabilitation at 3 months. Predictors of persistent stiffness at 6 months were evaluated using multivariate logistic regression.</p><p><strong>Results: </strong>At 3 months, 165 patients (46.9%) met stiffness criteria. Compared with patients without stiffness, the stiffness group had poorer functional outcome (<i>P</i> < .001), higher pain (VAS, 2.2 ± 1.1 vs 1.8 ± 1.2; <i>P</i> = .002), and a lower retear rate (6.7% vs 14.4%; <i>P</i> = .019). Among patients with early stiffness, 34 (20.6%) had persistent stiffness at 6 months. Fear or anxiety about tendon retear was the most common barrier (50.3%), followed by pain (32.7%); however, persistent stiffness was most prevalent when pain was the primary barrier (67.6%). Higher pain score at 3 months independently predicted persistent stiffness (odds ratio, 1.44 [95% CI, 1.01-2.05]; <i>P</i> = .044).</p><p><strong>Conclusion: </strong>Early stiffness after arthroscopic rotator cuff repair is heterogeneous. Pain-driven stiffness is associated with persistence, whereas stiffness related to fear or anxiety about tendon retear is common but largely reversible; tailored management may improve recovery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261477946"},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956310","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":"Sex-Specific Adolescent Development of the Trochlea and Distal Femoral Physis: A 3D Shape Modeling Study.","authors":"Bryan Khoo, Marissa Lee Sinopoli, Christian E Wright, Amin Alayleh, Alan Anaya Gallegos, Seth L Sherman, Scott Delp, Akshay Chaudhari, Kevin G Shea, Anthony A Gatti","doi":"10.1177/23259671261463132","DOIUrl":"10.1177/23259671261463132","url":null,"abstract":"<p><strong>Background: </strong>Trochlear dysplasia is a primary risk factor for patellar instability and is associated with high recurrence rates, early arthritis, and poor return-to-sport outcomes. Surgical correction with trochleoplasty can improve tracking but carries risks in skeletally immature patients, including physeal damage and growth disturbance.</p><p><strong>Purpose: </strong>To inform safer surgical decision-making and refine current treatment strategies with a clearer understanding of how the trochlea and physis develop during adolescence is needed.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence 3.</p><p><strong>Methods: </strong>The authors retrospectively analyzed 261 nondysplastic knee magnetic resonance images from individuals aged 8 to 22 years. The authors trained a deep learning model to segment diaphyseal and epiphyseal femoral structures, and then constructed sex-specific statistical shape models of distal femoral shape and physis location. Regression analyses indicated a typical progression of femur shape with age.</p><p><strong>Results: </strong>Between ages 13 and 19 years, both sexes demonstrated proximal migration of the physis and deepening of the trochlea, with greater lateral trochlear depth than medial trochlear depth. Across this age range, medial and lateral trochlear growth progressed at similar rates. After age 16, males demonstrated a significantly greater size-standardized lateral trochlear depth than females.</p><p><strong>Conclusion: </strong>These findings enhance understanding of sex-specific trochlear development and physeal positioning while demonstrating the utility of deep learning-based 3-dimensional modeling for characterizing knee growth.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261463132"},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956362","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":"Clinical Outcomes of Rotator Cuff Tear Repair in Patients ≤45 Years of Age: A Retrospective Analysis of 108 Patients.","authors":"Sandrine Mariaux, Mikael Chelli, Pierre Abadie, Maxime Antoni, Laurent Baverel, Alexandre Hardy, Yves Bouju, Xavier Ohl, Charles-Edouard Thélu, Arnaud Godenèche","doi":"10.1177/23259671261476548","DOIUrl":"10.1177/23259671261476548","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the general population, the prevalence of rotator cuff tears (RCTs) is approximately 20.7%, with good clinical outcomes typically observed after rotator cuff repair (RCR). This prevalence is lower among patients ≤45 years of age. However, younger patients often have higher expectations after RCR. Despite this, few studies have specifically focused on this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to evaluate the clinical outcomes of patients ≤45 years of age after full-thickness RCR. It was hypothesized that RCR improves pain score, strength, and clinical score significantly in this age group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case series; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The authors retrospectively analyzed the records of patients aged ≤45 years at the time of surgery who underwent arthroscopic repair of a full-thickness RCT from 2011 to 2022 in 10 institutions by senior shoulder surgeons. Exclusion criteria were partial tears, revision surgery, and follow-up &lt;1 year. Clinical follow-ups were conducted at 12, 24, and 120 months postoperatively, including evaluations of pain using the visual analog scale (VAS) score, range of motion, strength in abduction, and Constant-Murley score assessments. Additionally, the complication rate and the duration of preoperative symptoms were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The authors retrospectively included 108 shoulders in 108 patients ≤45 years of age at the time of surgery who underwent full-thickness arthroscopic repair by senior fellow-trained shoulder surgeons. A double-row repair was performed in 40% of cases; otherwise, a single-row repair was performed for posterosuperior RCTs. The mean age was 40.5 years, and 66% were men, with a mean follow-up of 2.4 years. Tears were traumatic in 41% of cases. Patients were employed in 97% of cases: 19% were office workers, 46% were light manual workers, and 32% were heavy workers. The VAS score, forward elevation, external and internal rotation, Constant score, and strength had all significantly improved at 1 year postoperatively. The mean Constant score gain was 30.0 in patients with a traumatic tear and 21.0 in patients with a degenerative tear (&lt;i&gt;P&lt;/i&gt; = .001). The increase between preoperative and postoperative Constant scores was higher in patients with symptoms for &lt;6 months at the time of surgery than in patients with symptoms for ≥6 months at the time of surgery (&lt;i&gt;P&lt;/i&gt; = .023). Few (8.3%) complications were observed; most of them (8 patients) were postoperative stiffness that needed a specific treatment, and 1 patient had a symptomatic retear. In multivariate analysis, shoulder trauma was associated with higher postoperative Constant scores (&lt;i&gt;P&lt;/i&gt; = .0042). Work-related tear was associated with lower Constant scores at 1 year (&lt;i&gt;P&lt;/i&gt; = .0301).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients ≤45 years of age with RCT generally have a good cli","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261476548"},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956236","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":"Platelet Concentration Is Not Associated With Improved Pain for Partial-Thickness Rotator Cuff Tears Treated With Platelet-Rich Plasma: A Systematic Review and Meta-analysis With Meta-regression of Level 1 Randomized Controlled Trials.","authors":"Joseph J Lim, John W Belk, Carson Keeter, Emilea A Stepaniuk, Sophie D Gerber, Jacob F Oeding, Eric C McCarty, Rachel M Frank","doi":"10.1177/23259671261480483","DOIUrl":"10.1177/23259671261480483","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) has emerged as a nonoperative treatment option to manage pain and improve functionality in patients with partial-thickness rotator cuff tears. Previous studies examining the efficacy of PRP for the management of partial-thickness rotator cuff tears describe heterogeneous results.</p><p><strong>Purpose: </strong>To determine whether platelet concentration of a PRP injection as management for partial-thickness rotator cuff tears affects visual analog scale (VAS) pain scores.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify level 1 randomized controlled trials (RCTs) that evaluated the clinical efficacy of PRP for the management of partial-thickness rotator cuff tears. The search phrase used was \"rotator cuff partial platelet rich plasma.\" Included RCTs were classified as utilizing high-dose or low-dose PRP based on their platelet concentration factor as greater than a 4-fold increase over whole blood. The primary outcome evaluated was the standardized mean differences of VAS scores. Mixed-effects and random effects meta-analyses were performed along with meta-regression to evaluate relationships in VAS scores associated with PRP platelet dose.</p><p><strong>Results: </strong>Ten studies met inclusion and exclusion criteria, including a total of 635 patients (PRP, n = 307; control, n = 328). The mean patient age at the time of injection was 50.6 years, the mean follow-up time was 10.0 months, and the mean male sex distribution was 44.4%. Of the 10 studies, 6 studies utilized high-dose PRP and 4 studies utilized low-dose PRP. In both the meta-analysis and the meta-regression analyses, there were no significant differences in mean postinjection VAS scores between platelet dosage groups (<i>P</i> = .36 and <i>P</i> = .37, respectively).</p><p><strong>Conclusion: </strong>Among level 1 RCTs reporting VAS pain scores after PRP injection for partial-thickness rotator cuff tears, platelet concentration was not significantly associated with improved pain outcomes. However, substantial heterogeneity and inconsistent reporting of PRP composition limit the certainty of this finding.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261480483"},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956196","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":"Screw Versus Suture Bridge Fixation for Medial Femoral Condyle Osteochondritis Dissecans Demonstrate Comparable Healing Rates.","authors":"Michael J Kutschke, Keinan B Agonias, Charles W Wyatt, Jordan L Scheinberg, Benjamin L Johnson, Henry B Ellis, Philip L Wilson","doi":"10.1177/23259671261474714","DOIUrl":"10.1177/23259671261474714","url":null,"abstract":"<p><strong>Background: </strong>Fixation of unstable medial femoral condyle (MFC) osteochondritis dissecans (OCD) lesions aims to achieve osseous union while preserving the articular cartilage. Suture bridge fixation has emerged as an alternative to bioabsorbable implants or metallic headless compression screws.</p><p><strong>Hypothesis: </strong>The authors hypothesized that rates of union, conversion to a secondary cartilage restoration procedure, and patient-reported outcomes would not differ significantly between screw and suture bridge fixation, with fewer implant-related complications after suture bridge fixation.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A cohort of consecutive patients at a single center with unstable MFC OCD lesions treated with metallic headless compression screws or suture bridge constructs was studied using prospectively collected data from the multicenter Research in Osteochondritis of the Knee (ROCK) registry. Inclusion required a minimum of 6-month follow-up. Patient and lesion characteristics and surgical variables were recorded. Radiographic and advanced imaging outcomes, including magnetic resonance imaging-based healing criteria, were assessed to determine union status. Reoperation, secondary articular surface changes, conversion to a secondary cartilage restoration procedure, and patient-reported outcomes were compared between groups.</p><p><strong>Results: </strong>A total of 69 lesions were included, with a mean patient age of 14.3 ± 2.4 years. Final union status and conversion rates to a secondary cartilage restoration procedure were similar between screw (17.2%) and suture bridge (20%) fixation (<i>P</i>≥ .999), with no difference in timing of conversion (12.7 ± 8.7 vs 12.6 ± 9.2 months, respectively; <i>P</i> = .833). Implant removal rates were similar between screw (89.7%) and suture bridge (81.3%) groups (<i>P</i> = .478); however, screw fixation was associated with earlier time to permanent implant removal (5.1 ± 4.1 vs 8.5 ± 7.8 months; <i>P</i> = .019), and more severe secondary articular surface changes, including International Cartilage Repair Society grade 4 defects (10.7%) observed exclusively in the screw cohort (<i>P</i> < .001). No differences were observed between groups in improvement from baseline or final Pediatric International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score subscores, or Pediatric Functional Activity Brief Scale scores.</p><p><strong>Conclusion: </strong>Metallic headless compression screw and suture bridge fixation demonstrated comparable union rates, equivalent improvements in patient-reported outcomes, and no statistically significant difference in conversion to a secondary cartilage restoration procedure in unstable MFC OCD lesions. Suture bridge fixation allowed longer implant retention with reduced secondary articular surface damage.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261474714"},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956307","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 Comparison of Patellar Fixation Techniques in Medial Patellofemoral Ligament Reconstruction: A Pediatric Cadaveric Study.","authors":"Bryan Khoo, Henry B G Baird, Jude Alawa, Amin Alayleh, Thomas Johnstone, Calvin Chan, Kevin G Shea","doi":"10.1177/23259671261465205","DOIUrl":"10.1177/23259671261465205","url":null,"abstract":"<p><strong>Background: </strong>The biomechanical properties of different medial patellofemoral ligament (MPFL) reconstruction (MPFLR) techniques have been described in adult cadaveric models. However, little is known about the biomechanical properties of these techniques in pediatric specimens.</p><p><strong>Purpose: </strong>To (1) evaluate the biomechanical fixation strength of pediatric patellae in the context of MPFLR and (2) compare the performance of suture-anchor (SA) and bone-tunnel (BT) patellar fixation.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Ten pediatric cadaveric patellae from 6 donors (3 male and 3 female, mean 9.8 + 0.75 years, range 9-11 years) were utilized. For the all-SA group, two 1.8-mm all-SA, each loaded with sutures, were placed on the medial side of the patella at the articular cartilage margin. For the BTs, two 2-mm tunnels were drilled from the medial side of the patella to the anterior patellar surface. No. 2 braided suture was then passed through the tunnels. Both constructs were loaded into a servomechanical testing apparatus, and a suture was tied to the top frame such that pullout would be in the same plane as the fixation construct, oriented to approximate the plane of the native MPFL insertion.</p><p><strong>Results: </strong>BT constructs demonstrated a mean ultimate failure load of 169.8 ± 88.6 N, significantly higher than the 55.3 ± 20.1 N observed for SA constructs (<i>P</i> = .002). No significant difference in stiffness was found between BT (6 ± 1.9 N/mm) and SA (6.4 ± 1.7 N/mm; <i>P</i> = .647). The mechanisms of failure were anchor pullout for all SAs and suture cheese-wiring for all BTs.</p><p><strong>Conclusion: </strong>In this pediatric cadaveric model, BT fixation demonstrated higher ultimate failure loads than the SA fixation, while construct stiffness was similar between techniques.</p><p><strong>Clinical relevance: </strong>To our knowledge, this is the first biomechanical study of MPFL patellar fixation reconstruction techniques performed in pediatric specimens. To reduce the risk of patellar graft fixation failure, the relatively low load-to-failure of all-SA fixation demonstrated in this study may be considered when treating pediatric patients with lower bone density. Moreover, biomechanically superior small-diameter oblique BTs with low fracture risk may be considered to maximize time-zero fixation strength compared with SAs in the pediatric population. However, these results are limited by evaluating only a single all-SA design and a testing methodology that focused on time-zero fixation strength, without cyclic loading or in vivo healing.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261465205"},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956281","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 Effect of Activating the Scapular Muscles During Warm-up on Shoulder Function and Baseball Pitching Performance in Male Adult Baseball Players: An Approach Using Electric Muscle Stimulation.","authors":"Katsutoshi Nishino, Naoto Okamura, Hiroyuki Sekine, Kaoru Abe, Noriaki Yamamoto","doi":"10.1177/23259671261479170","DOIUrl":"10.1177/23259671261479170","url":null,"abstract":"<p><strong>Background: </strong>Various warm-up exercises have been developed to improve baseball pitching performance and prevent throwing injuries. Although their effectiveness has been evaluated, their underlying mechanisms remain unclear. These mechanisms require elucidation to help develop more effective warm-up exercises for pitchers from different backgrounds. Many clinicians and team staff focus on optimal warm-up of the glenohumeral joint, which is a common site for throwing injuries; thus, it is important to expand the knowledge regarding developing the optimal warm-up.</p><p><strong>Purpose/hypothesis: </strong>The purpose was to investigate the effects of scapular muscle activation during warm-up on shoulder joint function, pitching mechanics, and performance. The hypothesis behind activating the scapular muscles was that doing so would increase shoulder joint mobility and improve pitching mechanics and performance.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Fifteen male adult pitchers participated in this study. Two exercises were performed on the shoulder joint of the throwing side: the participant's usual warm-up (control) and activation of 2 scapular muscles (lower trapezius and infraspinatus) using electric muscle stimulation (EMS). Furthermore, EMS was set at 2 stimulation levels, resulting in 3 warm-up approaches. Joint mobility and pitch tests were performed immediately after each approach. These tests for each approach were repeated 3 times for each participant, with a washout period >7 days.</p><p><strong>Results: </strong>Of the 15 participants, 14 accomplished all tests. The EMS approach with stronger stimulation showed the following results as compared with the other 2 approaches: a significant increase in shoulder horizontal adduction in the passive mobility test and significant increases in shoulder-related kinematics, performance, and joint reaction force during pitching.</p><p><strong>Conclusion: </strong>Warm-up of the scapular muscles using EMS increased the shoulder joint function and yielded immediate improvement in pitching mechanics and performance. However, there was a potential risk of increased stress on the shoulder joint.</p><p><strong>Clinical relevance: </strong>Although warm-up activating 2 scapular muscles may be important for achieving better pitching performance, this warm-up may also be needed to (1) provide a coordination exercise of the scapular muscles to stabilize the glenohumeral joint and (2) control the pitch count for restraining the risk related to throwing injuries.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261479170"},"PeriodicalIF":2.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930252","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":"Mid-Term Osteoarthritis Prevalence After Partial Meniscectomy in Knees With High Posterior Tibial Slope.","authors":"Muhammed Enes Karataş, Ahmet Mucteba Yıldırım, Furkan Basak, İlyas Kar, Mehmet Salih Söylemez, Mahmut Enes Kayaalp","doi":"10.1177/23259671261479404","DOIUrl":"10.1177/23259671261479404","url":null,"abstract":"<p><strong>Background: </strong>While meniscal repair and partial meniscectomy are common treatments for meniscal tears, their comparative influence on mid-term osteoarthritis (OA) progression, particularly in relation to patient-specific anatomic factors, such as posterior tibial slope (PTS), and lesion-specific characteristics, such as tear morphology, remains incompletely understood.</p><p><strong>Purpose: </strong>To compare mid-term OA development and clinical outcomes after meniscal repair versus partial meniscectomy, evaluating the influence of PTS and tear morphology.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective comparative cohort included 378 knees treated with partial meniscectomy (n = 202) or meniscal repair (n = 176), with a minimum 5-year follow-up. The primary outcome was incident radiographic OA, defined as progression from a baseline Kellgren-Lawrence (K-L) grade of 0 or 1 to a K-L grade of ≥2 at final follow-up. Secondary outcomes included revision rates, complications, and patient-reported outcome measures (International Knee Documentation Committee [IKDC], Lysholm). High PTS was defined as >10°; and PTS, tear morphology, and the procedure-by-PTS interaction were evaluated using multivariable models.</p><p><strong>Results: </strong>At a mean follow-up of 8.1 ± 2.4 years, the incident radiographic OA was more frequent after partial meniscectomy than meniscal repair (47.5% vs 24.4%; <i>P</i> < .001). High PTS was associated with an increased incidence of radiographic OA (62.7% vs 22.5%; <i>P</i> < .001), and a significant procedure-by-PTS interaction was observed (<i>P</i> = .01), suggesting that this association differed between partial meniscectomy and meniscal repair. Compared with partial meniscectomy, meniscal repair was associated with higher final IKDC and Lysholm scores (both <i>P</i> < 0.001), but also with a higher revision rate (15.9% vs 6.4%; <i>P</i> = .003) and a shorter mean time to revision (2.6 vs 4.1 years; <i>P</i> = .02). Early complication rates were comparable (<i>P</i> = .68).</p><p><strong>Conclusion: </strong>Partial meniscectomy was associated with greater mid-term radiographic OA progression than meniscal repair. PTS and tear phenotype should be considered in preoperative decision-making, although these findings should be interpreted in light of the retrospective study design and potential residual confounding.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261479404"},"PeriodicalIF":2.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930206","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":"Are Comparable Short-term Outcomes Between Hamstring and Quadriceps Tendon Autografts for ACL Reconstruction Statistically Robust? A Reverse Continuous Fragility Index Analysis of Randomized Controlled Trials.","authors":"Tzu-Hao Tseng, Shau-Huai Fu, Yao-Chang Lo, Chien-Lin Chen, Hongsen Chiang","doi":"10.1177/23259671261479032","DOIUrl":"10.1177/23259671261479032","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials (RCTs) and meta-analyses have generally reported comparable short-term outcomes between hamstring tendon (HT) and quadriceps tendon (QT) autografts for anterior cruciate ligament reconstruction (ACLR). However, the statistical robustness of these nonsignificant continuous outcomes remains unclear.</p><p><strong>Purpose/hypothesis: </strong>To evaluate the robustness of nonsignificant continuous outcomes in RCTs comparing HT and QT autografts for ACLR using the reverse continuous fragility index (rCFI). It was hypothesized that these outcomes would demonstrate statistical robustness.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and the Cochrane Library was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines from database inception to April 2026. Level 1 RCTs comparing HT and QT autografts for primary adult ACLR were included if they reported ≥1 nonsignificant continuous outcome with sufficient summary statistics for rCFI calculation. The primary analysis evaluated nonsignificant primary continuous outcomes at the longest available follow-up. rCFI values were calculated using pseudoindividual data sets generated from published summary statistics and were compared with loss to follow-up. Reverse continuous fragility quotients were also calculated. Sensitivity analysis using 20 simulation seeds assessed estimate stability.</p><p><strong>Results: </strong>Eight RCTs including 562 allocated patients were included. At the follow-up time point used for primary analysis, 482 patients were available, with an overall loss to follow-up of 80 patients. Six studies reported nonsignificant primary continuous outcomes eligible for rCFI analysis. The mean rCFI was 17.4 ± 7.3, and the mean reverse continuous fragility quotient was 0.296 ± 0.069. All eligible primary outcomes had rCFI values greater than the corresponding loss to follow-up, and sensitivity analysis showed stable findings. Among 21 eligible secondary outcomes, 19 had rCFI values greater than loss to follow-up.</p><p><strong>Conclusion: </strong>Nonsignificant primary continuous outcomes in RCTs comparing HT and QT autografts for ACLR demonstrated statistical robustness. These findings support the stability of randomized evidence showing comparable short-term continuous outcomes between HT and QT autografts.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261479032"},"PeriodicalIF":2.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930217","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}