Orthopaedic Journal of Sports Medicine最新文献

{"title":"Predicting ACL Reconstruction Failure with Machine Learning: Development of Machine Learning Prediction Models.","authors":"Rafael Krasic Alaiti, Caio Sain Vallio, Andre Giardino Moreira da Silva, Riccardo Gomes Gobbi, José Ricardo Pécora, Camilo Partezani Helito","doi":"10.1177/23259671251324519","DOIUrl":"10.1177/23259671251324519","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) is the predominant and widely accepted treatment modality for ACL injury. However, recurrence of ACL rupture or failure of the reconstruction remains a significant challenge. Despite several studies in the literature that have developed prediction models to address this issue by identifying prognostic factors for treatment outcomes using classical statistical methods, the predictive efficacy of these models is frequently suboptimal.</p><p><strong>Purpose: </strong>To (1) evaluate the predictive performance of different machine learning algorithms for the occurrence of failure in ACLR and (2) identify the most relevant predictors associated with this outcome.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 680 patients who underwent ACLR between January 2012 and July 2021 were evaluated. The study outcome was ACLR failure-defined as a complete tear confirmed by magnetic resonance imaging, arthroscopy, or clinical ACL insufficiency-evaluated at a minimum 2-year follow-up. Routinely collected data were used to train 9 machine learning algorithms-including k-nearest neighbors classifier, decision tree classifier, random forest classifier, extra trees classifier, gradient boosting classifier, eXtreme Gradient Boosting, CatBoost classifier, and logistic regression. A random sample of 70% of patients was used to train the algorithms, and 30% were left for performance assessment, simulating new data. The performance of the models was evaluated with the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The predictive performance of most models was good, with AUCs ranging from 0.71 to 0.85. The models with the best AUC metric were the CatBoost classifier (0.85 [95% CI, 0.81-0.89]) and the random forest classifier (0.84 [95% CI, 0.77-0.90). Knee hyperextension consistently emerged as the primary predictor for ACLR failure across all models subjected to our analysis.</p><p><strong>Conclusion: </strong>Machine learning algorithms demonstrated good performance in predicting ACLR failure. Moreover, knee hyperextension consistently emerged as the primary predictor for failure across all models subjected to our analysis.</p><p><strong>Clinical relevance: </strong>The findings of this study highlight the potential of machine learning as a valuable clinical tool for decision-making on surgical intervention. By offering nuanced insights, these algorithms may contribute to the evolving landscape of orthopaedic practice. Also, this study confirms knee hyperextension as an important risk factor for ACLR failure.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251324519"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720926","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":"Mechanical Properties of Tibialis Tendon Grafts Are Unchanged by Soaking in Tobramycin.","authors":"Michael Burton, Tyler Barker, Zachary Burnett, Robert Magnussen, Christopher Kaeding, Eric Milliron, Parker Cavendish, Franco Piscitani, Jeremy Seidt, David Flanigan","doi":"10.1177/23259671251325663","DOIUrl":"10.1177/23259671251325663","url":null,"abstract":"<p><strong>Background: </strong>Tendon graft soaking in vancomycin solution minimizes surgical infection risk and has no effect on graft strength, but the intermittent vancomycin shortages, presence of vancomycin-resistant organisms, and treatment needs of patients with vancomycin hypersensitivity merit investigation of alternative antibiotics. Tobramycin prevents infection at low concentrations and is a cost-effective alternative, but it is unknown if tobramycin alters graft mechanical properties.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to investigate the effects of tobramycin soaking on tendon graft mechanical properties. It was hypothesized that tobramycin soaking will not affect tendon graft mechanical properties.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 30 tibialis tendon grafts were wrapped in saturated gauze swabs containing saline (control; n = 10), vancomycin (n = 10; 5 mg/mL), or tobramycin (n = 10; 1 mg/mL) for 10 minutes. Grafts were then removed from the treated gauze swab wraps and mechanically tested under uniaxial tension loading conditions. Grafts were pulled at a rate of 10 mm/min to failure. Force and displacement data from each test were used to calculate the Young modulus (MPa), ultimate tensile stress (MPa), and elasticity limit (MPa).</p><p><strong>Results: </strong>There were no significant differences in Young modulus (552 ± 108, 583 ± 98, and 660 ± 237 MPa; <i>P</i> = .62), ultimate tensile stress (91.5 ± 20.8, 96.6 ± 17.8, and 99.7 ± 33.3 MPa; <i>P</i> = .85), or elasticity limit (51.7 ± 16.4, 53.2 ± 13.8, and 52.3 ± 15.3 MPa; <i>P</i> = .98) between the control, vancomycin, and tobramycin groups, respectively.</p><p><strong>Conclusion: </strong>Soaking of tibialis tendon grafts with tobramycin does not appear to alter mechanical properties of the tendon graft under uniaxial load conditions.</p><p><strong>Clinical relevance: </strong>If vancomycin use is not possible or contraindicated for certain patients, surgeons can soak grafts in tobramycin to achieve similarly effective infection mitigation without weakening the graft.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251325663"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720925","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 Outcomes in Application of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in Medial Collateral Ligament Recovery: An Animal Study.","authors":"Muhammad Sakti, Henry Yurianto, Dave Kennedy","doi":"10.1177/23259671251324472","DOIUrl":"10.1177/23259671251324472","url":null,"abstract":"<p><strong>Background: </strong>The medial collateral ligament (MCL) is one of the most commonly injured ligaments in the knee, accounting for 40% of all knee injuries. Autologous platelet concentrate, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), has been proposed as a novel therapy in ligament injury.</p><p><strong>Purpose: </strong>To evaluate the effectiveness of PRP and PRF in recovery after MCL injury.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>This study was a randomized, single-blind, in vivo study on MCL injury in Wistar rats (<i>Rattus norvegicus</i>). Rats that were sick, had a decrease in body weight of >10% after adaptation in the laboratory, or died were excluded. A total of 30 male Wistar rats were divided into 3 groups: group 1 (n=10) received no intervention, group 2 (n=7) received PRP, and group 3 (n=10) received PRF. The variables that were investigated included tensile strength and histopathological appearance. All statistical analysis was performed using SPSS 22.0 using the appropriate test based on the variable.</p><p><strong>Results: </strong>This study found that there was a significant difference in tensile strength across all groups (<i>P</i> = .004), with a significantly higher value in the PRF group compared with the PRP group (mean difference, 2.76; <i>P</i> = .003). There was no significant correlation between tensile strength and ligament length (<i>P</i> = .34). Based on the histopathological data, this study found that PRF resulted in a higher amount of collagen cell orientation when compared with PRP and control (<i>P</i> = .049).</p><p><strong>Conclusion: </strong>This study found that PRF was associated with greater tensile strength when compared with PRP and control. However, more studies with a longer observation period and further trials, especially in humans, should be conducted to confirm this finding.</p><p><strong>Clinical relevance: </strong>PRF injection can be a novel therapy consideration for ligament injury, with a better result in both function and histological appearance when compared with PRP.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251324472"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720924","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":"Surgical Stabilization Results in Superior Clinical Outcome, Lower Recurrent Instability, and Reduced Risk of Meniscal Tears Relative to Nonoperative Treatment of ACL Rupture: A 3-Year Prospective Controlled Cohort Study.","authors":"Mark D Porter, Bruce Shadbolt","doi":"10.1177/23259671251320647","DOIUrl":"10.1177/23259671251320647","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There has been renewed interest in nonoperative treatment of anterior cruciate ligament (ACL) rupture following research suggesting that some ACL ruptures can heal naturally. However, the research is based on magnetic resonance imaging grading of ACL injuries rather than clinical signs, and the accuracy of the grading system is unknown. Nonoperative treatment of ACL ruptures has been associated with a higher risk of meniscal tears and recurrent instability, both of which may have long-term implications for the knee in terms of degeneration and the need for more complex stabilization surgery. More research into the nonoperative management of clinically significant ACL injuries is indicated before consideration for use in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;Operative management of ACL rupture improves clinical outcome relative to nonoperative management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Covid-19 pandemic temporarily stopped elective surgery during 2020. For 2 months, those patients with isolated ACL ruptures underwent nonoperative treatment with bracing and physical therapy (Nonop group) were compared with a matched cohort undergoing ACL reconstruction (ACLR group) immediately before this period. Groups were compared at baseline with regard to age, gender, body mass index (BMI), lateral posterior tibial slope (LPTS), and the following patient-reported outcome measures (PROMs)-Tegner Activity Scale (TAS), International Knee Documentation Committee (IKDC), Sport and Recreation subscale (Sport/Rec) of the Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Related Quality of Life (KR QoL) subscale of the KOOS, and Lysholm Knee Score (LKS)-as well as recurrent instability and meniscal tears, over a period of 3 years. Pearson chi-square test and analysis of variance were used for baseline characteristics, generalized linear models and multivariate tests for changes in PROMs, and chi-square tests for meniscal tears and recurrent instability. Statistical significance was accepted at &lt;i&gt;P&lt;/i&gt; &lt; .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 82 patients were recruited, 41 in each group. The ACLR group and the Nonop group were similar with regard to all baseline variables, with the following mean ± SD values, respectively: age in years (22.1 ± 3.8 vs 21.3 ± 3.4; &lt;i&gt;P&lt;/i&gt; = .23), BMI in kg/m&lt;sup&gt;2&lt;/sup&gt; (21.0 ± 2.0 vs 20.4 ± 2.5; &lt;i&gt;P&lt;/i&gt; = .39), LPTS (8.1° ± 1.3° vs 7.9° ± 2.0°; &lt;i&gt;P&lt;/i&gt; = .65), and preinjury TAS (8.2 ± 1.1 vs 8.7 ± 1.0; &lt;i&gt;P&lt;/i&gt; = .33). The male:female ratio was 15:26 vs 17:24 (&lt;i&gt;P&lt;/i&gt; = .71), respectively. At 3-year follow-up, the ACLR group had greater improvement in all PROMs than the Nonop group: TAS, 8.0 ± 1.0 vs 5.5 ± 0.9; IKDC, 90.9 ± 3.8 vs 65.0 ± 8.1; Sport/Rec, 92.4 ± 7.6 vs 66.6 ± 6.1; KR QoL, 91.1 ± 5.5 vs 74.3 ± 6.6; and LKS, 92.2 ± 4.9 vs 66.9 ± 6.1, respectively (all &lt;i&gt;P&lt;/i&gt; &lt; .001). There was","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251320647"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692969","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":"Midterm Outcomes After Revision Posterior Labral Repair in Active-Duty Military Patients.","authors":"John P Scanaliato, Amy Thompson, Clare K Green, Alexis B Sandler, Cole M Patrick, John R Tyler, Nata Parnes","doi":"10.1177/23259671251322695","DOIUrl":"10.1177/23259671251322695","url":null,"abstract":"<p><strong>Background: </strong>Active-duty military service members experience posterior glenohumeral instability at a rate that far outpaces that of nonmilitary populations. While the outcomes after primary posterior labral repair (PLR) in this population are promising, the outcomes after revision procedures remain poorly described.</p><p><strong>Purpose: </strong>To report midterm outcomes after revision PLR in a population of active-duty military patients.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Patients who underwent revision PLR from January 2011 through December 2018 by the senior surgeon with a minimum of 5 years of follow-up were deemed eligible for inclusion. Preoperative and postoperative outcome scores for the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation (SANE), and the Rowe instability score as well as the rates of return to active duty and sports and the rate of recurrent instability were collected and pooled for analysis.</p><p><strong>Results: </strong>Overall, 21 patients with a mean follow-up of 77.95 ± 39.54 months met inclusion criteria and were available for analysis. At midterm follow-up, patients who underwent revision PLR experienced significantly improved VAS (from 7.3 ± 1.8 to 2.9 ± 2.4), ASES (from 49.5 ± 12.6 to 79.7 ± 16.7), SANE (from 45.0 ± 14.8 to 80.2 ± 20.3), and Rowe (from 37.6 ± 9.4 to 79.4 ± 24.7) scores. Over 80% of patients also achieved the minimal clinically important difference for these outcome measures; however, only 52% to 62% of patients achieved the Patient Acceptable Symptom State. The return-to-sport rate was 66.67%, and the return to active-duty rate was 80.95%.</p><p><strong>Conclusion: </strong>While patients who underwent revision PLR experienced improvements in outcomes and a decrease in pain on average, they exhibited rates of return to active-duty and sports that lagged behind those demonstrated in a previous cohort that underwent a primary procedure. Furthermore, the achievement of clinically significant outcomes after revision PLR was less consistent compared with that after primary PLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322695"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692963","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":"Use of Ankle-GO to Assess and Predict Return to Sport After Lateral Ankle Reconstruction for Chronic Ankle Instability.","authors":"Alexandre Hardy, Kinan Freiha, Mohamad K Moussa, Eugénie Valentin, Gauthier Rauline, Kylian Alvino, Francois Fourchet, Brice Picot, Ronny Lopes","doi":"10.1177/23259671251322903","DOIUrl":"10.1177/23259671251322903","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) develops in 20% to 40% of patients after ankle sprains because of inappropriate management or a premature return to sports (RTS). Patients become candidates for surgery when nonoperative treatment fails. The results of arthroscopic lateral ligament reconstruction have been shown to be excellent. However, there is no consensus on the RTS criteria in these cases. The Ankle-GO score, which has been validated in lateral ankle sprains, is an evidence-based protocol for RTS.</p><p><strong>Purpose: </strong>To evaluate the discriminant and predictive capacity of the Ankle-GO score for RTS after arthroscopic lateral ankle reconstruction.</p><p><strong>Study design: </strong>Cohort study. Level of evidence, 2.</p><p><strong>Methods: </strong>This prospective multicenter cohort study, conducted between January 2022 and January 2023, evaluated patients with CAI who underwent arthroscopic anatomic lateral ankle ligament reconstruction using gracilis tendon autografts or allografts. The RTS rates at 4 and 6 months postoperatively were the primary and secondary outcomes, respectively. The evaluated variable at both timelines was the Ankle-GO score-a composite of 4 functional tests and 3 questionnaires. The study determined the discriminant validity of the Ankle-GO score for RTS at each timeline-Ankle-GO scores at 4 months for RTS at 4 months; Ankle-GO scores at 6 months for RTS at 6 months. The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was also evaluated.</p><p><strong>Results: </strong>A total of 51 patients, with a mean age of 32.8 years, were included, of whom 23 (45%) had returned to sports at 4 months and 39 (76.5%) at 6 months. The mean Ankle-GO score was significantly higher in the group that returned to sports than in the group that did not (12 ± 4.7 vs 8.8 ± 4.7 at 4 months, respectively, <i>P</i> = .003; 16.8 ± 3.6 vs 11.3 ± 4.8 at 6 months, respectively, <i>P</i> = .002).The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was good, with an area under the curve of 0.74 (95% CI, 0.58-0.90; <i>P</i> = .005). The optimal threshold was 6 (sensitivity, 95%; specificity, 50%). The odds ratio of RTS when surpassing the Ankle-GO cutoff score was 18.5 (95% CI, 3-113.95; <i>P</i> = .002).</p><p><strong>Conclusion: </strong>The Ankle-GO score is effective in discriminating the RTS status at 4 and 6 months after lateral ligament reconstruction of the ankle. In addition, the Ankle-GO score at 4 months was also moderately predictive of RTS at 6 months after surgery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322903"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693002","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 Association Between Concomitant Meniscal Tear, Tibial Slope, Static Knee Position, and Anterior Knee Laxity in ACL-Deficient Patients.","authors":"Tzu-Ching Huang, Chi-Hsiu Wang, Kai-Lan Hsu, Fa-Chuan Kuan, Wei-Ren Su, Chih-Kai Hong","doi":"10.1177/23259671251324186","DOIUrl":"10.1177/23259671251324186","url":null,"abstract":"<p><strong>Background: </strong>Whether the tibial slope or the concomitant meniscal tear is related to static knee position or anterior knee laxity remains controversial.</p><p><strong>Purpose: </strong>To investigate the association between medial and lateral posterior tibial slope, concomitant meniscal tear, static knee position using magnetic resonance imaging (MRI), and anterior knee laxity measured with the GNRB arthrometer.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 60 patients who underwent anterior cruciate ligament (ACL) reconstructions were retrospectively enrolled from May 2020 to October 2022. All patients underwent both MRI and GNRB arthrometry after the injury. The static knee position and medial and lateral tibial slopes were measured using MRI. The meniscal tear type was confirmed during arthroscopic surgery. Descriptive data were retrospectively reviewed from the medical records.</p><p><strong>Results: </strong>The side-to-side differences of anterior tibial translation at 134 N in the intact meniscus, isolated lateral meniscal tear, isolated medial meniscal tear, and both meniscal tear groups were 3.63 ± 1.4 mm, 4.61 ± 1.5 mm, 2.85 ± 1.5 mm, and 4.85 ± 1.6 mm, respectively (<i>P</i> = .003). The slopes of the force-displacement curve in the GNRB arthrometer were 6.55 ± 4.8 mm/N, 16.99 ± 5.6 mm/N, 9.69 ± 10.8 mm/N, and 10.89 ± 7.4 mm/N in the intact meniscus, lateral meniscal tear, medial meniscal tear, and both meniscal tear groups, respectively (<i>P</i> = .001). Subgroup analysis showed that patients with lateral meniscal tears tended to have greater anterior knee laxity based on the GNRB arthrometer tests. The medial and lateral tibial slopes were not correlated with static knee position or anterior knee laxity.</p><p><strong>Conclusion: </strong>Patients with ACL deficiency and concomitant lateral meniscal tears are more likely to exhibit greater anterior knee laxity, as measured using the GNRB. Clinicians should consider the concomitant lateral meniscal tear when planning surgery and arranging postoperative care. Tibial slopes were not found to be correlated with static knee position or anterior knee laxity.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251324186"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692985","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":"In Vitro Ovine Cam Impingement Model and Its Effect on Acetabular Cartilage.","authors":"Onur Hapa, Selahaddin Aydemir, Fatma Bahar Sunay, Ahmet Emrah Acan, Pakize Nur Akkaya, Mustafa Celtik, Resit Bugra Husemoglu, Mehmet Salin","doi":"10.1177/23259671251322757","DOIUrl":"10.1177/23259671251322757","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome is a condition where abnormal contact occurs between the femoral head and the acetabulum, leading to chondral damage and hip osteoarthritis. To better understand and treat femoroacetabular impingement syndrome, it is crucial to establish in vitro models that mimic the condition and assess potential interventions.</p><p><strong>Purpose: </strong>To establish an in vitro ovine cam impingement model and assess the effectiveness of cam excision in reducing the incidence of type 3 acetabular labrum articular disruption (ALAD) (chondral flap) lesions.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Utilizing an ovine in vitro cam impingement model, 40 hips were subjected to testing across 5 groups (n = 8 per group): group 1 (control group), 750 N for 200 cycles; group 2 (cycle decrease), 750 N for 100 cycles; group 3 (load decrease), 500 N for 200 cycles; group 4 (cam excision), cam excision followed by 750 N for 200 cycles; and group 5 (halfway cam excision), 750 N for 100 cycles followed by cam excision under an additional 750 N for 100 cycles loading. Each specimen was subsequently assessed for chondral damage according to the ALAD classification, both macroscopically and microscopically.</p><p><strong>Results: </strong>The control group (group 1) demonstrated the highest ALAD scores (2.7 ± 0.4, 2.8 ± 0.3) compared with other groups, whereas the cam excision group (group 4) exhibited lower scores (0.5 ± 0.5, 0.7 ± 0.4) than both the cycle decrease group (group 2) (1.6 ± 0.5, 1.6 ± 0.5) and the halfway cam excision group (group 5) (1.8 ± 0.6, 2 ± 0.5) (<i>P</i> < .05) in both macroscopic and microscopic gradings (<i>P</i> < .05). The load decrease group (group 3) (1 ± 0.5) also displayed lower scores compared with group 5 (2 ± 0.5) at histological grading (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>An in vitro sheep model was established that reliably induces mechanical chondrolabral damage in the hip joint. The findings show that reducing the load results in less chondrolabral damage compared with reducing the number of cycles. Furthermore, this model emphasizes the protective effect of cam excision in the management of chondral flap lesions (ALAD type 3).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322757"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692957","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":"Examining Planar Contributions to Knee Total Joint Moment Between Women and Men During Loaded Gait Tasks.","authors":"Kellen T Krajewski, Camille C Johnson, Qi Mi, Shawn D Flanagan, William J Anderst, Christopher Connaboy","doi":"10.1177/23259671251322785","DOIUrl":"10.1177/23259671251322785","url":null,"abstract":"<p><strong>Background: </strong>Military personnel in combat roles observe a high prevalence of knee osteoarthritis. Knee total joint moment (KTJM) and the knee adduction moment percentage contribution (KAM%) of KTJM have been linked to knee osteoarthritis. It is postulated that sex, load carriage, and imposed locomotion patterns such as forced marching (FM) alter mechanics of the knee. The purpose of this study was to determine the effects of \"military-relevant\" load magnitudes, locomotion patterns, and sex on KTJM and its planar percentage contributions in recruit-aged adults during short-duration gait tasks.</p><p><strong>Hypothesis: </strong>The greatest load magnitude and FM will significantly increase KAM contribution to KTJM compared with lower magnitudes or no load. Additionally, women will exhibit greater KAM contribution to KTJM compared with men regardless of experimental condition.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Twenty healthy recruit-aged (18-35 years) adults (10 male, 10 female) executed trials of running and FM with no load (BW), an additional load of 45% of BW, and an additional load of 55% of BW. KTJM was calculated along with each plane of motion percentage contribution: knee flexion moment (KFM%), KAM%, and knee rotation moment (KRM%). A 3 × 2 × 2 mixed model analysis of variance was used to evaluate the effects of load carriage, locomotion pattern, and sex on KTJM, KFM%, KAM%, and KRM% at multiple gait events of stance phase.</p><p><strong>Results: </strong>FM exhibited a greater (<i>P</i> < .001) KTJM than running at heel strike. Running had greater KAM% (<i>P</i> = .01) and KRM% (<i>P</i> < .001) compared with FM. At midstance, running exhibited greater (<i>P</i> < .001) KTJM than FM for each load condition; however, FM had greater KAM% (<i>P</i> < .001) and KRM% (<i>P</i> = .002) compared with running at peak vertical ground reaction force and midstance. Men exhibited greater KAM% at heel strike (<i>P</i> = .02) independent of locomotion pattern and at midstance (<i>P</i> = .04) for FM.</p><p><strong>Conclusion: </strong>Load carriage increases KAM% to a magnitude similarly observed in populations with knee osteoarthritis, especially when executing FM. Interestingly, men exhibited greater KAM% than women, suggesting differing strategies to motor execution with relative load carriage.</p><p><strong>Clinical relevance: </strong>Screening recruits for greater KAM% during loaded gait tasks may identify individuals in need of specialized training to reduce the risk of knee osteoarthritis development.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322785"},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670464","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":"Midterm Outcomes of Hybrid Transepiphyseal ACL Reconstruction With Soft Tissue Quadriceps Tendon Autograft in Skeletally Immature Athletes.","authors":"Jesse Seilern Und Aspang, Jordan Serrano-Dennis, Kyle E Hammond, Harris S Slone, Jason G Garry, Camryn Petit, Gregory D Myer, Danielle Seguin, John W Xerogeanes","doi":"10.1177/23259671251322758","DOIUrl":"10.1177/23259671251322758","url":null,"abstract":"<p><strong>Background: </strong>Substantial developments in physeal-sparing surgical techniques for anterior cruciate ligament (ACL) reconstruction (ACLR) have demonstrated safety and efficacy in treating skeletally immature patients. However, outcomes using all-soft tissue quadriceps tendon (QT) autograft in this population are unknown.</p><p><strong>Purpose: </strong>To evaluate outcomes including return to sport (RTS) and reinjury risk in skeletally immature patients ≥2 years after undergoing hybrid transepiphyseal ACLR using QT autograft.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A consecutive series of skeletally immature patients who underwent primary QT autograft ACLR using a hybrid transepiphyseal technique with ≥2 years of follow-up were retrospectively analyzed. Outcomes included RTS (primary), ability to return to preinjury level of competition, and subsequent ipsilateral/contralateral knee injury (secondary).</p><p><strong>Results: </strong>A total of 50 patients were identified and contacted, of which 40 (80.0%) (35 male; mean age, 12.6 years [range, 9.4-16.0 years]) completed the survey at 5.7 ± 2.8 years (range, 2.0-11.5 years) postoperation. Of those, 26 (65.0%) were competitive middle/high school athletes and 18 (45.0%) competed in ≥2 sports. At a mean of 10.6 ± 2.3 months (range, 6-17 months) postoperatively, 37 patients (92.5%) returned to unrestricted sports participation, and 35 patients (87.5%) resumed competition at their preinjury level. Five patients required subsequent ipsilateral knee surgery for ACL revision (n = 2; 5.0%), meniscal injury (n = 2; 5.0%), or symptomatic hardware (n = 1; 2.5%) after a mean of 4.4 ± 1.7 years (range, 2.8-7.1 years). Three patients (7.5%) sustained a subsequent contralateral ACL injury, and 1 patient sustained a contralateral posterior cruciate ligament sprain.</p><p><strong>Conclusion: </strong>Findings of this study suggest that midterm outcomes of patients treated with hybrid transepiphyseal ACLR using QT autograft are promising, with a high and expedited RTS and relatively low graft tear risk.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322758"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658083","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}