Orthopaedic Journal of Sports Medicine最新文献

{"title":"Open Versus Arthroscopic Fixation of Tibial-Sided Posterior Cruciate Ligament (PCL) Avulsion Fractures in Pediatric and Adolescent Athletes.","authors":"Evan W Beatty, Joshua H Pang, Michael Quinn, Yi-Meng Yen, Dennis E Kramer, Mininder S Kocher, Benton E Heyworth","doi":"10.1177/23259671251350304","DOIUrl":"https://doi.org/10.1177/23259671251350304","url":null,"abstract":"<p><strong>Background: </strong>Posterior cruciate ligament (PCL) avulsion fractures pose unique technical challenges for surgical fixation in the pediatric and adolescent population. Both arthroscopic and open management have been pursued; nonetheless, the literature is devoid of comparative studies elucidating factors for technique selection or relative outcomes.</p><p><strong>Purpose: </strong>To compare the demographic characteristics, presenting features, clinical course, return to sports (RTS), patient-reported outcomes (PROs), and complications associated with open and arthroscopic fixation cohorts of pediatric patients who sustained an isolated tibial-sided PCL avulsion fracture.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A medical record review was performed for all patients aged 8 to 19 years who underwent operative fixation of a tibial-sided PCL avulsion fracture between 2003 and 2021 at a single pediatric tertiary referral center. Patients were excluded if they sustained a femoral-sided avulsion fracture, underwent a PCL reconstruction, or presented with multiligamentous knee injury requiring surgical intervention for >1 ligament. All patients were sent 3 PRO instruments validated for children: Pediatric International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score-Child, and Hospital for Special Surgery Functional Activity Brief Scale.</p><p><strong>Results: </strong>A total of 20 patients met the inclusion criteria, of whom 10 patients were treated with open fixation and 10 with arthroscopic fixation. Also, 15 (75%) patients (7 open, 8 arthroscopic) returned PROs. No differences were detected in demographic characteristics, RTS, or PROs between cohorts. One patient in the open cohort developed a deep-tissue infection in the popliteal fossa, requiring open irrigation and debridement. One patient in the arthroscopic cohort eventually required PCL reconstruction for fracture nonunion associated with persistent instability.</p><p><strong>Conclusion: </strong>No differences in outcomes were detected in this study between cohorts of pediatric patients undergoing open and arthroscopic fixation of tibial-sided PCL avulsion injuries. Regardless of surgical technique, most patients healed without complications and returned to high activity levels. Given the postoperative complications seen in the arthroscopic cohort, further research is needed to investigate the potential biomechanical superiority of open technique fixation constructs.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251350304"},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529137","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 Glenohumeral Range of Motion, Shoulder Strength, and Humeral Torsion Between Right- and Left-handed High School Baseball Pitchers.","authors":"Hitoshi Shitara, Tsuyoshi Tajika, Tsuyoshi Ichinose, Tsuyoshi Sasaki, Noritaka Hamano, Masataka Kamiyama, Ryosuke Miyamoto, Kurumi Nakase, Fukuhisa Ino, Takuma Kachi, Yuhei Hatori, Koichiro Yanai, Atsushi Yamamoto, Kenji Takagishi, Hirotaka Chikuda","doi":"10.1177/23259671251349721","DOIUrl":"https://doi.org/10.1177/23259671251349721","url":null,"abstract":"<p><strong>Background: </strong>Differences in shoulder range of motion (ROM), shoulder muscle strength, and humeral torsion between left- and right-handed high school baseball pitchers remain poorly characterized.</p><p><strong>Hypothesis: </strong>Similar differences in shoulder ROM, strength, and humeral torsion between right-handed pitchers (RHPs) and left-handed pitchers (LHPs) observed in professionals will also be present in high school pitchers, with potential variations due to developmental stages.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors included 921 high school baseball pitchers (706 RHPs and 215 LHPs) and evaluated their age, height, weight, body mass index, baseball experience, shoulder ROM, and muscle strength. Humeral torsion was measured in 211 RHPs and 57 LHPs. The Mann-Whitney <i>U</i> test was performed to determine the differences between the RHPs and LHPs and between the dominant and nondominant sides in each group. Pearson correlation analysis was performed to test the relationship between humeral torsion and shoulder ROM. Logistic regression analysis was conducted to determine the independent factors associated with LHP.</p><p><strong>Results: </strong>LHPs exhibited increased nondominant external rotation (ER) (103.1° vs 100.0°; <i>P</i> = .004), dominant horizontal adduction (HA) (23.0° vs 19.6°; <i>P</i> = .015), and side-to-side ratio in prone internal rotation (PIR) strength (107.6% vs 98.3%; <i>P</i> < .001) compared with RHPs. Additionally, LHPs were shorter (171.4 vs 172.9 cm; <i>P</i> = .002) with lower side-to-side differences in ER (5.7° vs 8.9°; <i>P</i> < .001) and HA (-6.5° vs -11.3°; <i>P</i> < .001), dominant prone ER (PER) strength (15.4 vs 16.8 kgf; <i>P</i> = .040), side-to-side ratio in PER strength (93.1% vs 103.7%; <i>P</i> < .001), and side-to-side differences in humeral torsion (5.8° vs 9.9°; <i>P</i> = .011) compared with RHPs. After adjusting for confounding factors, a smaller side-to-side ratio in PER strength (<i>P</i> < .001; OR, 0.911) and larger side-to-side ratio in PIR strength (<i>P</i> < .001; OR, 1.031) were independent factors associated with being an LHP.</p><p><strong>Conclusion: </strong>LHPs have a decreased side-to-side ratio in PER strength and increased side-to-side ratio in PIR strength compared with RHPs. These findings suggest that shoulder-related biomechanical differences between right- and left-handed pitchers are evident in high school athletes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251349721"},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529134","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 the 2021 MLB Foreign Substance Policy on Pitcher Injury Rates and Statistics.","authors":"S Andrew Samborski, Neal ElAttrache, Steven Karnyski, Brooke Bergeron, Karen Ladnier, Michael Banffy","doi":"10.1177/23259671251346984","DOIUrl":"https://doi.org/10.1177/23259671251346984","url":null,"abstract":"<p><strong>Background: </strong>Major League Baseball (MLB) implemented a new foreign substance policy in June 2021. The effect of the new policy on pitcher injuries, wild pitches, hit batters, and pitching statistics is unknown.</p><p><strong>Purpose: </strong>To determine the effect of the new foreign substance policy regarding grip enhancement before and after its implementation on pitcher injury rate, wild pitches, hit batters, base on balls, strikeouts (SO), and home runs (HR).</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>MLB pitchers from the 2019 season were retrospectively compared with the pitchers from the 2022 season. Data were retrospectively collected on injuries and pitching statistics utilizing publicly available data. Primary outcome measures included pitcher injury rate, wild pitches, and hit batters. Secondary outcome measures included base on balls, SO, and HR. A nonparametric Wilcoxon rank-sum test was utilized for computing <i>P</i> values when comparing unadjusted non-normally distributed continuous outcomes and covariates between 2019 and 2022, which was adjusted for number of batters faced using either a linear regression model for adjusting means or a quantile regression model for adjusting medians.</p><p><strong>Results: </strong>In total, 828 pitchers in the 2019 season and 867 pitchers in the 2022 season were evaluated and included in this analysis. Pitcher overall injury rate per 1000 batters faced, hit batters, and SO did not show a statistical difference (<i>P</i> > .05). There was a statistically significant decrease in the adjusted number of wild pitches (2.9 vs 2.51; <i>P =</i> .04), adjusted earned run average (ERA) (4.51 vs 3.75; <i>P</i> < .01), adjusted base on balls (22.6 vs 21.1; <i>P =</i> .04), and adjusted HR (8.1 vs 6.1; <i>P</i> < .01) between the 2019 and 2022 seasons (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>Our study showed that the effect of MLB policy enforcement regarding grip enhancement did not demonstrate a change in pitcher injury rate, hit batters, or SO; however, there was a significant decrease in wild pitches, ERA, and base on balls. As a result, the new policy appears to maintain previous injury rate and pitching statistics while attempting to control for foreign substance use.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251346984"},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529165","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":"Heated Irrigation Fluids Did Not Reduce the Prevalence of Rectally Measured Hypothermia During Hip Arthroscopic Surgery Compared With Room-Temperature Fluids: A Prospective Randomized Trial.","authors":"Ahmet Fırat, Enejd Veizi, İlknur Kalaycı, Başak Sinem Sezgin, Yasin Erdoğan, Safa Gürsoy, Bruno Capurro-Soler, Christos Koutserimpas","doi":"10.1177/23259671251350401","DOIUrl":"https://doi.org/10.1177/23259671251350401","url":null,"abstract":"<p><strong>Background: </strong>Close monitoring and heated irrigation fluids have been frequently used to avoid hypothermia and associated complications during hip arthroscopic surgery. Saline fluids are used extensively in hip arthroscopic surgery, but they are routinely stored at room temperature and are cooler than the patient's core temperature.</p><p><strong>Purpose: </strong>To investigate the efficacy of heated irrigation fluids to prevent hypothermia during hip arthroscopic surgery and whether the core temperature measured rectally during hip arthroscopic surgery differs from the core temperature measured at the temporal region.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 2.</p><p><strong>Methods: </strong>Patients who underwent hip arthroscopic surgery for the treatment of femoroacetabular impingement syndrome between 2021 and 2023 were prospectively enrolled and divided into 2 groups: those whose irrigation fluids were stored at room temperature (group 1) and those whose irrigation fluids were heated to 36°C to 38°C (group 2). A probe inserted in the rectal mucosa was used to measure the patient's body temperature every 15 minutes. The patient's temperature was also measured at the temporal region with a laser thermometer. A body temperature <36°C, detected by either method, was considered as hypothermia. The method that detected hypothermia more quickly was investigated, and the effect of the heated irrigation fluids was explored. Statistical analyses were conducted to compare temperature measurements and the incidence of hypothermia between the groups using appropriate tests for categorical and continuous variables based on the data distribution.</p><p><strong>Results: </strong>There were 60 patients randomized and allocated to group 1 and 56 patients to group 2. Hypothermia, defined as a temperature <36°C, occurred in 32 patients (53.3%) in group 1 and 24 patients (42.9%) in group 2. There was no difference between the groups using heated or room-temperature fluids in the onset of hypothermia (<i>P</i> = .425). Significantly more hypothermia cases were detected by the rectal temperature measurement than by the temporal temperature measurement (54 vs 2 patients, respectively; <i>P</i> < .001). The rectal temperature measurement was also quicker in detecting hypothermia (69.6 ± 47.2 vs 138.2 ± 56.8 minutes, respectively; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>This study demonstrates that the usage of either room-temperature or heated irrigation fluids did not influence the incidence of hypothermia. Rectal measurements of core body temperature detected hypothermia earlier during hip arthroscopic surgery.</p><p><strong>Registration: </strong>NCT05396924 (ClinicalTrials.gov).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251350401"},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529136","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":"Partial Transphyseal All-Inside Anterior Cruciate Ligament Reconstruction in Skeletally Immature Adolescent Patients: Two-Year Minimum Follow-up Clinical and Radiologic Results.","authors":"Alessandro Carrozzo, Edoardo Monaco, Adnan Saithna, Matteo Romano Cantagalli, Nicola Carlo Bianco, Serena Ciacio, Alessandro Annibaldi, Nicola Maffulli","doi":"10.1177/23259671251350298","DOIUrl":"https://doi.org/10.1177/23259671251350298","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anterior cruciate ligament (ACL) injuries in pediatric and adolescent populations have seen an uptick due to increased competitive sports participation. Treatment paradigms have shifted from nonoperative management to early reconstruction to prevent meniscal and cartilage damage. However, no consensus exists on the optimal reconstruction technique, particularly in skeletally immature patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to evaluate the efficacy and safety of a limited transphyseal all-inside ACL reconstruction (ACLR) technique, hypothesizing that it would yield favorable clinical results without growth disturbances, graft failure, or complications at minimum 2-year follow-up.&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;Consecutive patients aged between 10 and 18 years undergoing ACLR at Sant'Andrea University Hospital of Rome from January 2015 to June 2021 were enrolled. Exclusion criteria were closed physes, previous knee surgeries, and multiligament injuries. The limited transphyseal all-inside technique was used to minimize physeal damage during ACLR by carefully controlling tunnel size, orientation, and depth. Patients underwent standardized follow-ups at 2 and 6 weeks and at 3, 6, 12, and 24 months postoperatively. In addition, all patients were recalled for a final evaluation between February and August 2023. The final assessment included a physical examination (range of motion, pivot shift, Lachman test, Rolimeter-measured laxity, limb-length discrepancy, and deformity) and completion of patient-reported outcome measures (PROMs). Postoperative longstanding anteroposterior radiographs were obtained to evaluate radiographic growth disturbance. A comprehensive magnetic resonance imaging (MRI) assessment was performed by measuring the signal-to-noise quotient (SNQ), tunnel widening, graft healing, and graft maturity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 24 patients met inclusion criteria, with a mean age of 14.2 years. At a mean follow-up of 53.1 months (range, 28-90), the graft rupture rate was 12.5%, and the contralateral ACL rupture rate was 8.3%. Overall, the incidence of growth disturbances was 15.8% in patients who underwent radiologic evaluation. These included cases of angular deformity of &gt;5° or limb-length discrepancy of &gt;10 mm. The mean limb-length discrepancy was 0.31 cm, with no significant differences in limb alignment. MRI analysis revealed a mean tibial tunnel widening of 5.1%, and the mean SNQ was 2.85 ± 0.91 (range, 1.5-4.4). Graft maturity, assessed using the Howell grading system, was classified as grade 1 in 50% of patients and grade 2 in the remaining 50%, while graft healing was graded as 1 in 60% and 2 in 40%; in both, lower grades indicated better results. PROMs showed high scores for Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee, and Ly","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251350298"},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529138","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":"Disparities Research in Sports Medicine Lacks Qualitative Studies, Community Engagement, and Original Interventions.","authors":"Jasmin S Vargas, Abdullah Arif, Amin M Alayleh, Peter C Shen, Eric H Durudogan, Neeraj M Patel","doi":"10.1177/23259671251350400","DOIUrl":"https://doi.org/10.1177/23259671251350400","url":null,"abstract":"<p><strong>Background: </strong>Across the health care landscape, patients experience disparities based on insurance, sex, gender, race, and other determinants. Such findings have been reported in orthopaedic sports medicine; nonetheless, the overall quality of the literature, including its limitations and impact, is unknown. Understanding this will allow researchers to address areas of need and ultimately reduce disparities.</p><p><strong>Purpose: </strong>To explore trends in orthopaedic sports medicine disparities research, with attention to study design, community engagement, and the development of interventions.</p><p><strong>Study design: </strong>Scoping review; Level of evidence, 3.</p><p><strong>Methods: </strong>The Clarivate Web of Science platform was queried for English-language articles in the orthopedics and sports sciences categories between 2013 and 2022 with the following keywords: \"disparities,\"\"disparity,\"\"inequity,\"\"inequities,\"\"diversity,\"\"socioeconomic,\"\"sex,\"\"gender,\"\"insurance,\"\"race,\" and \"neighborhood.\" Abstracts were reviewed manually to determine study inclusion. Bibliometric data were collected, as was information on the area of focus, study design, determinants of interest, funding sources, and intervention design. Descriptive statistics were recorded.</p><p><strong>Results: </strong>The query yielded 7274 articles, of which 86 addressed disparities or diversity topics in sports medicine. A total of 57 (66.3%) articles were published between 2019 and 2022, and 24 (27.9%) were published in 2022. Predominant journals included the <i>Orthopaedic Journal of Sports Medicine</i> (23.3%) and the <i>American Journal of Sports Medicine</i> (12.8%). Also, 29 articles (33.7%) focused on anterior cruciate ligament (ACL) injuries, and 12 (14%) on rotator cuff tears. Of the 80 observational research articles, the majority (63.8%) were retrospective, and there was a lack of randomized controlled trials or qualitative/mixed methods designs. No studies primarily utilized a community-engaged approach. A total of 31 publications (36%) studied multiple determinants or descriptive data, while 30.2% focused on sex or gender, and 18.6% on insurance. Only 2 (2.3%) studied neighborhood factors. Notably, only 1 study focused on an intervention. Further, only 3 studies (3.5%) were supported directly by the National Institutes of Health funding.</p><p><strong>Conclusion: </strong>This study provides insights into the evolving landscape of sports medicine disparities research. Although the volume of this research has increased substantially in recent years, the literature consists mostly of retrospective studies with a lack of qualitative methodology, community engagement, and development of interventions to reduce disparities. These findings highlight areas for future research.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251350400"},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529135","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":"Corrigendum to \"The Association of Foot Arch Variations With Patellofemoral Pain Syndrome in Recreational Athletes\".","authors":"","doi":"10.1177/23259671251353162","DOIUrl":"https://doi.org/10.1177/23259671251353162","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/23259671251334776.].</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251353162"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507269","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":"Change in Early Patient-Reported Sexual Function After Periacetabular Osteotomy: A Study Utilizing the UK Non-Arthroplasty Hip Registry.","authors":"Richard James Holleyman, Christian Smith, Khurram Baig, Marcus Bankes, Johan Witt, Andy Judge, Vikas Khanduja, Ajay Malviya","doi":"10.1177/23259671251341475","DOIUrl":"10.1177/23259671251341475","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI; principally acetabular retroversion) in adults who are commonly of reproductive age.</p><p><strong>Purpose: </strong>To describe the effect of PAO on patient-reported sexual function (SF) using data from the UK Non-Arthroplasty Hip Registry (NAHR).</p><p><strong>Study design: </strong>Cohort study: Level of evidence, 3.</p><p><strong>Methods: </strong>Adult patients who underwent isolated PAO between January 2012 and July 2022 were extracted from the NAHR. The EuroQol-5 Dimensions (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at 6 and 12 months postoperatively. This included responses to 2 questions from the iHOT-12 questionnaire relevant to SF: (1) \"Are questions about SF relevant to you?\" and (2) \"How much trouble do you have with sexual activity because of your hip?\" (0 = severe; 100 = none).</p><p><strong>Results: </strong>A total of 773 patients (median age, 29 years (IQR, 23-37), 92.5% female) who underwent PAO for DDH (n = 703; 90.9%) or FAI (n = 70; 9.1%) were identified after exclusions. Of iHOT-12 respondents, 88.2% indicated that SF was relevant to them. Baseline median iHOT-12 SF scores were 33 (IQR, 18-53) for female and 73 (IQR, 36-90) for male patients. Female iHOT-12 SF improved by a mean of +19.9 points (95% CI, 16.5-23.2) at 6 months (<i>P</i> < .0001), with continued improvement to +26.4 points (95% CI, 23.0-29.8) at 12 months (<i>P</i> < .0001) versus preoperative SF scores. At 12 months, median iHOT-12 SF scores were 70 (IQR, 40-90) and 89 (IQR, 70-99) for female and male patients, respectively. Preoperative SF scores were significantly lower (<i>P</i> = .001) in patients who underwent PAO for indication of FAI (female median score 22; IQR, 10-38) compared with DDH (female median score: 34; IQR, 18-54); however, both indications saw significant improvement in SF scores at 12 months. iHOT-12 SF scores improved for 77.1% and worsened for 19.1% of female respondents with DDH. A strong positive association was seen between health-related quality of life (EQ-5D) and SF scores, and there was significant improvement in SF across studied ages.</p><p><strong>Conclusion: </strong>PAO was associated with significant improvement in patient-reported SF for the majority of patients. Some patients may have trouble with sexual activity even 1 year after PAO for DDH, with almost 20% reporting poorer SF compared with preoperative baseline.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341475"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507268","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":"Preoperative Moderate Pivot-Shift Phenomenon: A Risk Factor for Ramp Lesions in Patients Undergoing Anterior Cruciate Ligament Reconstruction?","authors":"Shoichi Hasegawa, Hideyuki Koga, Tomomasa Nakamura, Yusuke Nakagawa, Takashi Hoshino, Mai Katakura, Masaki Amemiya, Aritoshi Yoshihara, Yasumasa Tokumoto, Ichiro Sekiya, Nobutake Ozeki","doi":"10.1177/23259671251341586","DOIUrl":"10.1177/23259671251341586","url":null,"abstract":"<p><strong>Background: </strong>While various risk factors for ramp lesions have been reported, few studies have used multivariate and categorical analyses to quantify their specific impact.</p><p><strong>Hypothesis: </strong>Multivariate and categorical analyses would reveal a smaller pivot-shift phenomenon, along with previously reported factors, as independent factors for ramp lesions.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The records of consecutive patients who underwent primary anterior cruciate ligament reconstruction between January 2017 and August 2023 were retrospectively reviewed. Patients with past ligamentous injuries in the affected knee or accompanying grade 2 or 3 ligament injuries were excluded. Logistic regression analysis was performed to identify preoperative factors associated with ramp lesions by comparing groups with and without ramp lesions. The factors extracted from the multivariate analysis were also categorically analyzed.</p><p><strong>Results: </strong>A total of 262 patients were included in this study. Ramp lesions were identified in 58 patients (22.1%). Multivariate logistic regression analysis revealed that the pivot-shift test grade (OR, 1.560; 95% CI, 1.210-2.020; <i>P</i> < .01), age (OR, 0.966; 95% CI, 0.939-0.995; <i>P</i> = .02), and male sex (OR, 2.170; 95% CI, 1.120-4.190; <i>P</i> = .02) were independently associated with the ramp lesions. The categorical analysis revealed that the odds ratios for ramp lesions were 2.8-fold higher for those with pivot grade ≥4 than for those with grade <4, 2.0-fold higher for those aged <20 years than those aged ≥20 years, and 2.0-fold higher for males than females.</p><p><strong>Conclusion: </strong>Even a moderate pivot shift is a preoperative risk factor for ramp lesions, alongside younger age and male sex. Paying attention to these factors may reduce the chances of overlooking these lesions.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341586"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507270","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 Durability of Revision Anterior Cruciate Ligament Reconstruction: A Comparison of Patients at <5 Years and ≥5 Years After Revision.","authors":"Michael J Thimmesch, Sarah C Kurkowski, Jonas Keller, Henry A Kuechly, Sophia Le, Michael Kloby, Barton Branam, Christopher Utz, Brian Grawe","doi":"10.1177/23259671251339170","DOIUrl":"10.1177/23259671251339170","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Overall outcomes of revision anterior cruciate ligament reconstruction (ACLR) are well documented, although the durability of results, to the best of the authors' knowledge, has not been compared between short-term and midterm follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The primary aim was to assess the durability of revision ACLR outcomes at &lt;5 years after revision (short-term) to outcomes at ≥5 years after revision (midterm). For this study's purposes, durability was defined as not requiring additional revision surgery or the maintenance of good patient-reported outcomes (PROs). The secondary aims were to compare the outcomes between male and female patients, between patients with allografts and those with autografts, and between patients with traumatic mechanisms of a rerupture and those with atraumatic mechanisms of a rerupture.&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;This was a retrospective chart review with the prospective collection of PROs in 53 knees that underwent revision ACLR. PROs included scores for the International Knee Documentation Committee subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx activity rating scale, ACL-Return to Sport after Injury scale, visual analog scale for pain, and satisfaction. The time to return to sport or activity and the incidence of reruptures were collected as well. Data were analyzed via the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, chi-square test, Fisher exact test, and odds ratios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean follow-up from first revision surgery was 5.29 ± 2.96 years (range, 2.0-20.5 years) for the entire cohort. No significant differences in outcomes were found between the short-term (&lt;5 years from revision; 21/53 knees) and midterm (≥5 years from revision; 32/53 knees) groups, except in satisfaction (4.0/5 vs 2.5/5, respectively; &lt;i&gt;P&lt;/i&gt; = .014) and requiring second revision surgery (0.0% vs 25.0%, respectively; &lt;i&gt;P&lt;/i&gt; = .016). The mechanism of a rupture after primary ACLR leading to revision ACLR was traumatic in 64.7% and atraumatic in 35.3%, but no difference in outcomes was found based on the mechanism of reinjuries (&lt;i&gt;P&lt;/i&gt; &gt; .05). When comparing male to female patients, male patients were more active based on the Marx score at the time of follow-up than female patients (7.0 vs 2.0, respectively; &lt;i&gt;P&lt;/i&gt; = .046). Patients treated with autografts were younger and had higher KOOS Activities of Daily Living subscores than those treated with allografts, although no other differences were found (&lt;i&gt;P&lt;/i&gt; &gt; .05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study demonstrates that revision ACLR offered patients durable results after the failure of primary ACLR from short-term to midterm follow-up. Patient sex and graft choice did not drastically affect postoperative outcomes. Orthopaedic surgeons may decide, based on their clinical acumen, which graft choice is best for th","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251339170"},"PeriodicalIF":2.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497586","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}