Orthopaedic Journal of Sports Medicine最新文献

{"title":"Outcomes of ACL Reconstruction with Concomitant Meniscal Surgery: A Retrospective Cohort Study.","authors":"Zi Qiang Glen Liau, Kamaraj Thirukumaran, Kennan Zhi Guang Yeo, Ying Ren Mok, Yee Han Dave Lee","doi":"10.1177/23259671251327600","DOIUrl":"10.1177/23259671251327600","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injuries are common in sports. These injuries often present with ≥1 meniscal tears, which may affect pre- and postoperative patient outcomes.</p><p><strong>Purpose: </strong>To compare patient-reported outcome measures (PROMs) between isolated ACL reconstruction (ACLR) and ACLR with concomitant meniscal surgery, such as meniscal repair or arthroscopic partial meniscectomy, over 2 years to aid in preoperative counselling and rehabilitation.</p><p><strong>Study design: </strong>Cohort study; Level of evidence 3.</p><p><strong>Methods: </strong>This retrospective study included 415 consecutive patients who underwent ACLR at a tertiary referral hospital between January 2009 and December 2022. PROMs-including the Knee injury and Osteoarthritis Outcomes Score (KOOS) and the Lysholm score-were assessed preoperatively and at the 2-year follow-up between the isolated ACLR group and the ACLR with meniscal surgery group using the Mann-Whitney <i>U</i> test. A Wilcoxon signed-rank test within groups was used to assess preoperative to the 2-year follow-up improvements. Also, 95% CIs were utilized to provide the likely values of the true population mean. Two-tailed significance tests were used, and the statistical significance level was set at <i>P</i> < .05.</p><p><strong>Results: </strong>The patients in the 2 groups (isolated ACLR group, n = 205 and ACLR with meniscal surgery group, n = 210) had similar baseline characteristics for age, sex, and body mass index (<i>P</i> > .05). The meniscal surgery group showed significantly worse Lysholm scores (71.1 [95% CI, 68.8-73.5] vs 74.9 [95% CI, 72.6-77.1]; <i>P</i> = .017) and KOOS domain scores preoperatively compared with the isolated ACLR group: KOOS Symptoms, 72.4 (95% CI, 69.9-75) versus 77.3 (95% CI, 75-80) (<i>P</i> = .011); KOOS Activities of Daily Living, 81.4 (95% CI, 79-83.7) versus 85.6 (95% CI, 83.6-87.6) (<i>P</i> = .006); KOOS Pain, 76.3 (95% CI, 73.9-78.8) versus 81(95% CI, 78.7-83.2) (<i>P</i> = .006); and KOOS Quality of Life, 39.4 (95% CI, 36.4-42.5) versus 43.9 (95% CI, 41-46.9) (<i>P</i> = .028). However, the KOOS Sport and Recreation domain had a lower and insignificant mean (35.6 [95% CI, 31.7-39.4] vs 39.9 [95% CI, 36.2-43.6]; <i>P</i> = .061). Both groups significantly improved across all PROMs at the 2-year follow-up (<i>P</i> < .001). When compared with the isolated ACLR group, the meniscal surgery group had lower postoperative scores for Lysholm scores (93.8 [95% CI, 92.6-95] vs 95.3 [95% CI, 94.3-96.4]; <i>P</i> = .017), the KOOS Sport and Recreation Function (87.5 [95% CI, 85.1-90] vs 89.6 [95% CI, 87-92.2]; <i>P</i> = .025), and the KOOS Pain (97 [95% CI, 96-98] vs 96.7 [95% CI, 95.9-97.6]; <i>P</i> = .010), with insignificant differences in other KOOS domains (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>The study demonstrated that patients undergoing ACLR with concurrent meniscal surgery initially showed sligh","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251327600"},"PeriodicalIF":2.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Radiographic Investigation Exploring Differences in Static Anterior Tibial Translation Expressed as a Percentage Between ACL-Deficient and -Intact Patients to Improve Interobserver Variability Between Different Centers.","authors":"Michael J Dan, Nicolas Cance, Tomas Pineda, Guillaume Demey, David H Dejour","doi":"10.1177/23259671251330310","DOIUrl":"10.1177/23259671251330310","url":null,"abstract":"<p><strong>Background: </strong>Static anterior tibial translation (SATT) represents the amount of anterior translation due to axial load. It has been shown to be increased with anterior cruciate ligament (ACL) rupture, meniscal tear, and increased posterior tibial slope (PTS). It has also been shown to be correlated with ACL reconstruction failure. ACL reconstruction alone does not improve SATT. A sagittal plane slope-correcting osteotomy improves SATT, and SATT has recently been used to define the target slope correction after osteotomy. However, absolute values for SATT differ between institutions by >5 mm. Absolute measures differ based on the amount of magnification of the image, which varies based on the radiographic source to image distance, the source to object distance, rotation, and whether the medial or lateral condyle is presented to the source first. Scaled, or percentage radiographic measures, should correct for these differences.</p><p><strong>Purpose: </strong>To express SATT as a percentage (SATT%) of the medial plateau distance to improve accuracy and interinstitutional utilization of SATT.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A consecutive series of patients without ligamentous or meniscal injuries between 2019 and 2022 was reviewed. A matched consecutive cohort of patients with nonacute ACL injuries (surgery between 6 and 12 weeks after injury) without concomitant pathology was reviewed. Preoperative SATT and PTS were measured with a previously validated technique on lateral weightbearing knee radiographs. Regression analysis was performed to investigate the relationship between SATT% and PTS.</p><p><strong>Results: </strong>There were 101 controls and 115 patients with an ACL injury who were included in this study. In the control cohort, the mean SATT% was 3.18% (SD, 5.92%) and mean PTS was 10.61° (SD, 3.28°). This was significantly different from our ACL cohort's mean SATT% of 5.16% (SD, 7.41%) (<i>P</i> = .04) and mean PTS of 9.46° (2.85°) (<i>P</i> = .02). Linear regression analysis showed that for every 1° increase in PTS, there was a 0.08% increase in SATT% in the control cohort, so every 10° rise in slope was associated with an 0.8% increase in SATT%. In the ACL cohort, the effect of PTS on SATT% was larger; for every 1° of increase in PTS, there was an increase of 0.97% SATT%.</p><p><strong>Conclusion: </strong>The present study reports a reference SATT% value of 3.18% (SD, 5.92%) in a non-ACL injured cohort, which was lower than the ACL cohort's mean 5.16% (SD 7.41%), despite the ACL cohort's having a longer medial tibial plateau than the control population. The effect of slope on weightbearing anterior tibial translation was greater in the ACL population compared with the control cohort. These scaled, percentage values should improve the interinstitutional usage of SATT.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251330310"},"PeriodicalIF":2.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226122","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":"Therapeutic Effects of Polydeoxyribonucleotide and Atelocollagen into Achilles Tendon Injury in a Rat Model.","authors":"Da-Sol Kim, Yu Hui Won, Sung-Hee Park, Jeong-Hwan Seo, Myoung-Hwan Ko, Gi-Wook Kim","doi":"10.1177/23259671251324181","DOIUrl":"10.1177/23259671251324181","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Treatment of Achilles tendon injury varied from surgical to nonsurgical management, such as immobilization, step-by-step physical therapy, or injection with regenerative agents. Regenerative treatment has been studied using polydeoxyribonucleotide (PDRN), atelocollagen, prolotherapy, platelet-rich plasma, and mesenchymal stem cells. PDRN and atelocollagen monotherapy have been known to promote mitigation of fibroblasts, synthesis of collagen fibers, and secretion of growth factors for tissue remodeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare the therapeutic effects of PDRN, atelocollagen, and PDRN + atelocollagen treatments in rats with a partial Achilles tendon injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Controlled laboratory study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 32 Sprague-Dawley rats, aged 8 weeks, were divided into 4 groups-normal saline, PDRN, atelocollagen, and PDRN + atelocollagen. The partial Achilles tendon injury was induced using punch biopsy tools. The treatment was administered 1 day after the injury. The biomechanical evaluation using load to failure and energy absorbed, histology related to inflammation and collagen fiber arrangement, and immunohistochemistry evaluation with collagen-I, transforming growth factor beta1, vascular endothelial growth factor (VEGF), and fibroblast growth factor were measured at 1 week and 4 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The tensile strength test conducted at week 4 after injury measured a significantly higher energy absorbed in the PDRN + atelocollagen group than that in the control group. The hematoxylin and eosin (H&E) stain showed that neutrophil invasion was significantly higher in the control group compared with the other groups. Collagen fiber arrangement relatively increased in the atelocollagen and PDRN + atelocollagen groups. After 4 weeks, H&E in all groups showed decreased neutrophil invasion and lower inflammation index. Immunohistochemistry exhibited increased levels of collagen I in the PDRN group compared with the control group and an increased level of VEGF in the PDRN + atelocollagen group compared with the other groups at week 1. After 4 weeks, a high expression of collagen I, transforming growth factor beta1, and fibroblast growth factor was observed in the PDRN and PDRN + atelocollagen groups; the expression of VEGF showed an upward trend in the atelocollagen group compared with the PDRN + atelocollagen group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The combined use of PDRN and atelocollagen resulted in increased energy absorbed by the repaired tendons and increased expression of healing growth factors in a partial tendon injury rat model. These benefits appear to be greater than the use of either agent alone. The combined use of PDRN and atelocollagen should be investigated in human patients with tendon injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;PDRN and atelocollagen are commonly used in patients with tendon injuries; ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251324181"},"PeriodicalIF":2.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226093","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":"Patellofemoral Joint Chondral Defects Treated With Third-Generation Matrix-Induced Autologous Chondrocyte Implantation on Porcine Collagen Membrane: Minimum 2-Year Follow-up.","authors":"Guilherme M Palhares, Julia S Retzky, Francesca Coxe, Paige Hinkley, Morgan E Rizy, Ava G Neijna, Andreas H Gomoll, Sabrina M Strickland","doi":"10.1177/23259671251341474","DOIUrl":"10.1177/23259671251341474","url":null,"abstract":"<p><strong>Background: </strong>Third-generation autologous chondrocyte implantation (ACI), also known as matrix-induced ACI (MACI), was approved for clinical practice in December 2016. Studies specifically investigating outcomes of MACI for complex patellofemoral chondral lesions are limited.</p><p><strong>Purpose: </strong>To report patient-reported outcome measures (PROMs), complications, and failure rates after MACI for patellofemoral chondral defects at a minimum follow-up of 2 years.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>For this retrospective review of prospectively collected data, the authors identified patients who underwent treatment with MACI for focal chondral defects in the knee between August 2017 and September 2020. PROMs, including International Knee Documentation Committee (IKDC) score, Kujala score for patellofemoral disorders, and the Veterans RAND 12-item Health Survey (VR-12) score, were obtained preoperatively and a minimum of 2 years postoperatively. The percentage of patients who met the minimal clinically important difference (MCID) for each PROM was reported. Failure was defined as (1) graft failure on follow-up magnetic resonance imaging or second-look arthroscopy, (2) revision MACI or other chondral procedure, or (3) conversion to unicompartmental or total knee arthroplasty.</p><p><strong>Results: </strong>A total of 50 patients (34 female; mean age, 32.43 ± 7.33 years; mean follow-up, 2.71 ± 0.79 years) remained after application of the exclusion criteria. There was a significant increase in all PROMs from preoperatively to postoperatively, including the IKDC (43.39 vs 68.58; <i>P</i> < .001), Kujala (58.93 vs 77.07; <i>P</i> < .001), VR-12 Mental (53.12 vs 57.90; <i>P</i> = .002), and VR-12 Physical (40.40 vs 49.89; <i>P</i> < .001) scores, with 5 (10%) failures. The MCID was achieved by 77.8% of patients in IKDC score and 69.0% in the Kujala score. Kaplan-Meier survival analysis showed survival probabilities of 98.0%, 96.0%, and 85.7% at 1, 2, and 4 years, respectively. MACI for patellofemoral bipolar lesions (n = 11) showed significant improvement in IKDC (50.06 vs 74.07; <i>P</i> = .008) and Kujala (69.33 vs 84.33; <i>P</i> = .046) scores, and 2 (18.2%) failures. Kaplan-Meier survival analysis with log-rank test demonstrated no significant differences in survival distributions between unipolar and bipolar patellofemoral lesions (<i>P</i> = .387).</p><p><strong>Conclusions: </strong>Third-generation ACI (MACI) is a successful and effective treatment method for difficult-to-treat patellar, trochlear, and bipolar patellofemoral chondral defects.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 5","pages":"23259671251341474"},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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

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

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

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

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