Orthopaedic Journal of Sports Medicine最新文献

{"title":"Developing Presurgical Conversion Formulas to Predict Miniaci Angle for Personalized Realignment Targets in Opening-Wedge High Tibial Osteotomies.","authors":"Hongyu Chen, Liang Chen, Yuan Zhang, Qiang Wu, Mengning Yan, Xu Jiang, Liao Wang","doi":"10.1177/23259671241308916","DOIUrl":"10.1177/23259671241308916","url":null,"abstract":"<p><strong>Background: </strong>The correlation between the Miniaci angle and presurgical hip-knee-ankle (HKA) angle, weightbearing line (WBL) percentage, and changes in the HKA angle (ΔHKA angle) and WBL percentage (ΔWBL percentage) is significant in opening-wedge high tibial osteotomy (OWHTO). The conversion formulas that interrelate the Miniaci angle with pre-HKA angle (formula 1), pre-WBL percentage (formula 2), ΔHKA angle (formula 3), and ΔWBL percentage (formula 4) have been derived through the linear regression analysis. However, the accuracy of conversion formulas has not been validated.</p><p><strong>Purpose: </strong>To validate the precision of conversion formulas targeting various surgical objectives for OWHTO planning in the varus knee patient population.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective study of 155 lower limbs of 112 patients with medial unicompartmental knee osteoarthritis was conducted. A computer simulation of OWHTO was performed to calculate the Miniaci angle by delivering the WBL to the Fujisawa point (group 1), at 65% WBL percentage (group 2), and 4.5° of valgus (group 3). Spearman correlation and Bland-Altman analyses were conducted between the computer simulation and formula calculation.</p><p><strong>Results: </strong>Upon evaluating the widely accepted Fujisawa point as a postoperative target, all formula results demonstrated a strong correlation with computer simulation outcomes (<i>r</i> = 0.962-0.999). Compared with the simulated Miniaci angle, the mean bias of the calculated angles derived from formulas 1 to 4 was 0.098° (formula 1), -0.268° (formula 2), 0.065° (formula 3), and -0.246° (formula 4). Notably, the formula based on the ΔHKA angle exhibited an ideal correlation with the simulated Miniaci angle (<i>r</i> = 0.998-0.999). In the 3 groups with varying postoperative targets, the mean bias of this formula in predicting the Miniaci angle was 0.065° (group 1), 0.070° (group 2), and 0.080° (group 3).</p><p><strong>Conclusion: </strong>Formulas based on the presurgical HKA angle and WBL percentage showed perfect accuracy for measuring the Miniaci angle targeting the Fujisawa point. The formula based on ΔHKA angle achieved the best accuracy and may be a valuable tool for measuring the Miniaci angle in broader surgical targets.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241308916"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409834","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":"Evaluating the Statistical Fragility of Comparative Studies on Autografts for Pediatric ACL Reconstruction.","authors":"Gurbinder Singh, Sergei O Alexeev, Patrick Haugh, Ryan T Halvorson, Dean Wang, Nirav K Pandya, Brian T Feeley","doi":"10.1177/23259671241313472","DOIUrl":"10.1177/23259671241313472","url":null,"abstract":"<p><strong>Background: </strong>The literature presents conflicting findings regarding outcomes after pediatric anterior cruciate ligament reconstruction (ACLR) with various autograft options, reflecting a lack of consensus on the standard of practice. Fragility analyses may assist in evaluating the statistical robustness of these studies.</p><p><strong>Purpose: </strong>To evaluate the statistical fragility of comparative studies in pediatric ACLR through the fragility index (FI) and fragility quotient (FQ), as well as qualitative factors such as outcome type, outcome significance, and patients lost to follow-up.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>A systematic review conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines identified 1139 studies in the PubMed and Embase databases that met the search criteria; ultimately, 6 studies were selected for inclusion. A total of 32 comparative outcomes were assessed for fragility across the 6 studies. Descriptive statistics were employed to summarize the fragility data and generate subgroup comparisons.</p><p><strong>Results: </strong>The mean FI was 1.5, and the mean reverse FI was 3.19 (<i>P</i> < .01); the mean FQ was 0.0064, and the mean reverse FQ was 0.028 (<i>P</i>≤ .0001). No significant difference was found in the FIs between objective outcomes and patient-reported outcomes (<i>P</i> = .418). These findings suggested that a comparable number of patients would need to transition from a nonevent to an event to alter a statistically significant result to a nonsignificant one. The FI was lower than the estimated number of patients lost to follow-up for 30 of the 32 outcomes (93.7%).</p><p><strong>Conclusion: </strong>Comparative studies on pediatric ACLR autograft outcomes displayed vulnerability when assessed using fragility metrics, indicating a lack of statistically robust data. The findings revealed that many reported outcomes are fragile and may require further investigation. Future research should incorporate fragility analyses-especially in studies with long-term follow-ups-to enhance the reliability of conclusions regarding optimal graft selection in pediatric ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241313472"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433580","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":"Incidence and Risk Factors for Posttraumatic Osteoarthritis After Primary ACL Reconstruction in Pediatric Patients: A National Database Study.","authors":"Jay Moran, Michael J Gouzoulis, Kyle N Kunze, Christopher M LaPrade, Jonathan N Grauer, Timothy E Hewett, Jorge Chahla, Andrew E Jimenez, Scott D McKay, Peter D Fabricant, Robert F LaPrade, Corinna C Franklin","doi":"10.1177/23259671251313754","DOIUrl":"10.1177/23259671251313754","url":null,"abstract":"<p><strong>Background: </strong>The development of posttraumatic osteoarthritis (PTOA) of the knee after anterior cruciate ligament (ACL) reconstruction (ACLR) leads to additional morbidity in adults.</p><p><strong>Purpose: </strong>To determine the 5-year incidence of and risk factors for PTOA diagnoses after primary ACLR in pediatric patients.</p><p><strong>Study design: </strong>Case control study, Level of evidence, 3.</p><p><strong>Methods: </strong>A United States-based insurance database was used to identify patients aged ≤16 years who underwent primary ACLR from 2010 to 2019 and had at least 5 years of follow-up data. Patients with multiligament knee injuries, tibial eminence avulsion fractures, congenital/syndromic ACL absence syndrome, juvenile idiopathic arthritis, previous knee osteoarthritis or PTOA diagnoses, or previous knee injuries/surgeries were excluded. Demographic factors and concomitant meniscal and cartilage procedures at the time of primary ACLR were recorded. Delayed ACLR was defined as ≥3 months between initial ACL injury diagnosis and ACLR. We also recorded the presence of subsequent motion restoration reoperations, including lysis of adhesions and/or manipulation under anesthesia, after primary ACLR but before PTOA diagnosis. Risk factors for PTOA were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>Included were 16,935 patients (mean age at surgery, 15.1 ± 1.2 years; 62% women). PTOA was diagnosed in 267 patients (1.6%) within 5 years after ACLR; 148 of these patients (55.4%) were diagnosed within 2 years after ACLR. Independent risk factors associated with PTOA diagnosis included subsequent motion restoration procedures (odds ratio [OR], 5.03 [95% CI, 3.31-8.25]; <i>P</i> < .001), age ≥12 years at the time of ACLR (OR, 4.82 [95% CI, 1.54-29.20]; <i>P</i> = .027), delayed ACLR (OR, 1.87 [95% CI, 1.43-2.43]; <i>P</i> < .001), obesity (OR, 1.40 [95% CI, 1.01-1.94]; <i>P</i> = .046), and male sex (OR, 1.36 [95% CI, 1.06-1.74]; <i>P</i> = .015). Performing concomitant partial meniscectomy, meniscus repair, and cartilage restoration at the time of ACLR was not significantly associated with PTOA.</p><p><strong>Conclusion: </strong>The incidence of PTOA diagnoses was low within 5 years after primary ACLR in patients ≤16 years old with no subsequent cartilage, meniscus, and/or revision ligament procedures. The need for subsequent motion restoration procedures, age ≥12 years at the time of ACLR, delayed ACLR, obesity, and male sex were significant risk factors associated with a PTOA diagnosis.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251313754"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382973","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":"No Difference in Chondrocyte Viability Using Manual Versus Custom-Cutting Technique for Matrix-Induced Autologous Chondrocyte Implantation.","authors":"Wen-Teh Chang, Ran Atzmon, Monica S Vel, Kenneth M Lin, Geoffrey D Abrams, Seth L Sherman","doi":"10.1177/23259671241308855","DOIUrl":"10.1177/23259671241308855","url":null,"abstract":"<p><strong>Background: </strong>Matrix-induced autologous chondrocyte implantation (MACI) was developed for knee cartilage restoration involving seeding autologous chondrocytes onto a collagen membrane. Maintaining chondrocyte viability and achieving proper membrane size and contour are crucial for successful outcomes. Scissor cutting (Sc) has traditionally been used to shape the membrane, but recently, custom cutting (CC) have gained popularity for their enhanced preparation efficiency.</p><p><strong>Purpose: </strong>To determine the difference in chondrocyte viability using the Sc versus CC methods.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Using Sc and CC methods, 15 mm-diameter circular specimens were cut from 5 residual membranes. Membranes were stained, and confocal microscopy was used to visualize live/dead cells. Three zones were defined: the impact zone (the outermost zone at the cut edge), the central zone (the least manipulated zone), and the adjacent zone (the intermediate zone between the central and impact zones). For each circular specimen, the following measurements were recorded: the dimension of the impact zone, cell viability (percentage of live cells among total) for each zone, and the total number of cells within each zone (as cell density ×10⁵/cm²).</p><p><strong>Results: </strong>The width of the impact zone (mean ± standard error) was 355 ± 31 μm and 342 ± 24 μm for CC and Sc, respectively, and the impact zone occupied approximately 10% of the specimen. With both cutting techniques, cell viability was significantly lower in the impact zone (mean ± standard error: CC, 36.42% ± 3.85%; Sc, 40.94% ± 2.85%) compared with the adjacent zone (CC, 77.69% ± 2.97%; Sc, 74.17% ± 2.8%). The cell density from all zones varied from 5.84 ± 0.26 to 6.49 ± 0.34 × 10⁵/cm², with no significant difference in cell viability in the impact zones between the cutting methods.</p><p><strong>Conclusion: </strong>Both cutting techniques led to a significant reduction in cell viability in the impact zone compared with other zones of the MACI specimen. There was no significant difference in chondrocyte viability or cell density for membranes cut by Sc or CC.</p><p><strong>Clinical relevance: </strong>This evaluation of the newly introduced CC method on the chondrocyte viability of the MACI membrane will enable surgeons to make a more informed decision regarding cutting techniques.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241308855"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391443","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":"Management of First-Time Anterior Shoulder Dislocation-A Systematic Review and Meta-analysis: Arthroscopy Association of Canada Position Statement.","authors":"Hassaan Abdel Khalik, Danielle Dagher, Darius Luke Lameire, Eva Gusnowski, Michaela Kolpka, Marie-Eve LeBel, Bogdan A Matache, R Kyle Martin, Mark Sommerfeldt, Ivan Wong, Jarret Woodmass, Moin Khan","doi":"10.1177/23259671251316893","DOIUrl":"10.1177/23259671251316893","url":null,"abstract":"<p><strong>Background: </strong>While surgical stabilization is typically recommended for patients with recurrent shoulder instability, the management of first-time shoulder dislocation (FTSD) presents a unique challenge for health care providers.</p><p><strong>Purpose: </strong>To assess the efficacy of arthroscopic Bankart repair (ABR) compared with nonoperative management for FTSDs.</p><p><strong>Study design: </strong>Review.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and CENTRAL were searched from inception to December 26, 2023, for comparative studies assessing ABR versus nonoperative management of FTSDs. Outcomes of interest included rates of shoulder redislocation, cumulative shoulder instability (redislocation, subluxation, and/or subjective instability), subsequent shoulder stabilization surgery, return-to-sport rates, and patient-reported outcomes (Western Ontario Shoulder Instability [WOSI] score and Rowe score). Meta-analyses were performed on outcomes reported across a minimum of 3 comparative studies.</p><p><strong>Results: </strong>Eleven comparative studies with 694 patients (695 shoulders) were included in the final analysis. Patient demographics were comparable across arthroscopic stabilization (367 shoulders) and nonoperative management (328 shoulders) groups with a mean age of 21.6 ± 2.5 years across all studies, and 13.7% ± 13.6% of patients being female. The mean follow-up across all studies was 54.2 ± 28.5 months, with a mean loss to follow-up of 8.1% ± 10.3%. Meta-analyses demonstrated a reduction in the odds of cumulative instability in favor of the ABR group (odds ratio [OR], 0.04 [95% CI, 0.02 to 0.08]; <i>P</i> < .01), as well as reductions in the odds of shoulder redislocation (OR, 0.06 [95% CI, 0.02 to 0.17]; <i>P</i> < .01) and subsequent stabilization surgery (OR, 0.07 [95% CI, 0.03 to 0.14]; <i>P</i> < .01) in favor of ABR. Compared with the nonoperative group, patients in the ABR group were 3.87 times more likely to return to sport at the preoperative or higher level (OR, 3.87 [95% CI, 1.57 to 9.52]; <i>P</i> < .01). No differences were found across postoperative WOSI scores (mean difference, 8.08 [95% CI, -1.54 to 17.69]; <i>P</i> = .10). Subgroup analyses demonstrated similar outcomes between randomized controlled trials and observational studies.</p><p><strong>Conclusion: </strong>Early ABR of first-time anterior shoulder dislocations consistently demonstrated decreased subsequent rates of cumulative instability events, shoulder redislocations, and revision surgeries relative to nonoperative management.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251316893"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449707","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 Arthrofibrosis After ACL Reconstruction According to Graft Choice: Quadriceps Tendon Versus Bone-Patellar Tendon-Bone Autograft.","authors":"Bailey E Johnson, Chelsea L Smith, Cory D Smith, Edward J Quilligan, Viraj A Deshpande, Vance O Gardner, Kevin C Parvaresh, Michael F Shepard, Russell S Petrie, Carlos A Prietto, Robert C Grumet, David S Gazzaniga","doi":"10.1177/23259671241311916","DOIUrl":"10.1177/23259671241311916","url":null,"abstract":"<p><strong>Background: </strong>Arthrofibrosis is a complication of anterior cruciate ligament reconstruction (ACLR), and it is possible that graft choice such as the quadriceps tendon (QT) autograft may be a risk factor. With the increasing popularity of the QT autograft, it is important to compare it with other graft choices.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to identify whether graft choice, QT versus bone-patellar tendon-bone (BTB) autograft, is a risk factor for early return to the operating room for arthrofibrosis after ACLR. It was hypothesized that the rate of arthrofibrosis surgery would be higher for the QT autograft recipients.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A single-center retrospective chart review was conducted between January 2010 and November 2022. Skeletally mature patients who underwent primary ACLR with either QT or BTB autograft were considered for inclusion. Patients who received an alternate graft or those undergoing revision ACLR were excluded. The primary outcome of interest was return to the operating room for arthrofibrosis release (either manipulation under anesthesia or lysis of adhesions).</p><p><strong>Results: </strong>Of 1726 included patients (1155 receiving a BTB autograft and 571 receiving a QT autograft), 5.2% (n = 60) of BTB recipients and 6.5% (n = 37) of QT recipients required subsequent arthrofibrosis. There was no significant association between graft type and subsequent arthrofibrosis (<i>P</i> = .275). There was a significant association with graft type and presence of a cyclops lesion (65.0% of BTB grafts and 40.5% of QT grafts; <i>P</i> = .018). After removing those patients with chronic tears who underwent ACLR at >1 year, patients who required arthrofibrosis were found to have a significantly shorter time between injury and ACLR (mean, 59.23 ± 48.46 days) than those who did not require arthrofibrosis (mean, 81.7 ± 72.63 days) (<i>P</i>≤ .01). Significantly more female patients (9.25%) than male patients (2.79%) required arthrofibrosis (hazard ratio, 3.82; <i>P</i> < .001), and patients who required arthrosis were significantly younger (mean, 22.52 ± 9.35 years) than those who did not (mean, 25.74 ± 10.83 years) (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>Study findings indicated no statistically significant difference in the rate of secondary arthrofibrosis surgery between patients who underwent ACLR with either QT or BTB autograft.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241311916"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441564","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 Role of Crutches and Bracing in Preventing Secondary Meniscal Tears After Anterior Cruciate Ligament Injury in Pediatric Patients.","authors":"Arjun Gupta, Daniel Badin, R Jay Lee","doi":"10.1177/23259671241309862","DOIUrl":"10.1177/23259671241309862","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Secondary meniscal tears are a well-described sequela of delay in anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL injury. This study aimed to evaluate whether preoperative conservative interventions (ie, crutches, bracing, and physical therapy) are associated with a reduced risk of secondary meniscal pathology in pediatric patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;Preoperative conservative interventions of the ACL-deficient knee would be associated with fewer secondary meniscal tears in pediatric patients undergoing delayed (≥8 weeks postinjury) ACLR.&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;All pediatric patients (age, &lt;18 years) undergoing primary ACLR with a single surgeon between October 1, 2013, and January 31, 2022, were retrospectively identified. The exclusion criteria were as follows: previous ipsilateral knee injury; multiligamentous knee injuries; or time frommagnetic resonance imaging to surgery ≥52 weeks. Adherence to conservative management recommendations (ie, crutches, bracing, and physical therapy) was assessed through medical record review. Secondary meniscal injuries were defined as major tears that were discovered intraoperatively and required repair or substantial meniscectomy. Meniscal tears that occurred concomitantly with ACL rupture and were detectable on the initial (&lt;3 weeks after injury) magnetic resonance imaging scans were not considered secondary. In total, 71 pediatric patients (35 girls; 36 boys) were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 70 patients (99%) underwent ≥1 conservative interventions before ACLR-including 37 (52%) who used crutches, 47 (66%) who used bracing, and 69 (97%) who received physical therapy. There were no differences in use of conservative interventions between those who underwent early ACLR and those who had delayed ACLR (&lt;i&gt;P&lt;/i&gt; &gt; .05). Delayed ACLR was associated with a greater risk of medial, but not lateral, meniscal tears compared with early ACLR (&lt;i&gt;P&lt;/i&gt; = .04). Overall, 15 secondary meniscal tears were observed intraoperatively in 14 patients-including 4 medial and 11 lateral tears. Knee bracing was associated with fewer lateral meniscal tears in patients undergoing early ACLR (6% vs 35%; &lt;i&gt;P&lt;/i&gt; = .008), with multivariate regression analysis yielding an adjusted odds ratio of 0.06 (95% CI, 0.006-0.57; &lt;i&gt;P&lt;/i&gt; = .015). The use of crutches was associated with fewer medial meniscal tears in patients undergoing delayed ACLR (0% vs 37%; &lt;i&gt;P&lt;/i&gt; = .017). Since no new medial meniscal tears were observed in patients who used crutches, the adjusted odds ratio could not be calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Bracing and crutches were associated with the preservation of the menisci in the ACL-deficient knee in pediatric patients undergoing early and delayed ACLR, respectively. Surgeons should strongly encourage adherence to these conservative modali","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241309862"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409842","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":"Using Wearable Sensor Technology to Analyze Running Technique and Prospective Running-Related Injuries During United States Military Cadet Basic Training.","authors":"Amy N Weart, Lauren C Brown, Erin M Florkiewicz, Gregory M Freisinger, Kyle H East, Nicholas Reilly, Jinsup Song, Donald L Goss","doi":"10.1177/23259671241309273","DOIUrl":"10.1177/23259671241309273","url":null,"abstract":"<p><strong>Background: </strong>Running biomechanics have been linked to the development of running-related injuries in recreational and military runners.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to determine if personal characteristics or running biomechanical variables are associated with running-related injury incidence or time to injury in military cadets undergoing training. It was hypothesized that a rearfoot strike pattern, greater rate of impact, or a lower step rate would be related to a greater running-related injury incidence and a decreased time to injury.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Military cadets wore an on-shoe wearable sensor that analyzed biomechanical variables of foot strike pattern, rate of impact, running pace, step rate, step length, and contact time during cadet basic training (60 days). Running-related injuries during cadet basic training were determined by medical record review. Personal and running variables between the injured and uninjured cadets were compared using independent <i>t</i> tests and chi-square analyses. Time to injury and hazard ratios (HRs) were estimated using Kaplan-Meier survival curves and Cox proportional hazard regression models, respectively.</p><p><strong>Results: </strong>Of the 674 cadets who completed the study, 11% sustained a running-related injury. A significantly greater proportion of the injured participants were female (χ² = 7.95; <i>P</i> = .005) and had a prior history of injury (χ² = 7.36; <i>P</i> = .007). Univariate Cox proportional hazard regression models revealed greater injury risk in females (HR, 1.96; 95% CI, 1.22-3.16; <i>P</i> = .005) and cadets with a prior injury history (HR, 1.86; 95% CI, 1.18-2.93; <i>P</i> = .008). After adjusting Cox models for prior injury, females were found to be at a 1.89 times (95% CI, 1.17-3.04; <i>P</i> = .009) greater risk of injury. Running biomechanical variables were not associated with injury risk.</p><p><strong>Conclusion: </strong>Study results indicated that non-modifiable risk factors such as female sex and prior injury history increased the risk of running-related injury in cadets undergoing military training. Running biomechanical variables measured by the wearable sensor were not associated with injury in this study.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241309273"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409844","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":"Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study.","authors":"Arthur Cardoso Paroneto, Pedro Soneghet Gomes, Paulo Vitor Carrijo, Moises Cohen, Leonardo Addeo Ramos","doi":"10.1177/23259671241308590","DOIUrl":"10.1177/23259671241308590","url":null,"abstract":"<p><strong>Background: </strong>Although posterior cruciate ligament (PCL) reconstruction is often performed for grade 3 PCL injuries, the effectiveness of different surgical techniques and rehabilitation protocols is a topic of debate.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to evaluate and compare functional outcomes and residual instability in patients who underwent PCL reconstruction with versus without suture tape augmentation. It was hypothesized was that adding high-resistance suture tape to PCL reconstruction would improve functional scores and reduce postoperative laxity.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 48 patients were included in the study; all patients underwent PCL reconstruction with an autologous quadriceps tendon graft and had a minimum follow-up of 2 years. Overall, 23 patients were treated with a graft only, while 25 were treated with a graft and suture tape. Patients in the suture tape augmentation group also underwent an accelerated rehabilitation program with earlier range of motion and weightbearing. Patient characteristics, Lysholm scores, posterior tibial laxity on stress radiographs at 90° of knee flexion, and postoperative complications were compared between treatment groups.</p><p><strong>Results: </strong>No statistically significant differences were found between groups in terms of patient characteristics. Similar results were seen in both groups in terms of postoperative complications. Furthermore, on average, the Lysholm score increased from 1- to 2-year follow-up by 6.99 points (standard error = 0.97 points; <i>P</i> < .001), indicating progressive functional improvement, and posterior tibial laxity decreased from preoperatively to postoperatively by 7.55 mm (standard error = 0.24 mm; <i>P</i> < .001), indicating an improvement in knee stability. Patients in both treatment groups saw significant improvements during the follow-up period in the Lysholm score and posterior tibial laxity (<i>P</i> < .001 for both).</p><p><strong>Conclusion: </strong>PCL reconstruction with suture tape augmentation and an accelerated rehabilitation protocol did not result in significantly improved functional scores or postoperative laxity compared with isolated PCL reconstruction. The results showed no disadvantage of a more aggressive rehabilitation protocol.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241308590"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382976","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 Preseason Functional Movement Screen as a Predictive Tool for Shoulder and Elbow Injuries in High School Baseball Pitchers: A Prospective Cohort Study.","authors":"Hitoshi Shitara, Noritaka Hamano, Tsuyoshi Tajika, Tsuyoshi Ichinose, Tsuyoshi Sasaki, Masataka Kamiyama, Ryosuke Miyamoto, Kurumi Nakase, Fukuhisa Ino, Yuhei Hatori, Koichiro Yanai, Hirotaka Chikuda","doi":"10.1177/23259671241305607","DOIUrl":"10.1177/23259671241305607","url":null,"abstract":"<p><strong>Background: </strong>The Functional Movement Screen (FMS) is used to evaluate fundamental movement patterns in patients. It is unknown whether the FMS can be used as a predictive tool for the occurrence of pitching injuries in baseball players.</p><p><strong>Purpose: </strong>To prospectively investigate the relationship between shoulder and elbow injuries and individual components of the FMS during the preseason in high school baseball pitchers and determine which components of the FMS can be used as screening tools to predict shoulder and elbow injuries.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Eligible participants comprised 133 male high school baseball pitchers aged 15 to 17 years who underwent a preseason medical examination in 2017. Included participants were right-handed pitchers who had been involved in preseason practices without restrictions in baseball activities. The physical examination included assessments of background factors, bilateral shoulder and elbow range of motion, and grip and shoulder strength as well as the FMS. A shoulder or elbow injury was defined as any condition causing the inability to pitch for ≥8 days. Injuries occurring in the season immediately after the preseason medical examination were recorded. Logistic regression analysis was performed to identify risk factors associated with an injury.</p><p><strong>Results: </strong>Overall, 90 high school baseball pitchers were enrolled in this study. The incidence of injuries was 22.2%. A comparison of FMS scores revealed significantly higher values for shoulder mobility on both sides (dominant side: <i>P</i> = .025; nondominant side: <i>P</i> = .034) and lower values for rotary stability on the dominant side (<i>P</i> < .001) in the injured versus noninjured group. Logistic regression analysis identified poor rotary stability on the dominant side as a significant independent risk factor for baseball injuries (odds ratio, 5.30; <i>P</i> = .009).</p><p><strong>Conclusion: </strong>In right-handed high school baseball pitchers, a low FMS score for rotary stability on the dominant side during the preseason was a significant independent risk factor for injuries in the following season. The FMS score for rotary stability may be used as a predictive tool for the occurrence of pitching injuries in high school baseball pitchers.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241305607"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383005","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}