Orthopaedic Journal of Sports Medicine最新文献

{"title":"Health Disparities in Orthobiologics: Factors Influencing Access to Platelet-Rich Plasma for Knee Osteoarthritis.","authors":"Mohamed Addani, Jennifer Arthurs, Sadiq Haque, Andreea Geamanu, Lindsay Beaman, Shane Shapiro, Zubin Master","doi":"10.1177/23259671261458577","DOIUrl":"10.1177/23259671261458577","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) is an emerging therapy that demonstrates potential benefits for knee osteoarthritis (OA); however, the accessibility of PRP remains limited, in part, because its use is not covered by insurance.</p><p><strong>Purpose: </strong>To identify factors contributing to health disparities in PRP treatment for knee OA using machine learning models.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors collected data from electronic medical records at 2 upper Midwest medical centers (Mayo Clinic and Detroit Medical Center) from 2022 to 2023 encompassing demographic, socioeconomic, and clinical factors. Data collection encompassed age, sex, race, ethnicity, area deprivation index, marital status, income, rurality, insurance, employment, language, religion, treatment site, and region. Logistic regression and random forest models were applied to 3667 samples (80% training, 20% testing), comparing PRP recipients against a standard care group. Models were evaluated using 10-fold cross-validation to ensure robust performance assessment.</p><p><strong>Results: </strong>Logistic regression revealed that increased age, widowed status, lower income, rural residence, unemployment/disability, and Medicaid/Medicare insurance were associated with lower odds of receiving PRP. Upper-middle income, contracted insurance, and treatment at the Mayo-Arizona and Mayo-Florida sites were associated with higher odds. The model achieved areas under the curve of 0.83 (training set) and 0.82 (testing set). Random forest analysis identified distance to care, age, area deprivation index, income, and treatment site as top predictors, with areas under the curve of 0.92 (training) and 0.87 (testing).</p><p><strong>Conclusion: </strong>The current study demonstrated that both models discerned key barriers (income, distance to care, retirement status) and facilitators (regional differences) affecting PRP accessibility. These findings provide potential policy initiatives aimed at improving PRP access for underserved demographics, offering a quantitative blueprint to foster equitable access to regenerative therapies for knee OA.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261458577"},"PeriodicalIF":2.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579599","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":"Early Engagement, Lasting Impact: Predictors of Scholarly Activity in Orthopaedic Sports Medicine Fellowship Applicants.","authors":"Ignacio Pasqualini, Emma Humphrey, Shujaa T Khan, Lutul D Farrow","doi":"10.1177/23259671261458575","DOIUrl":"10.1177/23259671261458575","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Scholarly activity has become increasingly important for securing competitive orthopaedic sports medicine fellowship positions. However, it is not yet known whether the number of publications that an applicant has before a fellowship correlates with early career publication productivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate the association between publication output at the time of the sports medicine fellowship application and subsequent early career publication trajectory as well as to examine disparities in research productivity based on applicant characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Publication counts were determined through PubMed queries at the time of fellowship application and follow-up (median, 10 years). Applicant data, including sex, degree type (Doctor of Osteopathic Medicine [DO] and Doctor of Medicine [MD]), and medical school location (United States vs international medical graduate), were collected. Current board certification and American Academy of Orthopaedic Surgeons (AAOS) membership were assessed. Negative binomial regression was used to identify predictors of current publication productivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 305 orthopaedic sports medicine fellowship applicants to a single institution from 2011 to 2013 were analyzed. The cohort was predominantly male (94.8%) with MD degrees (89.8%). At the time of application for a fellowship, the median number of publications was 1.00 (interquartile range [IQR], 0.00-2.00), increasing to 4.00 (IQR, 2.00-12.00) at follow-up. Gender-based disparities persisted, with women averaging 5.75 current publications versus 12.13 for men. Multivariable analysis demonstrated that publication count at the time of application was associated with future productivity (incidence rate ratio [IRR], 1.23 per additional publication [95% CI, 1.18-1.30]; &lt;i&gt;P&lt;/i&gt; &lt; .001). DO degree holders had significantly lower research productivity than MD degree holders (IRR, 0.52 [95% CI, 0.32-0.89]; &lt;i&gt;P&lt;/i&gt; = .014). International medical graduates demonstrated higher productivity than United States medical graduates (IRR, 1.65 [95% CI, 1.10-2.54]; &lt;i&gt;P&lt;/i&gt; = .019). AAOS membership was positively associated with publication count (IRR, 1.54 [95% CI, 1.15-2.04]; &lt;i&gt;P&lt;/i&gt; = .003). Sex was not significantly associated in the multivariable model (&lt;i&gt;P&lt;/i&gt; = .538).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study demonstrated that early research engagement resulted in a trajectory toward sustained scholarly activity in orthopaedic sports medicine. Each additional publication at the time of the fellowship application increased future research output by 23%, while AAOS membership provided an additional 54% boost in productivity. Significant disparities persisted, with DO graduates producing 48% fewer publications than MD graduates and women averaging half the output of men, highlighting the need for ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261458575"},"PeriodicalIF":2.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579546","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":"Extrinsic Factors Contributing to Achilles Tendon Ruptures During NFL Games From 2010-2023: A Retrospective Analysis.","authors":"Kelan Queenan, Spencer DeMedal, Hasala Rannulu, Preston Rogers, Luke Jordan, Sreeram Ravi, Scott Lynch, Robert A Gallo","doi":"10.1177/23259671261458572","DOIUrl":"10.1177/23259671261458572","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon ruptures are serious injuries that significantly impair performance and career longevity among professional football players. The incidence of these injuries in National Football League (NFL) athletes has increased over the past decade. Given the sport's high physical demands and the potential for long-term functional limitations, understanding the extrinsic factors contributing to Achilles tendon tears is crucial.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to evaluate the role of extrinsic factors in the incidence of Achilles tendon ruptures among NFL players. Playing surface, timing within the season, quarter of play, and days of rest prior to the tear were examined. It was hypothesized that Achilles tendon tears would occur more frequently on artificial turf, during the fourth quarter of games, and in the latter half of the regular season.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Publicly available NFL injury data from 2010 to 2023 were retrospectively reviewed. Injury reports and related articles from major sports media sources were used to identify players placed on the injured reserve due to Achilles tendon ruptures sustained during official games. Descriptive statistics summarized player characteristics. Game-level analyses were conducted using analysis of variance and Pearson chi-square testing, while player-level comparisons utilized 1-sample <i>t</i> tests and chi-square tests of independence. <i>P</i> < .05 was considered statistically significant.</p><p><strong>Results: </strong>Of 1,477 players initially identified with ankle injuries, 103 players (103 ankles) sustained complete Achilles tendon ruptures across 101 games. The incidence of Achilles tears was highest in 2023 (n = 14 [13.59%]) and 2020 (n = 13 [12.62%]). The highest weekly incidence of tendon tear occurred in week 4 of the regular season (n = 13 [12.62%]). No significant differences in injury patterns were observed based on playing surface (2.68% grass vs 1.88% turf; χ² = 0.18; <i>P</i> = .67), game quarter (<i>P</i> = .18), or season timing (first half 57.42% vs. second half 27.18% of the season, <i>P</i> = .07).</p><p><strong>Conclusion: </strong>Our study demonstrated that Achilles tendon ruptures in NFL players have increased in frequency since 2020, without significant associations between playing surface, game timing, or season progression. Identifying modifiable external risk factors may help guide injury prevention strategies and optimize player training and conditioning.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261458572"},"PeriodicalIF":2.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579584","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":"Osteoarthritis Progression After Medial Meniscus Posterior Root Repair: An Analysis of Surgical Timing and Baseline Degenerative Severity.","authors":"Ali Can Koluman, Udit Dave, Trevor Poulson, Lika Dzidzishvili, Matthew Henriques, Nikhil N Verma, Adam B Yanke, Jorge Chahla","doi":"10.1177/23259671261422729","DOIUrl":"10.1177/23259671261422729","url":null,"abstract":"<p><strong>Background: </strong>Medial meniscus posterior root tears (MMPRTs) disrupt hoop stress transmission, leading to increased contact pressures, extrusion, and accelerated medial compartment osteoarthritis (OA). Although early surgical repair is widely recommended, it remains unclear whether surgical timing independently influences long-term radiographic outcomes after root repair.</p><p><strong>Purpose: </strong>To compare radiographic OA progression after acute (≤3 months from symptom onset) versus chronic (>3 months) MMPRT repair and to determine whether surgical timing independently predicts Kellgren-Lawrence (KL) grade progression after adjusting for baseline degenerative severity.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients undergoing isolated arthroscopic transtibial pullout repair for MMPRT between 2016 and 2023 were retrospectively reviewed. Inclusion required preoperative magnetic resonance imaging (MRI) and 2-year postoperative weightbearing radiographs. Patients were categorized as acute or chronic based on time from symptom onset to surgery, rather than confirmed time of tear occurrence. Primary outcome was change in KL grade (ΔKL). Secondary variables included preoperative meniscal extrusion percentage, joint space width, MRI diagnostic signs, mechanical alignment, and International Knee Documentation Committee (IKDC) scores. Multivariable linear regression was used to identify independent predictors of ΔKL progression.</p><p><strong>Results: </strong>In total, 61 patients met the inclusion criteria (acute: 30; chronic: 31). The chronic cohort demonstrated greater unadjusted KL progression (mean ΔKL: 0.65 vs 0.40; <i>P</i> = .049) and higher preoperative meniscal extrusion (47.9% vs 38.7%; <i>P</i> = .030). Multivariable analysis, however, showed that surgical timing (acute vs chronic) was not an independent predictor of ΔKL progression (<i>P</i> = .31). Instead, meniscal extrusion (β = 0.013, <i>P</i> = .023) and preoperative joint space width (β = -0.194, <i>P</i> = .051) were the strongest predictors of radiographic worsening. Joint space narrowing, MRI signs, mechanical alignment, and postoperative IKDC scores were comparable between groups.</p><p><strong>Conclusion: </strong>Although patients undergoing chronic MMPRT repair demonstrated greater unadjusted radiographic progression compared with those treated acutely, this effect does not persist after controlling for baseline degenerative severity. Osteoarthritis progression after root repair is primarily associated with the preoperative degenerative burden-particularly meniscal extrusion-rather than surgical timing itself. Early diagnosis and referral remain important because delayed presentation is associated with more advanced degeneration at the time of surgery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261422729"},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471994","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 Novel MRI Classification System for Hip Abductor Muscle Atrophy: The Wisconsin Hip Abductor (WHAb) Classification System.","authors":"Megan N Baughman, Donna G Blankenbaker, Samuel J Mosiman, Reagan S H Beyer, Anchal P Dhawan, Madeline R Tabor, Ariel H Kim, Andrea M Spiker","doi":"10.1177/23259671251415560","DOIUrl":"10.1177/23259671251415560","url":null,"abstract":"<p><strong>Background: </strong>Fatty atrophy of hip abductors is negatively associated with surgical outcomes in abductor repairs; however, there is no standardized system for its classification.</p><p><strong>Purpose: </strong>To (1) create a simple, reliable magnetic resonance imaging (MRI) classification system for fatty infiltration specific to hip abductors and (2) examine the correlation between fatty infiltration grades and hip pathology.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We retrospectively identified 200 hips from 100 patients who underwent bony pelvic MRI with no infection, fracture, tumor, or history of hip surgery. Fatty infiltration of the gluteus medius (GMed) and gluteus minimus (GMin) of both hips was graded on MRI. Grades consisted of a whole number (-2 to +2) corresponding to muscle thickness compared with mean values; a decimal number (0 to 0.4) representing various ratios of fat-to-muscle area; and a letter A (anterior), P (posterior), B (both), or N (none) indicating fat localization. Demographic information and details of MRI-identified hip pathology were collected for each patient. Kappa coefficients were calculated to determine intra- and interrater reliability. Descriptive data were compiled, and Wilcoxon rank sums were used to determine significant differences in grades based on pathology.</p><p><strong>Results: </strong>For both GMed and GMin, median muscle thickness was ≤1 SD of the reference value. In most cases, fat content fell between 0% and 50% in GMin and 0% and 25% in GMed. Fat was predominantly localized to the anterior portion of both muscles. Intra- and interrater reliability was moderate to substantial in all grading categories. Higher grades for fat content in the GMin and GMed correlated with tendon tear, tendinosis, and intra-articular cartilage loss (GMin: <i>P</i> < .001, <i>P</i> = .002, <i>P</i> < .001; GMed: <i>P</i> = .03, <i>P</i> = .001, <i>P</i> = .005, respectively). Higher fat content grades in the GMin were also associated with labral tear (<i>P</i> = .03), and in the GMed with greater trochanteric bursitis (<i>P</i> = .02). There was a positive association between width of the GMed and incidence of tendon tear, tendinosis, and intra-articular cartilage loss (<i>P</i> = .006, <i>P</i> = .006, <i>P</i> = .047, respectively).</p><p><strong>Conclusion: </strong>This newly described classification system offers a straightforward method of grading fatty atrophy in hip abductor muscles and demonstrates correlation with various hip pathologies.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671251415560"},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472032","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":"Longitudinal Changes and Prognostic Factors for Static Anterior Tibial Translation After Anatomic Anterior Cruciate Ligament Reconstruction.","authors":"Ryo Murakami, Shuji Taketomi, Ryota Yamagami, Kenichi Kono, Kohei Kawaguchi, Takashi Kobayashi, Tomoki Murakami, Sakae Tanaka","doi":"10.1177/23259671261450548","DOIUrl":"10.1177/23259671261450548","url":null,"abstract":"<p><strong>Background: </strong>Anterior tibial translation (ATT) is a reported risk factor for residual pivot shift after anterior cruciate ligament (ACL) reconstruction. However, longitudinal postoperative changes in ATT are not well defined. This study aimed to evaluate the longitudinal changes in postoperative static ATT assessed under weightbearing conditions and to identify prognostic factors associated with residual static ATT.</p><p><strong>Purpose: </strong>To evaluate the longitudinal changes in postoperative static ATT assessed under weightbearing conditions and to identify prognostic factors associated with residual static ATT.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who underwent primary anatomic ACL reconstruction between 2017 and 2023 with a minimum follow-up of 24 months were included. Static ATT was measured using lateral weightbearing radiographs preoperatively and at 6, 12, and 24 months postoperatively. A linear mixed-effects model estimated marginal predicted changes in static ATT over time, and additional mixed-effects models identified prognostic factors associated with postoperative static ATT. The association between postoperative static ATT at 24 months and residual postoperative pivot shift was analyzed.</p><p><strong>Results: </strong>In total, 95 patients were included. Static ATT significantly decreased at 6 months compared with preoperative values (<i>P</i> < .01) and remained stable at 12 and 24 months, with no significant differences among the postoperative time points. The predicted change in static ATT from preoperative to 24 months was -1.32 mm (95% CI, -1.93 to -0.70; <i>P</i> < .01). Multivariate linear mixed-effects regression analysis revealed that female sex (estimate, 1.45 mm; <i>P</i> = .03) and a greater lateral posterior tibial slope (estimate, 0.28 mm per degree; <i>P</i> = .01) were independently associated with increased postoperative static ATT. At 24 months, greater static ATT was associated with residual pivot shift (odds ratio, 1.45; 95% CI, 1.10-1.92; <i>P</i> = .01).</p><p><strong>Conclusion: </strong>Static ATT improved after ACL reconstruction and remained stable through 24 months. Female sex and a steeper lateral PTS were independently associated with less postoperative improvement in static ATT. Greater postoperative static ATT was also associated with residual pivot shift.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261450548"},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471969","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":"Structural Gains Without Symptomatic Benefit After Microfracture During High Tibial Osteotomy.","authors":"Do Kyung Lee, Joon Ho Wang","doi":"10.1177/23259671261455795","DOIUrl":"10.1177/23259671261455795","url":null,"abstract":"<p><strong>Background: </strong>High tibial osteotomy (HTO) realigns the mechanical axis and reduces medial compartment overload in knee osteoarthritis. Microfracture (MFx) is often added to stimulate cartilage repair, yet whether MFx provides additional clinical benefit in the degenerative osteoarthritic environment remains uncertain. Emerging evidence suggests that structural cartilage changes do not consistently correlate with symptoms, raising the possibility of structure-symptom discordance.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to evaluate whether MFx performed during HTO improves cartilage regeneration and postoperative patient-reported outcomes and to determine whether structural improvement corresponds with symptomatic benefit. It was hypothesized that MFx would enhance cartilage regeneration and lead to superior clinical outcomes compared with HTO alone.</p><p><strong>Study design: </strong>Cohort study; Level of evidence 3.</p><p><strong>Methods: </strong>A total of 62 patients who underwent navigation-assisted medial opening-wedge HTO with second-look arthroscopy at 2 years were included. Patients were categorized into 2 groups: HTO alone (group 1; n = 30) and HTO with MFx for well-shouldered focal defects (group 2; n = 32). Cartilage status was graded using the International Cartilage Regeneration & Joint Preservation Society (ICRS) system, and improvement was defined as a decrease in grade. Clinical outcomes were assessed at 2 years using the International Knee Documentation Committee (IKDC) subjective score. Group comparisons, correlation analyses, and multivariable linear regression were performed to determine independent predictors of postoperative IKDC score.</p><p><strong>Results: </strong>Cartilage improvement occurred in 33.3% of group 1 and 62.5% of group 2 (<i>P</i> = .04). In the MFx group, patients achieving low-grade postoperative lesions (ICRS 1-2) had significantly smaller initial defects (2.0 vs 6.0 cm²; <i>P</i> < .01). Despite better structural improvement, no significant between-group difference in 2-year IKDC score was found (55.2 vs 50.6; <i>P</i> = .26). MFx was identified as an independent negative predictor of postoperative IKDC score (β = -14.4; <i>P</i> = .01). Changes in cartilage status (ΔICRS) were not correlated with symptomatic improvement (ΔIKDC; ρ = -0.18; <i>P</i> = .14), demonstrating a structure-symptom discordance.</p><p><strong>Conclusion: </strong>MFx performed during HTO improved cartilage morphology but did not yield superior clinical outcomes. MFx was associated with significantly lower adjusted IKDC scores, and structural improvement did not correlate with symptomatic benefit.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261455795"},"PeriodicalIF":2.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Population-Specific Formulas for Glenoid Height-Based Assessment of Glenoid Bone Loss: A Systematic Review and Meta-analysis.","authors":"Woo-Sung Do, Tae-Hwan Yoon, Joon-Ryul Lim, Yun-Rak Choi, Yong-Min Chun","doi":"10.1177/23259671261455796","DOIUrl":"10.1177/23259671261455796","url":null,"abstract":"<p><strong>Background: </strong>Assessment of glenoid bone loss is essential in managing anterior shoulder instability. Although glenoid height-based methods are straightforward and practical for estimating native glenoid width in injured shoulders, inconsistent formulas across studies have created uncertainty in clinical practice, possibly due to population differences.</p><p><strong>Purpose: </strong>To systematically review the literature to (1) compare glenoid height and width according to sex and population and (2) synthesize unique sex- and population-specific regression equations for height-based assessment of glenoid bone loss.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 3.</p><p><strong>Methods: </strong>A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Cochrane Library, and Google Scholar were searched through July 2025 for studies reporting glenoid height and width using computed tomography. Data on demographics, glenoid height, width, and regression equations were extracted. Risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Pooled mean differences were calculated using random-effects meta-analysis, and sex- and population-specific regression equations were synthesized with inverse-variance weighting.</p><p><strong>Results: </strong>Five studies comprising 819 shoulders met the inclusion criteria. The MINORS scores ranged from 9 to 10 (out of 16). Males had significantly larger glenoid dimensions than females, with mean differences of 5.30 mm in height and 4.52 mm in width (both <i>P</i> < .0001). Western and Asian populations did not differ in glenoid height (<i>P</i> = .7562), but Western populations had significantly greater glenoid width (mean difference, 3.42 mm; <i>P</i> = .0043). Synthesized regression equations confirmed linear relationships between glenoid height and width, with regression models differing according to sex and population. Of note, Western females were predicted to have greater glenoid width than Asian males and females at equivalent glenoid heights.</p><p><strong>Conclusion: </strong>Estimating glenoid width from glenoid height has been proposed in multiple studies. Because this relationship differs by sex and population, subgroup-specific regression equations should be applied when making such estimations. While these formulas do not represent an individual's native glenoid anatomy, they can serve as reference values and support surgical decision-making, reinforcing the importance of population-specific strategies in instability surgery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261455796"},"PeriodicalIF":2.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456305","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":"Functional and Analgesic Effects of iPACK Blocks Added to Continuous Adductor Canal Blocks for ACL Reconstruction With Quadriceps Tendon Autograft: A Randomized Controlled Trial.","authors":"Carey L Brewbaker, Thomas E Moran, Christopher D Wolla, William M Pullen, Bethany J Wolf, Clinton F Pillow, Harris S Slone","doi":"10.1177/23259671261445908","DOIUrl":"10.1177/23259671261445908","url":null,"abstract":"<p><strong>Background: </strong>An adjunctive infiltration between popliteal artery and capsule of the posterior knee (iPACK) block-an infiltration between the popliteal artery and posterior knee capsule-has been used in knee surgery to address posterior knee pain, complementing the anterior and medial sensory coverage of an adductor canal block (ACB). Its benefit in all-inside anterior cruciate ligament reconstruction (ACL-R) using quadriceps tendon (QT) autograft remains uncertain.</p><p><strong>Purpose: </strong>To compare acute postoperative pain, opioid consumption, and 6-week knee range of motion between patients receiving continuous ACB alone and continuous ACB plus a single-shot iPACK block.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 2.</p><p><strong>Methods: </strong>Patients undergoing primary all-inside ACL-R with QT autograft were randomized to either continuous ACB with placebo skin wheal (ACB group) or continuous ACB with iPACK (ACB-iPACK group). Demographic and surgical data were collected prospectively. The primary outcome was visual analog scale (VAS) pain scores during the first 72 postoperative hours. Secondary outcomes included opioid use (morphine milligram equivalents), achievement of full knee extension, and difference in maximal flexion between the surgical and nonsurgical limb at 6 weeks.</p><p><strong>Results: </strong>A total of 71 patients were analyzed (ACB, n = 33; ACB-iPACK, n = 38), with no significant group differences in baseline characteristics. Median VAS scores at discharge were significantly lower in the ACB-iPACK group (20 mm) versus the ACB group (32.5 mm) (<i>P</i> = .049). No further differences occurred between 12 and 72 hours postoperatively. Perioperative and postoperative opioid consumption did not differ between groups (perioperative, <i>P</i> = .52; postoperative, <i>P</i> = .47 to ≥.99). Rates of achieving full extension were similar. At 6 weeks, the difference in knee flexion between limbs was significantly smaller in the ACB-iPACK group (37.7°) compared with the ACB group (47.6°) (mean difference, 9.9°; <i>P</i> = .02). No perioperative regional anesthesia complications occurred.</p><p><strong>Conclusion: </strong>Adding an iPACK block to continuous ACB for all-inside ACL-R with QT autograft provided a slight reduction in pain at discharge (VAS difference, 12.5 mm) and improved knee flexion at 6 weeks. However, pain scores and opioid use beyond the immediate postoperative period were not significantly different between groups. These findings may help guide patient counseling regarding the expected benefits of incorporating an iPACK block in this surgical setting.</p><p><strong>Registration: </strong>NCT05498870 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261445908"},"PeriodicalIF":2.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456284","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":"Association of Tibial Slope Morphology and Lateral-Medial Tibial Slope Asymmetry With Revision ACL Reconstruction in an Asian Cohort.","authors":"Francis Fong Jia Yi, Rachel Qin Huang, Wang Chen, Khalid Ameer, Mok Ying Ren, Lee Yee Han Dave, James Hoi Po Hui, Wang Ming","doi":"10.1177/23259671261449700","DOIUrl":"10.1177/23259671261449700","url":null,"abstract":"<p><strong>Background: </strong>Graft failure after anterior cruciate ligament (ACL) reconstruction remains a significant clinical challenge, particularly in revision surgery. Increasing biomechanical and clinical evidence suggests that tibial slope morphology influences anterior tibial translation and ACL graft forces, potentially increasing failure risk. While posterior tibial slope has been implicated in graft failure, the relative contributions of medial tibial slope (MTS), lateral tibial slope (LTS), and slope asymmetry remain incompletely defined.</p><p><strong>Purpose: </strong>To evaluate the association between tibial slope parameters and the risk of ACL reconstruction failure.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary academic center in Singapore, including 204 patients who underwent primary (n = 120) or revision (n = 84) ACL reconstruction between 2009 and 2022. Preoperative magnetic resonance imaging (MRI) was used to measure MTS, LTS, and LTS-MTS asymmetry using standardized anatomic landmarks. Demographic, clinical, and intraoperative variables were collected, along with patient-reported outcome measures (PROMs), including the Lysholm Knee Score and Knee injury and Osteoarthritis Outcome Score. Receiver operating characteristic (ROC) curve analysis was performed to determine predictive performance and optimal cutoff values for tibial slope parameters. Multivariable regression analysis was used to identify variables independently associated with revision ACL reconstruction.</p><p><strong>Results: </strong>Patients undergoing revision ACL reconstruction demonstrated significantly greater mean LTS (9.73°± 3.49° vs 7.91°± 3.12°; <i>P</i> < .01) and LTS-MTS asymmetry (1.68°± 3.99° vs 0.20°± 4.01°; <i>P</i> = .01) compared with patients undergoing primary reconstruction. No significant difference in MTS was observed between groups (<i>P</i> = .43). ROC analysis showed that LTS (area under the curve [AUC] 0.65; cutoff ≥7.65°) and LTS-MTS asymmetry (AUC 0.61; cutoff ≥1.85°) were significantly associated with the revision ACL reconstruction cohort, whereas MTS was not. Multivariable analysis identified LTS ≥7.65°, LTS-MTS asymmetry ≥1.85°, and concomitant meniscal tears as independently associated with the revision cohort. Higher tibial slope values were associated with lower PROM scores, although these differences were not clinically meaningful.</p><p><strong>Conclusion: </strong>This study underscores the importance of evaluating LTS and LTS-MTS asymmetry on MRI in relation to revision ACL reconstruction status. LTS ≥7.65°, LTS-MTS asymmetry ≥1.85°, and concomitant meniscal tears were significantly associated with belonging to the revision group, highlighting the need for careful assessment of tibial morphology and consideration of these parameters during preoperative planning.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261449700"},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448658","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}