Orthopaedic Journal of Sports Medicine最新文献

{"title":"Clinical Outcomes of Arthroscopic Bankart Repair With Remplissage Versus Bankart Repair With Remplissage and Arthroscopic Subscapularis Augmentation in Recurrent Anterior Shoulder Instability.","authors":"Michael Hantes, Vasileios S Akrivos, Nikolaos Stefanou, Zoe Dailiana, Artemis Hante, Sokratis Varitimidis","doi":"10.1177/23259671261418677","DOIUrl":"https://doi.org/10.1177/23259671261418677","url":null,"abstract":"<p><strong>Background: </strong>Recurrent anterior shoulder instability is frequently associated with Hill-Sachs and Bankart lesions, which compromise joint stability. While arthroscopic Bankart repair remains a widely accepted treatment for anterior shoulder instability, combining it with remplissage, with or without anterior subscapularis augmentation (ASA), has been proposed to enhance outcomes in these cases.</p><p><strong>Purpose: </strong>To compare the clinical and functional outcomes of arthroscopic Bankart repair with remplissage, with or without ASA, in patients with recurrent anterior shoulder instability and subcritical glenoid bone loss (GBL) (<15%).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 56 patients with recurrent anterior shoulder instability who underwent surgery at a single tertiary university hospital between 2018 and 2022. Patients were grouped into 2 categories based on the surgical approach: Bankart repair with remplissage (group A) and Bankart repair with both remplissage and ASA (group B). Functional outcomes were evaluated using the Rowe score and the modified Constant-Murley (CM) score, while external rotation (ER) deficits were measured in adduction (ER1) and at 90° abduction (ER2). In addition, recurrence rates and postoperative clinical scores were systematically analyzed to assess the efficacy of these techniques.</p><p><strong>Results: </strong>The recurrence rates were 5.1% in group A and 0% in group B. Both groups demonstrated significant postoperative improvements in clinical outcomes. In group A, the mean Rowe score improved from 37.8 ± 4.5 to 93.1 ± 5.3 and the CM score from 69.8 ± 7.2 to 96.5 ± 2.5 (<i>P</i> < .0001). In group B, the Rowe score increased from 37.5 ± 6.4 to 94.7 ± 1.2 and the CM score from 71.2 ± 8.3 to 95.4 ± 0.9 (<i>P</i> < .0001). No statistically significant differences were observed between groups in postoperative Rowe (<i>P</i> = .23) or CM scores (<i>P</i> = .08). However, when postoperative range of motion was analyzed, the addition of ASA was associated with greater ER deficits compared with remplissage, both in ER1 (-12.5°± 9.19° vs -18.33°± 2.46°; <i>P</i> = .013) and ER2 (-14.2°± 7.67° vs -18.83°± 1.94°; <i>P</i> = .017).</p><p><strong>Conclusion: </strong>This study demonstrates that adding ASA to arthroscopic Bankart repair with remplissage significantly reduces ER while maintaining excellent clinical outcomes and low recurrence rates. The combination of these techniques provides a viable option for managing recurrent anterior instability, particularly in cases with poor tissue quality and GBL <15%.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261418677"},"PeriodicalIF":2.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468773","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":"Return to Play and Performance Following UCL Reconstruction and Repair in Major League Baseball Position Players.","authors":"Michael A Mastroianni, Morgan R Dillon, Justin L Reyes, Mark Ren, Brian F Timoney, Brendan J Schwartz, Dongyeon J Kim, Maximiliano Gonzalez, Frank J Alexander, Christopher S Ahmad","doi":"10.1177/23259671251413601","DOIUrl":"https://doi.org/10.1177/23259671251413601","url":null,"abstract":"<p><strong>Background: </strong>Return to play and performance following elbow ulnar collateral ligament (UCL) reconstruction or repair in Major League Baseball (MLB) position players have not been well studied.</p><p><strong>Purpose: </strong>To evaluate return to play and return to performance using modern advanced analytics at 1 and 2 seasons following UCL surgery in MLB position players.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective analysis was performed on all 33 MLB position players who underwent primary UCL surgery between March 1, 2014, and November 1, 2024. Incidence, risk factors, and return-to-play rates were recorded. Return-to-performance analysis was conducted for 25 players who met the inclusion criteria and were compared to preoperative levels and 50 uninjured matched controls. Performance data were collected for all MLB position players using public sources. Binary logistic regression was also conducted.</p><p><strong>Results: </strong>Incidence of UCL surgery in MLB position players over the full 11-season period (2014-2024) was 2.9 ± 1.4 surgeries per season in our cohort, with an even greater average in the past 5 full seasons compared to 2014 to 2019 (<i>P</i> = .21) and 1984 to 2014 (<i>P</i> < .05). Cases had a significantly greater whiff percentage and fewer outs above average. A total of 81.8% returned to play at 1.5 years postoperatively (mean of 317 ± 111 days). UCL repairs (n = 8) resulted in 121 fewer days missed on average compared to reconstructions (n = 25; <i>P</i> < .01). Notably, position players provided significantly less value (FanGraphs wins above replacement [fWAR]) after returning. There were otherwise no differences in any mean offensive or defensive metric. Controls had higher proportions meeting prior performance levels in nearly every metric for the first and second seasons back. Preinjury weighted runs created plus (wRC+) in cases was the only predictor for returning to performance in fWAR postoperatively.</p><p><strong>Conclusion: </strong>Annual UCL surgery rates in MLB position players have tripled in recent seasons. Less contact and defensive ability were associated with getting UCL surgery. Over 80% of players returned to play by 1.5 years postoperatively, with those who underwent UCL repairs returning faster. Most performance metrics return at high rates, but the significant decline in player value after returning can likely be explained by decreased workload and possibly a slight decline in offensive performance.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671251413601"},"PeriodicalIF":2.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468870","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":"Side Hop Test as a Predictor of Successful Return to Sports After Nonoperative Treatment or Modified Broström Operation in Patients With Chronic Ankle Instability: Based on the Ankle-GO Score.","authors":"Jin Hyuck Lee, Gyu Bin Lee, Sang Woo Pyun, Woo Yong Chung, Ki Hun Shin, Min Su Bae, Ji Hye Choi, Jangsun Hwang, Woo Young Jang","doi":"10.1177/23259671261419111","DOIUrl":"https://doi.org/10.1177/23259671261419111","url":null,"abstract":"<p><strong>Background: </strong>The Ankle-GO score is an objective battery for return-to-sports (RTS) decision-making after nonoperative or surgical treatment in patients with chronic ankle instability (CAI). However, direct comparisons of Ankle-GO subscales between CAI patients with and without successful RTS are limited, and predictors of successful RTS remain unclear.</p><p><strong>Purpose: </strong>To directly compare the Ankle-GO subscales between CAI patients with and without successful RTS after nonoperative treatment and modified Broström operation (MBO) and to explore which Ankle-GO subscales are significantly associated with successful RTS.</p><p><strong>Study design: </strong>Case control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 100 patients (100 ankles) with CAI were enrolled. Of these, 52 ankles underwent nonoperative treatment (31 with successful RTS and 21 without) and 48 ankles underwent MBO (26 with successful RTS and 22 without). Successful RTS was defined as return to preinjury sport level with a Tegner activity score ≥6. The Ankle-GO, which consists of 6 subscales, was compared between patients with and without successful RTS: the single-leg stance test, modified star excursion balance test, side hop test (SHT), figure-of-8 test (F8T), Foot and Ankle Ability Measure, and Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI). Statistical analyses were performed using independent <i>t</i> tests and multivariable binary logistic regression analyses with receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>In the nonoperative treatment group, CAI patients with successful RTS demonstrated superior Ankle-GO scores, SHT, and F8T compared with those without successful RTS (all <i>P</i> < .001). In the MBO group, CAI patients with successful RTS demonstrated superior Ankle-GO scores, SHT, F8T, and ALR-RSI scores compared with those without successful RTS (all <i>P</i> < .001). Furthermore, SHT was a significant predictor of RTS in both the nonoperative treatment group (odds ratio [OR], 18.03; 95% CI, 2.8-36.8) and MBO group (OR, 4.59; 95% CI, 2.0-10.7).</p><p><strong>Conclusion: </strong>Our study demonstrated that in both the nonoperative treatment and MBO groups, SHT and F8T were key factors distinguishing patients with CAI who had successful RTS from those who did not. In addition, SHT was the strongest independent predictor of RTS in both the nonoperative treatment and MBO groups. Clinicians and therapists should consider these findings when planning rehabilitation and RTS strategies.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261419111"},"PeriodicalIF":2.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468844","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":"Six-Month SIRSI Scores and Return to Sport After Shoulder Stabilization in Adolescent Athletes.","authors":"Carolina Pavlenco, Bilal Khilfeh, Xing Wang, Michael Saper","doi":"10.1177/23259671261421228","DOIUrl":"https://doi.org/10.1177/23259671261421228","url":null,"abstract":"<p><strong>Background: </strong>Psychological readiness is increasingly recognized as a return-to-sport (RTS) determinant after shoulder stabilization surgery. The Shoulder Instability-Return to Sport After Injury (SIRSI) score is a tool to assess psychological recovery, yet prognostic value at intermediate postoperative milestones remains unclear.</p><p><strong>Purpose/hypothesis: </strong>The purpose was to evaluate whether 6-month SIRSI scores relate to 1-year patient-reported outcome measures (PROMs) and RTS in adolescents after shoulder stabilization surgery. It was hypothesized that higher 6-month SIRSI scores would be associated with improved 1-year PROMs and RTS rates.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This study included patients aged 14 to 18 years who underwent surgical shoulder stabilization between August 2022 and August 2023 with follow-up at 6 months and ≥1 year. Psychological readiness was assessed with the SIRSI score, and the following PROMs were collected: American Shoulder and Elbow Surgeons assessment form, Tegner Activity Scale, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and Pediatric/Adolescent Shoulder Survey. Associations between 6-month SIRSI scores and 1-year PROMs and RTS were analyzed.</p><p><strong>Results: </strong>Twenty-three athletes were included (mean ± SD age, 16.7 ± 1.1 years; 65.2% male; 69.6% dominant-arm surgery), including 5 (21.7%) anterior labral repairs, 1 (4.3%) posterior labral repair, and 17 (74.0%) combined anterior-posterior labral repairs. At 1 year, 17 athletes (73.9%) returned to their primary sport. Six-month SIRSI scores demonstrated moderate positive correlations with 1-year American Shoulder and Elbow Surgeons score (ρ = 0.42) and Tegner score (ρ = 0.51). Athletes who returned to their primary sport had higher median 6-month SIRSI scores (78.3) as compared with those who did not (46.7; <i>P</i> = .006). Improvements were observed across all PROMs from 6 months to 1 year.</p><p><strong>Conclusions: </strong>Six-month SIRSI scores are associated with 1-year functional outcomes and RTS success in adolescent athletes after shoulder stabilization surgery. Incorporating SIRSI into routine 6-month postoperative assessment may help identify athletes whose recovery-related confidence and readiness to RTS lag postoperative milestones, particularly in the context of limitations such as weakness, stiffness, or pain. Future research should stratify by surgical technique, sex, and other variables to better understand individualized recovery patterns and explore interventions that target psychological as well as physical readiness.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261421228"},"PeriodicalIF":2.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468859","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":"Return-to-Sport Rates and Functional Outcomes After Hip Arthroscopy for Femoroacetabular Impingement in Young Football Athletes: A 9.8-Year Follow-up.","authors":"Jacob J Schaefer, Louis S Kang, Gavin H Ward, Nathan R Graden, Bruce A Levy, Mario Hevesi, Aaron J Krych, Kelechi R Okoroha","doi":"10.1177/23259671261419484","DOIUrl":"https://doi.org/10.1177/23259671261419484","url":null,"abstract":"<p><strong>Background: </strong>Frequent pivoting, rotation, and deep hip flexion place football players at high risk for femoroacetabular impingement (FAI), a leading cause of hip pain in this population. Previous studies have primarily focused on professional National Football League athletes undergoing mixed surgical techniques, including labral debridement. Limited data exist on outcomes in younger, amateur players treated with labral repair.</p><p><strong>Purpose: </strong>To report return to sport (RTS) rates and functional outcomes at a minimum 5-year follow-up in primarily active high school and college football players undergoing primary hip arthroscopy with labral repair for FAI.</p><p><strong>Study design: </strong>Case series, Level of evidence, 4.</p><p><strong>Methods: </strong>All football players who underwent primary hip arthroscopy with labral repair for FAI between 2010 and 2019 were identified from an institutional database. Collected data included descriptive data, radiographic parameters, surgical details, and reoperations. At a minimum 5-year follow-up, RTS outcomes and patient-reported outcome measures (PROMs), such as the Modified Harris Hip Score (mHHS) and Hip Outcome Score (HOS), were evaluated.</p><p><strong>Results: </strong>A total of 36 hips in 27 male athletes (mean age, 18 years; body mass index, 28.1 kg/m²) were included. The majority of athletes competed at the high school (70%) or collegiate level (26%). Mean preoperative radiographic measurements were as follows: lateral center-edge angle, 31.6°; Tönnis angle, 4.1°; and alpha angle, 61.4°. Femoroplasty and acetabuloplasty were performed in 100% and 86% of cases, respectively. Also, 84% of players returned to football, all at the same or higher level than before surgery. At a mean follow-up of 9.8 years, all PROMs improved significantly from baseline (<i>P</i> < .002). Outcome scores at follow-up were as follows: mHHS 90.5; HOS-Activities of Daily Living, 94.5; HOS-Sports-Specific Subscale, 91.1; and visual analog scale (VAS) pain with use, 2.3/10; VAS pain at rest, 1.3/10; and surgical satisfaction, 8.5/10. No patients required revision surgery. However, 2 patients (7%) underwent reoperations-including 1 for heterotopic ossification excision and 1 for periacetabular osteotomy.</p><p><strong>Conclusion: </strong>American football players who underwent primary hip arthroscopy with labral repair for FAI achieved excellent long-term outcomes, with high RTS rates at the same or higher levels, and improvements in PROMs and patient satisfaction. Despite favorable outcomes, nonmedical factors, such as graduation, may influence RTS in competitive athletes, particularly at the high school and collegiate levels.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261419484"},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434729","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":"Assessing the Quality of Consumer Health Information Within the Realm of Shoulder Injuries on TikTok.","authors":"Bashar Jawich, Haytham Alqasmi, Alqasim Elnaggar, Shadi Kotob, Omar Abdalla, Imran Bitar, Ameen Suhrawardy, Rahul Vaidya","doi":"10.1177/23259671261419114","DOIUrl":"https://doi.org/10.1177/23259671261419114","url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain and injury are among the most prevalent musculoskeletal presentations in primary care. With the rise of consumer health information on TikTok, it is pivotal to assess and determine whether the information produced by content creators can serve as a supplement for shoulder rehabilitation and injury prevention.</p><p><strong>Hypothesis: </strong>It was hypothesized that content creators with professional degrees and extensive knowledge within the realm of shoulder injuries would yield valuable and accurate health information.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>On June 18, 2025, #ShoulderInjury was used as the search item under the TikTok search engine. A total of 9286 videos appeared after the initial search. The authors applied an inclusion criteria of at least 100 likes. Exclusion criteria removed irrelevant, non-English, and duplicate videos, resulting in 209 eligible videos for further analysis. These were evaluated using the DISCERN questionnaire, an instrument used to assess consumer health information on a 1 to 5 scale. Two independent raters scored the videos, and interrater reliability was calculated using weighted Cohen kappa.</p><p><strong>Results: </strong>The 209 analyzed videos garnered 1,408,268 likes and 12,536 comments, with a mean DISCERN score of 2.61. Physicians' videos (n = 41) had the highest mean score (3.52), significantly outperforming nonprofessionals (2.18), physical therapists (2.87), and other professionals (2.79) in critical DISCERN areas (<i>P</i> < .001). Educational content yielded the highest mean score (3.29), whereas personal story videos had the lowest (1.89). Weighted Cohen kappa showed very good agreement for physician videos (κ = 0.82), moderate for physical therapists (κ = 0.59), good for nonprofessionals (κ = 0.79), and fair for other professionals (κ = 0.40).</p><p><strong>Conclusion: </strong>This study highlights the potential of TikTok as an effective educational tool when used by qualified professionals. Professionally produced content consistently scored higher on the DISCERN scale. Although the findings are promising, it is important to note limitations, like potential biases in DISCERN scoring due to nonblinded raters, the influence of TikTok's algorithm, and the exclusion of videos with <100 likes. Future research should explore social media's role in medical education and assess how to optimize content delivery and engagement.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261419114"},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434555","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 Clinical Examination, Ultrasonography, and Magnetic Resonance Imaging in the Diagnosis of Arthroscopically Confirmed Partial Subscapularis Tears.","authors":"Ali Can Koluman, Nezih Ziroglu, Tuna Demirbas, Ersin Ercin","doi":"10.1177/23259671261418678","DOIUrl":"https://doi.org/10.1177/23259671261418678","url":null,"abstract":"<p><strong>Background: </strong>Partial-thickness subscapularis (SSC) tears are frequently underdiagnosed due to subtle clinical presentation and the limited sensitivity of routine imaging modalities, particularly magnetic resonance imaging (MRI). Dynamic ultrasonography (USG) and structured test combinations may improve early detection.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study is to compare the diagnostic accuracy of individual SSC-specific clinical tests, systematic 3-test combinations, USG, and MRI in detecting partial-thickness SSC tears, using arthroscopy as the reference standard. It was hypothesized that structured 3-test combinations and dynamic USG would outperform MRI in detecting partial SSC tears.</p><p><strong>Study design: </strong>Cohort Study (diagnosis); Level of evidence, 2.</p><p><strong>Methods: </strong>A total of 46 patients undergoing arthroscopy for rotator cuff pathology were prospectively assessed using 6 SSC-specific clinical tests, dynamic USG, and standardized MRI sequences. Two independent, blinded observers evaluated all diagnostic modalities. All clinically relevant 3-test combinations were systematically analyzed and considered positive when ≥2 tests were positive. Diagnostic performance metrics-including sensitivity, specificity, accuracy, area under the curve (AUC), and interobserver agreement-were compared with arthroscopic findings.</p><p><strong>Results: </strong>The triads of Bear Hug + Napoleon + internal rotation lag sign and Bear Hug + Belly Press + Napoleon demonstrated the highest clinical diagnostic accuracy (sensitivity, 83.9% [95% CI, 67.4-92.9]; specificity, 100% [95% CI, 79.6-100.0]; AUC, 0.92 [95% CI, 0.85-0.98]). USG outperformed MRI across all diagnostic metrics (sensitivity, ≤96.8% [95% CI, 83.8-99.4]; AUC, 0.92 [95% CI, 0.83-1.00]), whereas MRI showed limited sensitivity (ranging from 61.3% [95% CI, 43.8-76.3] to 67.7% [95% CI, 50.1-81.4]). Interobserver agreement was almost perfect for MRI (κ≈ 0.91) and substantial for USG (κ≈ 0.68). Diagnostic accuracy was higher for Lafosse type 2 tears, although USG and the top-performing clinical triad remained effective across both tear subtypes.</p><p><strong>Conclusion: </strong>Dynamic USG and structured SSC-specific clinical test combinations offer superior diagnostic accuracy compared with MRI for partial SSC tears.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261418678"},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434569","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":"Complications Leading to Reoperation After Pediatric Tibial Spine Fracture Fixation.","authors":"Benjamin R Caruso, Suzanna M Ohlsen, Keinan Agonias, Robert L Van Pelt, Michelle M Son, Michael G Saper, Jason Rhodes, J Marc Cardelia, Jay C Albright, Shital N Parikh, Kevin G Shea, Henry B Ellis, Philip L Wilson, Sheila Algan, Jennifer J Beck, Richard E Bowen, Jennifer M Brey, Matthew J Brown, Christian Clark, Allison Crepeau, Eric W Edmonds, Matthew Ellington, Peter D Fabricant, Jeremy Frank, Theodore J Ganley, Daniel W Green, Benton Heyworth, Ryan J Koehler, Alfred A Mansour, Stephanine Mayer, Scott D McKay, Molly C Meadows, Matthew Milewski, Emily L Niu, Donna M Pacicca, Stephanie S Pearce, Matthew R Schmitz, Stephen Storer, Curtis VandenBerg, Yi-Meng Yen, Gregory A Schmale","doi":"10.1177/23259671261419525","DOIUrl":"https://doi.org/10.1177/23259671261419525","url":null,"abstract":"<p><strong>Background: </strong>Tibial spine fractures (TSFs) are uncommon injuries in pediatric patients, often requiring operative fixation. While complications such as arthrofibrosis and anterior cruciate ligament (ACL) insufficiency have been previously reported, the risk factors associated with unplanned reoperation remain incompletely understood.</p><p><strong>Purpose: </strong>To identify the most common complications leading to reoperation and to evaluate associated risk factors, using a multicenter quality improvement registry.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A multicenter registry of operatively treated pediatric TSFs was retrospectively reviewed from July 2018 to March 2025 across 27 institutions. Grade 3 complications were defined as complications resulting in reoperation, unplanned hospitalization, or interventional radiologic procedures. Complication types, patient and injury characteristics, fixation methods, and intraoperative findings were analyzed. Bivariate and multivariate logistic regression analyses were performed to identify independent risk factors for Clavien-Dindo grade 3 complications.</p><p><strong>Results: </strong>A total of 532 patients were included (mean age, 12.1 years; 73.4% men). Overall, 56 patients (10.5%) underwent reoperation. The most common reasons for reoperation were stiffness (4.9%) and ACL insufficiency (3.6%). Screw fixation of TSFs was associated with a 4.5-fold increased risk of grade 3 complications compared with suture fixation (<i>P</i> = .009). Both suture and anchor fixation (<i>P</i> = .045) and longer operative times (<i>P</i> = .020) were also associated with higher complication rates. Meniscal or intermeniscal ligament entrapment was significantly associated with increased stiffness-related reoperation (<i>P</i> = .045). Patients who underwent delayed ACL reconstruction (ACLR) were older (<i>P</i> = .041) and more likely to have concomitant meniscal tears (<i>P</i> = .011) at the time of their TSF.</p><p><strong>Conclusion: </strong>Stiffness and ACL insufficiency represented the most frequent indications for reoperation after TSF fixation. Screw fixation, meniscal entrapment, and prolonged operative time were significant predictors of reoperation. Older age and concomitant meniscal injuries increased the risk of delayed ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261419525"},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434668","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":"Circumferential Labral Tears: Instability History and Outcomes of Arthroscopic Repair.","authors":"Ibrahim Kaya, Ethem Burak Oklaz, Semih Yas, Furkan Aral, Tayfun Ozel, Oguzhan Ak, Asim Ahmadov, Ulunay Kanatli","doi":"10.1177/23259671261418674","DOIUrl":"https://doi.org/10.1177/23259671261418674","url":null,"abstract":"<p><strong>Background: </strong>Circumferential labral tears are characterized by complete detachment of the labrum from the glenoid rim, and studies have reported significant improvements in patient-reported outcome measures (PROMs) after arthroscopic repair. However, patients' perspectives on the meaningfulness of these outcomes remain unknown, and debate continues regarding whether circumferential tears can occur after a single instability event.</p><p><strong>Purpose: </strong>To investigate the number of preoperative instability events in patients with circumferential tears and evaluate their clinical outcomes after arthroscopic repair according to the minimal clinically important difference (MCID), Substantial Clinical Benefit (SCB), and Patient Acceptable Symptom State (PASS) parameters.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This study was retrospective review of a consecutive series of patients who underwent shoulder arthroscopy for instability between February 2015 and July 2023. Patients with primary circumferential tears repaired using arthroscopic suture anchors, glenoid bone defects <13.5%, and a minimum 24-month follow-up were included. Analysis was conducted of patient demographics, clinical characteristics, and PROMs, including American Shoulder and Elbow Surgeons (ASES), Western Ontario Shoulder Instability Index (WOSI), and visual analog scale (VAS) scores. Patients who achieved the MCID, SCB, and PASS thresholds for these scores were determined.</p><p><strong>Results: </strong>Circumferential tears were identified in 3.6% (n = 41) of 1147 patients undergoing arthroscopic procedures for shoulder instability. Of these, 31 patients (mean age, 29.5 ± 9.3 years; 90% male; mean instability events, 5.5 ± 6.9; mean follow-up, 60.4 ± 30.1 months) meeting the inclusion criteria were analyzed. Overall, 39% (n = 12) had a single instability event, with 6 participating in contact sports and 4 in overhead or throwing sports, 9 of them at a competitive level. The proportions of patients who achieved MCID, PASS, and SCB thresholds were as follows: ASES (100, 80.6, and 80.6, respectively), WOSI total (100, 90.3, and 80.6, respectively), and VAS (90.3, 87.1, and 80.6, respectively).</p><p><strong>Conclusion: </strong>Circumferential labral tears are rare. One-third of them may occur even after a single instability event and, therefore, should be considered during clinical evaluation, regardless of the number of prior instability events. Reassuringly, most patients who underwent arthroscopic repair of circumferential tears using suture anchors achieved successful clinically meaningful outcomes at a mean follow-up of approximately 5 years.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261418674"},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434558","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":"An Epidemiological Analysis of Wrestling-Related Injuries: A 10-Year Analysis of National Injury Data.","authors":"Andrew K Chow, Zachary W Sigman, Frederick J Pimental, Marco T Di Stefano, Augustus D Mazzocca","doi":"10.1177/23259671261419521","DOIUrl":"10.1177/23259671261419521","url":null,"abstract":"<p><strong>Background: </strong>Wrestling is a high-impact sport characterized by rapid, forceful movements, posing a considerable injury risk to athletes who are often evaluated in emergency departments (EDs) across the United States. This study examines the principal mechanics, distributions, and epidemiological trends of wrestling-related injuries.</p><p><strong>Hypothesis: </strong>(1) Upper extremity injuries would be the most common, (2) young men would be the most affected group, and (3) sprains/strains would be the most frequent diagnosis.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Patients evaluated at US EDs for wrestling-related injuries between January 1, 2015, and December 31, 2024, were identified using the National Electronic Injury Surveillance System database. Patient characteristics, injury location, diagnosis, disposition, and mechanisms of injury were recorded. Data analysis was calculated using national estimates (NEs) and linear regression to assess trends and associations.</p><p><strong>Results: </strong>From 2015 to 2024, US EDs reported approximately 10,508 cases (NE, 370,089) of wrestling-related visits. Of these, 88.4% involved males (NE, 326,985). Pediatric patients (≤18 years of age) accounted for the majority of injuries, accounting for 84.9% of all cases (NE, 314,166), with a mean age of 15.9 ± 6.2 years for the entire cohort. The lowest number of wrestling-related injuries occurred in 2020 (NE, 20,270), while the highest number was reported in 2024 (NE, 57,026). The most commonly injured body regions were the shoulder (15.2%; NE, 56,150) and head (13.1%; NE, 48,619). Sprains and strains represented the most frequent injury type at 27.6% (NE, 102,253).</p><p><strong>Conclusion: </strong>This study showed that males constituted the predominant majority of ED visits from wrestling injuries, with shoulder and neck strains being the most prevalent. The significant rise in injuries from 2020 to 2024 highlights the necessity for preventative measures and heightened awareness of wrestling safety, especially in recreational environments, where occurrences are notably elevated.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 3","pages":"23259671261419521"},"PeriodicalIF":2.5,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378240","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}