Orthopaedic Journal of Sports Medicine最新文献

{"title":"Intraoperative Failure of Meniscus Fixation Devices After Range of Motion Cycling: A Survey of the Pediatric Research in Sports Medicine Society Membership.","authors":"Nicholas Bast, Hayley Ditmars, Christopher Baker, Benton E Heyworth, Aristides Cruz, Sasha Carsen, Dean Wang, John Schlechter","doi":"10.1177/23259671261449156","DOIUrl":"10.1177/23259671261449156","url":null,"abstract":"<p><strong>Background: </strong>Meniscal pathology often presents with concomitant anterior cruciate ligament (ACL) injury. During ACL reconstruction (ACLR), \"cycling the knee\" has been shown to help reduce graft creep after femoral fixation. Pullout of successfully deployed all-inside meniscal repair implants after knee \"cycling\" has been observed, but is sparsely documented in the setting of ACLR with concomitant meniscal pathology.</p><p><strong>Purpose: </strong>To investigate the frequency of and contributions to intraoperative meniscal repair failure during concurrent ACLR.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A brief survey was distributed to members of the Pediatric Research in Sports Medicine Society. Participants met the inclusion criteria if they self-identified as orthopaedic surgeons who perform ACLR. The primary objective of the survey was to assess surgeons' experience with meniscal implant failure and its relationship to practice patterns (ie, cycling the knee).</p><p><strong>Results: </strong>Of the 52 surveys distributed, 44 orthopaedic surgeons completed the survey after 3 months of data collection, representing a 84.6% response rate. The majority of participants reported treating patients primarily in the second or third decade of life. Participants unanimously reported they would address the meniscal pathology before performing the ACLR. Thirty-three (75%) participants reported cycling the knee before graft fixation. Nineteen (43.2%) respondents endorsed reinspection of the meniscus after ACL graft fixation, and among them, 7 (36.8%) reported at least 1 instance of meniscal implant failure. Meniscal implant failure was associated with fewer years in practice: surgeons who reported implant pullout had a median of 2 to 5 years in practice, while those who did not report implant pullout had a median of 5 to 10 years in practice (<i>P</i> = .027). No other factors were associated with meniscal implant failure. The sample size was insufficient to analyze the possible association of implant failure with cycling alone or hyperflexion alone.</p><p><strong>Conclusion: </strong>Meniscal repair with concomitant ACLR is a common surgery for orthopaedic sports medicine specialists. Although these procedures often result in favorable outcomes, this study concludes that failure of meniscal implants does occur and may be more common early in practice. Therefore, further investigation into optimal procedural strategies to address meniscal tears in the setting of ACLR is necessary.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261449156"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412568","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":"Knee Osteoarthritis on MRI in Symptomatic Young Adults After ACL Reconstruction From the SUPER-Knee Trial: Feature Prevalence and Association With Early-Stage Clinical Osteoarthritis Criteria.","authors":"Jamon L Couch, Thomas J West, Edwin Oei, Kay M Crossley, Matthew G King, Danilo De Oliveira Silva, Jackie L Whittaker, Andrea M Bruder, Michael A Girdwood, Mark Scholes, Brooke Patterson, Ewa M Roos, Adam G Culvenor","doi":"10.1177/23259671261455852","DOIUrl":"10.1177/23259671261455852","url":null,"abstract":"<p><strong>Background: </strong>One of the most common long-term consequences of a traumatic knee injury is the development of knee osteoarthritis (OA), yet the characteristics of OA structural change and their relationship to early-stage OA clinical criteria in those with persistent knee symptoms following traumatic knee injury has not been described.</p><p><strong>Purpose: </strong>To describe the prevalence of OA features on magnetic resonance imaging (MRI) and explore the association between MRI-defined OA and early-stage knee OA clinical criteria in young adults with a symptomatic knee at short- to medium-term follow-up after anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Knee MRIs from 184 SUPER-Knee trial participants with a symptomatic knee at 9 to 36 months post-ACLR (68 female; mean ± SD age, 30 ± 6 years; months post-ACLR, 27.6 ± 8.4) were assessed for tibiofemoral and patellofemoral OA features using the MRI Osteoarthritis Knee Score. The prevalence of MRI-defined OA was described based on published criteria by Hunter and colleagues. Logistic regression was used to explore the association between MRI-defined OA and the Luyten classification criteria for early-stage clinical knee OA.</p><p><strong>Results: </strong>Across participants, cartilage loss was the most prevalent MRI-defined OA feature in both the tibiofemoral (61%) and the patellofemoral (51%) joint. Osteophytes were more common in the tibiofemoral (52%) than patellofemoral (28%) joint of participants. Bone marrow lesions (tibiofemoral, 26%; patellofemoral, 13%), meniscal tears (42%), and meniscal extrusion (18%) were also observed. Based on MRI-defined criteria, 71 (39%) participants were characterized with OA (tibiofemoral, n = 58 [32%]; patellofemoral, n = 34 [18%]). No association was observed between MRI-defined OA and the Luyten classification criteria for early-stage clinical knee OA.</p><p><strong>Conclusion: </strong>Over half of symptomatic young adults 9 to 36 months post-ACLR demonstrated OA features on MRI, with the tibiofemoral joint more commonly affected than the patellofemoral joint. More than one-third of participants met the criteria for MRI-defined OA. A lack of association between MRI and clinical definitions of early-stage knee OA suggests a possible symptom-structure discordance in the early stages of post-traumatic OA disease.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261455852"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412543","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":"Are Suture Spanning Repair Techniques Replacing Traditional Tommy John Surgery? Prevalence and Complication Rates Following Ulnar Collateral Ligament Repair or Reconstruction.","authors":"Mitchell H Negus, Matthew E Guareschi, Lauren Wohlrab, Trevor Wolterink, Robert J Reis, Brandon L Rogalski, Richard J Friedman, Kit N Simpson, Josef K Eichinger","doi":"10.1177/23259671261454330","DOIUrl":"10.1177/23259671261454330","url":null,"abstract":"<p><strong>Background: </strong>Ulnar collateral ligament (UCL) reconstruction has historically been considered the gold standard treatment for severe UCL tears. With the advent of suture-spanning repair techniques, some studies suggest that UCL repair is being performed with increasing frequency. This study provides a large analysis of UCL reconstruction versus repair trends in the United States following the introduction of suture-spanning repair techniques.</p><p><strong>Purpose: </strong>To compare the prevalence and complication rates of UCL reconstruction versus repair over a 5-year span following the introduction of suture spanning repair techniques. We also sought to determine if there was an age-related preference for reconstruction versus repair and whether the addition of an ulnar nerve transposition (UNT) affected short-term complication rates.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Using the Merative MarketScan research databases, which contain deidentified patient national claims information, we retrospectively identified patients aged 14 to 30 years who underwent UCL reconstruction or repair between 2016 and 2021, with or without UNT. Patients with a fracture diagnosis at the time of surgery were excluded. Demographic information including age, sex, and geographic region was collected. The number of patients who experienced infection, ulnar neuropathy, device-related complications, and unspecified complications were obtained for each procedure.</p><p><strong>Results: </strong>A total of 1191 reconstruction patients and 696 repair patients were identified. 36.8% of patients who underwent either reconstruction or repair had a concomitant UNT. UCL reconstruction patients were approximately 3 years older than repair patients on average (<i>P</i> < .001). Male patients accounted for 89.5% of reconstruction patients and 77.7% of repair patients. From 2016 to 2021, the number of reconstructions declined 32.0% and the number of repairs increased 81.6%. There were no differences in the rate of infection (<i>P</i> = .36) and ulnar neuropathy (<i>P</i> = .73) between reconstruction and repair. The overall risk of developing any complication was higher for repair patients (1.58%) than reconstruction patients (0.67%); however, this difference was not significant (<i>P</i> = .09).</p><p><strong>Conclusion: </strong>Between 2016 and 2021, following the introduction of suture spanning UCL repair techniques, the number of UCL repairs increased and the number of reconstructions decreased. There was no difference in complication rates between UCL repair and UCL reconstruction and the rate of complication for either surgery remains low.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261454330"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412547","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":"Rate of Shoulder Arthroplasty After Anterior Shoulder Instability Surgery: A Systematic Review.","authors":"John Ruyle, Nicholas Dombrowski, Ian Harmon, Isaiah Roepe, Rachel Long, Sterre Van Den Anker, Matthew Vopat","doi":"10.1177/23259671261451245","DOIUrl":"10.1177/23259671261451245","url":null,"abstract":"<p><strong>Background: </strong>Recurrent or persistent anterior shoulder instability (ASI), the most common form of shoulder instability, may progress over time to osteoarthritis (OA) necessitating shoulder arthroplasty. Anterior shoulder instability surgery (ASIS) techniques, including soft-tissue and bony augmentation procedures, have been shown to reduce the risk of recurrent dislocation.</p><p><strong>Purpose: </strong>The purpose of this review is to evaluate the rates of progression to shoulder arthroplasty, time to conversion to shoulder arthroplasty, OA grades at time of conversion, and clinical outcomes of shoulder arthroplasty in patients with a history of ASI initially managed with ASIS, including glenoid labrum repair, Bankart repair, or coracoid transfer procedures.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>This systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using combinations of keywords related to shoulder arthroplasty and ASIS. The search was performed on February 26, 2026, across the PubMed, Ovid, MEDLINE, CINAHL, Embase, and Cochrane CENTRAL databases. Outcomes analyzed included the rate of shoulder arthroplasty after ASIS, time to conversion to shoulder arthroplasty, age at each procedure, OA grade at the time of conversion, range of motion, infection rate, revision rate, failure rate, and clinical outcome scores.</p><p><strong>Results: </strong>A total of 52 studies met preliminary inclusion criteria, and 19 studies met full inclusion criteria. Current studies suggest that the conversion rate from ASIS to shoulder arthroplasty is 1.25% and that shoulder arthroplasty was performed, on average, 25.3 years after initial ASIS. ASIS was performed at a mean age of 29 years, while shoulder arthroplasty was performed at a mean age of 61 years. Also, 55% of patients undergoing shoulder arthroplasty after ASIS had Walch grade A1 lesions.</p><p><strong>Conclusion: </strong>ASIS was associated with a low long-term conversion rate to shoulder arthroplasty, occurring at a mean of 2.5 decades postoperatively. These findings suggest that ASIS provides durable joint preservation with conversion to shoulder arthroplasty remaining rare over long-term follow-up.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261451245"},"PeriodicalIF":2.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405452","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, Performance, and Career Longevity After Shoulder Labral Repair in the National Football League: A Matched Cohort Analysis.","authors":"Morgan R Dillon, Michael A Mastroianni, Nicholas Frappa, Colton Evoniuk, William Curtis, David P Trofa, Charles M Jobin, Robert Ablove, William N Levine, Christopher S Ahmad","doi":"10.1177/23259671261454331","DOIUrl":"10.1177/23259671261454331","url":null,"abstract":"<p><strong>Background: </strong>Shoulder instability and labral pathology are common in National Football League (NFL) players, yet contemporary return-to-play (RTP), return-to-performance (RTPf), and postreturn career longevity outcomes after surgical labral repair are incompletely characterized.</p><p><strong>Purpose: </strong>To (1) describe RTP timing and rates after surgical labral repair, (2) quantify season-to-season changes in usage and performance versus matched controls, and (3) evaluate post-RTP career longevity.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Using publicly available NFL data (2015-2024), 111 labral repair episodes were identified and indexed to surgery date. RTP was defined as the first in-game snap after surgery, with rates summarized at 2, 6, 12 and 24 months and overall (ever RTP). For RTPf, episodes required ≥100 snaps in both a preindex season (T1) and a first post-RTP season (M1); 60 cases met criteria and were matched 1:2 to 120 controls by season and position group, with additional matching on age and T1 snap rate. Changes from T1→M1 (and T1→M2 when available) were compared between groups. Outcomes included usage (games, total snaps, snaps/game) and Pro Football Focus (PFF) season grades. Career longevity post-RTP was assessed using Kaplan-Meier and stratified Cox models.</p><p><strong>Results: </strong>Among 111 episodes, defensive backs (25.2%) and offensive linemen (21.6%) were the most common position groups. Overall, 86.5% returned at a median 265 days (IQR, 234-316); 3.6% returned within 6 months, 73.9% within 1 year, and 84.7% within 2 years. In the matched RTPf cohort (60 cases; 120 controls), usage changes from T1→M1 did not differ (all <i>P</i> > .05). Offensive PFF grade trended lower versus controls (Δdiff -3.78; <i>P</i> = .09), while defensive PFF grade declined significantly more (Δdiff -7.13; <i>P</i> = .01). In the M2 subset (34 cases; 68 controls), usage and offensive PFF remained nonsignificant, whereas defensive PFF remained significantly lower (Δdiff -10.12; <i>P</i> = .02). Career longevity did not differ between cases and controls by log-rank or stratified Cox analyses (all <i>P</i> > .05).</p><p><strong>Conclusion: </strong>NFL players undergoing isolated labral repair demonstrated high RTP rates with preserved postreturn workload and career longevity versus matched controls. However, defensive players showed a sustained reduction in performance grades through 2 postreturn seasons, suggesting that RTP may not uniformly translate to RTPf and may vary by position.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261454331"},"PeriodicalIF":2.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405405","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":"How Are We Matching in ACL Reconstruction Research? A Systematic Review of Methods, Reporting, and Covariate Selection.","authors":"Jay R Patel, Alejandro M Holle, Brooke S Halpin, Sailesh V Tummala, Karan A Patel, Anikar Chhabra","doi":"10.1177/23259671261444318","DOIUrl":"10.1177/23259671261444318","url":null,"abstract":"<p><strong>Background: </strong>Matching techniques such as direct covariate matching and propensity score matching (PSM) are increasingly used in anterior cruciate ligament reconstruction (ACLR) research to reduce bias in observational study designs. However, the rationale for covariate selection, consistency in methodological reporting, and patterns of matching practices remain unclear.</p><p><strong>Purpose: </strong>To systematically evaluate covariate matching practices in ACLR literature, including the types and number of covariates used, methodological transparency, and trends in matching strategies.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Methods: </strong>A systematic literature search of the PubMed, EMBASE, and Cochrane databases was conducted to evaluate covariate matching practices in the ACLR literature. A comprehensive search identified 798 unique studies, of which 97 met eligibility criteria. Data were extracted on study design, matching technique, covariate inclusion, reporting practices, and matching ratios. Descriptive and comparative statistics were used to summarize trends.</p><p><strong>Results: </strong>The 97 included studies encompassed 91,165 ACLRs. Most studies were retrospective (90.7%) and cohort in design (92.8%). PSM was used in 41 studies (42.3%), while 56 (57.7%) used direct matching. A total of 60 unique covariates were used across 76 different combinations. PSM studies used significantly more covariates than direct matching studies (6.17 ± 2.79 vs 3.75 ± 1.63; <i>P</i> < .0001), and database studies used more covariates than single-center studies (6.33 ± 2.89 vs 4.08 ± 1.96; <i>P</i> < .0001). The most commonly used covariates were age (96.9%), sex (84.5%), and body mass index (41.2%). Only 6 studies (6.2%) provided justification for covariate selection. The most frequent matching ratio was 1:1 (73.2%). While most studies reported descriptive statistics after matching (95.9%), only 10.3% did so before matching, and 13.4% failed to report prematching sample size.</p><p><strong>Conclusion: </strong>Matching practices in ACLR studies remain highly variable, with limited justification provided for covariate selection. PSM and database-based studies tend to incorporate a greater number of covariates, yet reporting of matching methodology is often inconsistent. To enhance the quality, reproducibility, and comparability of ACLR research, future studies should adopt standardized reporting practices for matching, including explicit descriptions of covariate selection, matching algorithms, balance diagnostics, and match ratios. These steps can serve as a foundation for a more unified research framework, enabling future studies to collectively generate higher quality, generalizable evidence for ACLR outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261444318"},"PeriodicalIF":2.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405467","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":"Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft in Baseball Players: A Cohort Analysis.","authors":"Michael C Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric DiDomenico, Harrison Fellheimer, Christopher C Dodson, Steven B Cohen, Michael G Ciccotti","doi":"10.1177/23259671261451763","DOIUrl":"10.1177/23259671261451763","url":null,"abstract":"<p><strong>Background: </strong>Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.</p><p><strong>Purpose: </strong>To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or Docking techniques, followed by a standardized rehabilitation protocol. Demographic characteristics, playing level, preoperative elbow function, and operative details were obtained. Included patients completed patient-reported outcomes (PROs), including the Kerlan-Jobe Orthopedic Clinic Shoulder & Elbow score (KJOC), the Timmerman and Andrews elbow score, the Conway-Jobe scale, and custom patient satisfaction and return-to-play (RTP) questionnaires.</p><p><strong>Results: </strong>A total of 71 athletes (50 GR, 21 PL) met the inclusion criteria. Groups did not differ in age, body mass index, level or position of play, preoperative range of motion, valgus/varus stability, magnetic resonance imaging tear thickness, ultrasound gapping, or preoperative KJOC scores. Surgical technique, use of internal brace, nerve management, and intra- or postoperative complications were similar between groups (<i>P</i>≥ .421). At ≥2-year follow-up, PROs were comparable: KJOC (GR: 77.6 ± 22.4 vs PL: 75 ± 22.6; <i>P</i> = .584), Timmerman-Andrews (GR: 89.9 ± 13.2 vs PL: 87.2 ± 8.16; <i>P</i> = .093). RTP outcomes by Conway-Jobe scale were similar (<i>P</i> = .867). Time to RTP did not differ between groups (GR: 12.5 ± 2.7 months vs PL: 10.8 ± 3.8 months; <i>P</i> = .170). The only postoperative difference was greater elbow flexion in the PL group (148° vs 144°; <i>P</i> < .001). Extension, supination, and pronation did not differ (<i>P</i>≥ .133).</p><p><strong>Conclusion: </strong>PL and GR autografts demonstrate equivalent clinical and RTP outcomes after UCLR in baseball players.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261451763"},"PeriodicalIF":2.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391500","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":"Effects of Medial Opening-Wedge High Tibial Osteotomy on 3-Dimensional Knee Joint Biomechanics and Trunk Posture.","authors":"Yuki Suzuki, Shigeyuki Sakurai, Kensaku Kawakami, Kengo Ukishiro, Tomohiro Onodera, Koji Iwasaki, Ko Suzuki, Tatsunori Maeda, Sho'ji Suzuki, Eiji Kondo, Norimasa Iwasaki, Yasumitsu Ohkoshi","doi":"10.1177/23259671261450211","DOIUrl":"10.1177/23259671261450211","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a common degenerative condition that leads to pain, disability, and reduced quality of life. Medial opening-wedge high tibial osteotomy (MOWHTO) is a surgical procedure designed to correct alignment and alleviate symptoms by redistributing load. While previous studies have focused on the coronal plane, the impact of MOWHTO on sagittal plane biomechanics and trunk posture remains unclear.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to evaluate 3-dimensional biomechanical changes in the knee joint and trunk posture after MOWHTO. It was hypothesized that MOWHTO would result in significant biomechanical changes not only in the coronal plane but also in the sagittal plane, along with changes in trunk posture.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This retrospective study included 55 patients (55 knees) with medial compartment KOA (Kellgren-Lawrence grade ≥2) who underwent MOWHTO. Preoperative and postoperative gait analyses were conducted using a 3-dimensional motion capture system and force plates to assess knee joint kinetics and kinematics including trunk posture. Knee joint moments (knee adduction moment [KAM], knee flexion moment [KFM], and knee rotation moment [KRM]) and total joint moment (TJM), along with relative contributions of each moment, were assessed. Radiographic parameters such as hip-knee-ankle (HKA) angle, percentage of mechanical axis (%MA), and femorotibial angle (FTA) were evaluated. Clinical outcomes were assessed using the Japanese Knee Osteoarthritis Measure and Knee Society Score. Paired <i>t</i> tests were performed for statistical analysis between pre- and postoperative results. A <i>P</i> value <.05 was considered statistically significant.</p><p><strong>Results: </strong>Postoperatively, significant reductions in KAM (<i>P</i> < .01) and TJM (<i>P</i> < .001) were observed, with a shift in the proportional contribution from KAM to KFM. KFM remained unchanged pre- and postoperatively. Knee varus angles decreased (<i>P</i> < .01), and trunk flexion angles significantly decreased, indicating better postural alignment (<i>P</i> < .01). Radiographic analysis demonstrated increased HKA angles and %MA, along with reduced FTA (<i>P</i> < .01). Clinical outcomes showed significant pain relief and functional improvement (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>MOWHTO was associated with significant changes in 3-dimensional gait biomechanics, including knee joint moments and trunk posture, highlighting its comprehensive role in restoring functional alignment in patients with medial compartment KOA, although the case series design may limit generalizability.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261450211"},"PeriodicalIF":2.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391528","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":"Injury and Economic Burden of Shoulder and Elbow Injuries in Major League Baseball Pitchers: A Retrospective 11-Year Analysis (2015-2025).","authors":"Morgan R Dillon, Michael A Mastroianni, Nicholas Frappa, Joseph Manzi, Danil V Chernov, Andrew J Luzzi, Frank J Alexander, Robert Ablove, Michael L Knudsen, William N Levine, Christopher S Ahmad","doi":"10.1177/23259671261450978","DOIUrl":"10.1177/23259671261450978","url":null,"abstract":"<p><strong>Background: </strong>Shoulder and elbow injuries are a significant source of morbidity among Major League Baseball (MLB) pitchers, yet comprehensive injury and economic burden analyses remain limited.</p><p><strong>Purpose: </strong>To quantify the epidemiological and economic burden of shoulder and elbow injuries among MLB pitchers from 2015 to 2025, including trends in injury incidence and salary lost over time.</p><p><strong>Study design: </strong>Descriptive epidemiological study.</p><p><strong>Methods: </strong>All MLB pitcher injured list (IL) placements for shoulder and elbow injuries from 2015 to 2025 were identified using publicly available databases (ie, Fangraphs, Spotrac). Salary lost was calculated using the daily rate methodology and adjusted for inflation in US dollars, based on the 2025 inflation rate. Injury incidence rates were calculated per 1000 athlete-exposures. Linear regression assessed temporal trends in injury costs and incidence.</p><p><strong>Results: </strong>A total of 1122 MLB pitchers sustained shoulder or elbow IL placements during the study period, comprising 2365 total IL stints and $3.33 billion in cumulative salary lost. Elbow injuries accounted for 68.3% ($2.28 billion) and shoulder injuries 31.7% ($1.06 billion). Ulnar collateral ligament (UCL) injuries were the costliest diagnosis ($1.29 billion, 539 events). Significant increasing trends were observed for overall injury incidence (slope = 0.187 per 1000 athlete-exposures per year, <i>P</i> < .001), with elbow incidence rising 2.9 times faster than shoulder incidence (elbow slope = 0.140 per 1000 athlete-exposures per year, <i>P</i> < .001; shoulder slope = 0.047 per 1000 athlete-exposures per year, <i>P</i> = .022). Relief pitchers demonstrated 27.4 IL days per 1000 pitches compared to 15.3 for starters, representing approximately 80% higher injury burden per pitch.</p><p><strong>Conclusion: </strong>Shoulder and elbow injuries among MLB pitchers represent a substantial and growing time-loss and economic burden, with cumulative salary lost exceeding $3.3 billion over the study period. Elbow injuries accounted for most of this burden, and UCL injuries represented the single costliest injury category. These findings quantify the considerable financial and roster burden associated with shoulder and elbow IL placements among MLB pitchers.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261450978"},"PeriodicalIF":2.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391531","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":"Varying Distance Between Suture Buttons Does Not Improve Stability of the Transected Syndesmosis and Deltoid Ligament in a Motion-Tracking Cadaveric Model.","authors":"Taylor Stauffer, Albert Anastasio, Billy I Kim, Gabriel Joseph, Kenneth Brinson, Calvin Chan, Hunter Storaci, David Oji, Loretta Chou, Brian C Lau","doi":"10.1177/23259671261449125","DOIUrl":"10.1177/23259671261449125","url":null,"abstract":"<p><strong>Background: </strong>A growing body of evidence favors the use of dynamic fixation techniques such as suture button fixation over rigid screw fixation for syndesmotic injuries. However, specific dynamic fixation techniques have been poorly evaluated.</p><p><strong>Purpose: </strong>To compare single suture button (SEB) fixation to double fixation with suture buttons placed 1 cm apart (DSEB 1) and double fixation with suture buttons placed 3 cm apart (DSEB 3).</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 24 lower leg specimens from 12 cadavers were tested using a custom biaxial apparatus. Internal rotation, external rotation, and anterior and posterior translation of the tibia and fibula were examined using motion-tracking systems after transection of deltoid and syndesmotic ligaments to compare 3 syndesmotic repair techniques: (1) an SEB placed 1 cm above the joint line, (2) 2 suture buttons placed 2 and 3 cm above the joint line, and (3) 2 suture buttons placed 1 and 4 cm above the joint line.</p><p><strong>Results: </strong>All 3 button constructs improved the stability of the syndesmosis by reducing aberrant motion after transection. There was no clear superiority of SEB, DSEB 1, or DSEB 3. DSEB 3 and DSEB 1 showed equal median laxity for tibial internal rotation (2.7°; DSEB 1, 2.0° to 3.2°; DSEB 3, 2.3° to 2.8°), tibial external rotation (-0.2°; DSEB 1, -0.4° to 0.4°; DSEB 3, -0.4° to 0.3°), and fibular external rotation (-0.3°; DSEB 1, -0.7° to 0.3°; DSEB 3, -0.7° to 0.7°).</p><p><strong>Conclusion: </strong>We found that utilization of a second suture button does not contribute additional stability to the syndesmosis after transection of the major syndesmotic ligaments. Moreover, we found that wider spread of 2 buttons (1 cm vs 3 cm apart) also did not confer additional stability. Future research should build upon these findings to further investigate the optimal configuration of suture button constructs.</p><p><strong>Clinical relevance: </strong>Our study provides a framework for clinicians to reconsider syndesmotic suture button repair techniques based on our finding that there appears to be no enhanced syndesmotic stability with additional buttons.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261449125"},"PeriodicalIF":2.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391542","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}