Orthopaedic Journal of Sports Medicine最新文献

{"title":"Comparison of Elbow Flexion in Youth Baseball Pitchers With and Without Throwing-Arm Pain.","authors":"Adam R Nebel, Anthony W Fava, Nicole M Bordelon, Gretchen D Oliver","doi":"10.1177/23259671241290841","DOIUrl":"10.1177/23259671241290841","url":null,"abstract":"<p><strong>Background: </strong>More than half of all youth baseball pitchers report throwing-related pain in their throwing arm throughout a season.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to investigate differences in elbow flexion throughout the pitching cycle between youth baseball pitchers with and without throwing-arm pain. It was hypothesized that pitchers with throwing-arm pain would have decreased elbow flexion throughout the pitching cycle compared with those who were pain-free.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 38 youth baseball pitchers (mean age, 13.3 ± 1.7 years; height, 164.4 ± 12.9 cm; weight, 57.1 ± 14 kg) were retrospectively selected from a database. Based on responses to a health history questionnaire, the pitchers were placed into a pain group if they indicated they were experiencing throwing-arm pain. Pitchers who indicated they were not experiencing throwing-arm pain were matched according to age, height, and weight to the pain group. All pitchers threw 3 fastballs to a catcher at the regulation distance. The mean elbow flexion of the 3 trials was used during analysis to investigate peak elbow flexion and time-normalized (0%-100%) elbow flexion across the pitch cycle (stride-foot contact to ball release). Elbow flexion was compared between the pain and pain-free groups using 1-dimensional statistical nonparametric mapping, and the mean peak elbow flexion between groups was compared using the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>No significant differences were observed between the groups in elbow flexion throughout the pitching cycle (<i>P</i> > .05) and no group differences in peak elbow flexion (<i>U</i> = 122; <i>P</i> = .09).</p><p><strong>Conclusion: </strong>Study findings indicated no significant differences in elbow flexion between youth baseball pitchers with versus without throwing-arm pain, unlike previous research reporting that pitchers with a history of medial elbow pain had altered elbow flexion and higher pitch velocities compared with those without a history of pain.</p><p><strong>Clinical relevance: </strong>Clinicians should consider other potential factors related to throwing-arm pain beyond elbow flexion. Moreover, it is advisable to focus on evidence-based modifiable factors shown to increase the risk of pain and injury in youth pitchers, such as exceeding pitch counts, number of innings pitched, increased training time, range-of-motion, and strength deficits.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241290841"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Biological Augmentation on Failure Rates and Complications in Acute Patellar Tendon Rupture Surgery Compared With Isolated Repair.","authors":"Rodrigo Olivieri, José Ignacio Laso, Nicolás Franulic, José T Muñoz, Jaime Ugarte, Piero Innocenti","doi":"10.1177/23259671241288848","DOIUrl":"10.1177/23259671241288848","url":null,"abstract":"<p><strong>Background: </strong>Patellar tendon ruptures are infrequent but disabling injuries. Surgical treatment is the gold standard to obtain good outcomes, and numerous techniques have been described. Biomechanical studies report better results when augmented techniques are used. However, there is a lack of consensus regarding the best standard technique.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to assess a cohort of patients with acute patellar tendon rupture that was surgically treated and to compare the clinical outcomes of 2 groups: isolated repair and biological augmentation techniques with autograft or allograft. It was hypothesized that the biological augmentation group would have better clinical outcomes than the isolated repair group.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>All patients with acute patellar tendon rupture surgically treated in our center between 2016 and 2022 were retrospectively reviewed. Patient and rupture characteristics, surgical technique, clinical outcomes, and complications were recorded. The primary outcome was rerupture rate, and secondary outcomes were infection rate, stiffness >15° of knee flexion deficit, and extensor mechanism lag >5°.</p><p><strong>Results: </strong>The study included 34 patients with 36 operated knees (2 patients with bilateral rupture). The mean age was 44.9 years. Isolated repair was performed in 20 knees (55.6%), and 16 knees underwent repair and biological augmentation with autograft or allograft. Both groups were comparable in terms of their demographic characteristics. A statistically significant association was found between the type of surgery and tendon rerupture. Of the patients in the isolated repair group, 5 of 20 (25%) experienced a failure, whereas in the biological augmentation group, no reruptures were recorded (<i>P</i> = .031). However, no statistically significant associations were found between the type of surgery and other complications, such as the development of stiffness (<i>P</i> = .54), residual extension lag >5° (<i>P</i> = .87), or the development of infection (<i>P</i> = .25).</p><p><strong>Conclusion: </strong>In this cohort of patients, biological augmentation reduced the rate of surgical failure for acute patellar tendon rupture without being associated with a higher risk of complications such as stiffness, residual extension lag, or the development of infection.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241288848"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676265","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":"Postoperative Pain Control After ACL Reconstruction With Semitendinosus Tendon Graft: A Randomized Controlled Trial Comparing Adductor Canal Block to Local Infiltration Analgesia.","authors":"Sermsak Sumanont, Khananut Jaruwanneechai, Aumjit Wittayapairoj, Punyawat Apiwatanakul, Artit Boonrod","doi":"10.1177/23259671241292604","DOIUrl":"10.1177/23259671241292604","url":null,"abstract":"<p><strong>Background: </strong>Both adductor canal block (ACB) and local infiltration (LI) are effective for postoperative pain management after arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction (ACLR). While LI is a more straightforward procedure, its effectiveness remains debated.</p><p><strong>Purpose: </strong>To evaluate morphine consumption within 48 hours after ACLR with a semitendinosus tendon graft, comparing ACB and LI; secondary objectives: to evaluate pain levels, patient satisfaction, quadriceps strength, range of knee motion, and complications.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 1.</p><p><strong>Methods: </strong>Patients undergoing primary ACLR with a semitendinosus tendon graft were randomized to receive either ACB (0.25% bupivacaine; 20 mL) or LI at the surgical wound, graft harvest area, and intra-articular injection. The LI group received morphine (3 mg), ketorolac (30 mg), and tranexamic acid (1 g). Morphine consumption within 48 hours was monitored using an intravenous patient-controlled analgesia device.</p><p><strong>Results: </strong>A total of 48 patients were analyzed (n = 24 in each group); baseline characteristics were similar between groups. The LI group consumed significantly less morphine than the ACB group at 6 hours (median [interquartile range, IQR], 3 mg [0-4.8 mg] for the LI group vs 5.5 mg [2-9] for the ACB group; <i>P</i> = .003). However, no significant differences were observed in morphine consumption at other time points. Additionally, no significant difference was found in cumulative morphine consumption at 48 hours between the groups (median [IQR], 21.5 mg [11-34.5 mg] for the ACB group vs 16.5 mg [8.5-21.8 mg] for the LI group; <i>P</i> = .137). Postoperative pain scores, quadriceps strength, and patient satisfaction were similar between the 2 groups.</p><p><strong>Conclusion: </strong>Morphine consumption at 48 hours postoperatively was comparable between the LI and ACB groups, and no significant group differences were found in postoperative pain, quadriceps strength, or patient satisfaction.</p><p><strong>Registration: </strong>TCTR20190320003 (Thai Clinical Trial Registry).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241292604"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648063","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 the Universal Designated Hitter Rule With Changes to Injuries in Major League Baseball Pitchers.","authors":"Eric Kholodovsky, Dylan Luxenburg, Blake Hodgens, Kevin Liebmann, Michael Baraga","doi":"10.1177/23259671241292655","DOIUrl":"10.1177/23259671241292655","url":null,"abstract":"<p><strong>Background: </strong>In 2022, Major League Baseball (MLB) implemented the universal designated hitter (DH) rule, thus allowing the pitcher to focus solely on defense while the DH, who bats for the pitcher, focuses solely on offense.</p><p><strong>Purpose/hypothesis: </strong>The purpose of our study was to determine if implementation of the universal DH rule affected the incidence of injuries in MLB pitchers when compared with before implementation. It was hypothesized that the shift to the universal DH rule would be associated with a decrease in the rate of offense-related pitcher injuries.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Using publicly available data, we identified injuries sustained by MLB pitchers during the 2021 (before the DH rule change) and 2022 (after the rule change) regular seasons. Pitchers placed on the injured list for non-gameplay related reasons were excluded. Statistical analysis was performed with the chi-square and independent <i>t</i> tests.</p><p><strong>Results: </strong>The injury incidence rate decreased significantly from before to after the rule change for MLB pitchers overall (from 6.58 to 5.60 injuries/1000 athlete game-exposures [AGE]; <i>P</i> = .02) and for National League pitchers (from 7.62 to 6.26 injuries/1000 AGE; <i>P</i> = .04). No significant changes were seen in American League pitchers (<i>P</i> = .20). Injury locations that decreased from before to after the rule change were the thigh (from 0.52 to 0.21 injuries/1000 AGE; <i>P</i> = .003) and the hand/finger/wrist (from 0.63 to 0.30 injuries/1000 AGE; <i>P</i> = .01). Total time lost decreased from 9471 days before the rule change to 8857 days after the rule change (<i>P</i> = .00001).</p><p><strong>Conclusion: </strong>Implementation of the universal DH rule was associated with a decrease in pitcher injuries overall and within the National League. Injuries to the thigh and hand/finger/wrist also decreased overall and within the National League. Furthermore, total days lost decreased from before to after the rule change. These findings may be due to the elimination of offensive gameplay requirements for pitchers, which highlights a positive consequence of the universal DH rule, but further studies are needed.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241292655"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648153","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":"Abdominal Oblique and Rectus Muscle Injuries in Major and Minor League Baseball Players: An Updated Epidemiological Review.","authors":"Zachary M Tenner, Abhinav Lamba, Christopher L Camp, Timothy B Griffith, Stan Conte","doi":"10.1177/23259671241293454","DOIUrl":"10.1177/23259671241293454","url":null,"abstract":"<p><strong>Background: </strong>Abdominal musculature injuries comprise the third most prevalent time-loss injury across professional baseball. Despite increased awareness and prevention attempts in the recent decade, the trends of these abdominal injury numbers in Major League Baseball (MLB) are not fully understood.</p><p><strong>Purposes: </strong>To update the trends in oblique and intercostal injuries, analyze the impact of these injuries based on time out of play, and identify factors that correlate with increased injury severity to help with recovery time prognostication for the sports medicine community.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Using the MLB Health and Injury Tracking System, the authors identified all abdominal and core musculature injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) between the 2011 and 2021 seasons. These were filtered for injuries that resulted in ≥1 days missed (DM) during spring training, the regular season, and postseason. A Student <i>t</i> test was utilized to assess for significant differences for all normally distributed values. Regression analysis was utilized for determining change over time. For all statistical comparisons, the threshold for alpha was set to <i>P</i> < .05.</p><p><strong>Results: </strong>During the study period between 2011 and 2021, there were 4560 total abdominal injuries among 3401 athletes. When filtered for in-season, time-loss injuries defined as spring training, regular season, and postseason, there were 2890 injuries. Of these, 1928 were oblique injuries, 453 were intercostal injuries, and 115 were rectus injuries. The number of oblique injuries each season increased for all of baseball (<i>P</i> < .001), as well as for MLB (<i>P</i> = .009) and MiLB (<i>P</i> = .012) individually. Of the 1928 oblique injuries, 498 (26%) oblique injuries occurred at the MLB level and 1430 (74%) occurred at the MiLB level. Batting and pitching-related injuries comprised 860 (45%) and 729 (38%) oblique injuries, with a total of 18,455 DM and 20,891 DM, respectively. This corresponded to a mean of 22 DM for batting injuries and 29 DM for pitching injuries (mean difference, 7.2; 95% CI, 5.27-9.13; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>This decade-long study on professional baseball revealed a significant increase in abdominal oblique injuries across MLB and MiLB, with the largest number of injuries observed in the 2021 season. Meanwhile, there was a significant decrease in intercostal injuries across professional baseball during these years. Such injuries continue to pose challenges, leading to substantial DM per injury and affecting players from various positions.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241293454"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648149","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 Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort.","authors":"Kinjal Vasavada, Vrinda Vasavada, Jay Moran, Sai Devana, Changhee Lee, Sharon L Hame, Laith M Jazrawi, Orrin H Sherman, Laura J Huston, Amanda K Haas, Christina R Allen, Daniel E Cooper, Thomas M DeBerardino, Kurt P Spindler, Michael J Stuart, Annunziato Ned Amendola, Christopher C Annunziata, Robert A Arciero, Bernard R Bach, Champ L Baker, Arthur R Bartolozzi, Keith M Baumgarten, Jeffrey H Berg, Geoffrey A Bernas, Stephen F Brockmeier, Robert H Brophy, Charles A Bush-Joseph, J Brad Butler V, James L Carey, James E Carpenter, Brian J Cole, Jonathan M Cooper, Charles L Cox, R Alexander Creighton, Tal S David, Warren R Dunn, David C Flanigan, Robert W Frederick, Theodore J Ganley, Charles J Gatt, Steven R Gecha, James Robert Giffin, Jo A Hannafin, Norman Lindsay Harris, Keith S Hechtman, Elliott B Hershman, Rudolf G Hoellrich, David C Johnson, Timothy S Johnson, Morgan H Jones, Christopher C Kaeding, Ganesh V Kamath, Thomas E Klootwyk, Bruce A Levy, C Benjamin Ma, G Peter Maiers, Robert G Marx, Matthew J Matava, Gregory M Mathien, David R McAllister, Eric C McCarty, Robert G McCormack, Bruce S Miller, Carl W Nissen, Daniel F O'Neill, Brett D Owens, Richard D Parker, Mark L Purnell, Arun J Ramappa, Michael A Rauh, Arthur C Rettig, Jon K Sekiya, Kevin G Shea, James R Slauterbeck, Matthew V Smith, Jeffrey T Spang, Steven J Svoboda, Timothy N Taft, Joachim J Tenuta, Edwin M Tingstad, Armando F Vidal, Darius G Viskontas, Richard A White, James S Williams, Michelle L Wolcott, Brian R Wolf, Rick W Wright, James J York","doi":"10.1177/23259671241291920","DOIUrl":"10.1177/23259671241291920","url":null,"abstract":"<p><strong>Background: </strong>As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights.</p><p><strong>Purpose: </strong>To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors prospectively recruited patients undergoing rACLR from the MARS cohort and obtained preoperative radiographs, surgeon-reported intraoperative findings, and 2- and 6-year follow-up data on patient-reported outcomes, additional surgeries, and graft failure. Machine learning models including logistic regression (LR), XGBoost, gradient boosting (GB), random forest (RF), and a validated ensemble algorithm (AutoPrognosis) were built to predict graft failure by 6 years postoperatively. Validated performance metrics and feature importance measures were used to evaluate model performance.</p><p><strong>Results: </strong>The cohort included 960 patients who completed 6-year follow-up, with 5.7% (n = 55) experiencing graft failure. AutoPrognosis demonstrated the highest discriminative power (model area under the receiver operating characteristic curve: AutoPrognosis, 0.703; RF, 0.618; GB, 0.660; XGBoost, 0.680; LR, 0.592), with well-calibrated scores (model Brier score: AutoPrognosis, 0.053; RF, 0.054; GB, 0.057; XGBoost, 0.058; LR, 0.111). The most important features for AutoPrognosis model performance were prior compromised femoral and tibial tunnels (placement and size) and allograft graft type used in current rACLR.</p><p><strong>Conclusion: </strong>The present study demonstrated the ability of the novel AutoPrognosis machine learning model to best predict the risk of graft failure in patients undergoing rACLR at 6 years postoperatively with moderate predictive ability. Femoral and tibial tunnel size and position in prior ACLR and allograft use in current rACLR were all risk factors for rACLR failure in the context of the AutoPrognosis model. This study describes a unique model that can be externally validated with larger data sets and contribute toward the creation of a robust rACLR bedside risk calculator in future studies.</p><p><strong>Registration: </strong>NCT00625885 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241291920"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648124","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 Outcomes Between Nonoperative Treatment and Arthroscopically Assisted Stabilization in Patients With Acute Rockwood Type 5 Acromioclavicular Dislocation.","authors":"Doruk Akgün, Henry Gebauer, Alp Paksoy, Larissa Eckl, Agahan Hayta, Ata Ücertas, Nicolas Barthod-Tonnot, Rony-Orijit Dey Hazra, Lucca Lacheta, Philipp Moroder, Jonas Pawelke","doi":"10.1177/23259671241289117","DOIUrl":"10.1177/23259671241289117","url":null,"abstract":"<p><strong>Background: </strong>Currently, Rockwood type 3 acromioclavicular (AC) joint dislocations are initially treated nonoperatively, whereas surgery is recommended for Rockwood type 5 dislocations. However, multiple studies have been published favoring nonoperative approaches in patients with high-grade Rockwood injuries.</p><p><strong>Purpose: </strong>To compare the clinical and radiological outcomes of patients with acute Rockwood type 5 AC joint dislocations treated nonoperatively versus with arthroscopically assisted stabilization.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Included were 48 patients with acute Rockwood type 5 dislocation who were initially treated nonoperatively between June 2010 and June 2022 and 48 patients matched according to age, sex, affected side, and follow-up interval who underwent arthroscopically assisted coracoclavicular (CC) stabilization using a suture-button technique, with additional percutaneous AC tape cerclage. Clinical outcomes were assessed based on the Subjective Shoulder Value, Nottingham Clavicle Score, Constant score, and visual analog scale for pain. The radiographic assessment included the CC distance, CC difference ratio, and degree of horizontal instability at final follow-up (62 ± 43 months).</p><p><strong>Results: </strong>At the final follow-up, the Constant score was significantly higher in the nonoperative group (<i>P</i> = .02). The operative group had significantly higher pain levels on palpation of the AC joint (1.2 ± 2.2 vs 0.19 ± 0.5 for the nonoperative group; <i>P</i> = .003). In the operative group, the mean CC difference ratio was significantly higher at the latest follow-up compared with postoperatively (1.3 ± 0.3 vs 0.67 ± 0.3, respectively; <i>P</i> < .001), whereas the CC difference ratio of the nonoperative group was significantly reduced at the latest follow-up compared with postinjury (2.0 ± 0.5 vs 2.6 ± 0.8, respectively; <i>P</i> < .001). The operative group had a significantly lower CC difference ratio compared with the nonoperative group at final follow-up (<i>P</i> < .001). More than half of the patients (56%) who were treated operatively had a loss of reduction resulting in a Rockwood type 3 state at the latest follow-up, whereas 54% of patients treated nonoperatively had spontaneous reduction of injury severity from Rockwood type 5 to Rockwood type 3.</p><p><strong>Conclusion: </strong>Although 15% of the nonoperatively treated patients eventually required surgery, successful nonoperative treatment showed similar outcomes to initial operative treatment in patients with acute Rockwood type 5 dislocation.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241289117"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Exogenous Testosterone Use and Risk for Primary Anterior Cruciate Ligament Rupture.","authors":"Matthew Quinn, Alex Albright, Nicholas J Lemme, Edward J Testa, Patrick Morrissey, Michel Arcand, Alan H Daniels, Paul Fadale","doi":"10.1177/23259671241291063","DOIUrl":"10.1177/23259671241291063","url":null,"abstract":"<p><strong>Background: </strong>In the United States, testosterone therapy has markedly increased in recent years. Currently, there is a paucity of evidence evaluating the risk of ligamentous injuries in patients taking testosterone replacement therapy (TRT).</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to quantify the association between TRT and the incidence of anterior cruciate ligament (ACL) injuries and the subsequent risk of ACL reconstruction (ACLR) failure. It was hypothesized that individuals receiving TRT would demonstrate an increased risk for index ACL injury and ACL rerupture.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This is a retrospective cohort study utilizing the PearlDiver database. Records were queried between 2011 and 2020 for patients aged 18 to 59 years who filled a testosterone prescription. A matched control group based on age, sex, Charlson Comorbidity Index, tobacco use, diabetes, and hypothyroidism consisted of patients aged 18 to 59 years who had never filled a prescription for exogenous testosterone. International Classification of Diseases, 9th and 10th Revisions and Current Procedural Terminology (CPT) codes were utilized to identify patients with ACL injuries and those undergoing reconstruction. Multivariable logistic regression was used to compare rates of ACL injury at 6 months, 1 year, and 2 years after initiating TRT. ACLR failure was also examined at 1-year intervals for 5 years for individuals filling a TRT prescription.</p><p><strong>Results: </strong>A total of 851,816 patients were enrolled, with 425,908 patients in the TRT and control groups, respectively. The TRT cohort was significantly more likely to experience an ACL tear during 6-month (OR, 2.66; 95% CI, 2.17-3.26), 1-year (OR, 2.46; 95% CI, 2.11-2.86), and 2-year (OR, 2.22; 95% CI, 1.98-2.48) periods. The rate of reconstruction failure did not differ between the 2 cohorts at up to 5 years of follow-up (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>Patients receiving TRT were significantly more likely to sustain a primary ACL rupture but were not at a statistically significant increased risk of reconstruction failure.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241291063"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648088","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":"Alterations to the Kinetic Chain Sequence After a Shoulder Injury in Throwing Athletes.","authors":"Liam P Owens, Ginny Coyles, Omid Khaiyat","doi":"10.1177/23259671241288889","DOIUrl":"10.1177/23259671241288889","url":null,"abstract":"<p><strong>Background: </strong>Kinetic chain (KC) sequencing is essential for efficient energy translation through the body in overhead-throwing sports. A sequencing breakdown can result in injuries to the throwing shoulder and thus the management of athlete recovery in an attempt to minimize the impact on both training and performance.</p><p><strong>Purpose: </strong>To determine kinematic differences in KC sequencing, imperative for the prevention and rehabilitation of a shoulder injury, during maximal throwing in overhead athletes with and without a shoulder injury.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Kinematic data were collected and analyzed for 36 male overhead athletes with (symptomatic) and without (asymptomatic) a shoulder injury (18 participants per group) during maximal overhead-throwing trials using 3-dimensional motion analysis (100 Hz). Peak angular velocities and associated timing of the throwing shoulder, throwing elbow, thorax, pelvis, lead hip, and rear hip were calculated to determine the KC sequence in both groups. Kinematic data were compared using independent <i>t</i> tests, and relationships between variables were assessed using the Pearson correlation coefficient (both <i>P</i> < .05).</p><p><strong>Results: </strong>The KC sequence in overhead athletes with or without a shoulder injury was the same, except for peak elbow extension and shoulder flexion angular velocities. These angular velocities occurred simultaneously in asymptomatic throwers (both 0.17 % before ball release [BR]) but sequentially in symptomatic throwers (0.06 % before BR and 0.67 % after BR, respectively). No differences were evident in stride length (m) or resultant ball velocity (m/s) between the groups, despite differences in key joint angular velocities across KC segments (<i>P</i> range, <.001-.035). Relationships between resultant ball velocity and all key joint angular velocities were evident for symptomatic but not asymptomatic throwers (<i>P</i> range, <.001-.026).</p><p><strong>Conclusion: </strong>Our study demonstrated that overhead athletes, regardless of their shoulder injury history, had similar KC sequencing across the lower limb and lumbopelvic-hip complex segments before differences in the timing of peak elbow extension and shoulder flexion angular velocities of the throwing arm approaching BR. Further research investigating muscle activity changes and technique parameters during overhead throwing may present explanations as to how we can ensure that the KC sequence is not altered as a result of an injury.</p><p><strong>Clinical relevance: </strong>This study provides a new perspective on the KC and how an injury may not change the sequence itself in overhead-throwing performance.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241288889"},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648151","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":"Slovenian Translation, Cross-Cultural Adaptation, and Content Validation of the Updated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2).","authors":"Kristina Drole, Kathrin Steffen, Armin Paravlic","doi":"10.1177/23259671241287767","DOIUrl":"10.1177/23259671241287767","url":null,"abstract":"<p><strong>Background: </strong>The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures.</p><p><strong>Purpose: </strong>To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem.</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient (<i>r</i> _S).</p><p><strong>Results: </strong>There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of .93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury (<i>r</i> _S = 0.754), overuse injury (<i>r</i> _S = 0.785), and illness (<i>r</i> _S = 0.894) (<i>P</i> < .001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load (<i>P</i> < .001 for all).</p><p><strong>Conclusion: </strong>The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score.</p><p><strong>Registration: </strong>NCT05471297 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241287767"},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625084","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}