Orthopaedic Journal of Sports Medicine最新文献

{"title":"Return to Sport and Long-term Performance Levels in Weight Lifters Treated for Advanced Glenohumeral Arthritis With Inlay Total Shoulder Arthroplasty.","authors":"Andrew A Barrett, Alexandra D Moutafis, Zachary A Blashinsky, Danielle M Olsen, Christopher D Ciesla, Camila A Torres-Caiaffa, Mymuna Monem, Matthias R Schurhoff, Luis A Vargas, John E Zvijac, John W Uribe","doi":"10.1177/23259671261436433","DOIUrl":"https://doi.org/10.1177/23259671261436433","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA) is challenging in weight lifters due to their relatively young age and desire for sport continuation.</p><p><strong>Purpose/hypothesis: </strong>This study aimed to assess return to weight lifting and long-term outcomes after inlay-TSA (iTSA). It was hypothesized that iTSA would lead to high return to sport and performance.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This study included weight lifters (<65 years of age) with advanced osteoarthritis (OA) treated with iTSA (2011-2023). Radiographic analysis established glenoid morphology (Walch classification), OA grade (Samilson-Prieto classification system), humeral head centralization (Walch index; contact point ratio), and periprosthetic loosening (modified Lazarus grading system; clinically relevant radiolucency: complete line >2 mm). The primary outcome was return to sport. Secondary outcomes included weight lifting frequency, Western Ontario Osteoarthritis of the Shoulder Index (WOOS) percentage, American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) pain score, satisfaction score, and range of motion (ROM). One-repetition maximum (1RM) and cumulative weight total (multiplying sets, repetitions, and weight lifted) were compared preoperatively and at the last follow-up on bench press (BP), overhead strict press (OSP; single arm and barbell), and military press (MP). The Wilcoxon rank-sum and paired <i>t</i> tests were used to compare preoperative and last follow-up functional and radiographic outcomes.</p><p><strong>Results: </strong>Eighteen male weight lifters (3 competitive, 15 recreational; 24 shoulders) with a mean age of 54.6 ± 6.8 years were included. Prearthritic weekly lifting frequency included ≥4 sessions (n = 16) or 2 to 3 sessions (n = 8). The mean follow-up was 83.5 ± 31.6 months. All athletes returned to weight lifting without restrictions at a median of 8.5 months (IQR, 6-24 months). Overall, 78% (n = 14) returned to the same or higher activity. The Cumulative lifetime maximum BP weight (preoperative: 6822.0 ± 2951.3 lb; postoperative: 5498.0 ± 2534.2 lb) was not significantly different (<i>P</i> = .177). Athletes returned to 73.4% ± 20.5% of their 1RM single-arm OSP (BP: 57.3% ± 21.8%; MP: 55.8% ± 23.3%). The final mean patient-reported outcomes were 81.7% ± 21.0% for WOOS percentage, 86.7 ± 16.9 for ASES score, 1.0 ± 2 for VAS pain score, and 8.8 ± 1.5 for satisfaction score. Preoperative ROM significantly improved in forward elevation (from 117.6°± 34.8° to 142.4°± 31.8°; <i>P</i> = .008) and external rotation (29.9°± 18.9° to 46.5°± 26.9°; <i>P</i> = .008). Centralization improved in the Walch index (from 0.58 ± 0.09 to 0.54 ± 0.05; <i>P</i> = .025) and contact point ratio (0.58 ± 0.08 to 0.51 ± 0.05; <i>P</i> < .001). Two glenoid components were removed due to posttraumatic injuries.</p><p><strong>Conclusion: </strong>All athl","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261436433"},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777940","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":"Epidemiology of Softball Injuries Comparison of Softball-Related Injuries at US Emergency Departments Between High School and Collegiate Athletes: A 10-Year NEISS Analysis, 2015-2024.","authors":"John R Tyler, Bodrie Jensen, Ian Rice, Ryan Card, Alex Paulini, John P Scanaliato, Nata Parnes","doi":"10.1177/23259671261434248","DOIUrl":"https://doi.org/10.1177/23259671261434248","url":null,"abstract":"<p><strong>Background: </strong>Softball is among the most widely played sports for women in the United States (US). However, contemporary comparisons of injury epidemiology between high school- and college-aged athletes are limited.</p><p><strong>Purpose: </strong>To provide an updated, comparative assessment of the epidemiology of softball-related injuries among female high school- and college-aged athletes and to characterize the burden of these injuries on emergency departments (EDs) across the United States.</p><p><strong>Study design: </strong>Descriptive epidemiological study.</p><p><strong>Methods: </strong>The National Electronic Injury Surveillance System (NEISS) was queried for softball-related injuries in female athletes aged 14 to 23 years from 2015 to 2024. Patients aged 14 to 18 years were categorized as high school-aged, and those aged 19 to 23 years as college-aged. Weighted national estimates were calculated using NEISS sampling weights. Participation data from the National Federation of State High School Associations and the National Collegiate Athletic Association were used to derive population-based incidence per 100 at-risk participants. Incidence rate ratios (IRRs) with 95% CIs compared high school- and college-aged athletes for incidence, injury patterns, and disposition.</p><p><strong>Results: </strong>A total of 3385 NEISS cases corresponded to a weighted national estimate of 376,295 softball-related injuries in female athletes aged 14 to 23 years treated in US EDs between 2015 and 2024. College-aged athletes had a higher overall injury incidence than high school-aged athletes (22.44 vs 9.35 per 100 at-risk persons; IRR, 2.40 [95% CI, 2.38-2.42]). Both groups exhibited a sharp decline in injury incidence in 2020, corresponding with the onset of the coronavirus disease 2019 pandemic. The head, ankle, knee, and face were the most frequently injured body regions. When expressed per 100 at-risk persons, college-aged athletes had significantly higher injury rates to the upper leg, ear, eye, foot, and mouth, as well as higher rates of nearly all diagnosis categories, including avulsions, dental injuries, and lacerations. Most injuries were treated and discharged, but college-aged athletes had higher rates of admission/transfer, observation, and leaving against medical advice.</p><p><strong>Conclusion: </strong>Our study showed that from 2015 to 2024, college-aged female softball athletes were more than twice as likely as high school-aged athletes to present to the ED with a softball-related injury, with higher incidence across most body regions, diagnoses, and ED dispositions. These findings highlight a substantial, level-specific injury burden and support targeted preventive strategies.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261434248"},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777770","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":"Mapping the Femoral Trochlea: Development of the Multi-level Axial Patellofemoral Score for Trochlear Dysplasia (MAPS-TD) to Classify Trochlear Dysplasia Severity.","authors":"Jason D Brenner, Steven M Henick, Leila Mehraban Alvandi, Edina Gjonbalaj, Jacob Schulz, Eric D Fornari, Yungtai Lo, Benjamin J Levy, Mauricio Drummond","doi":"10.1177/23259671261419430","DOIUrl":"https://doi.org/10.1177/23259671261419430","url":null,"abstract":"<p><strong>Background: </strong>There is currently no established standard classification system for stratifying trochlear dysplasia (TD) severity. Many magnetic resonance imaging (MRI)-based classification systems focus on only a single axial level, even though the trochlear groove (TG) spans several axial levels. Evaluating multiple axial levels of the TG may allow a complete assessment.</p><p><strong>Hypothesis: </strong>A novel MRI-based TD severity classification system based on 4 axial levels will yield a more comprehensive assessment of the TG.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Pediatric patients were retrospectively categorized into 2 groups: those with recurrent patellar dislocations (RPDs; n = 106; mean age, 15.29 ± 2.45 years) and those with no history of patellar dislocations (controls; n = 98; mean age, 15.56 ± 1.40 years). Cartilaginous sulcus angle (SA) measurements were conducted at 4 consecutive axial levels on MRI starting at the proximal TG (SA1 = most proximal, SA2 = near-proximal, SA3 = near-distal, and SA4 = most distal). Cutoff values were identified using the Youden index. Patients were classified based on the number of elevated SA values: all 4 elevated values indicated grade 4 TD, 3 elevated values indicated grade 3 TD, 2 elevated values indicated grade 2 TD, 1 elevated value indicated grade 1 TD, and all normal values indicated grade 0 TD. Proportions were calculated, and the Fisher exact test was used to compare TD severity between the RPD and control groups.</p><p><strong>Results: </strong>Diagnostic cutoff values were as follows: SA1, 160°; SA2, 154°; SA3, 153°; and SA4, 148°. The RPD group was more likely to have grade 4 TD (58% vs 4%, respectively; <i>P</i> < .001) and grade 3 TD (13% vs 4%, respectively; <i>P</i> = .03) compared with the control group. Conversely, the RPD group had less grade 0 TD (8% vs 68%, respectively; <i>P</i> < .001). There was no difference in the proportions with grade 2 TD (13% vs 9%, respectively; <i>P</i> = .39) or grade 1 TD (8% vs 14%, respectively; <i>P</i> = .27) between the RPD and control groups. Intraobserver reliability was excellent for SA1 to SA4, and interobserver reliability was excellent for SA1 and SA4 and good for SA2 and SA3.</p><p><strong>Conclusion: </strong>The Multi-level Axial Patellofemoral Score for Trochlear Dysplasia (MAPS-TD) is a novel classification system that stratifies TD severity and has demonstrated accuracy and reliability in distinguishing patients with RPDs from controls. Its primary clinical utility lies in differentiating more extensive TD (especially grade 4) from mild TD (grades 1 and 2). The MAPS-TD may help guide surgical decision-making, possibly even in identifying candidates for surgical procedures (ie, trochleoplasty) among those with grade 4 TD.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261419430"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777917","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":"Testosterone Therapy and Associated Rates of Tendon Tear and Surgical Repair: A Retrospective Analysis.","authors":"Al-Hassan Dajani, Timothy P Liu, Guillermo Araujo-Espinoza, Kevin Muy, Seth Cope, Kristofer Jones, Thomas J Kremen","doi":"10.1177/23259671261430731","DOIUrl":"https://doi.org/10.1177/23259671261430731","url":null,"abstract":"<p><strong>Background: </strong>Testosterone replacement therapy (TRT) use is increasing in both men and women with demonstrated benefits for muscle strength, sexual function, and well-being. However, previous studies have linked exogenous testosterone to elevated rates of tendon injury in upper and lower extremities. TRT has also been associated with higher rates of surgical repair and markedly elevated reoperation rates. Limited institutional data are available on tendon rupture rates and treatment trends.</p><p><strong>Purpose: </strong>To investigate the association between prescription TRT and tendon rupture risk, with a specific focus on rotator cuff tear (RCT) incidence and repair/revision rates at a single academic institution.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>We queried 1 institution's electronic health records using International Classification of Diseases (ICD-10) codes for patients ≥18 years with tendon rupture and prescription TRT use within 90 days of injury between 2015 and 2023. Individuals with risk factors predisposing them to tendon injury were excluded. A subanalysis of RCT was performed using a chart review of a subgroup of TRT patients and propensity-matched controls. Outcomes of interest included rupture location and rate, and, for the RCT, tear severity and rates of surgical repair/revision. Outcomes were compared between TRT users and nonusers.</p><p><strong>Results: </strong>We identified 410 TRT users and 14,474 nonusers with tendon rupture. Men on TRT had significantly higher rupture rates (3.6% vs 1.3%; odds ratio [OR], 2.88 [95% CI, 2.59-3.20]) across all ages and races. No significant increase in tendon rupture rate was observed in women on TRT. RCTs were the most common injury (77%). In the RCT subanalysis (78 TRT users, 355 matched controls), TRT users underwent nonoperative intervention more frequently than nonusers (74.4% vs 46.7%; OR, 3.3 [95% CI, 1.91-5.72]). Tear severity and revision rates did not differ significantly between groups.</p><p><strong>Conclusion: </strong>TRT is associated with increased tendon rupture risk in men but not women, potentially due to sex-specific differences in dosing. TRT users with RCT were less likely to undergo arthroscopic repair compared with matched controls, despite similar distributions of tear severity.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261430731"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777202","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":"Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty After Hip Arthroscopy With an 8-Year Minimum Follow-up.","authors":"Jackson G Woodrow, Jeffrey S Mun, Brandon J Allen, Rachel L Poutre, Srish S Chenna, Rishi P Earla, Stephen M Gillinov, Bilal S Siddiq, Scott D Martin","doi":"10.1177/23259671261432671","DOIUrl":"https://doi.org/10.1177/23259671261432671","url":null,"abstract":"<p><strong>Background: </strong>Acetabular labral tears are a common cause of hip pain. While larger tear size has been linked to worse outcomes after arthroscopic treatment, the influence of labral tear location remains incompletely understood.</p><p><strong>Purpose: </strong>To investigate how labral tear location affects functional outcomes, conversion to total hip arthroplasty (THA), and patient satisfaction after arthroscopy.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who underwent primary hip arthroscopy were retrospectively sent online surveys at a minimum of 8 years after their surgery. Tear location was classified into superior, anterosuperior, and posterosuperior based on intraoperative findings. Outcomes included patient-reported outcome measures, conversion to THA, Patient Acceptable Symptom State improvement, and overall patient satisfaction. Unadjusted and adjusted logistic regression models were performed to identify potential confounding variables.</p><p><strong>Results: </strong>In total, 138 patients were included with a mean ± SD follow-up time of 11.1 ± 2.5 years. There was no significant difference in all postoperative patient-reported outcome measures across tear locations, although posterosuperior tears demonstrated lower mean outcomes as compared with superior and anterosuperior. Labral tear location was also not found to significantly influence rates of Patient Acceptable Symptom State achievement. Satisfaction was similar among superior, anterosuperior, and posterosuperior tear locations. THA conversion occurred in 20.9% of patients and was not independently associated with tear location after adjusting for confounders. Age was the strongest predictor of THA conversion, and tear size was also significant.</p><p><strong>Conclusion: </strong>Acetabular labral tear location was not found to be a significant predictor of functional or clinical outcomes after hip arthroscopy. However, while labral tear location was not predictive of conversion to THA, age and tear size were significant predictors of conversion.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261432671"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777832","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":"Physeal Sparing Combined Extra-articular/Intra-articular Iliotibial Band ACL Reconstruction in Children: A Long-term Strength, Dynamic Balance, and Functional Analysis.","authors":"Benton E Heyworth, Elizabeth S Liotta, Jeffrey Kay, Kathryn A Williams, Mininder S Kocher, Lyle J Micheli, Dai Sugimoto","doi":"10.1177/23259671261430745","DOIUrl":"https://doi.org/10.1177/23259671261430745","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite excellent midterm clinical outcomes in several studies of pediatric anterior cruciate ligament (ACL) treatment, the modified McIntosh ACL reconstruction (ACLR) with iliotibial band (ITB) autograft (ITB ACLR) has been referred to as \"nonanatomic\" in nature. Moreover, the technique remains underinvestigated in terms of postoperative lower extremity recovery, strength, balance metrics, and hop tests, with little evidence on the effect of time from surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To assess performance parameters between ITB ACLR and contralateral noninjured knees of patients who underwent the procedure at various time points before testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case series; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who underwent ITB ACLR between 1 and 20 years before study initiation were identified from the surgical database of 3 high-volume ACL surgeons at a tertiary care pediatric hospital. Each patient in the cohort, which was randomly selected to achieve a broad distribution of times from surgery, participated in isometric strength tests (quadriceps, hamstring, and hip abductor), dynamic Y-balance tests, and functional hop tests. The limb symmetry index (LSI) was utilized for comparisons between knees, with equivalence and correlation analyses performed. Patient-reported outcomes (Pediatric International Knee Documentation Committee [Pedi-IKDC] form) and activity level (Hospital for Special Surgery Pediatric Functional Activity Brief Scale [HSS Pedi-FABS]) were recorded on the day of testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 40 patients (9 in 1 to &lt;2 years, 13 in 2 to &lt;5 years, 10 in 5 to 10 years, and 8 in &gt;10 years after ACLR) were enrolled. The mean time at which testing was completed was 5.8 years (SD, 4.8 years; range, 1.1-17.2 years) postoperatively. The mean Pedi-IKDC score was 95.9 (SD, 4.9), and the mean HSS Pedi-FABS score was 22.2 (SD, 6.0). When comparing the operative limb to the contralateral limb, the mean LSI for the single-leg hop test was 100.8% (SD, 13%) and that for the dynamic Y-balance test was 98.4% (SD, 4.8%). Of the strength tests, no significant differences were seen in mean strength testing for the hip abductor (LSI, 97.9%; &lt;i&gt;P&lt;/i&gt; = .207), quadriceps (LSI, 97.9%; &lt;i&gt;P&lt;/i&gt; = .260), or hamstring (LSI, 102.6%; &lt;i&gt;P&lt;/i&gt; = .264). Equivalence analysis confirmed equivalency between limbs for all measures (all &lt;i&gt;P&lt;/i&gt; &lt; .05). No correlation between scores and time from reconstruction was observed, other than improvement in hip abductor LSI (&lt;i&gt;r&lt;/i&gt; = 1.1; &lt;i&gt;P&lt;/i&gt; = .027) and decline in HSS Pedi-FABS scores (&lt;i&gt;r&lt;/i&gt; = -0.37; &lt;i&gt;P&lt;/i&gt; = .019) with increasing time from surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Lower extremity strength and functional testing after ITB ACLR demonstrates equivalence or minimal (&lt;3%) variation when comparing ACLR and contralateral noninjured limbs, with functional outcome scores in both short- and ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261430745"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777944","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-Sports Rates After Anterior Cruciate Ligament Reconstruction with High-Grade Impaction Fracture of the Posterolateral Tibial Plateau.","authors":"Sufen Ye, Jiuqun Li, Yunfeng Chu, Jiatong Li, Yulong Qi, Haochi Lun, Mingyang Zou, Tian You","doi":"10.1177/23259671261422713","DOIUrl":"https://doi.org/10.1177/23259671261422713","url":null,"abstract":"<p><strong>Background: </strong>High-grade fracture of the posterolateral tibial plateau (PLTP) has been reported to increase bone loss, which in turn is associated with residual rotational instability and impaired function after anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Purpose: </strong>To investigate whether high-grade impaction fracture in PLTP is associated with the rate of return to sports (RTS) after ACL reconstruction (ACLR).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This study retrospectively analyzed data from patients with complete ACL tears between December 2018 and June 2022. Inclusion criteria included primary ACLR with autologous hamstring reconstruction, standard preoperative magnetic resonance imaging (MRI) evaluation, and at least 2 years of postoperative follow-up. In contrast to bone contusions, a high-grade impaction fracture in PLTP is defined as subchondral or cortical bone displacement in this area involving the articular surface. Based on whether or not there were high-grade impaction fractures seen on the preoperative MRI, patients were divided into 2 groups: high-grade fracture and control group. Patients were followed up after surgery to assess their level of RTS, Tegner score, Lysholm score, and recovery time. The chi-square test was used to compare the differences in the RTS rate between the 2 groups.</p><p><strong>Results: </strong>Among 190 patients, 34 patients (17.9%) were in the high-grade group, while 156 patients (82.1%) were in the control group. Among the main outcomes, the high-grade fracture knee group performed worse in return to any sport (Tegner score ≥5) (71% vs 88.9%; <i>P</i> = .002) and level 1/2 (cutting) sports (26.5% vs 46.2%; <i>P</i> = .035), while there was no significant difference in return to strenuous sports (Tegner score ≥6) (48.4% in the high-grade group and 62.7% in the control group; <i>P</i> = .136) and return to play (2.9% in the high-grade group and 10.3% in the control group; <i>P</i> = .317). In the later follow-up period of survival analysis, the rate of recovery of any sport was slower in the high-grade fracture group (hazard ratio, 0.22; 95% CI, 0.07-0.72; <i>P</i> = .0118).</p><p><strong>Conclusion: </strong>The results of this study showed that high-grade impaction fracture of PLTP was associated with the rate of RTS after ACLR, mainly in the rate of return to any sport and level 1/2 (cutting) sports. Accordingly, the rehabilitation strategies and priorities for such patients should be adjusted to compensate for the impact.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422713"},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777922","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":"Introducing Increased Lateral Tibial Height and Decreased Medial Meniscal Bone Angle as Independent Risk Factors for Recurrent Patellar Dislocation.","authors":"Lingzhi Li, Zheng Li, Yibo Li, Zihan Lin, Juncai Liu, Yanshi Liu, Hao Jiang, Xu Liu, Zhong Li","doi":"10.1177/23259671261421933","DOIUrl":"https://doi.org/10.1177/23259671261421933","url":null,"abstract":"<p><strong>Background: </strong>Tibiofemoral rotational malalignment, recognized as a risk factor for recurrent patellar dislocation (RPD), has become a research focus. Although the relationship between femoral morphology and RPD is widely studied, the association between RPD and the tibial plateau and meniscus geometries related to the tibiofemoral rotation remains unexamined.</p><p><strong>Hypothesis: </strong>After accounting for the classic risk factors associated with knee rotation-tibial tuberosity-trochlear groove (TT-TG) distance and tibiofemoral angle (TFA)-targeted anatomical parameters are independently associated with adult RPD.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective case-control study included 50 adult patients with RPD and 50 age-, sex-, and body mass index-matched controls. Knee magnetic resonance imaging scans were used to assess parameters-including the lateral tibial slope (LTS), medial tibial slope (MTS), lateral tibial height (LTH), medial tibial depth (MTD), medial meniscal bone angle (MMBA), MTS-LTS (slope difference), MTS: LTS ratio, MTS: MMBA ratio, TT-TG distance, and TFA. Differences among groups were compared; a multivariate logistic regression model was created to evaluate independent factors, and the diagnostic performance of the substantial risk factors, individually and in combination, was assessed.</p><p><strong>Results: </strong>The LTS (<i>P</i> = .002), LTH (<i>P</i> < .001), MMBA (<i>P</i> < .001), MTS-LTS (<i>P</i> = .001), MTS: LTS ratio (<i>P</i> = .001), TT-TG distance (<i>P</i> < .001), and TFA (<i>P</i> < .001) were found to be significantly different between the groups. Logistic regression analysis identified the LTH (odds ratio [OR], 0.409; <i>P</i> = .014), MMBA (OR, 1.456; <i>P</i> < .001), and TT-TG distance (OR, 0.752; <i>P</i> ≤ .001) as independent adult RPD risk factors. Receiver operating characteristic analysis showed that combining LTH, MMBA, and TT-TG distance had excellent predictive ability for adult RPD, with an area under the curve (AUC) of 0.888, sensitivity of 82%, and specificity of 88%, surpassing their diagnostic values (AUCs, 0.694-0.804).</p><p><strong>Conclusion: </strong>The decreased LTS, increased LTH, decreased MMBA, increased MTS-LTS, and increased MTS: LTS ratio were associated with adult RPD. Importantly, even after controlling for TT-TG distance and TFA, increased LTH and decreased MMBA persisted as independent risk factors for adult RPD.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261421933"},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Hip Arthroscopy Patients with Concomitant Lumbosacral Spinal Pathology compared to a Matched Control Cohort at Five-Year Follow-Up.","authors":"Rachel L Poutre, Jackson G Woodrow, Brandon J Allen, Jeffrey S Mun, Srish S Chenna, Rishi P Earla, Stephen M Gillinov, Bilal S Siddiq, Kaveh A Torabian, Scott D Martin","doi":"10.1177/23259671261422260","DOIUrl":"https://doi.org/10.1177/23259671261422260","url":null,"abstract":"<p><strong>Background: </strong>Patients with hip and lumbosacral spinal pathologies may experience exacerbated symptoms as a result of these concomitant conditions. There is a paucity of midterm follow-up on patients who undergo primary hip arthroscopy before spinal surgery.</p><p><strong>Purpose: </strong>To assess patient-reported outcome measures (PROMs) among patients with hip arthroscopy and concomitant symptomatic lumbosacral pathology at 5-year follow-up and to compare revision rates and conversion to total hip arthroplasty between patients in a hip-spine (HS) cohort and patients in a matched control (MC) cohort without lumbosacral pathology.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective review analyzed prospective data of patients who underwent primary hip arthroscopy for treatment of symptomatic labral tears. The study included patients aged ≥18 years with PROMs at baseline and minimum 60-month follow-up. Patients with HS syndrome were propensity matched to a MC group without any lumbosacral pathologies. Patients in the HS cohort indicated (1) lower back pain/symptoms on preoperative surveys, (2) a pathologic lumbosacral spine diagnosis confirmed by a radiologist, and (3) clinical documentation. PROMs, clinically meaningful outcomes, improvement over time, revision rates, and conversion to total hip arthroplasty were compared.</p><p><strong>Results: </strong>A total of 76 patients were included, with 38 patients each in the HS and MC cohorts. The HS cohort had significantly worse functional outcomes at baseline and 12-, 24-, and 60-month follow-up. However, the HS cohort demonstrated no significant difference in achieving the minimal clinically important difference, Patient Acceptable Symptom State, and substantial clinical benefit but showed a mix of no significant difference or significantly greater mean magnitudes of improvement across various PROMs over time. There were no significant differences in rates of revision or conversion to total hip arthroplasty.</p><p><strong>Conclusion: </strong>Although hip arthroscopy patients with concomitant lumbosacral spinal pathology report lower functional outcomes at 5 years than MCs, they can expect similar, if not higher, magnitudes of improvement, as well as similar rates of achieving clinically meaningful outcomes and no increased risk of secondary surgery. These findings substantiate that HS pathology is not an absolute contraindication for hip arthroscopy.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422260"},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777914","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 Effect of Flexor Hallucis Longus Morphology on Os Trigonum Syndrome.","authors":"Nathan Chaclas, Morgan E Swanson, Vandan Patel, Jie C Nguyen, Kathleen J Maguire","doi":"10.1177/23259671261422731","DOIUrl":"https://doi.org/10.1177/23259671261422731","url":null,"abstract":"<p><strong>Background: </strong>Os trigonum (OT) is an accessory bone at the posterior ankle that can lead to posterior ankle impingement. The flexor hallucis longus (FHL) muscle is a potential contributor to this pathology as it passes through the fibro-osseous tunnel behind the medial malleolus adjacent to the talus.</p><p><strong>Purpose: </strong>To compare the morphology of the FHL muscle belly between patients with symptomatic and asymptomatic OT.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We performed a retrospective analysis of pediatric patients with an OT who underwent ankle magnetic resonance imaging at a single center from 2015 to 2023. We collected descriptive data, imaging indications, and the following radiographic measurements: distance from the distal end of the tibia to the FHL muscle musculotendinous junction (MTJ) (absolute FHL MTJ distance); ratio of absolute MTJ distance to the distance from the tibia to the tarsal tunnel (relative FHL MTJ distance); axial area of the FHL muscle belly or tendon at the midpoint of the OT/Stieda process; and axial and sagittal areas of the OT. A 1-tailed independent <i>t</i> test was used to compare continuous variables, guided by the Levene test for equality of variances.</p><p><strong>Results: </strong>The FHL was positioned significantly lower in the symptomatic group (n = 14) than in the asymptomatic group (n = 21), when represented by both absolute (<i>P</i> = .044) and relative FHL MTJ distances (<i>P</i> = .037). The relationship between symptoms and sex was significant (<i>P</i> = .024). The relationships were also significant between symptoms FHL MTJ distance/patient height (<i>P</i> = .049) and FHL MTJ distance/patient body mass index (<i>P</i> = .041). There was no significant difference in age, FHL axial area, or OT length, area, and volume between groups (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>These findings suggest that the FHL muscle may play a role in the pathogenesis and clinical presentation of OT syndrome. We propose that the evaluation and treatment of OT syndrome should include the assessment and management of the FHL muscle, and that future studies should explore the mechanisms underlying the association between the FHL muscle and OT syndrome.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422731"},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777217","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}