Orthopaedic Journal of Sports Medicine最新文献

{"title":"Corrigendum to ''Long-term Outcomes After Anterior Cruciate Ligament Reconstruction With 3 Different Surgical Techniques: A Prospective Randomized Clinical and Radiographic Evaluation at a Minimum of 20 Years' Follow-up''.","authors":"","doi":"10.1177/23259671251385668","DOIUrl":"https://doi.org/10.1177/23259671251385668","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/23259671241302348.].</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251385668"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213345","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":"Multiple Injections and Injections ≤6 Month Injections Before Rotator Cuff Repair May Increase the Risk of Retear: A Propensity Score-Matched Study.","authors":"Xinji Wang, Hengzhi Liu, Canlong Wang, Dengfeng Ruan, Weiliang Shen","doi":"10.1177/23259671251360366","DOIUrl":"10.1177/23259671251360366","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The role of preoperative corticosteroid injections (CSIs) in rotator cuff repair (RCR) outcomes is controversial, with mixed evidence regarding their effect on tendon healing and postoperative recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To control for potential variables that may affect tendon healing and to explore the effect of CSIs on tendon healing and the difference in the effect of injection frequency and time interval on outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included 365 patients who underwent arthroscopic RCR between February 2021 and June 2023. Patients were categorized into CSI group (CSI group; n = 113) having a history of injections ≤1 year before surgery and control group (n = 252, 1 patient with bilateral shoulder involvement) without preoperative injections. Propensity score matching (PSM) was employed to reduce the effect of confounding variables, including age, body mass index, tear size, and biceps pathology, resulting in 113 matched pairs. Outcomes, including pain, shoulder function (Constant-Murley Score, Oxford Shoulder Score) were assessed at 3, 6, and 12 months postoperatively. Tendon integrity was evaluated using magnetic resonance imaging (MRI) ≥6 months postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After PSM, baseline characteristics were balanced between the groups. At 3 months postoperatively, the CSI group exhibited significantly reduced active abduction and external rotation compared with the control group. Pain at night (visual analog scale, VAS) was also higher in the CSI group than the control group at 3 months (mean value 2.97 vs 2.31; &lt;i&gt;P&lt;/i&gt; = .03). However, no significant differences in patient-reported outcome measures (PROMs) were observed between the 2 groups at any time point. MRI assessments of Sugaya grade at ≥6 months postoperatively revealed a higher retear rate in the CSI group compared with control (23.9% vs 8.8%; &lt;i&gt;P&lt;/i&gt; = .02). Subgroup analysis indicated that patients who received 2 injections (OR, 3.25; 95% CI, 1.06-10.16; &lt;i&gt;P&lt;/i&gt; = .04) or ≥ 3 injections (OR, 5.71; 95% CI, 1.87-18.28; &lt;i&gt;P&lt;/i&gt; &lt; .001) had a significantly higher risk of retear compared with the control group. Additionally, patients who received CSI between 3 and 6 months and &lt;3 months before surgery also showed a significantly increased risk of retear compared with the control group (OR, 5.80; 95% CI, 2.07-17.40; &lt;i&gt;P&lt;/i&gt; &lt; .001 and OR, 7.25; 95% CI, 1.77-29.65; &lt;i&gt;P&lt;/i&gt; = .01, respectively). Cross-effect analysis revealed that receiving ≥ 2 injections within ≤ 6 months before surgery was significantly associated with a higher postoperative retear risk (OR, 7.30; 95% CI, 2.83-20.76; &lt;i&gt;P&lt;/i&gt; &lt; .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Preoperative CSIs, particularly when administered multiple times and within 6 months before surgery, are associated with a higher risk of retear after RCR.","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251360366"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213297","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 Exosome Size in Platelet-Rich Plasma on Outcomes in Patients Treated for Knee Osteoarthritis.","authors":"Ino Song, Natalie A Glass, Edward A Sander, James A Martin, Arman Hlas, Mederic M Hall, Ryan C Kruse, Dongrim Seol, Kyle R Duchman, Joseph A Buckwalter","doi":"10.1177/23259671251360410","DOIUrl":"10.1177/23259671251360410","url":null,"abstract":"<p><strong>Background: </strong>Intra-articular injections of autologous platelet-rich plasma (PRP) have been shown to reduce joint pain in many patients with mild to moderate knee osteoarthritis (OA) (PRP responders). However, for unclear reasons, 20% to 30% of patients experience little to no improvement in symptoms (PRP nonresponders). Understanding the mechanisms underlying PRP's action is crucial to address this limitation. In vitro and animal studies suggest that the benefits of PRP in knee OA are partly attributable to exosomes secreted by platelets and other cells.</p><p><strong>Purpose/hypothesis: </strong>This study aimed to (1) determine the effects of intra-articular PRP injections in patients with symptomatic knee OA on pain and physical function, and (2) evaluate whether PRP exosome concentration and size were associated with therapeutic efficacy. Responsiveness to PRP therapy in patients with knee OA may be related to exosome concentration and size.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 60 patients seeking nonsurgical treatment of symptomatic mild to moderate knee OA-Kellgren-Lawrence (KL) grades 1 to 3-were prospectively enrolled in the study. Baseline descriptive and health data were collected, including patient-reported pain and functional outcomes at baseline, 6 weeks, and 12 weeks after injection. PRP responders were defined as patients with ≥20% reduction in the Numerical Rating Scale (NRS) of joint pain at 12 weeks after treatment. Exosome size and concentration and platelet concentration were measured in each sample. Logistic regression was used to explore relationships between responder status and patient factors-age, body mass index (BMI), sex, and KL grade. The mean exosome size and concentration were also compared between responders and nonresponders using an independent <i>t</i>-test.</p><p><strong>Results: </strong>Of the 58 patients included in the analyses, 43 (73%) reported a 20% reduction in NRS scores. The mean exosome size among a subset of patients who reported unacceptable pain symptoms before treatment (n = 43) was 80.8 ± 2.7 nm for responders and 78.0 ± 1.5 nm for nonresponders, a statistically significant difference (<i>P</i> = .005). There was no significant difference between responders and nonresponders in terms of platelet or exosome concentration. Age, BMI, sex, and KL grade were not significantly associated with the odds of PRP treatment response (all <i>P</i> > .05).</p><p><strong>Conclusion: </strong>PRP-derived exosome size appears to be associated with improvements in pain at 12 weeks after injection.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251360410"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213286","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 Posterior Tibial Slope Measurement Methods Based on 3-Dimensional Reconstruction.","authors":"Jin-Gyu Kim, Min Jung, Kwangho Chung, Hyun-Soo Moon, Se-Han Jung, Youngjin Park, Sung-Hwan Kim","doi":"10.1177/23259671251378774","DOIUrl":"10.1177/23259671251378774","url":null,"abstract":"<p><strong>Background: </strong>The posterior tibial slope (PTS) influences knee sagittal balance and is linked to anterior cruciate ligament (ACL) injury and meniscal pathology. Various imaging modalities assess PTS, but differences in measurement techniques and reliability remain a concern.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this article was to evaluate the accuracy of calculating the lateral plateau slope using lateral radiograph (LR) and magnetic resonance imaging (MRI)-derived asymmetry. It was hypothesized that measurement error would be high and variable across imaging modalities and that 3-dimensional (3D) reconstruction would serve as a consistent and accurate reference for PTS assessment.</p><p><strong>Study design: </strong>Cohort study (Diagnosis): Level of evidence, 2.</p><p><strong>Methods: </strong>Between March 2020 and October 2023, ACL reconstruction patients were screened. PTS was measured on knee LRs, tibial long-bone LRs (LLRs), preoperative MRI, and 3D-reconstructed images from postoperative computed tomography scans. Two orthopaedic surgeons performed 2 measurements each. Reliability was assessed using intraclass correlation coefficients (ICCs), and agreement was analyzed using Bland-Altman plots, considering ±2° limits of agreement (LOA) as acceptable.</p><p><strong>Results: </strong>Among 132 screened patients, 32 met the inclusion criteria. Intrarater reliability was high for LR and LLR (ICC, 0.86-0.93), while interrater reliability was moderate for LR (ICC, 0.72) and excellent for LLR (ICC, 0.90). MRI showed moderate-to-good reliability (ICC, 0.65-0.79) but high variability (43.75%-65.60% within LOA). Three-dimensional reconstructions demonstrated excellent reliability (ICC, 0.93-0.97) with low variability. MRI-derived asymmetry (calculated as the difference between the PTS of the lateral tibial plateau (LTP) and the medial tibial plateau) showed good agreement with 3D imaging (ICC, 0.81; 73.44% within LOA). LLR had the highest agreement with 3D imaging for medial PTS (ICC, 0.88; 78.12% within LOA). No single method accurately estimated lateral PTS, but combining LLR-based medial PTS with MRI-derived asymmetry improved agreement with 3D LTP (ICC, 0.80; <i>r</i> = 0.826; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Medial PTS measurement using anterosuperior and posterosuperior reference points in lateral views (LR and LLR) proved to be highly accurate and consistent. In MRI, only the lateromedial PTS asymmetry demonstrated reliability and consistency. To estimate lateral PTS, combining the LLR-based medial PTS with the MRI-derived lateromedial PTS difference yielded intra- and interrater reliability comparable with existing methods but improved accuracy compared with MRI-based measurements alone.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251378774"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207289","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":"Effect of Tear Classification on Subscapularis Muscle Volume: A Deep Learning-based Semi-automatic Analysis of Pre- and Postoperative Changes in 246 Rotator Cuff Repair Patients With and Without First Facet Subscapularis Tears.","authors":"Kyosun Hwang, Jin Hyeok Lee, Dongkyun Lim, Kanghun Yu, Woong Kyo Jeong","doi":"10.1177/23259671251374303","DOIUrl":"10.1177/23259671251374303","url":null,"abstract":"<p><strong>Background: </strong>Partial-thickness subscapularis (SSC) tendon tears, although less studied than full-thickness tears, are prevalent and clinically significant. Recent classifications have proposed subdivisions for these partial-thickness tears. However, their clinical implications and correlation with SSC muscle volume remain poorly understood.</p><p><strong>Purpose: </strong>To evaluate SSC muscle volume in relation to tendon tear classification and assess the changes in muscle volume both pre- and postoperatively using deep learning-based magnetic resonance imaging (MRI) segmentation in patients undergoing arthroscopic rotator cuff repair.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This study included 246 patients who underwent arthroscopic rotator cuff repair between January 2018 and December 2023. SSC tendon tears were classified using the Yoo and Rhee system. SSC muscle volumes were measured on preoperative MRIs and 6 months postoperatively using a validated deep learning segmentation tool. These volumes were normalized to the scapular volume.</p><p><strong>Results: </strong>Preoperative normalized SSC volume (nSSC) varied significantly across tear types (F = 7.21; <i>P</i> < .001). Patients with type 2B tears had a significantly lower mean nSSC (1.45 ± 0.40) than those with no tears (1.68 ± 0.37; <i>P</i> = .018) and type 2A tears (1.74 ± 0.31; <i>P</i> = .023). Six months postoperatively, nSSC significantly decreased in patients with SSC tendon tears (nSSC = 1.48 ± 0.34; ΔnSSC = -0.10 ± 0.24; <i>P</i> < .001). For patients with type 2A or more severe tears, nSSC significantly decreased postoperatively in both the debridement (Δ nSSC = -0.13 ± 0.18; <i>P</i> = .004) and repair (Δ nSSC = -0.12 ± 0.29; <i>P</i> = .017) groups. However, the degree of volume change was not significantly different between the treatment groups.</p><p><strong>Conclusion: </strong>Even in partial-thickness tears affecting only the first facet, nSSC muscle volume decreases significantly with increasing tear severity. Furthermore, SSC muscle volume significantly decreases 6 months postoperatively in patients with SSC tendon tears, although the extent of this reduction does not vary among different treatment modalities.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251374303"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207240","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":"Cytocompatibility of Compound Betamethasone and Lidocaine on Human Degenerative Rotator Cuff Tendon Cells.","authors":"Jiapeng Wang, Feipeng Wu, Jing Cui, Chunsen Zhang, Long Pang, Songyun Yang, Tao Li, Xin Tang, Yizhou Huang","doi":"10.1177/23259671251374308","DOIUrl":"10.1177/23259671251374308","url":null,"abstract":"<p><strong>Background: </strong>Injections of compound betamethasone (BT) combined with lidocaine (LD) have been applied for the treatment of rotator cuff tendinopathy; however, their effects on human rotator cuff tendon cells remain unknown.</p><p><strong>Purpose: </strong>To explore the cytocompatibility of BT and LD on degenerative human rotator cuff tendon cells.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>BT and LD were diluted in cell culture medium (Dulbecco's modified Eagle medium) to match their common clinical concentrations, and degenerative rotator cuff tendon cells were cultured with the drugs for 24 hours. Cell morphology and density were monitored for 21 days after the treatment. To identify the safe concentrations, the viability, apoptosis, proliferation, and cytoskeleton of tendon cells were investigated. An enzyme-linked immunosorbent assay was performed to analyze the influence of the selected concentrations on extracellular matrix expressions.</p><p><strong>Results: </strong>When treated with the common clinical concentrations of 0.7 mg/mL BT and 0.5% LD, or their combination, tendon cells exhibited significant changes in cell morphology, along with reduced cell viability. Higher concentration, particularly LD concentration, exacerbated these side effects. In contrast, treatment with lower concentrations of BT, LD, or their combination did not induce notable cytotoxicity or alterations in cell morphology and extracellular matrix composition, indicating a potential safety threshold for clinical application. Compared with the effects of BT or LD alone, the combination of BT and LD enhanced cytotoxicity, which was primarily driven by LD. Based on in vitro cytocompatibility assays, the relatively safe concentrations were determined to be 0.175 mg/mL for BT, 0.05% for LD, and a combination of 0.175 mg/mL BT + 0.025% LD.</p><p><strong>Conclusion: </strong>BT and LD demonstrate concentration-dependent cytotoxicity in degenerative rotator cuff tendon cells, with the combined treatment of BT and LD enhancing this effect, wherein LD plays a predominant role. The relatively safe concentrations for BT, LD, and their combination resulted in only transient alterations, with complete recovery of cell morphology and viability observed.</p><p><strong>Clinical relevance: </strong>This finding can serve as a potential reference for the safer clinical application of BT and LD, especially in the treatment of degenerative rotator cuff tendinopathy.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251374308"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186230","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":"Onlay Fixation With an All-Suture Anchor Provides Sufficient Biomechanical Stability for Lateral Extra-articular Tenodesis.","authors":"Marcos D Tejada, Rachel M Frank, Oliver L Hauck, Coen A Wijdicks, Brian C Werner","doi":"10.1177/23259671251363607","DOIUrl":"10.1177/23259671251363607","url":null,"abstract":"<p><strong>Background: </strong>Spiked ligament staples (SLSs) and biocomposite suture anchors (BSAs) are commonly used onlay fixation devices for modified Lemaire lateral extra-articular tenodesis (LET). However, hardware prominence, tunnel penetration, footprint size, and irritation are documented issues. Knotless all-suture anchors (ASAs) are a promising alternative that mitigates these issues.</p><p><strong>Purpose: </strong>To compare the biomechanical behavior of LET using ASAs with SLSs and BSAs under simulated anterolateral forces.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Human iliotibial band grafts were harvested, whipstitched, and fixed onto fresh-frozen porcine femurs using ASAs, SLSs, or BSAs (n = 6/group). Each femur was placed in a custom fixture at the base of an electromechanical testing machine, oriented at 60° with iliotibial band grafts parallel to the load axis. Cyclic loading and load-to-failure testing were performed. Five millimeters of displacement was determined as the critical threshold for failure and survivorship analysis. Biomechanical outcomes included cyclic displacement, survivorship, and ultimate load.</p><p><strong>Results: </strong>Cyclic displacement values after all load ranges were 4.25 ± 0.28 mm, 3.94 ± 0.71 mm, and 8.14 ± 1.68 mm for ASA, SLS, and BSA, respectively. No significant differences in cyclic displacement were found between ASA and SLS, whereas significant differences were found in each load range between BSA and both ASA and SLS (<i>P</i> < .05). Survivorship was 100% for ASA, 83% for SLS, and 0% for BSA. The ultimate loads were 257 ± 40 N, 300 ± 47 N, and 205 ± 24 N for ASA, SLS, and BSA, respectively; only SLS and BSA were significantly different (<i>P</i> = .002).</p><p><strong>Conclusion: </strong>ASA onlay fixation for LET demonstrated comparable displacement to SLS and significantly lower displacement to BSA with greater survival during cyclic loading. ASA had comparable failure loading, with all groups exceeding the native anterolateral ligament failure load requirements. Therefore, ASA is a biomechanically viable alternative to SLS and BSA for iliotibial band fixation during LET.</p><p><strong>Clinical relevance: </strong>ASAs are a biomechanically viable alternative to spiked staples and biocomposite suture anchors for LET onlay fixation, potentially mitigating complications associated with conventional techniques.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251363607"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186330","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":"Low-Energy Availability Indicators Among Female Adolescents After Concussion: A Comparison With Uninjured Controls.","authors":"Katherine L Smulligan, Aubrey M Armento, Madison L Brna, William P Meehan, Julie C Wilson, David R Howell","doi":"10.1177/23259671251380877","DOIUrl":"10.1177/23259671251380877","url":null,"abstract":"<p><strong>Background: </strong>After concussion, metabolic disruption causes a mismatch between the brain's energy demand and the body's ability to deliver energy to the brain. Physical activity (ie, energy expenditure) is recommended after concussion to facilitate recovery. Low-energy availability (LEA) is defined as inadequate energy available to support physiologic function after accounting for exercise energy expenditure and may influence concussion symptoms or disrupt/prolong recovery.</p><p><strong>Purpose/hypothesis: </strong>The purpose was (1) to investigate LEA indicators (LEA-I) among female adolescents with and without recent concussion and (2) to examine the relationship between LEA-I and concussion symptom severity. It was hypothesized that (1) participants with concussion would have higher LEA-I than controls and (2) LEA-I and concussion symptom severity would be moderately correlated.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Two groups of female adolescents ages 13 to 18 years completed the Low Energy Availability in Females Questionnaire (LEAF-Q): uninjured controls and adolescents within 21 days of concussion. The LEAF-Q evaluates gastrointestinal symptoms, menstrual function, and injury frequency (range, 0-25). LEA-I was defined as scores ≥8, indicative of high LEA risk. Participants with concussion rated symptoms using the Post-concussion Symptom Inventory (PCSI; range, 0-120), with higher scores indicating more severe symptoms. We used independent samples <i>t</i> tests and calculated effect sizes to examine LEAF-Q between-group differences and linear regression for a multivariable comparison. For the concussion group, the correlation between LEAF-Q and PCSI scores was examined via Pearson <i>r</i> coefficients.</p><p><strong>Results: </strong>We enrolled 117 female adolescents: 88 controls (mean ± SD age, 15.9 ± 1.5 years) and 29 with concussion (age, 15.5 ± 1.4 years). Upon univariable analysis, the concussion group reported significantly higher LEAF-Q scores than controls (9.1 ± 4.0 vs 6.0 ± 3.7; <i>P</i> < .001; Cohen <i>d</i> = 0.81). After adjusting for age and body mass index, LEAF-Q scores were 3.23 points higher on average for the concussion group as compared with controls (β = 3.23; 95% CI, 1.49-4.96; <i>P</i> < .001). For the concussion group, there was a small and insignificant correlation between LEAF-Q and PCSI scores (<i>r</i> = -0.06, <i>P</i> = .74).</p><p><strong>Conclusion: </strong>Female adolescents after concussion had LEAF-Q scores indicative of high LEA risk, while controls did not. The lack of correlation between LEAF-Q and PCSI scores suggests that LEA-I is not associated with concussion symptoms.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251380877"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186405","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":"Distal Radioulnar Joint Kinematics Evaluated Using Ultrasonography During Handstanding in Female Gymnasts.","authors":"Shinya Nishimura, Yuki Wabiko, Hiroyuki Miura, Aina Kamiharako, Eiichi Tsuda","doi":"10.1177/23259671251368997","DOIUrl":"10.1177/23259671251368997","url":null,"abstract":"<p><strong>Background: </strong>Wrist pain prevalence is significantly higher in female gymnasts than in male gymnasts, and the pathological site varies depending on patient age. However, the differences between age groups have not been elucidated with a focus on changes in the kinematics of the distal radioulnar joint (DRUJ).</p><p><strong>Purpose: </strong>To analyze the effect of wrist weightbearing during a handstand on the kinematics of the DRUJ using ultrasonography in female elementary school (ES), junior high school (JH), and high school (HS) gymnasts, and to determine whether wrist pain affects the kinematic measurements in female gymnasts.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 66 wrist joints in 33 female gymnasts (5 ES, 9 JH, and 19 HS students) were included. Ultrasound examinations were performed in neutral extension, nonweightbearing (NENWB); full extension, nonweightbearing; and full extension, weightbearing (FEWB). The radioulnar joint kinematics were evaluated by measuring the radioulnar separation and dorsivolar shift. The change in distance in the FEWB condition was determined as a reference for those in the NENWB condition and for comparison between the 3 school groups. Also, the change in distance was compared between the gymnasts with and without wrist pain.</p><p><strong>Results: </strong>The radioulnar separation increased from the NENWB to the FEWB condition in all 3 groups, and a significantly larger change in distance was observed in HS students compared with ES students (<i>P</i> = .008). The dorsivolar shift decreased from the NENWB to the FEWB condition in ES and JH students; it was almost unchanged in HS students. There was a significant difference in change in dorsivolar shift from the NENWB to the FEWB condition between ES and JH students (<i>P</i> = .023). There were 2 ES, 2 JH, and 10 HS students with wrist pain. The change in radioulnar separation was significantly greater separation in gymnasts with wrist pain compared with those without wrist pain (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>The radioulnar joint kinematics during the FEWB condition varied with school age in female gymnasts. The larger increase in the radioulnar separation from the NENWB condition to the FEWB condition might be associated with a biomechanical mechanism of wrist pain in female gymnasts.</p><p><strong>Clinical relevance: </strong>Repetitive tensile loads put female gymnasts at risk of wrist pain and overuse injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251368997"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186389","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":"Prevalence of, and Factors Associated With, Symptoms of Anxiety and Depression in Young Adults With a Symptomatic Knee After ACL Reconstruction: Results from the SUPER-Knee study.","authors":"Hilary J A Grover, Andrea M Bruder, Thomas J West, Kay M Crossley, Michael A Girdwood, Jamon L Couch, Christian J Barton, Ewa M Roos, Adam G Culvenor","doi":"10.1177/23259671251371155","DOIUrl":"10.1177/23259671251371155","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injury and its lengthy recovery period can lead to adverse mental health outcomes. However, symptoms of anxiety and depression after ACL injury are infrequently investigated.</p><p><strong>Purpose: </strong>To investigate the prevalence of, and factors associated with, symptoms of anxiety or depression in young adults with a symptomatic knee after ACL reconstruction (ACLR).</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We analyzed baseline data from 184 adults with a symptomatic knee (defined as a mean score of <80/100 from 4 subscales of the Knee injury and Osteoarthritis Outcome Score [KOOS₄]) 9 to 36 months after ACLR who were enrolled in the SUPER-Knee trial (age 30 ± 6 years, 37% women, body mass index [BMI] 27.3 ± 5.2 kg/m²). Symptoms of anxiety or depression were assessed using the \"anxiety/depression\" item of the EQ5D 5-level questionnaire (EQ5D-5L) (1 = none, 2 = slight, 3 = moderate, 4 = severe, and 5 = extreme). Knee-related burden was assessed with the 5 KOOS subscales (0 = worst, 100 = best). The relationship between anxiety or depression with (1) demographic (age, sex, BMI, preinjury activity level, and socioeconomic status) and injury/surgery-related factors (combined meniscal/cartilage injury, >1 ACLR), and (2) KOOS and return to sports (RTS) was evaluated with ordered logistic regression.</p><p><strong>Results: </strong>A total of 104 (57%) participants reported symptoms of anxiety or depression (slight = 69, moderate = 33, and severe = 2). A higher BMI was the only demographic/injury/surgery-related factor associated with the severity of anxiety or depression symptoms (not anxious/depressed = 26.3 ± 4.5 kg/m², slightly anxious/depressed = 27.7 ± 5.4 kg/m², moderately/severely anxious/depressed = 28.7 ± 6.2 kg/m²). More severe anxiety or depression was associated with worse scores on all KOOS subscales, but not RTS.</p><p><strong>Conclusion: </strong>Over half of adults with knee symptoms 9 to 36 months after ACLR reported anxiety/depression symptoms, and almost 1 in 5 reported moderate to severe anxiety/depression symptoms. Greater severity of anxiety or depression symptoms was associated with overweight/obesity and worse knee-related burden. Mental health outcomes should be monitored after ACLR, and appropriate management and/or referral should be considered.ANZCTR: ACTRN12620001164987.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251371155"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186422","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}