Orthopaedic Journal of Sports Medicine最新文献

{"title":"Corrigendum to \"Comparison of Arthroscopic Single-row and Double-row Repair for Rotator Cuff Injuries With Different Tear Sizes A Systematic Review and Meta-analysis\".","authors":"","doi":"10.1177/23259671261487208","DOIUrl":"https://doi.org/10.1177/23259671261487208","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/23259671231180854.].</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261487208"},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900911","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":"Factors Associated With Return to Sport at Minimum 10-Year Follow-up in Athletes With Borderline Hip Dysplasia Undergoing Hip Arthroscopy With Capsular Plication.","authors":"Ady H Kahana-Rojkind, Matthew J Strok, Elizabeth G Walsh, Roger Quesada-Jimenez, Benjamin D Kuhns, Benjamin G Domb","doi":"10.1177/23259671261451218","DOIUrl":"10.1177/23259671261451218","url":null,"abstract":"<p><strong>Background: </strong>Literature on long-term return-to-sport (RTS) rates in athletes with borderline hip dysplasia (BHD) is limited.</p><p><strong>Purpose: </strong>To examine patient outcomes and RTS rates in athletes with BHD who underwent primary hip arthroscopy with capsular plication at a minimum 10-year follow-up.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Data were retrospectively reviewed for all patients with BHD (lateral center-edge angle 18°-25°) who underwent primary hip arthroscopy with labral treatment and capsular plication between September 2008 and May 2014. Athletes in the BHD group were propensity matched 1:1 to a control group of patients with normal acetabular coverage based on age, sex, body mass index, follow-up time, Tönnis grade, and preoperative sport competition level. Patient-reported outcome scores (modified Harris Hip Score, Non-Arthritic Hip Score, 12-item International Hip Outcome Tool, Hip Outcome Score Sports Specific Subscale, visual analog scale for pain, and satisfaction), RTS, and continuation-of-sport rates were also analyzed.</p><p><strong>Results: </strong>There were 50 patients (53 hips) in the BHD group and 53 patients (53 hips) in the control group. Both groups demonstrated similar increases in all PROs from preoperative to 10-year follow-up and favorable RTS rates. A total of 46 patients in the BHD group attempted to RTS and 40 (87.0%) were successful while 48 patients in the control group attempted to RTS and 41 (85.4%) were successful at the short to midterm. Of the patients who successfully returned to sport, 28 from the BHD cohort (70.0%) and 30 (73.2%) from the control cohort attempted to continue playing their respective sport 10 years postoperatively. Of these, 23 patients (82.1%) from the BHD cohort and 25 patients (83.3%) from the control cohort successfully continued their sport at a minimum of 10 years postoperatively. Over the course of 10 years of follow-up, 8 patients (16%) out of 50 in the BHD group at some point discontinued their sport, not due to their hip, but because of lifestyle changes or loss of interest.</p><p><strong>Conclusion: </strong>Athletes with BHD who underwent primary hip arthroscopy with capsular plication and labral treatment demonstrated a high rate of RTS at short-term follow-up, high rate of continuation of sport at long-term follow-up, and favorable long-term results. Loss of interest or lifestyle transitions had a greater impact on continuation of sport at long-term follow-up than persistent symptoms related to the hip.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261451218"},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900980","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":"Full-Construct Biomechanical Evaluation of Femoral Cortical Suspensory Fixation for Anterior Cruciate Ligament Reconstruction in a Porcine Knee Model.","authors":"Tomas F Vega, Juan Bernardo Villarreal Espinosa, Elizabeth Shewman, Zeeshan A Khan, Harsh Singh, Brady T Williams, Thomas Alter, Ron Gilat, Safa Gursoy, Andrew S Bi, Jorge Chahla","doi":"10.1177/23259671261445909","DOIUrl":"10.1177/23259671261445909","url":null,"abstract":"<p><strong>Background: </strong>Although recent studies show no clinical outcome differences between cortical button suspensory fixation devices for anterior cruciate ligament reconstruction (ACLR), biomechanical mechanisms of elongation and failure remain unclear for adjustable-loop devices (ALDs) and fixed-loop devices (FLDs).</p><p><strong>Purpose: </strong>To compare biomechanical outcomes of ALDs with button-locking device (BLD), suture-locking device (SLD), and dual-locking device (DLD) mechanisms relative to an industry-standard FLD.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Five femoral cortical suspension devices (n = 11 each; total = 55 constructs) were tested using porcine femurs and bovine tendons simulating doubled hamstring grafts: EndoButton (FLD), Infinity Button (BLD), ProCinch (SLD1), UltraButton (SLD2), and TightRope (DLD). Constructs underwent cyclic loading simulating early (10-250 N, 500 cycles) and late (10-400 N, 500 cycles) rehabilitation, followed by pull-to-failure at 50 mm/min. Outcomes included excursion over simulated early and late rehabilitation and the cumulative total of both loading protocols. Also assessed were maximum load, stiffness, energy to failure, and failure mode, categorized as bone, button, suture loop rupture, tendon, or locking mechanism failure.</p><p><strong>Results: </strong>No significant differences were observed in cyclic loading at 500 cycles of 10 to 250 N or across the cumulative 1000 loading cycles between any ALD and the FLD. During cyclic loading at 10 to 400 N specifically, the BLD (3.34 ± 1.71 mm) and DLD (3.63 ± 1.18 mm) demonstrated greater excursion than the FLD (1.49 ± 0.36 mm; both <i>P</i> < .01). SLD1 (1270.5 ± 204.7 N) and SLD2 (1232.7 ± 185.2 N) withstood higher maximum loads than the BLD (1011.4 ± 95.8 N) and DLD (1018.4 ± 63.1 N; <i>P</i> < .05), although no differences were observed between the FLD and all ALDs combined. Stiffness did not differ across groups. BLD and DLD constructs most often failed by suture rupture, whereas the FLD and SLDs failed by button failure. Suture rupture was associated with greater excursion during cyclic loading at 10 to 400 N, lower maximum load, and reduced energy absorption compared with button failure (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>All constructs exceeded forces expected during early and total rehabilitation after ACLR, confirming adequate initial biomechanical strength across ALDs and FLDs. Differences in excursion and load to failure were associated with locking mechanism design and resultant failure mode, although clinical implications remain uncertain.</p><p><strong>Clinical relevance: </strong>Although mechanical behavior varied by device mechanism, all systems provided fixation above physiologic loads, supporting that design-specific differences influence how devices fail but not their ability to provide adequate early postoperative stability in ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261445909"},"PeriodicalIF":2.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888052","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":"Comparative Postoperative Outcomes After Rotator Cuff Repair in Tobacco and Nontobacco Nicotine Users.","authors":"M Lane Moore, Alejandro M Holle, William H Rankin, Collin L Braithwaite, Eugenia Lin, Joseph C Brinkman, Jeffrey D Hassebrock","doi":"10.1177/23259671261470573","DOIUrl":"10.1177/23259671261470573","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use is a known risk factor for poor healing after rotator cuff repair (RCR), but the effects of nontobacco nicotine products remain unclear.</p><p><strong>Purpose: </strong>To compare postoperative complications among nontobacco nicotine users, tobacco users, and nonusers undergoing RCR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Using the PearlDiver database, the authors identified patients who underwent arthroscopic RCR with ≥2 years of follow-up. Three 1:1 propensity-matched comparisons were conducted: nontobacco nicotine users versus nonusers (n = 4844), tobacco users versus nonusers (n = 19,182), and nontobacco nicotine users vs tobacco users (n = 4882). Outcomes included 90-day complications and 2-year revision surgeries.</p><p><strong>Results: </strong>Nontobacco nicotine users had mildly higher rates of lysis of adhesions than controls (0.7% vs 0.4%; OR, 1.95; <i>P</i> = .033) but no other significant differences. Tobacco users showed increased rates of acute kidney injury (AKI), pneumonia, infections, emergency department (ED) visits, readmissions, and revision surgery compared to controls. Compared to tobacco users, nontobacco nicotine users had moderately strong lower risks of pneumonia (0.6% vs 1.2%; OR, 0.46), ED visits (8.8% vs 13.6%; OR, 0.62), and readmissions (0.8% vs 1.5%; OR, 0.54) (all <i>P</i> < .01).</p><p><strong>Conclusion: </strong>While nontobacco nicotine use was associated with a modestly increased risk of lysis of adhesions after RCR, it did not significantly elevate the risk of major medical complications, infections, or revision surgery when compared to nonnicotine users. In contrast, tobacco users demonstrated consistently worse postoperative outcomes across multiple domains, including higher rates of AKI, pneumonia, surgical site infection, ED visits, readmissions, and revision procedures. Notably, when compared directly to tobacco users, nontobacco nicotine users had significantly lower rates of pneumonia, ED utilization, and readmissions. These findings suggest that although nontobacco nicotine products may not be entirely benign, their perioperative risk profile appears to be less severe than that of traditional tobacco use.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261470573"},"PeriodicalIF":2.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888074","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":"Dynamic Ultrasound Assessment of Axial Extensor Mechanism Alignment in Adolescents With and Without Patellofemoral Instability.","authors":"Elliot M Greenberg, Bridget DeSandis, Sean Owens, Caroline Kim, Naomi Brown, Brendan Williams, J Todd R Lawrence","doi":"10.1177/23259671261468156","DOIUrl":"10.1177/23259671261468156","url":null,"abstract":"<p><strong>Background: </strong>Patellofemoral instability (PFI) is common among adolescents. Dynamic evaluation of extensor mechanism alignment during early knee flexion may improve the understanding of recurrent instability risk.</p><p><strong>Purpose: </strong>To evaluate the use of point of care ultrasound (POCUS) to dynamically measure axial extensor mechanism alignment in patients with and without PFI.</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>Patients diagnosed with either patellar subluxation or dislocation and aged between 10 and 18 years were eligible. Control participants included those without any knee pain, nor any history of PFI, fracture, or musculoskeletal developmental disorder. Axial extensor mechanism was visualized with POCUS and the distance between the midpoint of the patellar tendon and lateral trochlear ridge (MPT-LTR) and lateral edge of the patellar tendon and LTR (LPT-LTR) was measured under 4 conditions: (1) active knee hyperextension (ie, quadriceps set), (2) full passive extension, (3) 15° of knee flexion, and (4) 30° of knee flexion. Univariate statistical analyses compared MPT-LTR and LPT-LTR distances across cohorts and knee positions. The area under the curve (AUC) evaluated measurement performance.</p><p><strong>Results: </strong>The cohort (PFI; n = 19) and controls (n = 19) were similar with respect to age, height, and weight (<i>P</i> > .05). In both groups, the MPT-LTR and LPT-LTR were greatest in active hyperextension and progressively medialized with increasing knee flexion. Patients with PFI demonstrated statistically significantly more lateral MPT-LTR and LPT-LTR distance in all testing conditions (<i>P</i>≤ .01) when compared with controls. AUC analysis demonstrated acceptable performance across measures, ranging from 0.712 to 0.837.</p><p><strong>Conclusion: </strong>Patients with PFI consistently exhibited a more laterally oriented patella while performing active knee hyperextension and throughout the first 30° of knee flexion when measured using a novel POCUS evaluation.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 9","pages":"23259671261468156"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880900","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":"Evaluation of Spin Bias in the Use of Platelet-Rich Plasma for Augmentation of Meniscal Tear Repairs.","authors":"Christina Im, Al-Hassan Dajani, Aidan Marks, Timothy Liu, Christopher Hamad, Thomas J Kremen, Amanda Honsvall Hoefler, Edward C Cheung","doi":"10.1177/23259671261471384","DOIUrl":"10.1177/23259671261471384","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) is used as a biologic adjunct for meniscal repair (MR). Systematic reviews and meta-analyses are frequently used to inform treatment decisions, but their abstracts may contain spin bias, overstating benefits and misrepresenting the certainty of the evidence.</p><p><strong>Purpose: </strong>To determine the prevalence and patterns of spin in systematic reviews and meta-analyses evaluating PRP augmentation of MR.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>Relevant studies were reviewed and identified in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on July 14, 2025. Each abstract was assessed for 15 predefined spin bias categories, and their corresponding full text was evaluated for methodological quality using A Measurement Tool to Assess Systematic Reviews, Version 2 (AMSTAR 2). General information of the studies was also extracted. Descriptive statistics were used to summarize the incidence of spin bias types and AMSTAR 2 ratings and presented as percentages of total possible responses. Study characteristics, spin bias, and AMSTAR 2 associations were assessed using nonparametric statistical tests, with statistical significance set at <i>P</i> < .05.</p><p><strong>Results: </strong>Screening of 1047 records yielded 16 relevant studies that were included in this analysis. At least 1 form of spin bias was identified in 15 out of 16 (93.8%) of abstracts. The most frequent spin bias types included type 14 (failure to report a wide confidence interval of estimates), type 11 (conclusion focuses selectively on statistically significant efficacy outcome), and type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention), which each appeared in 43.8% of studies. AMSTAR 2 ratings were critically low in 68.8% of studies. No significant associations emerged between study characteristics, spin type, or AMSTAR 2 (all <i>P</i> > .05).</p><p><strong>Conclusion: </strong>The study demonstrated that abstract-level spin bias is highly prevalent in reviews of PRP augmentation for MR, often alongside low methodological confidence. More transparent abstract reporting is needed to ensure clinicians accurately interpret the strength and uncertainty of the available evidence. Reducing spin may help clinicians avoid overestimating PRP benefits when counseling patients and selecting treatments.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261471384"},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875721","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":"Inferior Outcomes after Subsequent Revision or Contralateral ACL Reconstruction: A Cross-Sectional Study.","authors":"Ramana Piussi, Rebecca Hamrin Senorski, Johan Högberg, Riccardo Cristiani, Roland Thomeé, Kristian Samuelsson, Eric Hamrin Senorski","doi":"10.1177/23259671261470914","DOIUrl":"10.1177/23259671261470914","url":null,"abstract":"<p><strong>Background: </strong>Outcomes after revision anterior cruciate ligament (ACL) reconstruction (ACLR) have been reported as inferior to those after primary reconstruction, but evidence comparing revision and contralateral ACLR in physical activity and patient-reported outcomes (PROs) during early rehabilitation remains limited.</p><p><strong>Purpose: </strong>To describe and compare rates of return to preinjury physical activity, muscle strength, and PROs between 12 and 24 months of rehabilitation in patients after primary, revision, and contralateral ACLR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients from a rehabilitation registry who underwent ACLR were included in this cross-sectional study. They were categorized into groups, defined as primary (n = 1317), revision (n = 111), or contralateral (n = 80) ACLR. Return to physical activity was assessed using the Tegner activity scale. Muscle function was measured via isokinetic strength testing. PROs were evaluated using different questionnaires. Outcomes were compared across groups at 12, 18, and 24 months. In addition, subgroup analysis was performed, dividing patients by sex.</p><p><strong>Results: </strong>At 24 months, a significantly greater proportion of patients in the primary ACLR group had returned to their preinjury physical activity level compared with both the revision and contralateral ACLR groups (43.9% vs 27.1% and 25.7%, respectively). Patients in the primary ACLR group scored higher on different questionnaires compared to the other groups at all follow-up time points. Sex-specific analysis showed significant differences among female patients in future knee self-efficacy and quality of life, favoring primary ACLR.</p><p><strong>Conclusion: </strong>Revision and contralateral ACLR were associated with lower rates of return to preinjury physical activity levels and less favorable PROs between 12 and 24 months after reconstruction compared with primary ACLR. Differences in muscle strength were limited, and most statistically significant differences had small effect sizes, ranging from η² = 0.007 to 0.056 for continuous outcomes and ω = 0.122 for return to preinjury physical activity, suggesting that the clinical relevance of these findings should be interpreted cautiously.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470914"},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875657","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":"Midterm Outcomes After Suture Button Fixation for Arthroscopically Confirmed Concomitant Syndesmotic Instability in Chronic Lateral Ankle Instability: A Retrospective Cohort Study.","authors":"Pengtao Shi, Yu Wei, Shengxuan Li, Mengheng Liu, Chen Yang, Qi Quan, Yanpeng Zhao, Zhidong Zhao, Min Wei","doi":"10.1177/23259671261468979","DOIUrl":"10.1177/23259671261468979","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Distal tibiofibular syndesmosis instability (DTSI) often coexists with chronic lateral ankle instability and may delay recovery. Suture button fixation is widely used, but its benefit in this setting is uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate midterm outcomes of suture button fixation for DTSI with concomitant lateral ankle instability.&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;Patients who underwent surgery for lateral ankle instability with arthroscopic syndesmosis assessment between 2017 and 2023 were retrospectively identified. Patients with an intact syndesmosis formed the intact group, whereas those with arthroscopically confirmed dynamic syndesmotic instability (≥2-mm diastasis) underwent additional suture button fixation and formed the instability group. All patients received standardized lateral ligament surgery and rehabilitation. Clinical assessments were performed preoperatively, at 12 months, and at final follow-up using Karlsson-Peterson, Foot and Ankle Ability Measure (FAAM), Tegner, Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI), visual analog scale (VAS) pain scores, and ankle range of motion. Group differences were analyzed with α = .05 and interpreted using minimal clinically important differences (MCIDs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 216 eligible patients, 154 completed follow-up at a mean of 67.3 ± 24.8 months (range, 24-113 months). No bilateral cases were included; therefore, the number of ankles was identical to the number of patients: 80 patients (80 ankles) in the intact syndesmosis group and 74 patients (74 ankles) in the syndesmotic instability group. Preoperatively, the instability group had lower Karlsson-Peterson scores than the intact group, with a median between-group difference of -4.00 points (95% CI, -6.00 to -2.00; &lt;i&gt;P&lt;/i&gt; &lt; .001). At 12 months, Karlsson-Peterson scores were comparable between groups (median between-group difference, 0.00 points; 95% CI, -1.00 to 1.00; &lt;i&gt;P&lt;/i&gt; = .63). At final follow-up, the instability group had a statistically higher Karlsson-Peterson score than the intact group, although the absolute difference was small (median between-group difference, 1.00 point; 95% CI, 0.00 to 2.00; &lt;i&gt;P&lt;/i&gt; = .02). The between-group difference in Karlsson-Peterson improvement was 4.88 points (95% CI, 3.13 to 6.63; &lt;i&gt;P&lt;/i&gt; &lt; .001), which did not exceed the MCID threshold of 13.50 points. After adjustment for preoperative Karlsson-Peterson score, sex, body mass index, age, anterior talofibular ligament surgical modality, and follow-up duration, syndesmotic instability treated with suture button fixation remained modestly associated with the final Karlsson-Peterson score (β = 1.525; 95% CI, 0.340 to 2.709; &lt;i&gt;P&lt;/i&gt; = .01). Final FAAM Activities of Daily Living, FAAM Sports, Tegner, ALR-RSI, and VAS scores showed no clinically meaningful between-group differences. Th","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261468979"},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875670","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":"Correlation Between Changes in Subchondral Bone Density Distribution and Clinical Outcomes at 2 Years After Opening-Wedge High Tibial Osteotomy.","authors":"Taku Ebata, Koji Iwasaki, Dai Sato, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki","doi":"10.1177/23259671261444313","DOIUrl":"10.1177/23259671261444313","url":null,"abstract":"<p><strong>Background: </strong>High tibial osteotomy (HTO) for medial knee osteoarthritis corrects lower limb alignment, redistributing knee joint stress from the medial to the lateral compartment and improving clinical outcomes. Subchondral bone density reflects joint stress distribution. While redistribution of subchondral bone density after HTO has been reported, the relationship between computed tomography-osteoabsorptiometry (CT OAM)-derived changes in subchondral bone density distribution and postoperative clinical outcomes has not been well-established.</p><p><strong>Purpose: </strong>To investigate the relationship between subchondral bone density distribution across the knee joint and clinical outcomes at 2 years after opening-wedge HTO (OW HTO).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective study included 27 patients (27 knees) with medial knee osteoarthritis who underwent OW HTO. Radiographic parameters and clinical outcomes were assessed preoperatively and 2 years postoperatively. Subchondral bone density was evaluated using CT OAM, analyzing the high-density area (HDA) in the medial and lateral tibial compartments. The medial ratio was defined as the proportion of HDA in the medial compartment relative to total HDA. Correlations between changes in the medial ratio (Δ medial ratio) and clinical outcomes were analyzed.</p><p><strong>Results: </strong>Postoperative alignment and medial ratio were significantly altered, with a reduced medial ratio compared with preoperative values (preoperative, 82.2%; postoperative, 74.6%; <i>P</i> < .001). Change in medial ratio correlated with postoperative percentage of mechanical axis (%MA) (<i>r</i> = 0.414; <i>P</i> = .03) and change in hip-knee-ankle angle (ΔHKA angle) (<i>r</i> = 0.502; <i>P</i> = .008). Partial correlation analysis revealed that Δ medial ratio significantly correlated with postoperative Lysholm score (partial <i>r</i> = 0.463; <i>P</i> = .02) and Knee injury and Osteoarthritis Outcome Score (KOOS) Sport and Recreation subscale (partial <i>r</i> = 0.538; <i>P</i> = .006), and Quality of Life subscales (partial <i>r</i> = 0.558; <i>P</i> = .004) and KOOS summary (42-item weighted mean) (partial <i>r</i> = 0.527; <i>P</i> = .006), after adjusting for postoperative %MA and Δ HKA angle.</p><p><strong>Conclusion: </strong>Our study demonstrated that a greater reduction in the medial ratio after OW HTO is associated with improved clinical outcomes, indicating that CT OAM-based subchondral bone density redistribution may reflect mechanical adaptation to postoperative load redistribution. Overall, Δ medial ratio may serve as a potential imaging marker of medial compartment unloading after OW HTO.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261444313"},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875665","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":"BMI Serves as a Predictor of PROMIS Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement at Minimum 1-Year Follow-up.","authors":"Hashim J F Shaikh, Omkar N Prabhavalkar, Patrick Castle, Sarah Wegman, Nicholas Morriss, Justin Harrington, Jacob Waldron, Urvi Patel, Brian D Giordano","doi":"10.1177/23259671261471379","DOIUrl":"10.1177/23259671261471379","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI) and metabolic health are increasingly recognized as important predictors of recovery after hip arthroscopy for femoroacetabular impingement, yet limited data exist on how outcomes vary across the full BMI spectrum.</p><p><strong>Purpose: </strong>To evaluate the impact of BMI-from underweight to morbidly obese-on Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and depression (Dep) scores following hip arthroscopy.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A single-institution review was performed for patients undergoing hip arthroscopy for femoroacetabular impingement from 2015 to 2024. Patients were stratified by BMI: underweight (<18.5), normal (18.5 ≤ to <30), obese (30 ≤ to ≤40), and morbidly obese (>40). PROMIS PF, PI, and Dep scores were collected preoperatively and ≥1 year postoperatively. Wilcoxon tests evaluated within-group changes; analysis of variance and regression analyses compared outcomes between BMI groups, adjusting for demographic covariates.</p><p><strong>Results: </strong>A total of 415 patients (mean follow-up, 28.1 ± 15.8 months) met inclusion criteria. Both normal and obese BMI groups demonstrated significant improvements across all PROMIS domains from pre- to postoperative assessments (<i>P</i> < .05). However, compared with the normal group, the obese group had significantly worse scores pre- and postoperatively in PF (<i>P</i> = .0004 and <i>P</i> = .005, respectively), PI (<i>P</i> = .01 and <i>P</i> = .03, respectively), and Dep (<i>P</i> = .002 and <i>P</i> = .007, respectively). Underweight patients had significantly lower preoperative PF scores (<i>P</i> = .02) but showed greater improvement in postoperative Dep scores (<i>P</i> = .04) compared with the other groups. Within-group analysis revealed that underweight patients improved only in PF (<i>P</i> = .005), while morbidly obese patients showed no significant improvement in any PROMIS domain.</p><p><strong>Conclusion: </strong>Extremes of BMI are associated with diminished recovery following hip arthroscopy for femoroacetabular impingement, particularly in pain and mental health domain improvement. These findings highlight the need for targeted preoperative optimization and patient counseling for individuals with metabolic or nutritional risk factors.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261471379"},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875681","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}