Orthopaedic Journal of Sports Medicine最新文献

{"title":"Pain and Hardware Removal After Tibial Tubercle Osteotomy: Incidence, Associated Factors, and Outcomes.","authors":"Michelle Davis, Fabien Meta, Malik E Dancy, Parker A Scott, Xuankang Pan, Adam J Tagliero, Aaron J Krych, Mario Hevesi, Kelechi R Okoroha","doi":"10.1177/23259671251324481","DOIUrl":"10.1177/23259671251324481","url":null,"abstract":"<p><strong>Background: </strong>While patients may report painful or prominent hardware after tibial tubercle osteotomy (TTO), little is known about the frequency, associated factors, and outcomes after removal of symptomatic hardware.</p><p><strong>Purpose/hypothesis: </strong>The purpose was to investigate the incidence of hardware removal after TTO due to pain or complications, factors associated with hardware removal, and postoperative outcomes after removal. It was hypothesized that clinical outcomes would be similar between patients who underwent TTO without hardware removal and those who underwent TTOs and subsequently hardware removal.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients who underwent TTO at a single institution from 2000 to 2023. Age at the time of the index surgery, sex, race, body mass index, number and size of screws, tibial tubercle-trochlear groove distance, and reason for hardware removal were collected retrospectively. Knee radiographs were reviewed for measurement of soft tissue-hardware distance. Patients were contacted via email to capture final patient-reported outcome measures (PROMs). A univariate logistic regression model was used to determine factors associated with hardware removal.</p><p><strong>Results: </strong>A total of 152 patients representing 171 knees were included. Of the overall cohort, 38 knees (22.2%) in 32 patients underwent TTO with subsequent hardware removal. The most common reason for hardware removal was anterior knee pain (79%). Compared with patients aged 11 to 20 years, patients aged 21 to 30 years demonstrated higher odds of undergoing hardware removal (OR, 3.67; 95% CI, 1.51-9.44; <i>P =</i> .009). Compared with a soft tissue-hardware distance of 0 to 4.9 mm, a distance of 10.0 to 14.9 mm demonstrated lower odds of hardware removal (OR, 0.24; 95% CI, 0.07-0.84; <i>P</i> = .027). Visual analog scale scores (0-10 scale) improved by a mean of 3.6 points after hardware removal (<i>P</i> = .003). In patients undergoing hardware removal for pain, no difference in final PROMs was found compared with patients who underwent TTO without hardware removal.</p><p><strong>Conclusion: </strong>Hardware removal in patients undergoing TTO was mainly attributed to hardware-related pain/irritation. On average, pain scores improved after hardware removal. There was no difference in final PROMs between patients who had their hardware removed due to pain (eg, without any clinically relevant concomitant pathology) and patients who did not require hardware removal. Size and number of screws were not associated with a subsequent hardware removal procedure. The thickness of the soft tissue envelope overlying implanted hardware was inconsistently associated with lower odds of hardware removal.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251324481"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658084","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":"Arthroscopic Bankart Repair Versus Arthroscopic Latarjet for Anterior Shoulder Instability: A Matched-Pair Long-Term Follow-up Study.","authors":"Cristina Delgado, Elena Calvo, Maria Valencia, Natalia Martínez-Catalán, Gonzalo Luengo-Alonso, Emilio Calvo","doi":"10.1177/23259671241313474","DOIUrl":"https://doi.org/10.1177/23259671241313474","url":null,"abstract":"<p><strong>Background: </strong>The Bankart and the Latarjet procedures are 2 of the most commonly utilized surgical techniques to treat anterior shoulder instability. However, the long-term outcomes after these procedures remain unclear, and there is not enough information regarding arthroscopic Latarjet.</p><p><strong>Purpose: </strong>To analyze long-term outcomes of patients with anterior glenohumeral instability managed with an arthroscopic Bankart or Latarjet procedure.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who underwent an arthroscopic Latarjet were matched-paired in a 1:1 ratio with patients who underwent an arthroscopic Bankart procedure at a single institution between 2007 and 2012. Recurrence at the time of follow-up as well as intraoperative and postoperative complications were recorded and compared between the 2 groups. Postoperative status was assessed at the final follow-up using the Rowe score, the Western Ontario Shoulder Instability Index (WOSI), the Subjective Shoulder Value, and the return-to-sport rate.</p><p><strong>Results: </strong>A total of 80 patients, 40 patients in each group, were included (overall mean age, 26.5 ± 15.4 years). The mean follow-up was 13.2 years (range, 10-17 years). The recurrence rate was significantly higher in the Bankart group compared with the Latarjet group (35% vs 10%, respectively; <i>P</i> = .009). The mean estimate for the cumulative proportion of stable shoulders at 15-year follow-up was 64.4% in the Bankart group and 89.6% in the Latarjet group (<i>P</i> = .008). Revision surgery because of instability was necessary in 8 (20%) patients in the Bankart group and 2 (5%) in the Latarjet group (<i>P</i> = .41). There was no significant group difference in complication rate (15% in the Bankart group vs 17.5% in the Latarjet group; <i>P</i> = .48). The WOSI score was significantly better in patients treated with arthroscopic Latarjet (<i>P</i> = .004). More than half of the patients were able to completely return to their previous sport (52.5%), with no significant difference between groups.</p><p><strong>Conclusion: </strong>Arthroscopic Latarjet was associated with a significantly lower recurrence rate and better postoperative WOSI score and sports activity level at long-term follow-up compared with arthroscopic Bankart, without any greater risk of complications.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241313474"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649738","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":"Rethinking the Schenck Classification for Multiligament Knee Injuries: Evaluating Whether the Schenck KD Grade Is Associated With the Presence of Vascular or Neurological Injuries in a Multicenter Study With 144 Patients.","authors":"Enrique Sanchez-Munoz, Beatriz Lozano Hernanz, Renato Andrade, Cristina Valente, João Espregueira-Mendes, Francisco Figueroa, David Figueroa, Kristien Vuylsteke, Peter C M Verdonk, Luís Eduardo Passarelli Tirico, Fabio Janson Angelini, Jacco A C Zijl, Nienke Wolterbeek, Antonio Maestro Fernández","doi":"10.1177/23259671241312697","DOIUrl":"https://doi.org/10.1177/23259671241312697","url":null,"abstract":"<p><strong>Background: </strong>Posterolateral corner (PLC) lesions and knee dislocations (KDs) have been recognized as risk factors for vascular and neurological injuries in patients with multiligament knee injury (MLKI), but an association between Schenck KD grade and neurovascular lesions has yet to be established.</p><p><strong>Hypothesis: </strong>The ligamentous injury pattern in MLKIs with high KD grades will be associated with a higher likelihood of vascular and neurological injuries.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Included were 144 patients from a multicenter database with surgically treated MLKI. All patients were skeletally mature, had MLKI lesion identified on magnetic resonance imaging and confirmed intraoperatively, and did not have any previous knee surgery or previous vascular or neurological lesions. Demographic data (sex, age), injury mechanism (high energy, sports injury, low energy), ligaments injured, and neurological and vascular lesions were recorded. A new classification for MLKI based on ligamentous injury pattern, and intended for all MLKIs (with and without KD) was developed, and all patients were categorized according to this classification. Associations were evaluated between the risk of vascular and neurological lesion and demographic data, injury mechanism, and new classification grade.</p><p><strong>Results: </strong>The mean patient age was 33.9 years (range, 15-64 years), and 72% were male. High-energy trauma was the most common injury mechanism (55.6%). Vascular injury was present in 5 patients (3.5%) and nerve injury in 17 (11.8%), with 1 patient (0.7%) having both. None of the analyzed variables were associated with the presence of vascular lesion. Univariate logistic regression showed that medial collateral ligament (MCL) lesion decreased the probability of neurological injury (odds ratio [OR], 0.29; 95% CI, 0.1-0.87; <i>P</i> = .03) while PLC injury increased that probability (OR, 12.66; 95% CI, 1.63-100; <i>P</i> = .02). Multivariate logistic regression showed that the proposed MLKI grade was significantly associated with the presence of neurological lesions, with a 2.5-fold increase in the odds of having a neurological injury for each increase in grade (OR, 2.47; 95% CI, 1.36-4.50; <i>P</i> = .003).</p><p><strong>Conclusion: </strong>PLC injuries increased the odds of neurological injury in MLKI, while MCL injuries decreased these odds. MLKI grade and presence of PLC injury was associated with the presence of neurological injury. MLKI grade was not associated with the presence of a vascular lesion.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241312697"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649114","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":"Altered Joint Forces Found in Symptomatic Dysplastic Hips in Women During Sport-Specific Activities.","authors":"Molly C Shepherd, Rannon Huo, John C Clohisy, Jeffrey J Nepple, Michael D Harris","doi":"10.1177/23259671251318736","DOIUrl":"https://doi.org/10.1177/23259671251318736","url":null,"abstract":"<p><strong>Background: </strong>Many patients with developmental dysplasia of the hip (DDH) are young and highly active but often become limited by activity-induced pain. Characterizing how the abnormal bony geometry of DDH affects hip joint loading and multiplanar kinematics during sport-specific motions relevant to active patients may provide insight into injury mechanisms and inform optimal treatment options.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to determine how hip joint loading and kinematics are altered in DDH during 2 common sport activities: running and multidirectional hop-cutting. It was hypothesized that superior and medial joint-reaction forces (JRFs) would be elevated during running and that medial JRFs would be elevated during hop-cutting when compared with controls.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Using patient-specific musculoskeletal modeling, both running and hop-cutting motions were analyzed for female patients with symptomatic DDH (DDH group) and female controls without hip disorders who were enrolled from October 2017 to August 2022. Hip joint angles, JRFs, and muscle forces were compared between the groups using 1-dimensional statistical parametric mapping.</p><p><strong>Results: </strong>Overall, 19 women in the DDH group and 19 female controls were included in the running analysis, and 13 women in the DDH group and 10 female controls were included in the hop-cutting analysis. During the running motion, medial hip JRFs and gluteal muscle forces were significantly elevated in the DDH group, while rectus femoris muscle forces were reduced. During the hop-cutting motion, medial hip JRFs, gluteus minimus, and gluteus medius muscle forces were elevated, while gluteus maximus forces were reduced in the DDH group. There were no significant group differences in hip joint angles for either activity.</p><p><strong>Conclusion: </strong>The lack of kinematic differences between women with symptomatic DDH and controls suggests that the JRF differences between groups stemmed from the abnormal joint geometry in the DDH group. These activities may have greater damaging potential than previously studied lower impact activities such as walking.</p><p><strong>Clinical relevance: </strong>Better understanding of how loading varies from activity to activity can help patients with DDH, and clinicians understand the mechanistic causes of DDH-related hip pain and damage and plan appropriate intervention strategies.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251318736"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649814","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":"Reliability in 2-Dimensional On-track/Off-track Measurements: Analysis of Key Values for Glenohumeral Bone Loss.","authors":"Anthony J Magee, Jonathan C Horng, Liang S Zhou, Willam E Daner, Hyeong J Ahn, Kyong S Min","doi":"10.1177/23259671241310441","DOIUrl":"https://doi.org/10.1177/23259671241310441","url":null,"abstract":"<p><strong>Background: </strong>The relationship between glenoid bone loss and Hill-Sachs lesions (HSLs), which is known as the glenoid track, has been well described in the literature. Off-track lesions have been found to be associated with recurrent shoulder instability.</p><p><strong>Purpose: </strong>To assess the intraobserver and interobserver reliability in glenoid track measurement using 2-dimensional (2D) computed tomography (CT).</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>Electronic medical records between 2009 and 2019 were reviewed for patients with known shoulder instability and bone loss. Using 2D CT, fellowship-trained orthopaedic surgeons and orthopaedic residents measured glenoid loss and humeral head bone loss to calculate the glenoid track and to assess for on-track and off-track lesions.</p><p><strong>Results: </strong>A total of 38 patients met the inclusion criteria. For fellowship-trained surgeons, there was moderate intraobserver reliability when assessing the glenoid diameter (intraclass correlation coefficient [ICC], 0.704) and HSI (ICC, 0.720). There was good reliability when evaluating glenoid defects (ICC, 0.761) and glenoid track (ICC, 0.825). Intraobserver assessment of on-track and off-track lesions according to kappa criteria was moderate (κ = 0.531; <i>P</i> < .001). The interobserver reliability among fellowship-trained surgeons for the glenoid track was good (ICC, 0.762); the reliability measurement for the glenoid defect (ICC, 0.672), glenoid diameter (ICC, 0.627), and HSI (ICC, 0.520) were moderate; and the on-track and off-track assessments were moderate (κ = 0.405; <i>P</i> < .001). For the residents, there was moderate intraobserver reliability when assessing the glenoid diameter (ICC, 0.633), glenoid defect (ICC, 0.709), HSI (ICC, 0.536), and glenoid track (ICC, 0.708). Interobserver reliability within the residents was moderate for the glenoid diameter (ICC, 0.542), glenoid defect (ICC, 0.574), and glenoid track (ICC, 0.629) and poor for the HSI (ICC, 0.292). Determination of on- and off-track lesions among residents was fair (κ = 0.234; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Among fellowship-trained surgeons, both the interobserver and intraobserver reliability of measuring the glenoid track on 2D CT were good; however, agreement on whether lesions were on-track or off-track was only moderate. The reliability among residents was moderate; however, their agreement on whether lesions were on-track or off-track was poor.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241310441"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Capsular Closure on Clinical Outcomes, Revision Rates, and Return to Sports in Adolescent Females Undergoing Hip Arthroscopy for Femoroacetabular Impingement.","authors":"Angelina M Vera, Kade S McQuivey, Sierra N Murphy, Joseph C Brinkman, Kostas J Economopoulos","doi":"10.1177/23259671241295755","DOIUrl":"10.1177/23259671241295755","url":null,"abstract":"<p><strong>Background: </strong>Young female patients undergoing hip arthroscopy have an increased prevalence of baseline capsular laxity of the hip joint. This laxity, along with superimposed postoperative iatrogenic capsular deficiency secondary to an unrepaired capsule, could potentially lead to worse outcomes after arthroscopic treatment of femoroacetabular impingement (FAI) in this population.</p><p><strong>Purpose: </strong>To compare outcomes and revision rates for young female patients undergoing hip arthroscopy for FAI and labral tear with capsular closure (CC group) versus capsular nonclosure (CNC group).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data of patients who underwent index hip arthroscopy using interportal capsulotomies by a single surgeon between January 2014 and February 2020 was performed. Female patients aged 12 to 21 years who underwent hip arthroscopy with cam or pincer osteoplasty and labral repair with a 2-year minimum follow-up were included. The Beighton score was assessed. The Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) were obtained preoperatively and at 3 months, 1 year, and 2 years postoperatively. Data were analyzed using the Mann-Whitney <i>U</i> test and Fisher exact test.</p><p><strong>Results: </strong>A total of 23 hips (20 patients) were included in the CC group and 17 hips (16 patients) were included in the CNC group. The groups were not different regarding characteristics and preoperative patient-reported outcome scores. At all follow-up intervals postoperatively, the CC group scored significantly higher HOS-ADL and HOS-SSS. Fifteen of 17 (88.2%) patients in the CC group returned to sports versus 8 of 14 (57.1%) in the CNC group (<i>P</i> = .03). Four (17.4%) hips in the CC group had revision surgery compared with 9 (52.9%) hips in the CNC group (odds ratio, 5.1; 95% CI, 1.2-22.5; <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Young female patients treated with CC while undergoing arthroscopic FAI had improved outcomes, fewer revisions, and a higher return-to-sports rate than those treated without CC.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241295755"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome of Bicruciate Ligament Reconstruction in Multiple-Ligament Knee Injuries: Comparison With Bicruciate Reconstruction and Collateral Ligament Surgery.","authors":"Zenta Joutoku, Eiji Kondo, Yusuke Muranaka, Koji Iwasaki, Tomohiro Onodera, Tomonori Yagi, Norimasa Iwasaki, Kazunori Yasuda","doi":"10.1177/23259671251319532","DOIUrl":"10.1177/23259671251319532","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Several procedures for combined rupture of both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in multiple-ligament knee injuries (MLKIs) have been reported. However, the clinical outcome of these treatments remains controversial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;Postoperative knee stability and clinical outcomes in patients who underwent simultaneous bicruciate reconstruction would be comparable with those that underwent bicruciate reconstruction with collateral ligament surgery.&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;A retrospective study was conducted with 41 patients (41 knees) who sustained unilateral MLKI with combined ACL and PCL rupture. Fifteen cases required simultaneous ACL and PCL reconstruction, and the others had additional surgical treatment as follows: At the time of cruciate ligament reconstruction, 14 cases required posteromedial corner (PMC) reconstruction and 8 cases required posterolateral corner (PLC) reconstruction. Five cases were treated with an initial PMC or PLC before the cruciate ligament reconstruction. One of these underwent PMC reconstruction at the second stage for residual valgus laxity. Then, the authors divided the cases into 2 groups based on surgical procedure: in group 1, 15 patients underwent only bicruciate reconstruction. In group 2, 26 patients underwent bicruciate and PMC or PLC reconstruction/repair. The patients were examined at ≥2 years after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The side-to-side difference in the total anteroposterior translation, and the relative position on the anterior and posterior stress radiographs significantly improved postoperatively in both groups (group 1: &lt;i&gt;P&lt;/i&gt; = .0115, &lt;i&gt;P&lt;/i&gt; = .0007; group 2: &lt;i&gt;P&lt;/i&gt; = .0004, &lt;i&gt;P&lt;/i&gt; &lt; .0001). In the valgus and varus stress tests, the medial and lateral joint opening significantly improved postoperatively in group 2 (&lt;i&gt;P&lt;/i&gt; &lt; .0001; &lt;i&gt;P&lt;/i&gt; = .0093). Anterior, posterior, valgus, and varus stress radiographs showed no significant differences in comparison with that in the uninjured knee. There were no significant differences in the postoperative anteroposterior laxity and the medial and lateral joint opening between the groups. The Lysholm score, the International Knee Documentation Committee evaluation, all subscales of the Knee injury and Osteoarthritis Outcome Score, the Tegner score, and the isokinetic peak torque of quadriceps and hamstring muscles significantly improved postoperatively in both groups (&lt;i&gt;P&lt;/i&gt; &lt; .0003). Each clinical parameter did not differ between the 2 groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There were no significant differences in the knee stability and clinical results after bicruciate reconstruction between those with and those without collateral ligament surgery. Reconstruction of bicruciate MLKIs with repair or reconstruction of associated collateral ligament injuries ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251319532"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Outcomes and Survivorship of Revision Arthroscopic Surgery for Femoroacetabular Impingement Compared With Matched Primary Cases.","authors":"Karen Mullins, David Filan, Patrick Carton","doi":"10.1177/23259671241308586","DOIUrl":"10.1177/23259671241308586","url":null,"abstract":"<p><strong>Background: </strong>The exponential rise in arthroscopy for femoroacetabular impingement (FAI) has led to increased revision surgery rates, although this is often an exclusion criterion from arthroscopy literature.</p><p><strong>Purpose: </strong>To examine the midterm (minimum 5-year follow-up) outcomes after revision arthroscopic correction of FAI compared with a matched control group of primary surgical cases.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Prospective outcome data, collected in a consecutive series of patients undergoing revision arthroscopic FAI correction, was retrospectively reviewed. Revision procedures were compared with a matched group of primary surgical cases. Survivorship was defined as the avoidance of total hip replacement (THR) and assessed using a Kaplan-Meier curve with the log-rank test. Regression analysis was conducted to identify predictors of THR conversion. Patient-reported outcomes (PROs) including modified Harris Hip Score (mHHS), University of California, Los Angeles (UCLA), 36-Item Short Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively and at 5 years postoperatively were compared between the groups. The proportion of patients across groups achieving the minimal clinically important difference (MCID) was compared for each PRO. Finally, a subgroup analysis was performed to compare the outcomes of those who had their index surgery at our clinic and those who had an index procedure elsewhere.</p><p><strong>Results: </strong>A total of 124 revision cases were compared with 268 primary cases. The most common indication for revision surgery was residual bony deformity. Both groups had high survivorship rates at 5 years (>90%) although revision cases did have a statistically higher conversion to THR than did primary cases (6.5% vs 1.5%; <i>P</i> = .008). Increasing age and revision surgery were identified in regression analysis as predictors for THR conversion. Where THR was avoided, improvements in PROs were observed in both groups (<i>P</i> < .05 for all). Before surgery, revision cases reported lower scores for all PROs. At 5 years, the only statistical difference between the groups was in the distribution of mHHS scores. There were no differences in the rate of MCID achievement between groups.</p><p><strong>Conclusion: </strong>Residual bony deformity is the most common indication for revision arthroscopy. Revision procedures may have a lower survival than primary cases, although overall survivorship at midterm follow-up is high. Of the revision cases, 17% required further arthroscopy. Where THR is avoided, improvements in pain and function can be expected that are similar to primary surgical cases.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241308586"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625737","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 After Isolated Medial Meniscus Posterior Root Repairs Using an Anatomic Transtibial Pullout Technique in Patients Older Than 60 Years: A Matched Cohort Study.","authors":"Garrett R Jackson, Derrick M Knapik, Zeeshan A Khan, Harkirat Jawanda, Obianuju A Obioha, Daniel J Kaplan, Johnathon R McCormick, Joan Sugrañes, Anjay Batra, Enzo S Mameri, Nikhil N Verma, Jorge Chahla","doi":"10.1177/23259671241274136","DOIUrl":"10.1177/23259671241274136","url":null,"abstract":"<p><strong>Background: </strong>Management of isolated medial meniscus posterior root (MMPR) tears is challenging, especially in older patients, where indications for repair must be weighed against potential repair failure and osteoarthritic progression.</p><p><strong>Purpose: </strong>To compare patient-reported outcomes and incidence of failure after anatomic transtibial pullout repair for isolated MMPR tears in patients >60 versus ≤60 years of age.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Included in the study were patients aged ≥18 years who underwent isolated anatomic transtibial pullout repair using either the single- or double-tunnel technique for MMPR tears at a single institution between January 2016 and September 2020. Patients with a minimum 2-year follow-up were divided based on age at surgery (>60 vs ≤60 years). Patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), and Veterans RAND 12-Item Health Survey (VR-12) Physical score preoperatively and at final follow-up. Differences between age groups in outcome scores as well as repair failures (defined as the need for repeat arthroscopy) were analyzed using the 2-sided Student <i>t</i> test or chi-square test.</p><p><strong>Results: </strong>A total of 20 patients aged >60 years (mean age, 65.7 ± 4.1 years; range, 60.2-74.9 years) were identified and compared against 40 patients aged ≤60 years (mean age, 49.3 ± 9.0 years; range, 23.4-59.8 years). Significant improvement on all outcomes scores was observed in both groups at final follow-up when compared with preoperative values, with no significant between-group difference on any of the scores at final follow-up. Revision repair was required in 1 patient (2.5%) in the ≤60-year group but not in patients in the >60-year group.</p><p><strong>Conclusion: </strong>Anatomic transtibial pullout repair for isolated MMPR tears resulted in improved IKDC, KOOS JR, and VR-12 Physical scores at minimum 2-year follow-up, with no significant differences between our cohorts of patients >60 versus ≤60 years of age.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241274136"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes After Ipsilateral Versus Contralateral Autograft Harvest for Anterior Cruciate Ligament Reconstruction: A Systematic Review.","authors":"Jack S Soeder, Ehsan Yavari, Darius L Lameire, Valerie Lemieux, Jihad Abouali","doi":"10.1177/23259671241310808","DOIUrl":"10.1177/23259671241310808","url":null,"abstract":"<p><strong>Background: </strong>Contralateral donor autografts in anterior cruciate ligament (ACL) reconstruction (ACLR) may act as an alternative to conventional ipsilateral donor grafts but are rarely used clinically because of the lack of evidence on patient outcomes and concerns around additional morbidity.</p><p><strong>Purpose: </strong>To investigate the effect of contralateral versus ipsilateral autograft use in ACLR on patient outcomes.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched from inception to October 2022 for comparative studies assessing the clinical or functional outcomes of ipsilateral versus contralateral autograft harvest in primary or revision ACLR. Given the heterogeneity of the included studies, data were summarized using descriptive statistics.</p><p><strong>Results: </strong>Included were 11 studies representing 1638 patients with a mean follow-up of 49 months. The mean time to return to sport was shorter in patients treated with a contralateral bone-patellar tendon-bone (BPTB) autograft in 2 of 3 studies that evaluated this outcome after primary ACLR and in the only study that evaluated this outcome after revision ACLR. Some studies found improved strength recovery in the contralateral ACL-reconstructed knee. Otherwise, there was no significant difference between contralateral and ipsilateral ACLRs on subjective or objective postoperative clinical outcome scores. Most studies reported minimal donor site morbidity. Clinical adverse events including postoperative graft rerupture and infection were low in both contralateral and ipsilateral ACLRs and were not significantly different.</p><p><strong>Conclusion: </strong>Contralateral ACL autograft harvest may lead to earlier return to sport when patients undergo BPTB ACLR. However, clinical outcomes, morbidity, risk of rerupture, and risk of donor knee injury were not significantly different in this review.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241310808"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616715","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}