Orthopaedic Journal of Sports Medicine最新文献

{"title":"Clinical Outcomes After Arthroscopic 270° Labral Repair in Active-Duty Military Patients: At Minimum 10-Year Follow-up.","authors":"John K McNamara, Alexis B Sandler, John P Scanaliato, John R Tyler, Ali Boolani, Nata Parnes","doi":"10.1177/23259671251342592","DOIUrl":"10.1177/23259671251342592","url":null,"abstract":"<p><strong>Background: </strong>Active-duty military servicemembers (ADSMs) exhibit a high prevalence of combined-type shoulder instability. Arthroscopic 270° labral repair has demonstrated promising outcomes at short- and intermediate-term follow-up, but there is a paucity of long-term outcomes data among ADSMs.</p><p><strong>Purpose: </strong>To report the outcomes of arthroscopic 270° labral repair at a minimum of 10-year follow-up in ADSMs.</p><p><strong>Study design: </strong>Case series; Level of evidence: 4.</p><p><strong>Methods: </strong>A total of 44 ADSMs who underwent arthroscopic 270° labral repair between January 2010 and December 2012 without major concomitant procedures had ≥10 years of follow-up and were deemed eligible for inclusion. Of these, 38 were included in the final outcome analysis.</p><p><strong>Results: </strong>Mean follow-up was 140.4 ± 14.4 months. Postoperatively, there was a statistically significant improvement in pain visual analog scale (VAS) scores (8.3 ± 1.3 to 1.63 ± 2.29; <i>P</i> < .0001) as well as American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment (42.7 ± 12.3 to 87.3 ± 19.0; <i>P</i> < .0001), Single Assessment Numeric Evaluation (SANE) (49.5 ± 18.9 to 91.9 ± 11.3; <i>P</i> < .0001), and Rowe instability (45.3 ± 12.5 to 89.3 ± 19.2; <i>P</i> < .0001) scores. There were no significant differences observed between pre- and postoperative range of motion. At final follow-up, 95% of patients met the minimal clinically important difference threshold for VAS, 89% for ASES, 92% for SANE, and 92% for the Rowe score; 58% met the substantial clinical benefit threshold for VAS, 61% for ASES, 11% for SANE, and 74% for Rowe scores; and 74% met the Patient Acceptable Symptom State threshold for VAS, 76% for ASES, 76% for SANE, and 74% for Rowe scores. At final follow-up, 89.5% of patients (n = 34) either returned to unrestricted duty or left the military for reasons other than continued shoulder-related disability, while 86.8% (n = 33) returned to unrestricted physical training. Two patients (5.3%) underwent reoperation, one requiring revision anterior labral repair and the other Latarjet after a traumatic dislocation of the operative shoulder.</p><p><strong>Conclusion: </strong>Arthroscopic 270° labral repair demonstrates favorable clinical outcomes at a minimum 10-year postoperative follow-up in an active-duty military patient population, with clinically and statistically significant improvements in pain, patient-reported outcomes measures, and an overall return-to-duty rate of 89.5%.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342592"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326485","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":"Defining Clinically Meaningful Subgroups in Patients Undergoing Arthroscopic Rotator Cuff Repair Using Unsupervised Machine Learning.","authors":"Yining Lu, Elyse J Berlinberg, Kareme Alder, Ethan Chervonski, Harsh H Patel, Morgan Rice, Adam B Yanke, Brian J Cole, Nikhil N Verma, Mario Hevesi, Brian Forsythe","doi":"10.1177/23259671251335977","DOIUrl":"10.1177/23259671251335977","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Outcomes after arthroscopic rotator cuff repair (RCR) are frequently measured through clinically significant outcomes (CSOs) such as the minimal clinically important difference, the substantial clinical benefit, and the Patient Acceptable Symptom State. Global achievement of CSOs is challenging to predict.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To determine if unsupervised machine learning can identify distinct patient subgroups based on CSO achievement after elective arthroscopic RCR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case-control study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospectively collected database was analyzed to identify patients who underwent elective arthroscopic RCR from 2015 to 2017. Tear dimensions were measured on magnetic resonance imaging utilizing a validated technique. CSO achievements on the American Shoulder and Elbow Surgeons, the Single Assessment Numeric Evaluation, and the Constant-Murley subjective score at 2-year follow-up were calculated. An unsupervised random forest algorithm was utilized to develop and internally validate patient subgroups with significantly different rates of CSO achievement. Patient subgroup membership, along with a total of 30 demographic and clinical variables, as well as preoperative patient-reported outcomes, were incorporated into a stepwise multivariable logistic regression to identify factors predictive of optimal CSO achievement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 346 patients (192 male; mean ± SD age, 57.2 ± 9.1 years; body mass index, 30.1 ± 5.4 kg/m&lt;sup&gt;2&lt;/sup&gt;) were eligible for inclusion and followed for a mean of 3.8 years (range, 2.0-6.2 years) Of these, a total of 333 patients were partitioned by the random forest algorithm into 2 subgroups (stability, 0.16; connectivity: 180.8; Dunn: 0.16; silhouette: 0.05), with 176 patients in the optimal achievement subgroup and 157 patients in the suboptimal achievement subgroup. The 2 subgroups differed significantly (all &lt;i&gt;P&lt;/i&gt;≤ .004) in the likelihood of achievement of all CSOs. Stepwise multivariable logistic regression identified an increase of 1 mm in tear size in the sagittal dimension beyond 1.9 cm to predict a 10% increase in the probability of suboptimal achievement. Additional risk factors for suboptimal CSO achievement included increasing number of tendons involved (odds ratio [OR], 14.07; 95% CI, 4.50-44.02; &lt;i&gt;P&lt;/i&gt; &lt; .001), subscapularis involvement (OR, 8.67; 95% CI, 2.45-30.71; &lt;i&gt;P&lt;/i&gt; = .01), and increased preoperative CMS score (OR, 1.11; 95% CI, 1.04-1.18; &lt;i&gt;P&lt;/i&gt; = .001). Protective factors included performance of a subpectoral biceps tenodesis compared with biceps tenotomy (OR, 0.22; 95% CI, 0.05-0.92; &lt;i&gt;P&lt;/i&gt; = .03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Clinically meaningful subgroups were uncovered using an unsupervised machine learning algorithm in patients undergoing arthroscopic RCR. Tear size, number of tendons involved, and subscapularis involvement were s","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251335977"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326486","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":"Global Acetabular Retroversion Is Associated With an Increased Risk of Conversion to Total Hip Arthroplasty After Primary Hip Arthroscopic Surgery: A Propensity Score-Matched Analysis With a Minimum 8-Year Follow-up.","authors":"Stephen M Gillinov, Jonathan S Lee, Bilal S Siddiq, Kieran S Dowley, Jeffrey S Mun, Zachary L LaPorte, Nathan J Cherian, Christopher T Eberlin, Frank J Simeone, Scott D Martin","doi":"10.1177/23259671251343840","DOIUrl":"10.1177/23259671251343840","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Global acetabular retroversion has been associated with an increased risk of hip osteoarthritis, femoroacetabular impingement, and intra-articular soft tissue abnormalities. However, the role of global acetabular retroversion on total hip arthroplasty (THA)-free survivorship has not been explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare long-term THA-free survivorship after primary hip arthroscopic surgery between patients with global acetabular retroversion and a propensity score-matched control group without global acetabular retroversion.&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 study examined patients aged ≥18 years with a minimum 8-year follow-up who underwent primary hip arthroscopic surgery by a single surgeon between May 2001 and September 2013 for the treatment of symptomatic labral tears secondary to femoroacetabular impingement. Patients with global acetabular retroversion, indicated by the combined presence of a crossover sign, ischial spine sign, and posterior wall sign on preoperative supine pelvic radiographs, were 1:1 propensity score matched by age, sex, body mass index, and labral treatment (repair vs debridement) to controls without global acetabular retroversion. Patient, radiographic, and intraoperative variables were compared between groups. Cox multivariate regression, controlling for global acetabular retroversion and Tönnis grade, was used to assess conversion to THA. Patient-reported outcome measure (PROM) scores were also compared between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 49 patients (49 hips) with global acetabular retroversion were 1:1 matched to 49 controls, with a mean follow-up of 10.7 ± 2.1 and 11.1 ± 2.8 years, respectively (&lt;i&gt;P&lt;/i&gt; = .524). There were no significant differences in patient characteristics and radiographic findings between groups. Patients with global acetabular retroversion had significantly greater rates of severe chondrolabral junction breakdown (&lt;i&gt;P&lt;/i&gt; = .010). Unadjusted Kaplan-Meier survival curves analyzed by the log-rank test demonstrated significantly decreased survivorship among patients with global acetabular retroversion (68.6%) compared with matched controls (83.9%) at final follow-up (&lt;i&gt;P&lt;/i&gt; = .036). Cox multivariate regression demonstrated that patients with global acetabular retroversion had a significantly greater risk of conversion to THA (hazard ratio, 3.94; &lt;i&gt;P&lt;/i&gt; = .039). There were no statistically significant differences in any PROM scores at final follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with global acetabular retroversion had significantly inferior THA-free survivorship at a minimum 8-year follow-up after hip arthroscopic surgery relative to matched controls as well as greater rates of severe chondrolabral junction breakdown, despite no statistically significant differences in PROM scores at final follow-up among patients","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343840"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Shoulder Morphological Changes and Glenohumeral Maximum External Rotation During Late Cocking Phase.","authors":"Makoto Takahashi, Hirotaka Mutsuzaki, Koji Iwamoto, Masahiko Monma, Makoto Nejishima, Tomoki Ono, Hiroshi Inami, Masahiro Takemura, Takashi Kawamura, Kazuhide Tomita","doi":"10.1177/23259671251343232","DOIUrl":"10.1177/23259671251343232","url":null,"abstract":"<p><strong>Background: </strong>Excessive external rotation of the glenohumeral joint during the late cocking phase of throwing is a factor in internal impingement; however, the relationship between maximum external rotation (MER) of the glenohumeral joint and morphological changes in the shoulder joint is unclear.</p><p><strong>Purpose: </strong>To clarify whether glenohumeral MER is associated with quantified assessment of morphological changes in the throwing shoulder joint.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>This study included 15 male university and adult baseball players from a competitive team. The posterior glenohumeral distance (mm) and area of impingement (mm²), reflecting morphological changes in the shoulder joint, were measured using open magnetic resonance imaging. The percent posterior glenohumeral distance (%PGHD) and percent area of impingement (%AOI) were calculated as these values of the throwing shoulder divided by those of the nonthrowing shoulder. With a 3-dimensional motion analysis system, bar markers were affixed to the acromion and humerus, and the glenohumeral MER angle was measured.</p><p><strong>Results: </strong>Simple linear regression analysis revealed that the glenohumeral MER angle was associated with the %PGHD (β coefficient = 0.685; <i>P</i> = .005) and %AOI (β coefficient = 0.754; <i>P</i> = .001).</p><p><strong>Conclusion: </strong>The glenohumeral MER angle was associated with the %PGHD and %AOI, which reflects morphological shoulder-joint changes.</p><p><strong>Clinical relevance: </strong>Assessment of excessive external rotation of the glenohumeral joint during the late cocking phase contributes to the understanding of morphological changes in the shoulder joint and related throwing injuries.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343232"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326484","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":"Improved Midterm Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in the Setting of a Previous Slipped Capital Femoral Epiphysis.","authors":"Adam H Kantor, Allan K Metz, Collin D R Hunter, Reece M Rosenthal, Ameen Z Khalil, Devin L Froerer, Travis G Maak, Stephen K Aoki","doi":"10.1177/23259671251342579","DOIUrl":"10.1177/23259671251342579","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hip arthroscopy after in situ fixation of a slipped capital femoral epiphysis (SCFE) is used to treat postoperative disability that develops from metaphyseal cam deformity after pinning. Short-term follow-up has demonstrated excellent outcomes in patients treated for SCFE with subsequent hip arthroscopy. Midterm follow-up of these patients has been sparse and rarely reported in the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate the midterm clinical and functional outcomes of patients undergoing hip arthroscopy after SCFE in situ fixation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case series; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with SCFE who underwent subsequent hip arthroscopy for femoroacetabular impingement (FAI) were enrolled in a prospective database. Inclusion criteria were a primary diagnosis of residual post-SCFE deformity and subsequent surgical treatment for FAI &gt;1 year before the start date of the study. Patients were excluded if they were unable to be contacted. Participants were sent a survey that included physical function (Patient-Reported Outcomes Measurement Information System [PROMIS]) and Likert-style questions assessing disability and satisfaction. Patient charts were retrospectively reviewed for patient characteristics, visual analog scale (VAS) pain scores, and a modified Harris Hip Score (mHHS) from the postfixation but prearthroscopy period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 63 patients receiving hip arthroscopy after treatment for SCFE, 41 patients met the inclusion criteria and 34 completed the midterm follow-up survey (54.0% response rate). The mean duration of follow-up was 6.17 years. Patient subjective outcomes demonstrated that 88.3% of patients reporting being satisfied or very satisfied with their surgical result. The mean preoperative baseline mHHS was 67.43, indicating poor functional status. The mean midterm follow-up PROMIS-PF &lt;i&gt;T&lt;/i&gt; score for this cohort was 50.81, indicating a slight overall improvement for the study cohort's functional status when compared with the general population. The mean VAS pain score at rest was 5.09 preoperatively and 1.91 at midterm follow-up. The mean postarthroscopy iHOT-12 score was 68.27 (SD, 28.58), indicating greater quality of life postoperatively, with 20 patients (59%) obtaining a Patient Acceptable Symptom State (PASS) and a revision rate of 15%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of the first midterm follow-up of patients undergoing hip arthroscopy after surgical pinning of SCFE demonstrate improved functional and clinical objective outcomes compared with preoperative scores. These patients demonstrated poor functional status preoperatively but average or above-average functional status at the midterm follow-up postoperatively. Additionally, 20 patients (58.8%) obtained a PASS and a revision rate of 15%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Arthroscopic treatment of post-SCFE FAI rep","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342579"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326488","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":"Pitching Kinematics and Kinetics Related to the Elbow Joint Load in Young Female Baseball Players: A Comparison With Young Male Baseball Players.","authors":"Katsutoshi Nishino, Noriaki Yamamoto, Naoto Okamura, Hiroyuki Sekine, Yasuo Tanaka, Takeyuki Nishizawa, Masaei Tanaka, Mutsuaki Edama, Go Omori","doi":"10.1177/23259671251343795","DOIUrl":"10.1177/23259671251343795","url":null,"abstract":"<p><strong>Background: </strong>Because the population of female baseball players has been increasing worldwide in recent years, it is important for female players to reduce the risk of elbow joint injuries, which occur frequently in baseball pitching. Although many biomechanical studies related to baseball pitching have clarified elbow joint loads, the participants in most of these studies were male baseball players, necessitating the expansion of investigations to female baseball players, particularly young female players.</p><p><strong>Purpose: </strong>The objective of the present study was to elucidate the pitching mechanics related to the elbow joint load in young female players by comparing them with young male players.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Overall, 295 participants, comprising 49 young female baseball players (mean age, 13.9 ± 2.0 years) and 246 young male baseball players (mean age, 14.3 ± 2.2 years), were included in the present study. Fastball pitching in the overhead style was assessed 3-dimensionally using a motion capture system and force plates. The pitching kinematics and kinetics were calculated, and sex differences were analyzed. Furthermore, multiple regression analysis evaluated the pitching kinematics and kinetics related to elbow varus moment (EVM).</p><p><strong>Results: </strong>Stride, shoulder kinematics, EVM, ground-reaction forces, and ball velocity in the pitching of young female players were significantly lower than those in young male players. On multiple regression analysis, EVM in the pitching of young female players was associated with shoulder kinematics, and contrastingly, EVM in the pitching of young male players was related to ground-reaction force with respect to the lower body.</p><p><strong>Conclusion: </strong>Although the pitching kinematics and kinetics in young female players were significantly lower than those in young male players, as in previous studies on adults, the pitching kinematics and kinetics that cause increases in the elbow joint load had a sex difference, and those in young female players depended on shoulder kinematics. This finding suggests that the mechanism of pitching injuries in young female players may differ from that in young male players.</p><p><strong>Clinical relevance: </strong>Young female baseball players ought to learn proper pitching mechanics to reduce the injury risk, and the approach for learning in young female players should be different from that in young male players.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343795"},"PeriodicalIF":2.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326489","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":"Subcoracoid Cyst: A Possible Predictive Marker for Postoperative Retears of Rotator Cuff After Arthroscopic Repair.","authors":"Mehmet Akan, Muhlik Akyürek, Emre Koraman, Yusuf İyetin, İsmail Türkmen","doi":"10.1177/23259671251341914","DOIUrl":"10.1177/23259671251341914","url":null,"abstract":"<p><strong>Background: </strong>Subcoracoid cysts (ScCs) are often associated with rotator cuff tears, but their relationship with rotator cuff retears remains unclear.</p><p><strong>Purpose: </strong>To investigate the correlation between ScCs and retears in patients having undergone arthroscopic rotator cuff repair.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent arthroscopic rotator cuff repair from November 2016 to March 2022. Patients with Patte stage 1 or 2 tears were included. Preoperative magnetic resonance imaging (MRI) assessed subscapularis and supraspinatus tendons, biceps pulley, and ScC volume. Postoperative MRI evaluated the same parameters as preoperative MRI, with the addition of rotator cuff retear assessment. On the basis of preoperative MRI, patients were classified into group A (with cyst) and group B (without cyst). According to postoperative MRI, groups were further divided into A1 (without retear), A2 (with retear), B1 (without retear) and B2 (with retear). Postoperative decrease in ScC volume (ScC delta), Sugaya classification, and Constant score were compared.</p><p><strong>Results: </strong>The study included 109 patients: 69 in group A (A1 = 40, A2 = 29) and 40 in group B (B1 = 35, B2 = 5). The retear rate was significantly higher in group A (34.8%) than in group B (12.5%) (<i>P</i> = .02). In group A, the median (minimum-maximum) ScC delta value was significantly greater in group A1 (2422 mm³ [257 to 7503 mm³]) compared with group A2 (625 mm³ [-1060 to 1978 mm³]), indicating no recurrence of the ScC (<i>P</i> = .03). Postoperative Constant shoulder scores were higher in the no retear groups (group A1, 79.3 ± 8.2; group A2, 66.2 ± 13.4; group B1, 83.2 ± 8.5; group B2, 61.4 ± 5.9) (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>For the patients with ScCs detected on preoperative MRI scans, preserved tendon integrity after rotator cuff repair was associated with a reduction in ScC volume. This reduction was evident on postoperative MRI scans when compared with preoperative measurements. Conversely, compromised tendon integrity did not lead to a significant reduction in ScC volume after surgery, potentially suggesting cyst reformation. Therefore, the postoperative identification of an ScC may indirectly indicate rotator cuff retear.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341914"},"PeriodicalIF":2.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326490","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 Formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT Initiative Part II-Prevention, Nonoperative Treatment and Return to Sport.","authors":"Robert Prill, C Benjamin Ma, Stephanie E Wong, Philippe Beaufils, Joan C Monllau, Elanna K Arhos, Roland Becker, Francesco Della Villa, J Brett Goodloe, James J Irrgang, Jitka Klugarova, Emma L Klosterman, Aleksandra Królikowska, Aaron J Krych, Robert F LaPrade, Robert Manske, Nicky van Melick, Jill K Monson, Marko Ostojic, Mark V Paterno, Tomasz Piontek, Simone Perelli, Alexandre Rambaud, James Robinson, Laura C Schmitt, Eric Hamrin Senorski, Thorkell Snaebjornsson, Adam J Tagliero, Airelle O Giordano, Nicolas Pujol","doi":"10.1177/23259671251349553","DOIUrl":"10.1177/23259671251349553","url":null,"abstract":"<p><strong>Purpose: </strong>Part II of this consensus aimed to provide recommendations for the prevention of meniscus injuries, nonoperative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures.</p><p><strong>Methods: </strong>This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA-American Orthopedic Society for Sports Medicine (AOSSM)-American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1-9). Final documents were assessed by an international peer review group for geographical adaptability.</p><p><strong>Results: </strong>Low to moderate scientific level of evidence was available, so that grades of recommendations were low (3 Grade A ratings, 4 Grade B, 3 Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8-9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programs and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and timebased. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process.</p><p><strong>Conclusion: </strong>This international EU-US consensus established recommendations for prevention strategies, describes rehabilitation of nonoperated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists.</p><p><strong>Level of evidence: </strong>Level I, consensus.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251349553"},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302646","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":"Increased Length of Surgery Is Associated With Increased Fluid Pump Pressure During Hip Arthroscopy.","authors":"Nicholas A Felan, Matthew J Kraeutler, Carson Keeter, Ben Mei-Dan, Kyle Jamar, Jessica H Lee, Omer Mei-Dan","doi":"10.1177/23259671251342584","DOIUrl":"10.1177/23259671251342584","url":null,"abstract":"<p><strong>Background: </strong>Elevated fluid pump pressures during hip arthroscopy have been associated with surgical complications including fluid extravasation, abdominal compartment syndrome, and higher use of pain medication.</p><p><strong>Purpose: </strong>To demonstrate the safe use of low pump pressures and to identify factors associated with the need for increased fluid pump pressure during hip arthroscopy.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective review was performed on all patients who underwent hip arthroscopy by a single surgeon between 2020 and 2021. Patients maintaining a pump pressure ≤20 mm Hg during surgery were assigned to group A, and patients who required a pump pressure >20 mm Hg at any point during surgery were assigned to group B. Univariate and multivariate analyses were performed to assess for relationships between elevated pump pressure (>20 mm Hg) during hip arthroscopy and the patient's age, sex, length of surgery, body mass index, Beighton hypermobility score, lateral center edge angle, alpha angle, Tegner activity score, femoral shaft torsion angle, highest systolic blood pressure during surgery, number of suture anchors, and the presence of medical comorbidities (ie, hypertension, clotting disorder, or diabetes mellitus).</p><p><strong>Results: </strong>A total of 103 patients (112 hips) were included. Group A consisted of 77 hips (54 female, 23 male) with a mean age of 33.3 years. Group B consisted of 35 hips (19 female, 16 male) with a mean age of 33.6 years. Multivariate regression analysis revealed that mean length of surgery was associated with a need to increase pump pressure (<i>P</i> < .001). On average, for every 1-minute increase in surgery duration, the odds of needing an increase in pump pressure increased by 2.0%. In addition, highest systolic blood pressure during surgery and number of anchors were associated with an elevated pump pressure on univariate analysis (<i>P</i> = .026 and <i>P</i> < .001, respectively).</p><p><strong>Conclusion: </strong>For a majority of patients who underwent hip arthroscopy, a pump pressure of 20 mm Hg resulted in adequate visualization for the duration of the case. Increased length of surgery was associated with an elevated pump pressure during hip arthroscopy.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342584"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302644","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 Arthroscopic Posterior Labral Repair With All-Suture Anchors in Football Players.","authors":"Daniel J Smigielski, Matthew P Ithurburn, Tomas F Vega, Alexander E Loeb, Sai Reddy, Trace Naman, Anna E Crawford, Campbell B Aiken, Ariel L Kidwell-Chandler, Cristian Arceo, Ryan Froom, Andrew Atkinson, Marcus A Rothermich, Benton A Emblom, Jeffrey R Dugas, E Lyle Cain","doi":"10.1177/23259671251343646","DOIUrl":"10.1177/23259671251343646","url":null,"abstract":"<p><strong>Background: </strong>Posterior glenoid labral injuries are more common in football players than in the general population. Arthroscopic repair with all-suture anchors has proven to be an effective technique to address other abnormalities, allowing for low-profile constructs that minimize damage to surrounding tissue. Few studies have examined the outcomes of posterior labral repair with all-suture anchors in football players.</p><p><strong>Hypothesis: </strong>It was hypothesized that after labral repair with all-suture anchors, functional outcomes would improve, revision rates would be low, return-to-sport rates would be high, and clinical outcomes would be comparable with those seen after arthroscopic repair performed with traditional solid anchors among football players.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>The authors identified patients in the institution's ongoing data repository who were football players when they underwent arthroscopic posterior glenoid labral repair using all-suture anchors. The authors collected baseline (preoperative) and follow-up demographic, clinical, surgical, and functional outcome data, with a minimum follow-up time of 2 years. Patient-reported outcome measures included the American Shoulder and Elbow Surgeons (ASES) score and the Western Ontario Shoulder Instability Index (WOSI).</p><p><strong>Results: </strong>The authors identified 52 male football athletes (mean age at surgery, 18.5 years) with both baseline and follow-up data (mean follow-up time, 3.8 years), with all competing at either the high school (n = 41 [79%]) or collegiate (n = 11 [21%]) level. Mean outcome scores improved significantly from baseline to follow-up for both the ASES score (baseline: 63.2; follow-up: 97.1) and the WOSI (baseline: 48.1; follow-up: 94.0). Overall, 37 of 52 (71%) returned to football at their preinjury level after surgery. However, only 38 of 52 athletes attempted to return to sport. Among athletes who attempted to return to sport, 97% (37/38) were able to return. There were no significant differences in follow-up ASES or WOSI scores between high school and collegiate athletes, between blocking and nonblocking positions, or between isolated posterior labral repair and combined labral repair.</p><p><strong>Conclusion: </strong>The results demonstrated excellent outcomes, including large and significant improvements in ASES and WOSI scores, in football players. While 29% did not return to football, 97% of those who attempted to return to play did so at their preinjury level. This study shows encouraging results for the use of all-suture anchors for posterior labral repair in this population of athletes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343646"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302645","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}