Orthopaedic Journal of Sports Medicine最新文献

{"title":"Passive Laxity With Functional Stability Reveals Potential Bilateral Dynamic Compensatory Mechanisms in Patients Undergoing ACL Reconstruction at Long-term Follow-up.","authors":"Jillian E Beveridge, Madalyn Hague, Meggin Q Costa, Lauren R Parola, Janine Molino, Braden C Fleming","doi":"10.1177/23259671251414857","DOIUrl":"10.1177/23259671251414857","url":null,"abstract":"<p><strong>Background: </strong>Knee stability can be conferred passively by ligaments and menisci and actively by the neuromuscular system. We sought to determine the relationship between passive tibiofemoral alignment and dynamic constraint in patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) and matched control participants who have been followed for more than a decade.</p><p><strong>Purpose/hypothesis: </strong>It was hypothesized that (1) anterior tibial position would be greater in the surgical knee compared to the contralateral knee and when compared to knees of control participants, and (2) the surgical limb differences would be greater in the dynamic state during a 1-leg hop-for-distance landing task.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 21 participants were recruited from a recently completed longitudinal clinical trial (NCT00434837): 10 patients who had undergone ACLR 10 to 15 years earlier and 11 matched control participants without knee injury. The 3-dimensional (3D) tibiofemoral position was extracted from each participant's computed tomography images as a measure of passive alignment. Dynamic 3D knee kinematics were recorded using biplane videoradiography during the landing of a 1-leg hop-for-distance activity. Side-to-side differences in knee kinematics between limbs were used as a measure of dynamic constraint. Peak anterior tibial position was the primary outcome measure, and peak anterior tibial position as a function of flexion angle was the secondary outcome measure.</p><p><strong>Results: </strong>The passive tibial position of patients with ACLR was 7.5 ± 2.3 mm more anterior compared to that of uninjured participants and 3.1 ± 1.1 mm more anterior than their contralateral limb (<i>P</i> < .05). The mean peak dynamic anterior position was not different between surgical and contralateral limbs in ACLR patients (<i>P</i> = .83). When anterior position was explored as a function of flexion angle, peak anterior tibial position was up to 10.3 mm greater in the ACLR surgical limbs (<i>P</i> = .01) and 7.5 mm in the contralateral limbs (<i>P</i> = .001) compared to the limbs of control participants.</p><p><strong>Conclusion: </strong>Passive alignment is abnormal long after ACLR, whereas side-to-side dynamic constraint is largely restored, but with a persistent bias toward greater anterior tibial position that is present bilaterally.</p><p><strong>Clinical relevance: </strong>Compared with similar studies at earlier postoperative time points, the results at long-term follow-up suggest that ACL graft function deteriorates with time, which can be compensated for to some degree by the neuromuscular system.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671251414857"},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Revision UCL Repair With Internal Brace for Failure of Primary UCL Reconstruction in Professional and Collegiate Baseball Pitchers: A First Look.","authors":"George J Richard, Anna E Crawford, Ryan J Froom, Sydney M Carlson, Andrew W Atkinson, Eric A Mussell, Eva Dreiling, Campbell Aiken, Kevin E Wilk, Glenn S Fleisig, Matthew P Ithurburn, Jeffrey R Dugas","doi":"10.1177/23259671261422231","DOIUrl":"10.1177/23259671261422231","url":null,"abstract":"<p><strong>Background: </strong>Injury of the ulnar collateral ligament (UCL) is common in baseball players. Pitchers are most commonly affected and most likely to have surgery for this injury. The gold standard surgical treatment is UCL reconstruction with autograft; yet, UCL repair with collagen-coated suture tape (ie, internal brace) has shown to be equally effective, and both procedures demonstrate high rates of return to sport and similar postoperative elbow function. However, revision UCL reconstructions have less favorable outcomes regardless of technique.</p><p><strong>Purpose: </strong>This pilot case series reports on short-term outcomes of collegiate or professional baseball pitchers whose primary UCL reconstruction failed and who subsequently underwent revision UCL repair with internal brace.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A retrospective billing query was performed for patients who had undergone revision UCL repair with internal brace. Patients were eligible for inclusion if they were a pitcher at the collegiate or professional level, were at least 1 year postoperative after revision UCL repair with internal brace, and had a history of ipsilateral primary UCL reconstruction. Clinical and surgical data were collected via electronic medical record review. Outcomes data included return to sport as well as elbow-related function from the American Shoulder and Elbow Surgeons elbow form, Kerlan-Jobe Orthopaedic Clinic score, and Andrews-Carson score.</p><p><strong>Results: </strong>A total of 11 pitchers met inclusion criteria (45% professional and 55% collegiate) and had follow-up data collected (mean follow-up time, 2.9 years; range, 1.0-5.0 years). All 11 (100%) were able to return to sport at the preinjury level or higher, and the mean time from surgery to return to competition was 9 months. At follow-up, the mean function score of the American Shoulder and Elbow Surgeons elbow form was 35.8 (out of 36), the mean Kerlan-Jobe Orthopaedic Clinic score was 88.3 (out of 100), and the mean Andrews-Carson score was 95.0 (out of 100).</p><p><strong>Conclusion: </strong>This pilot case series shows promising short-term results of using UCL repair with internal brace for high-level pitchers with recurrent UCL injury after UCL reconstruction. Specifically, we found excellent return-to-sport and patient-reported outcomes. Further study is warranted with larger sample sizes and longer follow-up to evaluate outcomes after revision of UCL surgery with UCL repair utilizing internal bracing.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422231"},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723393","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":"Kinematic and Kinetic Variables Associated With the Contralateral Knee Adduction Moment During Walking After Medial Open-Wedge High Tibial Osteotomy.","authors":"Koji Ikematsu, Hiroki Katagiri, Takehiro Ohmi, Midori Miyazaki, Masaki Amemiya, Jae-Sung An, Hideyuki Koga, Tetsuya Jinno, Tomoko Sakai","doi":"10.1177/23259671261422229","DOIUrl":"10.1177/23259671261422229","url":null,"abstract":"<p><strong>Background: </strong>In patients undergoing medial open-wedge high tibial osteotomy (MOWHTO), the contralateral knee adduction moment (KAM) increases significantly postoperatively, indicating an increased risk of knee osteoarthritis. However, the factors associated with an increased KAM on the nonoperated side remain unexplored.</p><p><strong>Purpose: </strong>To identify the factors associated with KAM changes on the nonoperated side before and after MOWHTO.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Thirty participants scheduled to undergo MOWHTO were recruited between August 2020 and November 2022. Physical findings and knee alignment were assessed preoperatively and 1 to 2 years postoperatively with 3-dimensional gait analysis. Gait data were collected with a 3-dimensional motion analysis system and 2 force plates. Multiple regression analysis was performed to identify the factors associated with changes in the first and second KAM peaks on the nonoperated side after MOWHTO.</p><p><strong>Results: </strong>The hip adduction moment on the nonoperated side (standard partial regression coefficient [SPRC], 0.45; <i>P</i> = .008; 95% CI, 0.37-2.29) and knee adduction angle on the nonoperated side (SPRC, 0.34; <i>P</i> = .041; 95% CI, 1.66-71.41) were significantly associated with the first KAM peak on the nonoperated side (<i>R</i> ² = 0.31). Hip adduction moment on the nonoperated side (SPRC, 0.56; <i>P</i> = .001; 95% CI, 0.58-1.97) and frontal pelvic obliquity angle (SPRC, 0.32; <i>P</i> = .040; 95% CI, 0.30-12.25) were significant factors associated with the second KAM peak on the nonoperated side (<i>R</i> ² = 0.48).</p><p><strong>Conclusion: </strong>Changes in the first and second KAM peaks on the nonoperated side were significantly associated with surrounding alignment and joint moments during gait. In post-MOWHTO gait, controlling the knee adduction angle during the initial stance phase and contralateral pelvic drop during the terminal stance phase may be associated with a reduced risk of KOA development on the nonoperated side.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422229"},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723387","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":"Postoperative Results of Posterior Ankle Impingement Syndrome in Athletes and Its Clinical Features.","authors":"Hideaki Nagamoto, Tomohiro Matsui, Hiroki Yabiku, Toshihiro Maemichi, Takeshi Sugimoto, Yasuyoshi Mase, Takanori Saito, Tsukasa Kumai","doi":"10.1177/23259671261422259","DOIUrl":"10.1177/23259671261422259","url":null,"abstract":"<p><strong>Background: </strong>Studies on posterior ankle impingement syndrome (PAIS) that focus on clinical features, characteristics, and surgical outcomes are limited.</p><p><strong>Purpose: </strong>To investigate postoperative outcomes of PAIS and identify the factors affecting it.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Demographic data, participating sports, the competing level of the sport, the source of pain, and concomitant pathologies were reviewed in 267 ankle samples from 240 athletes. For surgical cases, the following data were reviewed: preoperative pain duration, pre- and postoperative scores on the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, and time of return to training (RTT) and return to sports (RTS). Comparisons were statistically analyzed (1) between pre- and postoperative scores on the JSSF scale, (2) for the difference in RTT/RTS between sources of pain (bony vs soft tissue) and among sports and competition levels, and (3) for the relationship between preoperative pain duration and RTT/RTS.</p><p><strong>Results: </strong>The most common sports were ballet, followed by soccer, rugby, baseball, basketball, and swimming/water polo. Ankles of student athletes (mean ± SD age, 17.2 ± 2.6 years; range, 12-22) were the most commonly affected. The source of pain was bony impingement in 221 ankles (82.8%). The most common concomitant pathology was tenosynovitis of the flexor hallucis longus. A total of 147 ankles (55.1%) in 125 athletes were treated surgically. The preoperative JSSF scale score of 83.9 points significantly improved postoperatively to 99.4 points (<i>P</i> < .00001). RTT and RTS did not differ significantly between sources of pain and among sports and competition levels. The duration of preoperative pain was significantly correlated positively with RTT and RTS (<i>P</i> = .009 and <i>P</i> < .001, respectively).</p><p><strong>Conclusion: </strong>PAIS has been observed in many sports and is often associated with flexor hallucis longus-related pathologies, caused mainly by bony impingement. The preoperative pain duration was positively related to RTT and RTS. Surgical treatment of PAIS improves symptoms in most patients.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261422259"},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723440","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":"Relationships Among Bone Marrow Lesions, Cartilage Improvement, and Short- to Midterm Patient-Reported Outcomes After Opening-Wedge High Tibial Osteotomy.","authors":"Kosuke Kawamura, Eiji Sasaki, Takahiro Tsushima, Kyota Ishibashi, Hikaru Ishibashi, Yukiko Sakamoto, Yuka Kimura, Yasuyuki Ishibashi","doi":"10.1177/23259671261425635","DOIUrl":"10.1177/23259671261425635","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow lesions (BMLs) are associated with knee pain and predict structural changes and joint replacement. Their significance in the context of opening-wedge high tibial osteotomy (OWHTO) is, however, unclear.</p><p><strong>Purpose: </strong>To investigate whether preoperative BMLs are associated with cartilage regeneration-like tissue and postoperative patient-reported outcomes after OWHTO and to evaluate how 1-year changes in BMLs (ΔBML) relate to these outcomes.</p><p><strong>Study design: </strong>Cohort study: Level of evidence, 3.</p><p><strong>Methods: </strong>In this retrospective study, 138 knees underwent arthroscopy during OWHTO, and 85 knees underwent follow-up arthroscopy. Participants also completed questionnaires and underwent magnetic resonance imaging (MRI). Cartilage status at the medial femoral condyle (MFC) and medial tibial plateau (MTP) was evaluated using the International Cartilage Research Society (ICRS) grading system during initial and follow-up arthroscopies to assess improvement after OWHTO. Postoperative outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). BMLs were scored according to the MRI Osteoarthritis Knee Score, and ΔBML was calculated.</p><p><strong>Results: </strong>The preoperative BML score weakly correlated with the initial ICRS grade at the MFC (<i>r</i> = 0.306; <i>P</i> < .001) and MTP (<i>r</i> = 0.353; <i>P</i> < .001). At the MTP, a preoperative smaller BML score was significantly associated with cartilage improvement (<i>P</i> = .030). In addition, preoperative large BML significantly correlated with improvement in ΔBML scores at the MFC (<i>r</i> = 0.643; <i>P</i> < .001) and the MTP (<i>r</i> = 0.757; <i>P</i> < .001). Regression analysis demonstrated that postoperative valgus alignment and low body mass index (BMI) were correlated with cartilage improvement in MFC; in contrast, cartilage improvement in MTP was correlated with low BMI, preoperative higher ICR grade, and a smaller preoperative BML. Also, improvement in BML scores on MTP was correlated with better KOOS symptoms 1 year after high tibial osteotomy (HTO) (<i>P</i> = .045).</p><p><strong>Conclusion: </strong>Smaller preoperative BMLs were associated with greater postoperative cartilage improvement in MTP after OWHTO. Furthermore, BML improvement was significantly related to better knee symptoms in short- to midterm patient-reported outcomes after OWHTO.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261425635"},"PeriodicalIF":2.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723407","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":"Advanced Analytic and Pitch-Tracking Risk Factors for Capsulolabral Injuries in Major League Baseball Pitchers.","authors":"Michael A Mastroianni, Morgan R Dillon, Kyle K Obana, Cole R Morrissette, Nicholas Frappa, Andrew J Luzzi, Frank J Alexander, Michael L Knudsen, Christopher S Ahmad","doi":"10.1177/23259671261425670","DOIUrl":"https://doi.org/10.1177/23259671261425670","url":null,"abstract":"<p><strong>Background: </strong>Shoulder instability is a significant cause of disability in pitchers. The advent of advanced pitch-tracking technology now provides an opportunity to investigate the mechanical factors associated with these injuries on a large scale in Major League Baseball (MLB).</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to identify preinjury advanced analytic and pitch-tracking metrics associated with surgically treated shoulder instability in MLB. It was hypothesized that pitchers requiring surgery would demonstrate distinct preinjury profiles in advanced performance analytics and Statcast data compared with matched controls.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>MLB pitchers who underwent primary capsulolabral repair from 2017 to 2024 (n = 35) were identified using public web sources used in previous studies. Each case was matched 2:1 with uninjured control pitchers (n = 70) based on age, role, handedness, season, and total pitch count. Advanced analytic and various pitch-tracking metrics were compiled from MLB-sponsored databases commonly used in player evaluation and prior research. The statistical analysis included unpaired <i>t</i> tests to compare groups and binary logistic regression to identify risk factors.</p><p><strong>Results: </strong>MLB pitchers who underwent capsulolabral surgery demonstrated superior preinjury performance metrics (including the FanGraphs version of wins above replacement [fWAR], fielding independent pitching [xFIP], expected earned run average [xERA], Stuff+, and walks plus hits per inning pitched) and pitch characteristics (including fastball velocity and spin rate), along with a more medial release point compared with controls. Binary logistic regression identified both Stuff+ and a medial release point as independent factors associated with surgery. Notably, the composite Stuff+ metric demonstrated a stronger association than velocity or spin rate alone in the final model (<i>P</i> < 05 for all significant factors).</p><p><strong>Conclusion: </strong>Several modern advanced analytic and pitch-tracking metrics were looked at as potential risk factors for shoulder instability in MLB pitchers for the first time. Pitchers who underwent capsulolabral surgery were more likely to throw harder with higher spin rates and a more medialized release point than matched controls. Overall, MLB pitchers who were more effective and had superior Stuff+ were at the highest risk for shoulder instability requiring surgical intervention. These findings point to a potential trade-off in modern pitching; the pursuit of elite performance is linked to a greater likelihood of injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261425670"},"PeriodicalIF":2.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723389","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":"Superficial Quadriceps Versus Hamstring Tendon Grafts for Medial Patellofemoral Ligament Reconstruction: A 2-Center Comparative Study.","authors":"Burak Menderes Akdoğan, Fatih Barça, Şahan Güven, Emre Tam, Ekin Barış Demir, Mutlu Akdoğan, Enejd Veizi, Halis Atıl Atilla","doi":"10.1177/23259671261425632","DOIUrl":"https://doi.org/10.1177/23259671261425632","url":null,"abstract":"<p><strong>Background: </strong>Medial patellofemoral ligament (MPFL) reconstruction is an established treatment for recurrent patellar instability. Techniques requiring patellar drilling (tunnels or sockets for fixation) may increase the risk of iatrogenic patellar fracture.</p><p><strong>Purpose/hypothesis: </strong>The purpose was to compare clinical outcomes and complications after MPFL reconstruction using a superficial quadriceps tendon (QT) graft versus a hamstring tendon (HT) graft) fixed with patellar all-suture anchors. It was hypothesized that the superficial QT technique would yield patient-reported outcomes comparable with the HT technique, with a different profile of patella-related complications.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective, 2-center review identified 47 patients (49 knees) who underwent MPFL reconstruction for recurrent patellar instability. A total of 23 knees were reconstructed with a patellar tunnel-free superficial QT graft and 26 with an HT graft fixed to the patella using suture anchors and to the femur at the Schöttle point. Patients with prior patellar surgery, periarticular fractures, or insufficient follow-up were excluded. Preoperative radiographic parameters and patient-reported outcomes (Kujala, Lysholm, Tegner, and visual analog scale [VAS] for pain) were recorded. The primary outcome was the Kujala score at final follow-up; secondary outcomes included other scores and complications (recurrent instability, patellar fracture, positive apprehension, and range-of-motion limitation).</p><p><strong>Results: </strong>Groups were comparable in demographics and radiographic measures at baseline. The mean follow-up duration was 59.8 months in the QT group and 50.7 months in the HT group. No significant between-group differences were observed in Kujala, Lysholm, Tegner, or VAS pain scores (all <i>P</i> > .05). Overall complication rates were similar (21.7% vs 15.4%). Complications included redislocation, positive apprehension, flexion limitation, and 1 patellar fracture in the HT group. Patients who developed postoperative complications had lower clinical scores, irrespective of graft type.</p><p><strong>Conclusion: </strong>Superficial quadriceps and HT autografts provide similarly favorable clinical outcomes and complication rates in MPFL reconstruction. No patellar fractures occurred in the QT group; however, fracture rates were not statistically different between groups and the study was underpowered for rare events. The QT technique avoids patellar drilling and may be considered in patients perceived to be at higher risk for patellar fracture.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261425632"},"PeriodicalIF":2.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Braided and Nonbraided Hamstring Tendon Grafts in ACL Reconstruction: Impact on Graft Thickness, Rerupture Rates, and Clinical Outcomes.","authors":"Nihat Demirhan Demirkıran, Gustavo Vinagre, Süleyman Kaan Öner, Umur Batak, Gonzalo Samitier Solís","doi":"10.1177/23259671261421598","DOIUrl":"https://doi.org/10.1177/23259671261421598","url":null,"abstract":"<p><strong>Purpose: </strong>To compare braided and nonbraided hamstring tendon grafts in anterior cruciate ligament (ACL) reconstruction, specifically examining graft thickness, rerupture rates, and clinical outcomes, in order to assess whether braided grafts offer measurable advantages.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective study included 154 patients who underwent single-bundle ACL reconstruction between January 2017 and October 2022. Patients were divided into braided (n = 78) and nonbraided (n = 76) hamstring autograft groups. Graft diameter was measured intraoperatively at the midportion using calibrated sizing tubes after standardized preconditioning. The cohort was predominantly male (92.2%). Primary outcomes included graft diameter, rerupture rates, and Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and Lysholm score at baseline and 6, 12, and 24 months. Comparative analysis used the Mann-Whitney <i>U</i> test for continuous data and Fisher exact test for categorical data. Kaplan-Meier curves were used descriptively to illustrate rerupture-free survival.</p><p><strong>Results: </strong>Braided grafts showed a greater mean diameter (9.39 ± 0.63 mm) compared with nonbraided grafts (8.87 ± 0.74 mm) (<i>P</i> < .001) and a numerically lower rerupture rate (2/78 [2.6%] vs 6/76 [7.9%]); however, this difference did not reach statistical significance (Fisher exact test, <i>P</i> = .16; fragility index = 1). Functional outcomes (KOOS, IKDC, Lysholm) improved over time in both groups, with no statistically significant between-group differences at 2 years.</p><p><strong>Conclusion: </strong>Braided hamstring tendon grafts reliably achieved increased graft thickness, whereas the lower rerupture rate was numerical only, was not statistically significant, and was statistically fragile. Braiding can be considered an intraoperative option to optimize graft diameter without compromising clinical outcomes, but the findings should be interpreted as exploratory.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261421598"},"PeriodicalIF":2.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699492","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 Microfracture for Focal Glenoid Osteochondral Lesions in Young Active-Duty Military Patients: A Minimum 10-Year Follow-Up.","authors":"Erel Ben-Ari, Clare K Green, John P Scanaliato, Alexis B Sandler, Ron Gilat, John R Tyler, Nata Parnes","doi":"10.1177/23259671261419510","DOIUrl":"https://doi.org/10.1177/23259671261419510","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glenoid osteochondral defects (OCDs), while uncommon, are a recognized source of shoulder pain and dysfunction, particularly in young, active individuals. Arthroscopic microfracture (MFx) is a commonly used surgical option. However, long-term outcomes remain poorly defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate long-term clinical and functional outcomes after arthroscopic MFx for focal glenoid OCD in active-duty military patients.&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;A retrospective review was conducted of 31 active-duty military patients (&lt;54 years) who underwent arthroscopic MFx for focal, full-thickness (Outerbridge grade 4) glenoid OCD with concomitant biceps tendinitis, subacromial bursitis, and partial rotator cuff (RC) tears, performed by a single surgeon between January 2010 and June 2015. Descriptive data, trauma history, time from symptom onset to surgical intervention, and magnetic resonance imaging (MRI) findings were recorded. Pre- and postoperative clinical assessments included shoulder range of motion (ROM), visual analog scale (VAS) for pain, Single Assessment Numeric Evaluation (SANE), and American Shoulder and Elbow Surgeons (ASES) scores. Since minimal clinically important differences for glenoid MFx are not defined, validated thresholds from shoulder arthroplasty literature were used for context. Rates of return to sports, military duty, and revision procedures were assessed at final follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean follow-up was 138 ±14.85 months (range, 120-182 months). The mean age was 36 years (range, 22-54 months), and 94% (29/31) were men. A history of traumatic injury was recorded in 61% (19/31) of patients. The mean time from symptom onset to surgery was 31 ± 46.6 months. No significant differences in ROM were found postoperatively (&lt;i&gt;P&lt;/i&gt; &gt; .05). However, all patient-reported outcomes demonstrated statistically significant improvements: VAS (6.84 ± 1.92 to 2.52 ± 2.41), SANE (46.8 ± 20.1 to 81.1 ± 18), and ASES (51.1 ± 14.1 to 82.7 ±17) (&lt;i&gt;P&lt;/i&gt; &lt; .0001 for all). At final follow-up, 68% (21/31) returned to sports and 78% (24/31) resumed unrestricted active military duty. Revision procedures were required in 4 patients (13%): 2 underwent total shoulder arthroplasty, and 2 underwent revision MFx with debridement. MRI detected OCD lesions in only 29% (9/31) of cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Arthroscopic MFx offers durable pain relief and functional improvement for focal glenoid OCD with concomitant biceps tendinitis, subacromial bursitis, or partial RC tears in high-demand military patients. At a minimum 10-year follow-up, outcomes demonstrated sustained clinical benefits, high return to duty, moderate return to sports (RTS), and low revision rates. Limited MRI sensitivity and prolonged time to surgical treatment highlight the importance of early clinical suspicion and timely surgical ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261419510"},"PeriodicalIF":2.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699494","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":"Comparing the Efficacy and Safety of Intra-articular Injection Treatments for Hip Osteoarthritis: A Systematic Review and Network Meta-analysis.","authors":"Chunlin Liu, Jiawen Deng, Aazad Abbas, Darius Luke Lameire, Hassaan Abdel Khalik, Daniel Whelan, Tim Dwyer, Jaskarndip Chahal","doi":"10.1177/23259671261419519","DOIUrl":"https://doi.org/10.1177/23259671261419519","url":null,"abstract":"<p><strong>Background: </strong>Hip osteoarthritis is a debilitating condition that leads to progressive joint pain and stiffness. While total hip arthroplasty provides definitive treatment, intra-articular injections offer a less invasive alternative for patients. Several injection options are available, including corticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP). Previous reviews and network meta-analyses have compared the short-term efficacy of these injections, but it remains unclear if a particular injection provides superior symptom relief for up to 12 months.</p><p><strong>Purpose: </strong>To provide an updated summary of the current hip intra-articular injection literature and compare the efficacy of all injection types at 3 months, 6 months, and 12 months.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>Four databases were queried: Web of Science, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index Total Score (WOMAC-Total) and the visual analog scale (VAS) at 3, 6, and 12 months. The Cochrane risk-of-bias tool was used to assess study quality. Treatment effects were expressed as mean differences for the WOMAC-Total and standardized mean differences for the VAS.</p><p><strong>Results: </strong>A total of 14 studies were included in the final analysis with 1254 participants. Eight unique intra-articular injection types were identified: CS, HA of varying molecular weights (low, high, and ultra-high), PRP, CS + high molecular weight HA, PRP + HA, and standard of care/placebo (SOC/PBO) group. When compared with SOC/PBO, no statistically significant differences in WOMAC-Total and VAS outcomes were observed between any injections at 3, 6, or 12 months.</p><p><strong>Conclusion: </strong>There were no statistically significant differences in WOMAC-Total and VAS outcomes at any time point between all injection types to baseline. Future studies should compare the long-term efficacy of various intra-articular injections with a control and examine the efficacy of combined injections.</p><p><strong>Registration: </strong>CRD42024574937 (PROSPERO identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 4","pages":"23259671261419519"},"PeriodicalIF":2.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699524","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}