Orthopaedic Journal of Sports Medicine最新文献

{"title":"Use of Ankle-GO to Assess and Predict Return to Sport After Lateral Ankle Reconstruction for Chronic Ankle Instability.","authors":"Alexandre Hardy, Kinan Freiha, Mohamad K Moussa, Eugénie Valentin, Gauthier Rauline, Kylian Alvino, Francois Fourchet, Brice Picot, Ronny Lopes","doi":"10.1177/23259671251322903","DOIUrl":"10.1177/23259671251322903","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) develops in 20% to 40% of patients after ankle sprains because of inappropriate management or a premature return to sports (RTS). Patients become candidates for surgery when nonoperative treatment fails. The results of arthroscopic lateral ligament reconstruction have been shown to be excellent. However, there is no consensus on the RTS criteria in these cases. The Ankle-GO score, which has been validated in lateral ankle sprains, is an evidence-based protocol for RTS.</p><p><strong>Purpose: </strong>To evaluate the discriminant and predictive capacity of the Ankle-GO score for RTS after arthroscopic lateral ankle reconstruction.</p><p><strong>Study design: </strong>Cohort study. Level of evidence, 2.</p><p><strong>Methods: </strong>This prospective multicenter cohort study, conducted between January 2022 and January 2023, evaluated patients with CAI who underwent arthroscopic anatomic lateral ankle ligament reconstruction using gracilis tendon autografts or allografts. The RTS rates at 4 and 6 months postoperatively were the primary and secondary outcomes, respectively. The evaluated variable at both timelines was the Ankle-GO score-a composite of 4 functional tests and 3 questionnaires. The study determined the discriminant validity of the Ankle-GO score for RTS at each timeline-Ankle-GO scores at 4 months for RTS at 4 months; Ankle-GO scores at 6 months for RTS at 6 months. The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was also evaluated.</p><p><strong>Results: </strong>A total of 51 patients, with a mean age of 32.8 years, were included, of whom 23 (45%) had returned to sports at 4 months and 39 (76.5%) at 6 months. The mean Ankle-GO score was significantly higher in the group that returned to sports than in the group that did not (12 ± 4.7 vs 8.8 ± 4.7 at 4 months, respectively, <i>P</i> = .003; 16.8 ± 3.6 vs 11.3 ± 4.8 at 6 months, respectively, <i>P</i> = .002).The predictive capacity of the Ankle-GO score at 4 months for RTS at 6 months was good, with an area under the curve of 0.74 (95% CI, 0.58-0.90; <i>P</i> = .005). The optimal threshold was 6 (sensitivity, 95%; specificity, 50%). The odds ratio of RTS when surpassing the Ankle-GO cutoff score was 18.5 (95% CI, 3-113.95; <i>P</i> = .002).</p><p><strong>Conclusion: </strong>The Ankle-GO score is effective in discriminating the RTS status at 4 and 6 months after lateral ligament reconstruction of the ankle. In addition, the Ankle-GO score at 4 months was also moderately predictive of RTS at 6 months after surgery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322903"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693002","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 Association Between Concomitant Meniscal Tear, Tibial Slope, Static Knee Position, and Anterior Knee Laxity in ACL-Deficient Patients.","authors":"Tzu-Ching Huang, Chi-Hsiu Wang, Kai-Lan Hsu, Fa-Chuan Kuan, Wei-Ren Su, Chih-Kai Hong","doi":"10.1177/23259671251324186","DOIUrl":"10.1177/23259671251324186","url":null,"abstract":"<p><strong>Background: </strong>Whether the tibial slope or the concomitant meniscal tear is related to static knee position or anterior knee laxity remains controversial.</p><p><strong>Purpose: </strong>To investigate the association between medial and lateral posterior tibial slope, concomitant meniscal tear, static knee position using magnetic resonance imaging (MRI), and anterior knee laxity measured with the GNRB arthrometer.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 60 patients who underwent anterior cruciate ligament (ACL) reconstructions were retrospectively enrolled from May 2020 to October 2022. All patients underwent both MRI and GNRB arthrometry after the injury. The static knee position and medial and lateral tibial slopes were measured using MRI. The meniscal tear type was confirmed during arthroscopic surgery. Descriptive data were retrospectively reviewed from the medical records.</p><p><strong>Results: </strong>The side-to-side differences of anterior tibial translation at 134 N in the intact meniscus, isolated lateral meniscal tear, isolated medial meniscal tear, and both meniscal tear groups were 3.63 ± 1.4 mm, 4.61 ± 1.5 mm, 2.85 ± 1.5 mm, and 4.85 ± 1.6 mm, respectively (<i>P</i> = .003). The slopes of the force-displacement curve in the GNRB arthrometer were 6.55 ± 4.8 mm/N, 16.99 ± 5.6 mm/N, 9.69 ± 10.8 mm/N, and 10.89 ± 7.4 mm/N in the intact meniscus, lateral meniscal tear, medial meniscal tear, and both meniscal tear groups, respectively (<i>P</i> = .001). Subgroup analysis showed that patients with lateral meniscal tears tended to have greater anterior knee laxity based on the GNRB arthrometer tests. The medial and lateral tibial slopes were not correlated with static knee position or anterior knee laxity.</p><p><strong>Conclusion: </strong>Patients with ACL deficiency and concomitant lateral meniscal tears are more likely to exhibit greater anterior knee laxity, as measured using the GNRB. Clinicians should consider the concomitant lateral meniscal tear when planning surgery and arranging postoperative care. Tibial slopes were not found to be correlated with static knee position or anterior knee laxity.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251324186"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692985","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":"In Vitro Ovine Cam Impingement Model and Its Effect on Acetabular Cartilage.","authors":"Onur Hapa, Selahaddin Aydemir, Fatma Bahar Sunay, Ahmet Emrah Acan, Pakize Nur Akkaya, Mustafa Celtik, Resit Bugra Husemoglu, Mehmet Salin","doi":"10.1177/23259671251322757","DOIUrl":"10.1177/23259671251322757","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome is a condition where abnormal contact occurs between the femoral head and the acetabulum, leading to chondral damage and hip osteoarthritis. To better understand and treat femoroacetabular impingement syndrome, it is crucial to establish in vitro models that mimic the condition and assess potential interventions.</p><p><strong>Purpose: </strong>To establish an in vitro ovine cam impingement model and assess the effectiveness of cam excision in reducing the incidence of type 3 acetabular labrum articular disruption (ALAD) (chondral flap) lesions.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Utilizing an ovine in vitro cam impingement model, 40 hips were subjected to testing across 5 groups (n = 8 per group): group 1 (control group), 750 N for 200 cycles; group 2 (cycle decrease), 750 N for 100 cycles; group 3 (load decrease), 500 N for 200 cycles; group 4 (cam excision), cam excision followed by 750 N for 200 cycles; and group 5 (halfway cam excision), 750 N for 100 cycles followed by cam excision under an additional 750 N for 100 cycles loading. Each specimen was subsequently assessed for chondral damage according to the ALAD classification, both macroscopically and microscopically.</p><p><strong>Results: </strong>The control group (group 1) demonstrated the highest ALAD scores (2.7 ± 0.4, 2.8 ± 0.3) compared with other groups, whereas the cam excision group (group 4) exhibited lower scores (0.5 ± 0.5, 0.7 ± 0.4) than both the cycle decrease group (group 2) (1.6 ± 0.5, 1.6 ± 0.5) and the halfway cam excision group (group 5) (1.8 ± 0.6, 2 ± 0.5) (<i>P</i> < .05) in both macroscopic and microscopic gradings (<i>P</i> < .05). The load decrease group (group 3) (1 ± 0.5) also displayed lower scores compared with group 5 (2 ± 0.5) at histological grading (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>An in vitro sheep model was established that reliably induces mechanical chondrolabral damage in the hip joint. The findings show that reducing the load results in less chondrolabral damage compared with reducing the number of cycles. Furthermore, this model emphasizes the protective effect of cam excision in the management of chondral flap lesions (ALAD type 3).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322757"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692957","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":"Examining Planar Contributions to Knee Total Joint Moment Between Women and Men During Loaded Gait Tasks.","authors":"Kellen T Krajewski, Camille C Johnson, Qi Mi, Shawn D Flanagan, William J Anderst, Christopher Connaboy","doi":"10.1177/23259671251322785","DOIUrl":"10.1177/23259671251322785","url":null,"abstract":"<p><strong>Background: </strong>Military personnel in combat roles observe a high prevalence of knee osteoarthritis. Knee total joint moment (KTJM) and the knee adduction moment percentage contribution (KAM%) of KTJM have been linked to knee osteoarthritis. It is postulated that sex, load carriage, and imposed locomotion patterns such as forced marching (FM) alter mechanics of the knee. The purpose of this study was to determine the effects of \"military-relevant\" load magnitudes, locomotion patterns, and sex on KTJM and its planar percentage contributions in recruit-aged adults during short-duration gait tasks.</p><p><strong>Hypothesis: </strong>The greatest load magnitude and FM will significantly increase KAM contribution to KTJM compared with lower magnitudes or no load. Additionally, women will exhibit greater KAM contribution to KTJM compared with men regardless of experimental condition.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Twenty healthy recruit-aged (18-35 years) adults (10 male, 10 female) executed trials of running and FM with no load (BW), an additional load of 45% of BW, and an additional load of 55% of BW. KTJM was calculated along with each plane of motion percentage contribution: knee flexion moment (KFM%), KAM%, and knee rotation moment (KRM%). A 3 × 2 × 2 mixed model analysis of variance was used to evaluate the effects of load carriage, locomotion pattern, and sex on KTJM, KFM%, KAM%, and KRM% at multiple gait events of stance phase.</p><p><strong>Results: </strong>FM exhibited a greater (<i>P</i> < .001) KTJM than running at heel strike. Running had greater KAM% (<i>P</i> = .01) and KRM% (<i>P</i> < .001) compared with FM. At midstance, running exhibited greater (<i>P</i> < .001) KTJM than FM for each load condition; however, FM had greater KAM% (<i>P</i> < .001) and KRM% (<i>P</i> = .002) compared with running at peak vertical ground reaction force and midstance. Men exhibited greater KAM% at heel strike (<i>P</i> = .02) independent of locomotion pattern and at midstance (<i>P</i> = .04) for FM.</p><p><strong>Conclusion: </strong>Load carriage increases KAM% to a magnitude similarly observed in populations with knee osteoarthritis, especially when executing FM. Interestingly, men exhibited greater KAM% than women, suggesting differing strategies to motor execution with relative load carriage.</p><p><strong>Clinical relevance: </strong>Screening recruits for greater KAM% during loaded gait tasks may identify individuals in need of specialized training to reduce the risk of knee osteoarthritis development.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322785"},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Outcomes of Hybrid Transepiphyseal ACL Reconstruction With Soft Tissue Quadriceps Tendon Autograft in Skeletally Immature Athletes.","authors":"Jesse Seilern Und Aspang, Jordan Serrano-Dennis, Kyle E Hammond, Harris S Slone, Jason G Garry, Camryn Petit, Gregory D Myer, Danielle Seguin, John W Xerogeanes","doi":"10.1177/23259671251322758","DOIUrl":"10.1177/23259671251322758","url":null,"abstract":"<p><strong>Background: </strong>Substantial developments in physeal-sparing surgical techniques for anterior cruciate ligament (ACL) reconstruction (ACLR) have demonstrated safety and efficacy in treating skeletally immature patients. However, outcomes using all-soft tissue quadriceps tendon (QT) autograft in this population are unknown.</p><p><strong>Purpose: </strong>To evaluate outcomes including return to sport (RTS) and reinjury risk in skeletally immature patients ≥2 years after undergoing hybrid transepiphyseal ACLR using QT autograft.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A consecutive series of skeletally immature patients who underwent primary QT autograft ACLR using a hybrid transepiphyseal technique with ≥2 years of follow-up were retrospectively analyzed. Outcomes included RTS (primary), ability to return to preinjury level of competition, and subsequent ipsilateral/contralateral knee injury (secondary).</p><p><strong>Results: </strong>A total of 50 patients were identified and contacted, of which 40 (80.0%) (35 male; mean age, 12.6 years [range, 9.4-16.0 years]) completed the survey at 5.7 ± 2.8 years (range, 2.0-11.5 years) postoperation. Of those, 26 (65.0%) were competitive middle/high school athletes and 18 (45.0%) competed in ≥2 sports. At a mean of 10.6 ± 2.3 months (range, 6-17 months) postoperatively, 37 patients (92.5%) returned to unrestricted sports participation, and 35 patients (87.5%) resumed competition at their preinjury level. Five patients required subsequent ipsilateral knee surgery for ACL revision (n = 2; 5.0%), meniscal injury (n = 2; 5.0%), or symptomatic hardware (n = 1; 2.5%) after a mean of 4.4 ± 1.7 years (range, 2.8-7.1 years). Three patients (7.5%) sustained a subsequent contralateral ACL injury, and 1 patient sustained a contralateral posterior cruciate ligament sprain.</p><p><strong>Conclusion: </strong>Findings of this study suggest that midterm outcomes of patients treated with hybrid transepiphyseal ACLR using QT autograft are promising, with a high and expedited RTS and relatively low graft tear risk.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322758"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658083","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":"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}