Orthopaedic Journal of Sports Medicine最新文献

{"title":"Biomechanical Comparison of Inside-Out and All-Inside Meniscal Repair in Controlling the Peripheral Gap and Extrusion of the Lateral Meniscus With a Complete Radial Tear: A Cadaveric Study Using a Robotic Simulator.","authors":"Kousuke Shiwaku, Hidenori Otsubo, Katsunori Takahashi, Daisuke Suzuki, Satoshi Yamakawa, Tomoaki Kamiya, Tomoyuki Suzuki, Yohei Okada, Shinichiro Okimura, Kota Watanabe, Hiromichi Fujie, Atsushi Teramoto","doi":"10.1177/23259671241308854","DOIUrl":"10.1177/23259671241308854","url":null,"abstract":"<p><strong>Background: </strong>Although both the classical inside-out and all-inside techniques are performed for the repair of complete radial tears, which should be the standard technique is, to the authors' knowledge, controversial considering the clinical outcomes and biomechanical studies. There are no biomechanical studies of repairs of the lateral meniscus (LM) evaluating the peripheral side gap (peripheral gap) of the radial tear site and extrusion of the LM, which seems to be important in the treatment of radial tears.</p><p><strong>Purpose: </strong>To compare the inside-out and all-inside meniscal repair techniques by evaluating the peripheral gap and extrusion of the LM with complete radial tear using a 6 degrees of freedom robotic system and fresh-frozen cadavers.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>This study was performed using 6 fresh-frozen cadaveric knee specimens, a robotic testing system, and ultrasound evaluation. Ultrasound evaluations were performed to measure peripheral gaps and extrusions. The first ultrasound evaluation under 5 N·m of valgus load was performed on the knee at 30° and 90° of flexion. After a complete radial tear at the midsegment of the LM was created, a second ultrasound evaluation under valgus load was performed. Finally, all-inside and inside-out meniscal repairs done with 1 horizontal suture were performed on the same knee in a randomized order. Subsequently, the third and fourth ultrasound evaluations under valgus load were performed.</p><p><strong>Results: </strong>The peripheral gap of the inside-out meniscal repair technique was significantly smaller than that of all-inside meniscal repairs at knee flexion angles of 30° and 90° (6.0 vs 11.5 mm and 5.6 vs 10.9 mm [both <i>P</i> < .0167], respectively). The extrusion of inside-out meniscal repair was significantly smaller than that of all-inside meniscal repair at a knee flexion angle of 90° (2.6 vs 3.2 mm; <i>P</i> < .0083).</p><p><strong>Conclusion: </strong>The inside-out meniscal repair technique showed less peripheral gap and extrusion of the LM in a complete radial tear than the all-inside meniscal repair. Inside-out repair may be advantageous for radial tears over all-inside repair because only inside-out repair can tighten the peripheral side of the radial tear.</p><p><strong>Clinical relevance: </strong>The LM with a complete radial tear should be repaired using the inside-out technique.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241308854"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616714","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 of Morphological Changes in the Posterior Horn of the Meniscus of Knee With Anterior Cruciate Ligament Injury: A New Biological Evaluation Index.","authors":"Yupeng Zhu, Qizheng Wang, Ke Liu, Weili Zhao, Chenxi Wang, Honghao Wang, Ning Lang","doi":"10.1177/23259671251320657","DOIUrl":"10.1177/23259671251320657","url":null,"abstract":"<p><strong>Background: </strong>The shape and size of the meniscus are closely related to the stability of the knee joint and the anterior cruciate ligament (ACL) injury. Studies have confirmed the correlation between meniscal morphology and isolated ACL injury.</p><p><strong>Purpose: </strong>To investigate meniscal parameters, including morphological changes, in participants with isolated ACL injury.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective study, conducted from January to December 2021, compared 70 patients with isolated ACL injury with 70 patients with intact ACL. The meniscal slopes and posterior meniscal angles were measured using magnetic resonance imaging. The meniscal slopes include the slope of the anterior horn of the medial meniscus (SAHMM), slope of the posterior horn of the medial meniscus (SPHMM), slope of the anterior horn of the lateral meniscus (SAHLM), and slope of the posterior horn of the lateral meniscus (SPHLM). The posterior meniscal angles include the posterior base angle of the medial meniscus (PBAMM) and the posterior base angle of the lateral meniscus (PBALM). The receiver operating characteristic (ROC) curve was used to analyze the value of meniscal morphological parameters in judging ACL injury.</p><p><strong>Results: </strong>The SPHMM in participants with ACL injury was greater (mean, 23.24° ± 3.42°) than that in participants without (mean, 21.88° ± 3.35°) (<i>P</i> = .019). The PBAMM of participants with ACL injury was significantly higher than that in participants with intact ACL (mean, 73.78° ± 6.32° vs 67.82° ± 5.88°) (<i>P</i> < .001). The ROC cutoff value for SPHMM was 20.65°, and values greater than this had 81.4% sensitivity and 45.7% specificity for ACL injury. The ROC cutoff value for PBAMM was 73.55°, and values greater than this had 54.3% sensitivity and 84.3% specificity.</p><p><strong>Conclusion: </strong>The authors found a strong association between morphological changes in the SPHMM and ACL injury. Therefore, morphological changes in the meniscus can indicate ACL injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251320657"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625727","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":"Prospective Preference Assessment of a Pharmacological Clinical Trial to Alter the Progression of Posttraumatic Osteoarthritis After ACL Reconstruction.","authors":"Catherine T Yang, Jeffrey N Katz, Faith Selzer, Caitlin W Conley, Nicole G Lemaster, Austin V Stone, Mahima T Kumara, Elizabeth G Matzkin, Jason S Kim, Cale A Jacobs, Elena Losina, Morgan H Jones","doi":"10.1177/23259671241311906","DOIUrl":"10.1177/23259671241311906","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors contributing to willingness to participate in randomized clinical trials (RCTs) after anterior cruciate ligament reconstruction (ACLR) is crucial to optimizing recruitment and understanding whether interested participants represent the patient population that may benefit from the studied treatment.</p><p><strong>Purpose: </strong>To understand patients' willingness to participate in a future RCT of an oral medication to prevent posttraumatic osteoarthritis (PTOA) after ACLR.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 103 patients aged 18 to 45 years who were either planning to undergo ACLR in the next 4 months or had undergone ACLR within 1 year of the screening date were recruited from 2 institutions. The patients viewed a video explaining the trial and completed a questionnaire that included demographic characteristics, pain intensity, activity level, willingness to participate in the hypothetical trial, and their perceived risk (on a scale of 0%-100%) of developing knee PTOA (next 10 years or lifetime).</p><p><strong>Results: </strong>Within the cohort, 31% stated they were \"definitely willing,\" 38% were \"probably willing,\" 17% were \"unsure,\" and 14% were \"unwilling\" to participate in a hypothetical trial. Willingness did not differ by pain or activity level; however, younger patients stated they were less willing to participate. The most common reasons for unwillingness to participate included not wanting to take a medication daily (59%) and concerns about medication risks or side effects (59%). Respondents who indicated a definite willingness to participate in the trial had higher perceptions of their own PTOA risk over the next 10 years than those who indicated they would not participate (70% vs 50%).</p><p><strong>Conclusion: </strong>In this prospective preference assessment, 69% of survey respondents expressed a willingness to participate in an RCT involving an oral medication to potentially alter the progression of PTOA after ACLR. The results suggest that an RCT in this study should include clear and concise information on the risk of developing PTOA after ACLR and the safety and tolerability of study medications in the recruitment materials.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241311906"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616719","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 Repair With Side-to-Side Sutures for Full-Thickness Transtendinous Supraspinatus Tears Versus Traditional Tendon to Bone Fixation: Outcomes and Retear Rates at 4-Year Follow-up.","authors":"Amin Karimi, Fritz Steuer, Sophia McMahon, Stephen Marcaccio, Rajiv Reddy, Confidence Njoku-Austin, Ryan Gilbert, Matthew P Kolevar, Albert Lin","doi":"10.1177/23259671251321470","DOIUrl":"10.1177/23259671251321470","url":null,"abstract":"<p><strong>Background: </strong>Full-thickness, transtendinous supraspinatus rotator cuff tears involve a significant portion of the remanent tendon attached to the footprint.</p><p><strong>Purpose: </strong>To compare outcomes and failure rates for arthroscopic side-to-side (STS) suture repair for transtendinous tears versus traditional double-row repair for common tendon-to-bone type tears.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective cohort of 18 patients with full-thickness transtendinous supraspinatus tears who underwent STS suture repair was compared with a group of 36 matched controls with classic tendon avulsion who underwent double-row knotless transosseous-equivalent (TOE) repair. All patients had ≥2 years of follow-up. Demographics, postoperative active range of motion, and patient-reported outcomes (PROs) including American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) for pain, and Subjective Shoulder Value (SSV), were collected.</p><p><strong>Results: </strong>There were no significant differences between the STS and TOE groups regarding mean follow-up (48.2 ± 18.5 vs 47.9 ± 20.5 months; <i>P</i> = .70) or age (64.6 ± 7.2 vs 64.8 ± 7.3 years; <i>P</i> = .79). With respect to clinical outcomes and PROs, there were no differences in postoperative VAS pain score (STS vs TOE: 0.94 ± 1.5 vs 0.89 ± 1.8; <i>P</i> = .39), SSV score (92.4 ± 8.9 vs 90.1 ± 13.0; <i>P</i> = .79), or ASES score (90.8 ± 9.7 vs 92.6 ± 12.0; <i>P</i> = .15). No differences were identified for postoperative active forward flexion (STS vs TOE: 154.2° ± 13.3° vs 159.4° ± 11.3°; <i>P</i> = .10), external rotation (53.3° ± 6.2° vs 51.4° ± 8.7°; <i>P</i> = .47), or internal rotation (<i>P</i> = .69) score. Although there were larger anteroposterior tear sizes in the STS group (21.4 ± 9.3 vs 16.0 ± 6.7 for TOE; <i>P</i> = .04), there was no significant group difference in failure rates (11% [STS] vs 8% [TOE]; <i>P</i> > .99).</p><p><strong>Conclusion: </strong>Arthroscopic STS suture repair for transtendinous supraspinatus tears yielded excellent outcomes with low failure rates, comparable with tendon-to-bone double-suture anchor repair for typical tendon avulsion-type cuff tears. Retention of the large tendon stump on the greater tuberosity with STS repair also allows restoration of anatomy without undue tension in this uncommon scenario.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251321470"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Return to Sports Following Total Hip Arthoplasty With Custom Stems in Professional and Recreational Table Tennis Players.","authors":"Cyril Courtin, Idriss Tourabaly, Ankitha Kumble, Sonia Ramos-Pascual, Elodie Baraduc, Camille Rose, Mo Saffarini, Alexis Nogier","doi":"10.1177/23259671241311604","DOIUrl":"10.1177/23259671241311604","url":null,"abstract":"<p><strong>Background: </strong>Table tennis players execute short explosive movements, along with continuous hip flexion, abduction, and rotation, increasing their risk of injury. Previous studies reported a rate of return to sports (RTS) of 20% to 80% in athletes following total hip arthroplasty (THA). There are no studies reporting RTS in table tennis players following THA.</p><p><strong>Purpose: </strong>To evaluate the clinical outcomes and RTS following custom THA in professional, ex-professional, and recreational table tennis players.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Patients who underwent primary THA between April 2013 and January 2022 were retrospectively reviewed (n = 2977). Table tennis players of any level that received a custom femoral stem were included in the study (N = 17). At a minimum follow-up of 2 years, all players were assessed using the Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and the University of California Los Angeles (UCLA) activity score, as well as with a sports-specific questionnaire that included questions related to their table tennis practice. Descriptive statistics, including medians and interquartile ranges, were used to summarize the data.</p><p><strong>Results: </strong>All 17 players (22 hips) were available at ≥2 years, of which 3 were professional (5 hips), 4 were ex-professional (6 hips), and 10 were recreational (11 hips). The median OHS was 44.0 (IQR, 44.0-48.0) in professional, 48.0 (IQR, 48.0-48.0) in ex-professional, and 48.0 (IQR, 45.0-48.0) in recreational players. The median FJS was 92.0 (IQR, 88.0-98.0) in professional, 98.0 (IQR, 98.0-98.0) in ex-professional, and 100.0 (IQR, 93.0-100.0) in recreational players. The median UCLA activity score was 10.0 (IQR, 9.0-10.0) in professional, 9.0 (IQR, 9.0-9.8) in ex-professional, and 8.0 (IQR, 5.5-9.0) in recreational players. The rate of RTS was 100% for professional and ex-professional players, and 80% for recreational players. The hours played before onset of symptoms was higher than following surgery for professional (30.0 [IQR, 25.0-30.0] vs 20.0 [IQR, 16.0-22.5] h/week) and ex-professional players (19.5 [IQR, 11.0-29.3] vs 3.0 [IQR, 2.0-5.5] h/week), while it was constant for recreational players (4.0 [IQR, 2.3-4.0] vs 4.0 [IQR, 3.8-4.5] h/week).</p><p><strong>Conclusion: </strong>Our retrospective analysis demonstrated that at a minimum follow-up of 2 years THA using custom stems provided good to excellent clinical outcomes in professional, ex-professional, and recreational table tennis players. All professional and ex-professional players, as well as 80% of recreational players, were able to return to play table tennis, although both professional and ex-professional players reduced their number of hours of play compared with before surgery. These findings could be used to help set expectations for table tennis players who are scheduled to undergo THA.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241311604"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616716","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":"Hip Arthroscopic Management for Patients With Subchondral Stress Fractures of the Femoral Head: A Case-Control Study.","authors":"Yuki Okubo, Yoichi Murata, Hirotaka Nakashima, Makoto Kawasaki, Hitoshi Suzuki, Manabu Tsukamoto, Shinichiro Takada, Keisuke Nakayama, Akinori Sakai, Soshi Uchida","doi":"10.1177/23259671241294050","DOIUrl":"10.1177/23259671241294050","url":null,"abstract":"<p><strong>Background: </strong>A subchondral stress fracture of the femoral head (SSFFH) is managed with nonoperative treatment. There is a lack of knowledge regarding whether hip arthroscopic management is effective for active patients with SSFFHs.</p><p><strong>Purpose: </strong>To elucidate whether arthroscopic management of SSFFHs enables active patients to return to sports activity.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 22 patients undergoing hip arthroscopic management (labral repair/reconstruction and fragment fixation with hydroxyapatite and poly-L-lactic acid [HA/PLLA]-threaded pins) were enrolled and divided into 2 groups. The active group was defined as patients who participated in any kind of sports, regardless of the level of competition. The inactive group was defined as patients who did not participate in sports or any activity. Patient-reported outcome measure (PROM) scores, including the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS), were collected preoperatively and at 6 months, 12 months, and the final follow-up (mean, 70.0 ± 36.6 months [range, 24-144 months]) after surgery. The authors performed chi-square and Mann-Whitney <i>U</i> tests to compare the PROM scores between the 2 groups.</p><p><strong>Results: </strong>There were 10 patients in the active group and 12 patients in the inactive group in the final analysis. Overall, 14 SSFFHs underwent internal fixation with HA/PLLA-threaded pins. The PROM scores significantly improved from preoperatively to the final follow-up. The active group had significantly better PROM scores than the inactive group at 6 months (mHHS: 96.6 ± 5.0 vs 85.3 ± 13.6, respectively [<i>P</i> = .033]; NAHS: 74.3 ± 6.4 vs 57.0 ± 15.6, respectively [<i>P</i> = .008]) and 1 year (mHHS: 98.8 ± 1.8 vs 92.7 ± 8.6, respectively [<i>P</i> = .040]; NAHS: 78.0 ± 2.1 vs 65.9 ± 11.7, respectively [<i>P</i> = .007]). Additionally, 9 of 10 patients in the active group returned to their sports activity.</p><p><strong>Conclusion: </strong>The study showed that arthroscopic management (femoroacetabular impingement correction, labral preservation, and stabilization with HA/PLLA-threaded pins) provided favorable clinical outcomes and a high rate of return to sports activity in active patients with SSFFHs. Active patients with SSFFHs had better postoperative results than inactive patients.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241294050"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616718","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":"Resolution of Pain at Night and Improved Functional Outcomes After Arthroscopic Partial Meniscectomy.","authors":"Evan T Zheng, Koya Osada, Jillian L Mazzocca, Natalie A Lowenstein, Jamie E Collins, Elizabeth G Matzkin","doi":"10.1177/23259671251322749","DOIUrl":"10.1177/23259671251322749","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic partial meniscectomy (APM) is performed for symptomatic meniscal tears that fail conservative treatment. Patients often report pain at night, although little research has been done to evaluate corresponding outcomes.</p><p><strong>Purpose: </strong>To (1) evaluate patients with and without preoperative nighttime pain who underwent APM and (2) assess postoperative resolution of symptoms and associated patient-reported outcome measures (PROMs).</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Consecutive patients undergoing primary APM with or without chondroplasty at a tertiary academic center were prospectively enrolled in a database. Patient characteristics and PROMs were obtained pre- and postoperatively up to 2 years-including the visual analog pain scale, Knee injury and Osteoarthritis Outcome Score (KOOS), Marx Scale, and Veterans RAND 12-Item Health Survey (VR-12) physical and mental components. Patients were included if they had a minimum 3-month PROMs follow-up. Pain at night was defined as reporting greater than mild pain on KOOS P7. Intraoperatively, cartilage was assessed using the Outerbridge Classification.</p><p><strong>Results: </strong>A total of 587 patients were included, with 299 (50.9%) reporting preoperative pain at night, which corresponded with worse baseline PROMs. These patients were older and more likely to be women and smokers. No significant difference was observed in Outerbridge grade between patients with and without preoperative pain at night. Postoperatively, nighttime pain resolved by 2 years in 274 (91.6%) patients, 219 of whom (79.9%) reported improvement by 3 months. Patients whose pain at night persisted had a longer duration of symptoms preoperatively, higher body mass index, and a lack of baseline mechanical symptoms. PROMs significantly improved for patients with and without preoperative pain at night, although patients with baseline pain had worse scores compared with those without preoperative nighttime pain.</p><p><strong>Conclusion: </strong>Over half of patients undergoing APM reported preoperative pain at night, which was associated with worse baseline functional scores. Postoperatively, >90% of patients with baseline pain at night noted resolution of symptoms by 2 years, with nearly 80% showing improvement by 3 months. Functional scores improved after surgery for patients with and without initial pain at night, remaining lower for patients who had preoperative nighttime pain.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251322749"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573374","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":"Periacetabular Osteotomy Improves Hip Microinstability Between Supine and Standing Radiographs in Symptomatic Hip Dysplasia.","authors":"Kenji Kitamura, Masanori Fujii, Satoshi Hamai, Daisuke Hara, Kensei Yoshimoto, Itaru Kawashima, Hongjia He, Adam H Biedrzycki, Shinya Kawahara, Goro Motomura, Yasuharu Nakashima, Scott A Banks","doi":"10.1177/23259671251319994","DOIUrl":"10.1177/23259671251319994","url":null,"abstract":"<p><strong>Background: </strong>Whether periacetabular osteotomy (PAO) improves hip microinstability in patients with symptomatic hip dysplasia remains poorly understood.</p><p><strong>Purpose: </strong>To assess the femoral head translation with static postural change, considered a potential indicator of hip microinstability, comparing dysplastic hips before and after PAO with normal hips.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 26 patients (30 hips) with hip dysplasia underwent PAO, and 18 healthy individuals (18 hips) were eligible. Using a 3-dimensional-to-2-dimensional registration technique, femoral head translation before and after PAO was quantified as the displacement of the center of the femoral head relative to the center of the acetabulum between supine and standing positions. Morphological factors on supine anteroposterior pelvic radiographs before and after PAO correlated with the femoral head translation, particularly lateral translation, were examined.</p><p><strong>Results: </strong>Femoral head translation decreased after PAO (1.5 ± 0.4 mm vs 1.0 ± 0.4 mm; <i>P</i> < .001) but remained larger than in controls (1.0 ± 0.4 mm vs 0.7 ± 0.3 mm; <i>P</i> = .01). The more severe the hip dysplasia before PAO was, the greater the femoral head translation. However, the femoral head translation improved after PAO with sufficient acetabular correction. The acetabular roof obliquity (ARO) showed the strongest correlation with lateral translation of the femoral head from the supine to standing position before PAO. In contrast, no correlation was found after PAO.</p><p><strong>Conclusion: </strong>This study demonstrates that the severity of hip dysplasia influences hip microinstability, that PAO mitigates hip microinstability with adequate acetabular correction, and that PAO does not normalize hip stability because of residual joint incongruity. In patients with a larger ARO, the femoral head has more lateral translation in the standing position. Therefore, weightbearing postural radiographs are crucial for understanding hip biomechanics in hip dysplasia and refining surgical corrections during PAO.</p><p><strong>Clinical relevance: </strong>PAO can make the hip more stable in hip dysplasia, but not as stable as the normal hip. In hip dysplasia, pre-PAO standing radiographs should be evaluated due to their accurately representing the femoral head position relative to the acetabulum.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251319994"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573404","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":"High Return to Competition Rate After On-Field Rehabilitation in Competitive Male Soccer Players After ACL Reconstruction: GPS Tracking in 100 Consecutive Cases.","authors":"Filippo Picinini, Francesco Della Villa, Jamie Tallent, Stephen David Patterson, Lorenzo Galassi, Matteo Parigino, Giovanni La Rosa, Gianni Nanni, Jesus Olmo, Matthew Stride, Fabrizio Aggio, Matthew Buckthorpe","doi":"10.1177/23259671251320093","DOIUrl":"10.1177/23259671251320093","url":null,"abstract":"<p><strong>Background: </strong>Despite published guidelines describing on-field rehabilitation (OFR) frameworks for soccer, available evidence for practitioners who work with players with anterior cruciate ligament reconstruction (ACLR) is limited.</p><p><strong>Purpose: </strong>To document the activity and workloads completed by a large cohort of amateur and professional soccer players during OFR following ACLR after completing their indoor rehabilitation and to establish their return to competition (RTC) outcomes.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>OFR measurements/activities, global positioning system (GPS), and heart rate data were collected from 100 male 11-a-side soccer players with ACLR undergoing a criteria-based rehabilitation process, concluding with a 5-stage OFR program. Consent was obtained directly from the players involved in this study before completing a follow-up questionnaire to document RTC outcomes. Differences between the level of play (professional and amateur) and 5 OFR stages were investigated using separate linear mixed models.</p><p><strong>Results: </strong>A minimum 9-month follow-up was possible for 97 players (97%), with a median time of 2.3 years after ACLR and 84% RTC, with higher rates in professionals (100%) than amateurs (80%). Ten (10%) players sustained an ACL reinjury. Professionals completed more OFR sessions (20.6 ± 7.7 vs 13.2 ± 7.7; <i>P</i> < .001) over a shorter period (44.7 ± 30.3 vs 59.3 ± 28.5 days; <i>P</i> = .044) and achieved higher workloads mostly in the high-intensity GPS metrics in each OFR stage. Typical external workload outputs in the final OFR stage aligned with team training demands for the total distance (TD) (106%), high-intensity distance (HID) (104%), peak speed (PS) (88%), acceleration distance (ACC) (110%), and deceleration distance (DEC) (48%), but they were lower compared with match play demands (TD: 44%; HID: 51%; PS: 82%; ACC: 63%; and DEC: 26%).</p><p><strong>Conclusion: </strong>High RTC rates were reported in those players who participated in OFR after indoor rehabilitation. Completion of all five OFR stages almost prepared them for team training demands; however, workloads remain low compared to match play.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251320093"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573340","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":"Effect of Initial Graft Tension on Knee Osteoarthritis Outcomes After ACL Reconstruction: A Randomized Controlled Clinical Trial With 15-Year Follow-up.","authors":"Anika N Breker, Gary J Badger, Ata M Kiapour, Meggin Q Costa, Emma N Fleming, Stacy L Ferrara, Cynthia A Chrostek, Paul D Fadale, Michael J Hulstyn, Robert M Shalvoy, Holly C Gil, Braden C Fleming","doi":"10.1177/23259671251320972","DOIUrl":"10.1177/23259671251320972","url":null,"abstract":"<p><strong>Background: </strong>The graft tension applied during anterior cruciate ligament (ACL) graft fixation (subsequently referred to as initial graft tension) could potentiate posttraumatic osteoarthritis (PTOA) and influence other outcomes.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to analyze the effects of initial graft tension on imaging and patient-reported outcomes related to PTOA 15 years postreconstruction surgery. Clinical and functional outcomes were also assessed. It was hypothesized that (1) the high-tension group would have improved imaging findings and outcomes compared with the low-tension group at 15-year follow-up and (2) the imaging findings and outcomes for the high-tension group would be equivalent to the sex-, race-, age-, and activity level matched control group.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 1.</p><p><strong>Methods: </strong>Consented patients underwent ACL reconstruction (ACLR) with bone-patellar tendon-bone or a 4-strand hamstring tendon autograft. A matched uninjured control group was assembled for comparison. Two laxity-based tensioning procedures were randomized: (1) tension set to restore normal anteroposterior (AP) laxity at time of surgery relative to the contralateral uninjured knee (low-tension group) or (2) tension set to overconstrain AP laxity at time of surgery relative to the contralateral knee (high-tension group). Baseline outcome measures, radiographs, and magnetic resonance imaging (MRI) scans were collected prior to surgery and at 15 years postoperatively.</p><p><strong>Results: </strong>For medial joint space width, the differences between limbs across the 3 groups were not significant. Within the tension groups, the Whole Organ MRI Score was significantly higher in the surgical knee relative to the contralateral knee in both groups, while the Osteoarthritis Research Society International radiographic scores were higher in the surgical knee in the low-tension group only. A total of 43% of patients in both tension groups met the Knee injury and Osteoarthritis Outcome Score composite criteria for a symptomatic knee compared with controls (10%; <i>P</i> = .01). Most other outcomes, including AP laxity, International Knee Documentation Committee knee examination score, and single-leg hop test were not significantly different between the 3 groups.</p><p><strong>Conclusion: </strong>The results do not support the hypotheses that patients in the high-tension group would have better chondroprotection compared with the low-tension group and have equivalent outcomes with the matched controls. Overall, the results show that patients undergoing ACLR are more likely to develop PTOA and display inferior outcomes compared with the uninjured matched control group, regardless of graft tension.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251320972"},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573330","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}