Orthopaedic Journal of Sports Medicine最新文献

{"title":"Does Recalibration Response Shift Alter Perceived Treatment Effects in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction?","authors":"Hana Marmura, Alan Mj Getgood, Dianne M Bryant","doi":"10.1177/23259671261463386","DOIUrl":"10.1177/23259671261463386","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome measures (PROMs) are used longitudinally after anterior cruciate ligament reconstruction (ACLR). However, PROM scores depend on patients' perspectives, which are likely to change over time, particularly after a health-related event. This phenomenon, known as recalibration or \"response shift,\" may limit our ability to accurately interpret PROMs.</p><p><strong>Purpose: </strong>To identify whether recalibration response shift effects are present in PROM scores after ACLR and to investigate the influence of coping styles and life events on outcomes and recalibration response shift after ACLR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Patients having primary ACLR were recruited to complete the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee Subjective Knee Form (IKDC SKF) preoperatively and 1 and 2 years postoperatively. At both postoperative time points, patients completed a second KOOS and IKDC SKF based on their recollection of preoperative status, as well as brief COPE (Coping Orientation to Problems Experienced) and life event questionnaires. Unadjusted change (traditionally measured change), adjusted change (accounting for the patient perspective), and the magnitude of the recalibration response shift (the difference in change scores) were calculated for all outcomes, along with the proportion of patients exhibiting meaningful positive recalibration, meaningful negative recalibration, or no meaningful recalibration. Linear regression analyses evaluated the influence of coping strategies and life events on postoperative PROM scores and the magnitude of recalibration response shift.</p><p><strong>Results: </strong>Of 171 participants (mean age, 24 years, 56% male), 158 (92%) and 146 (85%) completed 1 and 2 years follow-up, respectively. Adjusted change was significantly greater than unadjusted change (<i>P</i> < .05) for all PROM scores except KOOS Sport at 1 year postoperatively (<i>P</i> = .17), with the magnitude of recalibration response shift ranging from 3 to 18 points. Three-quarters of participants' scores indicated a meaningful shift in response in at least 1 PROM. Coping and life event variables predicted follow-up PROM scores but not the magnitude of recalibration response shift.</p><p><strong>Conclusion: </strong>A meaningful recalibration response shift was clearly identified in IKDC SKF and KOOS scores 1 and 2 years after ACLR. Traditional within-patient change scores do not reflect participants' perceived change in constructs after ACLR, and recalibration response shifts may alter perceived treatment effects (both over- and underestimation).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261463386"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840928","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":"Therapeutic Efficacy of Combined Extracorporeal Shock Wave Therapy and Platelet-Rich Plasma Therapy in a Rat Model of Acute Achilles Tendinopathy.","authors":"Fumihide Terakawa, Michiaki Mukai, Nobuyasu Ochiai, Eiko Hashimoto, Fumiya Hattori, Nanako Yamakawa, Ryohei Sawada, Yutoku Yamada, Ikuko Tajiri, Seiji Ohtori","doi":"10.1177/23259671261438101","DOIUrl":"10.1177/23259671261438101","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP) therapy are effective treatments for tendinopathy; however, in some cases, these monotherapies are ineffective, leading to a delayed return to competition for athletes or the need for surgical intervention in middle-aged and older patients, creating challenges in clinical practice.</p><p><strong>Purpose/hypothesis: </strong>Few clinical reports have examined the synergistic therapeutic effects of combined ESWT and PRP therapy in fields other than tendinopathy, such as pseudarthrosis. The authors hypothesized that the combined use of ESWT and PRP would exert a synergistic therapeutic effect on tendon disorders. Consequently, when compared with monotherapy, the effects would be observed earlier, promoting pain relief and tendon healing. This study aimed to evaluate the therapeutic efficacy of combined ESWT and PRP therapy in a rat model of acute Achilles tendinopathy.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Fifty male Sprague-Dawley rats (10 weeks old) were randomly assigned to control, sham, ESWT, PRP, and combined treatment (E+P) groups. Collagenase-induced Achilles tendinopathy was established only in the left hindlimb of all mice, except those in the control group, on day -7. The ESWT, PRP, and E+P groups were administered ESWT on day 0 or injected with PRP on day 1 (stored at -30°C before injection). The load ratios between the injured and healthy hindlimbs were measured on days 0, 7, 14, 21, and 28. Pathologic evaluation and Achilles tendon scoring were performed on day 28.</p><p><strong>Results: </strong>On day 0, the load ratios of the injured limbs were significantly decreased in all groups, except the control group. On day 7, the ESWT and PRP groups demonstrated significant improvements in the ratios as compared with the sham group. The E+P group showed significantly superior improvement when compared with both groups. Pathologic analysis revealed remarkable tendon healing in the E+P group, which significantly outperformed ESWT and PRP monotherapy.</p><p><strong>Conclusion: </strong>ESWT combined with PRP administration produces a synergistic effect, resulting in earlier pain relief and better tendon repair than monotherapy alone.</p><p><strong>Clinical relevance: </strong>The combined use of ESWT and PRP may offer an enhanced therapeutic strategy for tendinopathies in clinical settings.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261438101"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840881","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":"Segmental Momentum Sequencing: Implication for Injury and Performance Between Collegiate Pitchers With Different Arm Slots.","authors":"Kai-Jen Cheng, Ryan M Zappa, Ian P Jump, Adam Hoechstetter, Gretchen D Oliver","doi":"10.1177/23259671261453310","DOIUrl":"10.1177/23259671261453310","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Baseball pitching requires precise coordination of the upper extremities to generate and transfer angular momentum efficiently while minimizing joint loading. Although the importance of temporal sequencing is recognized, few studies have examined how segmental momentum sequences vary across arm slot styles. Therefore, the purpose of this study was to evaluate the temporal sequence of peak angular momentum across segments and determine its capacity to predict ball velocity and upper extremity joint loading among overhead (OH), three-quarter (QT), and sidearm (SA) collegiate pitchers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To (1) quantify the timing of peak angular momentum in the torso, upper arm, forearm, and hand across different arm slot styles during baseball pitching; and (2) determine whether the relative timing of these segmental peaks predicts ball velocity and kinetic loads at the shoulder and elbow among various arm slot styles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Descriptive laboratory study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 363 National Collegiate Athletic Association Division I pitchers (90.99 ± 10.22 kg; 1.88 ± 0.49 m; 90.35 ± 40.39 ± 3.19 m/s) were analyzed using markerless motion capture and radar-based ball tracking during competition. A mixed-model multivariate analysis of variance tested interactions between arm slot and segmental timing, and multiple linear regressions within each arm slot predicted ball velocity and upper extremity kinetics. The overall significance level (α) was set at .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across all arm slot styles, pitchers demonstrated a consistent proximodistal sequence (torso → upper arm → hand → forearm). Earlier torso peak momentum and later hand peak momentum predicted greater ball velocity in OH and QT pitchers, whereas SA showed weaker relationships between sequencing and velocity. In OH and QT, early forearm peak momentum and delayed hand peak momentum were linked to higher shoulder distraction force, suggesting that timing disruptions may elevate joint loading. In contrast, kinetic loading in SA appeared less timing dependent and more influenced by the magnitude of angular momentum. In OH and SA, delayed forearm peak momentum and early hand peak momentum were linked to higher elbow varus torque. In QT, early hand peak momentum were linked to higher elbow varus torque.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings suggest that segmental sequencing influences both performance and joint loading across arm slot styles and that deviations from efficient timing may elevate injury risk. Training that improves trunk rotation and distal timing may enhance performance and reduce joint stress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;The association between segmental timing and upper-extremity loading suggests that timing characteristics may be an important factor when evaluating throwing-related injuries. Assessing arm slot-specific timing patterns m","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261453310"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840964","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":"Cannabis Use and Postoperative Complications After Primary Achilles Tendon Repair: A Propensity Score-Matched Cohort Study.","authors":"Jason Kreinces, Paige Miller, Zachary Vredenburgh","doi":"10.1177/23259671261471378","DOIUrl":"10.1177/23259671261471378","url":null,"abstract":"<p><strong>Background: </strong>Recreational and medical cannabis continue to increase substantially, yet its impact on musculoskeletal healing has not been investigated extensively.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to evaluate the association between preoperative cannabis use and postoperative complications after primary Achilles tendon repair. We hypothesized that cannabis users would demonstrate higher rates of complications and revision surgery.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients who underwent primary Achilles tendon repair, as reported in the TriNetX database. Patients were stratified into 2 cohorts based on documented cannabis use. Propensity score matching (1:1) was utilized to balance confounding baseline demographic characteristics and comorbidities. Primary outcomes were revision surgical repair and reinjury rate at 1 and 2 years, while other medical and surgical complications were also evaluated at 90 days and 6 months postoperatively. Statistical analysis was performed in the TriNetX system. Continuous variables were reported as the mean ± standard deviation. Categorical variables were reported as frequencies and percentages, with risk ratios and Kaplan-Meier analysis recorded for appropriate variables.</p><p><strong>Results: </strong>After propensity score matching, 1088 matched pairs were analyzed with appropriate covariate balance, all with standardized differences <0.10. Cannabis users demonstrated significantly higher rates of wound dehiscence at 90 days (4.32% vs 2.29%; <i>P</i> = .0075) and 6 months (5.60% vs 3.03%; <i>P</i> = .0149). Revision repair rates at 1 year (1.38% vs 1.01%; <i>P</i> = .340) and 2 years (2.02% vs 1.01%; <i>P</i> = .062) did not differ significantly between groups. Kaplan-Meier survival analysis showed no significant difference in revision-free survival at 1 year (98.35% vs 98.73%; <i>P</i> = .451) or 2 years (97.39% vs 98.55%; <i>P</i> = .117).</p><p><strong>Conclusion: </strong>These findings suggest that cannabis use may play a role in early wound healing without compromising long-term tendon structural repair. These data can help surgeons educate patients about potential increases in the risk of wound complications and prompt consideration of preoperative counseling and enhanced postoperative wound surveillance.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261471378"},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819185","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":"Rotator Cuff Reconstruction Using Biceps Tendon Autograft Versus Acellular Dermal Allograft: A Systematic Review and Meta-analysis of Clinical Outcomes.","authors":"Ahmed H Alhussain, Mohammed T Alzahrani, Ziad A Aljaafri, Abullah M Alanazi, Abdulrahman H Almalki, Khalid A Alsheikh","doi":"10.1177/23259671261470960","DOIUrl":"10.1177/23259671261470960","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Massive rotator cuff tears impose a challenge in shoulder surgery because of high failure rates and poor tendon healing. Augmentation using biological grafts emerged as a solution to enhance surgical outcomes; they provide structural reinforcement, while biceps tendon autografts offer native biological integration. The comparative effectiveness of these 2 techniques remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis/purpose: &lt;/strong&gt;We hypothesized that both techniques would provide comparable clinical outcomes, but differences may exist in graft integrity and complication rates. The purpose was to evaluate clinical outcomes, functional improvement, and graft healing rates after rotator cuff repair using human dermal (HD) allograft versus biceps tendon autograft augmentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Meta-analysis and systematic review; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A meta-analysis was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were identified through a comprehensive search of the PubMed, Embase, Scopus, and Cochrane Library databases. Studies comparing HD allografts and biceps tendon autografts for rotator cuff repair were included. Outcome measures included the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS), range of motion (ROM), acromiohumeral distance (AHD), and retear rates. A random-effects model was used to analyze pooled data, and heterogeneity was assessed using the &lt;i&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/i&gt; statistic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventeen observational studies involving 613 patients were included, comparing long head of the biceps tendon (LHBT) autograft (n = 322) and acellular HD allograft (n = 291). Both techniques demonstrated substantial improvements across functional, pain, and radiological outcomes. For functional recovery, the pooled standardized mean difference (SMD) in ASES scores was higher in the LHBT autograft group (SMD, 2.35 [1.63 to 3.07]) compared with the HD allograft group (SMD, 1.65 [1.40 to 1.90]). However, subgroup differences were not statistically significant (&lt;i&gt;P&lt;/i&gt; = .07). Pain outcomes showed marked improvement in both groups, with LHBT autograft demonstrating a greater reduction (VAS SMD, -2.25 [-2.89 to -1.61]) compared with HD allograft (SMD, -1.89 [-2.22 to -1.56]; &lt;i&gt;P&lt;/i&gt; = .32). ROM also improved, with forward elevation SMDs of 0.92 (LHBT) and 0.65 (HD), and external rotation SMDs of 1.08 and 0.22, respectively. AHD increased in both groups (LHBT SMD, 1.38; HD SMD, 1.13), with no significant intergroup differences observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both LHBT autograft and acellular HD allograft augmentation for massive rotator cuff repair showed improvements in function, pain, ROM, and AHD, with comparable retear rates. Despite heterogeneity among studies, HD allograft procedures appear to yield predictable clinical outcome","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470960"},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819158","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":"A Novel Approach to Segmental Meniscal Repair Improves Ultimate Strength and Resistance to Cyclic Fatigue.","authors":"Hisham Omar, Akbar N Syed, Kevin Landrum, Jacob Sommer, Kevin Shea, Theodore J Ganley, Michael W Hast","doi":"10.1177/23259671261468500","DOIUrl":"10.1177/23259671261468500","url":null,"abstract":"<p><strong>Background: </strong>Meniscal tears are common sports-related injuries, and surgical repairs continue to have undesirable clinical outcomes. Meniscal allograft transplantation is limited by the availability of suitable age-matched and size-matched allografts and poor long-term survival. Segmental meniscal transplantation may improve outcomes by preserving the meniscotibial ligament complex; however, little is known about how surgical techniques influence the biomechanics of such reconstructions.</p><p><strong>Purpose: </strong>To evaluate the biomechanical performance of 2 surgical reconstruction strategies for segmental meniscal transplantation using a cadaveric bovine meniscus model.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 24 bovine meniscus explants (12 medial, 12 lateral) underwent 2 repair techniques (n = 12 per group; 6 medial and 6 lateral per group): (1) Repair 1, using 2 hashtag, 1 vertical rip-stop, and 2 luggage tag sutures; and (2) Repair 2, using 4 luggage, 1 vertical mattress, and 2 horizontal mattress sutures. Half of the specimens (n = 12) underwent quasi-static uniaxial tensile testing to failure; the remaining half underwent 1000 loading cycles before failure. Outcomes included stiffness, maximum force, failure mode, construct deformation, and cyclic survival.</p><p><strong>Results: </strong>Repair 1 demonstrated significantly higher ultimate failure loads in both static (311.9 ± 26.2 N vs. 209.5 ± 82.6 N; <i>P</i> = .016) and dynamic testing (339 ± 43 N vs. 181 ± 89 N; <i>P</i> = .003) compared with Repair 2. During cyclic loading, 33% of Repair 2 specimens did not complete the full protocol. Cyclic stiffness and construct deformation favored Repair 1, although differences between groups did not reach significance at any individual cycle count.</p><p><strong>Conclusion: </strong>A surgical technique combining hashtag sutures with luggage-tag fixation (Repair 1) increased ultimate failure load and reduced the likelihood of cyclic failure, suggesting it may enhance the stability and durability of segmental meniscal repairs.</p><p><strong>Clinical relevance: </strong>Robust fixation of segmental meniscal repairs may improve surgical outcomes for meniscal deficiency and offer an alternative to full meniscal transplantation.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261468500"},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819131","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 Basketball-Related Injuries at US Emergency Departments Between High School-Aged and College-Aged Athletes: A 10-Year NEISS Analysis, 2015-2024.","authors":"John R Tyler, Mark Gamadia, Nata Parnes, Hunter Czajkowski, Mitchell J Christiansen, Mary K Mulcahey","doi":"10.1177/23259671261476937","DOIUrl":"10.1177/23259671261476937","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Basketball is widely played in the United States, yet contemporary comparisons of basketball-related injuries between high school- and college-aged athletes using nationally representative emergency department (ED) data remain limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare basketball-related injury epidemiology between high school- and college-aged athletes and characterize the burden of these injuries on US EDs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Descriptive epidemiological study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The National Electronic Injury Surveillance System (NEISS) was queried for basketball-related injuries in athletes aged 14 to 23 years from 2015 to 2024. Patients aged 14 to 18 years were categorized as high school-aged and those aged 19 to 23 years as college-aged. Weighted national estimates were calculated using NEISS sampling weights. US Census Bureau annual population estimates were summed across ages 14 to 18 years and 19 to 23 years to determine the population at risk for each group and calculate incidence rates (IRs) per 100,000 person-years. IR ratios (IRRs) with 95% CIs were used to compare age groups by overall incidence, injury pattern, and ED disposition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 61,279 basketball-related injuries among athletes aged 14 to 23 years were documented in the NEISS database, corresponding to an estimated 2,023,859 injuries treated in US EDs between 2015 and 2024. High school-aged athletes had a higher overall injury incidence than college-aged athletes (686.67 vs 252.63 per 100,000 person-years; IRR, 2.72; 95% CI, 2.67-2.77). Both groups showed a sharp decline in injury incidence in 2020, corresponding with the onset of the COVID-19 pandemic. The ankle (26.8%), knee (11.8%), finger (10.3%), and head (8.6%) were the most frequently injured body regions. High school-aged athletes had significantly higher rates of injuries to the head (IRR, 4.88; 95% CI, 4.52-5.27), lower arm (IRR, 5.02; 95% CI, 4.18-6.04), wrist (IRR, 4.12; 95% CI, 3.71-4.58), elbow (IRR, 4.12; 95% CI, 3.54-4.80), and finger (IRR, 3.64; 95% CI, 3.42-3.87), as well as higher rates of concussion (IRR, 6.64; 95% CI, 5.81-7.58), fractures (IRR, 3.43; 95% CI, 3.25-3.61), and strains and sprains (IRR, 2.73; 95% CI, 2.65-2.81). Treated-and-discharged injuries accounted for 97.6% of ED visits among high school-aged athletes and 96.8% among college-aged athletes; however, high school-aged athletes had higher rates of transfer or admission (IRR, 7.61; 95% CI, 5.26-10.99) and observation (IRR, 5.49; 95% CI, 3.06-9.84).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study showed that from 2015 to 2024, high school-aged athletes had substantially higher IRs than college-aged athletes for basketball-related ED injuries across most body regions, diagnoses, and ED dispositions. These findings support targeted injury prevention strategies at the high school level and highlight the burden basketball injuries place on ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261476937"},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795653","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":"Return to Dance and Functional Recovery After Hip Arthroscopy With Labral Repair in Competitive Dancers at Minimum 2-Year Follow-up.","authors":"Jason G Ina, Gavin H Ward, Sanathan Iyer, Kelechi R Okoroha, Bruce A Levy, Aaron J Krych, Mario Hevesi","doi":"10.1177/23259671261470942","DOIUrl":"10.1177/23259671261470942","url":null,"abstract":"<p><strong>Background: </strong>Dancers are at risk of femoroacetabular impingement (FAI) owing to supraphysiologic range of motion and associated demands placed on their hips. There remains a paucity of literature on midterm outcomes in dancers who undergo primary arthroscopy and labral repair for FAI.</p><p><strong>Purpose: </strong>To determine the rate of return to dance and patient-reported outcome measures in competitive dancers after hip arthroscopy with labral repair for FAI with minimum 2-year follow-up.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This study included dancers with FAI undergoing primary hip arthroscopy with labral repair from 2010 to 2022. Patient-reported outcome measures were collected at 2-year minimum follow-up: modified Harris Hip Score (overall, activities of daily living, gait, pain), Hip Outcome Score (activities of daily living, sports-specific subscale), Tegner Activity Scale, visual analog scale for pain, and surgery satisfaction. Patients were evaluated for preoperative radiographic measurements, postoperative return to sport, and revision surgery. Return to dance was evaluated.</p><p><strong>Results: </strong>Thirty-seven dancers were followed for a mean 7.4 years (range, 3.2-12.2) postoperatively (36 female and 1 male; mean ± SD age, 21 ± 7 years; mean body mass index, 23.3 ± 4.5). All outcome scores significantly improved postoperatively as compared with preoperatively (<i>P</i>≤ .037). Twenty dancers (71%) returned to dance. Of those who returned to dance, 17 (85%) returned to sport at the same or higher level as compared with the preoperative level. At final follow-up, 45% of dancers who initially returned to dance continued to dance. Of the dancers who no longer participated in dance at final follow-up, 7 (65%) quit dancing for nonhip-related reasons. Mean surgery satisfaction (0-10) at final follow-up was 7.1. Four patients (10%) underwent revision hip arthroscopy with revision labral repair.</p><p><strong>Conclusion: </strong>Hip arthroscopy with labral repair in dancers results in sustained improvements in function and pain at minimum 2-year follow-up. Most dancers return to their prior levels of dance, and nearly half remain active several years later. Notably, discontinuation of dance was often unrelated to hip symptoms, underscoring the importance of counseling patients on clinical and lifestyle factors influencing return to sport.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470942"},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795953","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":"Anterior Cruciate Ligament Reconstruction With or Without Lateral Extra-articular Tenodesis: A Systematic Review and Meta-analysis of Comparative Outcomes From Randomized Controlled Trials.","authors":"Faisal Alkhunein, Khalid Alrasheed, Rahaf Alrasheed, Mohammed Alorayyidh, Peter Cahusac, Hamzah Alhamzah","doi":"10.1177/23259671261470939","DOIUrl":"10.1177/23259671261470939","url":null,"abstract":"<p><strong>Background: </strong>Clinical outcomes continue to be a concern after anterior cruciate ligament reconstruction (ACLR). Lateral extra-articular tenodesis (LET) has reemerged as an adjunct procedure for enhancing knee function; however, its overall clinical effectiveness remains controversial.</p><p><strong>Hypothesis: </strong>The addition of LET to primary ACLR would result in superior clinical, functional, and patient-reported outcomes as compared with isolated ACLR.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 1.</p><p><strong>Methods: </strong>This study was conducted according to the PRISMA 2020 guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and registered in PROSPERO. Multiple databases were searched from 1995 to October 2025. Ten high-quality randomized controlled trials comparing ACLR with and without LET were included in the final meta-analysis. The outcomes assessed included graft failure, rotational and anterior knee stability, functional scores, patient-reported outcomes, and return-to-sport rates. Random effects models were used, and heterogeneity was evaluated.</p><p><strong>Results: </strong>When compared with isolated ACLR, ACLR augmented with LET demonstrated significantly lower graft failure rates (odds ratio [OR], -1.19; 95% CI, -1.73 to -0.65; <i>P</i> < .001) and improved rotational stability, as evidenced by superior pivot-shift outcomes (OR, -0.81; 95% CI, -1.11 to -0.52; <i>P</i> < .001). Significant improvements were also observed in Lysholm scores (OR, 1.98; 95% CI, 0.19-3.77; <i>P</i> = .030) and International Knee Documentation Committee (IKDC) subjective scores (OR, 1.65; 95% CI, 0.24-3.05; <i>P</i> = .22). No statistically significant differences were identified between the groups in KT-1000 measurements, Lachman test results, IKDC objective scores, Knee injury and Osteoarthritis Outcome Score subscales, Tegner activity scores, or return-to-sport rates. Heterogeneity was low across most outcomes (<i>I</i> ² = 0%), except for the Tegner scale (<i>I</i> ² = 83.12%).</p><p><strong>Conclusion: </strong>The addition of LET to primary ACLR was associated with significantly improved graft survival (log OR, -1.19; 95% CI, -1.73 to -0.65; <i>P</i> < .001); enhanced rotational stability as demonstrated by improved pivot-shift outcomes (log OR, -0.81; 95% CI, -1.11 to -0.52; <i>P</i> < .001); and better patient-reported knee function, including Lysholm scores (mean difference, 1.98; 95% CI, 0.19-3.77; <i>P</i> = .030) and IKDC subjective scores (mean difference, 1.65; 95% CI, 0.24-3.05; <i>P</i> = .22). However, no significant benefits were observed in anterior laxity or return-to-sport rates.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470939"},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795635","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 Efficacy of Synovectomy in Rotator Cuff Repair: A Randomized Controlled Trial.","authors":"Dong Min Kim, Jae Woo Cho, Sohee Oh, Chris Hyunchul Jo","doi":"10.1177/23259671261474635","DOIUrl":"10.1177/23259671261474635","url":null,"abstract":"<p><strong>Background: </strong>Synovitis is frequently observed in patients with rotator cuff tears and has been associated with increased pain and inferior clinical outcomes. Although synovectomy has demonstrated clinical benefits in primary synovial disorders, its role as an adjunctive procedure during arthroscopic rotator cuff repair remains controversial, particularly regarding early postoperative pain relief.</p><p><strong>Purpose: </strong>To evaluate the effect of synovectomy on clinical outcomes after arthroscopic rotator cuff repair.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 1.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included 60 patients with full-thickness rotator cuff tears who underwent arthroscopic rotator cuff repair between March 2017 and May 2018. Patients were randomly assigned to undergo rotator cuff repair with synovectomy (n = 30) or without synovectomy (n = 30). The primary outcome was worst pain measured using a 10-cm visual analog scale (VAS) at 3 months postoperatively. Secondary outcomes included other pain measures, range of motion, rotator cuff muscle strength, functional outcome scores, and patient-reported satisfaction. Outcomes were assessed preoperatively and at 3 months postoperatively by blinded assessors.</p><p><strong>Results: </strong>Worst pain VAS scores significantly improved from baseline to 3 months postoperatively in both groups (<i>P</i> < .05), with no significant between-group difference in the magnitude of improvement (<i>P</i> = .79). No significant between-group differences were observed at 3 months in any pain measure, range of motion, rotator cuff muscle strength, functional outcome scores, or overall satisfaction. Although supraspinatus strength decreased significantly from baseline only in the control group, the between-group difference in strength change was not significant.</p><p><strong>Conclusion: </strong>Synovectomy performed during arthroscopic rotator cuff repair did not provide additional short-term benefits in pain relief, functional recovery, or patient satisfaction at 3 months postoperatively. These findings do not support the routine use of synovectomy as an adjunctive procedure to improve early postoperative outcomes after rotator cuff repair.</p><p><strong>Registration: </strong>NCT03061942 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261474635"},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796145","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}