Orthopaedic Journal of Sports Medicine最新文献

{"title":"Trochleoplasty Utilization in the Management of Patellofemoral Instability: Results From an International Survey of Surgeons.","authors":"Brendan A Williams, Morgan G Batley, John A Schlechter, Lauren H Redler, Moshe Yaniv, Nicole A Friel, Shital N Parikh, J Lee Pace, Beth E Shubin Stein, Sean Waldron, Stephanie L Logterman, Kevin Shea, Kendall E Bradley, Eileen A Crawford, Elliot Greenberg, Joseph Hannon, Alicia Kerrigan, Megan H M Kuba, Jeffrey Albaugh","doi":"10.1177/23259671241303147","DOIUrl":"10.1177/23259671241303147","url":null,"abstract":"<p><strong>Background: </strong>Considerable variability exists in the described clinical and radiographic indications for use, surgical techniques, postoperative management, and risk profile after trochleoplasty for the management of patellofemoral instability (PFI). In areas of clinical uncertainty, a cohesive summary of expert opinion and identification of areas of variation in current practice can be useful in guiding current practice and future research efforts.</p><p><strong>Purpose: </strong>To assess the current indications for use, surgical techniques, postoperative rehabilitation practices, and observed complication profile for trochleoplasty in the management of PFI among surgeons who perform this procedure.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A 21-item cross-sectional survey was developed to evaluate trochleoplasty in its current practice among surgeons around the world. The survey was distributed between December 2021 and April 2022 to the orthopaedic surgeon membership of multiple national and international knee, arthroscopy, and sports medicine societies to identify any surgeon with experience performing the trochleoplasty procedure in practice for the management of PFI. Descriptive statistics of survey responses were performed to address study aims, and univariate analyses were performed to compare differences between high- and low-volume trochleoplasty surgeons.</p><p><strong>Results: </strong>Survey distribution identified 32 orthopaedic surgeons with experience performing the trochleoplasty procedure. Procedural indications were most commonly felt to be met with Dejour classification of B or D on magnetic resonance imaging. Trochleoplasty was felt by most to be appropriate as a primary surgical intervention for PFI. A majority of surgeons utilized a Bereiter (thin-flap) trochleoplasty technique with suture-based fixation and performed concurrent medial patellofemoral ligament reconstruction, but other concomitant procedures varied. Range-of-motion precautions and bracing practices varied among respondents, and arthrofibrosis was the most frequently cited observed complication. High- and low-volume trochleoplasty surgeons differed in their radiographic and age-based indications for the procedure.</p><p><strong>Conclusion: </strong>Study findings indicated that variation exists in the surgical indicators, technique, and postoperative rehabilitation practices of trochleoplasty surgeons, with specific differences noted between high- and low-volume trochleoplasty surgeons. The results of this survey identified areas of equipoise and treatment variation that should direct future research efforts in the study of the trochleoplasty procedure.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241303147"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984538","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":"Effects of Neuromuscular Electrical Stimulation on Quadriceps Femoris Muscle Strength and Knee Joint Function in Patients After ACL Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Zhikuan Li, Lingpeng Jin, Zhen Chen, Ziqi Shang, Yue Geng, Siman Tian, Jiangtao Dong","doi":"10.1177/23259671241275071","DOIUrl":"10.1177/23259671241275071","url":null,"abstract":"<p><strong>Background: </strong>Quadriceps weakness is a common barrier to effective rehabilitation after anterior cruciate ligament (ACL) surgery. Neuromuscular electrical stimulation (NMES)-the application of electrical currents to induce muscle contraction-has been used as part of the postoperative rehabilitation regimen.</p><p><strong>Purpose: </strong>To investigate the effects of NMES on the recovery of quadriceps strength and knee function after ACL surgery.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>A search was conducted in the Web of Science, Embase, Cochrane Library, and PubMed databases between inception and August 2023 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were randomized controlled trials of patients undergoing NMES as postoperative rehabilitation after ACL reconstruction or repair, with standard physical therapy as the control intervention. The quality of the included studies was assessed according to the Cochrane Collaboration risk-of-bias tool. Lower limb function was assessed qualitatively, and standardized mean differences (SMDs) in muscle strength and Lysholm scores were analyzed quantitatively and pooled using a random-effects model.</p><p><strong>Results: </strong>Eleven studies (N = 202 patients) met our inclusion criteria. The meta-analysis of muscle strength values, which included 9 studies, showed that patients who underwent physical rehabilitation with adjunctive NMES had better recovery and improvement in quadriceps muscle strength compared with standard physical therapy at both short- and long-term follow-ups (≤6 weeks: SMD, 0.53 [95% CI, 0.27-0.79] vs >6 weeks: SMD, 0.59 [95% CI, 0.18-0.99]; <i>p</i> < 0.001). Moreover, subgroup analyses showed that earlier physical rehabilitation with the assistance of NMES resulted in better muscle strength recovery (≤1 week: SMD, 1.48 [95% CI, 0.80-2.17] vs >1 week: SMD, 0.44 [95% CI, 0.21-0.67]; <i>p</i> < 0.001). The meta-analysis of Lysholm scores, which included 3 studies, did not indicate any significant differences between the assisted NMES and control groups.</p><p><strong>Conclusion: </strong>Our study demonstrated that in both short- and long-term follow-up studies, postoperative rehabilitation with NMES after ACL surgery significantly increased quadriceps muscle strength compared with standard rehabilitation alone.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241275071"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984467","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":"Indicators of Return to Sports at Preinjury Levels Following Surgery for Chronic Ankle Instability: Comparison of ALR-RSI, AOFAS, and Karlsson Scores.","authors":"Ali Fares, Brice Picot, Ronny Lopes, Fadi Nader, Yoann Bohu, Alain Meyer, Antoine Gerometta, Olivier Grimaud, Nicolas Lefevre, Mohamad K Moussa, Alexandre Hardy","doi":"10.1177/23259671241302078","DOIUrl":"10.1177/23259671241302078","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While there are several scales for measuring patients' outcomes after chronic ankle instability (CAI) surgery, a study comparing the predictive ability of these scores with regard to return to sports (RTS) at the preinjury level is lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to compare the Ankle Ligament Reconstruction-Return to Sport After Injury (ALR-RSI), American Orthopaedic Foot and Ankle Society (AOFAS), and Karlsson scores in predicting 2-year RTS outcomes after arthroscopic treatment of CAI. It was hypothesized that ALR-RSI would be superior in predicting 2-year RTS outcomes after CAI surgery and that a quantifiable increase in this score would significantly improve RTS outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective cohort study analyzed patients who underwent surgery for CAI at a sports surgery center between 2016 and 2018. The inclusion criteria focused on adult patients undergoing their first surgery for CAI with a minimum 2-year follow-up. The primary outcome was RTS at 2 years. The study evaluated 3 scores at 1 year postoperatively to predict RTS at the same level as the preinjury level at 2 years-ALR-RSI, AOFAS Ankle-Hindfoot Scale, and Karlsson score. The most predictive score, with its corresponding optimal threshold, was determined using the receiver operating characteristic (ROC) curve. This threshold signifies the score value above which the likelihood of RTS at the preinjury level is significantly increased. Once identified, the secondary outcome evaluated the impact of a 10-point increase in this score on RTS, after adjusting for confounding factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 159 patients (age, 35.7 ± 11.4 years) were included. Two years after surgery, 40.25% of patients returned to their preinjury level of sports. ROC curve analysis of the tested scores at 1-year postoperatively showed the ALR-RSI score had the best predictive ability for RTS (area under the curve [AUC], 0.70 [95% CI, 0.6-0.77]), whereas Karlsson and AOFAS scores were less predictive (AUC, 0.53 [95% CI, 0.43-0.63] and 0.61 [95% CI, 0.52-0.70], respectively). The optimal threshold for the ALR-RSI score was identified at 83 (Youden index = 0.35, sensitivity = 63%, and specificity = 71%). Confounder identification revealed earlier surgery and arthroscopic techniques were associated with higher RTS rates. A 10-point increase in the ALR-RSI score correlated with increased odds of RTS (1.27 [95% CI, 1.12-1.46]; &lt;i&gt;P&lt;/i&gt; = .0004) in univariate analysis and (1.29 [95% CI, 1.06- 1.61]; &lt;i&gt;P&lt;/i&gt; = .01) in multivariate analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed that none of the scores were great predictors of RTS after surgery for CAI. The ALR-RSI score was a stronger predictor of RTS to the same preinjury level after CAI surgery than AOFAS and Karlsson scores. The ALR-RSI optimal","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241302078"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984470","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":"Causal Relationships Between 4 Exposure Factors and Rotator Cuff Syndrome Using Mendelian Randomization Analysis.","authors":"Zeyang Zhang, Shun Han, Xiaowei Sun, Zelin Guo, Zhiqiang Wang, Peng Sha, Yuchen Liu, Bing Zhang, Yupeng Liu","doi":"10.1177/23259671241285860","DOIUrl":"10.1177/23259671241285860","url":null,"abstract":"<p><strong>Background: </strong>Although previous studies have investigated the risk factors for rotator cuff syndrome (RCS), there remains controversy due to uncontrolled and uncertain confounding factors in their analyses.</p><p><strong>Purpose: </strong>To perform Mendelian randomization (MR) analysis using single-nucleotide polymorphisms to investigate the causal relationship between RCS and 4 risk factors: type 2 diabetes mellitus (T2DM), high blood pressure (HBP), body mass index (BMI), and low high-density lipoprotein cholesterol (HDL-C).</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) data for T2DM (ebi-a-GCST006867), BMI (ieu-b-40), HBP (finn-b-I9_HYPTENS), HDL-C (ieu-b-109), and RCS (ukb-b-50) were obtained from the IEU Open GWAS Project. The dataset of each risk factor was combined with the dataset of RCS, generating 4 datasets. Potential confounders and single-nucleotide polymorphisms related to RCS were excluded from these datasets. The causal relationships between the exposure factors and RCS were analyzed using 5 regression models: MR-Egger, weighted median estimate (WME), inverse-variance weighting (IVW), simple mode, and weighted mode. Heterogeneity in the causal effects was assessed using MR-Egger regression and IVW analyses. Sensitivity analyses were performed to determine the stability of the results.</p><p><strong>Results: </strong>The MR-Egger regression intercepts for T2DM, BMI, HBP, and HDL-C showed no horizontal pleiotropic effects. The results of the Cochran <i>Q</i> test showed <i>P</i> values of .075 and .080 for BMI in the MR-Egger regression and IVW models, respectively, indicating the absence of heterogeneity between BMI and RCS. The results of the weighted median estimate and IVW regression analyses showed a significant causal association between BMI and RCS, with odds ratios of 1.002 (95% CI, 1-1.004; <i>P</i> = .038) and 1.003 (95% CI, 1.001-1.005; <i>P</i> = .0003), respectively. No significant associations were found for T2DM, HDL-C, or HBP.</p><p><strong>Conclusion: </strong>In the present study, BMI was positively associated with the risk of developing RCS, while T2DM, HBP, and low HDL-C were not associated with RCS development.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241285860"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984522","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":"Acute Effects of Unplanned and Planned Hop-Landing Training on Neurocognitive Function and Knee Biomechanics.","authors":"Mika Konishi, Nicholas C Clark, Duncan J McDonald, Masahiro Takemura, Nelson Cortes","doi":"10.1177/23259671241302326","DOIUrl":"10.1177/23259671241302326","url":null,"abstract":"<p><strong>Background: </strong>Athletes with decreased baseline neurocognitive function may experience noncontact anterior cruciate ligament (ACL) injury in unanticipated athletic situations. Many ACL injury prevention programs (IPPs) focus on improving closed-skill movements (eg, planned landing). However, the more open-skill movements (eg, unplanned reactive movements) required in unpredictable sports scenarios are commonly absent from ACL IPPs, and the acute effects of open-skill training on neurocognitive function remain unclear.</p><p><strong>Purpose: </strong>To investigate the acute effects of unplanned versus planned training on neurocognitive function and knee biomechanics associated with ACL injury risk during the side-step cutting motion.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 32 adult recreational athletes (16 female, 16 male) were randomly assigned to either an unplanned training (UT) group or a control (CON) group. The UT group performed unplanned hop-landing training while the CON group performed planned hop-landing training. Both before and after the training, neurocognitive function was evaluated using the Trail Making Test-part B and Stroop Color and Word Test. Additionally, unanticipated and anticipated side-step cutting tasks were performed while 3-dimensional kinematic and kinetic data for the dominant leg were collected. Neurocognitive test scores and biomechanical variables relevant to ACL injury were analyzed using 2-way repeated-measures analysis of variance to determine the main effects of training, group, and training × group interaction.</p><p><strong>Results: </strong>Trail Making Test-part B and Stroop Color and Word Test scores significantly improved from pre- to posttraining in both groups (<i>P</i> < .001 for both). There was a significant training × group interaction for peak knee abduction angle during the unanticipated side-step cutting task (pre- vs posttraining: -8.81°± 7.23° vs -7.40°± 7.24° [UT group]; -8.23°± 9.40° vs -9.99°± 9.83° [CON group]; <i>P</i> = .02) and for peak vertical ground-reaction force during the anticipated side-step cutting task (pre- vs posttraining: 3.86 ± 0.59 vs 4.08 ± 0.74 percentage body weight [%BW] [UT group]; 3.70 ± 0.62 vs 3.34 ± 0.62 %BW [CON group]; <i>P</i> = .04).</p><p><strong>Conclusion: </strong>Study findings showed a significant training × group interaction for knee abduction angle during the unanticipated side-step cutting task with unplanned training and for vertical ground-reaction force during the anticipated side-step cutting task with planned training.</p><p><strong>Clinical relevance: </strong>Designing ACL IPPs based on the sport type (ie, open skill or closed skill) may contribute to better preparation.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241302326"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971765","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 the Prevalence of Sports-Related Injuries in Collegiate Baseball Players.","authors":"Hiroaki Ishikawa, Daniel M Cushman, Robert Z Tashjian, Peter N Chalmers","doi":"10.1177/23259671241303473","DOIUrl":"https://doi.org/10.1177/23259671241303473","url":null,"abstract":"<p><strong>Background: </strong>Sports-related injuries remain a significant problem for collegiate baseball players. Although some studies reported the epidemiology of sports-related injuries among collegiate baseball players, the latest information on sport-related injuries should be provided.</p><p><strong>Purpose: </strong>To examine the current trends of sports-related injuries among collegiate baseball players in the Pacific 12 (PAC-12) Conference.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Demographic and injury data were obtained from a database of the PAC-12 Health Analytics Program between 2016 and 2021. Injury incidence, type, mechanism, and outcome were analyzed. The annual incidence of injuries was defined as the number of injuries per total players for 1 year. Detailed reports of the 20 most common specific diagnoses were generated.</p><p><strong>Results: </strong>A total of 1434 sports-related injuries occurred in 6 years, with the number increasing from 2016 (n = 75; incidence, 8.5 per 100 player-years) to 2021 (n = 378; incidence, 43 per 100 player-years). Most of the injuries occurred in pitchers (33.6%), were acute (76.6%), resulted in missed time (68.8%), and were new injuries (86.9%). In addition, most injuries were caused by noncontact events (53.2%) and occurred during in-season games (39.9%) and practice (47.4%). Only 1.3% of sports-related injuries did not result in a return to the previous activity level. Rotator cuff tendon injuries were the most common specific diagnoses (n = 98), followed by ulnar collateral ligament (UCL) injuries (n = 63), hamstring muscle strains (n = 60), ankle ligament sprains (n = 46), and hand/wrist fractures (n = 40). UCL injuries had the highest proportion of surgical interventions (41.3% of all UCL injuries) and the longest days to clearance (167 ± 197 days) among the 20 most common diagnoses.</p><p><strong>Conclusion: </strong>The number of sports-related injuries among PAC-12 collegiate baseball players has increased by approximately 5 times over the past 6 years. Rotator cuff tendon injuries followed by UCL injuries, hamstring muscle strains, ankle ligament sprains, and hand/wrist fractures are the most common specific diagnoses among this cohort of collegiate baseball players. Of the 20 most common specific diagnoses, UCL injuries most often require surgical interventions and had the longest return to playtime.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241303473"},"PeriodicalIF":2.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952853","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":"Surgical Outcomes of Lateral Ulnar Collateral Ligament Reconstruction Versus Repair for Posterolateral Rotatory Instability of the Elbow: A Systematic Review and Meta-analysis.","authors":"Erica Kholinne, Zhan Herr Ng, Maria Anastasia, Leonard Christianto Singjie, Jae-Man Kwak, In-Ho Jeon","doi":"10.1177/23259671241299831","DOIUrl":"https://doi.org/10.1177/23259671241299831","url":null,"abstract":"<p><strong>Background: </strong>The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.</p><p><strong>Purpose: </strong>To review studies comparing surgical outcomes of LUCL reconstruction versus repair in treating PLRI of the elbow.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was conducted on PubMed, Medline (via EBSCO), ProQuest, and ScienceDirect databases using the following keywords: \"(lateral ulnar collateral ligament reconstruction)\" OR \"(lateral ulnar collateral ligament repair)\" AND \"(outcome).\" Excluded were studies in languages other than English, those that included terrible triad injury, transolecranon fracture, radial head arthroplasty involvement, associated procedures, animal studies, and biomechanical studies. A total of 193 studies were identified after the initial search. The primary outcome measure was the Mayo Elbow Performance Score, which was compared between studies using a random-effects model.</p><p><strong>Results: </strong>Overall, 20 studies (N = 646 patients) were included, with 445 of 646 patients (68.8%) in the LUCL reconstruction group and 201 of 646 patients (31.1%) in the LUCL repair group. All injuries in the included studies were traumatic. The LUCL reconstruction group had a longer follow-up period compared with the LUCL repair group (72.05 ± 43.51 vs 36.86 ± 21.19 months, respectively). The postoperative range of motion arc was similar in both the repair and reconstruction groups (135.02°± 15.33° vs 133.60°± 8.84°, respectively). Both LUCL repair and LUCL reconstruction resulted in good to excellent outcomes on patient-reported outcome measures; however, a superior rate of return to activity and a lower complication rate were found after LUCL reconstruction versus LUCL repair (8.3% vs 14.9%). Ulnar nerve event (2.3%) was the most common complication in both groups.</p><p><strong>Conclusion: </strong>Findings indicated that LUCL reconstruction had a superior rate of return to activity and a lower complication rate compared with LUCL repair.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241299831"},"PeriodicalIF":2.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952854","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":"Effects of Early Sport Specialization on Injury Load Management and Athletic Success of National Basketball Association Players.","authors":"Luke Sang, Katherine Bach, Brian T Feeley, Nirav K Pandya","doi":"10.1177/23259671241304732","DOIUrl":"https://doi.org/10.1177/23259671241304732","url":null,"abstract":"<p><strong>Background: </strong>The effects of early sport specialization on professional athletes' resilience in handling increased workloads and athletic success have not been fully described.</p><p><strong>Hypothesis: </strong>National Basketball Association (NBA) players who were multisport athletes during high school would be able to withstand higher workloads with lower injury rates and have more athletic success compared with their single-sport peers.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Included were first-round NBA draft picks from 2013 to 2023 who had played ≥1 game in their first 3 seasons after being drafted. Athletes who had participated in ≥1 high school sports in addition to basketball were classified as multisport athletes, while those who had only played basketball were classified as single-sport athletes. For each player's first 3 NBA seasons, workload data (number of games played and distance traveled per game/season in meters), injury history, statistical performance (player efficiency rating), and end-of-season award history were collected through the official NBA advanced statistics database and through publicly available records.</p><p><strong>Results: </strong>Overall, 318 athletes were included, of whom 87 (27.4%) were multisport and 231 (72.6%) were single-sport. During their first 3 seasons combined, multisport athletes played in significantly more games (148.9 ± 67.1 vs 125.8 ± 63.8; <i>P</i> < .01), traveled greater total distances (133,183.9 ± 239,923.0 m vs 73,879.5 ± 165,093.9 m; <i>P</i> < .01), and had a significantly lower percentage of games missed due to injury (13.5% vs 16.9%; <i>P</i> < .001) compared with single-sport athletes. There was a significant correlation between increased workload (total distance traveled) and number of injuries in single-sport athletes (<i>ρ</i> = 0.37; <i>P</i> < .001) but not in multisport athletes (<i>ρ</i> = 0.14; <i>P</i> = .20). Last, multisport players had a significantly higher player efficiency rating (12.8 ± 11.6 vs 10.5 ± 5.1; <i>P</i> < .05) and award achievement likelihood (40.2% vs 19.0%; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>NBA players who had participated in multiple sports during high school demonstrated an ability to withstand higher workloads while having fewer games missed due to injury when compared with players who had only played basketball. Furthermore, athletes who delayed sport specialization had greater statistical and award success in their professional careers than those who focused on early single-sport specialization.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241304732"},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932367","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":"Evaluation of Factors Associated With Short-term Failure After Primary Isolated PCL Reconstruction: A Study of Patients From the Swedish and Norwegian Knee Ligament Registries.","authors":"Bálint Zsidai, Philipp W Winkler, Eric Naarup, Ebba Olsson, Alexandra Horvath, Gilbert Moatshe, Martin Lind, Volker Musahl, Eric Hamrin Senorski, Kristian Samuelsson","doi":"10.1177/23259671241305191","DOIUrl":"https://doi.org/10.1177/23259671241305191","url":null,"abstract":"<p><strong>Background: </strong>The rate of subjective failure after isolated primary posterior cruciate ligament reconstruction (PCL-R) is relatively high, requiring an improved understanding of factors associated with inferior outcomes.</p><p><strong>Purpose: </strong>To determine the association between patient and injury-related factors and total (surgical and clinical) failure at 2 years after PCL-R based on data from the Swedish National Knee Ligament Registry (SNKLR) and the Norwegian Knee Ligament Registry (NKLR).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients with primary isolated PCL-R registered between January 1, 2004 (NKLR), or January 1, 2005 (SNKLR), and December 31, 2020, were included. The primary study outcome was the risk of PCL-R failure at the 2-year follow-up, either surgical (≤2 years of index surgery) or clinical (Knee injury and Osteoarthritis Outcome Score [KOOS] Quality of Life subscale [QoL] <44) failure. Risk factors for failure were estimated utilizing univariable and multivariable logistic regression analyses.</p><p><strong>Results: </strong>Among the 189 included patients (36.0% from the SNKLR and 64.0% from the NKLR), the rate of 2-year surgical failure was 5.8%, while the rate of clinical failure was 45.0%. Multivariable analysis showed a negative association between the baseline KOOS QoL and the risk of PCL-R failure (OR, 0.74; 95% CI, 0.57-0.97; <i>P</i> = .027). Univariable analysis indicated a positive association between traffic-related injury mechanism and PCL-R failure risk (OR, 3.11; 95% CI, 1.48-6.50; <i>P</i> = .0026), with a further positive association shown in the adjusted (OR, 6.08; 95% CI, 2.00-18.50; <i>P</i> = .0015) and multivariable (OR, 6.11; 95% CI, 2.01-18.55; <i>P</i> = .0014) models. An area under the curve of 0.70 (95% CI, 0.60-0.80) was reported for the final multivariable model, implying at best poor to acceptable ability of the model to estimate PCL-R failure risk based on the variables considered.</p><p><strong>Conclusion: </strong>Patients with isolated primary PCL-R had a high (45%) rate of short-term clinical failure, and traffic-related injury was associated with increased odds of failure. No modifiable risk factors were determined as potential predictors of failure. Clinicians treating patients with isolated PCL-R associated with a traffic-related injury mechanism should be aware of a >6-fold increased odds of revision surgery and inferior knee-related quality of life at short-term follow-up.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241305191"},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932372","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 Failure Rates of Primary Quadriceps Tendon Repairs Across Different Surgical Techniques.","authors":"Mark S Katsma, Vaughn Land, S Hunter Renfro, Hunter Culp, George C Balazs","doi":"10.1177/23259671241303924","DOIUrl":"https://doi.org/10.1177/23259671241303924","url":null,"abstract":"<p><strong>Background: </strong>Quadriceps tendon ruptures occur infrequently in the general population. Biomechanical data suggest advantages with the use of suture anchor fixation for major tendon repair. Clinical studies of quadriceps tendon repair have been limited to small case series.</p><p><strong>Purpose: </strong>To evaluate clinical failure following primary quadriceps tendon repair with transosseous tunnel or suture anchor repair.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The Military Health System Data Repository was queried to identify all adult patients who underwent primary quadriceps tendon repair in the Military Health System between 2014 and 2018. Patients were excluded if they had incomplete records, polytrauma, open injury, prior ipsilateral total knee arthroplasty did not undergo quadriceps tendon repair, or underwent revision repair. Follow-up was obtained by manual chart review of both orthopaedic and nonorthopaedic records, recording any evidence of ongoing knee issues. Univariate analysis was performed to determine associations between potential risk factors and repair failure. Multicollinearity was assessed between potential risk factors, and candidate variables were included in multivariate logistic regression models to determine independent risk factors for repair failure.</p><p><strong>Results: </strong>Following application of inclusion/exclusion criteria, 245 knees in 234 patients were included. Mean age of the cohort was 52 years. Patients were predominantly male (223/234; 95%) and military retirees (143/234; 61%). Transosseous tunnel repair was the most frequently employed surgical technique (147/245; 60%), followed by suture anchor repair (78/245; 32%). Repair failure requiring revision surgery occurred in 11% of knees (27/245). Surgical-site infection following index surgery was associated with eventual rerupture (<i>P</i> = .02). There was no difference in failure rate between transosseous tunnel repair and suture anchor repair (12.2% vs 9.0%; <i>P</i> = .51). Among knees undergoing suture anchor repair, no difference in failure was found between knot-tying and knotless suture anchor fixation (<i>P</i> = .73).</p><p><strong>Conclusion: </strong>We observed no difference in failure of primary quadriceps tendon repair between transosseous tunnel and suture anchor repair types or between the 2 main suture anchor implant subtypes (knotless vs knot-tying anchors). A greater than previously reported rerupture rate was observed, indicating the need for continued investigation into optimal surgical techniques.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 1","pages":"23259671241303924"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932370","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}