Orthopaedic Journal of Sports Medicine最新文献

{"title":"Evaluating the Impact of Capsular Closure on Clinical Outcomes, Revision Rates, and Return to Sports in Adolescent Females Undergoing Hip Arthroscopy for Femoroacetabular Impingement.","authors":"Angelina M Vera, Kade S McQuivey, Sierra N Murphy, Joseph C Brinkman, Kostas J Economopoulos","doi":"10.1177/23259671241295755","DOIUrl":"10.1177/23259671241295755","url":null,"abstract":"<p><strong>Background: </strong>Young female patients undergoing hip arthroscopy have an increased prevalence of baseline capsular laxity of the hip joint. This laxity, along with superimposed postoperative iatrogenic capsular deficiency secondary to an unrepaired capsule, could potentially lead to worse outcomes after arthroscopic treatment of femoroacetabular impingement (FAI) in this population.</p><p><strong>Purpose: </strong>To compare outcomes and revision rates for young female patients undergoing hip arthroscopy for FAI and labral tear with capsular closure (CC group) versus capsular nonclosure (CNC group).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data of patients who underwent index hip arthroscopy using interportal capsulotomies by a single surgeon between January 2014 and February 2020 was performed. Female patients aged 12 to 21 years who underwent hip arthroscopy with cam or pincer osteoplasty and labral repair with a 2-year minimum follow-up were included. The Beighton score was assessed. The Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) were obtained preoperatively and at 3 months, 1 year, and 2 years postoperatively. Data were analyzed using the Mann-Whitney <i>U</i> test and Fisher exact test.</p><p><strong>Results: </strong>A total of 23 hips (20 patients) were included in the CC group and 17 hips (16 patients) were included in the CNC group. The groups were not different regarding characteristics and preoperative patient-reported outcome scores. At all follow-up intervals postoperatively, the CC group scored significantly higher HOS-ADL and HOS-SSS. Fifteen of 17 (88.2%) patients in the CC group returned to sports versus 8 of 14 (57.1%) in the CNC group (<i>P</i> = .03). Four (17.4%) hips in the CC group had revision surgery compared with 9 (52.9%) hips in the CNC group (odds ratio, 5.1; 95% CI, 1.2-22.5; <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Young female patients treated with CC while undergoing arthroscopic FAI had improved outcomes, fewer revisions, and a higher return-to-sports rate than those treated without CC.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241295755"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625750","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":"Clinical Outcome of Bicruciate Ligament Reconstruction in Multiple-Ligament Knee Injuries: Comparison With Bicruciate Reconstruction and Collateral Ligament Surgery.","authors":"Zenta Joutoku, Eiji Kondo, Yusuke Muranaka, Koji Iwasaki, Tomohiro Onodera, Tomonori Yagi, Norimasa Iwasaki, Kazunori Yasuda","doi":"10.1177/23259671251319532","DOIUrl":"10.1177/23259671251319532","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Several procedures for combined rupture of both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in multiple-ligament knee injuries (MLKIs) have been reported. However, the clinical outcome of these treatments remains controversial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;Postoperative knee stability and clinical outcomes in patients who underwent simultaneous bicruciate reconstruction would be comparable with those that underwent bicruciate reconstruction with collateral ligament surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted with 41 patients (41 knees) who sustained unilateral MLKI with combined ACL and PCL rupture. Fifteen cases required simultaneous ACL and PCL reconstruction, and the others had additional surgical treatment as follows: At the time of cruciate ligament reconstruction, 14 cases required posteromedial corner (PMC) reconstruction and 8 cases required posterolateral corner (PLC) reconstruction. Five cases were treated with an initial PMC or PLC before the cruciate ligament reconstruction. One of these underwent PMC reconstruction at the second stage for residual valgus laxity. Then, the authors divided the cases into 2 groups based on surgical procedure: in group 1, 15 patients underwent only bicruciate reconstruction. In group 2, 26 patients underwent bicruciate and PMC or PLC reconstruction/repair. The patients were examined at ≥2 years after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The side-to-side difference in the total anteroposterior translation, and the relative position on the anterior and posterior stress radiographs significantly improved postoperatively in both groups (group 1: &lt;i&gt;P&lt;/i&gt; = .0115, &lt;i&gt;P&lt;/i&gt; = .0007; group 2: &lt;i&gt;P&lt;/i&gt; = .0004, &lt;i&gt;P&lt;/i&gt; &lt; .0001). In the valgus and varus stress tests, the medial and lateral joint opening significantly improved postoperatively in group 2 (&lt;i&gt;P&lt;/i&gt; &lt; .0001; &lt;i&gt;P&lt;/i&gt; = .0093). Anterior, posterior, valgus, and varus stress radiographs showed no significant differences in comparison with that in the uninjured knee. There were no significant differences in the postoperative anteroposterior laxity and the medial and lateral joint opening between the groups. The Lysholm score, the International Knee Documentation Committee evaluation, all subscales of the Knee injury and Osteoarthritis Outcome Score, the Tegner score, and the isokinetic peak torque of quadriceps and hamstring muscles significantly improved postoperatively in both groups (&lt;i&gt;P&lt;/i&gt; &lt; .0003). Each clinical parameter did not differ between the 2 groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There were no significant differences in the knee stability and clinical results after bicruciate reconstruction between those with and those without collateral ligament surgery. Reconstruction of bicruciate MLKIs with repair or reconstruction of associated collateral ligament injuries ","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671251319532"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625732","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 Outcomes and Survivorship of Revision Arthroscopic Surgery for Femoroacetabular Impingement Compared With Matched Primary Cases.","authors":"Karen Mullins, David Filan, Patrick Carton","doi":"10.1177/23259671241308586","DOIUrl":"10.1177/23259671241308586","url":null,"abstract":"<p><strong>Background: </strong>The exponential rise in arthroscopy for femoroacetabular impingement (FAI) has led to increased revision surgery rates, although this is often an exclusion criterion from arthroscopy literature.</p><p><strong>Purpose: </strong>To examine the midterm (minimum 5-year follow-up) outcomes after revision arthroscopic correction of FAI compared with a matched control group of primary surgical cases.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Prospective outcome data, collected in a consecutive series of patients undergoing revision arthroscopic FAI correction, was retrospectively reviewed. Revision procedures were compared with a matched group of primary surgical cases. Survivorship was defined as the avoidance of total hip replacement (THR) and assessed using a Kaplan-Meier curve with the log-rank test. Regression analysis was conducted to identify predictors of THR conversion. Patient-reported outcomes (PROs) including modified Harris Hip Score (mHHS), University of California, Los Angeles (UCLA), 36-Item Short Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively and at 5 years postoperatively were compared between the groups. The proportion of patients across groups achieving the minimal clinically important difference (MCID) was compared for each PRO. Finally, a subgroup analysis was performed to compare the outcomes of those who had their index surgery at our clinic and those who had an index procedure elsewhere.</p><p><strong>Results: </strong>A total of 124 revision cases were compared with 268 primary cases. The most common indication for revision surgery was residual bony deformity. Both groups had high survivorship rates at 5 years (>90%) although revision cases did have a statistically higher conversion to THR than did primary cases (6.5% vs 1.5%; <i>P</i> = .008). Increasing age and revision surgery were identified in regression analysis as predictors for THR conversion. Where THR was avoided, improvements in PROs were observed in both groups (<i>P</i> < .05 for all). Before surgery, revision cases reported lower scores for all PROs. At 5 years, the only statistical difference between the groups was in the distribution of mHHS scores. There were no differences in the rate of MCID achievement between groups.</p><p><strong>Conclusion: </strong>Residual bony deformity is the most common indication for revision arthroscopy. Revision procedures may have a lower survival than primary cases, although overall survivorship at midterm follow-up is high. Of the revision cases, 17% required further arthroscopy. Where THR is avoided, improvements in pain and function can be expected that are similar to primary surgical cases.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241308586"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes After Isolated Medial Meniscus Posterior Root Repairs Using an Anatomic Transtibial Pullout Technique in Patients Older Than 60 Years: A Matched Cohort Study.","authors":"Garrett R Jackson, Derrick M Knapik, Zeeshan A Khan, Harkirat Jawanda, Obianuju A Obioha, Daniel J Kaplan, Johnathon R McCormick, Joan Sugrañes, Anjay Batra, Enzo S Mameri, Nikhil N Verma, Jorge Chahla","doi":"10.1177/23259671241274136","DOIUrl":"10.1177/23259671241274136","url":null,"abstract":"<p><strong>Background: </strong>Management of isolated medial meniscus posterior root (MMPR) tears is challenging, especially in older patients, where indications for repair must be weighed against potential repair failure and osteoarthritic progression.</p><p><strong>Purpose: </strong>To compare patient-reported outcomes and incidence of failure after anatomic transtibial pullout repair for isolated MMPR tears in patients >60 versus ≤60 years of age.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Included in the study were patients aged ≥18 years who underwent isolated anatomic transtibial pullout repair using either the single- or double-tunnel technique for MMPR tears at a single institution between January 2016 and September 2020. Patients with a minimum 2-year follow-up were divided based on age at surgery (>60 vs ≤60 years). Patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), and Veterans RAND 12-Item Health Survey (VR-12) Physical score preoperatively and at final follow-up. Differences between age groups in outcome scores as well as repair failures (defined as the need for repeat arthroscopy) were analyzed using the 2-sided Student <i>t</i> test or chi-square test.</p><p><strong>Results: </strong>A total of 20 patients aged >60 years (mean age, 65.7 ± 4.1 years; range, 60.2-74.9 years) were identified and compared against 40 patients aged ≤60 years (mean age, 49.3 ± 9.0 years; range, 23.4-59.8 years). Significant improvement on all outcomes scores was observed in both groups at final follow-up when compared with preoperative values, with no significant between-group difference on any of the scores at final follow-up. Revision repair was required in 1 patient (2.5%) in the ≤60-year group but not in patients in the >60-year group.</p><p><strong>Conclusion: </strong>Anatomic transtibial pullout repair for isolated MMPR tears resulted in improved IKDC, KOOS JR, and VR-12 Physical scores at minimum 2-year follow-up, with no significant differences between our cohorts of patients >60 versus ≤60 years of age.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241274136"},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625752","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":"Clinical Outcomes After Ipsilateral Versus Contralateral Autograft Harvest for Anterior Cruciate Ligament Reconstruction: A Systematic Review.","authors":"Jack S Soeder, Ehsan Yavari, Darius L Lameire, Valerie Lemieux, Jihad Abouali","doi":"10.1177/23259671241310808","DOIUrl":"10.1177/23259671241310808","url":null,"abstract":"<p><strong>Background: </strong>Contralateral donor autografts in anterior cruciate ligament (ACL) reconstruction (ACLR) may act as an alternative to conventional ipsilateral donor grafts but are rarely used clinically because of the lack of evidence on patient outcomes and concerns around additional morbidity.</p><p><strong>Purpose: </strong>To investigate the effect of contralateral versus ipsilateral autograft use in ACLR on patient outcomes.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched from inception to October 2022 for comparative studies assessing the clinical or functional outcomes of ipsilateral versus contralateral autograft harvest in primary or revision ACLR. Given the heterogeneity of the included studies, data were summarized using descriptive statistics.</p><p><strong>Results: </strong>Included were 11 studies representing 1638 patients with a mean follow-up of 49 months. The mean time to return to sport was shorter in patients treated with a contralateral bone-patellar tendon-bone (BPTB) autograft in 2 of 3 studies that evaluated this outcome after primary ACLR and in the only study that evaluated this outcome after revision ACLR. Some studies found improved strength recovery in the contralateral ACL-reconstructed knee. Otherwise, there was no significant difference between contralateral and ipsilateral ACLRs on subjective or objective postoperative clinical outcome scores. Most studies reported minimal donor site morbidity. Clinical adverse events including postoperative graft rerupture and infection were low in both contralateral and ipsilateral ACLRs and were not significantly different.</p><p><strong>Conclusion: </strong>Contralateral ACL autograft harvest may lead to earlier return to sport when patients undergo BPTB ACLR. However, clinical outcomes, morbidity, risk of rerupture, and risk of donor knee injury were not significantly different in this review.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 3","pages":"23259671241310808"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616715","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":"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}