Orthopaedic Journal of Sports Medicine最新文献

{"title":"Change in Early Patient-Reported Sexual Function After Periacetabular Osteotomy: A Study Utilizing the UK Non-Arthroplasty Hip Registry.","authors":"Richard James Holleyman, Christian Smith, Khurram Baig, Marcus Bankes, Johan Witt, Andy Judge, Vikas Khanduja, Ajay Malviya","doi":"10.1177/23259671251341475","DOIUrl":"10.1177/23259671251341475","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI; principally acetabular retroversion) in adults who are commonly of reproductive age.</p><p><strong>Purpose: </strong>To describe the effect of PAO on patient-reported sexual function (SF) using data from the UK Non-Arthroplasty Hip Registry (NAHR).</p><p><strong>Study design: </strong>Cohort study: Level of evidence, 3.</p><p><strong>Methods: </strong>Adult patients who underwent isolated PAO between January 2012 and July 2022 were extracted from the NAHR. The EuroQol-5 Dimensions (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at 6 and 12 months postoperatively. This included responses to 2 questions from the iHOT-12 questionnaire relevant to SF: (1) \"Are questions about SF relevant to you?\" and (2) \"How much trouble do you have with sexual activity because of your hip?\" (0 = severe; 100 = none).</p><p><strong>Results: </strong>A total of 773 patients (median age, 29 years (IQR, 23-37), 92.5% female) who underwent PAO for DDH (n = 703; 90.9%) or FAI (n = 70; 9.1%) were identified after exclusions. Of iHOT-12 respondents, 88.2% indicated that SF was relevant to them. Baseline median iHOT-12 SF scores were 33 (IQR, 18-53) for female and 73 (IQR, 36-90) for male patients. Female iHOT-12 SF improved by a mean of +19.9 points (95% CI, 16.5-23.2) at 6 months (<i>P</i> < .0001), with continued improvement to +26.4 points (95% CI, 23.0-29.8) at 12 months (<i>P</i> < .0001) versus preoperative SF scores. At 12 months, median iHOT-12 SF scores were 70 (IQR, 40-90) and 89 (IQR, 70-99) for female and male patients, respectively. Preoperative SF scores were significantly lower (<i>P</i> = .001) in patients who underwent PAO for indication of FAI (female median score 22; IQR, 10-38) compared with DDH (female median score: 34; IQR, 18-54); however, both indications saw significant improvement in SF scores at 12 months. iHOT-12 SF scores improved for 77.1% and worsened for 19.1% of female respondents with DDH. A strong positive association was seen between health-related quality of life (EQ-5D) and SF scores, and there was significant improvement in SF across studied ages.</p><p><strong>Conclusion: </strong>PAO was associated with significant improvement in patient-reported SF for the majority of patients. Some patients may have trouble with sexual activity even 1 year after PAO for DDH, with almost 20% reporting poorer SF compared with preoperative baseline.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341475"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507268","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":"Preoperative Moderate Pivot-Shift Phenomenon: A Risk Factor for Ramp Lesions in Patients Undergoing Anterior Cruciate Ligament Reconstruction?","authors":"Shoichi Hasegawa, Hideyuki Koga, Tomomasa Nakamura, Yusuke Nakagawa, Takashi Hoshino, Mai Katakura, Masaki Amemiya, Aritoshi Yoshihara, Yasumasa Tokumoto, Ichiro Sekiya, Nobutake Ozeki","doi":"10.1177/23259671251341586","DOIUrl":"10.1177/23259671251341586","url":null,"abstract":"<p><strong>Background: </strong>While various risk factors for ramp lesions have been reported, few studies have used multivariate and categorical analyses to quantify their specific impact.</p><p><strong>Hypothesis: </strong>Multivariate and categorical analyses would reveal a smaller pivot-shift phenomenon, along with previously reported factors, as independent factors for ramp lesions.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The records of consecutive patients who underwent primary anterior cruciate ligament reconstruction between January 2017 and August 2023 were retrospectively reviewed. Patients with past ligamentous injuries in the affected knee or accompanying grade 2 or 3 ligament injuries were excluded. Logistic regression analysis was performed to identify preoperative factors associated with ramp lesions by comparing groups with and without ramp lesions. The factors extracted from the multivariate analysis were also categorically analyzed.</p><p><strong>Results: </strong>A total of 262 patients were included in this study. Ramp lesions were identified in 58 patients (22.1%). Multivariate logistic regression analysis revealed that the pivot-shift test grade (OR, 1.560; 95% CI, 1.210-2.020; <i>P</i> < .01), age (OR, 0.966; 95% CI, 0.939-0.995; <i>P</i> = .02), and male sex (OR, 2.170; 95% CI, 1.120-4.190; <i>P</i> = .02) were independently associated with the ramp lesions. The categorical analysis revealed that the odds ratios for ramp lesions were 2.8-fold higher for those with pivot grade ≥4 than for those with grade <4, 2.0-fold higher for those aged <20 years than those aged ≥20 years, and 2.0-fold higher for males than females.</p><p><strong>Conclusion: </strong>Even a moderate pivot shift is a preoperative risk factor for ramp lesions, alongside younger age and male sex. Paying attention to these factors may reduce the chances of overlooking these lesions.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341586"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507270","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 Durability of Revision Anterior Cruciate Ligament Reconstruction: A Comparison of Patients at <5 Years and ≥5 Years After Revision.","authors":"Michael J Thimmesch, Sarah C Kurkowski, Jonas Keller, Henry A Kuechly, Sophia Le, Michael Kloby, Barton Branam, Christopher Utz, Brian Grawe","doi":"10.1177/23259671251339170","DOIUrl":"10.1177/23259671251339170","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Overall outcomes of revision anterior cruciate ligament reconstruction (ACLR) are well documented, although the durability of results, to the best of the authors' knowledge, has not been compared between short-term and midterm follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The primary aim was to assess the durability of revision ACLR outcomes at &lt;5 years after revision (short-term) to outcomes at ≥5 years after revision (midterm). For this study's purposes, durability was defined as not requiring additional revision surgery or the maintenance of good patient-reported outcomes (PROs). The secondary aims were to compare the outcomes between male and female patients, between patients with allografts and those with autografts, and between patients with traumatic mechanisms of a rerupture and those with atraumatic mechanisms of a rerupture.&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;This was a retrospective chart review with the prospective collection of PROs in 53 knees that underwent revision ACLR. PROs included scores for the International Knee Documentation Committee subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx activity rating scale, ACL-Return to Sport after Injury scale, visual analog scale for pain, and satisfaction. The time to return to sport or activity and the incidence of reruptures were collected as well. Data were analyzed via the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, chi-square test, Fisher exact test, and odds ratios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean follow-up from first revision surgery was 5.29 ± 2.96 years (range, 2.0-20.5 years) for the entire cohort. No significant differences in outcomes were found between the short-term (&lt;5 years from revision; 21/53 knees) and midterm (≥5 years from revision; 32/53 knees) groups, except in satisfaction (4.0/5 vs 2.5/5, respectively; &lt;i&gt;P&lt;/i&gt; = .014) and requiring second revision surgery (0.0% vs 25.0%, respectively; &lt;i&gt;P&lt;/i&gt; = .016). The mechanism of a rupture after primary ACLR leading to revision ACLR was traumatic in 64.7% and atraumatic in 35.3%, but no difference in outcomes was found based on the mechanism of reinjuries (&lt;i&gt;P&lt;/i&gt; &gt; .05). When comparing male to female patients, male patients were more active based on the Marx score at the time of follow-up than female patients (7.0 vs 2.0, respectively; &lt;i&gt;P&lt;/i&gt; = .046). Patients treated with autografts were younger and had higher KOOS Activities of Daily Living subscores than those treated with allografts, although no other differences were found (&lt;i&gt;P&lt;/i&gt; &gt; .05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study demonstrates that revision ACLR offered patients durable results after the failure of primary ACLR from short-term to midterm follow-up. Patient sex and graft choice did not drastically affect postoperative outcomes. Orthopaedic surgeons may decide, based on their clinical acumen, which graft choice is best for th","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251339170"},"PeriodicalIF":2.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497586","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":"Retrospective Clinical Outcomes of Ulnar Collateral Ligament Reconstruction in the Setting of an Ossified Ulnar Collateral Ligament.","authors":"Roger V Ostrander, Adam W Anz, Steve E Jordan, James Kee, Jessi Truett, Cooper Williams, James R Andrews","doi":"10.1177/23259671251344228","DOIUrl":"10.1177/23259671251344228","url":null,"abstract":"<p><strong>Background: </strong>The ulnar collateral ligament (UCL) plays a vital role in maintaining the stability of the elbow joint during overhead throwing activities. Stress to the UCL may lead to high-grade or full-thickness tears that require reconstruction or repair and lengthy rehabilitation in athletes. Workup of these injuries can sometimes reveal ossification in the ligament. It is unknown if ossification in the UCL affects postoperative outcomes.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to investigate whether different preoperative ossification conditions of the UCL might influence various clinical and return-to-play (RTP) outcomes in athletes undergoing UCL reconstruction (UCLR). It was hypothesized that patients with preoperative ossification conditions in the UCL who underwent reconstruction would experience comparable rates of RTP and level of competition compared with all players undergoing UCLR.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>An internal search was conducted to identify all cases of UCLR performed by 3 participating surgeons at the Andrews Institute between 2007 and 2022. Patients who had undergone primary UCLR and showed radiographic evidence of UCL ossification were included for analysis if they were ≥2 years after reconstruction. Retrospective chart reviews were performed for all included patients, and their radiographs were categorized by location of ossification. Differences in age, level of play, range of motion, and RTP status between patients with different ossification types were evaluated.</p><p><strong>Results: </strong>Between August 2007 and December 2022, 386 patients who underwent UCLR at the Andrews Institute were identified. Among these patients, 26% (n = 100) were found to have ossified UCLs. However, only 79 of these patients had complete medical records and were included in the analysis. Among the 79 athletes in this study with ossified ligaments, 71 (90%) who underwent UCLR returned to competitive sports. Athletes exhibited various classification conditions, including heavily calcified ligaments, calcified sublime tubercles, and humeral and/or ulnar-sided ossicles. No differences were found in the level of competitive RTP among the ossification groups.</p><p><strong>Conclusion: </strong>RTP rates in athletes with ossified ligaments are high and comparable with those in the literature across all ossification conditions.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251344228"},"PeriodicalIF":2.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485364","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":"Interposition Patches for Massive Rotator Cuff Tears: Helpful or Not? A Prospective Study of 164 Interposition Polytetrafluoroethylene Patches.","authors":"James Bilbrough, Ala Hawa, Mina Shenouda, Christyon Hayek, George A C Murrell","doi":"10.1177/23259671251333801","DOIUrl":"10.1177/23259671251333801","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;It is undetermined how well interposition polytetrafluoroethylene (PTFE) patch repairs for massive and irreparable rotator cuff tears perform in the longer term and whether the procedure can prevent proximal humeral migration, glenohumeral arthritis, and conversion to reverse total shoulder arthroplasty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To answer the following questions: (1) Do interposition PTFE patch repairs inserted for massive and irreparable rotator cuff tears improve patient pain and function, shoulder strength, and range of motion? (2) How long do interposition PTFE patches last? (3) Do interposition PTFE patches prevent proximal humeral migration and glenohumeral arthritis? (4) Do interposition PTFE patches prevent patient conversion to reverse total shoulder arthroplasty?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case series; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective cohort study of 164 consecutive patients with interposition PTFE patch repairs for massive and irreparable rotator cuff tears, with a median follow-up time of 26 months. Patient-reported pain and function, shoulder strength, and range of motion were assessed preoperatively, at 6 months postoperatively, and at the final follow-up. Ultrasound was used to assess PTFE patch integrity at 6 months postoperatively and at the final follow-up, and shoulder radiographs were taken at 6 months postoperatively and at the final follow-up. Kaplan-Meier survival analysis was used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients with intact PTFE patches on ultrasound had greater improvements in pain and function, strength, and range of motion at the final follow-up (median, 26 months; range, 6 months to 19 years) when compared with patients with nonintact PTFE patches (&lt;i&gt;P&lt;/i&gt; &lt; .05). Of 164 interposition PTFE patches, 50 (30%) functionally failed at a median time of 5 years. In the whole cohort, Kaplan-Meier analysis estimated that the median survivorship time of these PTFE patches was 7.4 years. Furthermore, patients with intact interposition PTFE patches demonstrated a 21% lower severity of glenohumeral arthritis (&lt;i&gt;P&lt;/i&gt; = .03) and a 46% lower incidence of proximal humeral migration (&lt;i&gt;P&lt;/i&gt; &lt; .001) than patients with nonintact interposition PTFE patches. At the final follow-up, 93% of participants were free from conversion to reverse total shoulder arthroplasty after interposition PTFE patch repair for a massive and irreparable rotator cuff tear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Based on the results of this study, interposition PTFE patch repairs for massive and irreparable rotator cuff tears were efficacious at improving patients' pain and function, strength, and range of motion. Patients with intact interposition PTFE patches were associated with reduced severity of glenohumeral arthritis and reduced incidence of proximal humeral migration. At the final follow-up, 93% of participants were free from conversion to reverse to","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251333801"},"PeriodicalIF":2.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476230","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 Full-Thickness Versus Partial-Thickness Quadriceps Tendon Grafts for ACL Reconstruction.","authors":"Jalen Dansby, James Tibone, Dave T Huang, Andrew Nakla, Casey Batten, Melodie F Metzger","doi":"10.1177/23259671251342607","DOIUrl":"10.1177/23259671251342607","url":null,"abstract":"<p><strong>Background: </strong>The quadriceps tendon (QT) autograft is increasingly becoming the graft of choice for reconstructing of the anterior cruciate ligament (ACL), likely because recent clinical studies demonstrate low harvest-site morbidity and failure rates. Both full-thickness QT (FQT) and partial-thickness QT (PQT) graft techniques have been described for ACL reconstruction, but there is currently limited research to guide surgeons on which thickness is optimal.</p><p><strong>Purpose: </strong>To analyze and compare the material and mechanical properties of PQT and FQT grafts versus the standard patellar tendon (PT) graft.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 8 PQTs and 8 FQTs, each 10 mm wide, were harvested from the extensor mechanism from matched paired donors with a 10-mm PT graft. Specimens were loaded in tension to failure while load and displacement were continually recorded. Mechanical and material properties were calculated and compared using a 1-way analysis of variance.</p><p><strong>Results: </strong>FQT grafts had a greater cross-sectional area and were stronger and stiffer compared with PQT and PT grafts (<i>P</i> < .05). There were no significant differences in strength and stiffness between the PQT and PT grafts when loaded to failure. Both quadriceps grafts recorded a lower ultimate strain at failure compared with the PT grafts (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>The biomechanical results from this study demonstrate that PQT grafts have similar biomechanical properties to the current gold standard PT grafts.</p><p><strong>Clinical relevance: </strong>These results suggest PQT grafts are mechanically sufficient and may be preferred, as they do not carry concerns of residual postoperative weakness and knee pain that are associated with FQT and PT grafts, respectively.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342607"},"PeriodicalIF":2.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476227","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":"Validation of the Ligamentous-Fossa-Foveolar Complex (LFFC) Grading System With Clinical Correlation for Patients Undergoing Hip Arthroscopy.","authors":"Benjamin D Kuhns, Peter S Chang, Jarrod Brown, Vera M Stezelberger, Joseph J Ruzbarsky, Jonathan Godin, Leslie Vidal, Marc J Philippon","doi":"10.1177/23259671251340986","DOIUrl":"10.1177/23259671251340986","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pathology involving the acetabular fossa is often identified during hip arthroscopy, with many of the descriptive classification systems focusing on the ligamentum teres (LT). Recently, a novel grading system for ligamentous-fossa-foveolar complex (LFFC) lesions was introduced for open hip preservation surgery that included evaluation of the cotyloid fossa and perifoveal cartilage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To validate the LFFC grading system for hip arthroscopy and correlate these results with preoperative and intraoperative findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study (diagnosis); Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;High-resolution arthroscopic images of the central compartment were obtained identifying the LT, cotyloid fossa, and perifoveal cartilage in a prospective series of patients undergoing hip arthroscopy. Each structure was graded according to increasing pathology on a scale of 0 to 4 based on a modified LFFC classification system to include the pulvinar intra-articular adipose tissue. Five surgeons graded the images, which were then randomized and regraded for intraobserver reliability. Agreement was quantified by the intraclass correlation coefficient (ICC) and kappa (κ) statistic to determine inter- and intraobserver reliability. Grading discrepancies were resolved in conference with the senior author, and final LFFC grades were compared with preoperative clinical and radiographic data as well as intraoperative findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 93 patients were included in the study. LFFC component intraobserver reliability for 2 rounds of grading resulted in an LT ICC of 0.78 to 0.90, cotyloid fossa ICC of 0.85 to 0.93, and perifoveal cartilage ICC of 0.78 to 0.87 with an LFFC total score ICC of 0.87 to 0.95. Interobserver reliability resulted in an LT ICC of 0.73 to 0.91, cotyloid fossa ICC of 0.84 to 0.95, perifoveal cartilage ICC of 0.83 to 0.91, and LFFC total score ICC of 0.89 to 0.96. Severe central compartment pathology (LFFC total score &gt;6) was significantly associated with age (48.2 vs 34.4; &lt;i&gt;P&lt;/i&gt; = .0002), preoperative Tönnis grade 1 (43% vs 4%; &lt;i&gt;P&lt;/i&gt; &lt; .0001), preoperative Tönnis angle (8.7 vs 5.2; &lt;i&gt;P&lt;/i&gt; = .002), and intraoperative femoral head weightbearing chondral lesions (14% vs 0%; &lt;i&gt;P&lt;/i&gt; = .02) when compared to patients with an LFFC score &lt;6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The modified LFFC grading system demonstrated satisfactory intraobserver and interobserver reliability for patients undergoing hip arthroscopy that compares favorably with existing arthroscopic classification systems for the acetabular fossa. The addition of a descriptive classification system for the pulvinar intra-articular adipose tissue did not decrease the reliability of the grading system. Increasing LFFC scores were found to be associated with known risk factors for inferior outcomes after hip arthroscopy providing enhanced clinical uti","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251340986"},"PeriodicalIF":2.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476232","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":"Comparative Outcomes After Bone-Patellar Tendon-Bone Allograft Reconstruction of the Anterior Cruciate Ligament Using Various Allograft Processing Protocols.","authors":"Benjamin Miltenberg, Randall Timothy Kreulen, Gaston Davis, William L Johns, Rahul Muchintala, Jonathan Berg, Fotios P Tjoumakaris, Kevin B Freedman","doi":"10.1177/23259671251345676","DOIUrl":"10.1177/23259671251345676","url":null,"abstract":"<p><strong>Background: </strong>Graft choice in anterior cruciate ligament reconstruction (ACLR) is determined by surgeon preference, patient factors, and graft characteristics. An allograft is a viable option with benefits such as decreased operative times and no donor site morbidities, and it can be the preferred graft choice in certain patient populations. Despite this, there is no established standard for allograft processing.</p><p><strong>Purpose: </strong>To determine whether allograft processing techniques influence the risk of graft failure, patient-reported outcomes, and revision surgery in patients undergoing ACLR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Consecutive patients from 3 fellowship-trained sports medicine surgeons undergoing ACLR with patellar tendon allografts from January 1, 2016, to January 1, 2022, were identified. Descriptive data, mechanism of injury, graft processing technique, revision history, and patient-reported outcome scores were collected. The primary endpoint was aseptic failure as defined by graft rupture on magnetic resonance imaging. Statistical analysis was performed with the χ² test or the Fisher exact test as indicated for categorical variables and with the <i>t</i> test and analysis of variance as indicated for continuous variables. The significance level for statistical tests was set at 5%.</p><p><strong>Results: </strong>A total of 189 patients who underwent ACLR and met the inclusion/exclusion criteria were identified, with 103 Musculoskeletal Transplant Foundation (MTF), 55 Allowash XG, and 31 BioCleanse allografts. The mean age of patients was 43.4 ± 10.5 years, and 60.9% were women. No significant difference was observed between the groups with regard to sex and body mass index (<i>P</i> = .25 and <i>P</i> = .64, respectively). However, age at the time of surgery was significantly different between groups (<i>P</i> = .03). The mean patient follow-up time was 4.65 ± 1.40 years. Four patients experienced graft failure (MTF 1% [1/103]; Allowash XG 5.5% [3/55]; BioCleanse 0% [0/31]), with no significant difference in graft failure between groups (<i>P</i> = .20). There were no reported infections. Postoperative International Knee Documentation Committee (IKDC) scores (MTF, 82.6; Allowash XG, 81.7; BioCleanse, 80.2) were not different between groups (<i>P</i> = .60).</p><p><strong>Conclusion: </strong>Bone-patellar tendon-bone allografts processed using BioCleanse, Allowash XG, and the MTF protocol had similar rates of graft failure and postoperative IKDC scores. Although underpowered, the data suggest that each of these techniques can be used safely with low failure rates and good functional outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251345676"},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476228","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":"Comparative Results After Latarjet Procedure for Shoulder Instability Management Between Primary and Revision Cases After Failed Arthroscopic Bankart Procedure: A Midterm Follow-up Study.","authors":"Efstathios Konstantinou, Nikolaos Stefanou, Theodoros Mylonas, Alexandros Koskiniotis, Georgios Komnos, Socratis Varitimidis, Michael Hantes","doi":"10.1177/23259671251343807","DOIUrl":"10.1177/23259671251343807","url":null,"abstract":"<p><strong>Background: </strong>Anterior shoulder dislocation is often complicated by recurrent instability, with reported rates being as high as 70% in young patients. Bony lesions, young age, and contact sports have been correlated with higher rates of recurrent instability. The optimal surgical modality remains debatable, with the majority of surgeons preferring the arthroscopic Bankart procedure as the primary repair for recurrent instability.</p><p><strong>Purpose: </strong>To compare the outcomes of the Latarjet procedure performed as a primary procedure versus the Latarjet procedure in the setting of a previously failed Bankart repair.</p><p><strong>Study design: </strong>Cohort study; Level of evidence 3.</p><p><strong>Methods: </strong>A retrospective comparative study was conducted of patients with traumatic anterior shoulder instability who underwent an open Latarjet as primary or revision surgery between 2012 and 2019. Outcomes were assessed using the Rowe score, Oxford Shoulder Instability (OSI) score, visual analog scale (VAS) score, and rate of recurrent instability. All patients had at least 4 years of follow-up. Radiographs were analyzed using the Samilson and Pietro classification.</p><p><strong>Results: </strong>In total, 43 and 17 patients were included in the primary and revision groups, respectively. Mean follow-up was 7.7 years for the primary group and 7.9 years for the revision group. Postoperatively, Rowe and VAS scores were not significantly different between groups, but OSI scores were significantly worse for the revision group versus the primary group (40.6 ± 1.3 vs 42.1 ± 1.4, respectively). The difference in OSI scores was less than the minimal clinically important difference (8.6), indicating limited clinical relevance. Return to daily activities, including sports activities, was comparable between the 2 groups. One patient from each group had recurrent instability (<i>P</i> = .34). No major complication was recorded in either group during the follow-up. Seven (16%) patients from the primary group and 4 (23%) patients from the revision group showed preoperatively radiographic signs of mild (grade I) osteoarthritis.</p><p><strong>Conclusion: </strong>The Latarjet procedure effectively prevented chronic anterior shoulder instability and was associated with high patient satisfaction as both a primary and a revision procedure. OSI scores were marginally lower in patients with previous failed Bankart repair compared with primary Latarjet. Similar outcomes were observed for shoulder stability and arthritis development, although these findings are limited to midterm follow-up. These findings support the use of primary arthroscopic Bankart repair with revision Latarjet as a realistic surgical option for previous surgical failure.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343807"},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Tibia:Femur Ratio and Anterior Cruciate Ligament Injury.","authors":"Jonathan McKeeman, Ryan DeLeon, Daniel Heckman","doi":"10.1177/23259671251343811","DOIUrl":"10.1177/23259671251343811","url":null,"abstract":"<p><strong>Background: </strong>The tibia:femur ratio (TFR) is an anatomic proportion describing the length of the tibia relative to the femur, with an established normative mean of 0.78 in skeletally mature individuals. Variation in TFR affects lower extremity biomechanics, and there is an association between elevated TFR and hip/knee osteoarthritis and patellar instability.</p><p><strong>Hypothesis: </strong>TFR variation may also be associated with anterior cruciate ligament (ACL) injury; thus, the purpose of this study is to determine if the mean TFR in patients with ACL injury is different from the mean normative TFR in the general population.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 50 patients with magnetic resonance imaging-confirmed ACL injury underwent full-length lower extremity scanograms. Femoral length was measured from the most superior point of the femoral head to the center point of the medial femoral condyle. Tibial length was measured from the center point of the medial tibial plateau to the center point of the tibial plafond. The TFR was calculated by dividing the tibial length by the femoral length. The mean TFR of the study group was compared with the previously published mean TFR for normative controls with a 2-tailed <i>t</i> test.</p><p><strong>Results: </strong>The mean TFR for the entire cohort of patients with ACL injury was 0.759 (SD, 0.029), which was significantly lower than the mean normative TFR of 0.781 (<i>P</i> = .0001). There were 29 (58.0%) male and 21 (42.0%) female patients. The mean TFR was similar for male (0.760) and female (0.757) patients (<i>P</i> = .77).</p><p><strong>Conclusion: </strong>Patients with ACL injury demonstrated a significantly lower TFR than the previously published TFR for normative controls, which suggests that an association between TFR and ACL injury may exist. It is possible that decreasing tibial length relative to femoral length alters lower extremity biomechanics in such a manner that places the ACL at risk for injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343811"},"PeriodicalIF":2.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476231","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}