Orthopaedic Journal of Sports Medicine最新文献

{"title":"Real-Time Biplane Versus Single-Plane US-guided Hip Joint Injection: A Single-Center Prospective Study.","authors":"Guozheng Zhao, Chunbao Li, Hao Sun, Ping An, Yan Wang, Mingbo Zhang","doi":"10.1177/23259671261474640","DOIUrl":"10.1177/23259671261474640","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US)-guided hip joint injection is a cornerstone of musculoskeletal care, but conventional single-plane US presents a steep learning curve for novice operators. Real-time biplane US, which provides orthogonal imaging planes, may improve procedural accuracy and efficiency, yet its utility in hip injection remains understudied.</p><p><strong>Purpose: </strong>To compare procedural performance and learning curves between conventional single-plane US and real-time biplane US for hip joint injection, particularly in novice operators.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>This prospective single-center study enrolled 70 consecutive patients (July 2024-December 2024) scheduled for US-guided hip injection, nonrandomly assigned to single-plane US (n = 35) or biplane US (n = 35) groups. All procedures were performed by a radiologist with 7 years of diagnostic US experience, limited previous US-guided interventional exposure, and no experience in hip joint injection. Primary outcomes were first-attempt success (successful intra-articular access and injection on the initial insertion without needle withdrawal or redirection) and final success (successful completion within no more than 2 insertion attempts). Secondary outcomes included puncture time, needle adjustments, operator confidence score, and complication. Learning curves were analyzed using cumulative sum (CUSUM) modeling for puncture time (seconds).</p><p><strong>Results: </strong>Compared with the single-plane group, the biplane group had significantly higher first-attempt success rate (48.6% vs 25.7%; relative risk [RR], 1.889 [95% CI, 1.103-3.648]; <i>P</i> = .048) and final success rate (91.4% vs 71.4%; RR, 1.280 [95% CI, 1.014-1.616]; <i>P</i> = .031). The biplane group also had shorter puncture time (median, 120 [interquartile range, IQR, 64-182] vs 153 [90- 234] seconds; <i>P</i> = .020), fewer needle adjustments (median, 1 [IQR, 0-2] vs 2 [0-3]; <i>P</i> = .008), and higher operator confidence score (median, 2 [IQR, 1-3] vs 1 [1-2]; <i>P</i> = .043). One minor complication occurred in the single-plane group. CUSUM analysis demonstrated cubic learning curves for both techniques (single-plane: <i>R²</i> = 0.893; biplane: <i>R²</i> = 0.979; both <i>P</i> < .05). Phase-specific analysis further showed that the advantage of biplane guidance was most pronounced during the learning phase, while shorter puncture time persisted after proficiency was achieved.</p><p><strong>Conclusion: </strong>In novice operators, real-time biplane US guidance was associated with higher procedural success, fewer needle adjustments, shorter puncture time, and faster early skill acquisition than conventional single-plane US for hip joint injection. Its greatest benefit was observed during the learning phase, although multicenter studies are needed to confirm generalizability.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261474640"},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795955","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":"Recovery of Medial Elbow Dynamic Stability 24 Hours After Pitching Under Contraction of the Forearm Flexor-Pronator Muscles in High School Baseball Pitchers.","authors":"Hiroshi Hattori, Shun Okamura, Toby Hall, Katsunobu Sakaguchi, Kiyokazu Akasaka","doi":"10.1177/23259671261472672","DOIUrl":"10.1177/23259671261472672","url":null,"abstract":"<p><strong>Background: </strong>Repetitive pitching causes temporary functional impairment of the medial elbow. The recovery process in medial elbow dynamic stabilizing mechanisms is not clear.</p><p><strong>Hypothesis/purpose: </strong>This study aimed to investigate the recovery process of the medial elbow dynamic stabilizers over 24 hours after 100 pitches. We hypothesized that while some recovery occurs 24 hours after pitching, there would not be a complete return to baseline.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 26 high school baseball pitchers participated in this study (mean age, 16 ± 0.5 years). Participants pitched 100 times (5 blocks of 20 pitches). Medial elbow joint width and strain ratio (higher values indicate harder tissue) of the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) under FPM contraction associated with gripping were measured at baseline, immediately after pitching, and at 1, 3, 6, 18, and 24 hours after pitching. The data before pitching and at each measurement time point were compared.</p><p><strong>Results: </strong>Medial elbow joint width during contraction significantly increased immediately after pitching (<i>P</i> < .05), but this was not maintained at 24 hours. The UCL strain ratio during contraction significantly decreased immediately after pitching (<i>P</i> < .05), but this was not maintained 18 hours after pitching. The FPMs strain ratio during contraction showed no significant change over time (<i>P</i> = .747).</p><p><strong>Conclusion: </strong>After 100 pitches, resistance to elbow valgus laxity associated with FPMs contraction temporarily decreases but recovers 24 hours after pitching. In addition, the UCL becomes temporarily vulnerable but recovers by 18 hours after pitching.</p><p><strong>Clinical relevance: </strong>Baseball pitchers may be allowed to throw low-intensity pitches 24 hours after a pitching session from the perspective of a restoration in dynamic stability. However, rather than determining pitching eligibility based solely on a uniform number of pitches or rest days, objective assessment incorporating medial elbow stabilizing indices may support individualized determination of when to resume pitching.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261472672"},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Modified Bankart Repair Technique for the Throwing Shoulder to Prevent External Rotation Loss and Facilitate Return to Play in Baseball Players.","authors":"Yasuhiro Mitsui, Kazuto Higuchi, Koji Hara, Ryunosuke Abe, Syuichiro Sakai, Toshihiko Yoshida, Masafumi Gotoh","doi":"10.1177/23259671261449195","DOIUrl":"https://doi.org/10.1177/23259671261449195","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic Bankart repair (ABR) is the standard surgical treatment for traumatic anterior shoulder instability. In overhead athletes, however, postoperative limitations in external rotation (ER) can impair throwing mechanics and limit return to play (RTP).</p><p><strong>Purpose: </strong>The dynamic anterior glenohumeral capsular ligament tensioning (DAGHT) technique aims to preserve ER by assessing capsular tension in abduction and external rotation (ABER) before suture passage, avoiding excessive tightening. This study evaluated clinical outcomes of ABR with DAGHT in competitive baseball players with traumatic instability of the throwing shoulder.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A total of 24 competitive baseball players (mean age, 18.2 ± 3.8 years) underwent ABR with DAGHT between January 2017 and April 2024 and were retrospectively reviewed. Competitive baseball players were defined as those competing at the high school, collegiate, semiprofessional, or professional level. The inclusion criteria were traumatic dislocation of the throwing shoulder, a Bankart lesion confirmed by imaging and arthroscopy, failed conservative management, and active competition. The exclusion criteria were multidirectional instability, glenoid bone loss >20%, rotator cuff tears, or glenohumeral osteoarthritis. The sample comprised consecutive eligible patients. Clinical outcomes were evaluated at a mean follow-up of 27.7 ± 12.9 months (range, 12-54 months), with a minimum follow-up of 12 months. Assessments included the ABER range of motion; Jobe score; Kerlan-Jobe Orthopedic Clinic score; Disabilities of the Arm, Shoulder, and Hand sports module; Western Ontario Shoulder Instability Index; Rowe score; and RTP rate.</p><p><strong>Results: </strong>All 24 participants returned to play; 83.3% (20/24) resumed the same or a higher level of competition. The mean time to RTP was 8.2 ± 3.7 months. Postoperative ABER on the throwing side averaged 95.2°± 8°, exceeding that of the contralateral shoulder (92.2°± 7.4°; <i>P</i> = .02), suggesting no reduction in ER relative to the contralateral shoulder. All clinical scores improved significantly compared with preoperative values (<i>P</i> < .001). One participant sustained a single subluxation after RTP.</p><p><strong>Conclusion: </strong>ABR with DAGHT yielded favorable outcomes in competitive baseball players. The technique may preserve ER and address the thrower's paradox while maintaining stability and offering a useful option for overhead athletes requiring both stability and motion.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261449195"},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796347","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":"Quantifying Risk Factors for Osteochondritis Dissecans in Children: A Propensity-Matched Retrospective Cohort Study.","authors":"Joseph A Magoline, Daniel F Wagner, David C Kaelber, R Justin Mistovich","doi":"10.1177/23259671261463082","DOIUrl":"https://doi.org/10.1177/23259671261463082","url":null,"abstract":"<p><strong>Background: </strong>Osteochondritis dissecans (OCD) is a developmental orthopaedic condition in pediatric patients characterized by disruption of epiphyseal cartilage vascular supply leading to secondary subchondral bone changes and potential joint degeneration. While repetitive trauma is implicated, emerging evidence suggests a contributing role of biological and hereditary risk factors.</p><p><strong>Purpose: </strong>To quantify the relative risk (RR) of OCD with specific biological comorbidities and athletic participation in a large representative pediatric and adolescent population.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We queried the TriNetX US Collaborative Network for patients aged ≤25 years between 2017 and 2024. Using International Classification of Diseases (ICD-10) diagnosis codes, we identified patients with potentially associated medical conditions (eg, hypopituitarism, vitamin D deficiency, coagulopathies, obesity, and nicotine dependence) and participation in common youth sports. The RR of OCD development for each condition and sport was calculated after propensity matching on age and sex. Annual incidence and prevalence were also assessed.</p><p><strong>Results: </strong>We identified 18,493 patients with OCD (mean age at first ICD diagnosis: 13.4 ± 3.45 years; 59% male). The most common OCD location was the knee (49%). From 2017 to 2024, the annual incidence rose from 15 to 23 per 100,000. Gymnastics (RR, 4.96; [95% CI, 3.14-7.83]), volleyball (RR, 2.96 [95% CI, 1.84-4.74]), and cheerleading (RR, 2.83 [95% CI, 1.47-5.47]) were associated with the highest OCD risk among included sports. Among medical comorbidities, primary thrombophilia (RR, 3.20 [95% CI, 1.57-6.51]), von Willebrand Factor deficiency (RR, 2.90 [95% CI, 1.41-5.95]), and Factor V Leiden (RR, 2.70 [95% CI, 1.31-5.58]) carried the highest risk. Hypopituitarism (RR, 1.71 [95% CI, 1.21-2.41]) and body mass index ≥35kg/m² (RR, 1.14 [95% CI, 1.01-1.29]) were also significantly associated. Nicotine dependence was associated with decreased risk (RR, 0.72 [95% CI, 0.57-0.91]).</p><p><strong>Conclusion: </strong>This large-scale analysis provides updated epidemiologic trends and quantifies risk factors associated with pediatric OCD. Age, sex, specific medical conditions, and athletic participation were linked to increased OCD risk, and novel associations between OCD and coagulopathies were identified.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261463082"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761237","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":"Influence of Concomitant Articular Cartilage Injury on the Diagnostic Performance of Physical Examination Tests for Meniscal Tears.","authors":"Suguru Kawanishi, Nobuto Kitamura","doi":"10.1177/23259671261470917","DOIUrl":"https://doi.org/10.1177/23259671261470917","url":null,"abstract":"<p><strong>Background: </strong>Meniscal tears are common knee injuries that frequently coexist with articular cartilage damage. Although physical examination remains essential for clinical diagnosis, the diagnostic performance of meniscal tests may be influenced by concomitant cartilage injury.</p><p><strong>Purpose: </strong>To investigate whether articular cartilage injury affects the diagnostic performance of the McMurray test and joint line tenderness for meniscal tears, including traumatic and degenerative lesions.</p><p><strong>Study design: </strong>Cohort Study (Diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 186 knees from 179 consecutive patients who underwent an arthroscopic evaluation were retrospectively analyzed. Physical examination findings, including the McMurray test and joint line tenderness, were compared with arthroscopically confirmed meniscal tears. Articular cartilage injury was defined as an International Cartilage Repair Society grade ≥2. The diagnostic performance was evaluated in knees with and without concomitant cartilage injury. Logistic regression analysis was used to evaluate interactions between physical examination findings and cartilage status.</p><p><strong>Results: </strong>Medial meniscal tears were identified in 91 knees and lateral meniscal tears in 86 knees, including 9 knees with combined tears. Articular cartilage injury was present in 109 knees, including 18 without meniscal tears. Cartilage injury was associated with older age (<i>P</i> < .001), patellar ballottement (<i>P</i> = .019), and medial joint line tenderness (<i>P</i> = .022). In the overall cohort, joint line tenderness showed high sensitivity for medial and lateral meniscal tears (80.2% and 73.3%, respectively), whereas the McMurray test showed high specificity (91.4% and 91.2%, respectively). Similar diagnostic patterns were observed in knees without concomitant cartilage injury. In adjusted analyses, the McMurray test was not significantly affected by cartilage injury in either compartment (medial, <i>P</i> = .667; lateral, <i>P</i> = .064). However, medial joint line tenderness showed significantly reduced diagnostic performance in the presence of medial compartment cartilage injury (odds ratio [OR], 0.10; <i>P</i> = .027).</p><p><strong>Conclusion: </strong>The diagnostic performance of the McMurray test for meniscal tears appears largely preserved regardless of concomitant articular cartilage injury. However, medial joint line tenderness may demonstrate a reduced diagnostic performance in the presence of medial compartment cartilage injury, suggesting that palpation-based findings should be interpreted with caution.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470917"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762393","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":"Posterior Plate Positioning Without Distal Placement in Medial Closing-Wedge Distal Femoral Osteotomy.","authors":"Hyun-Soo Moon, Hyoung-Taek Hong, Min Jung, Kwangho Chung, Se-Han Jung, Jun-Hee Cho, Min-Ho Lee, Kyoung-Tak Kang, Sung-Hwan Kim","doi":"10.1177/23259671261469346","DOIUrl":"https://doi.org/10.1177/23259671261469346","url":null,"abstract":"<p><strong>Background: </strong>Despite efforts to improve mechanical stability and reduce complications after medial closed-wedge distal femoral osteotomy (MCDFO), the role of plate positioning in determining mechanical stability remains unclear.</p><p><strong>Purpose: </strong>To determine the biomechanically optimal plate position during MCDFO using finite element analysis (FEA).</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Five distinct 3-dimensional finite element models of the distal femur and implant (TomoFix Medial Distal Femur Plate and screws) were developed from computed tomography data, and a virtual MCDFO was performed. To identify the biomechanically optimal implant positioning, nine unique configurations were created by systematically varying the plate height (proximal-distal) and depth (anterior-posterior) in 5 mm increments. Physiological loading conditions were simulated by applying joint loads at 0°, 30°, and 90° of knee flexion. Biomechanical stability of the bone-implant construct, including the osteotomy site, was evaluated based on the following parameters: (1) micromotion at the osteotomy site, (2) mean stress applied to the bone and implant, (3) mean stress in the lateral hinge of the distal femur, and (4) peak von Mises stress (PVMS) on the plate and each screw.</p><p><strong>Results: </strong>A total of 30 analyses were conducted by performing 6 simulations for each model to meet the sample size requirement determined by a priori power analysis. Micromotion at the osteotomy site was significantly reduced with posterior and proximal plate positioning, a trend consistent across all knee flexion angles. The mean stress in the bone and implant showed no clear directional trend with plate position, whereas stress at the lateral hinge of the distal femur was lowest with posterior-middle placement and remained consistent across all flexion angles. PVMS revealed that anterior-distal placement tended to produce the highest stresses across the plate and screws-occasionally exceeding the titanium alloy's yield strength-while posterior-proximal repositioning progressively reduced them.</p><p><strong>Conclusion: </strong>Posterior plate positioning without distal placement was associated with improved biomechanical stability of the bone-implant construct during MCDFO in this FEA.</p><p><strong>Clinical relevance: </strong>Because plate position can be readily adjusted during MCDFO, the present findings provide practical biomechanical guidance for implant placement and may help reduce mechanical complications associated with the procedure.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261469346"},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the PIVOT App and Pivot Shift Test for Assessing Knee Laxity after ACL Injury: Validity and Impact of Thigh Muscle Coactivity.","authors":"Madison Landry, Matthew J Jordan, Denise Chan, Jean-Michel Galarneau, Kati Pasanen, Volker Musahl, Nicholas Mohtadi","doi":"10.1177/23259671261469739","DOIUrl":"https://doi.org/10.1177/23259671261469739","url":null,"abstract":"<p><strong>Background: </strong>The pivot shift is an important and widely used orthopaedic test for assessing anterior cruciate ligament (ACL)-deficient (ACL-D) knees. A continuous measure of the pivot shift test may allow for a more objective assessment of ACL laxity.</p><p><strong>Purpose: </strong>To assess the efficacy of a novel iPad application (PIVOT App) that uses video image analysis to evaluate ACL deficiency. The main objectives were to (1) assess the PIVOT App's ability to distinguish between categorically assigned pivot shift test grades; (2) assess the PIVOT App's ability to differentiate between normal and abnormal knees, and (3) quantify the effects of thigh muscle coactivity on pivot shift grades using electromyography (EMG) analysis.</p><p><strong>Study design: </strong>Cohort Study (Diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>ACL-deficient (ACL-D) participants recruited via convenience sampling underwent the pivot shift test on their injured and contralateral knees. Some patients were evaluated in the clinic (n = 33), and others were evaluated under anesthesia (n = 20). Control participants (n = 7) with no history of knee injury also had the pivot shift test conducted on both knees while awake in the clinic. Tests were graded categorically by the examiner and simultaneously videotaped and analyzed by the PIVOT App, while EMG activity was recorded from the rectus femoris and semitendinosus muscles.</p><p><strong>Results: </strong>Pivot shift grades 1, 2, and 3 classified knees showed a consistent, incremental increase in tibial reduction. Grade 0 knees showed lower tibial reduction than grade 2 and 3 knees (<i>P</i> < .05). The PIVOT App's classification accuracy of normal versus abnormal knees was 73%. There were no effects of RF or ST EMG activity on the pivot shift test.</p><p><strong>Conclusion: </strong>The PIVOT App is a promising, noninvasive measuring device that can provide an objective, continuous assessment of the pivot shift test, addressing multiple limitations of the current reference standard.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261469739"},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762611","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":"Subjective Shoulder Instability Following Anterior Stabilization: Incidence and Time to Resolution After Latarjet Versus Bankart Repair.","authors":"Vasileios S Akrivos, Antonios Koutalos, Nikolaos Stefanou, Nikolaos Metaxiotis, Sokratis Varitimidis, Michael Hantes","doi":"10.1177/23259671261470584","DOIUrl":"https://doi.org/10.1177/23259671261470584","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Isolated arthroscopic Bankart repair and the Latarjet procedure are widely used to treat recurrent anterior shoulder instability. The incidence and duration of postoperative subjective instability, and whether they differ between these techniques, remain poorly defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare the postoperative subjective sense of instability between patients undergoing Latarjet versus isolated Bankart repair for anterior shoulder instability, with secondary analysis of functional outcomes, dislocation, subluxation, and reoperation rates.&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;Patients treated with either primary open Latarjet or arthroscopic isolated Bankart repair were retrospectively reviewed between 2014 and 2022, with a minimum of 4 years' follow-up. Patients undergoing revision procedures or those who underwent concomitant procedures at the time of either Latarjet or arthroscopic Bankart repair were excluded. Functional outcomes (Constant and Rowe scores), subjective instability, dislocation, and reoperation rates were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 104 patients met inclusion criteria, of whom 53 underwent the Latarjet procedure and 51 underwent arthroscopic isolated Bankart repair. The mean follow-up duration was comparable between groups (Latarjet: 69.4 ± 20.6 months; Bankart: 69.9 ± 19.0 months; &lt;i&gt;P&lt;/i&gt; = .90). Patients in the Latarjet group were younger (23.3 ± 4.6 vs 25.7 ± 5.3 years; &lt;i&gt;P&lt;/i&gt; = .01) and more frequently engaged in manual labor (81.1% vs 33.3%; &lt;i&gt;P&lt;/i&gt; &lt; .001). Functional outcomes were favorable in both groups, with significantly higher Rowe scores observed in the Latarjet group (94.0 ± 2.9 vs 86.3 ± 19.2; &lt;i&gt;P&lt;/i&gt; = .004), while Constant scores were comparable. Postoperative subjective instability was reported less frequently after Latarjet compared with Bankart repair (39.6% vs 62.7%; &lt;i&gt;P&lt;/i&gt; = .02), although mean time to resolution did not differ significantly (19.6 vs 28.0 months; &lt;i&gt;P&lt;/i&gt; = .09). Persistent subjective instability at final follow-up was observed at similar rates between groups (13.2% vs 15.7%; &lt;i&gt;P&lt;/i&gt; = .71). Redislocation rates were significantly lower in the Latarjet group (3.8% vs 17.6%; &lt;i&gt;P&lt;/i&gt; = .02), with a longer mean time to dislocation (56.5 vs 30.0 months; &lt;i&gt;P&lt;/i&gt; = .004). Revision surgery rates did not differ significantly between groups. Cox proportional hazards regression demonstrated that surgical technique was a significant predictor of postoperative dislocation, with Latarjet associated with a lower hazard of dislocation (hazard ratio, 0.139; 95% CI, 0.026-0.737; &lt;i&gt;P&lt;/i&gt; = .02), whereas time to resolution of subjective instability was not predictive of dislocation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The sense of postoperative instability was common and occurred more frequently after isolated arthroscopic Bankart repair than after the Latarj","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261470584"},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760600","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 Donor Characteristics and Graft Storage Time with Survivorship of Osteochondral Allograft Transplantation in the Knee.","authors":"Suzanne M Tabbaa, Julie C McCauley, Dennis C Crawford, William D Bugbee","doi":"10.1177/23259671261457786","DOIUrl":"10.1177/23259671261457786","url":null,"abstract":"<p><strong>Background: </strong>The effect of donor tissue characteristics on osteochondral allograft (OCA) efficacy for treating chondral and osteochondral lesions of the knee is poorly understood. Studies on graft storage time show inconsistent effects on clinical outcomes, and research on donor-specific factors remains limited.</p><p><strong>Purpose: </strong>To (1) assess the association between donor characteristics and graft storage time with allograft recipient survivorship; and (2) determine whether patient-reported outcomes and satisfaction differed across donor characteristics.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 220 patients (236 knees) who underwent primary fresh OCA transplantation of the knee with a minimum 2-year follow-up were included in this study. Patients with degenerative indications were excluded. Failure (defined as further procedure such as removal or revision) and survivorship rates were compared between patients receiving OCA grafts from donors aged ≤20 or >20 years, with a body mass index (BMI) ≤30 or >30 kg/m², of the same sex (sex-matched) or different sex (sex-mismatched), released early (1-14 days) or late (15-28 days). International Knee Documentation Committee (IKDC) scores and satisfaction were compared between groups.</p><p><strong>Results: </strong>The mean follow-up was 8.2 years. Grafts from older donors (>20 years) had a significantly higher failure rate than grafts from younger donors (11.7% vs 3.7%; <i>P</i> = .039). Ten-year survival was 89.3% in the older donor group and 100% in the younger donor group. OCA failure rate for early-release grafts (22.7%) was significantly higher than late-release grafts (6%) (<i>P</i> = .002). Survivorship was 85.6% at 10 years for early-release grafts and 96.1% for late-release grafts. Grafts from older donors were 6.96 times more likely to fail than grafts from younger donors (<i>P</i> = .039), and early-release grafts were 6.90 times more likely to fail than late-release grafts (<i>P</i> = .002). Donor BMI and sex matching did not impact failure rate or survivorship. IKDC scores and satisfaction did not differ statistically between donor characteristic groups.</p><p><strong>Conclusion: </strong>These findings suggest that donor age should be considered for OCA transplantation and that shorter graft storage times, donor BMI, and sex matching may not be required for successful clinical outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261457786"},"PeriodicalIF":2.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722774","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":"Achilles Tendon Injuries in Major League Soccer: A 10-year Analysis of Injury Rate, Return to Play, and Performance Metrics.","authors":"Brian Forsythe, Catherine Hand, Francis Hand, Henry Eilen, Matthew Varano, Jared Sasaki, Camden Bohn, Anne Timmermann, Lauren Fertig, Eric Giza, Robert H Brophy, Bert Mandelbaum, Kirk McCullough","doi":"10.1177/23259671261449641","DOIUrl":"10.1177/23259671261449641","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Injuries to the Achilles tendon, such as tears or ruptures, are commonly observed among elite athletes. These injuries can be debilitating for professional soccer players, leading to prolonged recovery and potential performance declines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate the annual incidence, return-to-play (RTP) duration, and postinjury performance outcomes of Major League Soccer (MLS) players who sustained Achilles tendon injuries from 2010 to 2021.&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 retrospective matched-cohort study evaluated MLS players with Achilles tendon injuries from 2010 to 2021, identified through the MLS Injury Surveillance database, and compared outcomes, including RTP duration, between players with ruptured and nonruptured (soreness, contusion, inflammation, irritation, sprain, tendinosis, tendinitis) injuries. Uninjured controls were matched 2:1 by age, position, and MLS experience. Annual injury incidence, RTP duration, and performance metrics, including games played, minutes played, goals, assists, and defensive contributions, were compared between injured and control cohorts. Multivariate linear regression was performed to identify independent predictors of RTP duration, adjusting for age, player position, injury type, mechanism of onset, field type, weather condition, and injury period. Statistical analyses set significance at &lt;i&gt;P&lt;/i&gt;≤ .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean RTP for ruptured Achilles injuries (n = 20) was 229 days, with no significant difference between 2010-2015 and 2016-2021 (&lt;i&gt;P&lt;/i&gt; = .718). Nonruptured injuries (n = 352) had a significantly shorter RTP of 14.9 days versus rupture injuries with an RTP of 229 days (&lt;i&gt;P&lt;/i&gt; &lt; .001). Player age was significantly associated with RTP time, with younger players (≤26 years) exhibiting prolonged RTP durations (303.56 ± 112.97 days) compared to older players (&gt;26 years) (168.09 ± 99.66 days; &lt;i&gt;P&lt;/i&gt; = .017). There was no difference in RTP with field type (artificial turf vs grass, &lt;i&gt;P&lt;/i&gt; = .59). Reinjury rates increased over time but were not statistically significant (&lt;i&gt;P&lt;/i&gt; = .77). Following multivariate analysis, injury type was the only statistically significant factor affecting RTP duration, with ruptured Achilles injuries associated with significantly increased time missed compared to nonrupture injuries (95% CI, 171.15-264.11 days; &lt;i&gt;P&lt;/i&gt; &lt; .001). Forwards with ruptured Achilles injuries exhibited a decline in games played in the index year (-9.00 ± 8.49 vs 3.00 ± 1.73 games; &lt;i&gt;P&lt;/i&gt; = .041). Midfielders with ruptured Achilles injuries demonstrated a significantly greater increase in goals than controls in the index year (1.00 ± 1.41 vs -0.43 ± 0.25 goals; &lt;i&gt;P&lt;/i&gt; = .004) and a smaller decline in assists than controls (-0.50 ± 2.83 vs -1.00 ± 2.31 assists; &lt;i&gt;P&lt;/i&gt; = .024) relative to preinjury performance. Among goalkeepers","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261449641"},"PeriodicalIF":2.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713370","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}