Orthopaedic Journal of Sports Medicine最新文献

{"title":"Pitch Clock Increases Tolerated Workload Before Ulnar Collateral Ligament Injury: A Retrospective Cohort Study of Major League Baseball.","authors":"Ryan K Card, Brendan J Liakos, John T Schwartz, Alexander Baur, Jonathan Pettegrew, Michael B Purnell, Eric Giang, Eric G Huish","doi":"10.1177/23259671251366422","DOIUrl":"10.1177/23259671251366422","url":null,"abstract":"<p><strong>Background: </strong>In 2023, Major League Baseball (MLB) implemented a pitch clock (PC) to reduce game duration. Concerns have emerged regarding its effect on injury rates, particularly ulnar collateral ligament (UCL) tears, by reducing recovery time between pitches.</p><p><strong>Purpose: </strong>To assess the correlation between the MLB PC and UCL injury.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>UCL tear incidence was compared between pre-PC (PPC) (2021-2022) and PC (2023-2024) eras. Data on UCL injuries were collected from publicly available databases. Variables collected included player demographics, advanced pitching metrics, total pitches, innings pitched, and games played. The primary outcome was UCL tear incidence per 1000 innings pitched. Secondary outcomes included UCL tears per innings pitched in the season of injury (preinjury workload innings [PIWi]) and UCL tears per pitches thrown in the season of injury (preinjury workload pitches [PIWp]), pitch count per season, fastball velocity, and pitch selection.</p><p><strong>Results: </strong>There was no significant difference in UCL tear incidence between PPC (0.63) and PC (0.67) eras (<i>P</i> = .73). However, PIWp was significantly higher in the PC era (n = 721) compared with the PPC era (n = 442) (<i>P</i> = .009), and PIWi was significantly higher in the PC (45.7) era compared with the PPC era (26.5) (<i>P</i> = .003). Pitchers in the PC group were significantly younger (28.4 vs 31.0) (<i>P</i> = .0002), threw more pitches per season (710 vs 441) (<i>P</i> = .02), and averaged more pitches per game (54.9 vs 35.5) (<i>P</i> = .0005).</p><p><strong>Conclusion: </strong>The PC had no observed effect on overall UCL tear incidence but was associated with a higher preinjury workload. These findings challenge fatigue-related injury theories and suggest potential protective effects of the PC.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251366422"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041011","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":"Arthrofibrosis After Adolescent Anterior Cruciate Reconstruction with Quadriceps Tendon with Bone Block Autograft.","authors":"Dallyn Udall, Remy Zimmerman, Halle Walls, Evelyn Thomas, Tracey Bastrom, John Schlechter","doi":"10.1177/23259671251364255","DOIUrl":"10.1177/23259671251364255","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) utilizing quadriceps tendon autografts with a patellar bone block (QTB) has gained popularity in children and adolescents, with favorable patient-reported outcomes being reported at 2 years postoperatively. The incidence of arthrofibrosis after ACLR in pediatric patients for all graft types is between 2% and 10%. However, there is a paucity of research focused on arthrofibrosis in pediatric patients undergoing ACLR with QTB.</p><p><strong>Purpose: </strong>To quantify children after ACLR with QTB and compare with previously published studies evaluating an all-soft tissue quadriceps autograft.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>This was a retrospective review of children and adolescents aged ≤17 years who underwent primary ACLR with QTB between 2019 and 2023. Demographic characteristics (age, sex, body mass index [BMI]), insurance type, and pre-, intra-, and postoperative records were reviewed. The incidence of arthrofibrosis was assessed at 3 months postoperatively and at the last follow-up. Arthrofibrosis was defined as a 20° flexion deficit and/or a 10° extension deficit at 3 months.</p><p><strong>Results: </strong>A total of 80 patients with a mean age of 15.9 years (range, 12.8-17 years) were included. At 3 months, arthrofibrosis occurred in 22 of 80 patients (27.5%). At the last follow-up (mean duration of 13.3 months; range, 6-47 months), 7 of 80 patients (8.8%) required procedural intervention with manipulation under anesthesia (MUA). Those with arthrofibrosis at 3 months postoperatively had significantly reduced preoperative flexion compared with those without arthrofibrosis (120.5° vs 130.7°; <i>P</i> = .02) and at postoperative week 6 (91.7° vs 111.9° flexion; <i>P</i> < .001). The presence of medial meniscal repair (MMR) was significantly higher in the arthrofibrosis group (<i>P</i> = .04). No significant difference in age, sex, or BMI existed (<i>P</i> > .05). However, patients with government insurance were disproportionately more likely to develop arthrofibrosis at 3 months, as opposed to those with private insurance (<i>P</i> = .02).</p><p><strong>Conclusion: </strong>More children and adolescents undergoing ACLR with QTB have a higher rate of arthrofibrosis at 3 months. However, return to the operating room for MUA is similar to other graft types. Reduced flexion preoperatively and at 6 weeks postoperatively, as well as concomitant MMR, were significant predictors of arthrofibrosis.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251364255"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040986","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":"Differences in Pitching Kinetics and Kinematics During Various Effort Level Pitching.","authors":"Jakob H Wolf, Sam Kinney, Brian R Waterman, Garrett S Bullock, Kristen Nicholson","doi":"10.1177/23259671251356631","DOIUrl":"10.1177/23259671251356631","url":null,"abstract":"<p><strong>Background: </strong>After a pitching injury, players must go through a return to sports protocol to enable them to get back to competition. However, this should be done while reducing the risk of reinjury. In the early stages of the return to sports protocol, it is important to minimize kinetics while ideally working on pitching mechanics, which may be achieved through interval throwing progressions.</p><p><strong>Purpose: </strong>To assess the differences in kinetics and kinematics during reduced effort pitching.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Collegiate-aged pitchers (n = 19) throw 5 fastballs at each effort level, including 60%, 70%, 80%, 90%, and 100%. Kinetics and kinematics were recorded. Variables of interest included elbow varus torque, shoulder rotation at maximum external rotation (MER), elbow flexion at MER, maximum resultant shoulder force, peak pelvis rotation velocity, peak trunk rotation velocity, peak shoulder internal rotation velocity, peak elbow extension velocity, shoulder abduction at MER, maximum shoulder horizontal abduction, and maximum hand velocity. Once the data were extracted from the Kinatrax database, separate analyses of covariance tests were performed on each set of data, followed by a Tukey Honest Significant Difference post hoc test when the analysis of variance test returned a statistically significant <i>P</i> value (<i>P</i> < .05).</p><p><strong>Results: </strong>Only elbow varus torque was found to have statistically significant differences between effort levels, and only a statistically significant difference between 100% and 60% effort levels was found. At 100% effort level, elbow varus torque showed a mean value of 92.5 N·m, while 60% effort level pitching showed a mean elbow varus torque of 73.2 (<i>P</i> = .017).</p><p><strong>Conclusion/clinical relevance: </strong>These results suggest that players can throw at close to half effort to reduce their elbow kinetics while maintaining kinematics that would be occurring at 100% effort pitching.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251356631"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Outcomes at Mean 4.8 Years After Repair of Types 3 and 4 Lateral Meniscal Oblique Radial Tears during ACL Reconstruction.","authors":"Jarod M Karom, Grace E Monroe, Zachary Burnett, Parker A Cavendish, Eric M Milliron, Robert A Magnussen, Christopher C Kaeding, David C Flanigan","doi":"10.1177/23259671251361491","DOIUrl":"10.1177/23259671251361491","url":null,"abstract":"<p><strong>Background: </strong>Lateral meniscal oblique radial tears (LMORTs) of the posterior horn typically occur in the setting of an acute anterior cruciate ligament (ACL) rupture. Despite publications pertaining to the prevalence, biomechanics, and surgical repair techniques of LMORTs, studies reporting mid-term outcomes after LMORT repair are lacking.</p><p><strong>Purpose: </strong>To examine both clinical and functional outcomes after the surgical repair of LMORTs.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 845 patients who underwent a meniscal repair at The Ohio State University Sports Medicine Center from 2017 to 2019. Operative reports and images were manually reviewed to identify LMORTs occurring concomitantly with ACL rupture. Subsequent knee surgery, meniscal repair failure, and postoperative complications were identified, with failure defined as retear at the same meniscal site. Patients without at least 2 years of follow-up were excluded. Patients were contacted postoperatively for evaluation of patient-reported outcomes (PROs)-including the Knee injury and Osteoarthritis Outcome Score (KOOS), Marx activity rating scale (Marx), and pain on a visual analog scale (VAS).</p><p><strong>Results: </strong>A total of 25 patients were identified who underwent repair of an LMORT at the time of ACL reconstruction during the study period, with 18 patients available for a 2-year follow-up. The mean age was 21.3 ± 5 years, the mean body mass index was 26.7 ± 4.3 kg/m², and 56% of patients were men. The mean follow-up was 4.8 ± 1 years. There were no identified failures of LMORT repair. Postoperative complications were reported in 9 patients (50%), of whom 7 underwent repeat arthroscopy of the index knee for stiffness, pain, and/or repeat injury. The mean follow-up was 4.9 years from the initial date of surgery. The mean KOOS, Marx, and VAS scores were 86.5 ± 8.6, 7.1 ± 4.7, and 2.1 ± 1.4, respectively.</p><p><strong>Conclusion: </strong>LMORT repair is associated with a low risk of failure and favorable PRO measures at the mid-term follow-up. However, a complication rate of 50% was found within the cohort because of joint stiffness, postoperative pain, and reinjury of the index knee.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251361491"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015939","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":"Interportal Capsulotomy Closure Does Not Improve the Results After Hip Arthroscopy at 1-Year Follow-up: A Prospective Randomized Controlled Study.","authors":"Bjarne Mygind-Klavsen, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Torsten G Nielsen, Lene Lindberg Miller, Marc Philippon, Christian Dippmann","doi":"10.1177/23259671251363604","DOIUrl":"10.1177/23259671251363604","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Management of the capsulotomy at termination of hip arthroscopic procedures in the treatment of femoroacetabular impingement syndrome (FAIS) is debated. Clinical outcomes in favor of capsular closure were demonstrated in a retrospective study; nonetheless, this finding could not be confirmed in a recent randomized, controlled trial comparing capsular closure with unrepaired capsulotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;This randomized, controlled multicenter trial aimed to evaluate the effect of capsular closure on subjective postoperative outcomes and revision rates in patients undergoing hip arthroscopy for FAIS. It was hypothesized was that capsular closure would result in better patient-reported outcome scores compared with no closure of the interportal capsulotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Randomized controlled clinical trial; Level of evidence, 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All eligible patients with FAIS from 4 surgical centers in Denmark, referred for hip arthroscopy (n = 200), were randomly assigned to either closure or no closure of the interportal capsulotomy at termination of the arthroscopic procedure. The capsular closure was performed with 2 to 3 absorbable sutures, using the \"Quebec City Slider\" knot technique. The primary outcome was the Copenhagen Hip and Groin Outcome Score (HAGOS) Sport/Recreation subscale. The secondary outcomes were the other HAGOS subscales, International Hip Outcome Tool (iHOT-12), Hip Sports Activity Scale (HSAS), pain during rest and activity measured on a numerical rating scale (NRS), and a measure of the overall well-being by the European Quality of Life-5 dimensions (EQ-5D). Furthermore, the rate of revision procedures and the rate of conversion to total hip replacement were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline epidemiological and morphological characteristics were comparable between the treatment groups, except for a higher percentage of women in the capsular closure group (65% vs 48%; &lt;i&gt;P&lt;/i&gt; &lt; .05). Both cohorts had significantly improved scores 1 year after surgery, with no difference between the 2 groups, except for the HSAS: HAGOS-Pain (&lt;i&gt;P&lt;/i&gt; = .19), HAGOS-Symptoms (&lt;i&gt;P&lt;/i&gt; = .33), HAGOS-Activities of Daily Living (&lt;i&gt;P&lt;/i&gt; = .21), HAGOS-Sport/Recreation (&lt;i&gt;P&lt;/i&gt; = .52), HAGOS-Physical Activity (&lt;i&gt;P&lt;/i&gt; = .59), HAGOS-Quality of Life (&lt;i&gt;P&lt;/i&gt; = .16), iHOT-12 (&lt;i&gt;P&lt;/i&gt; = .15), HSAS (&lt;i&gt;P&lt;/i&gt; = .03), EQ-5D (&lt;i&gt;P&lt;/i&gt; = .12), NRS-rest (&lt;i&gt;P&lt;/i&gt; = .20), and NRS-activity (&lt;i&gt;P&lt;/i&gt; = 0.23). Five patients received revision hip arthroscopy after 1 year-1 in the unrepaired versus 4 in the repaired cohort. No patients had conversion to total hip replacement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This randomized, controlled multicenter trial showed no effect on clinical outcomes (HAGOS, iHOT-12, EQ-5D, and NRS) 1 year after hip arthroscopy for FAIS of closure of the interportal capsulotomy at termination of surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;R","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251363604"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015948","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 between Meniscal Injuries at the Time of an Anterior Cruciate Ligament Reconstruction and Lower Return-to-Sport Rates: An Analysis at 5 Years of Follow-up of the MERIscience Cohort.","authors":"Clément Cazemajou, Thibault Marty-Diloy, Nicolas Graveleau, Pierre Laboudie, Nicolas Bouguennec","doi":"10.1177/23259671251358394","DOIUrl":"10.1177/23259671251358394","url":null,"abstract":"<p><strong>Background: </strong>While meniscal tears, particularly when treated by meniscectomy concurrent with anterior cruciate ligament reconstruction (ACLR), are known to increase the risk of osteoarthritis and lead to poorer outcomes, their effects on return to sport (RTS) have been little studied so far.</p><p><strong>Purpose: </strong>To assess the effect of meniscal tears on RTS in the context of ACLR depending on the affected meniscus.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors conducted a retrospective analysis based on data from a prospective cohort single-center study involving 504 patients who received the same postoperative follow-up for a minimum of 3 years between April 2015 and December 2019. The preinjury Tegner Activity Scale score was collected preoperatively, and the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) score was collected 6 months after surgery. At the last follow-up, information such as RTS levels, return to the same sport and same athletic level, Self Knee Value, International Knee Documentation Committee score, ACL-RSI score, Tegner score, graft failure, contralateral rupture, and reintervention was collected. Isolated ACLR was compared with ACLR involving medial meniscus (MM), lateral meniscus (LM), and bi-menisci (BM) injuries, and then meniscal repair and meniscectomies were compared for MM and LM injuries.</p><p><strong>Results: </strong>A total of 504 patients were included with a mean follow-up of 4.9 ± 1.2 years; 6 patients were lost to follow-up. The mean postoperative Tegner score was significatively lower for ACLR with MM injuries than for isolated ACLR (5.4 ± 2.0 vs 6.0 ± 2.0; <i>P</i> = .01). Compared with isolated ACLR (93.9%), the RTS rate was significantly lower for MM injuries (85.1%) and BM injuries (84.1%) (<i>P</i> = .02). Outcomes were similar in ACLR with LM and in isolated ACLR. MM repairs significantly increased the mean Tegner score compared with MM meniscectomies (5.8 ± 1.9 vs 4.7 ± 2.1; <i>P</i> < .001). No other significant differences were found on RTS.</p><p><strong>Conclusion: </strong>MM tears encountered at the time of ACLR led to a lower Tegner score and a lower RTS rate. Patients undergoing MM repair had higher postoperative activity levels than those undergoing meniscectomy. These findings highlight the importance of repairing MM tears whenever possible at the time of ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251358394"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015963","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":"Factors Affecting the Health-Related Quality of Life in Taiwanese Adolescent Baseball Players: A Prospective Longitudinal Study.","authors":"Po-Cheng Chen, Hou-Tsung Chen, Kuan-Ting Wu, Yu-Chi Huang, Nai-Lun Lee, Chi-Fa Hung, Wen-Yi Chou","doi":"10.1177/23259671251343236","DOIUrl":"10.1177/23259671251343236","url":null,"abstract":"<p><strong>Background: </strong>Adolescent baseball players often experience throwing arm complaints from the repetitive activity of baseball, which can affect performance and overall well-being. More focus is needed on their psychological and social challenges in order to achieve better treatment outcomes.</p><p><strong>Purpose: </strong>To investigate changes in the health-related quality of life (HRQOL) among adolescent baseball players in Taiwan and identify the factors that influence HRQOL.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Taiwanese adolescent baseball players (12-18 years old) of all positions from junior and senior high schools were surveyed every 3 months for 1 year (starting in August 2022). Data on demographic characteristics, training volume, throwing arm injury history, and Functional Arm Scale for Throwers (FAST) scores (1 measurement of HRQOL for baseball players) were collected and analyzed using mixed-effects regression models.</p><p><strong>Results: </strong>The study included 299 adolescent baseball players (mean age, 14 years; range, 12-18 years). Pitchers and outfielders exhibited higher FAST total scores than infielders and catchers (mean ± SE, 14.74 ± 16.60 and 14.24 ± 18.76 vs 8.92 ± 9.77 and 9.52 ± 9.56, respectively; <i>P</i> = .027), which indicated more physical disability and psychological impact. In the mixed-effects regression model for FAST total scores, injury history (estimate for mild injury, 7.18 ± 1.25; moderate injury, 18.28 ± 3.00; severe injury, 22.94 ± 3.76 vs healthy), player position (pitcher 4.20 ± 1.97 vs infielder), and months of follow-up (estimate for 3 months, -4.86 ± 1.33; 6 months, -4.55 ± 1.48; 9 months, -4.27 ± 1.85; 12 months -5.84 ± 2.28 vs 0 months). Training volume did not significantly affect HRQOL scores (<i>P</i> = .629).</p><p><strong>Conclusion: </strong>Our study demonstrated significant differences in most FAST total and subscale scores among player positions. Pitchers and outfielders exhibited higher FAST scores than the other positions, indicating more physical disability and psychological impact. Furthermore, the severity of throwing arm injury history significantly influenced FAST scores, with more severe injuries correlating with poorer outcomes. However, training volume did not significantly impact FAST scores. These data may help in future studies integrating patient-reported outcomes and HRQOL to evaluate athlete's' well-being beyond just physical parameters.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251343236"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015979","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":"Increases in Ball Weight and Size Decrease Elbow Varus Torque During Baseball Pitching.","authors":"Glenn S Fleisig, Jonathan S Slowik, J Bradford Hall, David P Beason, E Lyle Cain","doi":"10.1177/23259671251368999","DOIUrl":"10.1177/23259671251368999","url":null,"abstract":"<p><strong>Background: </strong>The rates of ulnar collateral ligament injury and surgery continue to rise in baseball. Increased ball velocity and elbow varus torque may correlate with the increased risk of injury.</p><p><strong>Hypothesis: </strong>Increased ball weight and/or size correlate with decreased elbow varus torque during pitching.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Motion capture data of 20 healthy professional and high-level collegiate baseball pitchers pitching fastballs with 4 types of baseballs were collected. The baseballs were 5 oz (standard weight) or 6 oz, with a circumference of 9 inches (standard size) or 5% larger. Five kinetic parameters, 25 kinematic parameters, and 7 ball movement parameters were calculated. Differences for each parameter were compared using 2-factor (ball weight × size) repeated-measures analysis of variance (<i>P</i> < .05).</p><p><strong>Results: </strong>As hypothesized, elbow varus torque decreased with increased ball weight and with increased ball circumference. Ball velocity, shoulder internal rotation velocity, elbow extension velocity, and shoulder kinetics also decreased with increased ball weight and/or increased ball circumference. Ball break decreased with increased ball weight, while ball location as it crossed home plate was also affected by ball weight and/or size. There were no clinically important differences in pitching kinematics with the different baseballs.</p><p><strong>Conclusion: </strong>Increasing the weight of baseballs from 5 oz to 6 oz and/or the circumference by 5% may reduce elbow varus torque. Future research in league play or simulated play is warranted.</p><p><strong>Clinical relevance: </strong>As elbow varus torque has been staassociated with UCL injury risk, increasing ball weight and/or size may reduce the rate of injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 9","pages":"23259671251368999"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015917","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":"Patient Perception of Autograft Options in ACL Reconstruction Using a Validated Online Survey Marketplace.","authors":"Robert S Dean, Tanner Hafen, Ryan McNassor, Collin Braithwaite, Kevin X Farley, Robert F LaPrade, Joseph H Guettler, James Bicos","doi":"10.1177/23259671251362631","DOIUrl":"10.1177/23259671251362631","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) is a common surgery performed with a variety of different autograft options. While there is much research that highlights the benefits and drawbacks of each of these options, there is little known about the knowledge of the general population regarding these options and how patient education may influence their choice.</p><p><strong>Purpose: </strong>To evaluate the general population's perception of commonly utilized autografts in ACLR.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Using an online marketplace, a random selection of participants from the general population were asked about demographic data and preferences for autograft type. All respondents then participated in a survey sent in August 2024, reviewed information from an evidence-based sheet, and completed a posteducation test. Participants were again asked about graft preferences. Participants were asked whether they would change their preference based on surgeon recommendation and what factors influenced their decisions. Statistical analysis was performed using Shapiro-Wilks test to determine normality, and Student paired <i>t</i> test was used for comparison.</p><p><strong>Results: </strong>There were 491 participants with a mean age of 39.9 (range, 19-72). Before participant education regarding graft types, 19.3% preferred bone-patellar tendon-bone (BPTB), 18.7% preferred quadriceps tendon (QT), 12.6% preferred hamstring tendon (HT), and 53.4% had no preference. Following education, a significantly greater number of participants chose each graft type; 37.7% (<i>P</i> < .01) preferred BPTB, 21.6% (<i>P</i> < .01) preferred QT, and 13.8% (<i>P</i> < .01) preferred HT. Significantly fewer participants had no preference (26.9%; <i>P</i> < .01). Among the most important factors in patient preference was surgeon preference (n = 357; 72.7%), as 424 (86.4%) participants said they would switch their graft preference if their surgeon recommended it.</p><p><strong>Conclusion: </strong>The findings of this study imply that informed patients can participate in medical decision making with respect to their graft choices in ACLR and that providing educational information can help surgeons and patients work together to optimize patient care.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251362631"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963551","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":"Cost Comparison of Sports Medicine Procedures in Ambulatory Surgery Centers Versus Hospital Outpatient Departments for Medicare Recipients.","authors":"Johnathon R McCormick, William E Harkin, Vincent P Federico, Vince K Morgan, Robert B Browning, Luis M Salazar, Garrett R Jackson, Zeeshan A Khan, Daniel J Kaplan, Nikhil N Verma, Brian J Cole, Jorge Chahla","doi":"10.1177/23259671251333110","DOIUrl":"10.1177/23259671251333110","url":null,"abstract":"<p><strong>Background: </strong>Healthcare costs in the United States are rising in conjunction with an increased utilization of outpatient centers, particularly in sports medicine.</p><p><strong>Purpose/hypothesis: </strong>The primary purpose of this study was to utilize Medicare data to compare the overall cost of sports medicine procedures performed in the ambulatory surgery centers (ASCs) and hospital outpatient department (HOPD) settings. The secondary purpose of this study was to compare facility fees, surgeon fees, Medicare payments, and patient payments between ASCs and HOPDs. It was hypothesized that procedures performed at ASCs would demonstrate a lower overall cost than those performed at HOPDs.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Publicly available data from the Centers for Medicare & Medicaid Services (CMS) were accessed via the Medicare Procedure Price Lookup Tool. Current Procedural Terminology (CPT) codes were used to identify sports medicine procedures approved for the outpatient setting by CMS. Facility fees, surgeon fees, total costs, Medicare payments, and patient payments were extracted. Descriptive statistics were utilized to calculate the mean and standard deviation for each category of fee and payment.</p><p><strong>Results: </strong>A total of 62 CPT codes were identified. Compared with HOPDs, shoulder procedures (n = 25) at ASCs had lower total costs ($3622 ± $1160 vs $6261 ± $1759; <i>P</i> < .001), facility fees ($2777 ± $1020 vs $5416 ± $1606; <i>P</i> < .001), Medicare payments ($2898 ± $928 vs $5009 ± $1407; <i>P</i> < .001), and patient payments ($724 ± $232 vs $1252 ± $352; <i>P</i> < .001) compared with HOPDs. Knee procedures (n = 31) at ASCs had lower total costs ($4236 ± $2741 vs $6668 ± $3341; <i>P</i> = .006), facility fees ($3408 ± $2507 vs $5840 ± $3116; <i>P</i> = .006), Medicare payments ($3389 ± $2193 vs $5458 ± $2955; <i>P</i> = .006), and patient payments ($847 ± $548 vs $1209 ± $429; <i>P</i> = .011). Hip procedures (n = 6) at ASCs had lower total costs ($3583 ± $698 vs $6671± $1451; <i>P</i> = .025), facility fees ($2725 ± $669 vs $5813 ± $1431; <i>P</i> = .025), Medicare payments ($2866 ± $558 vs $5336 ± $1161; <i>P</i> = .025), and patient payments ($716 ± $139 vs $1333 ± $290; <i>P</i> = .025) compared with HOPDs.</p><p><strong>Conclusion: </strong>Our study demonstrates that sports medicine procedures performed at ASCs for Medicare recipients result in considerable overall total cost savings when compared with those performed at HOPDs. Sports medicine providers should be aware of differences in costs when determining the best setting for these procedures.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251333110"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963769","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}