Orthopaedic Journal of Sports Medicine最新文献

{"title":"Translation and Validation of the Spanish Version of the Banff Patellofemoral Instability Instrument 2.0.","authors":"Juan Pablo Martinez-Cano, Maura D Iversen, Alejandro Gallego, Luis Alfonso Gallon, Marie Askenberger, Johan von Heideken","doi":"10.1177/23259671241298306","DOIUrl":"10.1177/23259671241298306","url":null,"abstract":"<p><strong>Background: </strong>The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a patient-reported outcome measure (PROM) tailored specifically for patellofemoral instability. The BPII 2.0 was developed in English and has been validated for adolescents and translated into several languages, but not into Spanish.</p><p><strong>Purpose/hypothesis: </strong>This investigation involved translating the BPII 2.0 into Spanish and evaluating and validating its psychometric properties. It was hypothesized that there would be a moderate correlation between the Spanish BPII 2.0 and the Spanish version of the Kujala score.</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>The BPII 2.0 underwent forward and backward translations into Colombian Spanish according to the Consensus-Based Standards for the Selection of Health Measurement Instrument guidelines. Colombian patients aged 9 to 18 years who experienced knee symptoms after a primary or recurrent patellar dislocation were recruited from a hospital-based orthopaedic clinic. Participants completed the Spanish BPII 2.0 and the Kujala score during their initial visit (t₀) and the Spanish BPII 2.0 again 1 week later (t₁). Internal consistency and test-retest reliability were assessed using the intraclass correlation coefficient (ICC). Concurrent validity of the Spanish BPII 2.0 with the Kujala score was explored through Pearson correlation analysis.</p><p><strong>Results: </strong>A total of 46 participants (31 [67%] female; mean age, 15.1 ± 2.0 years) were included. The mean time since first patellofemoral dislocation was 22 ± 28 months. Of the 4 participants who received operative treatment for patellar instability, the mean time since surgery was 12 months (range, 7-18 months). All patients completed the BPII 2.0 at t₀ and at t₁, a mean of 7 days later (range, 6-7 days), and 45 (98%) participants completed the Kujala score at t₀. Five Spanish BPII 2.0 items exhibited floor or ceiling effects, however no subscales demonstrated these effects. Th Spanish BPII 2.0 demonstrated excellent internal consistency at both t₀ (ICC, 0.94; 95% CI, 0.92-0.96) and t₁ (ICC, 0.96; 95% CI, 0.93-0.97), along with excellent test-retest reliability (ICC, 0.98; 95% CI, 0.97-0.99). Concurrent validity of the Spanish BPII 2.0 with the Spanish Kujala score was good to strong (<i>r</i> = 0.74; 95% CI, 0.57-0.85).</p><p><strong>Conclusion: </strong>The Spanish BPII 2.0 had excellent internal consistency and test-retest reliability, suggesting this PROM is a reliable and valid questionnaire.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298306"},"PeriodicalIF":2.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829326","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":"Fifteen-Year Radiographic Follow-up Comparison of Early Versus Delayed ACL Reconstruction: A Retrospective Review of a Previous Prospective Randomized Clinical Trial.","authors":"Christian A Cruz, James A Pruneski, Rebecca N McAllister, David Riopelle, Craig R Bottoni","doi":"10.1177/23259671241298753","DOIUrl":"10.1177/23259671241298753","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic osteoarthritis (PTOA) after anterior cruciate ligament injury and reconstruction (ACLR) is a prevalent cause of long-term disability. Few studies have compared the effect of ACLR timing on the development of PTOA.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to compare the rate of PTOA at a long-term follow-up between patients who underwent early ACLR (<21 days after injury) versus delayed ACLR (>6 weeks after injury). The authors hypothesized that patients who underwent early ACLR would have lower rates of PTOA compared with the delayed ACLR cohort.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>The authors contacted patients from a previous prospective randomized controlled trial who were randomized to undergo either early (<21 days) or delayed (>6 weeks) ACLR with hamstring tendon autografts. Weightbearing radiographs were obtained at a minimum 15-year follow-up, and radiographic PTOA was evaluated using the Kellgren-Lawrence (K-L) classification system. The prevalence of pathologies was compared between the early and delayed groups using appropriate testing, and logistic regression was used to evaluate for associations with failure-a K-L grade of ≥2 or conversion to total knee arthroplasty (TKA).</p><p><strong>Results: </strong>At a mean follow-up of 15.6 years, radiographs were obtained for 58 (28 early, 30 delayed) of the original 69 (84.1%) patients. High rates of PTOA (K-L grade ≥2) were observed in the early (82.1%) and delayed (86.7%) cohorts (<i>P</i> = .634). Two (7.1%) patients in the early cohort converted to TKA compared with 4 (13.3%) patients in the delayed cohort (<i>P</i> = .44). Surgical timing did not affect arthritis severity (<i>P</i>≥ .4), and no factors predicted developing radiographic PTOA in either cohort (<i>P</i> > .2). Increased time from injury decreased the odds of failure in the early ACLR cohort (odds ratio, 0.79; <i>P</i> = .041).</p><p><strong>Conclusion: </strong>In this study, >80% of patients who underwent ACLR with hamstring tendon autografts had radiographic evidence of PTOA at a mean 15.6-year follow-up, with no difference in the prevalence or severity of PTOA between the early and delayed groups. In addition, 11% of patients had converted to TKA by the time of the final follow-up, and the conversion rate did not differ according to the timing of ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298753"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818878","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":"Treatment of Initial Anterior Shoulder Instability in National Hockey League Players: A Survey of NHL Team Physicians.","authors":"Neilen A Benvegnu, Ryan Gnandt, Michael Nammour, Neel Patel, William Schulz, Ryan Eads, Dharmesh Vyas","doi":"10.1177/23259671241271704","DOIUrl":"10.1177/23259671241271704","url":null,"abstract":"<p><strong>Background: </strong>Managing an in-season anterior shoulder instability poses a special challenge for team physicians, as they need to balance the aim of promptly returning the athlete to play while mitigating the chances of recurrence and further injury to the shoulder.</p><p><strong>Purpose: </strong>To investigate and report on the treatment preferences of National Hockey League (NHL) team physicians when managing in-season first-time anterior shoulder instability in professional hockey players.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A survey consisting of 33 sport-specific questions focused on the treatment options and preferences for anterior shoulder instability in hockey players was developed, and 32 NHL team physicians were invited to anonymously complete the survey. Following the collection of the data, the distribution of the responses to each question was documented as counts and percentages.</p><p><strong>Results: </strong>Of the 32 invited team physicians, 31 (97%) completed all (n = 28) or most (n = 3) of the survey. The mean experience of the respondents was 13 ± 11 years. A total of 28 (90%) respondents would attempt nonoperative treatment of an in-season initial anterior shoulder dislocation with an isolated soft tissue injury, while 28 (90%) would recommend operative treatment of the same injury with bony involvement. Of the 31 respondents, 30 (97%) utilized rehabilitation parameters rather than time from injury when determining whether a player could return to play. Of those parameters, clinical strength (100%), range of motion (87%), anterior apprehension (84%), and pain (65%) were the most utilized. For surgical management of an isolated soft tissue lesion, 28 (90%) of the respondents preferred arthroscopic repair, while 2 (7%) preferred open repair.</p><p><strong>Conclusion: </strong>Of the 32 NHL team physicians surveyed, 28 preferred nonoperative management for the treatment of initial anterior shoulder dislocations with isolated soft tissue injuries, while initial operative management was preferred by the same number of team physicians for any injuries with bony involvement.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241271704"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829328","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 Articular Incongruence After Trochleoplasty and Long-term Patellofemoral Osteoarthritis.","authors":"Tomas Pineda, Michael J Dan, Nicolas Cance, Guillaume Demey, David H Dejour","doi":"10.1177/23259671241299486","DOIUrl":"10.1177/23259671241299486","url":null,"abstract":"<p><strong>Background: </strong>Trochleoplasty has shown promising results in selected patients with patellar instability. However, concerns persist regarding its potential relationship with long-term osteoarthritis (OA) and the underlying causes.</p><p><strong>Purpose: </strong>To evaluate the correlation between postoperative patellofemoral incongruence after trochleoplasty and long-term OA.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors conducted a retrospective review of patients who underwent sulcus-deepening trochleoplasty between 2003 and 2013 and identified 43 patients after their initial search. All patients were assessed at a minimum follow-up of 10 years. Preoperative, immediate postoperative, and end-of-follow-up lateral and axial view knee radiographs were used to evaluate patellofemoral OA using the Iwano classification, the patellar articular surface angle (PA), and the trochlear articular surface angle (TA). Data on patellar redislocation, reoperations, and International Knee Documentation Committee (IKDC), Kujala, and patient satisfaction scores were also collected. Pearson correlation analysis was used to evaluate the relationship between articular surface angles and OA, and Spearman rank correlation analysis was used to assess the association between categorical and ordinal variables. A 2-tailed Student <i>t</i> test was used to compare the mean values of the clinical scores between groups.</p><p><strong>Results: </strong>Ten patients (10 knees) met the inclusion criteria, with a mean follow-up of 15.3 ± 3.93 years. The PA and TA were 148.5°± 24.75° and 148.5°± 17.85°, respectively, with a mean patellofemoral incongruence of 21.4°± 16.03°. None of the patients had preoperative OA, and 4 (40%) developed postoperative OA: 2 with Iwano grade 1 and 2 with Iwano grade 2. Higher patellofemoral incongruence was found to correlate with the development of patellofemoral OA (<i>P</i> = .017). No independent correlation was found between the TA and OA (<i>P</i> = .553) or the PA and OA (<i>P</i> = .884). The satisfaction, Kujala, and IKDC scores were 8.2 ± 1.75, 82.5 ± 10.09, and 84.4 ± 9.79, respectively. Only 1 patient (10%) reported a traumatic patellar dislocation, none required reoperations, and all (100%) indicated they would undergo surgery again.</p><p><strong>Conclusion: </strong>This study demonstrated that patellofemoral incongruence after trochleoplasty was associated with the development of long-term OA without an independent correlation with a flat trochlea or a flat patella.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241299486"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818865","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":"Nonsurgical Knee Osteoarthritis Treatments for Reducing Inflammation as Measured on MRI Scans: A Systematic Review of Randomized Controlled Trials.","authors":"Julia R Gottreich, Jeffrey N Katz, Morgan H Jones","doi":"10.1177/23259671241272667","DOIUrl":"10.1177/23259671241272667","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a debilitating condition, and synovitis is a structural marker of disease progression that can be identified on magnetic resonance imaging (MRI). Nonsurgical therapies have been developed with the goal of targeting this inflammation to reduce pain and slow disease progression.</p><p><strong>Purpose: </strong>To review current randomized controlled trials (RCTs) that measured changes in pain outcomes and synovitis on MRI scans after nonsurgical treatment for persons with knee OA.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>The PubMed database was searched using the terms \"knee osteoarthritis AND (synovitis OR inflammation)\" for RCTs published between 2012 and 2022. Included were studies that collected both pain outcomes and quantitative measurements of synovitis on MRI scan before and after treatment; studies that investigated surgical treatments were excluded. We calculated standardized response means (SRMs) to analyze the effect sizes of treatment on pain and synovitis outcomes; SRMs were classified as having low responsiveness to treatment if <0.5, moderate responsiveness to treatment if between 0.5 and 0.8, and large responsiveness to treatment if >0.8.</p><p><strong>Results: </strong>Included in the review were 9 RCTs. Vitamin D and exercise therapy were the only 2 treatments that improved both pain and synovitis outcomes in comparison with their respective control groups. Statistically significant group differences in favor of treatment were seen in changes in pain after lutikizumab (anti-interleukin-1α/β dual variable domain immunoglobulin; SRM, 0.22; <i>P</i> = .050), allogenic human chondrocytes transduced with retroviral vector encoding transforming growth factor-β1 (<i>P</i> = .0119 at 12 weeks, <i>P</i> = .120 at 52 weeks, and <i>P</i> = .0074 at 72 weeks), and <i>Curcuma longa</i> (turmeric; SRM, 0.35; <i>P</i> = .039 on the visual analog scale for pain and SRM, 0.47; <i>P</i> = .006 on the Western Ontario and McMaster Universities Osteoarthritis Index pain subscore). One study reported a statistically significant group difference in synovitis only after treatment with intra-articular methylprednisolone (<i>P</i> = .01 at 14 weeks and <i>P</i> = .0006 at 26 weeks).</p><p><strong>Conclusion: </strong>Only vitamin D and exercise therapy were found to improve pain and synovitis after treatment in this review. Further research is needed to validate these findings and investigate alternative treatments for reducing pain and synovitis in persons with knee OA.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241272667"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829400","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":"Trends and Complications of Medial Patellofemoral Ligament Reconstruction Among Applicants for the American Board of Orthopaedic Surgery Part II and Maintenance of Certification Examinations: Analysis of Data Over a 15-Year Period.","authors":"Brian J Chilelli, Sanjeev Bhatia, Victoria Das, Ronak M Patel","doi":"10.1177/23259671241299359","DOIUrl":"10.1177/23259671241299359","url":null,"abstract":"<p><strong>Background: </strong>Medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercle osteotomy (TTO) are commonly performed surgical procedures that often have a high learning curve.</p><p><strong>Purpose: </strong>To review the American Board of Orthopaedic Surgery (ABOS) Part II oral examination case list and the Maintenance of Certification (MOC) examination case list databases for trends in MPFLR (isolated and with concurrent TTO) and complication rates.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We reviewed the ABOS Part II and MOC case list databases for diagnosis codes relating to patellar instability and Current Procedural Terminology codes specific to MPFLR and TTO regarding cases submitted by applicants for these examinations between 2003 and 2017 (for ABOS Part II) and between 2010 and 2017 (for MOC). Data were analyzed using generalized estimating equations with a binomial distribution and logit link to determine how trends in MPFLR changed over the study period in these applicant groups (ABOS vs MOC) as well as any influence on complication rates.</p><p><strong>Results: </strong>In the ABOS group, the number of MPFLRs performed by surgeons increased a mean 3% each year, ranging from 66 in 2003 to 184 in 2015 (injury rate ratio, 1.03; 95% CI, 1.02-1.04; <i>P</i> < .001). In the MOC group, the mean number of MPFLRs did not change significantly (range, 119 in 2011 vs 230 in 2013; <i>P</i> = .772). In the ABOS group, after adjusting for patient age and examination year, MPFLR combined with TTO was associated with 92% greater odds of having a complication versus isolated MPFLR (odds ratio, 1.92; 95% CI, 1.24-2.98; <i>P</i> = .004), whereas the MOC group demonstrated no significant difference in the odds of having a complication between cases with versus without a concurrent TTO (<i>P</i> = .214).</p><p><strong>Conclusion: </strong>In the current study, the number of MPFLRs performed by the less experienced surgeons in the ABOS group increased a mean 3% each year, whereas this number remained stable for the more experienced MOC group. Additionally, there were significantly more complications with MPFLR and concomitant TTO among the ABOS Part II candidates compared with the MOC candidates. These findings may be helpful in surgical decision making and education in patellofemoral instability.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241299359"},"PeriodicalIF":2.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818882","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":"Identifying Hip Arthroscopy Trends in Turkey.","authors":"Yigit Umur Cirdi, Izzet Bingol, Saygın Kamacı, Sinem Bayram, Naim Ata, M Mahir Ulgu, Suayip Birinci, Asim Kayaalp, Safa Gursoy","doi":"10.1177/23259671241293741","DOIUrl":"10.1177/23259671241293741","url":null,"abstract":"<p><strong>Background: </strong>Hip arthroscopy (HA) procedures have continued to increase worldwide. However, no data are currently available regarding the increasing HA case volume and trends in Turkey.</p><p><strong>Purpose: </strong>To identify trends in postoperative care habits and incidence of HA in Turkey using data from the national Health Coding Reference Server (SKRS) database.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Patients who underwent HA and were recorded in the SKRS database between 2016 and 2023 were identified and retrospectively analyzed. Age, sex, institution type, geographic zone, and number of procedures were determined. The incidence of HA, overall annual case volume, chemoprophylaxis prescriptions, and postoperative care habits were also evaluated. The International Classification of Diseases, 10th Revision codes for femoral neck fracture after the index procedure and total hip arthroplasty conversion rate were analyzed. The authors utilized Poisson regression to determine the ratios of before and after periods in comparison with the same periods. Statistical analysis was performed using the statistical package SPSS software.</p><p><strong>Results: </strong>In total, 1580 HA procedures were identified. The mean age of the included patients was 39.2 ± 11.0 years (range, 18-65 years). Throughout the research period, an 833% increase in the number of surgeries was observed, whereas the incidence increased from 0.37 to 2.86 per 100,000 cases (<i>P</i> = .001). A significant annual increase in incidence was noted from 2017, 2018 and 2021 compared with the respective prior year. Moreover, 56.1% of all HA cases were performed in the Marmara region, whereas 47.7% of the cases were treated in private hospitals. Femoral neck fractures were encountered in 2 (0.1%) cases throughout the study duration. Enoxaparin sodium was the most preferred chemoprophylactic drug (99.4%). The 2-year total hip arthroplasty conversion rate was 3.5%.</p><p><strong>Conclusion: </strong>This study describes the current trends in HA across Turkey and provides a perspective on physician preferences. Notably, HA procedure counts, the ratio between HA and other orthopaedic procedures, and the incidence of HA demonstrated an increasing trend, with enormous potential for further advancement. These findings highlight the need for the creation of a national registry capable of obtaining more specific and accurate data.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241293741"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818880","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 Revision and Redislocation Rates After First-Time Anterior Shoulder Instability Between Subluxators and Dislocators: A Midterm Outcome Study.","authors":"Ehab M Nazzal, Zachary J Herman, Ian D Engler, Janina Kaarre, Robert T Tisherman, Christopher M Gibbs, Justin J Greiner, Ajinkya Rai, Jonathan D Hughes, Bryson P Lesniak, Albert Lin","doi":"10.1177/23259671241298014","DOIUrl":"10.1177/23259671241298014","url":null,"abstract":"<p><strong>Background: </strong>Anterior shoulder instability is a common pathology seen especially in young men and highly active patient populations. Subluxation is a commonly encountered clinical issue, yet little is known about the effects of first-time subluxation compared with dislocation on shoulder stability and clinical outcomes after surgical stabilization.</p><p><strong>Purpose: </strong>To compare revision and redislocation rates as well as patient-reported outcomes (PROs) between subluxators and dislocators after a first-time anterior shoulder instability event.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Included were patients who underwent operative intervention for a first-time anterior instability event between 2013 and 2020 at a single institution. Exclusion criteria were posterior/multidirectional instability, revision surgery, and recurrent instability. The main outcomes of interest were the rates of redislocation and revision. Demographics and surgical details were retrospectively collected. Instability was categorized as subluxation (no documentation of formal shoulder reduction) or dislocation (documented formal shoulder reduction). Labral tear location and size were determined from preoperative magnetic resonance imaging scans. PROs and return-to-sport, redislocation, and revision rates were collected from prospective survey data.</p><p><strong>Results: </strong>A total of 256 patients (141 subluxators and 115 dislocators) were available for analysis. There were no significant differences in baseline demographics or preoperative physical examination findings. Rates of bony Bankart lesions were comparable, but Hill-Sachs lesions were more commonly present in dislocators compared with subluxators (88.7% vs 53.9%; <i>P</i> < .01). There were no group differences in labral tear size, incidence of concomitant posterior or superior labrum anterior-posterior tears, or number of anchors used. Rates of remplissage were comparable between groups. Prospectively collected survey data of 60 patients (35 subluxators, 25 dislocators) were collected at 6.4 and 7.1 years of follow-up, respectively. Rates of recurrent dislocation (11.8% vs 20.0%) and revision (8.8% vs 16.0%) were comparable between subluxators and dislocators, respectively. All PROs and return-to-sport rates were comparable between groups.</p><p><strong>Conclusion: </strong>Subluxators and dislocators may present with comparable rates of redislocation and revision surgery even at midterm follow-up. Both cohorts may further present with comparable injury characteristics and PROs. Given the findings, future prospective studies comparing outcomes of first-time instability events are needed.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298014"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Performance Among National Basketball Association Players After Jones Fractures: A Retrospective Cohort Study.","authors":"Andrew H Kim, Myung-Jin Cha, Alvina Pan, Gianna Dafflisio, Miguel A Cartagena-Reyes, Frederick Mun, Jonathan R Kaplan, Amiethab A Aiyer","doi":"10.1177/23259671241300330","DOIUrl":"10.1177/23259671241300330","url":null,"abstract":"<p><strong>Background: </strong>In professional basketball, Jones fractures are among the most common cause of lower extremity stress injury. Despite its prevalence, there is a paucity of research on the impact of Jones fractures on athletic performance in the National Basketball Association (NBA).</p><p><strong>Purpose: </strong>To determine the impact of Jones fractures on return to play and performance among NBA players when compared with preinjury values and healthy matched controls.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>NBA injury reports were analyzed to identify 18 players who sustained a Jones fracture between 2011 and 2022. Reports were verified through public press releases, social media accounts, and player profiles. A publicly available database was used to collect player data including position, age, and years of NBA experience. Performance and advanced statistics were collected for seasons pre- and postinjury. Players were 1:1 matched with healthy controls based on age, player position, and career performance. Univariate and multivariable regression analyses were performed to compare advanced and per-game performance statistics between injured and healthy control players.</p><p><strong>Results: </strong>NBA players who sustained a Jones fracture had a mean age of 23.9 ± 2.31 years at the time of injury. The mean NBA experience was 3.00 ± 2.35 years and mean preinjury minutes played per game was 19.64 ± 11.24. All players (18/18) were able to return to NBA-level competition the year following the injury. There was no change in player efficiency rating (PER), value added, and estimated wins added metrics when comparing pre- and postinjury performances among injured players. Injured players missed more games (<i>P</i> < .001) postinjury compared with the matched controls. Multivariate analysis revealed that for players with a height of <2 m, every additional centimeter of height significantly decreased postinjury PER by 1.08 (95% CI, 0.35-1.80; <i>P</i> < .01).</p><p><strong>Conclusion: </strong>Despite its severity, most NBA players who sustain Jones fractures can return to preinjury performance and level of competition. There was no statistically significant decline in advanced statistics in the following season after injury, with a significant decrease in games played when comparing injured players with their healthy controls.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241300330"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818874","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":"Does Tibial Plateau Slope and Depth Influence ACL Strain In Vivo?","authors":"Jacqueline N Foody, Samantha Tayne, Zoë A Englander, Andrzej S Kosinski, Annunziato Amendola, Charles E Spritzer, Jocelyn R Wittstein, Louis E DeFrate","doi":"10.1177/23259671241271662","DOIUrl":"10.1177/23259671241271662","url":null,"abstract":"<p><strong>Background: </strong>The anterior cruciate ligament (ACL) is loaded under tension when the tibia translates anteriorly relative to the femur. The shape of the articular surfaces of the tibiofemoral joint may influence the amount of anterior tibial translation under compressive loading. Thus, a steep lateral tibial plateau and a shallow medial plateau are thought to be risk factors for ACL injury.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to evaluate whether tibial plateau slope and depth influence peak ACL strain during a single-leg jump. We hypothesized that there would be a significant correlation between tibial plateau slope and depth with ACL strain.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 17 healthy participants (8 male, 9 female) were assessed using magnetic resonance imaging (MRI) and high-speed biplanar radiography to obtain peak ACL strain during a single-leg jump. Two orthopaedic surgeons used the sagittal plane MRI scans to measure the medial and lateral tibial plateau slopes and the medial tibial plateau depth. The intraclass correlation coefficient was used to assess measurement reliability, and the Spearman rank correlation was used to evaluate the relationship between measurements of tibial morphology and peak ACL strain during the single-leg jump.</p><p><strong>Results: </strong>The overall range of intraclass correlation coefficients for intra- and interrater reliability of the medial and lateral tibial plateau slopes and medial plateau depth was 0.59 to 0.97. No significant correlations were found between peak ACL strain and any of the slope or depth measurements.</p><p><strong>Conclusion: </strong>In this cohort of healthy participants, correlations between any of the tibial plateau measurements with peak ACL strain during a single-leg jump were not detected. These findings are consistent with prior work, suggesting that tibial plateau slope and depth may not be linked to risk for ACL rupture. However, it is possible that tibial plateau morphology may interact with other factors to increase ACL injury risk or that individuals with extreme slope angles may produce differing results.</p><p><strong>Clinical relevance: </strong>This study enhances the knowledge of the loading mechanisms for the ACL and thus improves the understanding of risk factors for ACL injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241271662"},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818870","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}