Orthopaedic Journal of Sports Medicine最新文献

{"title":"Conditional Survivorship of Osteochondral Allograft Transplantation in the Knee.","authors":"Nathanial W Linstrom, William D Bugbee, Tim Wang","doi":"10.1177/23259671261468538","DOIUrl":"10.1177/23259671261468538","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral allograft (OCA) transplantation has demonstrated reliable long-term outcomes in treating chondral and osteochondral lesions of the knee. Although several pre- and intraoperative factors associated with graft failure have been identified, the temporal distribution of graft failures after OCA transplantation has not been described.</p><p><strong>Purpose: </strong>To evaluate the timing and rate of graft failure after knee OCA transplantation and to report conditional survivorship (CS) to inform postoperative patient counseling.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>We identified 288 knees (267 patients) that underwent OCA transplantation by a single surgeon between 1997 and 2015, with a minimum follow-up of 10 years. Graft failure was defined as any reoperation requiring removal of the allograft. Nonfailure reoperation was defined as any surgical procedure on the affected knee that did not involve graft removal. Rates of graft failure and nonfailure reoperation were estimated using piecewise linear regression applied to inverse Kaplan-Meier curves. Kaplan-Meier analysis estimated overall and 10-year CS.</p><p><strong>Results: </strong>The median patient age was 33.1 years (range, 11-68 years), and 58% were male. Overall graft survivorship was 78% at 10 years. Graft failure occurred in 64 knees (22%) at a median of 2.7 years (range, 0.3-23.6) postoperatively. Annual failure rates were 4.9% in the first 3 years postoperatively and decreased to 1.5% from 3 to 10 years. Nonfailure reoperations occurred in 48 knees, with a median of 1.5 years postoperatively, and followed a similar temporal pattern, with most occurring in the early postoperative period. CS analysis demonstrated that grafts remaining in situ at 4 years postoperatively had a 90% probability of survival to 10 years.</p><p><strong>Conclusion: </strong>OCA transplantation of the knee demonstrated an overall 10-year graft survivorship of 78%. Graft failures were not uniformly distributed over time, with the highest failure rates occurring during the early postoperative period and substantially decreasing after 3 years postoperatively to a low steady-state of 1.5% annually. This temporal pattern was also noted with nonfailure reoperations, which occurred predominantly during the early postoperative period. CS analysis offers a patient-centered approach for interpreting these findings and may inform postoperative patient counseling.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261468538"},"PeriodicalIF":2.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Preoperative Anxiety on the Incidence of Arthrogenic Muscle Inhibition After Anterior Cruciate Ligament Reconstruction.","authors":"Pierre Denis-Aubrée, Mohamad Moussa, Eugénie Valentin, Nicolas Lefèvre, Alain Meyer, Thibaut Noailles, Alexandre Hardy","doi":"10.1177/23259671261462819","DOIUrl":"10.1177/23259671261462819","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A patient's psychological state plays an important role in the functional outcome of anterior cruciate ligament (ACL) reconstruction. The outcome can be impaired by arthrogenic muscle inhibition (AMI), which is a potentially severe complication after ACL reconstruction. It is better to identify patients at risk of AMI to provide appropriate management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The goal of this study was to evaluate the impact of preoperative anxiety on the incidence of AMI at 21 days after ACL reconstruction. It was hypothesized that patients with high preoperative anxiety would more frequently have AMI on day 21 (D21) after ACL reconstruction than less anxious patients. The secondary goal of this study was to evaluate the rate of AMI on D21 after ACL reconstruction in the high and low anxiety groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective cohort study was performed on 143 patients who underwent ACL reconstruction between May and June 2024 at a sports surgery center. The Surgical Fear Questionnaire (SFQ), assessing surgery-related anxiety, was completed by patients before surgery. The incidence of AMI (grade ≥1a) on D21 was the main outcome measure. Patients were divided into 2 groups according to their median SFQ score (≥30 = high anxiety; &lt;30 = low anxiety) and paired for age, sex, and Tegner score. Analysis of the receiver operating characteristic curve and logistic regression analysis were performed to identify the optimal SFQ score to predict the presence of AMI on D21. The rate of secondary arthrolysis was also retrospectively recorded at 6 months after surgery in all patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After pairing, 55 patients were included in the high anxiety group (mean age, 31.0 ± 11.7 years; mean SFQ score, 43.7 ± 10.8) and 45 in the low anxiety group (mean age, 33.5 ± 11.6 years [&lt;i&gt;P&lt;/i&gt; = .281]; mean SFQ score, 13.7 ± 8.7 [&lt;i&gt;P&lt;/i&gt; &lt; .001]). The groups were comparable, except for the preoperative International Knee Documentation Committee score (55.9 ± 18.2 vs 65.7 ± 15.8, respectively; &lt;i&gt;P&lt;/i&gt; = .007). The rate of AMI was higher (80.0%) in the high anxiety group on D21 than in the low anxiety group (55.6%) (&lt;i&gt;P&lt;/i&gt; = .010). Patients with an SFQ score ≥27 had a 3.17-fold higher risk (95% CI, 1.33-7.81; &lt;i&gt;P&lt;/i&gt; = .010) of developing AMI on D21. Receiver operating characteristic curve analysis showed an area under the curve of 0.77 (95% CI, 0.65-0.88). The Youden index reached a maximum value of 0.521 at the optimal SFQ score threshold of 27, corresponding to a sensitivity of 84.2% and a specificity of 67.9%. The distribution of AMI grades on D21 showed that severe forms (grade 2b) were more frequent in the high anxiety group than in the low anxiety group (58.2% vs 37.8%, respectively). Additionally, 2 cases of grade 3 AMI required secondary arthrolysis, with one in each group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conc","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261462819"},"PeriodicalIF":2.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697754","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":"Litigation Against Physicians Caring for Collegiate Athletes in the United States.","authors":"Aidan C O'Brien, Zachary Kyros, Sawyer H Farmer, Peter Boufadel, Xinning Li","doi":"10.1177/23259671261468579","DOIUrl":"10.1177/23259671261468579","url":null,"abstract":"<p><strong>Background: </strong>Physicians caring for collegiate athletes practice in a high-stakes environment where return-to-play decisions and delayed diagnoses may increase exposure to malpractice claims. Despite growing medicolegal concern, litigation involving physicians caring for collegiate athletes has not been comprehensively characterized.</p><p><strong>Purpose/hypothesis: </strong>The purpose was to characterize negligence claims against physicians caring for collegiate athletes and assess temporal trends, allegations, and outcomes. The hypothesis was that there would be an increase in cases against physicians caring for collegiate athletes in recent years.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A search of publicly available legal databases, court records, and news archives was conducted in December 2025 to identify litigation claims involving physicians caring for collegiate athletes in the United States. Cases were included if a physician was named as a defendant. No restrictions on case year were applied. Case characteristics, allegations, outcomes, and monetary awards were abstracted. Awards were inflation adjusted to 2026 US dollars. Data were presented descriptively.</p><p><strong>Results: </strong>Thirty cases met inclusion criteria. The number of identified litigation cases increased over time, with a greater concentration of cases in more recent decades. Most defendants were male (93%) and team physicians (61%), with orthopaedic surgery being the most common specialty (41%). The most frequent allegations, expressed as a proportion of all recorded allegations, were improper/inadequate treatment (27%), negligent medical clearance (19%), and failure to diagnose (18%). Outcomes favored the defense in 60% of cases, while 23% resulted in plaintiff verdicts or settlements. The mean inflation-adjusted award in plaintiff-favorable cases was $2.02 million.</p><p><strong>Conclusion: </strong>The current study demonstrated that based on publicly available data, a limited number of litigation cases involving physicians caring for collegiate athletes were identified, with more cases observed in recent decades. Although most cases favor the defense, plaintiff-favorable outcomes involve substantial financial exposure. These findings are based on publicly available cases and may overrepresent litigated outcomes, but they highlight the importance of accurate diagnosis, prudent return-to-play decision making, a multidisciplinary approach to care, and proactive risk mitigation in the management of collegiate athletes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261468579"},"PeriodicalIF":2.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697750","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":"Modified Postoperative Rehabilitation Including Dynamic Posterior Cruciate Ligament Brace to Reduce Recurrence of Posterior Tibial Translation After Posterior Cruciate Ligament Reconstruction: A Retrospective Comparative Cohort Study.","authors":"Yuta Tachibana, Yoshinari Tanaka, Takuya Kitaguchi, Tomoya Nishikawa, Ayaka Tanaka, Shuji Horibe, Masayuki Hamada, Hiroyuki Tanaka, Seiji Okada, Kazutaka Kinugasa","doi":"10.1177/23259671261463127","DOIUrl":"10.1177/23259671261463127","url":null,"abstract":"<p><strong>Background: </strong>Recurrence of posterior tibial translation (PTT) is one of the challenges of posterior cruciate ligament (PCL) reconstruction. Several studies have emphasized the importance of protecting the transplanted graft. However, the impact of such protective measures on clinical outcomes has rarely been investigated.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to compare postoperative outcomes between conventional and modified rehabilitation (CR and MR, respectively) protocols after double-bundle PCL reconstruction. It was hypothesized that an MR protocol designed to protect the transplanted graft, combined with a dynamic PCL brace, would improve PTT and patient-reported outcomes (PROs) compared with CR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This study included 25 patients with isolated grade 2 or 3 PCL injuries who underwent double-bundle reconstruction using autogenous hamstring grafts between 2017 and 2022. Patients were categorized into 2 groups: the CR group (n = 14), which received CR without a dynamic PCL brace, and the MR group (n = 11), which received MR with a dynamic PCL brace. PTT was evaluated by gravity sag view radiographs preoperatively, immediately after surgery, and at 3 months, 6 months, 1 year, and 2 years after surgery. PROs were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at 2 years.</p><p><strong>Results: </strong>PTT decreased from preoperative to immediate postoperative evaluation in both groups without a significant difference between the 2 groups (CR group: 9.9 ± 3.0 mm to -1.0 ± 1.9 mm; MR group: 9.6 ± 3.5 mm to -1.4 ± 0.5 mm). At 3 months, 6 months, 1 year, and 2 years after surgery, the CR group demonstrated PTT of 3.7 ± 1.5, 4.0 ± 1.7, 4.4 ± 1.6, and 4.7 ± 1.7 mm, respectively, whereas the MR group demonstrated significantly smaller values of 0.8 ± 1.9, 1.9 ± 1.6, 2.6 ± 2.1, and 2.6 ± 2.2 mm, respectively (<i>P</i> < .05). Residual posterior sagging (PTT >5 mm) occurred in 29% of the CR group and 9% of the MR group (<i>P</i> = .34). No major complications were observed. The KOOS Sport and Recreation subscale score tended to be higher in the MR group.</p><p><strong>Conclusion: </strong>MR with a dynamic PCL brace to protect the graft significantly improved tibial position after PCL reconstruction compared with CR, without increasing the risk of complications.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261463127"},"PeriodicalIF":2.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697797","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 Mental Health, Quality of Life, and Sport Specialization Using the Wisconsin Sport Specialization Questionnaire Among Adolescent Athletes.","authors":"Rachel Meyers, Sarah Petersen, Veronica Hogg-Cornejo, Emily Sweeney, Aubrey Armento, David Howell, Gregory Walker","doi":"10.1177/23259671261467554","DOIUrl":"10.1177/23259671261467554","url":null,"abstract":"<p><strong>Background: </strong>Higher sport specialization levels have been associated with increased mental health issues. A recently validated questionnaire, the Wisconsin Sport Specialization Questionnaire (WISSQ), may provide clarity about the degree of sport specialization to investigate associations with mental health/quality of life (QoL) among adolescent athletes.</p><p><strong>Purpose: </strong>To examine the association of sports specialization, as measured by the WISSQ, and mental health/QoL outcomes among uninjured adolescent athletes, as well as the effect of age on the interaction between mental health/QoL outcomes and sport specialization.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 2.</p><p><strong>Methods: </strong>During the preseason assessment, performed in July and August from 2023 to 2025, participants completed the WISSQ and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global 25 (Version 1.1). A multiple linear regression model was constructed that evaluated the association between 6 PROMIS domains and WISSQ ratings, adjusting for age, sex, and self-reported physical activity volume. To address the secondary purpose, linear regression models with an interaction term were used to examine the association between each PROMIS domain and age with sport specialization.</p><p><strong>Results: </strong>A total of 251 uninjured adolescent athletes completed the study (mean ± SD age, 15.9 ± 1.4 years). The mean WISSQ rating was 54.1 (SD, 15.4). Results from the multivariable linear regression model indicated that higher depressive symptoms (β = 0.46; 95% CI, 0.16-0.76; <i>P</i> = .003) and pain interference ratings (β = 0.30; 95% CI, 0.02-0.57; <i>P</i> = .03) were significantly associated with higher WISSQ ratings, after adjusting for baseline physical activity, age, sex, and history of anxiety or depression diagnosis. For the secondary purpose, there was a significant interaction between fatigue and age group on sport specialization (β coefficient = 0.49; 95% CI, 0.02-0.95; <i>P</i> = .04). The relationship between fatigue and sport specialization differed by age: a stronger association occurred among older adolescents than younger adolescents. There were no other age × QoL interactions.</p><p><strong>Conclusion: </strong>This study demonstrated that higher depressive symptoms and pain interference ratings were significantly associated with higher WISSQ ratings. In addition, there was a significant interaction between fatigue and age group, with a stronger association identified among older adolescents. Higher specialized and older adolescent athletes may be more at risk for developing mental health/QoL concerns and may benefit from more targeted screening.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261467554"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697761","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 Patellofemoral Degeneration After Three Types of High Tibial Osteotomy: Retrotuberosity Biplane Open-Wedge, Supratuberosity Biplane Open-Wedge, and Closed-Wedge Techniques.","authors":"Sang Jun Song, Kyoung Ho Yoon, Min Sung Kim, Cheol Hee Park","doi":"10.1177/23259671261467542","DOIUrl":"10.1177/23259671261467542","url":null,"abstract":"<p><strong>Background: </strong>Retrotuberosity biplane open-wedge high tibial osteotomy (RTOWHTO) <i>may reduce</i> negative patellofemoral joint outcomes. However, no studies have compared patellofemoral cartilage degeneration between RTOWHTO and supratuberosity biplane open-wedge high tibial osteotomy (STOWHTO) using arthroscopic assessment nor compared patellofemoral cartilage degeneration or radiographic patellofemoral-specific parameters between RTOWHTO and closed-wedge high tibial osteotomy (CWHTO).</p><p><strong>Purpose: </strong>To compare the arthroscopically assessed femoral trochlear cartilage degeneration and radiographic patellofemoral-specific parameters after RTOWHTO, STOWHTO, and CWHTO.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 58 RTOWHTOs, 59 STOWHTOs, and 88 CWHTOs were examined using first-look arthroscopy between 2013 and 2022. The demographics did not differ significantly between the groups. Hardware removal and second-look arthroscopy were performed, on average, 29.7, 26.9, and 26.7 months after the RTOWHTOs, STOWHTOs, and CWHTOs, respectively (<i>P</i> = .30). Degeneration of the femoral trochlear cartilage was arthroscopically evaluated using the International Cartilage Regeneration & Joint Preservation Society grading system. Patellar translation and height were evaluated radiographically, and patellar height was assessed using the modified Blackburne-Peel ratio.</p><p><strong>Results: </strong>The prevalence rates of femoral trochlear cartilage degeneration were 17.2% (10/58), 39% (23/59), and 19.3% (17/88) in the RTOWHTO, STOWHTO, and CWHTO groups, respectively (<i>P</i> = .008). The prevalence was significantly higher in STOWHTOs than in both RTOWHTOs and CWHTOs (both <i>P</i> = .01), but not significantly different between RTOWHTOs and CWHTOs (<i>P</i> = .83). The increase in lateral patellar translation was significantly greater in the STOWHTOs (1.1 ± 1.5 mm) than in both the RTOWHTOs (-0.1 ± 2.0 mm) and the CWHTOs (0.5 ± 1.2 mm) (<i>P</i> = .001 and .04, respectively). There was no significant difference between the RTOWHTOs and CWHTOs with respect to the increases in lateral translation (<i>P</i> = .10). The lowering in patellar height was significantly greater after the STOWHTOs (-0.2 ± 0.1) than after both the RTOWHTOs (0.0 ± 0.1) and the CWHTOs (-0.1 ± 0.2) (<i>P</i> < .001 and .002, respectively). The lowering was significantly smaller in the RTOWHTOs than in the CWHTOs (<i>P</i> = .02).</p><p><strong>Conclusion: </strong>RTOWHTO may provide favorable patellofemoral joint outcomes, with a lower prevalence of trochlear cartilage degeneration and less lateral patellar translation than STOWHTO, as well as less patellar height lowering than both STOWHTO and CWHTO.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261467542"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697838","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":"Prevalence of Capitellar Osteochondritis Dissecans and Medial Epicondylar Abnormalities in Female Youth Baseball Players: A Large-Scale Ultrasonographic Screening Study.","authors":"Masaru Munemori, Daisuke Momma, Kyosuke Numaguchi, Keiko Goto, Eiji Kondo, Nobuo Adachi, Norimasa Iwasaki","doi":"10.1177/23259671261469729","DOIUrl":"10.1177/23259671261469729","url":null,"abstract":"<p><strong>Background: </strong>Capitellar osteochondritis dissecans (OCD) and medial epicondylar apophyseal abnormalities are recognized throwing-related elbow injuries in youth baseball. However, most epidemiological data have been derived from male athletes and the prevalence of these conditions among female youth baseball players has not been well characterized.</p><p><strong>Purpose: </strong>To determine the prevalence of capitellar OCD and medial epicondylar abnormalities among female youth baseball players using large-scale ultrasonographic screening data and to compare these findings with those of male players.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors analyzed a prospectively collected regional screening database of 13,483 youth baseball players (13,130 male, 353 female) collected between 2014 and 2025. Standardized field-based ultrasonography was used to assess the capitellum and medial epicondyle. Player position and arm dominance were recorded. Sex-based prevalence and position-related differences (female subgroup) were compared using prespecified tests.</p><p><strong>Results: </strong>Capitellar OCD was identified in 2.4% of male players (313/13,130) and 0.57% of females (2/353), showing no significant sex-based difference (<i>P</i> = .09). The prevalence of medial epicondylar abnormalities was 24.0% in male players (3147/13,130) and 16.4% in female players (58/353; <i>P</i> < .001). In female athletes, all cases involved the dominant arm, and prevalence was higher among pitchers/catchers (28.9%) than among infielders/outfielders (11.6%) (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Capitellar OCD was observed in female youth baseball players, with no significant difference in prevalence compared with male players. Medial epicondylar abnormalities occurred at a lower rate in female players, but were still observed, particularly among pitchers and catchers and exclusively in the dominant throwing arm. These findings indicate that female athletes are also at risk for throwing-related elbow conditions and support the inclusion of female players in routine screening and workload management programs.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261469729"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697843","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":"Complications Related to Arthroscopic Isolated Posterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of 4162 Patients.","authors":"Osama Z Alzobi, Isam Moghamis, Mohanad Alebbini, Amgad Elshoeibi, Ashraf Hantouly, Bashir Zikria, Khalid Alkhelaifi","doi":"10.1177/23259671261466475","DOIUrl":"10.1177/23259671261466475","url":null,"abstract":"<p><strong>Background: </strong>Posterior cruciate ligament (PCL) reconstruction (PCLR) is increasingly performed for mid-substance tears, but complications after isolated PCLR remain poorly characterized.</p><p><strong>Purpose: </strong>To identify the complication profile of isolated arthroscopic PCLR.</p><p><strong>Study design: </strong>Systematic review and meta-analysis; Level of evidence, 4.</p><p><strong>Methods: </strong>Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, databases were searched. Adult studies of isolated mid-substance PCLR reporting at least 1 postoperative complication were included. Pooled proportions and 95% CIs were calculated using random-effects models. A quantitative synthesis of data was conducted to compare complication rates between single- and double-bundle reconstructions and between autograft and allograft types.</p><p><strong>Results: </strong>A total of 65 studies comprising 4162 patients met the inclusion criteria. The overall complication rate was 14.8% (n = 616). The most frequent postoperative complications were persistent postoperative pain (4.2% [95% CI, 2.3%-6.6%]), residual posterior laxity (4.1% [95% CI, 2.4%-6.2%]), and arthrofibrosis (3.1% [95% CI, 1.8%-4.8%]). Structural complications occurred at lower rates, including tunnel enlargement (2.5% [95% CI, 0.5%-5.8%]), graft failure or rupture (1.7% [95% CI, 0.8%-2.8%]), and postoperative osteoarthritis (2.2% [95% CI, 1.2%-3.6%]). Reoperations remained infrequent, with nonrevision reoperations at 3.4% (95% CI, 1.8%-5.4%) and revision PCLR at 1.1% (95% CI, 0.7%-1.6%). All other complications, including infection, venous thromboembolism, vascular injury, neurologic symptoms, hardware failure, and conversion to arthroplasty, were reported with weighted proportions <1%. Subgroup analyses showed no statistically significant differences by bundle type (single vs double) or graft selection (autograft vs allograft). However, these pooled results should be interpreted with caution, given the heterogeneity across studies.</p><p><strong>Conclusion: </strong>Isolated arthroscopic PCLR demonstrates a pooled complication rate of 14.8%, with persistent pain, residual posterior laxity, and arthrofibrosis being the most frequently reported complications. Major complications were uncommon in the available literature. Subgroup analysis showed no statistically significant differences by the number of bundles reconstructed or by the use of an autograft or an allograft.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261466475"},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689491","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":"Prevalence and Incidence of Isthmic Spondylolisthesis in Children and Adolescents: A Systematic Review.","authors":"Nazanin Rostamian, Maria Fernanda Lopez Gomez, Philipp Stoffers, Michael Cassel","doi":"10.1177/23259671261466477","DOIUrl":"10.1177/23259671261466477","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;For children and adolescents active in organized sports, a relationship between spondylolisthesis and low back pain (LBP) has been postulated. Reported prevalence rates vary widely due to inconsistent definitions, populations, and diagnostic methods. Reliable data are needed to inform preventive strategies and clinical decisions, particularly for adolescents engaged in sports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To conduct a systematic review on the prevalence and incidence of radiologically confirmed spondylolisthesis in children and adolescents, considering age, organized sports participation, LBP, and the diagnostic method used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Systematic review, Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, PubMed, Scopus, and Web of Science databases were searched by 2 independent reviewers up to August 01, 2025. Original studies reporting cross-sectional or longitudinal data on radiologically confirmed spondylolisthesis in those ≤20 years of age were included. Subgroups were defined by participation in organized sports and LBP: general population (GP/GP-LBP) and individuals active in organized sports (AS/AS-LBP). Descriptive statistics (median [interquartile range, IQR]) were used to analyze subgroups. Correlations between age and prevalence were estimated using the Spearman rank correlation. Study quality was assessed with the Joanna Briggs Institute (JBI) Checklist for Studies Reporting Prevalence Data, and bias was evaluated according to the Cochrane Handbook.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 1566 records, 21 studies (n = 5623; median age 13.1 years [IQR, 11.2-15 years]) were included. The median JBI score was 78% (7 high-, 11 moderate-, 3 low-quality). The pooled prevalence of spondylolisthesis in childhood and adolescence was 3.4% [IQR, 1.9%-4.9%]. Subgroup analyses showed higher prevalence in AS (median, 4.5% [IQR, 4.2%-5.2%]) and AS-LBP (5.3%) compared with GP (median, 2.3% [IQR, 0.5%-2.7%]) and GP-LBP (median, 3.8% [IQR, 2.3%-5.2%]). A positive correlation with age was observed for the AS group (&lt;i&gt;P&lt;/i&gt; = .61). Incidence was reported in only 1 study. Magnetic resonance imaging-based studies reported higher prevalence estimates than computed tomography- or radiography-based studies in descriptive comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study demonstrates that the prevalence of spondylolisthesis increases with age, participation in organized sports, and LBP, indicating a significant number of acquired cases during adolescence. Reported prevalence rates vary depending on the diagnostic method used. Incidence remains insufficiently characterized, underscoring the need for standardized longitudinal research improving evidence on the development of isthmic spondylolisthesis. These findings suggest that repetitive mechanical loading of the pars interarticularis may","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261466477"},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689459","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":"Differential Quadriceps Muscle Activation Preoperatively and at the Time of Return to Sport After Medial Patellofemoral Ligament Reconstruction.","authors":"Josh Riesenberg, Helen Emerson, Sophia Ulman, Ashley L Erdman, Alex M Loewen, Charles W Wyatt, Henry Ellis, Philip Wilson","doi":"10.1177/23259671261466476","DOIUrl":"10.1177/23259671261466476","url":null,"abstract":"<p><strong>Background: </strong>Patients with patellofemoral instability (PFI) often demonstrate altered movement patterns and strength deficits. The vastus medialis plays an important role in patellar stabilization as a dynamic medial force vector on the patella.</p><p><strong>Hypothesis: </strong>It was hypothesized that limb-to-limb asymmetries in muscle activity would be present preoperatively and at the time of return to sport (RTS).</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 25 adolescents with unilaterally treated PFI were evaluated before arthroscopic assisted medial patellofemoral ligament reconstruction with an allograft. A separate group of 16 patients with PFI were examined for RTS clearance. All participants completed an unweighted squat task in a motion capture laboratory. Surface electromyography sensors were placed on the rectus femoris, vastus medialis, semitendinosus, tibialis anterior, and gastrocnemius. Electromyography data were filtered and rectified, and a linear envelope was created. Peak activity of each muscle was analyzed. The Wilcoxon signed-rank test was used to compare muscle activity between limbs (α = 0.05).</p><p><strong>Results: </strong>Preoperatively, peak rectus femoris activity of the involved limb was 40% less than that of the contralateral limb (<i>P</i> = .006). At the time of RTS, peak vastus medialis activity was 73% less in the involved limb than in the contralateral limb (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>A preoperative reduction in rectus femoris activity of the involved limb indicated that there might be compensations in movement patterns among those with PFI. At the time of RTS after medial patellofemoral ligament reconstruction, vastus medialis discrepancies suggested that there might be a muscle imbalance after surgery and continue through physical therapy. A greater emphasis on vastus medialis training may prove beneficial during the rehabilitation process and help to prevent the reduction in activity observed at the time of RTS.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 8","pages":"23259671261466476"},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689427","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}