Orthopaedic Journal of Sports Medicine最新文献

{"title":"Hip Joint Intercartilage Space, Range of Motion, and Lateral Differences in Elite and Subelite Ice Hockey Players: A Case-Control Trial.","authors":"Jitka Mala, Tomas Hybner, Petr Stastny","doi":"10.1177/23259671251344240","DOIUrl":"10.1177/23259671251344240","url":null,"abstract":"<p><strong>Background: </strong>Ice hockey players experience groin pain and imbalances in the muscles of the hip joint, possibly because of the condition of the intercartilage space (ICS).</p><p><strong>Purpose: </strong>To describe the lateral differences in size of the articular ICS, range of motion, and adductor/abductor muscle strength between elite and subelite ice hockey players and a control group of participants who did not play ice hockey.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>33 elite hockey players, 26 subelite hockey players, and 30 non-ice hockey player controls were compared in terms of ICS thickness, isometric hip abductor muscle strength, hip range of motion, functional test results, and pain score. Two-way analysis of variance was used to identify differences in laterality and performance levels.</p><p><strong>Results: </strong>The ICS of the hip joint was smaller (<i>P</i> < .001) in both groups of ice hockey players than in the control group (0.97 ± 0.11 mm) and smaller (<i>P</i> = .005) on the backhand side (elite 0.66 ± 0.24 mm; subelite 0.65 ± 0.15 mm) than on the forehand side (elite 0.78 ± 0.18 mm; subelite 0.74 ± 0.24 mm) in both groups of hockey players. Compared with the control (41.6°± 4°) and subelite groups, the elite group had less (<i>P</i> < .001) hip external rotation (elite 30.4°± 6.1°; subelite 35°± 6.5°) and internal rotation (elite 31.5°± 5.1°; subelite 35.1°± 6.5°), with no differences in laterality (<i>P</i> > .05). Both hockey groups had positive hip pain provocation tests and greater (<i>P</i> < .001) hip adduction (elite 457 ± 85 N; subelite 450 ± 82 N) and abduction (elite 429 ± 60 N; subelite 422 ± 63 N) muscle strength than the controls (adduction 347 ± 70 N; abduction 346 ± 75 N). Elite players had a greater (<i>P</i> = .008) adductor strength ratio on the backhand side (1.16 ± 19) than the control group (1.02 ± 0.15).</p><p><strong>Conclusion: </strong>Ice hockey players had a smaller ICS of the hip joint, particularly on the backhand side. These structural changes were accompanied by reduced range of motion in the hip joint, increased pain, and asymmetries in muscle strength. Hip range of motion and symmetry of adductor/abductor muscle strength should be considered when diagnosing ice hockey players. ICS assessment via sonography might become a useful tool for the evaluation of structural changes in the hip. Research on ice hockey-related injuries should focus more on the structural and functional condition of the backhand side of the hip.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251344240"},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333656","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":"Improvement of Accuracy of Femoral Tunnel Positioning in ACL Surgery for Low-Volume Surgeons Using Intraoperative Fluoroscopy.","authors":"Maximilian M Mueller, Nico Hinz, Tobias Drenck, Lena Eggeling, Karl-Heinz Frosch, Juergen Hoeher, Ralph Akoto","doi":"10.1177/23259671251346647","DOIUrl":"10.1177/23259671251346647","url":null,"abstract":"<p><strong>Background: </strong>Less experienced surgeons have an increased risk for tunnel malpositioning as a predominant risk factor for failure of anterior cruciate ligament reconstruction (ACLR). Fluoroscopic guidance can improve the precision of tunnel positioning.</p><p><strong>Purpose: </strong>To investigate whether low-volume surgeons can achieve precise femoral tunnel placement in ACLR under fluoroscopic control comparable to that of experienced mid- and high-volume surgeons.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This study retrospectively included 150 patients who underwent primary ACLR between January 2021 and March 2023 and were prospectively enrolled in an in-clinic registry. Three groups were defined: high-volume surgeon (1 surgeon with >100 ACLRs per year; 50 images), mid-volume surgeon (1 surgeon with >10 to <50 ACLRs per year; 50 images), and low-volume surgeon (5 surgeons with ≤10 ACLRs per year; 50 images). The analysis of the femoral tunnel position was performed digitally on strictly lateral fluoroscopic images by determining the depth and height relations according to the quadrant method of Bernard and Hertel.</p><p><strong>Results: </strong>All surgeons, regardless of experience, achieved high precision of femoral tunnel placement (depth relation: SD, 3.41% [1.58 mm]; height relation: SD, 5.33% [1.33 mm]). The variances of the tunnel placements did not show significant differences between the 3 groups with the Brown-Forsythe test (depth relation: probability (<i>Pr</i>) > <i>F</i> = 0.332; height relation: <i>Pr</i> > <i>F</i> = 0.081; <i>P</i> < .05). The precision of the high-volume surgeon (depth relation: SD, 3.29%; height relation: SD, 4.92%) was comparable to that of the mid-volume surgeon (depth relation: SD, 2.98%; height relation: SD, 5.9%) and low-volume surgeon (depth relation: SD, 3.58%; height relation: SD, 4.62%).</p><p><strong>Conclusion: </strong>In this study, fluoroscopically guided tunnel placement allowed low-volume surgeons to achieve a level of precision comparable to that of the experienced surgeons. Fluoroscopy might especially help low-volume surgeons to achieve a standardized and highly reproducible femoral tunnel position and thus avoid tunnel malpositioning.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251346647"},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333657","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":"Tibial Tuberosity-Trochlear Groove Ratio Adjusts for Sex Differences and Improves Accuracy in Assessing Patellofemoral Instability.","authors":"Tomas Pineda, Nicolas Cance, Michael J Dan, Sophie Putman, Guillaume Demey, David H Dejour","doi":"10.1177/23259671251344227","DOIUrl":"10.1177/23259671251344227","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tibial tuberosity-trochlear groove (TT-TG) distance has typically been used to determine the need for a tibial tuberosity medialization. However, because it is an absolute value, TT-TG distance does not consider the patient's size and, therefore, has the potential to over- or underestimate the need for a medialization of the tibial tuberosity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The aim of the study was to propose a ratio combining the TT-TG distance and the posterior bicondylar width (PBCW) of the femur as a representation of patient size. It was hypothesized that this ratio would provide a more accurate assessment of patellofemoral instability than the TT-TG distance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study (diagnosis); Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A consecutive series of patients with recurrent patellofemoral instability between 2020 and 2022 was reviewed and compared with a consecutive cohort of patients with isolated meniscal tears. The TT-TG distance and PBCW were assessed using magnetic resonance imaging, and the ratio created using both measurements (TT-TG ratio was calculated by expressing the TT-TG distance as a percentage of the PBCW) was compared to the TT-TG distance alone to evaluate differences in diagnostic accuracy and differences based on femoral size and sex.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 129 patients with objective patellofemoral instability (OPI) and 105 controls were included in this study. The mean TT-TG distance was 15 ± 5.2 mm in the OPI group and 8.6 ± 3.6 mm in the control group (&lt;i&gt;P&lt;/i&gt; &lt; .001), with a cutoff value of 11.15 mm for distinguishing between the 2 groups. The TT-TG ratio was 22.3% ± 3% in the OPI group and 11.7% ± 4.6% in the control group (&lt;i&gt;P&lt;/i&gt; &lt; .001), with a cutoff value of 16%. The TT-TG distance had an area under the curve of 0.848, whereas the TT-TG ratio had an area under the curve of 0.892. Subgroup analysis indicated that the TT-TG distance (&lt;i&gt;P&lt;/i&gt; = .02) and PBCW (&lt;i&gt;P&lt;/i&gt; &lt; .001) were significantly different based on sex in the OPI group; however, the TT-TG ratio did not show significant differences (&lt;i&gt;P&lt;/i&gt; = .84).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The TT-TG ratio provides an enhanced discriminant value compared with the TT-TG distance in distinguishing patients with patellofemoral instability from controls. This ratio accounts for inherent sex- and size-based differences associated with the TT-TG distance, offering a more individualized assessment when considering the need for tibial tuberosity osteotomy and the extent of medialization required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;This study highlights the importance of the TT-TG ratio in the analysis of patients with patellofemoral instability, providing improved diagnostic accuracy while accounting for sex and size-based differences. This allows for a more personalized treatment approach and can lead to better decision making regarding tibial","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251344227"},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333658","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":"Clinical Outcomes After Arthroscopic 270° Labral Repair in Active-Duty Military Patients: At Minimum 10-Year Follow-up.","authors":"John K McNamara, Alexis B Sandler, John P Scanaliato, John R Tyler, Ali Boolani, Nata Parnes","doi":"10.1177/23259671251342592","DOIUrl":"10.1177/23259671251342592","url":null,"abstract":"<p><strong>Background: </strong>Active-duty military servicemembers (ADSMs) exhibit a high prevalence of combined-type shoulder instability. Arthroscopic 270° labral repair has demonstrated promising outcomes at short- and intermediate-term follow-up, but there is a paucity of long-term outcomes data among ADSMs.</p><p><strong>Purpose: </strong>To report the outcomes of arthroscopic 270° labral repair at a minimum of 10-year follow-up in ADSMs.</p><p><strong>Study design: </strong>Case series; Level of evidence: 4.</p><p><strong>Methods: </strong>A total of 44 ADSMs who underwent arthroscopic 270° labral repair between January 2010 and December 2012 without major concomitant procedures had ≥10 years of follow-up and were deemed eligible for inclusion. Of these, 38 were included in the final outcome analysis.</p><p><strong>Results: </strong>Mean follow-up was 140.4 ± 14.4 months. Postoperatively, there was a statistically significant improvement in pain visual analog scale (VAS) scores (8.3 ± 1.3 to 1.63 ± 2.29; <i>P</i> < .0001) as well as American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment (42.7 ± 12.3 to 87.3 ± 19.0; <i>P</i> < .0001), Single Assessment Numeric Evaluation (SANE) (49.5 ± 18.9 to 91.9 ± 11.3; <i>P</i> < .0001), and Rowe instability (45.3 ± 12.5 to 89.3 ± 19.2; <i>P</i> < .0001) scores. There were no significant differences observed between pre- and postoperative range of motion. At final follow-up, 95% of patients met the minimal clinically important difference threshold for VAS, 89% for ASES, 92% for SANE, and 92% for the Rowe score; 58% met the substantial clinical benefit threshold for VAS, 61% for ASES, 11% for SANE, and 74% for Rowe scores; and 74% met the Patient Acceptable Symptom State threshold for VAS, 76% for ASES, 76% for SANE, and 74% for Rowe scores. At final follow-up, 89.5% of patients (n = 34) either returned to unrestricted duty or left the military for reasons other than continued shoulder-related disability, while 86.8% (n = 33) returned to unrestricted physical training. Two patients (5.3%) underwent reoperation, one requiring revision anterior labral repair and the other Latarjet after a traumatic dislocation of the operative shoulder.</p><p><strong>Conclusion: </strong>Arthroscopic 270° labral repair demonstrates favorable clinical outcomes at a minimum 10-year postoperative follow-up in an active-duty military patient population, with clinically and statistically significant improvements in pain, patient-reported outcomes measures, and an overall return-to-duty rate of 89.5%.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342592"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326485","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":"Defining Clinically Meaningful Subgroups in Patients Undergoing Arthroscopic Rotator Cuff Repair Using Unsupervised Machine Learning.","authors":"Yining Lu, Elyse J Berlinberg, Kareme Alder, Ethan Chervonski, Harsh H Patel, Morgan Rice, Adam B Yanke, Brian J Cole, Nikhil N Verma, Mario Hevesi, Brian Forsythe","doi":"10.1177/23259671251335977","DOIUrl":"10.1177/23259671251335977","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Outcomes after arthroscopic rotator cuff repair (RCR) are frequently measured through clinically significant outcomes (CSOs) such as the minimal clinically important difference, the substantial clinical benefit, and the Patient Acceptable Symptom State. Global achievement of CSOs is challenging to predict.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To determine if unsupervised machine learning can identify distinct patient subgroups based on CSO achievement after elective arthroscopic RCR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case-control study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospectively collected database was analyzed to identify patients who underwent elective arthroscopic RCR from 2015 to 2017. Tear dimensions were measured on magnetic resonance imaging utilizing a validated technique. CSO achievements on the American Shoulder and Elbow Surgeons, the Single Assessment Numeric Evaluation, and the Constant-Murley subjective score at 2-year follow-up were calculated. An unsupervised random forest algorithm was utilized to develop and internally validate patient subgroups with significantly different rates of CSO achievement. Patient subgroup membership, along with a total of 30 demographic and clinical variables, as well as preoperative patient-reported outcomes, were incorporated into a stepwise multivariable logistic regression to identify factors predictive of optimal CSO achievement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 346 patients (192 male; mean ± SD age, 57.2 ± 9.1 years; body mass index, 30.1 ± 5.4 kg/m&lt;sup&gt;2&lt;/sup&gt;) were eligible for inclusion and followed for a mean of 3.8 years (range, 2.0-6.2 years) Of these, a total of 333 patients were partitioned by the random forest algorithm into 2 subgroups (stability, 0.16; connectivity: 180.8; Dunn: 0.16; silhouette: 0.05), with 176 patients in the optimal achievement subgroup and 157 patients in the suboptimal achievement subgroup. The 2 subgroups differed significantly (all &lt;i&gt;P&lt;/i&gt;≤ .004) in the likelihood of achievement of all CSOs. Stepwise multivariable logistic regression identified an increase of 1 mm in tear size in the sagittal dimension beyond 1.9 cm to predict a 10% increase in the probability of suboptimal achievement. Additional risk factors for suboptimal CSO achievement included increasing number of tendons involved (odds ratio [OR], 14.07; 95% CI, 4.50-44.02; &lt;i&gt;P&lt;/i&gt; &lt; .001), subscapularis involvement (OR, 8.67; 95% CI, 2.45-30.71; &lt;i&gt;P&lt;/i&gt; = .01), and increased preoperative CMS score (OR, 1.11; 95% CI, 1.04-1.18; &lt;i&gt;P&lt;/i&gt; = .001). Protective factors included performance of a subpectoral biceps tenodesis compared with biceps tenotomy (OR, 0.22; 95% CI, 0.05-0.92; &lt;i&gt;P&lt;/i&gt; = .03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Clinically meaningful subgroups were uncovered using an unsupervised machine learning algorithm in patients undergoing arthroscopic RCR. Tear size, number of tendons involved, and subscapularis involvement were s","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251335977"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326486","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":"Global Acetabular Retroversion Is Associated With an Increased Risk of Conversion to Total Hip Arthroplasty After Primary Hip Arthroscopic Surgery: A Propensity Score-Matched Analysis With a Minimum 8-Year Follow-up.","authors":"Stephen M Gillinov, Jonathan S Lee, Bilal S Siddiq, Kieran S Dowley, Jeffrey S Mun, Zachary L LaPorte, Nathan J Cherian, Christopher T Eberlin, Frank J Simeone, Scott D Martin","doi":"10.1177/23259671251343840","DOIUrl":"10.1177/23259671251343840","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Global acetabular retroversion has been associated with an increased risk of hip osteoarthritis, femoroacetabular impingement, and intra-articular soft tissue abnormalities. However, the role of global acetabular retroversion on total hip arthroplasty (THA)-free survivorship has not been explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare long-term THA-free survivorship after primary hip arthroscopic surgery between patients with global acetabular retroversion and a propensity score-matched control group without global acetabular retroversion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study examined patients aged ≥18 years with a minimum 8-year follow-up who underwent primary hip arthroscopic surgery by a single surgeon between May 2001 and September 2013 for the treatment of symptomatic labral tears secondary to femoroacetabular impingement. Patients with global acetabular retroversion, indicated by the combined presence of a crossover sign, ischial spine sign, and posterior wall sign on preoperative supine pelvic radiographs, were 1:1 propensity score matched by age, sex, body mass index, and labral treatment (repair vs debridement) to controls without global acetabular retroversion. Patient, radiographic, and intraoperative variables were compared between groups. Cox multivariate regression, controlling for global acetabular retroversion and Tönnis grade, was used to assess conversion to THA. Patient-reported outcome measure (PROM) scores were also compared between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 49 patients (49 hips) with global acetabular retroversion were 1:1 matched to 49 controls, with a mean follow-up of 10.7 ± 2.1 and 11.1 ± 2.8 years, respectively (&lt;i&gt;P&lt;/i&gt; = .524). There were no significant differences in patient characteristics and radiographic findings between groups. Patients with global acetabular retroversion had significantly greater rates of severe chondrolabral junction breakdown (&lt;i&gt;P&lt;/i&gt; = .010). Unadjusted Kaplan-Meier survival curves analyzed by the log-rank test demonstrated significantly decreased survivorship among patients with global acetabular retroversion (68.6%) compared with matched controls (83.9%) at final follow-up (&lt;i&gt;P&lt;/i&gt; = .036). Cox multivariate regression demonstrated that patients with global acetabular retroversion had a significantly greater risk of conversion to THA (hazard ratio, 3.94; &lt;i&gt;P&lt;/i&gt; = .039). There were no statistically significant differences in any PROM scores at final follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with global acetabular retroversion had significantly inferior THA-free survivorship at a minimum 8-year follow-up after hip arthroscopic surgery relative to matched controls as well as greater rates of severe chondrolabral junction breakdown, despite no statistically significant differences in PROM scores at final follow-up among patients","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343840"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326487","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 Shoulder Morphological Changes and Glenohumeral Maximum External Rotation During Late Cocking Phase.","authors":"Makoto Takahashi, Hirotaka Mutsuzaki, Koji Iwamoto, Masahiko Monma, Makoto Nejishima, Tomoki Ono, Hiroshi Inami, Masahiro Takemura, Takashi Kawamura, Kazuhide Tomita","doi":"10.1177/23259671251343232","DOIUrl":"10.1177/23259671251343232","url":null,"abstract":"<p><strong>Background: </strong>Excessive external rotation of the glenohumeral joint during the late cocking phase of throwing is a factor in internal impingement; however, the relationship between maximum external rotation (MER) of the glenohumeral joint and morphological changes in the shoulder joint is unclear.</p><p><strong>Purpose: </strong>To clarify whether glenohumeral MER is associated with quantified assessment of morphological changes in the throwing shoulder joint.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>This study included 15 male university and adult baseball players from a competitive team. The posterior glenohumeral distance (mm) and area of impingement (mm²), reflecting morphological changes in the shoulder joint, were measured using open magnetic resonance imaging. The percent posterior glenohumeral distance (%PGHD) and percent area of impingement (%AOI) were calculated as these values of the throwing shoulder divided by those of the nonthrowing shoulder. With a 3-dimensional motion analysis system, bar markers were affixed to the acromion and humerus, and the glenohumeral MER angle was measured.</p><p><strong>Results: </strong>Simple linear regression analysis revealed that the glenohumeral MER angle was associated with the %PGHD (β coefficient = 0.685; <i>P</i> = .005) and %AOI (β coefficient = 0.754; <i>P</i> = .001).</p><p><strong>Conclusion: </strong>The glenohumeral MER angle was associated with the %PGHD and %AOI, which reflects morphological shoulder-joint changes.</p><p><strong>Clinical relevance: </strong>Assessment of excessive external rotation of the glenohumeral joint during the late cocking phase contributes to the understanding of morphological changes in the shoulder joint and related throwing injuries.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343232"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326484","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":"Improved Midterm Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in the Setting of a Previous Slipped Capital Femoral Epiphysis.","authors":"Adam H Kantor, Allan K Metz, Collin D R Hunter, Reece M Rosenthal, Ameen Z Khalil, Devin L Froerer, Travis G Maak, Stephen K Aoki","doi":"10.1177/23259671251342579","DOIUrl":"10.1177/23259671251342579","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hip arthroscopy after in situ fixation of a slipped capital femoral epiphysis (SCFE) is used to treat postoperative disability that develops from metaphyseal cam deformity after pinning. Short-term follow-up has demonstrated excellent outcomes in patients treated for SCFE with subsequent hip arthroscopy. Midterm follow-up of these patients has been sparse and rarely reported in the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate the midterm clinical and functional outcomes of patients undergoing hip arthroscopy after SCFE in situ fixation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Case series; Level of evidence, 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with SCFE who underwent subsequent hip arthroscopy for femoroacetabular impingement (FAI) were enrolled in a prospective database. Inclusion criteria were a primary diagnosis of residual post-SCFE deformity and subsequent surgical treatment for FAI &gt;1 year before the start date of the study. Patients were excluded if they were unable to be contacted. Participants were sent a survey that included physical function (Patient-Reported Outcomes Measurement Information System [PROMIS]) and Likert-style questions assessing disability and satisfaction. Patient charts were retrospectively reviewed for patient characteristics, visual analog scale (VAS) pain scores, and a modified Harris Hip Score (mHHS) from the postfixation but prearthroscopy period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 63 patients receiving hip arthroscopy after treatment for SCFE, 41 patients met the inclusion criteria and 34 completed the midterm follow-up survey (54.0% response rate). The mean duration of follow-up was 6.17 years. Patient subjective outcomes demonstrated that 88.3% of patients reporting being satisfied or very satisfied with their surgical result. The mean preoperative baseline mHHS was 67.43, indicating poor functional status. The mean midterm follow-up PROMIS-PF &lt;i&gt;T&lt;/i&gt; score for this cohort was 50.81, indicating a slight overall improvement for the study cohort's functional status when compared with the general population. The mean VAS pain score at rest was 5.09 preoperatively and 1.91 at midterm follow-up. The mean postarthroscopy iHOT-12 score was 68.27 (SD, 28.58), indicating greater quality of life postoperatively, with 20 patients (59%) obtaining a Patient Acceptable Symptom State (PASS) and a revision rate of 15%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of the first midterm follow-up of patients undergoing hip arthroscopy after surgical pinning of SCFE demonstrate improved functional and clinical objective outcomes compared with preoperative scores. These patients demonstrated poor functional status preoperatively but average or above-average functional status at the midterm follow-up postoperatively. Additionally, 20 patients (58.8%) obtained a PASS and a revision rate of 15%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Arthroscopic treatment of post-SCFE FAI rep","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342579"},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326488","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":"Pitching Kinematics and Kinetics Related to the Elbow Joint Load in Young Female Baseball Players: A Comparison With Young Male Baseball Players.","authors":"Katsutoshi Nishino, Noriaki Yamamoto, Naoto Okamura, Hiroyuki Sekine, Yasuo Tanaka, Takeyuki Nishizawa, Masaei Tanaka, Mutsuaki Edama, Go Omori","doi":"10.1177/23259671251343795","DOIUrl":"10.1177/23259671251343795","url":null,"abstract":"<p><strong>Background: </strong>Because the population of female baseball players has been increasing worldwide in recent years, it is important for female players to reduce the risk of elbow joint injuries, which occur frequently in baseball pitching. Although many biomechanical studies related to baseball pitching have clarified elbow joint loads, the participants in most of these studies were male baseball players, necessitating the expansion of investigations to female baseball players, particularly young female players.</p><p><strong>Purpose: </strong>The objective of the present study was to elucidate the pitching mechanics related to the elbow joint load in young female players by comparing them with young male players.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Overall, 295 participants, comprising 49 young female baseball players (mean age, 13.9 ± 2.0 years) and 246 young male baseball players (mean age, 14.3 ± 2.2 years), were included in the present study. Fastball pitching in the overhead style was assessed 3-dimensionally using a motion capture system and force plates. The pitching kinematics and kinetics were calculated, and sex differences were analyzed. Furthermore, multiple regression analysis evaluated the pitching kinematics and kinetics related to elbow varus moment (EVM).</p><p><strong>Results: </strong>Stride, shoulder kinematics, EVM, ground-reaction forces, and ball velocity in the pitching of young female players were significantly lower than those in young male players. On multiple regression analysis, EVM in the pitching of young female players was associated with shoulder kinematics, and contrastingly, EVM in the pitching of young male players was related to ground-reaction force with respect to the lower body.</p><p><strong>Conclusion: </strong>Although the pitching kinematics and kinetics in young female players were significantly lower than those in young male players, as in previous studies on adults, the pitching kinematics and kinetics that cause increases in the elbow joint load had a sex difference, and those in young female players depended on shoulder kinematics. This finding suggests that the mechanism of pitching injuries in young female players may differ from that in young male players.</p><p><strong>Clinical relevance: </strong>Young female baseball players ought to learn proper pitching mechanics to reduce the injury risk, and the approach for learning in young female players should be different from that in young male players.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343795"},"PeriodicalIF":2.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326489","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":"Subcoracoid Cyst: A Possible Predictive Marker for Postoperative Retears of Rotator Cuff After Arthroscopic Repair.","authors":"Mehmet Akan, Muhlik Akyürek, Emre Koraman, Yusuf İyetin, İsmail Türkmen","doi":"10.1177/23259671251341914","DOIUrl":"10.1177/23259671251341914","url":null,"abstract":"<p><strong>Background: </strong>Subcoracoid cysts (ScCs) are often associated with rotator cuff tears, but their relationship with rotator cuff retears remains unclear.</p><p><strong>Purpose: </strong>To investigate the correlation between ScCs and retears in patients having undergone arthroscopic rotator cuff repair.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent arthroscopic rotator cuff repair from November 2016 to March 2022. Patients with Patte stage 1 or 2 tears were included. Preoperative magnetic resonance imaging (MRI) assessed subscapularis and supraspinatus tendons, biceps pulley, and ScC volume. Postoperative MRI evaluated the same parameters as preoperative MRI, with the addition of rotator cuff retear assessment. On the basis of preoperative MRI, patients were classified into group A (with cyst) and group B (without cyst). According to postoperative MRI, groups were further divided into A1 (without retear), A2 (with retear), B1 (without retear) and B2 (with retear). Postoperative decrease in ScC volume (ScC delta), Sugaya classification, and Constant score were compared.</p><p><strong>Results: </strong>The study included 109 patients: 69 in group A (A1 = 40, A2 = 29) and 40 in group B (B1 = 35, B2 = 5). The retear rate was significantly higher in group A (34.8%) than in group B (12.5%) (<i>P</i> = .02). In group A, the median (minimum-maximum) ScC delta value was significantly greater in group A1 (2422 mm³ [257 to 7503 mm³]) compared with group A2 (625 mm³ [-1060 to 1978 mm³]), indicating no recurrence of the ScC (<i>P</i> = .03). Postoperative Constant shoulder scores were higher in the no retear groups (group A1, 79.3 ± 8.2; group A2, 66.2 ± 13.4; group B1, 83.2 ± 8.5; group B2, 61.4 ± 5.9) (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>For the patients with ScCs detected on preoperative MRI scans, preserved tendon integrity after rotator cuff repair was associated with a reduction in ScC volume. This reduction was evident on postoperative MRI scans when compared with preoperative measurements. Conversely, compromised tendon integrity did not lead to a significant reduction in ScC volume after surgery, potentially suggesting cyst reformation. Therefore, the postoperative identification of an ScC may indirectly indicate rotator cuff retear.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341914"},"PeriodicalIF":2.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326490","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}