Orthopaedic Journal of Sports Medicine最新文献

{"title":"The Formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT Initiative Part II-Prevention, Nonoperative Treatment and Return to Sport.","authors":"Robert Prill, C Benjamin Ma, Stephanie E Wong, Philippe Beaufils, Joan C Monllau, Elanna K Arhos, Roland Becker, Francesco Della Villa, J Brett Goodloe, James J Irrgang, Jitka Klugarova, Emma L Klosterman, Aleksandra Królikowska, Aaron J Krych, Robert F LaPrade, Robert Manske, Nicky van Melick, Jill K Monson, Marko Ostojic, Mark V Paterno, Tomasz Piontek, Simone Perelli, Alexandre Rambaud, James Robinson, Laura C Schmitt, Eric Hamrin Senorski, Thorkell Snaebjornsson, Adam J Tagliero, Airelle O Giordano, Nicolas Pujol","doi":"10.1177/23259671251349553","DOIUrl":"10.1177/23259671251349553","url":null,"abstract":"<p><strong>Purpose: </strong>Part II of this consensus aimed to provide recommendations for the prevention of meniscus injuries, nonoperative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures.</p><p><strong>Methods: </strong>This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA-American Orthopedic Society for Sports Medicine (AOSSM)-American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1-9). Final documents were assessed by an international peer review group for geographical adaptability.</p><p><strong>Results: </strong>Low to moderate scientific level of evidence was available, so that grades of recommendations were low (3 Grade A ratings, 4 Grade B, 3 Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8-9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programs and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and timebased. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process.</p><p><strong>Conclusion: </strong>This international EU-US consensus established recommendations for prevention strategies, describes rehabilitation of nonoperated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists.</p><p><strong>Level of evidence: </strong>Level I, consensus.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251349553"},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302646","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":"Increased Length of Surgery Is Associated With Increased Fluid Pump Pressure During Hip Arthroscopy.","authors":"Nicholas A Felan, Matthew J Kraeutler, Carson Keeter, Ben Mei-Dan, Kyle Jamar, Jessica H Lee, Omer Mei-Dan","doi":"10.1177/23259671251342584","DOIUrl":"10.1177/23259671251342584","url":null,"abstract":"<p><strong>Background: </strong>Elevated fluid pump pressures during hip arthroscopy have been associated with surgical complications including fluid extravasation, abdominal compartment syndrome, and higher use of pain medication.</p><p><strong>Purpose: </strong>To demonstrate the safe use of low pump pressures and to identify factors associated with the need for increased fluid pump pressure during hip arthroscopy.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective review was performed on all patients who underwent hip arthroscopy by a single surgeon between 2020 and 2021. Patients maintaining a pump pressure ≤20 mm Hg during surgery were assigned to group A, and patients who required a pump pressure >20 mm Hg at any point during surgery were assigned to group B. Univariate and multivariate analyses were performed to assess for relationships between elevated pump pressure (>20 mm Hg) during hip arthroscopy and the patient's age, sex, length of surgery, body mass index, Beighton hypermobility score, lateral center edge angle, alpha angle, Tegner activity score, femoral shaft torsion angle, highest systolic blood pressure during surgery, number of suture anchors, and the presence of medical comorbidities (ie, hypertension, clotting disorder, or diabetes mellitus).</p><p><strong>Results: </strong>A total of 103 patients (112 hips) were included. Group A consisted of 77 hips (54 female, 23 male) with a mean age of 33.3 years. Group B consisted of 35 hips (19 female, 16 male) with a mean age of 33.6 years. Multivariate regression analysis revealed that mean length of surgery was associated with a need to increase pump pressure (<i>P</i> < .001). On average, for every 1-minute increase in surgery duration, the odds of needing an increase in pump pressure increased by 2.0%. In addition, highest systolic blood pressure during surgery and number of anchors were associated with an elevated pump pressure on univariate analysis (<i>P</i> = .026 and <i>P</i> < .001, respectively).</p><p><strong>Conclusion: </strong>For a majority of patients who underwent hip arthroscopy, a pump pressure of 20 mm Hg resulted in adequate visualization for the duration of the case. Increased length of surgery was associated with an elevated pump pressure during hip arthroscopy.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251342584"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302644","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":"Outcomes After Arthroscopic Posterior Labral Repair With All-Suture Anchors in Football Players.","authors":"Daniel J Smigielski, Matthew P Ithurburn, Tomas F Vega, Alexander E Loeb, Sai Reddy, Trace Naman, Anna E Crawford, Campbell B Aiken, Ariel L Kidwell-Chandler, Cristian Arceo, Ryan Froom, Andrew Atkinson, Marcus A Rothermich, Benton A Emblom, Jeffrey R Dugas, E Lyle Cain","doi":"10.1177/23259671251343646","DOIUrl":"10.1177/23259671251343646","url":null,"abstract":"<p><strong>Background: </strong>Posterior glenoid labral injuries are more common in football players than in the general population. Arthroscopic repair with all-suture anchors has proven to be an effective technique to address other abnormalities, allowing for low-profile constructs that minimize damage to surrounding tissue. Few studies have examined the outcomes of posterior labral repair with all-suture anchors in football players.</p><p><strong>Hypothesis: </strong>It was hypothesized that after labral repair with all-suture anchors, functional outcomes would improve, revision rates would be low, return-to-sport rates would be high, and clinical outcomes would be comparable with those seen after arthroscopic repair performed with traditional solid anchors among football players.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>The authors identified patients in the institution's ongoing data repository who were football players when they underwent arthroscopic posterior glenoid labral repair using all-suture anchors. The authors collected baseline (preoperative) and follow-up demographic, clinical, surgical, and functional outcome data, with a minimum follow-up time of 2 years. Patient-reported outcome measures included the American Shoulder and Elbow Surgeons (ASES) score and the Western Ontario Shoulder Instability Index (WOSI).</p><p><strong>Results: </strong>The authors identified 52 male football athletes (mean age at surgery, 18.5 years) with both baseline and follow-up data (mean follow-up time, 3.8 years), with all competing at either the high school (n = 41 [79%]) or collegiate (n = 11 [21%]) level. Mean outcome scores improved significantly from baseline to follow-up for both the ASES score (baseline: 63.2; follow-up: 97.1) and the WOSI (baseline: 48.1; follow-up: 94.0). Overall, 37 of 52 (71%) returned to football at their preinjury level after surgery. However, only 38 of 52 athletes attempted to return to sport. Among athletes who attempted to return to sport, 97% (37/38) were able to return. There were no significant differences in follow-up ASES or WOSI scores between high school and collegiate athletes, between blocking and nonblocking positions, or between isolated posterior labral repair and combined labral repair.</p><p><strong>Conclusion: </strong>The results demonstrated excellent outcomes, including large and significant improvements in ASES and WOSI scores, in football players. While 29% did not return to football, 97% of those who attempted to return to play did so at their preinjury level. This study shows encouraging results for the use of all-suture anchors for posterior labral repair in this population of athletes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343646"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302645","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":"Establishing Threshold Values for the Patient Acceptable Symptom State After Anterior Cruciate Ligament Reconstruction for the Self Knee Value and the Anterior Cruciate Ligament-Return to Sport after Injury Scale.","authors":"Alexis Gerfroit, Thibault Marty-Diloy, Pierre Laboudie, Nicolas Graveleau, Nicolas Bouguennec","doi":"10.1177/23259671251343073","DOIUrl":"10.1177/23259671251343073","url":null,"abstract":"<p><strong>Background: </strong>The Patient Acceptable Symptom State (PASS) has become a useful indicator, but to date, no threshold value has been defined for the Self Knee Value (SKV) and the Anterior Cruciate Ligament-Return to Sport after Injury (ALC-RSI) scale.</p><p><strong>Purpose: </strong>To define the PASS thresholds for the SKV and ACL-RSI scale in patients 1 to 5 years after anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors conducted a retrospective analysis based on data from a prospective cohort study of patients who underwent primary ACLR. Patients <50 years completed a survey at the end of follow-up, ranging from 1 to 5 years after reconstruction. The survey covered the SKV, the ACL-RSI scale, and a PASS question for each patient-reported outcome (PRO). The PASS was calculated using the area under the receiver operating characteristic (ROC) curve and absolute postoperative PROs.</p><p><strong>Results: </strong>A total of 890 patients answered the questionnaire, at a mean follow-up of 39.2 ± 16.8 months after primary ACLR. Among them, 85.8% achieved an acceptable symptom state based on the SKV, and 76% based on the ACL-RSI scale. The ROC curve analysis allowed determination of PASS thresholds at 71% (sensitivity, 0.86; specificity, 0.80) for the SKV and 60% (sensitivity, 0.84; specificity, 0.74) for the ACL-RSI scale. Those who achieved the PASS were younger: SKV-PASS-Y = 28.0 ± 9.7 years vs. 30.1 ± 10.3 years (<i>p</i> = 0.03) for SKV-PASS-N and 27.9 ± 9.7 years for the ACL-RSI vs. 29.6 ± 10.1 years (<i>p</i> = 0.03) for ACL-RSI-PASS-N, and had a lower body mass index for both scores with a mean BMI of 24.0 ± 3.6 vs. 24.7 ± 3.7 (<i>p</i> = 0.04) and 23.9 ± 3.6 vs. 24.7 ± 3.8 (<i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Although the PASS has been validated in several previous studies, this is the first study to determine PASS thresholds for the SKV and ACL-RSI scale with excellent sensitivity and excellent to acceptable specificity, at 1 to 5 years after primary ACLR. This should allow practitioners to extend the use of the PASS to PROs such as the SKV and the ACL-RSI scale, and thus facilitate the assessment of large cohorts of patients in future studies.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343073"},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275532","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 Ischemic Preconditioning of the Operative Limb Reduce Pain After Hip Arthroscopy? A Prospective, Single-Blind, Randomized Controlled Trial.","authors":"Caitlin Orner, Andrew Usoro, Brooke Bergeron, Michael Banffy","doi":"10.1177/23259671251343762","DOIUrl":"10.1177/23259671251343762","url":null,"abstract":"<p><strong>Background: </strong>Ischemic preconditioning (IPC) involves brief periods of circulatory occlusion and reperfusion to stimulate protective effects on tissues. Studies on IPC prior to knee surgery have shown improvements in postoperative pain and decreased opioid consumption. Through a combination of neural and circulating humoral factors, IPC has also been shown to have systemic effects outside the area of ischemia.</p><p><strong>Purpose: </strong>To determine whether preoperative IPC of the operative limb at the thigh affects postoperative pain scores or opioid consumption after hip arthroscopy.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 1.</p><p><strong>Methods: </strong>Adult patients undergoing hip arthroscopy for femoroacetabular impingement or labral tear were prospectively enrolled and randomized to IPC or control groups. Limb preconditioning was performed within 24 hours before surgery using the Delphi Personalized Tourniquet System with the cuff on the proximal thigh. The IPC group received a 30-minute treatment consisting of 3 rounds of 5 minutes at limb occlusion pressure alternating with 5 minutes of reperfusion. The control group received the same protocol at 20% of limb occlusion pressure. Arthroscopy was performed according to standard of care. Surveys were administered through RedCap starting the day of surgery through postoperative day 7. Patients were asked to rate their pain from 0 to 10 with the visual analog scale (VAS) and to record use of pain medication. Statistical analysis included chi-square and <i>t</i> tests.</p><p><strong>Results: </strong>A total of 68 patients (34 IPC, 34 control) were enrolled. Demographic characteristics and specific surgical procedures were similar between groups. Survey compliance was higher in the IPC group than the control group, 6.3 ± 2.7 days versus 3.7 ± 3.38 days, respectively (<i>P</i> < .05). Both groups reported significant reductions in their VAS pain scores from the day of surgery to postoperative day 7 (<i>P</i> < .05). No significant difference was found between the groups in VAS pain scores at any time point. No significant difference was found between the groups in mean daily opioid consumption (expressed as morphine milligram equivalents) or acetaminophen consumption.</p><p><strong>Conclusion: </strong>IPC of the operative limb at the thigh did not appear to decrease pain scores or pain medication use after hip arthroscopy. This study suggests that although IPC of the limb at the level of the thigh may be useful for some orthopaedic procedures, it may not have a significantly beneficial effect for hip arthroscopy patients.</p><p><strong>Registration: </strong>NCT04925791 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251343762"},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275531","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":"Vascularization Characteristics of the Different Meniscal Layers: Three-Dimensional Assessment With Micro-CT.","authors":"Federica Orellana, Stefano Zaffagnini, Ruslan Hlushchuk, Oleksiy-Zakhar Khoma, Sébastien Halm, Annapaola Parrilli, Alberto Grassi","doi":"10.1177/23259671251341472","DOIUrl":"10.1177/23259671251341472","url":null,"abstract":"<p><strong>Background: </strong>Degenerative meniscal lesions are often characterized by horizontal cleavage tears, and there is currently no established gold standard for treating these injuries. Understanding the vascularization and distribution of blood vessels along the meniscal layers could offer valuable insights into the management and healing of these tears.</p><p><strong>Hypothesis: </strong>Distinct vascularization patterns could be identified in different layers of the meniscus along the proximal-distal axis, providing new insights and potentially expanding or refining existing classification systems.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>To visualize the meniscal microvasculature, human cadaveric legs were perfused with a polymer-based contrast agent, followed by micro-computed tomography imaging. The menisci were virtually divided into transverse (layers), radial (thirds), and circumferential zones to quantify the vascular contribution of each zone and to evaluate vascular parameters such as segment diameter, tortuosity, and the number of vessel segments.</p><p><strong>Results: </strong>In the medial meniscus, the inferior surface of the outermost zone and the intermediate layers of the peripheral zones showed a potential reduction in vessel percentage. In the lateral meniscus, a relatively higher percentage of vessels was observed from the superficial to the inferior layers of the posterior horn, extending into the inner zones. Additionally, the lateral meniscus exhibited a greater number of vessels with smaller diameters compared with the medial meniscus.</p><p><strong>Conclusion: </strong>This micro-computed tomography approach for analyzing spatial vascular distribution offers a more comprehensive view of meniscal vasculature across multiple planes and regions.</p><p><strong>Clinical relevance: </strong>This study may pave the way for new classifications that identify highly and poorly vascularized regions of the meniscus, potentially improving the effectiveness of treatments for meniscal injuries, ultimately reducing recovery time and improving long-term joint health for patients.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341472"},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266893","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":"Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Comparative Study of Pediatric, Adolescent, and Young Adult Populations.","authors":"Deepak Chona, Jeffrey Kay, Nazgol Tavabi, Michael Quinn, Dennis Kramer, Yi-Meng Yen, Melissa Ann Christino, Matthew Milewski, Mininder S Kocher, James Pruneski, Ata Kiapour, Benton E Heyworth","doi":"10.1177/23259671251334591","DOIUrl":"10.1177/23259671251334591","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists regarding septic arthritis (SA) after anterior cruciate ligament reconstruction (ACLR) in pediatric and adolescent patients.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to compare post-ACLR SA cases during a 21-year period in pediatric and adolescent patients to those in a young adult control cohort. It was hypothesized that the incidence would be similarly low in both subpopulations.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Records of patients who underwent ACLR between 2000 and 2020 were retrospectively reviewed for diagnoses of postoperative SA of the ipsilateral knee, defined by culture-positive arthrocentesis or synovial fluid white blood cell count >50,000 cells/mL. Surgical details, culture results, and clinical course were analyzed. Age-based cohorts-pediatric (<13 years of age), adolescent (13-19 years of age), and young adult (20-35 years of age)-were compared using chi-square tests for age, graft source, graft type, concurrent meniscal procedures, and SA incidence. Time between ACLR and subsequent surgeries was analyzed utilizing <i>t</i> tests.</p><p><strong>Results: </strong>Of 5638 ACLR cases (pediatric: n = 606, 10.7%; adolescent: n = 4123, 73.1%; young adult: n = 909, 16.1%), SA was diagnosed in 13 patients (0.23%; adolescent: n = 12, 0.30%; young adult: n = 1, 0.11%) a median of 15 days (range 6-632 days) after ACLR. One or more arthroscopic irrigation and debridement (I&Ds) (mean, 2; range, 1-3) were performed, and anterior cruciate ligament (ACL) grafts were retained for all patients. The mean clinical follow-up was 3.5 years (range, 0.6-9.2 years). Subsequent surgeries include 2 lysis of adhesions, 3 meniscectomies, 1 meniscal repair, 3 patellar chondroplasties, 1 loose-body removal, 2 patellar biopsies, 1 debridement, and 1 revision ACLR 6 years postoperatively for acute ACL graft rupture. The most common microbes were <i>Staphylococcus aureus</i> (n = 3; 23.1%) and other forms of <i>Staphylococcus</i> species (n = 9; 69.2%). No significant associations were identified between age-based cohort and graft source, graft type, age, or concurrent meniscal surgery.</p><p><strong>Conclusion: </strong>Post-ACLR SA was similarly rare for adolescents and young adults, and no cases were identified in 606 pediatric patients. No associations were identified between SA and demographic factors, graft source, graft type, or concurrent meniscal surgery. <i>Staphylococcus</i> species were identified in most cases. Aggressive initial surgical treatment with multiple I&Ds was associated with graft retention, with no disproportionate subsequent graft rupture risk.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251334591"},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266892","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":"Outcomes of Concomitant Hip Arthroscopic Surgery for Intra-articular Abnormalities and Endoscopic Abductor Tendon Repair at a Minimum 2-Year Follow-up: A Systematic Review.","authors":"Jack Gagné, Michael S Lee, Seema M Patel, Trevan Klug, Peter F Monahan, Nancy Park, Serkan Surucu, Stephen M Gillinov, Jay Moran, Andrew E Jimenez","doi":"10.1177/23259671251341479","DOIUrl":"10.1177/23259671251341479","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hip labral and chondral lesions are commonly found as co-occurring conditions in patients with abductor tendon tears. Concomitant hip arthroscopic surgery for the correction of intra-articular abnormalities and endoscopic abductor tendon repair has therefore emerged as a strategy to address these conditions simultaneously.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To systematically review the existing literature assessing clinical outcomes after endoscopic abductor tendon repair with concomitant hip arthroscopic surgery for the treatment of intra-articular abnormalities.&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;Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the PubMed, CENTRAL, and Scopus databases were queried in May 2023 to conduct this systematic review using the keywords \"hip arthroscopy,\"\"gluteal,\"\"abductor,\"\"gluteus,\"\"minimus,\" and \"medius.\" Articles were included if they reported preoperative and postoperative patient-reported outcome measure (PROM) scores for patients undergoing endoscopic abductor tendon repair for gluteus medius and/or gluteus minimus tears with concomitant hip arthroscopic surgery for the treatment of labral tears and/or femoroacetabular impingement. We identified a total of 404 articles after our initial search. Title, author, publication date, study design, patient characteristics, preoperative radiographic findings (lateral center-edge angle, alpha angle, and Tönnis grade), concomitant surgical procedures performed, preoperative and postoperative PROM scores, measures of clinical benefit, and secondary surgery performed (revision arthroscopic surgery, revision abductor tendon repair, and conversion to total hip arthroplasty) were recorded. &lt;i&gt;P&lt;/i&gt; values were extracted from the articles included in our review, all of which defined statistical significance as &lt;i&gt;P&lt;/i&gt; &lt; .05. We were unable to create forest plots for these data, given that no single PROM (preoperative and postoperative scores in means and standard deviations) was reported in ≥3 articles. This also prevented us from further analyzing heterogeneity. We calculated the total rate of secondary surgical procedures by dividing the instances of these events by the total number of patients across the 4 studies that included these outcome measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After duplicate articles were removed, 270 articles entered the abstract screening phase, and 11 full-text articles were reviewed. Overall, 5 articles were included in the systematic review. A total of 223 hips were included, with mean follow-up times ranging from 26 to 74 months. All studies reported a significant improvement (&lt;i&gt;P&lt;/i&gt; &lt; .05) on all reported PROMs from preoperative to latest postoperative time points. There were 2 studies that compared combined endoscopic abductor tendon repair and labral treatment with a matched group undergoing h","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251341479"},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266891","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 Availability and Pricing of Orthobiologic Knee Injections in the Chicago Metropolitan Area: A Market Assessment Study.","authors":"Zeeshan A Khan, Daniel J Kaplan, Mario Hevesi, Suhas P Dasari, Benjamin Kerzner, Luc M Fortier, Garrett R Jackson, Christopher M Brusalis, Adam B Yanke, Jorge Chahla, Brian J Cole, Nikhil N Verma","doi":"10.1177/23259671241310452","DOIUrl":"10.1177/23259671241310452","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite mounting clinical evidence for the utility of orthobiologics in nonoperative management of orthopaedic pathology, the market for orthobiologic therapies remains largely unregulated by the Food and Drug Administration, giving rise to a wide range of pricing for these therapeutics by different provider types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To determine the availability and pricing for platelet-rich plasma (PRP), amniotic or adipose \"stem cell,\" and bone marrow aspirate concentrate (BMC) injections for the treatment of knee osteoarthritis among orthopaedic sports medicine and alternative providers (eg, chiropractic clinics and stand-alone \"regenerative medicine\" clinics) in a major metropolitan city.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Orthopaedic sports medicine providers in the Chicagoland area were identified through the American Orthopaedic Society for Sports Medicine (AOSSM) and Arthroscopy Association of North America (AANA) surgeon databases. Alternative clinics offering orthobiologic injections were systematically compiled using Yelp! and Google search listings and reviews. Clinics were contacted using a standardized telephone script. Data were collected for each site on the types of injections offered, whether price was disclosed over the telephone, the price of injections offered, and the source of stem cell injections if they were provided. Mann-Whitney &lt;i&gt;U&lt;/i&gt; tests were used to compare the mean price between practices. &lt;i&gt;F&lt;/i&gt; tests for equality of variances were used to compare the variability in prices between practice types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 25 unique orthopaedic sports medicine practices (comprising 80 AOSSM/AANA surgeons) and 40 alternative clinics offered PRP, stem cell, and/or BMC injections, as indicated over the telephone. There was no difference in likelihood of offering PRP (&lt;i&gt;P&lt;/i&gt; = .698) or BMC injections (&lt;i&gt;P&lt;/i&gt; = .340). However, alternative clinics were significantly more likely to offer stem cell injections (&lt;i&gt;P&lt;/i&gt; &lt; .001). There was no difference in the willingness to disclose the price for PRP (&lt;i&gt;P&lt;/i&gt; = .269), stem cell injections (&lt;i&gt;P&lt;/i&gt; = .302), and BMC (&lt;i&gt;P&lt;/i&gt; = .528) or the source of what each clinic advertised as stem cell injections (&lt;i&gt;P&lt;/i&gt; = .630). The mean price for a single PRP injection was significantly higher (&lt;i&gt;P&lt;/i&gt; = .011) and significantly more variable (&lt;i&gt;F&lt;/i&gt; statistic = .139; &lt;i&gt;P&lt;/i&gt; &lt; .001) at alternative clinics. Similarly, the mean price for a single stem cell injection was significantly higher (&lt;i&gt;P&lt;/i&gt; &lt; .001) and significantly more variable (&lt;i&gt;F&lt;/i&gt; statistic = 0.080; &lt;i&gt;P&lt;/i&gt; = .025) at alternative clinics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates that orthobiologic knee injections are highly prevalent for in-clinic use within the Chicago metropolitan area, with PRP being the most commonly used therapeutic. When compared with orthopae","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671241310452"},"PeriodicalIF":2.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Histological Analysis of the Superior Capsule of the Glenohumeral Joint and the Supraspinatus Tendon.","authors":"Nabil Mehta, Allison K Perry, Deborah J Hall, Ian M Clapp, Derrick M Knapik, Grant E Garrigues, Nikhil N Verma","doi":"10.1177/23259671251334782","DOIUrl":"10.1177/23259671251334782","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Complete understanding of rotator cuff pathology relies on a comprehensive knowledge of the anatomic relationships between the supraspinatus tendon (ST) and the superior capsule (SC) of the glenohumeral joint. However, the native anatomy of these structures across the glenohumeral joint and at their attachment sites remains incompletely understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To (1) determine the histological anatomy and absolute and relative thicknesses of the SC compared with the ST across the glenohumeral joint at the anterior, midpoint, and posterior portions of the ST; (2) quantify the percentage of the humeral footprint occupied by the SC versus the ST; and (3) measure the width of the SC insertion on the glenoid.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Descriptive laboratory study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fourteen right cadaveric shoulders were dissected, fixed in formalin, embedded in plastic, and sectioned into 3 sections encompassing the anterior, middle, and posterior portions of the ST. Sections were then surface-stained with toluidine blue and basic fuchsin. The SC and ST thicknesses at the medial, midpoint, and lateral aspects of the ST; the medial-lateral width of the humeral insertions of the SC and ST; and the width of the SC insertion on the glenoid were measured. Measurements at each location were compared using 1-way analysis of variance with post hoc Bonferroni corrections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was no statistically significant variation in the relative thickness of the SC versus the ST at the medial, midpoint, or lateral aspects of the tendon. The SC and ST were histologically distinct at their insertions on the humeral footprint. The SC comprised 15.2% to 16.2% of the total footprint width. The ST was consistently thicker at its humeral insertion than at its medial-lateral midpoint (&lt;i&gt;P&lt;/i&gt; &lt; .05). The anterior and posterior humeral insertions of the SC were significantly thicker than the corresponding midpoints (&lt;i&gt;P&lt;/i&gt; = .015 anteriorly; &lt;i&gt;P&lt;/i&gt; = .042 posteriorly). The SC was consistently thicker at its glenoid insertion than at its midpoint (&lt;i&gt;P&lt;/i&gt; &lt; .05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The humeral insertions of the ST and SC were generally thicker than their midpoints. The SC was also thicker at its glenoid insertion compared with its midpoint. The SC occupied approximately 15% of the width of the native rotator cuff insertion, which is smaller than previously defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;By providing improved clarity on the histological differences between the SC and ST, these data may allow for a better understanding of rotator cuff pathology, particularly delaminated tears. These results suggest that, when present, the deepest 1 to 2 mm of tissue in the articular layer may represent the SC, while articular-sided layers &gt;2 mm in thickness likely include portions of the supraspinatus musculotendinous unit. This knowledge may serve","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 6","pages":"23259671251334782"},"PeriodicalIF":2.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249047","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}