Orthopaedic Journal of Sports Medicine最新文献

{"title":"Effect of Different Footwear on the Knee Joint: Biomechanical Analysis and Acute T2 Relaxation Time Changes After Walking in Minimalistic and Neutral Footwear.","authors":"Jan Malus, Victor Casula, Jan Urbaczka, Dominik Vilimek, Miika Nieminen, Joe Hamill, Veronika Horka, Marketa Rygelova, Jaroslav Uchytil","doi":"10.1177/23259671251346985","DOIUrl":"10.1177/23259671251346985","url":null,"abstract":"<p><strong>Background: </strong>Walking in minimalistic footwear (MF) increases mechanical loading on the knee joint, exposing it to acute stresses that may heighten the risk of early onset of knee osteoarthritis. This type of footwear can modify walking patterns in the lower limbs, further intensifying joint stress and contributing to the deterioration of articular surfaces.</p><p><strong>Purpose: </strong>First, to evaluate the differences in kinetic variables associated with the early onset of knee osteoarthritis between MF and neutral footwear (NF) during walking; second, to determine the extent of acute cartilage loading in the knee joint, particularly footwear after 45 minutes of walking in an urban environment, using magnetic resonance imaging (T2 relaxation times [T2RTs] and percentage change of loading) in weightbearing zones.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Knee forces and knee moments were obtained during walking trials of 20 healthy participants using statistical parametric mapping. The analysis focused on alterations across specific intervals of the stance phase, expressed as percentages of the gait cycle. T2RT values of cartilage were quantified using a 1.5 T magnetic resonance imaging at baseline and immediately after 45 minutes of walking in each condition.</p><p><strong>Results: </strong>Significant differences were observed in knee force during the stance phase: (1) in the sagittal plane, greater values were between 2% and 9% and between 90% and 100%, and lower values were between 18% and 40% and between 62% and 85% in MF; (2) the frontal plane showed lower values between 7% and 14% and 98% in MF, and greater values were between 7% and 14% and 98% in MF; and (3) the transversal plane showed greater values between 0% and 9% and between 54% and 78%, and lower values were between 25% and 40% and between 81% and 100% in MF. Knee adduction moment showed significantly lower values between 0% and 8%, 32% and 90%, and >92% and 100%. Knee flexion moment showed significantly lower values between 3% and 5%, 25% and 69%, and >7% and 19% in MF. The main effect of loading in NF of cartilage showed significantly lower T2RT values in all superficial femur parts and significantly greater T2RT values in deep central tibia. MF showed significantly lower T2RT values in the superficial anterior-posterior femur in the medial cartilage compartment.</p><p><strong>Conclusion: </strong>Increased knee moments in all planes reflect the effect of an acute change to particular footwear. NF reveals a greater response to loading in weightbearing knee cartilage zones. The superficial layers appeared to be more sensitive to loading after 45 minutes of walking.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251346985"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963849","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 Relationship of Meniscal Extrusion to Subchondral Bone Density in Medial Knee Osteoarthritis.","authors":"Taku Ebata, Koji Iwasaki, Tomoya Sato, Yoshiaki Hosokawa, Masanari Hamasaki, Dai Sato, Masatake Matsuoka, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki","doi":"10.1177/23259671251366424","DOIUrl":"10.1177/23259671251366424","url":null,"abstract":"<p><strong>Background: </strong>The hoop function of the meniscus plays a crucial role in stress distribution across the knee joint. While medial meniscal extrusion is known to contribute to the progression of medial knee osteoarthritis (OA) by altering load distribution within the knee joint, its exact effect on living humans remains unclear.</p><p><strong>Purpose: </strong>To investigate the influence of meniscal extrusion on subchondral bone density distribution in patients with medial knee OA.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective study included 59 patients with medial knee OA (OA group) and 19 control participants (non-OA group). Radiographic parameters, including the hip-knee-ankle angle (HKA) and meniscal extrusion ratio (MER), were assessed. The subchondral bone density was evaluated using computed tomography-osteoabsorptiometry to analyze the high-density area (HDA) in the medial and lateral compartments on the articular surface of the proximal tibia. Correlations between these parameters were assessed using single and multiple regression analyses, with subgroup analysis conducted in OA patients with and without meniscal tears.</p><p><strong>Results: </strong>In the OA group, the HKA, medial MER (MMER), and the ratio of the medial compartment HDA to the total HDA (medial ratio) were -7.4°, 64.8%, and 81.8%, respectively. In the non-OA group, these values were -2.1°, 12.5%, and 62.0%. Simple regression analysis showed that, in the OA group, the medial ratio was correlated with HKA (<i>R</i> ² = 0.216; <i>P</i> < .001) and MMER (<i>R</i> ² = 0.307; <i>P</i> < .001). Among non-OA participants, only MMER was correlated with the medial ratio (<i>R</i> ² = 0.217; <i>P</i> = .045). The multivariable regression analysis demonstrated an adjusted <i>R</i> ² value of 0.38 (<i>P</i> < .001) in the OA group. The standardized coefficients were 0.465 for MMER and -0.340 for HKA. Subgroup analysis further indicated that meniscal injury in OA patients amplified the effect of extrusion on subchondral bone density distribution, with an adjusted <i>R</i> ² of 0.54 in the meniscal tear group.</p><p><strong>Conclusion: </strong>MMER had a greater influence on the mediolateral distribution of subchondral bone density in patients with medial knee OA than lower limb alignment, suggesting that the hoop function of the meniscus plays a more important role in altering stress distribution than leg alignment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251366424"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963796","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 Comparison of Notch Width Index Differences When Measured on Axial and Coronal MRI.","authors":"Jonathan McKeeman, Ryan DeLeon, Neil Jain, Daniel Heckman","doi":"10.1177/23259671251366425","DOIUrl":"10.1177/23259671251366425","url":null,"abstract":"<p><strong>Background: </strong>There are several known risk factors for ACL injury including knee valgus moment, smaller notch width index (NWI), female sex, increased tibial slope, and meniscal deficiency. Among these, the NWI has typically been determined using either coronal or axial magnetic resonance imaging (MRI) cuts; however, it is unknown whether these measurements differ in each plane.</p><p><strong>Purpose: </strong>To compare axial versus coronal NWI measurements in ACL-injured patients to establish a benchmark for calculation.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients ≥14 years of age with a confirmed ACL injury on MRI were included for review. Two orthopaedic resident physicians measured the NWI using both axial and coronal cuts using previously described measurement criteria as well as a modification utilizing the MRI cuts with the widest bicondylar width. The NWI was computed and a <i>t</i> test was performed to compare the axial and coronal measurements. Interobserver reliability was assessed using 2-way mixed intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>A total of 64 patients with ACL injuries were included. Modified axial and coronal NWIs for the cohort were a mean ± SD of 0.27 ± 0.02 and 0.23 ± 0.02, respectively. Modified axial NWIs were greater than coronal NWIs (<i>P</i> < .001). Standard axial and coronal NWIs for the cohort were 0.29 ± 0.03 and 0.25 ± 0.03, respectively. Standard axial NWIs were greater than coronal NWIs (<i>P</i> < .001). Modified axial and coronal NWIs for male and female patients were not different (<i>P</i> = .61 and <i>P</i> = .14, respectively). Axial notch width measurements were greater than coronal notch widths for both modified and standard measurements (<i>P</i> < .001). Axial intercondylar distances were not different from coronal intercondylar distances for both standard and modified measurements (<i>P</i> = .06 and <i>P</i> = .22, respectively). The ICCs for modified coronal and axial NWIs were 0.88 and 0.97, respectively. The ICCs for standard coronal and axial NWIs were 0.99 and 0.99, respectively.</p><p><strong>Conclusion: </strong>NWIs were greater when measured on an axial MRI compared with the coronal plane for both measurement methods. This was because notch widths were measured wider in this plane since intercondylar distances were not statistically different.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251366425"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963737","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":"From Head to Toe: Investigating Postconcussion Risks for Lower Extremity Injuries in Young Athletes.","authors":"Jackson Woodrow, Arjun Vohra, Youssef Galal, Wyatt Koolmees, Evan Lederman, Steven Erickson, Anup Shah","doi":"10.1177/23259671251361489","DOIUrl":"10.1177/23259671251361489","url":null,"abstract":"<p><strong>Background: </strong>Between 1.7 and 3 million sports-related concussions occur every year. While most concussion symptoms resolve within 3 weeks, the absence of biomarker-based tests makes evaluating return to sport difficult. Existing guidelines primarily focus on cognitive and executive functions and often overlook proprioceptive abilities. This omission may increase athletes' risk of subsequent lower extremity injuries during competition.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to assess the rate of lower extremity injuries in athletes in the year following their first concussion. It was hypothesized that athletes with a concussion would be at an increased risk for a subsequent lower extremity injury within 1 year compared with nonconcussed counterparts.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the PearlDiver database and was queried on March 29, 2024. International Classification of Diseases, Tenth Revision (ICD-10) codes for sports physicals, activity in sports, and concussions were used to create concussed and nonconcussed athlete cohorts. ICD-10 codes for acute lower extremity injuries were used to identify specific injuries within the concussed and nonconcussed populations at 3, 6, 9, and 12-month intervals. Relative risks (RRs) were then calculated for each observed injury.</p><p><strong>Results: </strong>Of the 899,269 athletes, 58,569 (6.5%) suffered a concussion, and of these concussed athletes, 6051 (10.3%) suffered a subsequent lower extremity injury within 1 year. Compared with nonconcussed athletes, there was a significantly increased risk of an unspecified ankle injury (RR, 1.40; <i>P</i> < .05), unspecified knee sprain (RR, 1.36; <i>P</i> < .05), unspecified foot injury (RR, 1.23; <i>P</i> < .001), medial collateral ligament sprain (RR, 1.23; <i>P</i> < .05), ankle sprain (RR, 1.18; <i>P</i> < .001), and foot sprain (RR, 1.10; <i>P</i> < .05). There was no significantly increased risk of sustaining lateral collateral ligament sprains, medial malleolar fractures, and lower extremity muscle strain ≤1 year after a concussion.</p><p><strong>Conclusion: </strong>This study found a significant increase in several lower extremity injuries ≤1 year after a concussion. Additional studies are warranted to better understand the different factors affecting concussion risk, which could include inadequate return-to-sport (RTS) protocols and prolonged vestibular dysfunction.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251361489"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963873","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":"Comparable Outcomes Across 4 Hamstring Tendon Graft Configurations in ACL Reconstruction, Despite Increased Knee Laxity With Gracilis Tendon Harvesting.","authors":"Riccardo Cristiani, Christoffer von Essen, Eric Hamrin Senorski, Riccardo D Ambrosi, Camilo P Helito, Kristian Samuelsson, Anders Stålman","doi":"10.1177/23259671251363585","DOIUrl":"10.1177/23259671251363585","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is a lack of studies that have thoroughly compared subjective and objective outcomes in patients undergoing anterior cruciate ligament reconstruction (ACLR) using different hamstring tendon (HT) graft configurations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to compare anterior knee laxity, isokinetic knee extension and flexion strength, single-leg hop (SLH) test performance, subjective knee function, and the 5-year revision surgery rates between patients who underwent ACLR using 4 HT graft configurations. It was hypothesized that there would be no significant differences in the outcomes examined between the groups.&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;Patients ≥16 years without concomitant ligamentous injuries who underwent primary ACLR with an HT autograft at Capio Artro Clinic, Stockholm, Sweden, between January 1, 2005, and December 31, 2018, were identified. Anterior knee laxity was evaluated using the KT-1000 arthrometer (134 N) both preoperatively and at 6 months postoperatively. Isokinetic knee extension and flexion strength, along with SLH test performance, were evaluated 6 months postoperatively. Subjective knee function was evaluated using the Knee injury and Osteoarthritis Outcome Score, which was collected preoperatively and at 1, 2, and 5 years postoperatively. Revision ACLRs performed at any institution in Sweden within 5 years of the primary surgery were captured using the Swedish National Knee Ligament Registry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5673 patients (55.7% male) were included: tripled semitendinosus tendon (ST3), 245 patients; quadrupled semitendinosus tendon (ST4), 4359 patients; doubled semitendinosus + doubled gracilis tendon (ST-G4), 915 patients; and quadrupled semitendinosus + doubled gracilis tendon (ST-G6), 154 patients. Preoperatively, the groups showed no significant differences in anterior knee laxity. Postoperatively, the ST-G4 and ST-G6 exhibited greater mean anterior side-to-side (STS) laxity and increased STS laxity based on the International Knee Documentation Committee examination form, with fewer patients showing STS laxity ≤2 mm and more patients having STS laxity between 3 and 5 mm and &gt;5 mm (&lt;i&gt;P&lt;/i&gt; &lt;.001). No significant differences were found between the groups in terms of extension and flexion strength or SLH test performance. Regarding subjective knee function, the only significant differences between the groups, though not clinically relevant (&lt;8-10 points), were observed in the preoperative Pain and Quality of Life subscales of the KOOS, as well as in the 1-year Symptoms subscale. The 5-year revision ACLR rates were as follows: ST4, 4.7% (207/4359); ST3, 5.3% (13/245); ST-G4, 3.7% (34/915); and ST-G6, 5.8% (9/154). The hazard of revision ACLR within 5 years of primary surgery in the ST3, ST-G4, and ST-G6 groups was not significantly different from t","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251363585"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963758","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":"Analysis of the Distribution of Private Research Funding to Sports Medicine Orthopaedic Surgeons.","authors":"Aakash K Shah, Isha K Shah, Robert J Burkhart, Heath P Gould, Jacob G Calcei, Sabrina M Strickland, James E Voos","doi":"10.1177/23259671251343817","DOIUrl":"10.1177/23259671251343817","url":null,"abstract":"<p><strong>Background: </strong>The Physician Payments Sunshine Act mandated the public reporting of all industry payments above a $10 value that are disbursed to physicians in the United States. Understanding the pattern of research payments among sports medicine orthopaedic surgeons (SMOSs) may help uncover potential biases and conflicts of interest, thereby promoting transparency and ethical conduct in musculoskeletal research.</p><p><strong>Purpose: </strong>To identify trends in private research payment distribution among SMOSs and to explore potential sources of disparity in the disbursement of research-related private funding.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A cross-sectional analysis of the Open Payments Database was conducted between 2015 and 2021 to identify research payments disbursed to SMOSs. The <i>h</i>-index, number of publications, and years since completion of residency/fellowship training were collected from Scopus and the affiliated institution profile. Descriptive statistics were conducted for payments at the individual surgeon level. Wilcoxon rank-sum tests were utilized to assess the difference in median payment disbursement by surgeon sex. Nonparametric analyses were performed to identify predictors for payment.</p><p><strong>Results: </strong>During the study period, $81,268,687 in private research payments from 79 different industry companies was disbursed to 578 sports medicine surgeons at 397 different institutions. Sports medicine projects represented 23% of all orthopaedic payments, growing from 18% in 2015 to 26% in 2021. Male surgeons comprised 96% of all SMOSs receiving funding and collected 98% of the research payments. There was no statistically significant difference between the median male or female payment. However, the <i>h</i>-index, number of publications, and number of years in practice were all significantly associated with greater median private research payment in a univariate quantile model. The <i>h</i>-index and years out of training were positively associated with greater private research payment in the multivariate model.</p><p><strong>Conclusion: </strong>There was no statistically significant difference in median payment to SMOSs between sexes. A higher <i>h</i>-index and more years out of training were associated with receiving larger private research payments.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251343817"},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963792","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 Surgical Timing With Complications and Patient-Reported Outcomes After Achilles Tendon Repair.","authors":"Michael A Hewitt, Samuel D Stark, Alexander L Vlasak, Jeremy J Kalma, Sara E Buckley, Katherine D Drexelius, Joshua A Metzl, Kenneth J Hunt","doi":"10.1177/23259671251365622","DOIUrl":"10.1177/23259671251365622","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon ruptures pose a challenging recovery for patients, and complications after surgical repair are often associated with poor patient outcomes. The optimal timing for surgery remains a topic of debate and has not been extensively studied.</p><p><strong>Purpose: </strong>To determine whether the time from Achilles rupture injury to surgical repair is associated with postoperative complication rates and long-term patient-reported outcomes (PROs).</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients undergoing surgical treatment for an Achilles rupture between 2016 and 2022 were retrospectively reviewed. Patients were stratified based on time-to-surgery (acute: 0-6 days, subacute: 7-13 days, delayed: 14-41 days, and chronic: 42+ days) and operative technique (open vs percutaneous). Surgical complications were assessed using clinical notes, while PROs-including Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF, PROMIS Pain Interference (PI), and Foot and Ankle Single Assessment Numeric Evaluation (FA SANE)-were collected via a digital survey. A minimum clinical follow-up of 3 months was required for inclusion in the complication analysis, and a minimum survey follow-up of 6 months was required for inclusion in the PRO analysis.</p><p><strong>Results: </strong>Complications were assessed in 350 patients: 116 acute (33%), 131 subacute (37%), 78 delayed (22%), and 25 chronic (7%). A total of 64 complications occurred in 56 patients (16%): 14 minor wound complications (4%), 8 major wound complications (2.3%), 13 reruptures (3.7%), 15 deep vein thromboses (4.3%), 3 sural nerve injuries (0.9%), and 9 cases of neuropathic pain (2.6%). There was no clinically meaningful difference in complication rates among the time-to-surgery cohorts. PROs were available for 146 patients (42%), with a mean follow-up of 23.8 ± 15.6 months and a similar distribution of time to surgery (33% acute, 44% subacute, 17% delayed, and 6% chronic). The mean postoperative PROMIS PF scores were highest in the acute group and decreased in later time-to-surgery groups (<i>P</i> = .016). No significant differences were found between groups with respect to PROMIS PI or FA SANE scores.</p><p><strong>Conclusion: </strong>The timing of surgical intervention after an Achilles tendon rupture did not significantly affect the overall postoperative complication rate. However, patients treated within the first week reported higher PF scores at the follow-up.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251365622"},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963775","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 Preoperative Central Joint Space Holds Greater Clinical Significance in Patients Aged 35 and Older Undergoing Primary Hip Arthroscopy.","authors":"Onur Gürsan, Mustafa Çeltik, Selahaddin Aydemir, Özgür Aydın, Gürhan Tukel, Mehmet Emin Arayıcı, Onur Hapa","doi":"10.1177/23259671251366417","DOIUrl":"10.1177/23259671251366417","url":null,"abstract":"<p><strong>Background: </strong>Hip arthroscopy effectively treats femoroacetabular impingement (FAI) to preserve joint function and alleviate symptoms. Joint space widths (JSWs) and ratios may predict surgical outcomes, especially in older patients.</p><p><strong>Purpose: </strong>To assess the relationship between the preoperative lateral-to-medial (L/M) ratio, the central-to-medial (C/M) ratio, and postoperative functional scores following arthroscopic treatment for FAI in patients aged ≥35 years.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who had primary hip arthroscopy for FAI between February 5, 2013, and June 1, 2022, with a minimum 2-year follow-up, were included and categorized into 2 age groups (≥35 years and <35 years). Radiographic measurements of JSW on plain anteroposterior pelvic radiographs were used to calculate L/M and C/M ratios. Patient-reported outcomes included the modified Harris Hip Score (mHHS) and visual analog scale for pain. Statistical analysis included chi-square, Mann-Whitney <i>U</i>, and Wilcoxon tests to compare categorical and continuous variables. The receiver operating characteristic (ROC) curve and area under the curve (AUC) assessed threshold values for L/M and C/M ratios predicting the Patient Acceptable Symptom State (PASS) for mHHS at 2 years.</p><p><strong>Results: </strong>A total of 110 patients (114 hips) were identified, comprising 56 hips from the older group (age ≥35 years) and 58 hips from the younger group (age <35 years). The ROC curve for preoperative C/M effectively distinguished between patients who achieved and did not achieve a second-year PASS value, with an AUC of 0.70 in older patients. Older patients, compared with younger, demonstrated lower postoperative mHHS (89 ± 10 vs 94 ± 8; <i>P</i> = .01) but similar rates of PASS achievement (75% vs 88%; <i>P</i> = .07). The C/M ratio was a significant predictor of functional outcomes in patients aged ≥35. Patients with a preoperative C/M ratio ≥1.08 achieved significantly better outcomes. No significant predictive value was found for L/M ratios in older patients or for L/M and C/M ratios in younger patients.</p><p><strong>Conclusion: </strong>Our study demonstrated that the central JSW is a sensitive prognostic indicator in older patients undergoing primary hip arthroscopy. A preoperative C/M ratio ≥1.08 correlates with higher rates of achieving PASS. Identifying preoperative predictors, such as the C/M JSW ratio, assists surgeons in determining patients (≥35 years) who are more likely to benefit from hip arthroscopy.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251366417"},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963791","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":"Biomechanical Properties of the All-Inside Anterior Cruciate Ligament Graft: A Scoping Review of Laboratory Evidence on Graft Configuration and Fixation.","authors":"Amirzeb Aurangzeb, Sir Young James Loh","doi":"10.1177/23259671251363592","DOIUrl":"10.1177/23259671251363592","url":null,"abstract":"<p><strong>Background: </strong>There are limited comparisons of graft configurations and fixation methods for the all-inside anterior cruciate ligament (ACL) technique based on a laboratory investigation.</p><p><strong>Purpose/hypothesis: </strong>This review aimed to evaluate the biomechanical data from controlled laboratory studies on different graft configurations and fixation methods in correlation to graft strength and stability in all-inside ACL reconstruction. It was hypothesized that graft configuration and supplementary fixation would significantly contribute to graft strength and stability.</p><p><strong>Study design: </strong>Scoping review.</p><p><strong>Methods: </strong>A literature search was conducted via PubMed on January 15, 2025, including studies that examined all-inside ACL graft techniques in a controlled biomechanical manner; reported data on stiffness and/or ultimate load to failure, and utilized cadaveric, porcine, or bovine tendons with cyclic loading and pull-to-failure testing protocols. A total of 150 studies were shortlisted before being narrowed down to 11 biomechanical studies, with descriptive statistical analysis performed.</p><p><strong>Results: </strong>This review demonstrated that quadrupled ACL grafts outperformed tripled grafts in stiffness and load to failure. Adjustable-loop devices provided robust primary fixation, while supplementary fixation further enhanced graft stability. Overall, 3 failure modes emerged: graft failure, fixation failure, and suture failure, directly linked to surgical technique choices. Findings established evidence-based benchmarks for optimizing all-inside ACL reconstruction outcomes.</p><p><strong>Conclusion: </strong>Our search and review demonstrated that a quadruple-folded graft with the side-to-side suturing technique, suspended by 2 adjustable-loop devices with additional tensioning and knot tying, and supplementary fixation with tibial reinforcement appears to offer the most stability. This has the potential to optimize functional recovery after ACL reconstruction via improved graft stability and reduced rerupture rates.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251363592"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963819","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":"Corrigendum to \"Comparative Analysis of 3D MRI and CT in Assessing Static Bone Loss and Dynamic Bipolar Interaction in Glenohumeral Instability\".","authors":"","doi":"10.1177/23259671251371068","DOIUrl":"10.1177/23259671251371068","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/23259671251343325.].</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 8","pages":"23259671251371068"},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963800","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}