Orthopaedic Journal of Sports Medicine最新文献

{"title":"Cephalomedullary Nail Fixation for Prophylactic Treatment of Incomplete Femoral Neck Stress Fractures in Athletes.","authors":"Christopher J McMellen, Margaret A Sinkler, Ethan Winter, Elika Fanaeian, John T Strony, Austin D Williams, Robert J Wetzel","doi":"10.1177/23259671251314442","DOIUrl":"10.1177/23259671251314442","url":null,"abstract":"<p><strong>Background: </strong>The traditional management of femoral neck stress fractures (FNSFs)-such as cannulated screw fixation-requires a period of protected weightbearing and does not provide fixed angle stability.</p><p><strong>Purpose: </strong>To report the technique and outcomes of a single surgeon's case series of prophylactic fixation of incomplete FNSFs using cephalomedullary nailing (CMN) followed by immediate weightbearing.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A retrospective review of 17 FNSFs treated using CMN by a single surgeon over 7 years was conducted. descriptive, injury, and treatment-related data were collected. Perioperative complications and recovery courses were included for each case. Descriptive statistics were used to summarize the characteristics, clinical presentation, diagnostic imaging findings, treatment details, and follow-up outcomes of the study population.</p><p><strong>Results: </strong>There were no perioperative complications across the 17 injuries. The mean intraoperative blood loss was 67 mL (range, 20-150 mL). In all 17 cases, immediate full weightbearing was recommended. All patients were able to initiate a return to running by 6 weeks postoperatively. Time until completion of narcotic use was noted for 15 cases, with narcotic medications no longer required at 2 weeks for 12 injuries (71%), at 6 weeks for 2 injuries (12%), and at 3 months for 1 injury (5.9%). Patients had a mean of 12.4 months of follow-up (range, 6-48 months). At the final follow-up, 5 cases (29%) had persistent pain-1 from gluteus medius tendinosis and 4 from painful distal interlocking screws. Two patients underwent the removal of symptomatic hardware.</p><p><strong>Conclusion: </strong>This study demonstrated that prophylactic fixation of FNSFs with CMN in endurance athletes is a safe and effective construct that permits early return to baseline impact activity because of the inherent stability of the construct, with a favorable complication profile-although with a 30% rate of persistent pain from the surgical site.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251314442"},"PeriodicalIF":2.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483739","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":"Systematic Video Analysis of ACL Injuries in Male Professional English Soccer Players: A Study of 124 Cases.","authors":"Francesco Della Villa, Matthew Stride, Antonio Bortolami, Andy Williams, Michael Davison, Matthew Buckthorpe","doi":"10.1177/23259671251314642","DOIUrl":"10.1177/23259671251314642","url":null,"abstract":"<p><strong>Background: </strong>Improving our understanding of the situations and biomechanics that result in anterior cruciate ligament (ACL) injury will support the design of effective injury risk mitigation programs. A few video analyses have been published in recent years, but not specifically involving English soccer.</p><p><strong>Purpose: </strong>To describe the mechanisms, situational patterns, and biomechanics (kinematics) of ACL injuries of players involved in matches involving teams in the top 2 tiers of professional English soccer (the Premier League and the Championship).</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>We identified 148 consecutive ACL injuries across 11 seasons of professional English soccer. Overall, 124 (84%) injury videos were analyzed for mechanism and situational patterns, while biomechanical analysis was possible in 91 injuries. Three independent reviewers evaluated each video. ACL injury epidemiology (month, timing within the match, and location on the playing field at the time of injury) was also reported.</p><p><strong>Results: </strong>More injuries occurred in defensive (n = 79; 64%) than offensive (n = 45; 36%) playing situations; 24 (19%) injuries were direct contact, 52 (42%) indirect contact, and 47 (38%) noncontact. Of the indirect and non-contact ACL injuries (n = 100), most (91%) occurred during 4 main situational patterns: (1) pressing/tackling (n = 50; 50%); (2) being tackled (n = 18; 18%), (3) landing from a jump (n = 13; 13%), and (4) regaining balance after kicking (n = 10; 10%). These injuries generally involved a knee flexion strategy (with minimal hip/trunk flexion and reduced plantarflexion) in the sagittal plane and appearance of knee valgus in most cases (70%; 96% of identifiable cases). More (n = 71; 57%) injuries occurred in the first half of matches than in the second half (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Indirect contact rather than noncontact was the main ACL injury mechanism in male elite English soccer players. Four main situational patterns were described, with pressing/tackling and being tackled accounting for two-thirds of all indirect and noncontact injuries. Biomechanical analysis confirmed a multiplanar mechanism, with knee loading patterning in the sagittal plane accompanied with dynamic valgus. More injuries occurred in the first half of matches.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251314642"},"PeriodicalIF":2.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483771","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":"Tear Pattern of the Complete Discoid Lateral Meniscus According to Meniscal Morphology.","authors":"Ho Yeon Kim, Jong-Min Kim, Bum-Sik Lee, Jaejung Ryu","doi":"10.1177/23259671241306842","DOIUrl":"10.1177/23259671241306842","url":null,"abstract":"<p><strong>Background: </strong>The pattern and distribution of tears for the complete discoid lateral meniscus (DLM) are not well documented.</p><p><strong>Purpose: </strong>To investigate the prevalence and pattern of tear types for the complete DLM using magnetic resonance imaging (MRI) and arthroscopic data.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>We reviewed consecutive series of 1219 patients (1406 knees) who underwent arthroscopic knee surgery for any pathology and were diagnosed with DLM between January 1998 and December 2022. After excluding cases with incomplete DLM (774 knees) and previous history of ipsilateral knee surgery (55 knees), a total of 486 patients (577 knees; mean age, 37.4 years; range, 5-76 years) with complete DLM were evaluated. Preoperative MRI and intraoperative arthroscopic findings were analyzed to classify tears into the following: peripheral tear-including bucket-handle tear; horizontal tear; radial tear; flap tear; and no tear. In addition, preoperative MRI was used to categorize 2 distinct morphological variants of complete DLM: (1) a block-shaped type with a thick blunt free edge; and (2) a wedge-shaped type with a tapering sharp free edge.</p><p><strong>Results: </strong>When categorized by meniscal morphology, 435 knees (75.4%) were classified as block-type and 142 knees (24.6%) as wedge-type complete DLM. Peripheral tears (66.7%) were the most prevalent in the block type, followed by horizontal tears (22.5%) and radial tears (0.7%). In the wedge type, horizontal tears (43%) were observed most frequently, followed by radial tears (18.3%), peripheral tears (11.3%), and flap tears (5.6%).</p><p><strong>Conclusion: </strong>A block-shaped morphology was the predominant form of complete DLM in this cohort of operatively treated patients. The wedge-type morphology had a distinctly different tear pattern, with horizontal tears being the most common. While the block type exhibited either a peripheral or horizontal tear, the wedge type was characterized by a greater variation in tear pattern.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241306842"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483773","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":"Is There a Hamstring Autograft Diameter Threshold for Anterior Cruciate Ligament Reconstruction?","authors":"Raffy Mirzayan, Richard N Chang, Kathryn E Royse, Chelsea E Reyes, Heather A Prentice, Gregory B Maletis","doi":"10.1177/23259671241305427","DOIUrl":"10.1177/23259671241305427","url":null,"abstract":"<p><strong>Background: </strong>Hamstring autograft (HA) is a popular graft for anterior cruciate ligament reconstruction (ACLR). Although multiple studies have demonstrated that increasing the graft diameter decreases the risk of failure or revision surgery, the exact minimum graft diameter remains controversial, with the unofficial standard being 8 mm.</p><p><strong>Purpose: </strong>To evaluate the risk of aseptic revision after HA-ACLR in patients aged ≤25 years, comparing graft diameters of (1) <8 versus ≥8 mm and (2) ≤8 versus >8 mm. A secondary purpose was to determine whether there was a threshold for graft diameter that best identifies patients at a higher risk of aseptic revision.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 5972 primary HA-ACLRs were identified using data from the ACLR registry of Kaiser Permanente. Propensity score-weighted Cox regression was used to evaluate revision risk for HAs with <8 versus ≥8 mm diameter and with ≤8 versus >8 mm diameter. An effect plot and receiver operating characteristic curve and area under the curve (AUC) analysis were also created to model the probability of revision based on the HA diameter to determine whether there was a specific diameter threshold to minimize revision risk.</p><p><strong>Results: </strong>In the propensity score-weighted Cox model, <8 mm autografts had a higher risk of aseptic revision compared with ≥8 mm autografts (hazard ratio [HR], 1.32 [95% CI, 1.01-1.71]; <i>P</i> = .039); a higher risk was also observed when comparing ≤8 to >8 mm grafts (HR, 1.32 [95% CI, 1.06-1.66]; <i>P</i> = .015). In receiver operating characteristic analysis, an HA diameter that best identified patients at a higher risk for revision after ACLR could not be identified (AUC, 0.56). However, the adjusted effect plot showed a direct decrease in revision risk with each increasing increment in graft size.</p><p><strong>Conclusion: </strong>A 32% higher risk of revision was observed in smaller graft diameter groups (<8 or ≤8 mm) compared with larger graft sizes (≥8 or >8 mm), regardless of specific diameter cutoff. In a cohort of almost 6000 HA-ACLR, the authors were unable to determine a definitive minimum graft diameter threshold that should be used.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241305427"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543042","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 Biomechanical Performance of Tibial Spine Fracture Repair With Suture and Anchor Fixation in Pediatric Cadaveric Knees.","authors":"Thomas M Johnstone, Ian Hollyer, Kelly McFarlane, Amin Alayeh, Marc Tompkins, Theodore Ganley, Yi-Meng Yen, Henry B Ellis, Calvin K Chan, Daniel W Green, Seth L Sherman, Kevin G Shea","doi":"10.1177/23259671241306194","DOIUrl":"10.1177/23259671241306194","url":null,"abstract":"<p><strong>Background: </strong>Prior studies in porcine and adult human bone suggest that suture fixation is superior to screw fixation of pediatric tibial spine fractures (TSFs). However, we have previously demonstrated that 2-suture repair was biomechanically comparable with 2-screw repair in human pediatric cadaveric knees.</p><p><strong>Purpose: </strong>To evaluate whether TSF fixation with sutures attached to anchors placed in stronger metadiaphyseal bone would produce biomechanically superior repair to 2-screw and 2-suture constructs.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Six pediatric cadaveric knees were acquired. We applied the same TSF creation protocol used in our previous study, then repaired the fractures by passing 2 No. 2 FiberWire sutures through the fracture fragment and the base of the anterior cruciate ligament, with sutures passed through bony tunnels and secured to two 2.8-mm anchors in the metadiaphyseal cortex. This construct of suture plus suture anchor (suture anchor group) underwent the same biomechanical loading protocol used in our prior study, in which pediatric knees were randomly assigned to either screw fixation (n = 6; fractures reduced with two 4.0-mm cannulated screws and washers) or suture fixation (n = 6; fractures repaired as in the suture anchor group except the sutures were tied across a metaphyseal bony bridge after their exit from the bony tunnels). All specimens were mounted in flexion and biomechanically tested with cyclic loading followed by a load-to-failure test. New data were statistically compared with the prior study's results.</p><p><strong>Results: </strong>The suture anchor group had a median age of 9.00 years, while the screw and suture groups had identical median ages (8.50 years). All groups had an identical number of samples of each laterality. The ultimate failure load differed significantly across fixation methods (<i>P</i> = .006), primarily driven by higher ultimate failure loads in the suture anchor group (225.50 ± 46.46 N) when compared with the screw group (143.52 ± 41.97 N; <i>P</i> = .01) and suture group (135.35 ± 47.94 N; <i>P</i> = .009).</p><p><strong>Conclusion: </strong>TSF fixation with sutures tied to metadiaphyseal suture anchors provided significantly stronger repair than 2-suture and 2-screw constructs.</p><p><strong>Clinical relevance: </strong>The suture anchor fixation method for TSF may offer enhanced stability and durability to reduce the risk of postoperative complications while improving functional patient outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241306194"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483762","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":"Reason Profiles for not Returning to Preinjury Activity Level Following Anterior Cruciate Ligament Reconstruction- A Latent Class Analysis With Subgroup Comparison of Patient-Reported Outcome Measures.","authors":"Joseph D Lamplot, Erich J Petushek, Camryn B Petit, Shayla M Warren, Kim D Barber Foss, Alexis B Slutsky-Ganesh, Melanie Valencia, Charles D Kenyon, April L McPherson, John W Xerogeanes, Gregory D Myer, Jed A Diekfuss","doi":"10.1177/23259671241300300","DOIUrl":"10.1177/23259671241300300","url":null,"abstract":"<p><strong>Background: </strong>Given the high proportion of athletes who do not return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR), strategies are needed to identify at-risk patients and optimize rehabilitation for successful RTS after ACLR.</p><p><strong>Purpose/hypothesis: </strong>This study used latent class analysis (LCA) to characterize a unique clustering of reasons why athletes do not return to their preinjury activity level after ACLR. We hypothesized that patients with high pain scores and high levels of fear would be less likely to return to their preinjury activity level.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>All patients at a single institution who underwent primary ACLR between 2005 and 2021 were contacted to complete a survey via REDCap. Patients' ability to RTS and their preinjury activity level, reasons for inability to return to the preinjury activity level, and patient-reported outcome scores were collected from 981 patients. LCA was performed to identify and compare patterns among patients' reasons for not returning to the preinjury activity level.</p><p><strong>Results: </strong>Of the 981 patients included, only 446 (45.5%) were fully able to return to their preinjury activity level. LCA categorized patients into 3 groups based on their reasons for not returning to preinjury activity levels: a high-function group (75.5%), which reported no barriers; a multisymptom group (16.1%), which cited pain, lack of strength, and instability; and a fear-limited group (8.4%), which reported fear as the sole reason. Among the high-function group, 86.2% reported RTS compared with <36.7% in the other classes. There was no difference in Knee injury and Osteoarthritis Outcome Score (KOOS) subscales-including Pain, Symptoms, or Activities of Daily Living-between the high-function and fear-limited groups; however, the multisymptom group presented with the lowest scores in all KOOS subscales (<i>P</i> < .001). In addition, patient characteristics, the time from the index ACLR to the follow-up, and subsequent revision ACLR were similar between groups; however, the multisymptom profile demonstrated the highest proportion of allograft ACLR (<i>P</i> = .04) and secondary ipsilateral surgery (<i>P</i> < .001). Overall subjective knee grade (1-100) and Marx scores were highest in the high-function group, followed by fear-limited and multisymptom groups (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Patients were differentiated into 3 distinct classes after primary ACLR. Furthermore, those with patient-reported characteristics of pain, lack of strength, instability, or fear were significantly less likely to return to their preinjury activity level or sport.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241300300"},"PeriodicalIF":2.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542790","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":"Investigating the Impact of Preoperative Kinesiophobia and Pain on Postoperative Gait Biomechanics Following Anterior Cruciate Ligament Injury.","authors":"Caroline Lisee, Shelby Baez, Elizabeth Bjornsen, Louise Thoma, Troy Blackburn, Jeffrey T Spang, R Alexander Creighton, Ganesh Kamath, Jessica Hu, Brian Pietrosimone","doi":"10.1177/23259671241301376","DOIUrl":"10.1177/23259671241301376","url":null,"abstract":"<p><strong>Background: </strong>Aberrant gait biomechanics-ie, lower knee abduction moment (KAM) impulse- are linked to the development of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). There is a clinical need to identify modifiable factors, such as kinesiophobia and pain, that may contribute to aberrant gait development after ACLR to advance multimodal rehabilitation strategies.</p><p><strong>Purpose/hypothesis: </strong>This study aimed to determine associations between preoperative kinesiophobia and pain and gait biomechanics linked to posttraumatic osteoarthritis development at 2 and 4 months after ACLR. We hypothesized that worse preoperative kinesiophobia and pain would be associated with lower KAM impulses in the ACLR limb but not the uninjured limb at 2 and 4 months after ACLR.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 2.</p><p><strong>Methods: </strong>Patients within 6 weeks of ACL injury and planning to undergo ACLR with bone-patellar tendon-bone autografts were recruited for the study. Preoperatively, participants completed the Tampa Scale of Kinesiophobia (TSK-11) and Knee injury and Osteoarthritis Outcome Score Pain (KOOS Pain) subscale surveys to assess kinesiophobia (ie, psychological component to pain) and knee pain, respectively. Participants returned at 2 and 4 months after ACLR to complete a 3-dimensional gait biomechanics analysis. KAM impulses during the stance phase were calculated (N*m*s/N*m) for both limbs. Associations of preoperative TSK-11 and KOOS Pain scores with KAM impulses in ACLR and uninjured limbs were analyzed using separate linear regressions.</p><p><strong>Results: </strong>A total of 36 participants (58% women; mean age, 21.4 ± 4.31 years; body mass index, 24.1 ± 3.59 kg/m² ) completed 3 study visits. Higher preoperative kinesiophobia was associated with lower KAM impulses in the ACLR limb (<i>R</i> ² = 0.14; <i>P</i> = .02) but not the uninjured limb (<i>R</i> ² = 0.01; <i>P</i> = .58) at 4 months after ACLR. Preoperative KOOS Pain scores were not associated with KAM impulses in the ACLR and uninjured limbs at 2 and 4 months after ACLR (Δ<i>R</i> ² range, <0.01-0.02; <i>P</i> range = .53-.90).</p><p><strong>Conclusion: </strong>Preoperative kinesiophobia, but not pain, was weakly associated with lower KAM impulses during early to midphases of clinical recovery at 4 months after ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241301376"},"PeriodicalIF":2.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543041","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":"Differences in the Association Between Medial Meniscus Tears and Focal Cartilage Lesions According to Tear Configuration.","authors":"Taehyeon Jeon, Jong-Min Kim, Bum-Sik Lee, Seong-Il Bin, Jongjin Lee, Kinam Bae, Donghyok Kim","doi":"10.1177/23259671241302782","DOIUrl":"10.1177/23259671241302782","url":null,"abstract":"<p><strong>Background: </strong>There are no statistical analyses on the association between the configuration of medial meniscus tears and the location of focal cartilage lesions.</p><p><strong>Purpose: </strong>To investigate the association between the configuration of medial meniscus tears and focal cartilage lesions and analyze whether the location of medial meniscus tears corresponds with that of focal cartilage lesions.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The authors retrospectively evaluated the medical records of 317 patients with isolated medial meniscus tear who underwent arthroscopic surgery from January 2016 to December 2020. The configuration of the medial meniscus tear was determined based on the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification. Patients with flap, radial, and longitudinal tears were included in the vertical tear group. For subgroup analysis, vertical tears were divided into medial meniscus posterior root tears and remaining tears. The location of the medial meniscus tear was categorized as anterior, middle, or posterior according to the ISAKOS classification. The cartilage of the medial femoral condyle (MFC) and that of the medial tibial condyle (MTC) were divided into 6 and 4 zones, respectively, and the location of cartilage lesions on the MFC and MTC was evaluated by preoperative magnetic resonance imaging.</p><p><strong>Results: </strong>There was a higher incidence of focal cartilage lesions with vertical versus horizontal medial meniscus tears (<i>P</i> < .001). For middle and posterior vertical tears with focal cartilage lesions, there was a significant concordance in location between the tear and the lesion (<i>P</i> < .001). In a subgroup analysis of medial meniscus posterior root tears, there was significantly more discordance in location between the tear and the lesion with medial meniscus posterior root tears (23/26 tears; 88.5%) compared with the remaining vertical tears (60/177 tears; 33.9%) (<i>P</i> < .001); instead, the focal cartilage lesions were mainly distributed in the lateral anterior and central portions of both the MFC and MTC.</p><p><strong>Conclusion: </strong>Vertical tears of the medial meniscus were significantly associated with the presence of focal cartilage lesions, whereas horizontal tears were not. Additionally, middle and posterior vertical tears with focal cartilage lesions showed significant concordance in location between the tear and the lesion.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241302782"},"PeriodicalIF":2.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543040","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":"Current Methods Used to Evaluate Glenoid Bone Loss: A Survey of Orthopaedic Surgeons.","authors":"Hailey Huddleston, Kevin Credille, Zachary Wang, William Cregar, Drew Anderson Lansdown, Jorge Chahla, Grant E Garrigues, Nikhil N Verma, Adam B Yanke","doi":"10.1177/23259671241288163","DOIUrl":"10.1177/23259671241288163","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of glenoid bone loss is critical in preoperative planning, as bone loss >13.5% has been associated with worse clinical outcomes. While 3-dimensional computed tomography (3D CT) and the Pico method have been the gold standard in bone loss evaluation, it is unclear how most orthopaedic surgeons evaluate for bone loss in practice.</p><p><strong>Purpose: </strong>To investigate the techniques used by orthopaedic surgeons to measure glenoid bone loss.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A 12-question survey was sent to members of the AOSSM and Arthroscopy Association of North America. This survey included questions regarding the participants' demographic information, typical surgical practice and volume, and glenoid bone loss identification method. Friedman testing with multiple comparisons using Bonferroni correction was used to evaluate the ordinal variable, use frequency, while Kruskal-Wallis testing and Spearman correlations were used to evaluate the role of surgeon demographic factors on method usage.</p><p><strong>Results: </strong>Overall, 171 orthopaedic surgeons responded to the survey. Participating surgeons were from a variety of locations, practice settings, and years in practice; 91.1% of respondents said that they routinely measure glenoid bone loss. The imaging modality most commonly used for bone loss evaluation was 3D CT, followed by 2-dimensional (2D) magnetic resonance imaging, then 2D CT and radiographs. Percentage diameter loss was the most commonly used method of bone loss evaluation. The intraoperative probe length method was used occasionally, the Pico method was used rarely, and the chord length method was never used. There was no significant effect of time in practice or practice location on bone loss methods used. Surgeons in private practice (<i>P</i> = .022) or other settings (<i>P</i> = .015) had a higher frequency of using the intraoperative probe length method compared with those in the military.</p><p><strong>Conclusion: </strong>Overall, this study highlights the inconsistency in surgeon evaluation of glenoid bone loss in shoulder instability, despite good evidence of its clinical importance, especially in preventing recurrent instability. This lack of consistency may be mitigated with the establishment of best practice guidelines or accepted algorithms for evaluation and assessment of glenoid bone loss in shoulder instability.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241288163"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449679","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":"Smaller Width Quadriceps Tendon Grafts Maintain Advantageous Biomechanical Properties for ACL Reconstruction.","authors":"Richard C Lee, Steven D Voinier, Conor F McCarthy, Donald F Colantonio, Shawn M Gee, Christopher J Tucker, Melvin D Helgeson, Nicholas P Lopreiato","doi":"10.1177/23259671251318014","DOIUrl":"10.1177/23259671251318014","url":null,"abstract":"<p><strong>Background: </strong>Despite clinical evidence of risks in knee arthrofibrosis and graft impingement with larger grafts, the optimal size for quadriceps tendon (QT) autografts in anterior cruciate ligament reconstruction (ACLR) has not been established.</p><p><strong>Purpose/hypothesis: </strong>This study aimed to evaluate the mechanical properties of full-thickness 6-mm and 8-mm wide QT grafts compared with 10-mm patellar tendon (PT) and 10-mm QT grafts. The hypothesis was that both the 6- and 8-mm QT grafts would exhibit similar or superior ultimate tensile strength compared with the 10-mm PT graft.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 18 matched pairs of cadaveric knees were used in this study. From each pair, a 10-mm wide full-thickness QT was harvested from 1 knee. Based on randomization, a 6-mm wide or 8-mm wide full-thickness QT along with a 10-mm wide PT were harvested from the contralateral knee. Each tendon was clamped, tensioned, and cycled on a servohydraulic testing machine before final loading to failure.</p><p><strong>Results: </strong>The ultimate failure load was 1286 ± 237.3 N for the 10-mm QT, 1056 ± 226.7 N for the 8-mm QT, 935.1 ± 283.8 N for the 6-mm QT, and 816 ± 192.7 N for the 10-mm PT. Ultimate tensile strength differed significantly between the 10-mm and 8-mm QT (<i>P</i> = .004), 10-mm and 6-mm QT (<i>P</i> < .001), 10-mm QT and 10-mm PT (<i>P</i> < .001), and 8-mm QT and 10-mm PT grafts (<i>P</i> < .001), but not between the 6-mm QT and 10-mm PT grafts (<i>P</i> = .152).</p><p><strong>Conclusion: </strong>The 8-mm QT had higher ultimate tensile strength than the 10-mm PT, and the 6-mm QT was comparable to the 10-mm PT. Full-thickness QT grafts <10 mm in width may maintain sufficient tensile strength for ACLR.</p><p><strong>Clinical relevance: </strong>Given these biomechanical properties, smaller QT graft sizes may be advantageous in minimizing arthrofibrosis risk while maintaining graft strength.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251318014"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449712","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}