Matthew P Kolevar, Evan L Honig, Michael S Rocca, Samir Kaveeshwar, Andrew Tran, Jacob T Hartline, Natalie L Leong, Jonathan D Packer, R Frank Henn, Sean J Meredith
{"title":"Patient-Reported Outcomes Associated With \"Completely Better\" Status at 2 Years After Hip Arthroscopy.","authors":"Matthew P Kolevar, Evan L Honig, Michael S Rocca, Samir Kaveeshwar, Andrew Tran, Jacob T Hartline, Natalie L Leong, Jonathan D Packer, R Frank Henn, Sean J Meredith","doi":"10.1177/23259671241266642","DOIUrl":"10.1177/23259671241266642","url":null,"abstract":"<p><strong>Background: </strong>Measures such as the Patient Acceptable Symptom State and minimum clinically important difference have been used to contextualize patient-reported outcomes (PROs). Assessment of patients' perception of being \"completely better\" (CB) after hip arthroscopy has not been studied.</p><p><strong>Purposes: </strong>To (1) determine the prevalence and characteristics of patients who report being CB at 2 years after hip arthroscopy; (2) determine whether PROs measuring function, pain, and mental health are associated with CB status; and (3) determine threshold values for PROs predictive of achieving CB status.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients undergoing hip arthroscopy at a single institution from October 2015 to January 2020 were administered electronic surveys assessing sociodemographic variables and PROs at baseline and 2 years postoperatively. The CB anchor question was \"<i>Is the condition for which you underwent surgery completely better now?</i>\" Threshold values for PROs associated with achieving CB status at 2 years postoperatively were identified with 90% specificity. Variables with an area under the curve of >0.80 on a receiver operating characteristic curve were selected for multivariate analysis.</p><p><strong>Results: </strong>Overall, 29 of 62 patients (47%) achieved CB status. There were no differences in age, sex, body mass index, race, prior hip surgery, preoperative opioid use, smoking status, or preoperative expectations between the CB and no-CB groups. The CB group had better 2-year postoperative and pre- to postoperative change values on all PROs (<i>P</i> < .05 for all) except for the Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Numeric Pain Scale (NPS) for whole-body pain. Two-year postoperative PRO thresholds for achieving CB status were determined as PROMIS-Physical Function (PF) ≥51.3 or increase in PROMIS-PF ≥12 points, PROMIS-Pain Interference ≤46.6 or decrease in PROMIS-Pain Interference ≥12.2 points, NPS for operative hip pain of ≤1.0, Musculoskeletal Outcomes Data Evaluation and Management System-expectations met ≥95.0, and Surgical Satisfaction Questionnaire (SSQ-8) ≥87.5. Multivariate analysis demonstrated that higher SSQ-8 score and greater improvement on the PROMIS-PF were independent predictors of achieving CB status.</p><p><strong>Conclusion: </strong>Almost half of the study patients perceived being CB at 2 years after hip arthroscopy. Multiple postoperative PROs scores were associated with achieving CB status.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241266642"},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813459","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}
Michel Meisterhans, Christoph Zindel, Bastian Sigrist, Sandro F Fucentese, Lazaros Vlachopoulos
{"title":"Optimizing Reduction Guide Stability in Osteotomy Using Patient-Specific Instrumentation: A Basic Guideline.","authors":"Michel Meisterhans, Christoph Zindel, Bastian Sigrist, Sandro F Fucentese, Lazaros Vlachopoulos","doi":"10.1177/23259671241275124","DOIUrl":"10.1177/23259671241275124","url":null,"abstract":"<p><strong>Background: </strong>The use of patient-specific instruments (PSIs) for osteotomies is becoming more popular in orthopaedic surgery for correcting mechanical axis and posttraumatic deformities. However, the PSI reduction guides have great potential for intraoperative deformation, which adversely affects the accuracy of the procedure.</p><p><strong>Purpose: </strong>To conduct a finite element analysis (FEA) to analyze different design parameters to improve the intraoperative stability of the reduction guides.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A reduction guide with a rectangular cross section and four 4-mm K-wire slots was simplified, and the following parameters were modified: width, height, profile design, K-wire thickness, and positions. Bending and torsional moments were applied to the guide construct and guide deformation and equivalent stress were determined using FEA.</p><p><strong>Results: </strong>Increasing the profile height by 25% resulted in a 44% reduction in guide deformation for bending (37% for torsion). A 25% increase in profile width led to an 18% deformation reduction for bending (22% for torsion). Transverse K-wire slots resulted in 51% less deformation in torsion compared with longitudinally oriented slots. Placing the central K-wire slots 25% closer to the osteotomy reduced guide deformation by 20% for bending and 11% for torsion.</p><p><strong>Conclusion: </strong>The most effective methods to increase reduction guide stability are to increase the guide height and reduce the central K-wire distance to the osteotomy.</p><p><strong>Clinical relevance: </strong>When performing opening or closing wedge osteotomies, which mainly involve bending of the guide, a high-profile guide and longitudinally oriented K-wire slots should be used. When torque is expected as in rotational osteotomies, the K-wire holes in guides should be oriented transversely to reduce intraoperative deformation.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241275124"},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812994","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}
Ryne Jenkins, John Bianchi, Jeremy Watson, Jason Shinners, Pooja Jaisinghani, Brett Spain, Charles Ruotolo
{"title":"Risk and Prognosis of Hamstring Injuries in the National Football League: A 12-Year Review.","authors":"Ryne Jenkins, John Bianchi, Jeremy Watson, Jason Shinners, Pooja Jaisinghani, Brett Spain, Charles Ruotolo","doi":"10.1177/23259671241298622","DOIUrl":"10.1177/23259671241298622","url":null,"abstract":"<p><strong>Background: </strong>Hamstring injuries can have a significant burden on a professional football player's career and performance. One in 4 players will suffer a lower extremity strain in their career, with the hamstring being the most common. These injuries are often fraught with extended periods of recovery and reinjury rates varying between 16% and 38%.</p><p><strong>Purpose: </strong>To determine the progression and duration of hamstring injury as well as risk factors and probability of reinjury in the National Football League (NFL).</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Data were extracted from the official publicly accessible NFL database of injuries. NFL players suffering a hamstring injury during the study period of 2008-2020 were identified. Injuries were reported weekly as mandated by the NFL. Players were deemed cleared from injury when no longer listed in the injury report (IR). Reinjury was defined as any subsequent hamstring injury after a player's initial injury. The duration of injury and factors associated with injury were analyzed. Secondary objectives included team-specific injury rates and timing of injury.</p><p><strong>Results: </strong>A total of 2101 hamstring injuries occurred among 1354 players. The mean duration of the IR was 2.4 ± 2.1 weeks. A total of 442 (33%) players suffered subsequent reinjury, 27% of which occurred during the same season. The mean duration on the IR for reinjury was 2.4 ± 1.8 weeks, with no significant difference in duration compared with initial injury (2.4 <b>±</b> 1.8 vs 2.2 <b>±</b> 1.7; <i>P</i> = .138). Defensive skill players were most frequently injured (50.4%) followed by offensive skill players (37.7%). Of the 4812 total IR listings, 1806 (38%) did not participate in practice. A total of 1590 (33.5%) had limited participation in practice, and 1353 (28.5%) had full participation in practice. Injury rates among teams varied and ranged from 0.6% (Baltimore Ravens) to 5.7% (Houston Texans), with a median of 3.1% (<i>P</i> < .0001).</p><p><strong>Conclusion: </strong>Hamstring injuries can have a lasting impact on a player's career with more than a third of players suffering subsequent reinjury. Although suffering a hamstring injury predisposes a player to reinjury, previous injury was not associated with longer recovery times. Rates of injury among organizational teams vary; thus, further research to understand the difference in preventive measures and treatment protocols may be warranted.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298622"},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801959","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}
Diego Gonzalez-Morgado, Tammy R Hoffman, Javier Ardebol, Matthew B Noble, Lisa A Galasso, Matthew Nugent, Cameron Phillips, Patrick J Denard
{"title":"Comparison of Clinical Outcomes Between Arthroscopic Rotator Cuff Repair and Reverse Total Shoulder Arthroplasty in Patients With Massive Rotator Cuff Tears and High-Grade Fatty Atrophy Without Glenohumeral Osteoarthritis.","authors":"Diego Gonzalez-Morgado, Tammy R Hoffman, Javier Ardebol, Matthew B Noble, Lisa A Galasso, Matthew Nugent, Cameron Phillips, Patrick J Denard","doi":"10.1177/23259671241298664","DOIUrl":"10.1177/23259671241298664","url":null,"abstract":"<p><strong>Background: </strong>Despite the effectiveness of reverse total shoulder arthroplasty (RSA) and arthroscopic rotator cuff repair (ARCR) for treating massive rotator cuff tears (MRCTs), controversies remain in patients without glenohumeral osteoarthritis (GHOA).</p><p><strong>Purpose: </strong>To compare clinical outcomes of ARCR or RSA in patients with MRCT with high-grade fatty atrophy without GHOA.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This was a retrospective study on patients with MRCTs without GHOA and with grades 3 or 4 Goutallier muscle changes who underwent ARCR or RSA, with a minimum 2-year follow-up. Range of motion (ROM) and patient-reported outcomes (PROs) were collected-including visual analog scale for pain, American Shoulder and Elbow Surgeons score, Veterans Rand 12-Item Health survey, and Subjective Shoulder Value. Postoperative results were compared based on rotator cuff tendon healing in the ARCR group.</p><p><strong>Results: </strong>A total of 81 patients met the study criteria-56 underwent ARCR and 25 underwent RSA. Patients in the RSA (age, 71.7 ± 7.7 years) group were older than those in the ARCR (age, 66.7 ± 7.4 years) group (<i>P</i> = .01) and more likely to have pseudoparalysis (52% vs 21.4%; <i>P</i> = .016). The mean follow-up for the ARCR and RSA groups was 56.5 ± 19 months and 36.1 ± 7.6 months, respectively (<i>P</i> < .001). The rate of patients with ≥2 tendons with grade 3 or 4 changes was higher in the RSA group compared with the ARCR group: 96% versus 47% (<i>P</i> < .001). PROs significantly improved after surgery in both groups (<i>P</i> < .05). Postoperative forward flexion (FF) and internal rotation were higher after ARCR compared with RSA-144°± 22° versus 113°± 25° and L3 ± L4 versus S1 ± S2, respectively (<i>P</i> <.001 and <i>P</i> = .002, respectively). Also, 31 of the rotator cuff repairs (55%) healed. PROs were similar between the healed and unhealed ARCR groups, with the only difference observed in postoperative FF-150°± 18° in the healed group versus 136°± 26° in the unhealed group (<i>P</i> = .044).</p><p><strong>Conclusion: </strong>Both ARCR and RSA improved functional outcomes in patients with MRCT without GHOA. While healing was moderate after ARCR, the postoperative ROM was greater after ARCR compared with RSA in appropriately selected patients. Moreover, healed rotator cuffs demonstrated improved postoperative FF compared with unhealed repairs.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298664"},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801958","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}
Eli M Snyder, Kyle K Obana, Abed Abdelaziz, Robert L Parisien, Christopher S Ahmad, Charles A Popkin, David P Trofa
{"title":"Decreasing Incidence of Youth Wrestling Injuries: A 10-Year Analysis of National Injury Data.","authors":"Eli M Snyder, Kyle K Obana, Abed Abdelaziz, Robert L Parisien, Christopher S Ahmad, Charles A Popkin, David P Trofa","doi":"10.1177/23259671241297988","DOIUrl":"10.1177/23259671241297988","url":null,"abstract":"<p><strong>Background: </strong>Wrestling is among the most common youth sports in the United States, with about 260,000 high school participants annually. There is a lack of literature investigating wrestling injury profiles and mechanisms of injuries. In the past 15 years, urgent care utilization has increased, and National Federation of State High School Associations (NFHS) concussion protocols have been developed and implemented.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to analyze causes, diagnoses, body parts, and trends associated with wrestling injuries presenting to US emergency departments. It was hypothesized that there would be (1) decreased overall injuries presenting to emergency departments because of increased urgent care utilization and (2) decreased concussions because of the NFHS rule implementation and revision.</p><p><strong>Study design: </strong>Descriptive epidemiology study; Level of evidence, 3.</p><p><strong>Methods: </strong>Youth wrestling injuries presenting to US emergency departments between January 1, 2013, and December 31, 2022, were queried from the National Electronic Injury Surveillance System database. The data included date of presentation, age, sex, race, body part, injury diagnosis, disposition, and a brief injury narrative. National estimates (NE) were calculated using the associated statistical weight of the reporting hospital. Linear regressions were performed to investigate the relationship between year and NE for overall injuries, diagnoses, body parts, mechanisms of injury, and other subanalyses. Statistical significance was set at <i>P</i> < .05.</p><p><strong>Results: </strong>A total of 8628 (NE = 296,502) wrestling injuries met the inclusion criteria for this study. The mean age at presentation was 14.3 ± 2.6 years (range, 3 to 18 years). The shoulder (NE = 43,207 [14.6%]), head (NE = 40,875 [13.8%]), and knee (NE = 30,218 [10.2%]) were the most injured body parts. The most common diagnoses were strain/sprain (NE = 91,924 [31%]), other/not stated (NE = 53,736 [18.1%]), and fracture (NE = 52,261 [17.6%]). Common mechanisms of injury included not specified (NE = 148,169 [50%]), impact with mat (NE = 61,557 [20.8%]), and abnormal rotation/strain (NE = 37,449 [12.6%]). Overall injuries (<i>P</i> = .01) (coefficient: -1763 [95% CI, -2963 to -563]) and concussions (<i>P</i> = .01) (coefficient: -178 [95% CI, -302 to -55]) statistically significantly decreased.</p><p><strong>Conclusions: </strong>Our study showed a trend in the decrease in overall injuries and concussions in high school wrestlers. Strains/sprains were the most common diagnoses with the shoulder being the most common site. Youth wrestlers would benefit from future research analyzing risks associated with these injuries as well as advances in protective gear.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241297988"},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786340","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}
Stefan Schneider, Robert Ossendorff, Sebastian G Walter, Moritz Berger, Christoph Endler, René Kaiser, Ansgar Ilg, Gian M Salzmann, Johannes Holz
{"title":"Arthroscopic Autologous Minced Cartilage Implantation of Cartilage Defects in the Knee: A 2-Year Follow-up of 62 Patients.","authors":"Stefan Schneider, Robert Ossendorff, Sebastian G Walter, Moritz Berger, Christoph Endler, René Kaiser, Ansgar Ilg, Gian M Salzmann, Johannes Holz","doi":"10.1177/23259671241297970","DOIUrl":"10.1177/23259671241297970","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic cartilage defects of the knee joint are frequently diagnosed and can be treated with different available surgical methods. Nevertheless, there is currently no gold standard treatment for all indications. Minced cartilage implantation is increasingly coming into focus as a refined surgical technique.</p><p><strong>Purpose: </strong>To investigate the 2-year clinical and radiological outcomes of arthroscopic autologous minced cartilage repair with the standardized commercial implantation system AutoCart.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A total of 62 consecutive patients were included and prospectively evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively. Outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Single Assessment Numeric Evaluation (SANE), and Tegner activity scale at all follow-up time points. The examination of preoperative magnetic resonance imaging (MRI) was performed using the Area Measurement and Depth and Underlying Structures (AMADEUS) score, and the examination of MRI at 24 months was performed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score.</p><p><strong>Results: </strong>There were 34 male and 28 female patients (mean age, 38.79 ± 10.78 years) with symptomatic cartilage lesions with a mean defect size of 2.53 ± 1.24 cm<sup>2</sup>. Lesions were predominantly International Cartilage Repair Society grade 3 located in the region of the femoral condyles. Concomitant surgery was performed in 40.3% of patients. The total KOOS score significantly improved from 62.4 ± 13.1 at baseline to 74.4 ± 15.9 at 24 months (<i>P</i> < .001). The secondary outcome measures of the VAS, WOMAC, and SANE showed a similar pattern, with score improvements in the follow-up period compared to baseline. The mean AMADEUS score was 64.75 ± 13.87, while the mean MOCART 2.0 score was 62.88 ± 9.86, among 20 available patients. The revision surgery rate was 8.1% mainly because of hypertrophy (6.5%).</p><p><strong>Conclusion: </strong>Among this cohort of patients, minced cartilage implantation demonstrated satisfying 2-year outcomes with increased patient-reported outcome measure scores from 3 to 24 months postoperatively. Regenerated tissue quality on MRI was comparable to that using other cartilage repair methods and showed no associations with patient characteristics or patient-reported outcome measures. Larger cohorts, longer postoperative intervals, and comparable trials are needed to further evaluate the role of this technique in treating cartilage defects.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241297970"},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786214","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}
Merve Demir Benli, Marinus Winters, Aynur S Arslan, Ebru Ceylan, Cenk Benli, Metin Ergün
{"title":"Validity and Reliability of the Turkish Version of the Medial Tibial Stress Syndrome Score.","authors":"Merve Demir Benli, Marinus Winters, Aynur S Arslan, Ebru Ceylan, Cenk Benli, Metin Ergün","doi":"10.1177/23259671241296885","DOIUrl":"10.1177/23259671241296885","url":null,"abstract":"<p><strong>Background: </strong>Medial tibial stress syndrome (MTSS) is a common leg injury in military personnel and athletes and is especially related to running and jumping. A patient-reported outcome measure, the MTSS score, was developed to determine the severity of MTSS.</p><p><strong>Purpose: </strong>To translate, culturally adapt, and validate the MTSS score for the Turkish language.</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 2.</p><p><strong>Methods: </strong>Established guidelines were used for translation and adaptation. The Turkish version of the MTSS (MTSS-Tr) score was completed twice with a 1-week interval between assessments. In the first assessment, patients also completed the Turkish version of the 36-Item Short-Form Survey (SF-36-Tr) and a visual analog scale (VAS) for pain. Test-retest reliability and internal consistency of the MTSS-Tr were measured with the intraclass correlation coefficient (ICC) and Cronbach α coefficient, respectively. The construct validity was demonstrated with the Spearman correlation coefficient (<i>r</i> <sub>S</sub>).</p><p><strong>Results: </strong>A total of 48 participants were included in the study. The test-retest reliability was good and internal consistency was good (ICC, 0.9; Cronbach α, 0.884). The MTSS-Tr score was highly negatively correlated with the physical component score of the SF-36-Tr (<i>r</i> <sub>S</sub> = -0.716; <i>P</i> < .001). There was a moderate correlation between the MTSS-Tr score and the VAS pain score (<i>r</i> <sub>S</sub> = 0.465; <i>P</i> = .001).</p><p><strong>Conclusion: </strong>The translated MTSS-Tr score has good internal consistency and good reliability and validity. Therefore, the MTSS-Tr score is useful to evaluate symptoms in patients with MTSS.</p><p><strong>Registration: </strong>NCT05400668 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241296885"},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786343","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}
Joo Hyung Han, Min Jung, Kwangho Chung, Se-Han Jung, Chong-Hyuk Choi, Sung-Hwan Kim
{"title":"Bone Marrow Aspirate Concentrate Injections for the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials.","authors":"Joo Hyung Han, Min Jung, Kwangho Chung, Se-Han Jung, Chong-Hyuk Choi, Sung-Hwan Kim","doi":"10.1177/23259671241296555","DOIUrl":"10.1177/23259671241296555","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) poses a significant global burden, with conventional treatments like corticosteroid and hyaluronic acid (HA) injections commonly used. Emerging injectable biologics, including bone marrow aspirate concentrate (BMAC), show promise in OA management.</p><p><strong>Purpose: </strong>To investigate the clinical efficacy of BMAC injection compared with other injection treatments for knee OA.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Embase, Cochrane Library, and Google Scholar to identify randomized controlled trials with Level 1 evidence that compared the clinical efficacy of BMAC with other injections. The visual analog scale for pain and the Pain subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS) were used as clinical scores representing pain. For functional assessment, the Western Ontario and McMaster Universities Osteoarthritis Index and the International Knee Documentation Committee subjective form were used. For studies comparing BMAC with HA, each clinical score was standardized to pain and function scales based on the minimal clinically important difference (MCID).</p><p><strong>Results: </strong>Eight studies, consisting of a total of 937 patients, were included. Patients treated with BMAC showed a significant improvement in clinical scores compared with baseline, starting at 1 month postinjection. For pain scores at 6-month (<i>P</i> = .033) and 12-month follow-up (<i>P</i> = .011), BMAC demonstrated favorable results over HA, with a statistically significant difference. However, these differences did not exceed the MCID. When BMAC was compared with other injections, no significant differences were observed in the degree of clinical score improvement. No serious adverse events or events significantly associated with BMAC compared with other treatments were reported.</p><p><strong>Conclusion: </strong>BMAC injections demonstrated effectiveness in providing pain relief and functional improvement for patients with knee OA. When BMAC was compared with other intra-articular injection options, distinct differences surpassing the MCID were not evident. Further research is deemed necessary to investigate the role of BMAC in the treatment of knee OA.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241296555"},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786219","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}
Philip M Lee, Eli M Snyder, Kyle K Obana, David Trofa, Lorrin Lee, Jae You
{"title":"Prevalence of Upper Extremity Volleyball Injuries Within Different Adult Age Groups: A Comprehensive Analysis of National Data From 2013-2022.","authors":"Philip M Lee, Eli M Snyder, Kyle K Obana, David Trofa, Lorrin Lee, Jae You","doi":"10.1177/23259671241298586","DOIUrl":"10.1177/23259671241298586","url":null,"abstract":"<p><strong>Background: </strong>The mean age of volleyball athletes has increased over the past decade, raising concerns about musculoskeletal injuries. There is no literature on how different mechanisms of injury (MOI) affect different adult age groups.</p><p><strong>Purpose: </strong>To evaluate epidemiologic trends, diagnoses, and mechanisms of volleyball-related upper extremity injuries within different adult age groups.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Data from the National Electronic Injury Surveillance System for volleyball-related upper extremity injuries in patients aged between 19 and 79 years, between January 1, 2013, and December 31, 2022, were analyzed. Data included body parts, diagnosis, MOI, and disposition. Calculations used corresponding hospital sample weights for national estimates (NEs). Patients were divided into either 20-39, 40-59, or 60+ years age groups. Linear regressions were used to analyze annual trends, chi-square tests were used to analyze categorical variables, and the Holm <i>P</i> value adjustment method was utilized in post hoc analysis.</p><p><strong>Results: </strong>A weighted NE of 41,164 volleyball-related upper extremity injuries occurred in the study period. The mean age was 35.8 ± 14 years, and male patients constituted 49.4% of all patients. The most injured body parts of all age groups were fingers (33.2%), shoulders (28.9%), and wrists (16%). The most common identifiable MOI were impacts with the floor (24%), impacts with the ball (18.7%), and spikes/serves (6.9%). The 20-39 age group experienced shoulder dislocations at the greatest rate of all age groups (NE = 3362 [37%]) and sustained injuries from spike/serve movements at the greatest rates (NE = 2214 [8.2%]; <i>P</i> < .01). Of the 3362 shoulder dislocations in the 20-39 age group, 1445 (43%) were during spikes/serves. The 60+ age group had the greatest rates of sprains/strains (NE = 1353 [41.1%]). Additionally, the 60+ age group suffered from injuries secondary to impacts on the floor (NE = 1242 [37.7%]) and impacts with the ball (NE = 769 [23.4%]) at the greatest rates (<i>P</i> < .01).</p><p><strong>Conclusion: </strong>Our study demonstrated that adult populations are at risk for volleyball-related upper extremity injuries, specifically affecting the finger, wrist, and shoulder. MOI among age groups differed, as younger adults more often sustained injuries from dynamic movements, whereas older adults sustained injuries from trauma.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241298586"},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786341","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}
Petar Golijanin, Justin W Arner, Claire B Ryan, Qais Zai, Liam A Peebles, Annalise M Peebles, Phob Ganokroj, Ryan J Whalen, Stephanie K Eble, Danielle Rider, Srdjan Ninković, Matthew T Provencher
{"title":"Characteristics of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging.","authors":"Petar Golijanin, Justin W Arner, Claire B Ryan, Qais Zai, Liam A Peebles, Annalise M Peebles, Phob Ganokroj, Ryan J Whalen, Stephanie K Eble, Danielle Rider, Srdjan Ninković, Matthew T Provencher","doi":"10.1177/23259671241297071","DOIUrl":"10.1177/23259671241297071","url":null,"abstract":"<p><strong>Background: </strong>The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated.</p><p><strong>Purpose: </strong>To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were reviewed. 3D models of unilateral proximal humeri and glenoids were reconstructed. The volume, surface area, width, and depth of identified HSLs were quantified, along with their location (medial, superior) and orientation (Hill-Sachs angle). The percentage, width, and length of GBL as well as the glenoid track status were calculated. The on-track and off-track groups were compared using the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>The off-track group had greater HSL surface area (374.23 vs 272.64 mm<sup>2</sup>, respectively; <i>P</i> = .001), more HSL medialization (14.96 vs 17.62 mm, respectively; <i>P</i> = .028), greater HSL volume (603.08 vs 433.61 mm<sup>3</sup>, respectively; <i>P</i> = .007), and a greater mean HSL width (16.06 vs 11.53 mm, respectively; <i>P</i> = .001) than the on-track group. The off-track group also had greater GBL (22.55% vs 17.73%, respectively; <i>P</i> = .037), a greater GBL width (6.92 vs 3.58 mm, respectively; <i>P</i> < .001), and a greater GBL length (21.61 vs 16.1mm, respectively; <i>P</i> = .015) than the on-track group. Further analysis of large off-track lesions revealed a greater Hill-Sachs angle (33.16° vs 26.20°, respectively; <i>P</i> = .035) and a more superior extent of HSLs compared with borderline off-track and on-track lesions.</p><p><strong>Conclusion: </strong>Off-track lesions were found to have larger GBL, a larger HSL width, a more medialized HSL, and greater HSL surface area. This study outlines the specific characteristics of high-risk bipolar bone loss lesions to simplify the identification of patients in a clinical setting and aid in appropriate treatment planning.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241297071"},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786143","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}