Orthopaedic Journal of Sports Medicine最新文献

{"title":"Short-Term Workload Patterns Before Achilles Tendon Rupture in National Basketball Association Players: A Descriptive Epidemiology Study.","authors":"Vineet Kumar, Luke Sang, Wyatt David, Nirav Pandya","doi":"10.1177/23259671261463385","DOIUrl":"10.1177/23259671261463385","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture (ATR) is one of the most serious injuries in professional basketball, requiring nearly a year of recovery and resulting in declines in player performance and career longevity. In the 2024-2025 NBA season, a record-high 7 ATRs highlighted the need to evaluate workload-related risk factors.</p><p><strong>Hypothesis: </strong>NBA players experiencing ATR may have a higher-than-average workload in games preceding injury, which could be associated with increased risk.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>This retrospective exploratory review analyzed publicly available NBA data from the 2014-2015 to 2024-2025 seasons. Inclusion required players to have sustained a basketball-related ATR during a regular season or playoff game after participating in at least 1 full game that season. Variables included age, position, specialization, meters run, minutes played (5-, 10-, 15-game spans before ATR), games played, and scheduling metrics (back-to-backs, rest days). Data sources included official NBA statistics, StatMuse, and ESPN. Statistical analyses included paired and unpaired <i>t</i> tests, 1-way analysis of variance, and Spearman correlations.</p><p><strong>Results: </strong>Nineteen players (19 ATRs; mean age, 27.8 ± 3.2 years; mean league experience: 7.4 ± 3.2 years) sustained basketball-related ATRs. Playing time was significantly higher in the 10 games (29.0 ± 2.1 vs 27.4 ± 2.0 min/game; <i>P</i> = .01) and 15 games (28.6 ± 2.1 vs 27.4 ± 2.0 min/game; <i>P</i> = .03) preceding injury compared with each player's season average. Years of league experience were positively correlated with workload measures, including total season minutes (<i>P</i> = .02) and minutes in the 5 games preceding rupture (<i>P</i> = .0498), such that veteran players generally accumulated higher workload, whereas ATRs among less-experienced players occurred in the setting of comparatively lower observed workload.</p><p><strong>Conclusion: </strong>Significant workload spikes were found in the 10 to 15 games preceding Achilles ruptures for NBA players. Veteran players carried heavier cumulative workloads, whereas younger players ruptured tendons under lighter use. Proactive workload management, athlete education, and targeted prevention strategies may help preserve player health and career longevity in the NBA.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463385"},"PeriodicalIF":2.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593021","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 Epidemiology of Catastrophic Head and Neck Injuries in High School and College Non-Football Sports: A 4-Decade Review.","authors":"Courtney M Meyer, Kristen L Kucera, Samantha E Scarneo-Miller, Zachary K Winkelmann, Susan W Yeargin","doi":"10.1177/23259671261455859","DOIUrl":"10.1177/23259671261455859","url":null,"abstract":"<p><strong>Background: </strong>Catastrophic head and neck injuries (CHNIs) in sport are rare but can have disabling or fatal outcomes. Prior studies have focused on football, equipment-laden sports, or different injury severities, not CHNI in nonfootball sports.</p><p><strong>Purpose: </strong>To describe the epidemiology of CHNI across levels (high school vs collegiate) in nonfootball sports and evaluate differences in injury rates (IRs) by sport, sex, and decade.</p><p><strong>Study design: </strong>Descriptive epidemiological study.</p><p><strong>Methods: </strong>This study utilized 40 academic years (1982-1983 to 2021-2022) of surveillance data from the National Center for Catastrophic Sports Injury Research. Descriptive statistics summarized athlete, event, and injury characteristics. IRs were calculated from available institutional participation data for high school and collegiate levels. Athlete-exposure was defined as 1 athlete participating in 1 sport season. IRs per 100,000 athlete seasons (AS), IR ratios (IRRs), and 95% CIs were computed using negative binomial regression.</p><p><strong>Results: </strong>A total of 470 eligible CHNI events were included, capturing 17 unique sports. Most injuries transpired in those who were male (69.4%; n = 326), ranged in age from 12 to 25, and competed at the high school level (76.2%; n = 358). Of injuries, 12.6% were fatal (n = 59), 38.7% were permanently disabling (n = 182), and 44.9% were temporarily disabling (n = 211). Of all male patients (n = 326), traumatic brain injury (33.4%; n = 109) and spinal fractures (34.1%; n = 111/326) were reported most frequently, while traumatic injuries (n = 144) including brain (34.0%; n = 49) and other traumatic injuries (ie, nerve injury, facial fractures, etc [30.6%; n = 44]) occurred most frequently in female patients. CHNI occurred at a lower rate in female than male patients (IR, 0.12 vs 0.48 per 100,000 AS; IRR, 0.25; 95% CI, 0.18-0.33; <i>P</i> < .001) and in collegiate than high school athletes (IR, 0.11 vs 0.53 per 100,000 AS; IRR, 0.20; 95% CI, 0.15-0.27; <i>P</i> < .001). Sports with the highest CHNI rates included gymnastics (IR, 1.66) and ice hockey (IR, 1.52). Rates declined each decade, with the largest difference in rate occurring between 1982 and 1992 (IR, 0.59; IRR, 8.93; 95% CI, 2.23-35.68) and between 2012 and 2022 (IR, 0.06).</p><p><strong>Conclusion: </strong>CHNI rates in nonfootball sports declined over 4 decades and were higher among athletes who were male, competing at the high school level, or participating in gymnastics or ice hockey. Over half of the athletes sustaining CHNI experienced outcomes of permanent disability or fatality.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261455859"},"PeriodicalIF":2.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584941","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":"Foot and Ankle Contributions to Noncontact ACL Injury Risk: A Systematic Review.","authors":"Lexy Farrington, Clare Hotze, Roxy Markowsky, Reed Coda, Sterre van den Anker, Bryant Vopat, Lisa Vopat","doi":"10.1177/23259671261463141","DOIUrl":"10.1177/23259671261463141","url":null,"abstract":"<p><strong>Background: </strong>Noncontact anterior cruciate ligament (ACL) injuries are common and carry long-term consequences for the athlete. Altered foot and ankle biomechanics, landing patterns, and prior ankle injury have been implicated in ACL injury risk and may inform prevention strategies.</p><p><strong>Purpose: </strong>To identify key biomechanical risk factors associated with the foot and ankle that may contribute to ACL injury risk.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. PubMed, Cochrane, and SPORTDiscus databases were searched for English-language studies (2010-2025) evaluating ACL injuries and reporting on the foot or ankle. Screening was performed using Rayyan, followed by full-text review. Data were extracted, and then risk of bias was assessed using the methodological index for non-randomized studies (MINORS).</p><p><strong>Results: </strong>Out of 1772 studies evaluated, a total of 48 (2.7%) studies met inclusion criteria. Overall, 33 studies (68.8%) identified variables associated with increased ACL injury risk, while 11 (22.9%) reported decreased risk and 9 (18.8%) found no association. Foot and ankle biomechanics were examined in 32 studies (66.7%), foot strike pattern in 8 (16.7%), toe direction in 7 (14.6%), and prior ankle injury history in 5 (10.4%). Statistically supported findings were present in 81% of studies. Greater dynamic rearfoot motion (eversion/inversion), increased dorsiflexion, and medial arch collapse (eg, navicular drop) were commonly associated with increased risk. Forefoot landings were protective, while rearfoot and flatfoot strikes, as well as toe-in or toe-out positions, were consistently linked to higher injury risk. Sex-specific analysis showed that female athletes demonstrated more high-risk biomechanical patterns than their male counterparts. Sport-specific analysis revealed basketball (n = 14), soccer (n = 8), and handball (n = 6) as the most studied sports, with >75% of these studies identifying ≥1 foot- or ankle-related ACL injury risk factor. Study quality was generally low, with predominantly noncomparative designs and modest MINORS.</p><p><strong>Conclusion: </strong>Foot and ankle factors, including prior injury, alignment, foot strike patterns, and toe progression, contribute meaningfully to ACL injury risk, yet their precise influence on knee stabilization remains unclear. The foot and ankle are understudied, with few investigations addressing their role in dynamic tasks that challenge knee stability. High-quality comparative research that accounts for sex and sport differences is needed to inform targeted prevention and improve risk stratification.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463141"},"PeriodicalIF":2.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562628","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":"Morphometric and Cellular Evaluation of Delaminated Cartilage From the Acetabulum.","authors":"Sebastian Gebhardt, Janosch Schoon, Emely Bortel, Georgi I Wassilew, Alexander Zimmerer","doi":"10.1177/23259671261450542","DOIUrl":"10.1177/23259671261450542","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Delaminated acetabular cartilage flaps are associated with inferior outcomes of arthroscopic treatment of femoroacetabular impingement syndrome. Recently, concomitant arthroscopic minced cartilage implantation has shown encouraging early clinical results under such circumstances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study is to investigate the morphology, outgrowth, and functionality of chondrocytes from delaminated acetabular cartilage flaps in comparison to controls, in order to assess their suitability for minced cartilage implantation. It was hypothesized that despite morphologic differences, chondrocyte viability and functionality do not differ between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Controlled laboratory study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Delaminated acetabular chondral flaps were obtained from 11 patients undergoing hip arthroscopy. Control samples were taken either from the acetabulum in patients undergoing total hip arthroplasty for avascular necrosis (2 samples) or from patients undergoing minced cartilage implantation at the knee (12 samples). Synchrotron radiation microcomputed tomography (SR-µCT) analyses and histologic evaluations were conducted. In vitro investigations assessed cell proliferation, metabolic activity, and redifferentiation potential in 3-dimensional spheroid cultures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Microcomputed tomography revealed a significantly increased mean number of chondrocyte lacunae in delaminated acetabular cartilage compared to control samples, along with a significant reduction of lacunar diameter. Morphometric and histologic analyses demonstrate cell-free, necrotic areas with fiber structures within delaminated acetabular cartilage samples. Regarding the number of outgrown cells, metabolic activity, and proliferation capacity, no differences between delaminated acetabular cartilage and control samples were observed. Initially cultured chondrogenic spheroids of cells from delaminated acetabular cartilage samples had lower protein and proteoglycan content compared to controls, but no differences were observed for spheroids cultured with TGF-β1 supplementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Delaminated acetabular cartilage exhibits altered morphology. However, cell numbers, outgrowth potential, and population doublings of chondrocytes isolated from delaminated acetabular cartilage were comparable to those of controls. Redifferentiation of chondrocytes isolated from delaminated acetabular cartilage relies on TGF-β1 stimulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Delaminated acetabular flaps are strongly degenerated, characterized by atrophic chondrocyte lacunae and tissue necrosis, indicating that autograft utilization is unfavorable. However, cell outgrowth and functionality suggest that delaminated acetabular cartilage flaps provide a suitable tissue source for minced cartilage implantation after augmentation with TGF","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261450542"},"PeriodicalIF":2.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562588","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":"Return-to-Sport Outcomes After Suture Button Fixation for Syndesmotic Injury in Elite Athletes With Chronic Lateral Ankle Instability: A Prospective Case Series.","authors":"Cheng Wang, Cheng Chen, Shaoling Fu, Jiazheng Wang, Chenglin Wu, Jieyuan Zhang, Xin Ma, Zhongmin Shi","doi":"10.1177/23259671261463133","DOIUrl":"10.1177/23259671261463133","url":null,"abstract":"<p><strong>Background: </strong>Chronic lateral ankle instability (CLAI) with concomitant syndesmotic injury presents a complex challenge for elite athletes. The arthroscopic modified Broström procedure (AMBP) is the gold-standard surgical treatment for CLAI, and suture button fixation (SBF) is an effective method for dynamically stabilizing the syndesmosis.</p><p><strong>Purpose: </strong>To evaluate functional outcomes and return-to-sport (RTS) metrics and identify prognostic factors after combined AMBP and SBF in this specific population.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>A total of 70 elite athletes with CLAI and a confirmed syndesmotic injury who underwent AMBP and SBF between January 2021 and June 2023 were prospectively enrolled. Outcomes included the Foot and Ankle Outcome Score (FAOS), Karlsson-Peterson score, mean time to RTS, RTS rate, ankle range of motion (ROM), and complication rates. Weightbearing computed tomography was analyzed to measure anatomical parameters, including anterior, posterior, and maximum tibiofibular distances (ATFD, PTFD, maxTFD), angle of fibular rotation (AFR), and syndesmotic area (SA). Univariate and multivariate regression analyses identified factors associated with improvement in FAOS (Δ-FAOS).</p><p><strong>Results: </strong>A total of 68 patients (68 ankles [97.1%]), with a minimum 2-year follow-up, were included in our analysis. The mean time to unrestricted RTS was 53.2 ± 14.7 days, with a 98.5% (67/68) successful RTS rate. All FAOS subscales and the Karlsson-Peterson score demonstrated significant improvements from baselines (<i>P</i> < .001). Ankle ROM was restored to symmetry in all patients. One patient (1.5%) experienced transient superficial wound irritation. Univariate analysis indicated that Δ-FAOS was associated with sex, reduction in body mass index (BMI) (ΔBMI), duration of symptoms before surgery, and preoperative PTFD, maxTFD, AFR, and SA. Multivariate analysis confirmed that a greater reduction in BMI (<i>P</i> = .032; β = 1.8; [95% CI, 1.1-3.1]) and a smaller preoperative SA (<i>P</i> = .018; β = -0.7 [95% CI, 0.5-0.9]) were independent predictors of greater Δ-FAOS.</p><p><strong>Conclusion: </strong>Our study demonstrated that the combined AMBP and SBF procedure may facilitate rapid, successful RTS, with satisfactory patient-reported outcomes and a low complication rate among elite athletes. Preoperative SA and postoperative weight management (ΔBMI) may be significant prognostic factors for optimal clinical outcome.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463133"},"PeriodicalIF":2.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549995","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":"Femoral Tunnel Position Thresholds Associated With Functional Outcomes After Medial Patellofemoral Ligament Reconstruction.","authors":"Byeong-Hun Jeon, Min Jung, Kwangho Chung, Hyun-Soo Moon, Se-Han Jung, Jusung Lee, Sung-Hwan Kim","doi":"10.1177/23259671261464017","DOIUrl":"10.1177/23259671261464017","url":null,"abstract":"<p><strong>Background: </strong>While numerous studies have examined the effects of femoral tunnel malposition in medial patellofemoral ligament (MPFL) reconstruction (MPFLR), the extent to which deviation from the anatomic femoral insertion can be tolerated before patient-reported outcome measures (PROMs) are adversely affected has not been clearly established.</p><p><strong>Purpose: </strong>To evaluate postoperative improvements in PROMs after MPFLR, determine outcome-based cutoffs for femoral tunnel placement using 3-dimensional imaging, and assess the effects of directional deviations.</p><p><strong>Study design: </strong>Cohort study, Level of evidence 3.</p><p><strong>Methods: </strong>This retrospective study included 50 knees that underwent MPFLR between 2011 and 2023, with or without concomitant tibial tubercle osteotomy. PROMs (Lysholm, Tegner, International Knee Documentation Committee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], and Kujala) were collected pre- and postoperatively, and minimal clinically important differences (MCIDs) were calculated using a distribution-based method. Femoral tunnel positions were analyzed in 37 knees using postoperative computed tomography. Pearson correlation and receiver operating characteristic (ROC) curve analyses identified tunnel deviation thresholds associated with clinically meaningful improvements, and directional analyses assessed anterior-posterior and proximal-distal variations.</p><p><strong>Results: </strong>All PROMs significantly improved after surgery, with MCID achievement rates of up to 68%. Femoral tunnel deviation was negatively correlated with the IKDC, KOOS, and Kujala scores. ROC analysis identified a 7.2-mm cutoff for predicting meaningful IKDC improvement (area under the curve = 0.892). Directional analysis showed no significant differences between anterior and posterior placements; however, a distal deviation >4.5 mm was associated with significantly poorer IKDC, KOOS pain, and KOOS sports outcomes.</p><p><strong>Conclusion: </strong>This study establishes a PROM-based cutoff for femoral tunnel positioning in MPFLR. A deviation of >7.2 mm from the anatomic insertion significantly compromises functional improvement, and excessive distal displacement has a particularly detrimental effect on outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261464017"},"PeriodicalIF":2.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550033","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":"Qualitative and Quantitative Evaluation of Loose Bodies as a Novel Cell Source for Autologous Chondrocyte Implantation.","authors":"Shunsuke Takeuchi, Yoshinari Tanaka, Ryohei Uchida, Yuta Tachibana, Kazutaka Kinugasa, Masashi Kusano, Shinobu Yanada, Katsura Sugawara, Takayuki Tsuda, Yukiyoshi Toritsuka","doi":"10.1177/23259671261463932","DOIUrl":"10.1177/23259671261463932","url":null,"abstract":"<p><strong>Background: </strong>Autologous chondrocyte implantation (ACI) has recently produced successful outcomes, but donor site morbidity remains an urgent issue to be resolved. Thus, alternative cell sources are highly desirable to minimize donor site morbidity.</p><p><strong>Purpose: </strong>To qualitatively and quantitatively evaluate the potential of loose bodies as a novel cell source for ACI.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Loose bodies were obtained from 10 patients during arthroscopic surgery. They were evaluated by gross appearance and histology and classified into normal, abnormal, and no-cartilage groups. Then, 3-dimensional (3D)-cultured cartilage was prepared using chondrocytes from the loose bodies, and cell proliferation and glycosaminoglycan production in the 3D-cultured cartilage were compared with those from native cartilage obtained from patients who underwent total knee arthroplasty. Finally, expression of 42 genes by primary chondrocytes from the loose bodies was analyzed by chondrocyte gene spatial mapping analysis (CGSMA) and compared with that of reference chondrocytes to visualize their global properties, including ossification and denaturation.</p><p><strong>Results: </strong>Of 10 loose bodies, 4 were histologically classified into the normal cartilage group, 4 into the abnormal cartilage group, and 2 into the no-cartilage group. The mean cell proliferation rate of 3D-cultured cartilage from the loose bodies in the normal and abnormal cartilage groups was significantly higher than that of the native cartilage (<i>P</i> = .020), while there was no significant difference in mean glycosaminoglycan production. Scores for the chondrocyte gene spatial mapping analysis showed that the 3D-cultured cartilage produced from 2 loose bodies exhibited gene expression within the reference range of native cartilage. While 2 of the 10 loose bodies (20%) met the predefined criteria across all 3 evaluations, this proportion increased to 50% (2 of 4) when the analysis was restricted to loose bodies classified in the normal cartilage group.</p><p><strong>Conclusion: </strong>A subset of loose bodies demonstrated matrix-producing capacity without ossification or denaturation, supporting their potential as a cell source for ACI.</p><p><strong>Clinical relevance: </strong>Appropriately selected loose bodies are a potential cell source for ACI while minimizing donor site morbidity.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463932"},"PeriodicalIF":2.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550079","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":"Endoscopic Lumbar Discectomy in Professional Athletes: A Case Series and Structured Rehabilitation Protocol Enabling Rapid Return to Play.","authors":"Marc Szadkowski, Xavier Castel, Jean Baptiste Odent, Elie Saghbini, Anuj Gupta, Sebastien Pinon, Thais Dutra Vieira, Henri d'Astorg","doi":"10.1177/23259671261459223","DOIUrl":"10.1177/23259671261459223","url":null,"abstract":"<p><strong>Background: </strong>Full-endoscopic lumbar discectomy (FELD) has become a validated, minimally invasive treatment for lumbar disc herniation (LDH). However, evidence remains scarce regarding outcomes and rehabilitation strategies for professional athletes undergoing this procedure.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study is to evaluate return to play (RTP) outcomes, functional recovery, and postoperative complications in professional athletes undergoing FELD, and to describe the structured postoperative rehabilitation protocol implemented. It was hypothesized that FELD, combined with standardized rehabilitation, would result in a high RTP rate within 3 months and restoration of preinjury performance levels.</p><p><strong>Study design: </strong>Case series; Level of evidence 4.</p><p><strong>Methods: </strong>Twenty professional athletes with LDH who underwent FELD between 2021 and 2024 were included. All included patients were elite athletes, defined as professional or international-level competitors. This included athletes participating in top-tier professional basketball and rugby leagues, as well as winter sports athletes competing at the international level (World Cup and Olympic competitions). Outcome measures included pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), quality of life (Short Form-12 [SF-12]), time to RTP, and postoperative level of athletic performance, which were objectively evaluated by return to official competition (defined as participation in official matches or competitive events at the preinjury level). All patients followed a standardized, phased rehabilitation protocol incorporating progressive strength and flexibility testing. Descriptive statistics were used to summarize the data. Paired comparisons were performed using the Student <i>t</i> test or the Wilcoxon signed-rank test, depending on data distribution, with statistical significance set at <i>P</i> < .05.</p><p><strong>Results: </strong>The mean age of patients was 25.5 ± 3.7 years, and 75% were men. The mean RTP time was 3.4 months. At 1-year follow-up, 80% of athletes had resumed their preinjury performance level. VAS and ODI scores improved significantly (<i>P</i> < .005), with 90% reporting excellent satisfaction. No major complications occurred, although 4 patients experienced recurrent herniation, and 3 underwent reoperation. One athlete did not RTP.</p><p><strong>Conclusion: </strong>Our study demonstrated that FELD combined with a structured rehabilitation pathway appears to be a safe and effective surgical option for professional athletes with LDH, which may facilitate early RTP and high functional recovery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261459223"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497881","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":"Comparing Postconcussion Sway Balance and Cognitive Test Performance With Preinjury Baseline Identifies a Higher Percentage of Impaired Concussed Athletes Than Comparison With Normative Values.","authors":"Philip Schatz, Jennifer Chikar","doi":"10.1177/23259671261463390","DOIUrl":"10.1177/23259671261463390","url":null,"abstract":"<p><strong>Background: </strong>Baseline and postinjury neurocognitive and balance testing assist in the assessment and management of sports-related concussion. We evaluated the utility of comparing postinjury performance on the Sway Medical System Sports+ test battery with individualized baseline data and normative reference data.</p><p><strong>Hypothesis: </strong>Comparisons with baseline data would identify a higher proportion of concussed athletes with impaired scores, as opposed to comparing postinjury performance with normative data.</p><p><strong>Study design: </strong>Cohort study (Diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>Baseline assessments were conducted 1 year apart using the Sway Sports+ battery. Postinjury assessments were conducted within 3 days of concussion and compared with both baseline and normative data using thresholds for 70%, 80%, 90% and 95% CIs. Outcomes were evaluated based on the number of modules within the test battery that surpassed confidence interval thresholds.</p><p><strong>Results: </strong>Both comparison approaches identified a high proportion of concussed athletes as impaired when considering impairment on ≥1 measures (eg, 95% using baseline data, 89% using normative data [70% CI]; 89% baseline, 80% normative [80% CI]; 82% baseline, 70% normative [90% CI]). However, impairment on a single module was common and occurred in both the concussed and the nonconcussed samples. When impairment on ≥2 modules was considered, the baseline comparison method correctly identified a higher proportion of concussed athletes as impaired than the normative comparison method (eg, 82% vs 68% [70% CI]; 67% vs 58% [80% CI]; 52% vs 47% [90% CI]). Impairment on ≥2 modules was uncommon in the control sample but occurred frequently in the concussed sample.</p><p><strong>Conclusion: </strong>Baseline comparisons consistently classified a greater percentage of athletes as concussed than normative comparisons, across all confidence intervals.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463390"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497847","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":"Two-Year Outcomes of ACL Reconstruction With Osteochondral Allograft Transplantation Versus Isolated ACL Reconstruction: A Matched Cohort Study.","authors":"Walter R Lowe, Bonnie Gregory, Carol Martin, Melanie Buckner, Jena-Claire Auten, Jacquelyn Kleihege, Lane Bailey, Steven Higbie","doi":"10.1177/23259671261463928","DOIUrl":"10.1177/23259671261463928","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral allograft transplantation (OCA) has been established as a viable restorative chondral procedure, although few studies have examined its effectiveness in the setting of anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Purpose: </strong>To compare self-reported function and return-to-sport rates after ACL reconstruction with OCA to those of matched controls undergoing isolated ACL reconstruction.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective matched cohort study was conducted utilizing a single-surgeon database of patients undergoing ACL reconstruction between 2016 and 2021. Included patients were 15 to 70 years of age, underwent ACL reconstruction with OCA, and desired to return to sport. Patients were age and sex matched to a cohort of patients who underwent isolated ACL reconstruction. Baseline characteristics were collected along with preinjury Marx score and surgical details. Outcomes at time of return to sport included self-reported function, time to return to sport, range of motion, and single-leg squat and hopping performance. Two-year outcomes included Single Assessment Numeric Evaluation (SANE) scores, return-to-sport rates, and reinjury rates. Between-group differences were analyzed utilizing chi-square analyses and 1-way analysis of variance with an a priori α value of .05.</p><p><strong>Results: </strong>A total of 43 patients who underwent ACL reconstruction with OCA were identified and matched to 43 patients who underwent isolated ACL reconstruction. Patients in the ACL reconstruction with OCA group reported lower preinjury Marx scores (3.9 ± 5.7 vs 9.6 ± 5.9; <i>P</i> < .001). The ACL reconstruction with OCA group demonstrated a longer time to return to sport (9.1 ± 4.1 months vs 7.9 ± 3.4 months; <i>P</i> = .040); however, no differences existed between groups for all self-reported and objective outcomes at the time of return to sport. At 2 years, no differences existed regarding SANE scores (85.4 ± 12.1 vs 87.0 ± 13.5; <i>P</i> = .334), ACL graft reinjury rate (4.7% vs 2.3%; <i>P</i> = .481), and return to prior level of sport rates (69.8% vs 72.1%; <i>P</i> = .387).</p><p><strong>Conclusion: </strong>Patients undergoing ACL reconstruction with OCA demonstrate similar self-reported function and return-to-sport rates, along with a delayed time to return to sport, to those undergoing isolated ACL reconstruction. A majority (83.7%) of patients undergoing ACL reconstruction with OCA can return to level 1 to 3 sports with low graft failure rates.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"14 7","pages":"23259671261463928"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497856","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}