Orthopaedic Journal of Sports Medicine最新文献

{"title":"The Difference in Achilles Tendon Loading within Immobilizing Boots Based on Ankle Angle, Boot Type, and Walking Speed.","authors":"Todd J Hullfish, Madison M Woods, Michelle P Kwon, Lorraine A T Boakye, Casey Jo Humbyrd, Josh R Baxter","doi":"10.1177/23259671241283806","DOIUrl":"10.1177/23259671241283806","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture is an increasingly common injury treated with progressive rehabilitation in an immobilizing boot. However, it is poorly understood how ankle angle, boot type, and walking speed affect Achilles tendon loading.</p><p><strong>Hypothesis: </strong>These different parameters would affect Achilles tendon loading in terms of (from greatest to least) ankle angle constraint, immobilization style, boot construction, and walking speed.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Ten healthy young adults (8 women and 2 men; age, 21 ± 2 years; body mass index, 21.5 ± 3.0 kg/m²) walked in 3 different immobilizing boots at self-selected slow, medium, and fast walking speeds. The authors estimated Achilles tendon loading using a 3-part instrumented insole within the immobilizing boot. The authors averaged tendon load across every stride for each condition and calculated 2-sided bootstrap confidence intervals. Peak tendon loading was compared across all boots, ankle angles, and walking speeds.</p><p><strong>Results: </strong>All boots and immobilization styles decreased tendon loading with respect to shod walking. Immobilization angle had the largest effect on tendon loading, followed by boot construction, and finally walking speed.</p><p><strong>Conclusion: </strong>Ankle angle, boot type, and walking speed can be modified to change loading progression during rehabilitation.</p><p><strong>Clinical relevance: </strong>Understanding how immobilization affects tendon loading will enable clinicians to modify rehabilitation to improve functional outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241283806"},"PeriodicalIF":2.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568795","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":"Concussion in Female Athletes of Contact Sports: A Scoping Review.","authors":"Jana Fahr, Oliver Kraff, Cornelius Deuschl, Richard Dodel","doi":"10.1177/23259671241276447","DOIUrl":"https://doi.org/10.1177/23259671241276447","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have described higher incidences of concussion, with more severe symptoms and worse outcomes in female athletes compared with male athletes.</p><p><strong>Purpose: </strong>To compile current knowledge about sex-specific differences in incidence, biomechanics, biomarkers, imaging, and outcomes of concussion in athletes participating in contact sports to better understand which fields should be explored in more detail.</p><p><strong>Study design: </strong>Scoping review; Level of evidence, 3.</p><p><strong>Methods: </strong>The PubMed database was searched for articles published between January 2000 and November 2020 using the Medical Subject Headings terms \"craniocerebral trauma\" and \"brain concussion\" combined with the contact sports \"football,\"\"soccer,\"\"hockey,\" and \"boxing.\" Eligibility criteria were based on the recommendations of the Scottish Intercollegiate Guidelines Network. It focused on sex-specific differences within 5 major topics: (1) epidemiology, (2) biomechanics, (3) biomarkers, (4) imaging, and (5) specific concussion outcome variables, including neurocognitive performance, injury severity, and behavioral and psychological symptoms.</p><p><strong>Results: </strong>A total of 22 studies were included. Eight studies investigated the incidence of concussion, with 4 of the 8 finding a significantly higher incidence rate for female versus male athletes. Six studies that focused on biomechanics found that female athletes received fewer impacts with lower magnitudes. One study addressed biomarkers, showing that S100 calcium-binding protein B and neuron-specific enolase were increased after a game in female athletes, and the level of increase was similar to the changes found in male athletes. Based on the 3 imaging studies, affected brain tissue was greatest in areas associated with tau pathology in chronic traumatic encephalopathy. One study showed a lower hypointensity burden index after a season of ice hockey for female athletes, while another study showed more regions with white matter alterations. Seven studies examined concussion outcomes, with 4 studies showing more severe neuropsychological deficits; in addition, female athletes reported more and worse symptoms than male athletes.</p><p><strong>Conclusion: </strong>The results of this review indicated that female athletes had a higher risk of sustaining a concussion, although they received fewer impacts with lower magnitudes than male athletes. Biomarkers were able to be used equally for both sexes. Female athletes also had a higher neuropsychological deficit and increasingly worse symptoms after a concussion.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241276447"},"PeriodicalIF":2.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471780","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":"Effectiveness of In-Home, Augmented Reality-Based Telerehabilitation After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.","authors":"Ji Young Lim, Hee Ju Yu, Seo Hyun Kim, Jong In Lee, Jae-Young Lim, Joon Ho Wang, Ji Hye Hwang","doi":"10.1177/23259671241271729","DOIUrl":"https://doi.org/10.1177/23259671241271729","url":null,"abstract":"<p><strong>Background: </strong>New digital technology-based rehabilitation may be a viable option for patients after anterior cruciate ligament reconstruction (ACLR), with advantages such as easy access to treatment and learning as well as cost-effectiveness.</p><p><strong>Purpose: </strong>To investigate the effects of an augmented reality (AR)-based, telerehabilitation system in patients after ACLR compared with a brochure-based rehabilitation program in terms of patient-reported outcomes and functional performance measures.</p><p><strong>Study design: </strong>Randomized controlled trial; Level of evidence, 2.</p><p><strong>Methods: </strong>This was a multicenter, assessor-blinded study. Enrolled participants were allocated randomly to either the intervention group, who underwent AR-based telerehabilitation system, or to the control group, who underwent a brochure-based rehabilitation program with a self-log. Both groups performed the same postoperative rehabilitation exercise protocol. Subjective knee function was assessed using the International Knee Documentation Committee (IKDC) as the primary outcome; secondary outcomes were a numeric rating scale for pain, the EuroQol 5-Dimension 5-Level, isometric knee strength, range of motion, and the single-leg hop test. The intervention group also completed a satisfaction survey. Follow-up was conducted at 2, 6, 12, and 24 weeks postoperatively.</p><p><strong>Results: </strong>A total of 28 patients were enrolled in each group; 1 patient in the control group was lost to follow-up. Patients in both groups demonstrated improvement on all outcomes over time. There were no significant between-group differences in the IKDC score from baseline to 12 weeks postoperatively. The intervention group saw a greater increase in the relative isometric strength of the quadriceps on the involved limb at 6, 12, and 24 weeks postoperatively (<i>P</i> < .05 for all). No significant group differences were observed in the remaining secondary outcomes.</p><p><strong>Conclusion: </strong>Study findings indicated that patients who underwent AR-based telerehabilitation in the early rehabilitation phase after ACLR demonstrated similar improvements as those who followed a brochure-based rehabilitation program and had a quicker recovery of knee extensor strength.</p><p><strong>Registration: </strong>NCT04513327 (ClinicalTrials.gov identifier).</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241271729"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471782","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":"Characteristics and Outcomes of Surgical Treatment for Anterolateral Ankle Impingement Due to the Distal Fascicle of the Anterior Inferior Tibiofibular Ligament.","authors":"Ho Dong Na, In Ha Woo, Seung Jae Cho, Chul Hyun Park","doi":"10.1177/23259671241275959","DOIUrl":"https://doi.org/10.1177/23259671241275959","url":null,"abstract":"<p><strong>Background: </strong>The pathomechanism of anterolateral ankle impingement (ALAI) due to the distal fascicle of the anterior inferior tibiofibular ligament (DF-AITFL) has not been fully elucidated. In addition, because of its rarity, no definitive diagnostic criteria have been established for ALAI due to DF-AITFL.</p><p><strong>Purpose: </strong>To document the symptom characteristics and magnetic resonance imaging (MRI) and and arthroscopic findings as well as postoperative clinical outcomes of ALAI due to DF-AITFL.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Included were 12 patients (5 male and 7 female; mean age, 34.4 years [range, 21-76 years]) who were diagnosed with ALAI due to DF-AITFL and underwent excision of the DF-AITFL from November 2017 to August 2021. Symptom characteristics and symptom-related medical histories were evaluated, as were MRI and arthroscopic findings. Clinical outcomes were assessed using the visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot functional scale, and Foot Function Index.</p><p><strong>Results: </strong>All 12 patients had a history of ankle sprain before symptom onset. DF-AITFL was confirmed by MRI in all patients. Bone edema of the talus was observed in 2 patients (16.7%), and cartilage abnormalities in 3 patients (25%). Arthroscopy showed that the DF-AITFL contacted the anterolateral aspect of the talar dome during range of motion in all patients and that the AITFL was bent where it contacted the anterolateral dome of the talus in 3 patients (25%). Partial tear or adhesion of the DF-AITFL was noted in 7 patients (58.3%), and cartilage deformation at the anterolateral talar dome in 4 patients (33.3%). Mean visual analog scale pain, American Orthopaedic Foot & Ankle Society, and Foot Function Index scores improved significantly from preoperatively to postoperatively.</p><p><strong>Conclusion: </strong>ALAI due to DF-AITFL should be considered a possible cause of anterolateral ankle pain after an ankle sprain. The diagnosis can be reliably made with a thorough clinical examination and imaging studies. Half of the patients in this series also had lateral ankle instability. Surgical resection of the DF-AITFL and ligament reconstruction, if necessary, resulted in significant symptom improvement.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241275959"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471776","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":"Predicting the Presence of Pain in Youth Baseball Pitchers Using the Concept of Biomechanical Efficiency.","authors":"Adam R Nebel, Kevin A Giordano, Nicole M Bordelon, Gretchen D Oliver","doi":"10.1177/23259671241277596","DOIUrl":"https://doi.org/10.1177/23259671241277596","url":null,"abstract":"<p><strong>Background: </strong>Increases in peak shoulder distraction force and peak elbow valgus torque may influence throwing-arm pain and injury risk in youth pitchers.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to determine whether shoulder distraction force and elbow valgus torque while accounting for anthropometrics and pitch velocity can predict the presence of pain in youth baseball pitchers. It was hypothesized that throwing-arm pain could be predicted using the concept of biomechanical efficiency, where a pitcher who is less efficient (having higher force or torque with the same pitch velocity) is more likely to experience pain.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 38 youth baseball pitchers (mean age, 13.3 ± 1.7 years) were divided into a pain group and pain-free group based on presence of throwing-arm pain as reported on a health history questionnaire. Each pitcher threw 3 maximal-effort fastballs to a catcher at regulation distance, and kinematics were measured using an electromagnetic motion-capture system (minimum 100 Hz). Height and weight as well as mean peak shoulder distraction force, peak elbow valgus torque, and pitch velocity across the 3 trials were evaluated. Logistic regression analyses determined whether shoulder distraction force or elbow valgus torque could predict the presence of throwing-arm pain when holding anthropometrics (body weight for shoulder distraction force; body weight and height for elbow valgus torque) and pitch velocity constant.</p><p><strong>Results: </strong>Shoulder distraction force significantly predicted the presence of throwing-arm pain after accounting for body weight and pitch velocity (χ² = 9.49; <i>P</i> = .023). Specifically, for every 1-N increase in peak shoulder distraction force while holding body weight and pitch velocity constant, there was a 0.6% increased likelihood of experiencing throwing-arm pain. Elbow valgus torque could not predict the presence of pain when holding body weight, height, and pitch velocity constant.</p><p><strong>Conclusion: </strong>The models demonstrated that increases in peak shoulder distraction forces when holding pitch velocity and body weight constant increased a youth baseball pitcher's likelihood of experiencing throwing-arm pain. The study results support the concept of the biomechanical efficiency framework by offering evidence that maintaining pitch velocity with a lower joint load led to a lower likelihood of pain.</p><p><strong>Clinical relevance: </strong>Results suggest that practicing efficient movement strategies can decrease the likelihood of experiencing throwing-arm pain while maintaining performance.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241277596"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471798","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":"Muscle Architecture Properties of the Deep Region of the Supraspinatus: A Cadaveric Study.","authors":"Isabella T Wu, Sydnee A Hyman, Mackenzie B Norman, Gabriela Sendek, Jenna J Powell, Tyler N Kirchberg, David B Berry, John G Lane, Anshuman Singh, Samuel R Ward","doi":"10.1177/23259671241275522","DOIUrl":"https://doi.org/10.1177/23259671241275522","url":null,"abstract":"<p><strong>Background: </strong>The supraspinatus is most frequently involved in rotator cuff tears, a common orthopaedic condition. However, the architecture of this muscle has been described only for the superficial, anterior, and posterior regions.</p><p><strong>Purpose: </strong>To determine the muscle architecture of the deep supraspinatus.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Muscle architecture measurements were collected from 25 cadaveric supraspinatus specimens (13 intact [without tendon tears], 3 with partial-thickness tears, 9 with full-thickness tears). The muscle was divided into deep, superficial anterior, and superficial posterior regions. Pennation angle, raw and normalized fiber length, and sarcomere length and number were compared using repeated-measures analyses of variance.</p><p><strong>Results: </strong>First, mean architecture measurements were compared between regions using only the intact specimens (n = 13). The deep region had a lower mean pennation angle (3.3° ± 1.0°) compared with the posterior region (11.0° ± 3.9°; <i>P</i> < .0001), which in turn had a significantly higher pennation angle compared with the anterior region (7.6 ± 2.6°; <i>P</i> = .0005). Normalized fiber lengths in the deep region were 21.1% (<i>P</i> = .0052) and 34.5% (<i>P</i> < .0001) shorter than the posterior and anterior normalized fiber lengths, respectively. Sarcomere lengths in the deep region were longer (3.4 ± 0.2 μm) compared with the posterior (3.1 ± 0.2 μm; <i>P</i> = .0012) and anterior (3.2 ± 0.2 μm; <i>P</i> = .0390) regions. Sarcomere numbers also decreased in the deep region by 21.2% (<i>P</i> = .0056) and 34.2% (<i>P</i> < .0001) compared with the posterior and anterior regions, respectively.</p><p><strong>Conclusion: </strong>The deep supraspinatus had significantly lower pennation angles, shorter fiber lengths, and fewer but longer sarcomeres in series compared with other subregions within the muscle. These structural differences suggest a functionally unique \"submuscle\" within the supraspinatus.</p><p><strong>Clinical relevance: </strong>Understanding the architecture of the supraspinatus muscle can provide insight into muscle function in health and disease. Specifically, this deep submuscle may play a different role in rotator cuff function than the rest of the muscle.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241275522"},"PeriodicalIF":2.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471797","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":"Clinical Outcomes of the Arthroscopic Capsular Suture-Lifting Technique in the Treatment of Femoroacetabular Impingement in Patients With Borderline Developmental Dysplasia of the Hip.","authors":"Guanying Gao, Chang Zhou, Guangjin Zhou, Shiyu He, Yan Ju, Jianquan Wang, Yan Xu","doi":"10.1177/23259671241275661","DOIUrl":"10.1177/23259671241275661","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with femoroacetabular impingement (FAI) are likely to present with borderline developmental dysplasia of the hip (BDDH). Considering the prolonged risk of negative prognosis in these patients, the need for surgical management of the capsule has been emphasized. Although previous studies have advocated different techniques of capsular closure during surgery, no consensus has been achieved. Therefore, the aim of this study was to evaluate the clinical outcomes of a new arthroscopic capsular suture-lifting technique for the treatment of FAI combined with BDDH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;The arthroscopic capsular suture-lifting technique would achieve better anterior stability and show better clinical outcomes compared with routine capsular closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive patients diagnosed with FAI and BDDH and who underwent hip arthroscopy in our hospital between September 1, 2017, and April 30, 2021, were evaluated. Data were collected prospectively and analyzed retrospectively. Patients were divided into 2 groups according to the capsule closure methods used: capsular suture-lifting technique (lifting group) and routine capsular closure (control group). Anteroposterior hip radiography, Dunn view radiography, and computed tomography imaging were carried out for all patients preoperatively and postoperatively. Patient-reported outcomes, including the modified Harris Hip Score (mHHS) and visual analog scale (VAS) for pain, were collected preoperatively and at least 1 year after surgery and compared between the 2 groups. The Wilcoxon signed-rank test was used to evaluate changes in preoperative to postoperative mHHS scores and VAS. Mann-Whitney &lt;i&gt;U&lt;/i&gt; test was used to evaluate significant differences in postoperative mHHS and VAS scores in the 2 groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In all, 144 patients were included in this study, of whom 77 (53.5%) underwent the arthroscopic capsular suture-lifting technique and 67 (46.5%) underwent routine arthroscopic surgery. The patients in both groups had significant improvement in postoperative mHHS and VAS compared with the preoperative assessment (&lt;i&gt;P&lt;/i&gt; &lt; .05). The postoperative VAS score of patients in the suture-lifting group was significantly lower (2.6 vs 3.8; &lt;i&gt;P&lt;/i&gt; &lt; .05) and the mHHS score was significantly higher (75.2 vs 68.5; &lt;i&gt;P&lt;/i&gt; &lt; .05) than those of patients in the control group. Of the 77 patients in the suture-lifting group, 68 (88.3%) surpassed the minimal clinically important difference (MCID) and 49 (63.6%) achieved the Patient Acceptable Symptom State (PASS). Of the 67 patients in the control group, 26 (38.8%) surpassed MCID and 32 (47.8%) achieved PASS. The percentage of patients achieving MCID and PASS in the suture-lifting group was significantly greater than that in the control group (&lt;i&gt;P&lt;/i&gt; = .007 for MCID; &lt;i&gt;P&lt;/i&gt; = .03 for PAS","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241275661"},"PeriodicalIF":2.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568716","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":"Long-term Outcomes of Complete Tears of the Distal Biceps Tendon: An Analysis of Surgical Management at a Median Follow-up of 14.7 Years.","authors":"Adam J Tagliero, Sara E Till, Xuankang Pan, Anna K Reinholz, Adam C Johnson, Joaquin Sanchez-Sotelo, Jonathan D Barlow, Christopher L Camp","doi":"10.1177/23259671241283787","DOIUrl":"https://doi.org/10.1177/23259671241283787","url":null,"abstract":"<p><strong>Background: </strong>Surgical repair of full thickness biceps tears has demonstrated adequate outcomes in short and mid-term studies. However, data on the long-term outcomes of full thickness distal biceps injuries and their treatment are currently lacking.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to report on patient demographics, injury characteristics, and long-term outcomes for patients with full-thickness distal biceps tears. It was hypothesized that complete distal biceps tears managed operatively would demonstrate robust clinical success at long-term follow-up.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Patients with magnetic resonance imaging-confirmed, complete distal biceps tendon rupture sustained between 1996 and 2016 were identified. Patients were cross-referenced with a regional geographic database.</p><p><strong>Results: </strong>A total of 66 patients (3 female, 63 male) with a median age of 50.8 years (IQR, 41.5-60.4) and a median clinical follow-up of 14.7 years (IQR, 9.6-17.9 years) were included. Patients who sustained a full-thickness distal biceps tendon tear were likely to be in their early 50s, male, right-hand dominant, current/former smokers, and laborers with a history of traumatic injury during an intentional movement. Most of these patients had pain and supination weakness but no loss of range of motion. All included tears were treated operatively. At final follow-up, patients maintained a majority of near-normal range of motion (median total arc of flexion/extension 140° and supination/pronation 80°), excellent elbow flexion strength (91% of patients had full strength), and adequate elbow supination strength (76% of patients had full strength). The overall complication rate was 24%, with 16 out of 66 patients experiencing some type of complication between infection, rerupture, heterotopic ossification, reoperation, and nerve complications. Overall return to work was 98%, and 85% of those who returned to work did so without restrictions.</p><p><strong>Conclusion: </strong>Complete tears of the distal biceps were most common in patients 50 years of age, male sex, right-hand dominant, and current/former smokers. The most common profession was laborer, and injuries were primarily traumatic in nature during intentional activity. Patients managed operatively demonstrated high rates of success at long-term follow-up with respect to elbow function and clinical outcomes.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241283787"},"PeriodicalIF":2.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471796","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":"Relationship of Forearm-Hand Inertia With Throwing Motion Patterns and Elbow Valgus Load in Adolescent Baseball Players.","authors":"Toshiharu Tsutsui, Wataru Sakamaki, Toshihiro Maemichi, Suguru Torii","doi":"10.1177/23259671241272488","DOIUrl":"https://doi.org/10.1177/23259671241272488","url":null,"abstract":"<p><strong>Background: </strong>Growth-specific physical characteristics in adolescence may mediate throwing-related loads and movement patterns associated with elbow injuries. In a previous study, the authors calculated the forearm-hand inertia, which is the moment of inertia centered at the elbow joint.</p><p><strong>Purpose: </strong>To determine the relationship of forearm-hand inertia values with throwing motion patterns and elbow valgus load in adolescent baseball players.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 35 adolescent baseball players underwent measurements by dual-energy x-ray absorptiometry (DXA) scans and a throwing trial. Forearm-hand inertia was determined as the joint moment around the elbow using the subregion analysis mode of DXA. Elbow valgus torque and ball speed during throwing were measured using a dedicated sensor and speed gun, and throwing efficiency was calculated by dividing the elbow valgus load by the ball speed. Players were divided according to the throwing motion pattern in which maximum acceleration occurred: pelvis-upper arm-forearm (proximal-to-distal sequencing [PDS] group; n = 19) or pelvis-forearm-upper arm (proximal upper extremity [PUE] group; n = 16). The groups were compared in terms of ball speed, elbow valgus torque, throwing efficiency, and forearm-hand inertia using <i>t</i> tests and analysis of covariance, with forearm-hand inertia as covariates. The chi-square test was used to examine the relationship between throwing motion patterns and forearm-hand inertia.</p><p><strong>Results: </strong>The PUE group had a higher elbow valgus load (effect size [ES] = 0.65; <i>P</i> = .03), throwing efficiency (ES = 0.63; <i>P</i> = .02), and forearm-hand inertia values (ES = 0.64; <i>P</i> = .04) than the PDS group. In addition, a significant relationship was observed with throwing patterns when forearm-hand inertia values were 350 kg·m² (OR, 2.36; 95% CI, 1.09-5.12; <i>P</i> = .012) and 400 kg·m² (OR, 1.68; 95% CI, 0.99-2.85; <i>P</i> = .037).</p><p><strong>Conclusion: </strong>Study results indicated that growth-specific physical characteristics in adolescent baseball players exhibited in forearm-hand inertia mediated the relationship between high elbow valgus and poor throwing efficiency caused by poor throwing motion patterns.</p><p><strong>Clinical relevance: </strong>A better understanding of the details in muscle function with throwing mechanics may prevent future injuries.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241272488"},"PeriodicalIF":2.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471801","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 Suprascapular Artery as a Reference for the Evaluation of Supraspinatus Fatty Infiltration on Magnetic Resonance Imaging.","authors":"Siyi Guo, Pu Zhang, Qihuang Qin, Chunyan Jiang","doi":"10.1177/23259671241272456","DOIUrl":"https://doi.org/10.1177/23259671241272456","url":null,"abstract":"<p><strong>Background: </strong>Fatty infiltration (FI) of the supraspinatus is commonly seen in chronic large-to-massive rotator cuff tears. Evaluating FI in patients with severe muscle atrophy can be confusing.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to investigate the anatomic relationship between the suprascapular artery and supraspinatus muscle on magnetic resonance imaging (MRI) to provide a method for defining the border of the supraspinatus muscle on Y-view MRI. It was hypothesized that the branches of the suprascapular artery would encircle the supraspinatus muscle on Y-view and adjacent MRI slices and could be used for defining the supraspinatus outline on oblique sagittal images.</p><p><strong>Study design: </strong>Cohort study (diagnosis); Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 172 shoulders that had undergone arthroscopic repair for large-to-massive rotator cuff tears were retrospectively included. Two methods, one based on the supraspinous fossa and trapezius (SF method) and the other based on the region bounded by the branches of the suprascapular artery (SA method), were used for defining the supraspinatus outline on Y-view MRI for the assessment of FI. Preoperative supraspinatus FI grade and tangent sign and postoperative tendon integrity were evaluated. Shoulder function was assessed using the American Shoulder and Elbow Surgeons (ASES) score and active range of motion.</p><p><strong>Results: </strong>The branches of the suprascapular artery encircled the supraspinatus in all shoulders, with the diameter of the branches ranging from 0.5 to 3 mm. The agreement in supraspinatus FI grading between the SF and SA methods was 65.12%. When limited to the 61 shoulders with a positive tangent sign, the agreement dropped to 22.95% (κ = 0.032). The group (FI grade 2 by SA method and ≥3 by SF method) showed no significant difference in postoperative outcomes compared with the 2-vs-2 group but had significantly better postoperative ASES scores (<i>P</i> = .001) and active range of motion in forward elevation (<i>P</i> = .020) compared with the ≥3-vs-≥3 group. The tangent sign was positive in 92.16% of the 2-vs-≥3 group.</p><p><strong>Conclusion: </strong>The suprascapular artery is a reliable reference for the evaluation of supraspinatus FI. When a positive tangent sign presents, supraspinatus FI is likely to be overestimated if the hyperintensity outside the region bounded by the branches of the suprascapular artery is mistaken as FI.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 10","pages":"23259671241272456"},"PeriodicalIF":2.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471804","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}