Orthopaedic Journal of Sports Medicine最新文献

{"title":"Novel Noninvasive Imaging Techniques to Assess Structural, Functional, and Material Properties of Tendon, Ligament, and Cartilage: A Narrative Review of Current Concepts.","authors":"Julia S Retzky, Matthew F Koff, Ogonna K Nwawka, Scott A Rodeo","doi":"10.1177/23259671251317223","DOIUrl":"10.1177/23259671251317223","url":null,"abstract":"<p><strong>Background: </strong>Novel noninvasive imaging modalities such as quantitative magnetic resonance imaging (qMRI) and shear wave elastography (SWE) allow for assessment of soft tissue microstructure and composition, which ultimately may be associated with functional and material properties.</p><p><strong>Purpose: </strong>To provide a narrative review of the scientific techniques and clinical applications of qMRI and SWE for the evaluation of soft tissue about the knee and shoulder, including the meniscus, the anterior cruciate ligament (ACL), and the rotator cuff.</p><p><strong>Study design: </strong>Review.</p><p><strong>Methods: </strong>A literature search was performed in October 2022 via PubMed using the following keywords: \"quantitative MRI tendon,\" quantitative MRI ligament,\"\"quantitative MRI cartilage,\" or \"shear wave elastography tendon.\" Only articles related to clinical applications were included in this review.</p><p><strong>Results: </strong>Conventional imaging techniques, including standard morphologic magnetic resonance imaging (MRI) and ultrasound imaging, have limited ability to evaluate the material and functional properties of soft tissue; qMRI builds on the limitations of conventional morphologic MRI by allowing for detection of early articular cartilage changes, differentiation of healed versus unhealed meniscal tissue, and quantification of ACL graft maturity. SWE can evaluate the material properties of rotator cuff and Achilles tendons after injury, which may provide insight into both the chronicity and the healing status of the aforementioned injuries.</p><p><strong>Conclusion: </strong>Our review of the literature showed that quantitative imaging techniques, including qMRI and SWE, may both improve early detection of pathology and aid in comprehensive evaluation after treatment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671251317223"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449710","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 Role of Isolated Lateral Extra-Articular Tenodesis in Managing Residual Pivot Shift After Primary Anterior Cruciate Ligament Reconstruction and a New Medial Meniscal Tear.","authors":"Alexander J Hoffer, Joseph C Brinkman, Sailesh V Tummala, Sofia C Economopoulos, Kostas J Economopoulos","doi":"10.1177/23259671241308570","DOIUrl":"10.1177/23259671241308570","url":null,"abstract":"<p><strong>Background: </strong>Persistent mildly abnormal knee kinematics after anterior cruciate ligament (ACL) reconstruction (ACLR) is an ongoing clinical problem.</p><p><strong>Purpose: </strong>To compare the clinical outcomes of revision ACLR (rACLR), rACLR and lateral extra-articular tenodesis (LET), or isolated LET in patients with a grade ≥2 pivot shift after ACLR with an intact or partially torn graft and a new, symptomatic medial meniscal tear.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A retrospective review of all patients with a new, symptomatic medial meniscal tear diagnosed after a primary ACLR was performed. Patients were included if they demonstrated a grade ≥2 pivot shift on physical examination with an intact or partially torn ACL graft. Exclusion criteria included complete graft rupture. The senior author's management evolved in a practice change design from rACLR to rACLR with LET, to isolated LET over the study period. The primary outcomes were the International Knee Documentation Committee (IKDC), Lysholm, and Tegner patient-reported outcomes (PROs) at 2 years postoperatively.</p><p><strong>Results: </strong>A total of 47 patients, with 16 in the rACLR group, 12 in the rACLR and LET group, and 19 in the isolated LET group were included. Baseline characteristics between groups were similar. At 2 years, the rACLR group IKDC score was 86.1 ± 6.6 and was lower than the rACLR and LET group (91.9 ± 4.4; <i>P</i> = .009; 95% CI, -10.4 to -1.2) and the isolated LET group scores (91.7 ± 3.0; <i>P</i> = .004; 95% CI, -9.7 to -1.6). The Lysholm score was lower in the rACLR group (85.8 ± 6.3) when compared with the rACLR and LET group (91.8 ± 4.6; <i>P</i> = .03; 95% CI, -11.8 to -0.39). There was no difference in any Tegner scores at 2 years (<i>P</i> = .09).</p><p><strong>Conclusion: </strong>In patients with grade ≥2 pivot shift after an ACLR with an intact or partially torn graft and a new, symptomatic medial meniscal tear, the addition of an LET with or without rACLR led to improved PROs compared with an isolated rACLR. An isolated LET in this patient population should be considered an acceptable treatment option.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241308570"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382917","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":"Evaluating Donor-Recipient Sex Mismatch in Anterior Cruciate Ligament Reconstruction With Allograft: Outcomes at 2 Years Postoperatively.","authors":"Connor R Crutchfield, Natalie A Lowenstein, Chilan B G Leite, Christian Lattermann, Elizabeth G Matzkin","doi":"10.1177/23259671241307559","DOIUrl":"10.1177/23259671241307559","url":null,"abstract":"<p><strong>Background: </strong>Female patients tend to suffer a greater risk of reinjury and worse patient-reported outcome measures (PROMs) after anterior cruciate ligament reconstruction (ACLR) than male patients, regardless of the graft type used.</p><p><strong>Purpose/hypothesis: </strong>This study explored the role of donor-recipient sex mismatching to help explain these sex-based disparities in outcomes after ACLR with an allograft. The hypothesis was that allograft donor-recipient sex mismatch would adversely affect surgical outcomes at a 2-year follow-up, with male-to-female graft donations yielding the lowest rates of success.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>Patients who underwent primary ACLR with an allograft between 2012 and 2022 were eligible for recruitment. The following PROMs were collected from baseline through a 2-year follow-up: Knee injury and Osteoarthritis Outcome Score subscales, Marx activity rating scale, visual analog scale for pain, and Veterans RAND 12-Item Health Survey. Demographic and graft-specific variables were also collected. Sex-<i>matched</i> cases were compared with sex-<i>mismatched</i> cases and an identical subgroup analysis was performed for female patients only.</p><p><strong>Results: </strong>Of the 112 included patients (N = 70 women), 59 (52.7%) were sex mismatched. The mean patient age was 40.7 ± 10.9 years, and the mean body mass index was 26.8 ± 4.7 kg/m². Most reconstructions (89.3%) used a semitendinosus tendon graft, with a mean implanted graft diameter of 9.7 ± 0.5 mm (quadrupled). Of the mismatched cases, 96.6% involved a male allograft donated to female recipients. Overall, the matched group demonstrated higher PROM scores across all time points compared with the mismatched group, although statistical significance was only reached for the Marx score at baseline (<i>P</i> = .012) and 1 year postoperatively (<i>P</i> = .022). In the female-only subgroup analysis, a larger graft diameter was measured in the mismatched cases (receiving male allografts) compared with the matched female cases (9.7 ± 0.6 vs 9.2 ± 0.4 mm, respectively; <i>P</i> = .002). Moreover, the mismatched cases tended to report better postoperative PROM scores, although this trend was not statistically significant.</p><p><strong>Conclusion: </strong>The study findings indicated that male donors provided larger allografts than female donors, and that donor-recipient allograft sex matching did not contribute significantly to ACLR outcomes. Other factors may be more important to outcomes in female patients.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241307559"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382964","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":"Failure Rate of Meniscal Repair With ACL Reconstruction Among Professional Athletes: A Study of 196 Patients From the SANTI Study Group With a Mean Follow-up of 96 Months.","authors":"Jae-Sung An, Mohammed Lahsika, Alice Nlandu, Giancarlo Giurazza, Julien Chamoux, Marc Barrera Uso, Silvia Cardarelli, Thais Dutra Vieira, Bertrand Sonnery-Cottet","doi":"10.1177/23259671241308591","DOIUrl":"10.1177/23259671241308591","url":null,"abstract":"<p><strong>Background: </strong>There is still controversy regarding the ideal management method for meniscal tears combined with anterior cruciate ligament (ACL) injury, especially for professional athletes.</p><p><strong>Purposes: </strong>To (1) describe the incidence of secondary meniscectomy in professional athletes after undergoing meniscal repair concomitant to primary ACL reconstruction (ACLR) and (2) identify the associated risk factors for repair failure of the medial meniscus (MM) and/or lateral meniscus (LM) in this population at long-term follow-up.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>This was a retrospective comparative study. Included were professional athletes who underwent arthroscopic primary ACLR and repair of MM and/or LM tears between January 2013 and December 2022and who had ≥2 years of follow-up. Risk factors associated with secondary meniscectomy were analyzed using a Cox proportional hazards model.</p><p><strong>Results: </strong>Out of 230 professional athletes (mean ± SD age, 23.3 ± 5.0 years; mean Tegner score, 9.3 ± 1.0) who underwent primary ACLR, 196 patients (85.2%) also had meniscal repair. The most common type of graft used was hamstring tendon (74%), and 74% of patients underwent a concomitant lateral extra-articular procedure. Among the 196 patients with meniscal lesions, 37% had LM lesions, 29% had MM lesions, and 34% had both LM and MM lesions. LM tears were repaired in 92.8% of cases, while 7.2% were left in situ. The most common type of repair for LM tears was the all-inside technique. MM tears were repaired in 97.6% of cases, with 2.4% left alone. The most common type of repair for MM tears was the suture hook technique, and no meniscectomies were performed. At a mean follow-up of 95.8 ± 45.1 months, 26 patients (13.3%) underwent a secondary meniscectomy: 7 (5.0%) for LM and 19 (15.4%) for MM. A Cox model revealed no significant risk factors associated with secondary lateral or medial meniscectomy.</p><p><strong>Conclusion: </strong>At long-term follow-up, the meniscal repair failure rate in this population of patients who underwent primary ACLR was 13.2% overall, 5% for LM tears and 15.4% for MM tears. No risk factors for secondary meniscectomy were found.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241308591"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382968","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":"Outperformance of Combined Artificial Anterolateral Ligament and ACL Reconstruction Compared With Isolated Artificial ACL Reconstruction in Knees With Anterolateral Structure and ACL Deficiency: A Biomechanical Analysis.","authors":"Rongshan Cheng, Dimitris Dimitriou, Gai Yao, Xianghui Li, Xiaolong Lv, Yangyang Yang, Hua Ying, Ziming Wang, Tsung-Yuan Tsai","doi":"10.1177/23259671241309270","DOIUrl":"10.1177/23259671241309270","url":null,"abstract":"<p><strong>Background: </strong>Despite the promising clinical outcomes of artificial polyethylene terephthalate (PET) ligaments in isolated anterior cruciate ligament reconstruction (ACLR), their biomechanical performance after combined anterolateral ligament reconstruction (ALLR)/ACLR in anterolateral structure (ALS)/anterior cruciate ligament (ACL)-deficient knees has not been investigated.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to compare biomechanical performance in cadaveric knees between combined artificial ALLR/ACLR and isolated artificial ACLR using PET ligaments. It was hypothesized that combined artificial ALLR/ACLR would restore native knee stability and outperform isolated artificial ACLR in ALS/ACL-deficient knees.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>Eight fresh-frozen cadaveric knees were tested using a robotic manipulator. Each knee was tested in 4 states: (1) ALS/ACL intact, (2) ALS/ACL deficient, (3) ACLR, and (4) ALLR/ACLR. The anterior tibial translation (ATT) and tibial internal rotation (IR) in each knee condition were measured under 3 loads: (1) 89 N of anterior tibial loading, (2) 5 N·m of IR torque, and (3) simulated pivot shift (combined 5 N·m of IR torque and 7 N·m of valgus load).</p><p><strong>Results: </strong>During 89 N of anterior tibial loading, there were no significant differences in ATT between the isolated ACLR and ALLR/ACLR knees. During 5 N·m of IR torque, the mean tibial IR at 45° of flexion was significantly higher in the ACLR knees (32.49°± 7.96°) than in the ALLR/ACLR knees (21.78°± 3.03°) (<i>P</i> < .05). During the simulated pivot shift, the mean ATT and tibial IR at 30° and 45° of flexion were significantly higher in the ACLR knees (ATT: 5.09 ± 2.74 mm at 30°, 5.43 ± 2.79 mm at 45°; IR: 30.08°± 7.31° at 30°, 32.55°± 6.48° at 45°) than in the ALLR/ACLR knees (ATT: 1.93 ± 2.71 mm at 30°, 1.17 ± 2.26 mm at 45°; IR: 22.12°± 4.05° at 30°, 22.18°± 3.37° at 45°) (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>Combined artificial ALLR/ACLR restored native knee stability across multiple flexion angles and outperformed isolated artificial ACLR in ALS/ACL-deficient knees, particularly with respect to ATT and tibial IR during the pivot-shift test.</p><p><strong>Clinical relevance: </strong>The indications of the artificial PET ligament may be expanded to include combined ALLR/ACLR to restore knee stability better than isolated artificial ACLR in ALS/ACL-deficient knees.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241309270"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409840","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":"Effects of Integrating Lower-Leg Exercises Into a Multimodal Therapeutic Approach on Medial Tibial Stress Syndrome Management Among Recreational Runners: A Randomized Controlled Study.","authors":"Aynollah Naderi, Mohammad Fallah Mohammadi, Aida Heidaralizadeh, Maarten H Moen","doi":"10.1177/23259671241311849","DOIUrl":"10.1177/23259671241311849","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medial tibial stress syndrome (MTSS) can impair training and daily activities, underscoring the need for effective treatment. However, there's limited evidence on using lower-leg exercises for MTSS in recreational runners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of the present study was to determine whether adding lower-leg exercises to a multimodal therapeutic intervention improves the recovery from MTSS in recreational runners. It was hypothesized that adding lower-leg exercises to a multimodal therapeutic intervention would enhance its effect on foot posture and make MTSS recovery more effective than multimodal therapeutic interventions alone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Randomized controlled trial; Level of evidence, 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 40 recreational runners diagnosed with MTSS using history and physical examination (40% women; mean ± SD age, 23.9 ± 3.9 years) were then randomly divided into intervention (n = 20) and control (n = 20) groups. Both groups underwent a multimodal therapeutic intervention involving ice massage, foot orthoses, and extracorporeal shockwave therapy. The intervention group additionally received a tailored lower-leg exercise protocol involving stretching, strengthening, sensorimotor exercises, and foam roller myofascial release. Pain intensity, MTSS severity, perceived treatment effect, quality of life (QoL), and static and dynamic foot posture were assessed at baseline, 6-week, and 12-week follow-up evaluations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A mixed model analysis of variance found no significant differences in pain intensity (&lt;i&gt;P&lt;/i&gt; = .17) or MTSS severity (&lt;i&gt;P&lt;/i&gt; = .30) between the intervention group and the control group. However, there were significant improvements in QoL (&lt;i&gt;P&lt;/i&gt; = .003), static foot posture index (FPI) (&lt;i&gt;P&lt;/i&gt; = .02), and dynamic arch index (DAI) (&lt;i&gt;P&lt;/i&gt; &lt; .001), for the intervention group. After 6 and 12 weeks, the intervention group displayed lower DAI scores than controls (&lt;i&gt;P&lt;/i&gt; = .04 and &lt;i&gt;P&lt;/i&gt; = .02, respectively). By week 12, the intervention group exhibited significantly higher QoL scores (&lt;i&gt;P&lt;/i&gt; = .02) and lower FPI scores (&lt;i&gt;P&lt;/i&gt; = .04) compared with controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study demonstrated that lower-leg exercises within a multimodal treatment positively affected foot posture and QoL, although they did not significantly alleviate pain or affect MTSS severity in recreational runners. Therefore, health care providers are encouraged to integrate these exercises into rehabilitation programs to improve foot posture and QoL for individuals with MTSS. However, future research should focus on larger sample sizes, objective measures, resting control groups, and longer follow-up periods to enhance the understanding of the effects of lower-leg exercises on MTSS management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Registration: &lt;/strong&gt;IRCT 20170114031942N5 (Iranian Registry of Clinical Trials)","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241311849"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Ligament Involvement in High-Energy and Polytraumatic Multiligament Knee Injuries Compared With Low-Energy or Isolated Injuries.","authors":"Collin D R Hunter, Joseph Featherall, Natalya McNamara, Patrick E Greis, Travis G Maak, Stephen K Aoki, Antonio Klasan, Justin J Ernat","doi":"10.1177/23259671241312251","DOIUrl":"10.1177/23259671241312251","url":null,"abstract":"<p><strong>Background: </strong>Multiligament knee injuries (MLKIs) due to high-energy (HE) or polytraumatic (PT) mechanisms result in worse patient outcomes after surgery versus low-energy (LE) or nonpolytraumatic (NPT) mechanisms. There remains a paucity of research in the literature investigating MLKIs resulting from these mechanisms of injury.</p><p><strong>Purpose: </strong>To characterize differences in ligamentous injury/surgery patterns between different mechanism groups: HE versus LE and PT versus NPT.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>This is a retrospective chart review of consecutive surgical MLKIs from a single institution. Demographics, clinical/radiographic findings, and intraoperative variables were obtained. HE versus LE mechanisms were stratified. Patients with inadequate data were excluded. PT versus NPT classifications were based on presence of concurrent nonknee injuries. Subgroup comparisons were made based on body mass index, age, sex, number/type of ligaments injured, and surgeries performed.</p><p><strong>Results: </strong>From a total of 226, 176 (78%) patients were included (41 PT [23%] and 135 NPT [77%]; 62 HE [35%] and 114 LE [65%]). PT mean age was 30.7 ± 13.7 years (male, 32 [78%)], while NPT mean age was 27.1 ± 12.3 years [male, 91/135 [67%]). HE mean age was 31.4 ± 13.1 years (male, 49/62 [79%]), and LE mean age was 25.6 ± 11.8 years (male, 73/114 [64%]). Posterior cruciate ligament (PCL) injuries were higher in PT (27/41 [66%]) and HE (42/62 [68%]) versus NPT (58/135 [43%]) and LE (44/114 [39%]), respectively. Lateral collateral ligament (LCL) injuries were higher in PT (29/41 [71%]) and HE (41/62 [66%]) versus NPT (66/135 [49%]) and LE (55/114 [48%]), respectively. The mean number of ligaments injured was higher in PT versus NPT (2.9 vs 2.4) and in HE versus LE (2.8 vs 2.4). LCL surgical interventions were more common in PT (23/41 [55%]) versus NPT (49/135 [36%]) and in HE (33/62 [53%]) versus LE (39/114 [34%]). No other differences in injuries/surgeries existed between PT and NPT or HE and LE, in anterior cruciate, medial collateral, or medial patellofemoral ligaments.</p><p><strong>Conclusion: </strong>PT and HE MLKIs are characterized by increased rates of PCL and LCL injuries compared with LE and NPT. HE and PT patients experience more injured ligaments than LE and NPT and are more likely to require reconstruction/repair of the LCL. These findings suggest injury severity and mechanism may facilitate clinical decision making in MLKIs.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241312251"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414679","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":"Mechanisms of Severe Adductor Longus Injuries in Professional Soccer Players: A Systematic Visual Video Analysis.","authors":"Aleksi Jokela, Giulio Pasta, Francesco Della Villa, Arnaldo Abrantes, Dimitrios Kalogiannidis, Alvaro García-Romero-Pérez, Marco Marano, Dmitriy Skibinskyi, Stefano Mazzoni, Ricard Pruna, Xavier Valle, Lasse Lempainen","doi":"10.1177/23259671241309647","DOIUrl":"10.1177/23259671241309647","url":null,"abstract":"<p><strong>Background: </strong>Changing direction, kicking, reaching, and jumping have been found to be the primary mechanisms of adductor longus injury. No previous studies specifically analyzing severe adductor longus injury mechanisms using video analysis have been published.</p><p><strong>Purpose: </strong>To systematically analyze video footage to describe the mechanisms of severe acute adductor longus injuries in male professional soccer players.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 20 professional male soccer players (median age, 27 years; range, 18-35 years) who experienced an acute adductor longus injury during a match between October 2017 and December 2023 were included. All analyzed injuries were severe, either complete adductor longus tendon ruptures or partial lesions resulting in an absence from soccer competition of >28 days. Two authors independently reviewed the injuries based on a comprehensive injury causation model. Factors analyzed included playing situation, player/opponent behavior, and biomechanical descriptions encompassing whole-body and joint movements/positions.</p><p><strong>Results: </strong>Of the 20 included injuries, 13 (65%) were considered noncontact and 7 (35%) were indirect contact. A closed kinetic chain (CKC) injury mechanism was found in 14 injuries (70%), an open kinetic chain (OKC) mechanism was found in 3 injuries (15%), and the injury occurred during high-speed running in the remaining 3 cases (15%). Player actions at the time of injury included reaching with the uninjured leg (CKC stretching; n = 11 [55%]), reaching with the injured leg (OKC stretching; n = 2 [10%]), dribbling (n = 2 [10%]), and landing (n = 2 [10%]). In CKC injuries, hip extension, hip abduction, and external rotation were all found in 64% of the cases. All OKC injuries involved hip abduction, external rotation, and rapid change of movement from hip extension to flexion.</p><p><strong>Conclusion: </strong>Severe adductor longus injuries occurred predominantly during CKC actions, particularly when reaching for the ball with the uninjured leg. These injuries were consistently characterized by a combination of hip extension, abduction, and external rotation. A crucial aspect in these injuries appears to be the involvement of an eccentric muscle action, featuring rapid muscle activation during rapid muscle lengthening.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241309647"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409838","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":"Cam Morphology and Sex-Based Differences in the Proximal Femur Anatomy of Collegiate Athletes Without Hip Pain: A 3-Dimensional Statistical Shape Modeling Analysis.","authors":"Bergen Braun, Joseph D Mozingo, Penny R Atkins, K Bo Foreman, Allan K Metz, Stephen K Aoki, Travis G Maak, Andrew E Anderson","doi":"10.1177/23259671241309604","DOIUrl":"10.1177/23259671241309604","url":null,"abstract":"<p><strong>Background: </strong>Radiographic studies have reported a high prevalence of cam morphology in athletes, especially in male athletes, suggesting these individuals are at an elevated risk of developing femoroacetabular impingement syndrome (FAIS). However, recent research has shown that 2-dimensional measurements do not accurately characterize cam deformities, motivating the need for 3-dimensional (3D) analyses.</p><p><strong>Purpose: </strong>To develop a 3D statistical shape model of the proximal femur to evaluate cam morphology in collegiate athletes through (1) quantifying shape variation, (2) establishing sex-based shape differences, and (3) comparing shapes between male athletes and male cam FAIS patients.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>Double-echo steady-state magnetic resonance images were prospectively acquired of the hips of Division I collegiate athletes (28 male, 23 female). An existing data set of computed tomography scans of cam FAIS patients (26 male) and morphologically screened controls (30 male, 17 female) was also evaluated. The proximal femur was segmented, reconstructed into a 3D surface, and analyzed to generate a correspondence model using ShapeWorks. Principal component analysis, parallel analysis, and linear discriminant analysis quantified variation in proximal femoral shape.</p><p><strong>Results: </strong>Variation in the full cohort primarily occurred in the head-neck junction, femoral offset, and location of the greater trochanter relative to the head/neck (mode VIII, adjusted <i>P</i> = .01; modes I and IV, adjusted <i>P</i> = .002 and adjusted <i>P</i> = .003, respectively; modes IV and VIII, adjusted <i>P</i> = .0003 and adjusted <i>P</i> = .0007, resepctively. <i>P</i> < .001). Modes represented anatomic variation significantly different between pairs within a group. Variation between male and female athletes occurred in the concavity of the head at the head-neck junction, length of the femur, and length of the femoral offset (modes I and II, adjusted <i>P</i> = .006 and adjusted <i>P =</i> .009, respectively). Variation between male athletes and male patients and between male patients and male controls occurred in the concavity of the head at the head-neck junction and femoral torsion (mode IV, adjusted <i>P</i> = .02 and adjusted <i>P</i> = .003, respectively). Shape scores, which represented a generalized value of the entire shape, were significantly different between athletes and patients (adjusted <i>P</i> = .003) and patients and controls (adjusted <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>Athletes in our study had a proximal femur shape more similar to morphologically screened controls than FAIS patients. Sex-based differences occurred in athletes in regions where cam morphology typically occurs.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241309604"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391431","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":"Recent Trends in Quadriceps Tendon and Patellar Tendon Injuries in the National Football League.","authors":"John R Baumann, Ashwin R Garlapaty, James L Cook, Steven F DeFroda","doi":"10.1177/23259671241304437","DOIUrl":"10.1177/23259671241304437","url":null,"abstract":"<p><strong>Background: </strong>While quadriceps tendon (QT) and patellar tendon (PT) tears are relatively rare in the National Football League (NFL), the impact they can have on a player's season and career is significant. Despite the importance of extensor tendon injuries within the NFL, there is a lack of recent literature describing their risk factors, incidence, and impact on performance.</p><p><strong>Purposes: </strong>To determine the incidence and impact of QT and PT injuries in the NFL between the 2009-2010 and 2022-2023 seasons and to explore the impact that player and injury characteristics have on injury risk, return to play (RTP), and player performance.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>Publicly available data were reviewed to capture all PT and QT tears reported in the NFL between the 2009-2010 and 2022-2023 seasons. RTP and performance metrics were recorded for each player during the season before injury and the first 2 seasons postinjury. Data were analyzed to determine statistically significant differences in proportions using chi-square tests, Fisher exact tests, or McNemar tests. Statistical significance was set at <i>P</i> < .05.</p><p><strong>Results: </strong>A total of 80 extensor tendon tears (24 QT tears, 56 PT tears) were identified between the 2009-2010 and 2022-2023 NFL seasons. Risk factors for QT injury included body mass index ≥31, age ≥26 years, and >4 years of NFL experience. The risk for QT injury was higher in offensive and defensive linemen compared with skill players. The risk for PT injury was higher for offensive linemen compared with other position groups. Overall, 96.3% of extensor tendon injuries were season ending. The RTP rate for QT injuries was greater (58.3%) than that for PT injuries (55.4%). QT injuries resulted in a greater rate of return to prior performance level and a quicker return to performance compared with PT injuries.</p><p><strong>Conclusion: </strong>The rates of QT and PT injury were higher in this study compared with those found in prior NFL studies. This study found similar RTP rates after QT injury but significantly lower RTP rates after PT injury compared with the previous literature. This highlights the significant, devastating, and increasing impact that extensor tendon injuries have on NFL players.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 2","pages":"23259671241304437"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382981","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}