Orthopaedic Journal of Sports Medicine最新文献

{"title":"Familial Predisposition to Anterior Cruciate Ligament Injury in Australian Rules Footballers.","authors":"Sara Hasani, Julian A Feller, Kate E Webster","doi":"10.1177/23259671241295613","DOIUrl":"10.1177/23259671241295613","url":null,"abstract":"<p><strong>Background: </strong>A community athlete with an anterior cruciate ligament (ACL) injury is 2.5 times more likely to have a family history of ACL injury than an athlete without an ACL injury. The prevalence of family history and its relationship to ACL injury has not been investigated in elite athletes playing a high-risk sport such as Australian rules football.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to determine whether there is an association between primary ACL injury and family history in professional male and female Australian Football League (AFL) players. It was hypothesized that players with a history of ACL injury would have greater rates of family history.</p><p><strong>Study design: </strong>Case-control study; Level of evidence, 3.</p><p><strong>Methods: </strong>All AFL players in the state of Victoria, Australia, were invited to complete a survey querying about their history of ACL injury and whether they had any immediate family members with a history of ACL injury. ACL injury history was compared in those with and without a family history of ACL injury according to sex.</p><p><strong>Results: </strong>Completed surveys were obtained from 615 out of a possible 672 (91.5%) AFL players, of whom 410 were men and 205 were women. Of players with a history of ACL injury, family history was reported in 47% of male players (15 of 32) and 32% of female players (7 of 22). Male players with an ACL injury history were 3.19 times (95% CI, 1.55-6.76; <i>P</i> < .003) more likely to have a positive family history compared with those without ACL injury, and female players with an ACL injury history were 1.7 times (95% CI, 0.66-4.5; <i>P</i> = .2) more likely to report a family history than those without.</p><p><strong>Conclusion: </strong>A strong association was observed between family history and primary ACL injury history in male Australian rules football players. The same association was not statistically significant in female players.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241295613"},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769963","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":"Pediatric Concussion Injuries in Soccer: Emergency Department Trends in the United States From 2012 to 2023.","authors":"Georgia R Sullivan, Eugenia A Lin, Alexander Hoffer, Meghan Richardson, Anikar Chhabra","doi":"10.1177/23259671241303180","DOIUrl":"10.1177/23259671241303180","url":null,"abstract":"<p><strong>Background: </strong>Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week.</p><p><strong>Purpose: </strong>To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Methods: </strong>A retrospective cohort from the National Electronic Injury Surveillance System database was assessed. Age, sex, and injury type were extracted for all soccer-related emergency department visits between January 1, 2012, and December 31, 2023. Univariate and multiple regression analyses were used to assess concussions as a percentage of all soccer-related injuries based on sex, age group (6-9, 10-13, and 14-17 years), and year. The following time frames were assessed: 2012-2015, 2016-2019, and 2020-2023.</p><p><strong>Results: </strong>The proportion of concussions decreased from 8.2% of all soccer-related injuries in 2012-2015 to 6.1% in 2020-2023 (<i>P</i> < .01). The relative risk reduction for soccer-related concussions presenting to an emergency department in 2020-2023 compared with 2012-2015 was 25.6%. Overall, the proportion of concussions among 10- to 13-year-old and 14- to 17-year-old players was higher than for 6- to 9-year-old players (6.6% and 8.9% vs 4.9%, respectively; <i>P</i> < .01). Despite having a lower frequency of soccer-related injuries overall, female players had a greater proportion of concussions than male players (9.6% vs 6.2% of all soccer-related injuries; <i>P</i> < .01). In the multiple regression analysis, injuries that occurred in 2020-2023 were associated with lower odds of concussion compared with 2012-2015 (odds ratio [OR], 0.75 [95% CI, 0.69-0.81]). Compared with 6- to 9-year-old and male players, the 10- to 13-year-old (OR, 1.30 [95% CI, 1.16-1.45]), 14- to 17-year-old (OR, 1.79 [95% CI, 1.61-1.99]), and female players (OR, 1.53 [95% CI, 1.43-1.63]) were associated with higher odds of concussion.</p><p><strong>Conclusion: </strong>A 25.6% reduction in the relative risk of presenting to the emergency department with a soccer-related concussion was found when comparing 2020-2023 (after USSF header policy implementation) with 2012-2015 (before policy implementation). The USSF youth soccer header policy may improve player safety by reducing head impacts in the pediatric population.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241303180"},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770525","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":"Operative Treatment of Nonprimary Osteochondral Lesions of the Talus: A Systematic Review.","authors":"Rui Correia Cardoso, Renato Andrade, Inês Monteiro, Cátia Machado, Filipe Sá Malheiro, Pedro Serrano, Paulo Amado, João Espregueira Mendes, Bruno S Pereira","doi":"10.1177/23259671241296434","DOIUrl":"10.1177/23259671241296434","url":null,"abstract":"<p><strong>Background: </strong>Nonprimary osteochondral lesions of the talus (OLT) pose a significant challenge in orthopaedics, with no definitive consensus on optimal surgical treatment.</p><p><strong>Purpose: </strong>To consolidate the most recent evidence on operative treatments for nonprimary OLT by assessing patient-reported outcomes (PROs), postoperative complications, and clinical failures.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 4.</p><p><strong>Methods: </strong>This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA in Exercise, Rehabilitation, Sport medicine and Sports science guidelines. Searches were conducted in PubMed, Embase, and Cochrane Library databases through June 2023. Eligible studies evaluated operative outcomes in skeletally mature patients with nonprimary OLT after failed previous surgeries. Primary outcomes included clinical and functional PROs. Secondary outcomes included postoperative complications and clinical failures. Quantitative analyses involved weighted means, mean differences, minimal clinically important differences, success rates (95% binomial proportion confidence interval), and a pre-to-postoperative meta-analysis.</p><p><strong>Results: </strong>Out of 3992 identified records, 50 studies involving 806 ankles from 794 patients were included. All operative treatments significantly improved PROs (<i>P</i> < .05), except osteochondral allograft transplantation (OCA) for American Orthopaedic Foot and Ankle Society and pain (visual analog scale/numeric rating scale [VAS/NRS]) scores and HemiCAP for pain (VAS/NRS) scores. Autologous chondrocyte implantation (ACI) and osteochondral autologous transplantation (OAT) demonstrated the greatest PRO success rates, exceeding 80%. Postoperative complications occurred in 4% of cases, most frequently with HemiCAP. Clinical failures affected 22% of cases, particularly with autologous matrix-induced chondrogenesis, OAT, OCA, and HemiCAP.</p><p><strong>Conclusion: </strong>Our systematic review demonstrated that ACI and OAT are promising treatments for nonprimary OLT, with ACI showing fewer clinical failures than OAT. Conversely, OCA and HemiCAP exhibited lower effectiveness and higher clinical failure rates, suggesting a need for reassessment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241296434"},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770475","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":"Anterior Cruciate Ligament Reconstruction in Patients Older Than 50 Years: A Descriptive Study With Minimum 10-Year Follow-up.","authors":"Grégoire Micicoi, Rayan Fairag, Axel Machado, Adil Douiri, Nicolas Bronsard, Justin Ernat, Jean-François Gonzalez","doi":"10.1177/23259671241292071","DOIUrl":"10.1177/23259671241292071","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) reconstruction is increasingly being performed in patients >50 years old; however, the long-term outcomes are unclear.</p><p><strong>Purpose: </strong>To analyze the functional results, osteoarthritic progression, reoperation rate, and failure rate at minimum 10-year follow-up in patients >50 years old who have undergone primary ACL reconstruction.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>Included in this study were patients >50 years old who underwent primary ACL reconstruction and had at least 10 years of follow-up data. All patients had instability with limitation of their activities, indicating the necessity of surgical intervention. Patients with revision surgeries, ACL repairs, and nonoperative treatment were excluded. Failure was defined as the presence of revision, high-grade Lachman, positive pivot shift (2+), or subjective instability. The Knee injury and Osteoarthritis Outcome Score (KOOS), subjective and objective functional scores, and osteoarthritic progression were analyzed at final follow-up.</p><p><strong>Results: </strong>A total of 38 patients were identified. The mean age at surgery was 56.8 ± 5.7 years (range, 50.6-70 years). The mean clinical follow-up was 16.2 ± 4.3 years (range, 10.9-23.3 years). The failure rate was 10.5% (4/38): 1 of the 4 patients had a recurrence of instability at 13 years postoperatively and underwent revision with a modified Lemaire extra-articular tenodesis, 1 patient had a positive pivot shift (2+) without subjective instability, and 2 patients underwent total knee arthroplasty. The overall KOOS was 74.2 ± 22.2, and 91.4% of patients were satisfied or very satisfied with the results of the procedure. Radiographic osteoarthritis was identified in 88.5% of patients at final follow-up; however, there was no statistical significance on clinical outcomes (<i>P</i> > .05). Concomitant partial medial meniscectomy (<i>P</i> < .01) and meniscal repair (<i>P</i> < .01) were associated with the presence of Ahlbäck grade 3 or 4 osteoarthritic manifestations.</p><p><strong>Conclusion: </strong>In patients over the age of 50 years who underwent primary ACL reconstruction, there was a low long-term failure rate and a high level of patient satisfaction, despite osteoarthritic progression in 88.5% of cases. Concomitant meniscal procedures were associated with more severe osteoarthritic progression.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241292071"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771152","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 Use of the Anterior Labral Circumferential Onlay Technique to Reconstruct the Anterior Labrum and Biomechanically Restore Glenohumeral Joint Stability.","authors":"Maria E Dey Hazra, Rony-Orijit Dey Hazra, Alex W Brady, Phob Ganokroj, Justin R Brown, Alexander R Garcia, Amelia H Drumm, Peter J Millett","doi":"10.1177/23259671241271529","DOIUrl":"10.1177/23259671241271529","url":null,"abstract":"<p><strong>Background: </strong>A labral injury contributes to glenohumeral instability. The Anterior Labral Circumferential Onlay Technique (ALCOT) reconstructs the labrum using the long head of the biceps tendon.</p><p><strong>Hypothesis: </strong>The ALCOT would restore glenohumeral joint stability in a cadaveric model without glenoid bone loss (1) comparable to the native state and (2) comparable to the Latarjet procedure.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>A total of 10 fresh-frozen cadaveric shoulders were tested using a 6 degrees of freedom robotic arm in 5 consecutive states: (1) native, (2) capsular repair, (3) labral tear, (4) ALCOT, and (5) Latarjet procedure. Biomechanical testing consisted of 80 N of anteroinferior force and 50 N of compression in 90° of humerothoracic abduction. Lateral displacement of the humeral head and the force ratio during a dislocation were measured.</p><p><strong>Results: </strong>The mean lateral translation of the humeral head during a dislocation in the native state was 6.5 ± 2.2 mm and decreased to 5.4 ± 2.4 mm in the labral tear state (<i>P</i> < .001). The mean lateral translation of the humeral head was restored to 6.4 ± 2.2 mm (<i>P</i> > .99) with the ALCOT, showing no difference from the native state. The Latarjet procedure restored the mean force ratio during a dislocation to 1.3 ± 0.6 but failed to restore lateral translation, with a value of 5.6 ± 2.8 mm (<i>P</i> = .003 vs native; <i>P</i> = .94 vs labral tear). The mean force ratio was 1.8 ± 0.1 in the native state, decreased to 1.1 ± 0.4 in the labral tear state, and was 1.4 ± 0.4 (<i>P</i> < .27) with the ALCOT, showing no difference from the native state.</p><p><strong>Conclusion: </strong>The ALCOT is a novel technique for labral reconstruction that may have a role in the treatment of anterior glenohumeral instability in the setting of a deficient labrum without bone loss. In this study, the ALCOT restored the force ratio and lateral translation of the humeral head compared to the native state. The Latarjet procedure restored the force ratio but not lateral translation of the humeral head compared to the native state.</p><p><strong>Clinical relevance: </strong>This study proposes and biomechanically validates the ALCOT as a surgical technique for labral reconstruction that may have a role in treating patients with chronic anterior shoulder instability in the setting of a deficient labrum.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 12","pages":"23259671241271529"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770551","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":"Assessing the Elasticity of the Flexor Pronator Muscles After Throwing Using Ultrasound Shear Wave Elastography.","authors":"Shintaro Mukohara, Yutaka Mifune, Atsuyuki Inui, Hanako Nishimoto, Takashi Kurosawa, Kohei Yamaura, Issei Shinohara, Yuichi Hoshino, Takehiko Matsushita, Tomoyuki Matsumoto, Ryosuke Kuroda","doi":"10.1177/23259671241298001","DOIUrl":"10.1177/23259671241298001","url":null,"abstract":"<p><strong>Background: </strong>The medial ulnar collateral ligament (UCL) of the elbow joint is the primary restraint to valgus stress during the throwing motion. The flexor pronator muscles (FPMs) also stabilize the elbow joint against valgus forces; however, assessment of FPM stiffness in baseball players has been limited.</p><p><strong>Purpose: </strong>To use ultrasound shear wave elastography (USWE) to evaluate the change in tissue elasticity of the FPMs due to pitching.</p><p><strong>Study designs: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>Included were 14 healthy male amateur baseball players (mean age, 28.0 ± 2.6 years) who had played intermediate-level high school or college baseball. The tissue elasticity of the flexor digitorum superficialis (FDS) in the superficial layer of the FPMs and the flexor digitorum profundus (FDP) in the deep layer of the FPMs were measured using USWE before, immediately after, and 24 hours after a throwing session of 100 pitches. The intra- and interrater reliability of the measurements were evaluated using the Pearson correlation coefficient and intraclass correlation coefficient (ICC). The elasticity of each muscle was analyzed using repeated-measures analysis of variance followed by post hoc analysis.</p><p><strong>Results: </strong>Reliability of the USWE measurements was good to excellent (intrarater ICCs, 0.78-0.94; interrater ICCs, 0.85-0.96). The mean tissue elasticity values before, immediately after, and 24 hours after pitching were 22.3 ± 4.4, 41.0 ± 13.8, and 38.3 ± 11.2 kPa, respectively, for the FDS and 27.1 ± 5.8, 48.0 ± 22.3, and 29.6 ± 11.5 kPa, respectively, for the FDP. For both the FDS and FDP, elasticity was significantly higher immediately after pitching than before pitching (<i>P</i> < .001 and <i>P</i> = .0027, respectively). While the elasticity of the FDS at 24 hours after pitching remained significantly higher compared with before pitching (<i>P</i> = .0011), the elasticity of the FDP at 24 hours decreased to the same level as before pitching (<i>P</i> = .91).</p><p><strong>Conclusion: </strong>Results using USWE indicated that the elasticity of the FDS did not decrease 24 hours after pitching and remained significantly higher than before pitching, suggesting that it may not be fully functioning as a dynamic stabilizer during this period.</p><p><strong>Clinical relevance: </strong>Pitching in such a condition may result in greater stress on the UCL and increase the risk of UCL injury.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241298001"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751400","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":"Bone-Patellar Tendon-Bone Versus Quadriceps Tendon-Bone Autografts in Anatomic Rectangular Tunnel Anterior Cruciate Ligament Reconstruction.","authors":"Kazunori Shimomura, Akira Tsujii, Ayaka Tanaka, Masayuki Hamada, Yasukazu Yonetani","doi":"10.1177/23259671241297104","DOIUrl":"10.1177/23259671241297104","url":null,"abstract":"<p><strong>Background: </strong>Anatomic rectangular tunnel anterior cruciate ligament reconstruction (ART-ACLR) can mimic the fiber arrangement of the native ACL and restore normal knee biomechanics, compared with the conventional round tunnel ACLR. ART-ACLR using a bone-patellar tendon-bone (BPTB) graft can provide satisfactory clinical outcomes; however, some issues such as secondary ACL injury and donor-site morbidity, including postoperative anterior knee pain (AKP), remain to be solved. Due to these issues, quadriceps tendon-bone (QTB) grafts have recently become more popular.</p><p><strong>Purpose: </strong>To compare the 2-year clinical outcomes of ART-ACLR with BPTB and QTB autografts.</p><p><strong>Study design: </strong>Cohort study; Level of evidence, 3.</p><p><strong>Methods: </strong>A total of 134 patients underwent primary ART-ACLR with BPTB (n = 70) or QTB (n = 64). All patients had a minimum follow-up period of 2 years postoperatively. Outcome evaluations included the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), side-to-side differences (SSDs) with the KT-1000 knee arthrometer, rate of secondary ACL injury, and incidence of AKP.</p><p><strong>Results: </strong>Regarding age, sex, height, weight,and concomitant procedures, there were no significant differences between the 2 groups. All clinical scores significantly improved from preoperatively to 6 months postoperatively and further increased throughout the 2-year postoperative period in both groups. The IKDC and all subscales of the KOOS, except Sport and Recreation, were equivalent between the BPTB and QTB groups at each postoperative time point. There were no significant differences in the SSD value of KT-1000 arthrometer between the 2 groups. The rates of secondary ACL injury were 10.0% on the ipsilateral side and 2.9% on the contralateral side in the BPTB group and 3.1% on the ipsilateral side and 4.7% on the contralateral side in the QTB group, with no significant difference between both groups. The incidence of AKP was 17.1% and 4.9% in the BPTB group and QTB group, respectively, with significance of <i>P</i> = .02).</p><p><strong>Conclusion: </strong>The clinical scores, SSD value of the KT-1000 arthrometer, and secondary ACL injury rates were equivalent between the BPTB and QTB groups. However, the incidence of AKP was significantly lower in the QTB group, suggesting that QTB could be a favorable graft for ACLR.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241297104"},"PeriodicalIF":2.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751413","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":"Effect of Platelet-Rich Plasma Injection on the Treatment of Achilles Tendinopathy: A Systematic Review and Meta-analysis.","authors":"Samuel Ka-Kin Ling, Clarence Tsz-Kit Mak, Jasmine Pui-Yin Lo, Patrick Shu-Hang Yung","doi":"10.1177/23259671241296508","DOIUrl":"10.1177/23259671241296508","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendinopathy is a common condition without a reproducible and timely treatment modality. Platelet-rich plasma (PRP) injection has been proposed as an enticing treatment option, but there is no consensus regarding its effectiveness.</p><p><strong>Purpose: </strong>To pool the available data and evaluate the evidence of the effect of PRP injections on Achilles tendinopathy.</p><p><strong>Study design: </strong>Systematic review; Level of evidence, 1.</p><p><strong>Methods: </strong>This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. CINAHL via EBSCOhost, Cochrane Library, and PubMed databases were searched for randomized controlled trials comparing PRP injection with nonoperative treatment, with the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire score or maximal Achilles tendon (AT) thickness on ultrasound as outcome measures. Risk-of-bias assessment was performed of the included studies, and meta-analyses compared differences in outcome measures between PRP injection and control at the short-term (3-month), intermediate-term (6-month), and long-term (12-month) follow-ups.</p><p><strong>Results: </strong>Of 409 publications, 6 publications (N = 422 patients with chronic midportion Achilles tendinopathy) were identified from the literature search. Risk-of-bias assessment revealed 2 studies were low risk, 1 was of some concern, and 3 were high risk of bias. Meta-analysis revealed no significant differences between PRP injection and control at any time point for both VISA-A score (short term: <i>P</i> = .29; intermediate term: <i>P</i> = .42; long term: <i>P</i> = .57) and maximal AT thickness (short term: <i>P</i> = .60; intermediate term: <i>P</i> = .20; long term: <i>P</i> = .55).</p><p><strong>Conclusion: </strong>Our review demonstrated that although recent trends have shown an increasing popularity of PRP injection, no solid evidence has been established. The heterogenicity of the tendinopathy pathology and the PRP injection content and methodology should be controlled by better-designed clinical trials. Further research is needed before it should be recommended as a standard treatment.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241296508"},"PeriodicalIF":2.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751434","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":"Effect of Patient Resilience on Functional Outcomes After Meniscectomy.","authors":"Adeeb Jacob Hanna, Andres R Perez, Alice He, John Hayden Sonnier, Henson Destine, Rahul Muchintala, Ralph W Cook, Sean Bryan, Fotios P Tjoumakaris, Kevin B Freedman","doi":"10.1177/23259671241293911","DOIUrl":"10.1177/23259671241293911","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of significant osteoarthritis who completed the brief resilience scale (BRS) preoperatively were considered for inclusion. Included patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain at a minimum of 2 years postoperatively. Based on BRS scores, patients were stratified into low resilience (LR), normal resilience (NR), and high resilience (HR) groups, and differences and changes in outcomes were compared among the groups using the analysis of variance or the Kruskal-Wallis test for continuous data and the chi-square test for categorical data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 100 patients were included (LR group, n = 17; NR group, n = 65; HR group, n = 18). Patients with higher preoperative resilience had higher preoperative IKDC (&lt;i&gt;P&lt;/i&gt; = .004) and KOOS-JR (&lt;i&gt;P&lt;/i&gt; = .003) scores. However, resilience was not a fixed construct: The median BRS increased in the LR group and decreased in the HR group from pre- to postoperatively (+0.17 and -0.58, respectively; &lt;i&gt;P&lt;/i&gt; = .001). At the 2-year follow-up, there was no difference in patient-reported outcome scores across resilience groups, nor was there a difference in the change in IKDC or KOOS-JR scores. Although a positive correlation was observed between preoperative resilience and preoperative IKDC (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;S&lt;/sub&gt; = 0.331) and KOOS-JR (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;S&lt;/sub&gt; = 0.334) scores, preoperative resilience did not correlate with postoperative or 2-year improvements in IKDC or KOOS-JR scores. A weak positive correlation was observed between postoperative resilience and postoperative IKDC (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;S&lt;/sub&gt; = 0.229) and SANE (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;S&lt;/sub&gt; = 0.202) scores, and a weak negative correlation was observed between postoperative resilience and VAS pain scores (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;S&lt;/sub&gt; = ∓0.256).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study indicated that preoperative patient resilience was not predictive of functional outcome scores at a 2-year follow-up after arthroscopic meniscectomy.&lt;/p","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241293911"},"PeriodicalIF":2.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751429","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 Influence of Modifiable Physical Measures on the Elbow Varus Torque - Ball Velocity Relationship in Collegiate Baseball Pitchers.","authors":"Adam J Barrack, Motoki Sakurai, Choo Phei Wee, Paul R Diaz, Carl Stocklin, Andy R Karduna, Lori A Michener","doi":"10.1177/23259671241296496","DOIUrl":"10.1177/23259671241296496","url":null,"abstract":"<p><strong>Background: </strong>The mechanism of ulnar collateral ligament (UCL) injury during pitching is excessive elbow varus torque (EVT). The EVT-ball velocity (T-V) relationship allows concurrent assessment of player performance and UCL injury risk. Modifiable physical capacities may underlie individual variation seen in the T-V relationship.</p><p><strong>Purpose: </strong>To identify physical performance characteristics that impact the T-V relationship during pitching.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 87 National Collegiate Athletic Association Division I pitchers participated. Pitching collection involved measurement of EVT and ball velocity during 5 maximal effort fastballs thrown to a catcher. Physical measures collected were the following: shoulder and hip passive range of motion (ROM) and strength, shoulder rate of torque development (RTD), grip strength, and lumbopelvic stability. Physical measures were entered into univariate linear mixed models with ball velocity as a covariate to predict EVT. Variable reduction for multivariate models involved selection of physical measures based on random forest-derived variable importance and univariate relationship significance, rendering a 27-variable pool. Multivariate linear mixed models predicting EVT, adjusting for physical measures and other physical characteristics, were then created using backward elimination.</p><p><strong>Results: </strong>In univariate analysis, for every 1 m/s (2.2 mph) increase in ball velocity, the mean EVT increased by 1.51 Nċm (95% CI, 0.66-2.37 Nċm; <i>P</i> = .001). In univariate analysis, hip abduction strength symmetry and bilateral lumbopelvic stability significantly increased EVT, while dominant-shoulder ROM, scaption RTD symmetry, and hip ROM significantly decreased EVT. Variables that increased EVT while controlling for ball velocity in the final model include grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight. Increased dominant-shoulder internal rotation (IR) strength, dominant-shoulder flexion ROM, and scaption strength asymmetry decreased EVT as ball velocity increased.</p><p><strong>Conclusion: </strong>Several modifiable physical measures affected EVT in the univariate analysis. In our final model, when controlling for ball velocity, EVT increased with increased grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight and decreased with increased dominant-shoulder IR strength, dominant-shoulder flexion ROM, and scaption strength asymmetry.</p><p><strong>Clinical relevance: </strong>Defining the individual and multivariate effects of these physical capacities on EVT contextualizes their role in the T-V relationship and helps identify access points through which coaches and clinicians can optimize a pitcher's T-V relationship.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"12 11","pages":"23259671241296496"},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731046","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}