Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Arthroscopic Repair of Distal Triceps Tendon Rupture Provides Excellent Functional Outcomes With Minimal Complications","authors":"Felix H. Savoie M.D.,&nbsp;Nolan M. Reinhart M.D.,&nbsp;Jackson P. Tate M.D.,&nbsp;Taylor M. Troutman M.D.,&nbsp;Sara M. Yuter B.S.,&nbsp;William F. Sherman M.D., M.B.A.","doi":"10.1016/j.asmr.2025.101164","DOIUrl":"10.1016/j.asmr.2025.101164","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the outcomes of patients who underwent arthroscopic distal triceps tendon repair using double-row anatomic footprint repair with suture anchors.</div></div><div><h3>Methods</h3><div>This was a retrospective review of patients who underwent arthroscopic triceps tendon repair between 2012 and 2022 performed by a single surgeon. The inclusion criteria included a full-thickness tear of the distal triceps tendon confirmed by magnetic resonance imaging and repaired arthroscopically. The exclusion criteria included patients with documented follow-up of less than 24 months for whom postoperative outcome measures were lacking, as well as tear size of less than 50% of the width of the tendon. The primary outcome measures were retear rates and reoperation rates. Secondary outcomes included change in pain score (visual analog scale), postoperative functional score (Mayo Elbow Performance Score), postoperative Single Assessment Numeric Evaluation score, manual muscle testing, and rate of perioperative wound complications.</div></div><div><h3>Results</h3><div>A total of 16 patients (age range, 37-80 years) were included. All patients had an intact triceps tendon on ultrasound at a mean follow-up of 79.3 months (range, 24.6-149.1 months). The mean preoperative visual analog scale pain score decreased from 4 to 0, ranging from 0 to 6 preoperatively (<em>P</em> &lt; .001). The postoperative Mayo Elbow Performance Score averaged 100, indicating no functional limitations. The mean Single Assessment Numeric Evaluation score were 98, ranging from 90 to 100. No major perioperative wound complications, retears, or reoperations were reported. Muscle strength was graded as equal to the opposite side on manual strength testing.</div></div><div><h3>Conclusions</h3><div>In this study, we found that arthroscopic triceps tendon repair is safe and effective, with excellent pain relief, excellent functional scores, minimal complications, and the ability to address concomitant elbow pathologies.</div></div><div><h3>Level of Evidence</h3><div>Level IV, therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101164"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resizing and Reshaping Anterior Cruciate Ligament Stump Tissue Does Not Compromise Cell Viability, and Infiltration Into Patellar Tendon Grafts Does Not Compromise Tensile Properties","authors":"Juliana Heimur D.O. ,&nbsp;Mark Callanan M.D. ,&nbsp;Jessi Truett Ed.D., B.C.B.A. ,&nbsp;Achraf Cohen Ph.D. ,&nbsp;Murilo Basso B.E. ,&nbsp;Nick Carssow ,&nbsp;Adam W. Anz M.D.","doi":"10.1016/j.asmr.2025.101201","DOIUrl":"10.1016/j.asmr.2025.101201","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether a technique to process anterior cruciate ligament (ACL) stump tissue for needle infiltration into tendon grafts for ACL reconstruction would affect the viability of the cells within the tissue or the tensile properties of infiltrated grafts.</div></div><div><h3>Methods</h3><div>ACL stump and Hoffa fat pad tissue was harvested from 13 ACL reconstruction patients and processed. Harvesting involved a standard arthroscopic shaver and an inline suction device. Processing involved 3 steps, 2 syringes, and 3 syringe transfer devices of decreasing size. After processing, tissue could pass through a needle for infiltration into ACL reconstruction tendon grafts. Tissue analysis was performed at each serial step of the processing technique and included cell counts and viability testing. Tensile testing involved 15 matched-pair cadaveric knees, from which bone–patellar tendon–bone (BPTB) grafts, stump tissue, and fat pad tissue were harvested. Harvested and processed tissue was infiltrated into BPTB grafts, and tensile biomechanical testing was performed.</div></div><div><h3>Results</h3><div>Unprocessed tissue showed average cell viability (ACV) of 72.8% during cell viability testing. After step 1 of the process, ACV was 66.4%; after step 2, ACV was 73.1%; and after step 3, ACV was 67.1%. There was no significant difference in cell viability between processing steps (<em>P</em> = .528). When un-infiltrated control grafts were compared with infiltrated grafts, expected significant differences were found for weight (6.55 ± 1.51 g vs 8.91 ± 0.98 g, <em>P</em> &lt; .001), width (9.53 ± 1.35 mm vs 13.74 ± 2.04 mm, <em>P</em> &lt; .001), thickness (5.2 ± 1.26 mm vs 10.78 ± 2.11 mm, <em>P</em> &lt; .001), and Young’s modulus (94.55 ± 47.19 MPa vs 28.57 ± 16.37 MPa, <em>P</em> &lt; .001). There were no significant differences in tensile failure load (536.65 ± 168.00 N vs 509.55 ± 139.31 N, <em>P</em> = .49), deformation at failure (9.34 ± 2.96 mm vs 9.28 ± 3.21 mm, <em>P</em> = .91), or stiffness (97.04 ± 32.34 N/mm vs 86.82 ± 24.37 N/mm, <em>P</em> = .11) between the groups.</div></div><div><h3>Conclusions</h3><div>A technique to process remnant ACL and fat pad tissue for infiltration does not affect the viability of cells within the tissue. Infiltration of tissue into BPTB graft increases overall volume and mass and does not significantly alter the graft’s tensile load to failure when compared with matched controls.</div></div><div><h3>Clinical Relevance</h3><div>Evaluation of the biomechanical properties of a graft injected with minimally manipulated biologic material obtained at the time of harvest may provide laboratory data on the procedure's safety and viability as a direct delivery method for ACL grafts. These data could contribute to future studies involving clinical application during ACL reconstruction.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101201"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Research Regarding the Latarjet Procedure Is Focused on Technical Refinements, Fixation Alternatives, and Individualized Surgical Planning","authors":"Jingyue Su M.D. ,&nbsp;Pengyu Xiang M.D. ,&nbsp;Chenhao Jia M.D. ,&nbsp;Jiali Ma M.D. ,&nbsp;Zhiyun Li M.D. ,&nbsp;Jian Xu M.D., Ph.D. ,&nbsp;Shengwu Yang M.D. ,&nbsp;Chunwu Zhang M.D. ,&nbsp;Wei Lu M.D. ,&nbsp;Zhenhan Deng M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101160","DOIUrl":"10.1016/j.asmr.2025.101160","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the literature regarding the Latarjet procedure to identify clinical practices and current areas of research focus.</div></div><div><h3>Methods</h3><div>Publications related to the Latarjet procedure in English, published between 1985 and 2024, were retrieved from the Web of Science Core Collection. Document types, including corrections, meeting abstracts, early access articles, and biographical items, were excluded from the analysis. The study employed CiteSpace, VOSviewer, R-Bibliometrix, and GraphPad Prism for data analysis. Evaluated metrics encompassed publication/citation trends, country/institution contributions, author impact, keyword co-occurrence patterns, thematic evolution across the study period.</div></div><div><h3>Results</h3><div>Among 1,133 publications, annual output surged post-2010, peaking in 2021. The United States and France dominated contributions, while <em>Arthroscopy</em> and <em>Journal of Shoulder and Elbow Surgery</em> were the leading journals. Provencher and Hurley were prolific authors, while Burkhart had the most cited papers. Keyword analysis revealed shifting priorities; “sport,” “return,” “fixation,” “epidemiology,” “remplissage,” and “glenoid bone loss” were the new keyword bursts in recent years and are still popular today. “Adolescent” and “congruent arc Latarjet technique” were new terms that had only emerged in the past 2 years.</div></div><div><h3>Conclusions</h3><div>The Latarjet procedure remains the standard treatment for anterior instability, with research increasingly focused on technical refinements, fixation alternatives, and individualized surgical planning.</div></div><div><h3>Clinical Relevance</h3><div>By identifying areas of research focus, this study may guide future advancements in the Latarjet procedure, ultimately improving the surgical management of shoulder dislocation.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101160"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three or More Revision Hip Arthroscopy Surgeries Is More Common in Female Patients and High-Grade Acetabular Chondral Lesions Lead to Increased Risk of Failure","authors":"Joseph J. Ruzbarsky M.D. ,&nbsp;Spencer M. Comfort M.D. ,&nbsp;Vera M. Stetzelberger M.D. ,&nbsp;Justin J. Ernat M.D. ,&nbsp;Nicholas A. Felan B.A. ,&nbsp;Grant J. Dornan M.S. ,&nbsp;Marc J. Philippon M.D.","doi":"10.1016/j.asmr.2025.101166","DOIUrl":"10.1016/j.asmr.2025.101166","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize risk factors for patients who underwent multiple-revision hip arthroscopies and report survivorship at a minimum 2 years after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Patients aged 18-65 years who underwent revision hip arthroscopy between January 2011 and September 2018 with ≥2-year follow-up were included. Exclusion criteria were age &lt;18 or &gt;65 years at time of surgery, center-edge angle &lt;20°, previous ipsilateral periacetabular osteotomy, or refusal to participate. Procedures were categorized as first (R1), second (R2), or third or more (R3+) revisions. Demographics, preoperative radiographic measurements, baseline patient-reported outcomes (PROs), intraoperative findings, and survivorship were compared across groups and between those requiring further surgery or total hip arthroplasty (THA) and those who did not. Survivorship was defined as re-revision and arthroplasty-free survival. PROs included modified Harris Hip Score, Hip Outcome Score – Activities Daily Living, HOS-Sport, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form Physical and Mental Component Scores (12-Item Short Form Physical Component Score/Mental Component Score).</div></div><div><h3>Results</h3><div>A total of 284 hips (246 patients) met inclusion criteria, with mean follow-up of 4.3 ± 2.1 years. Female sex (52% vs 63% vs 78%, <em>P</em> = .03), primary hip arthroscopy at an outside institution (62% vs 78% vs 96%, <em>P</em> &lt; .001), smaller alpha angle (64° vs 56° vs 50°, <em>P</em> &lt; .001), and worse baseline PROs (modified Harris Hip Score, Hip Outcome Score – Activities Daily Living, HOS-Sport, Western Ontario and McMaster Universities Osteoarthritis Index; <em>P</em> = .05, <em>P</em> = .01, <em>P</em> &lt; .001, <em>P</em> = .01) were associated with more previous revisions. Failure incidence did not differ between groups (<em>P</em> = .29), but the hazard ratio for further surgery or THA was greater for R3+ versus R1 (hazard ratio 2.4, 95% confidence interval 1.04-5.38, <em>P</em> = .04).</div></div><div><h3>Conclusions</h3><div>At a minimum 2-year follow-up, more prior revisions were associated with female sex, lower baseline PROs, capsular deficiency, and greater failure risk. Patients with lower nondysplastic lateral center-edge angles, severe acetabular cartilage damage, or ≥3 revisions had elevated risk for re-revision or THA.</div></div><div><h3>Level of Evidence</h3><div>Level IV, therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101166"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thigh Muscle Volume Remains Decreased on 3-Dimensional Magnetic Resonance Imaging at Minimum of 5 Years After Patellar Tendon but not Allograft Anterior Cruciate Ligament Reconstruction","authors":"Collin D.R. Hunter B.S.,&nbsp;Natalya McNamara M.D.,&nbsp;Reece M. Rosenthal,&nbsp;Joseph Featherall M.D.,&nbsp;Patrick Greis M.D.,&nbsp;Travis G. Maak M.D.,&nbsp;Stephen K. Aoki M.D.,&nbsp;Justin J. Ernat M.D.","doi":"10.1016/j.asmr.2025.101191","DOIUrl":"10.1016/j.asmr.2025.101191","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate thigh muscle volume differences in patients undergoing anterior cruciate ligament reconstruction (ACLR) with either allograft tissue or bone−patellar tendon−bone (BPTB) autografts, using 3-dimensional magnetic resonance imaging (MRI) modeling.</div></div><div><h3>Methods</h3><div>This is a retrospective, single-center study of patients undergoing primary ACLR with either ipsilateral BPTB autograft or allograft tissue. Inclusion criteria were age 18-45 years, 5 to 8 years of follow-up, and body mass index &lt;30. Patients were excluded if they had multiligamentous knee injuries, surgical treatment of meniscus tears (repair or reconstruction), and any subsequent knee procedures after the index ACLR. 3D MRI of the bilateral thighs was performed and images were rendered with 3D modeling software and the total thigh, anterior-, posterior-, and medial-thigh compartment musculature were individually segmented and the volumes were calculated. Data were evaluated using a <em>t</em> test, and muscle volumes were standardized as a percentage of the corresponding nonoperative extremity and then tested in comparison with the alternative graft type.</div></div><div><h3>Results</h3><div>Ten allograft and 10 patients with BPTB were included. Patients with allograft were older at surgery (mean age 34.6 vs 23.4 years (<em>P</em> &lt; .001) and at study MRI (mean age 40.9 vs 29.7 years; <em>P</em> &lt; .001). Allografts showed no differences in total thigh or compartmental muscle volumes between the operative and nonoperative limbs. BPTB showed a statistically significant reduction in total thigh volume on the operative side (103 cm³, 97.0%, <em>P</em> = .013), whereas compartment volumes remained similar between limbs. Percentage changes in volume comparing injured with contralateral thigh volume was not significantly different between graft type groups.</div></div><div><h3>Conclusions</h3><div>No significant side-to-side differences were found in individual thigh compartments or total volume after allograft ACLR. BPTB ACLR has a modest effect (∼3%) on long-term total thigh muscle volume.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101191"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Variables Are Rarely Reported in Studies Investigating Ulnar Collateral Ligament Reconstruction: A Systematic Review","authors":"Erin L. Brown B.A. ,&nbsp;Kenneth T. Nguyen B.S. ,&nbsp;Won-Kwem W. Kim B.S. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101189","DOIUrl":"10.1016/j.asmr.2025.101189","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the reporting of sociodemographic variables in studies related to ulnar collateral ligament (UCL) reconstruction.</div></div><div><h3>Methods</h3><div>A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Scopus were searched on April 9, 2024, using the terms “medial ulnar collateral ligament reconstruction,” “ulnar collateral ligament reconstruction,” “ulnar collateral ligament surgery,” or “Tommy John Surgery.” Studies were included if they were randomized controlled trials, case control studies, cross-sectional studies, cohort studies, and case series in English. The presence of sociodemographic variables, including sex or gender and age, as well as the presence of sociodemographic variables, including race, ethnicity, insurance status, income, housing status, work status, and level of education were collected. Descriptive statistics and χ² tests or Fisher exact tests were used for analysis.</div></div><div><h3>Results</h3><div>The initial database search yielded 1,504 studies, with 831 duplicates removed and an additional 598 studies excluded after title and abstract screening. Of the remaining 75 studies, 31 were excluded after full-text screening, leaving 44 studies for inclusion, all published between 2006 and 2024. Among these, sociodemographic variables (e.g., race: 0/44, ethnicity: 0/44, insurance status: 0/44, level of education: 10/44, income: 0/44, work status: 12/44) were reported significantly less frequently than demographic factors such as age (42/44; 95.5%), and sex or gender (24/44; 54.5%; <em>P</em> &lt; 0.05). There was no significant difference in reporting of any sociodemographic variables among included journals (<em>P</em> = .83) or by year of publication (<em>P</em> = .67).</div></div><div><h3>Conclusions</h3><div>This systematic review highlights a critical lack in the reporting of sociodemographic variables within studies examining UCL reconstruction, with a significantly greater rate of reporting of demographic factors, such as age and sex or gender, compared with sociodemographic variables like race and ethnicity.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of level II-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101189"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Online Ratings of Sports Medicine Surgeons Most Commonly Relate to Bedside Manner and Communication","authors":"Shea E. Randall B.A. ,&nbsp;Klea Gjonaj M.S. ,&nbsp;Raheyma N. Siddiqui B.A. ,&nbsp;Julia Mansour B.S. ,&nbsp;Siddharth Mehrotra B.S. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101202","DOIUrl":"10.1016/j.asmr.2025.101202","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether online ratings of sports medicine surgeons are more heavily influenced by clinical or nonclinical factors and to determine whether gender and geographic region influence surgeon reviews.</div></div><div><h3>Methods</h3><div>A list of 102 sports medicine surgeons who were members of the American Academy of Orthopaedic Surgeons was randomly generated. Each surgeon was searched on the Healthgrades and Google Reviews websites, and every 1- and 5-star review for each surgeon since 2022 was compiled. The comments within these reviews were subsequently classified as clinical and nonclinical based on predetermined categories.</div></div><div><h3>Results</h3><div>Surgeons averaged 25 five-star reviews (range, 0-119) and 1 one-star review (range, 0-7) from Healthgrades and Google Reviews. Among 5-star reviews, the most common positive comments were related to bedside manner (n = 1,336; 56%), communication (n = 1,216; 50.9%), and treatment success (n = 453; 19%). The most common negative comments among 1-star reviews were related to communication (n = 59; 46.8%), bedside manner (n = 57; 45.2%), and appointment efficiency/scheduling (n = 38; 30.2%). Overall, both 1- and 5-star reviews contained a higher proportion of nonclinical comments than clinical comments. Female sports medicine surgeons had a higher proportion of clinical comments in their 1-star reviews (28 of 58, 48.3%) compared with their male counterparts (58 of 202, 28.7%) (<em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Most 5- and 1-star reviews of sports medicine surgeons complimented or critiqued nonclinical aspects of patient care. Among both 5- and 1-star reviews, the most common comments related to communication and bedside manner. Thus, sports medicine surgeons can improve patient satisfaction by focusing on overall demeanor and communication skills.</div></div><div><h3>Clinical Relevance</h3><div>These findings offer valuable insights into patient satisfaction and guide efforts to improve patient experiences and outcomes within orthopaedic sports medicine.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101202"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major League Baseball Pitchers Experienced Increased Flexor Tendon and Forearm Injuries 2 Years After Pitch Clock Implementation","authors":"Troy B. Puga D.O., M.B.A., M.P.H. ,&nbsp;McKenna W. Box M.D. ,&nbsp;Winston Scambler B.S. ,&nbsp;Hans Drawbert M.S., M.D. ,&nbsp;John T. Riehl M.D.","doi":"10.1016/j.asmr.2025.101171","DOIUrl":"10.1016/j.asmr.2025.101171","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the incidence of pitcher injuries 2 years after implementation of the Major League Baseball (MLB) pitch clock.</div></div><div><h3>Methods</h3><div>Injury data were collected for the 2021, 2022, 2023, and 2024 MLB seasons using the <span><span>fangraphs.com</span><svg><path></path></svg></span> injury database. The incidence rate ratio was calculated to compare the injury rate for the 2024 season with that for each of the 2021, 2022, and 2023 seasons. Data were pooled for the pre- and post-pitch clock seasons and were compared in similar fashion to the individual seasons using the incidence rate ratio. The <em>z</em> test for proportions was used to determine significance.</div></div><div><h3>Results</h3><div>The 2024 MLB season, with 366 overall injuries, showed a decrease in the overall number of injuries compared with the 2021 season, which had 467 overall injuries (<em>P</em> &lt; .001), and the 2022 season, which had 461 overall injuries (<em>P</em> &lt; .001). The 2024 season, with 61 lower-extremity injuries, showed a decrease in the number of lower-extremity injuries compared with the 2021 season, which had 104 lower-extremity injuries (<em>P</em> = .001), and the 2022 season, which had 87 lower-extremity injuries (<em>P</em> = .03). The 2024 season, with 55 torso injuries, showed a decrease in the number of torso injuries compared with the 2022 season, which had 75 torso injuries (<em>P</em> = .04). The 2024 season, which had 62 flexor tendon/forearm injuries, revealed a statistically significant rise in flexor tendon/forearm injuries compared with the 2021 season, with 37 injuries (<em>P</em> = .01); the 2022 season, with 33 injuries (<em>P</em> = .005); and the 2023 season, with 36 injuries (<em>P</em> = .02). There was no statistically significant difference in the number of ulnar collateral ligament operations when the 2024 MLB season (n = 34) was compared with the 2021 season (n = 20), 2022 season (n = 30), and 2023 season (n = 27). When the pre-and post-pitch clock pooled data were compared, there was a significant decrease in overall injuries (<em>P</em> &lt; .001) and lower-extremity injuries (<em>P</em> = .004). This comparison also revealed a significant increase in flexor tendon/forearm injuries (<em>P</em> = .04).</div></div><div><h3>Conclusions</h3><div>Two years after the implementation of the MLB pitch clock, there was a decrease in the incidence of overall injury rates and lower-extremity injuries. There remained no associated increase in ulnar collateral ligament operations 2 years after implementation. However, the pre- versus post-pitch clock comparison showed a rise in flexor tendon and forearm injuries in the 2024 season.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101171"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 Pandemic Did Not Have a Negative Impact on Psychological Readiness to Return to Sport 6 Months After Anterior Cruciate Ligament Reconstruction","authors":"Adam Nasreddine M.D. ,&nbsp;Aditi S. Majumdar M.D. ,&nbsp;Rohit Siddabattula B.A. ,&nbsp;Matthew D. Milewski M.D. ,&nbsp;Emma C. Gossman B.S. ,&nbsp;Ryan P. Coene M.S. ,&nbsp;Danielle L. Cook M.A. ,&nbsp;Mininder S. Kocher M.D., M.P.H. ,&nbsp;Dennis E. Kramer M.D. ,&nbsp;Lyle J. Micheli M.D. ,&nbsp;Yi-Meng Yen M.D., Ph.D. ,&nbsp;Melissa A. Christino M.D.","doi":"10.1016/j.asmr.2025.101174","DOIUrl":"10.1016/j.asmr.2025.101174","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare 6-month postoperative levels of psychological readiness to return to sport (RTS) in patients who underwent anterior cruciate ligament reconstruction (ACLR) before and during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Patients between 8 and 35 years of age were enrolled 6 months post primary ACLR at an academic sports medicine practice from December 2018 to May 2021 and categorized into pre-COVID-19 and COVID-19 groups. Demographics and outcomes scores, including ACL-Return to Sport after Injury Scale, Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences, International Knee Documentation Committee Score (IKDC), Pediatric Functional Activity Brief Scale, and physician RTS clearance were compared. χ², Student <em>t</em> tests, and linear regression were performed. A matched analysis between groups was completed, controlling for age, sex, and graft type.</div></div><div><h3>Results</h3><div>A total of 231 patients were included (89 male, 142 female, average age 16.9 years), with 76% (176/231) in the pre-COVID-19 group and 24% (55/231) in the COVID-19 group. No significant differences in age and sex were noted between cohorts. A significant difference in time from surgery to enrollment was seen in the COVID-19 group compared to the pre-COVID-19 group (7.1 vs 6.2 months, <em>P</em> &lt; .001). In the matched analysis cohort (n = 126, 37/126 COVID-19 group), the COVID-19 group received RTS clearance earlier than the pre-COVID-19 group (6.9 months vs 8.8 months, <em>P</em> &lt; .001). Six-month ACL-RSI scores showed no significant differences between groups (63.8 pre-COVID-19 vs 67.0 COVID-19, <em>P</em> = .42), with both groups scoring low. There were no significant differences between matched groups in Patient-Reported Outcomes Measurement Information System Psychological Stress Experiences (<em>P</em> = .37), IKDC (<em>P</em> = .43), Pedi-IKDC (<em>P</em> = .35), and Pedi-Function Activity Brief Scale (<em>P</em> = .74).</div></div><div><h3>Conclusions</h3><div>Young patients showed similar levels of psychological readiness to RTS at 6 months after ACLR before and during the COVID-19 pandemic. Patient-reported outcome scores were comparable between groups, suggesting minimal COVID-19 pandemic impact on perceptions of recovery. Psychological readiness may not be fully optimized at 6 months post-ACLR, and young patients may benefit from additional time and rehabilitation.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort analysis of prospectively collected data.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101174"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Younger Age, Female Sex, Low Income, and Poor Mental Health Are Patient-Perceived Risk Factors for Poor Access to Care for Rotator Cuff Tears","authors":"Alejandro M. Holle B.S. ,&nbsp;Sayi P. Boddu B.A. ,&nbsp;Vikram S. Gill B.S. ,&nbsp;Joseph C. Brinkman M.D. ,&nbsp;Sailesh V. Tummala M.D. ,&nbsp;Jens T. Verhey M.D. ,&nbsp;John M. Tokish M.D.","doi":"10.1016/j.asmr.2025.101167","DOIUrl":"10.1016/j.asmr.2025.101167","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate which patient factors are associated with specific metrics of poor access to care in patients with a rotator cuff tear (RCT).</div></div><div><h3>Methods</h3><div>The All of Us Database was utilized to form a cohort of patients with RCT between May 2018 and May 2023. Patients with a diagnosis of RCT using Systematized Nomenclature of Medicine clinical terms were included. The association of RCT diagnosis and patient-specific factors on self-reported outcomes of “delayed care,” “could not afford care,” “skipped medication,” and “have not seen provider in more than 1 year” were analyzed. Statistical tests performed were univariate regression and multivariable logistic regression.</div></div><div><h3>Results</h3><div>In total, 4,265 patients with RCT who completed the access to care survey were included. In the RCT cohort, 26.7% reported delayed care, 24.9% reported an inability to afford care, 12.1% reported skipped medications, and 1.7% reported not seeing a provider in more than 1 year. Multivariable analysis of patient treatment and demographic features revealed younger age, female sex, lower income, poor physical health, and poor mental health to be strongly associated with higher reported rates of delayed care, inability to afford care, and skipped medications. History of rotator cuff repair, marital status, and sexual orientation were not associated with reported poor access to care.</div></div><div><h3>Conclusions</h3><div>A quarter of patients with rotator cuff tears report delays in overall medical care and inability to afford care. Among patients diagnosed with RCT, patients of younger age, female sex, low income, and poor physical and mental health have higher odds of decreased access to health care.</div></div><div><h3>Clinical Relevance</h3><div>Health care disparities and access to care are topics that should be investigated to reduce them.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101167"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}