Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Patients Have Similar Clinical Outcomes and Failure Rates After Anterior Cruciate Ligament Reconstruction With Tibialis Anterior Tendon, Bone–Patellar Tendon–Bone, Hamstring Tendon, or Achilles Tendon Allografts: A Systematic Review","authors":"Udit Dave B.S. ,&nbsp;Juan Bernardo Villarreal-Espinosa M.D. ,&nbsp;Harshal Shah B.S. ,&nbsp;Eric J. Cotter M.D. ,&nbsp;Fernando Gómez-Verdejo M.D. ,&nbsp;Melissa Carpenter B.S. ,&nbsp;Cameron Gerhold B.S. ,&nbsp;Alexander Mamonov ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Nikhil N. Verma M.D.","doi":"10.1016/j.asmr.2024.101035","DOIUrl":"10.1016/j.asmr.2024.101035","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare postoperative outcomes and functionality in patients who undergo primary allograft anterior cruciate ligament reconstruction (ACLR) with tibialis anterior (TA) tendon, bone–patellar tendon–bone (BPTB), hamstring tendon (HT), and Achilles tendon allografts.</div></div><div><h3>Methods</h3><div>In April 2024, a comprehensive search of the PubMed, Embase, and Cochrane Library databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies were included if they evaluated primary ACLR using allograft, were prospective randomized controlled trials or retrospective studies, compared outcomes in patients undergoing primary ACLR with different allograft types, and were published between 2000 and 2024. Data collection included patient demographic characteristics, graft type, activity level, drilling technique, concomitant and augmentation procedures, patient-reported outcome measures, complications, and graft rerupture rates. Pooling of data was avoided, and qualitative data comparison was conducted.</div></div><div><h3>Results</h3><div>The initial search identified 957 studies, 7 of which were included in this systematic review. Of these, 5 were randomized controlled trials and 2 were retrospective studies. A total of 735 patients were included, with 167 HT patients, 252 BPTB patients, 162 TA patients, and 153 Achilles patients. The mean ages within the cohorts ranged from 23.9 to 37.2 years. The mean follow-up times across studies ranged from 25.6 to 90.0 months. Demographic characteristics were similar among the graft cohorts, and each study had a low risk of bias. Failure rates ranged from 2% to 65% across studies. Similar International Knee Documentation Committee, Lysholm, and Tegner scores were reported among the graft types. Additionally, similar functional outcomes as measured by side-by-side differences in arthrometer readings and similar complication rates after primary ACLR with HT, BPTB, TA, and Achilles allografts were found.</div></div><div><h3>Conclusions</h3><div>Primary ACLR with allografts in patients older than 23 years is safe and effective with few differences in patient-reported outcomes, postoperative function, and graft failure rates among graft options.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101035"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845220","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":"Analysis of Injury Epidemiology in Soccer Players in the 2019 Confederation of North, Central America and Caribbean Association Football Gold Cup as Reported by Team Physicians","authors":"Brian Forsythe M.D. ,&nbsp;Derrick M. Knapik M.D. ,&nbsp;Daanish Khazi-Syed B.S. ,&nbsp;Joshua Chang B.S. ,&nbsp;Camden Bohn B.A. ,&nbsp;Catherine Hand B.S. ,&nbsp;Avinaash Korrapati M.D. ,&nbsp;Ophelie Lavoie-Gagne M.D. ,&nbsp;George Chiampas M.D. ,&nbsp;Bert R. Mandelbaum M.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101074","DOIUrl":"10.1016/j.asmr.2024.101074","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe and characterize injuries reported in professional soccer athletes participating in the 2019 Confederation of North, Central America and Caribbean Association Football (CONCACAF) Gold Cup tournament.</div></div><div><h3>Methods</h3><div>Data were collected from electronic medical reports submitted after each match of the 2019 CONCACAF Gold Cup tournament. Reports were generated from a 20-question online survey completed by team physicians from all 16 participating teams. For every recorded injury, a separate survey was completed by team physicians documenting athlete demographic characteristics, context of injury, injury characteristics, and expected time lost from injury.</div></div><div><h3>Results</h3><div>A total of 62 surveys were distributed, of which 80% (50 of 62) were collected for analysis. A total of 27 injuries (7%) were recorded among the 368 participating athletes. Injuries most frequently occurred during matches (92%, 24 of 27), with a significantly higher number of injuries recorded between the 61st and 75th minutes of play (<em>P</em> &lt; .05). New injuries constituted 85% of all injuries (23 of 27), whereas 15% of injuries (4 of 27) were recorded as recurrences of prior injuries. Defenders had the highest number of injuries (41%, 11 of 27). Injuries to the lower extremities comprised 52% of all injuries (14 of 27), with thigh strains being the most common.</div></div><div><h3>Conclusions</h3><div>During the 2019 CONCACAF Gold Cup, injuries were recorded in 7% of athletes (27 of 368), with 89% of injuries recorded as occurring during match play, primarily consisting of injuries involving strains to the thigh.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the epidemiology of soccer (football) injuries can help physicians better educate athletes including their patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101074"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845277","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":"Posterior Cruciate Ligament Reconstruction Improves Sexual Health Postoperatively","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Federico Valli M.D. ,&nbsp;Pietro Marchetti M.D. ,&nbsp;Nicola Ursino M.D. ,&nbsp;Amit Meena M.B.B.S., M.S., D.N.B.","doi":"10.1016/j.asmr.2024.101041","DOIUrl":"10.1016/j.asmr.2024.101041","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate changes in sexual function and quality of life following arthroscopic posterior cruciate ligament (PCL) reconstruction.</div></div><div><h3>Methods</h3><div>Patients aged between 18 and 45 years who underwent PCL reconstruction were considered for inclusion. At the time of hospital admission, each patient was asked to complete the New Sexual Satisfaction Scale-Short Form, before injury (preinjury) and at the time of hospital admission (preoperative). In addition, patients were followed for a minimum of 24 months (final follow-up). Quality of life was measured using the Anterior Cruciate Ligament Quality of Life Questionnaire at hospital admission (preoperative) and at the 24-month follow-up visit (final follow-up).</div></div><div><h3>Results</h3><div>A total of 35 patients were included in the study; 24 (68.6%) were male, and 11 were female (31.4%). The mean age at the time of surgery was 29.23 <em>±</em> 7.52 years, and the mean follow-up duration was 52.97 <em>±</em> 22.69 months. In all patients, the hamstring tendon was used. Sexual activity at the last follow-up visit was significantly different from that preoperatively (<em>P</em> = .024), while no difference was observed between the preinjury and last follow-up values (<em>P</em> = . 243). Sexual activity was more frequent before injury than preoperatively (<em>P</em> = . 009). Quality of life at the last follow-up visit was significantly better than that preoperatively (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Reconstructive surgery after PCL injury improves the sexual health of patients regardless of age or sex.</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 2","pages":"Article 101041"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845137","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":"A Substantial Increase in Injuries and Hospitalizations Associated With Playing Pickleball From 2020 to 2022","authors":"Ryan Cheng B.A. ,&nbsp;Jay Moran M.D. ,&nbsp;Billy Kim M.D. ,&nbsp;Marshall S. Yuan Pharm.D. ,&nbsp;Connor J. O’Leary B.A. ,&nbsp;Calvin Wang B.S. ,&nbsp;Joshua S. Dines M.D. ,&nbsp;Brian M. Katt M.D. ,&nbsp;Andrew E. Jimenez M.D.","doi":"10.1016/j.asmr.2024.101067","DOIUrl":"10.1016/j.asmr.2024.101067","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the estimated number and the types of pickleball-related injuries stratified by sex and age presenting to U.S. emergency departments from 2020 to 2022, as estimated by the National Electronic Injury Surveillance System (NEISS) database.</div></div><div><h3>Methods</h3><div>Data from the NEISS database were queried to characterize pickleball-related injuries that presented to 96 NEISS-affiliated emergency departments across the United States between 2020 and 2022. The estimated numbers of injuries and hospital admissions were calculated using weights assigned by the NEISS based on geographical location. Narratives for each emergency department visit were manually reviewed to categorize injuries by type and site. Multivariable analyses were used to determine risk factors associated with pickleball-related hospital admissions.</div></div><div><h3>Results</h3><div>The estimated number of annual pickleball-related injuries presenting to U.S. emergency departments increased by 91% from 2020 to 2022 (8,894 injuries vs 16,997 injuries). Pickleball-related hospital admissions increased by 257% from 2020 in 2022 (992 hospital admissions vs 3,541 hospital admissions). Most injuries (73%, 9,932 estimated injuries per year) were sustained by patients aged between 60 and 79 years (mean ± standard deviation, 63.9 ± 14.7 years). The most common types of injuries were fractures (29%, 3,990 estimated injuries per year) and strains/sprains (21%, 2,808 estimated injuries per year). Multivariable analyses controlling for age, sex, injury type, and injury site showed that patients aged 65 years or older were at an increased risk of hospitalization (odds ratio, 2.48; 95% confidence interval, 1.54-4.11; <em>P</em> &lt; .001) compared with those younger than 65 years.</div></div><div><h3>Conclusions</h3><div>The estimated number of pickleball-related injuries presenting to U.S. emergency departments and subsequent hospital admissions has increased by 91% and 257%, respectively, from 2020 to 2022. Patients who were aged 65 years or older at the time of injury were at an increased risk of hospital admission.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the current trends and types of pickleball-related injuries presenting to U.S. emergency departments is critical toward the development of injury prevention measures and understanding the U.S. health care system, particularly as participation in pickleball continues to grow.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101067"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845276","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":"Female Patient Representation Is Acceptable in Studies Regarding Hip Arthroscopy With Labral Repair Yet Deficient in Key Study Design and Sport-Specific Features","authors":"Benjamin M. Ose M.P.H. ,&nbsp;Libby Frye B.S. ,&nbsp;Dylan Wentzel B.S. ,&nbsp;Richard McEntee M.D. ,&nbsp;Ashley A. Herda Ph.D. ,&nbsp;Scott M. Mullen M.D. ,&nbsp;John P. Schroeppel M.D. ,&nbsp;Bryan G. Vopat M.D. ,&nbsp;Lisa M. Vopat M.D.","doi":"10.1016/j.asmr.2024.101069","DOIUrl":"10.1016/j.asmr.2024.101069","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically review and examine the current literature regarding the representation of female athletes in studies examining arthroscopic hip labral repair procedures.</div></div><div><h3>Methods</h3><div>Studies regarding arthroscopic hip labral repair were identified in PubMed. We included human studies of all levels of evidence written in English that identified the biological sex of study participants and were conducted in the United States or non-US countries that offer the same treatment strategies available in the United States. Data regarding study population, athletic caliber, menstrual status, research theme, sample of males and females, journal impact factor, and paper Altmetric score were recorded and analyzed.</div></div><div><h3>Results</h3><div>We screened 1,152 studies and identified 62 to be included in this audit. Females made up 55% of the population of participants. Female-only and male-only studies represented 4.8% and 14.5% of studies investigated, respectively. No studies investigated outcomes of female participants at the highest athletic caliber. Menstrual status was not considered or included as a variable in any study. Participants within athletic performance, indirect association, and health research theme had 32.8%, 61.1%, and 58.6% female representation, respectively. Median impact factor was similar among study population classifications. Study Altmetric score was highest among male-only studies and studies of the highest levels of athletic caliber.</div></div><div><h3>Conclusions</h3><div>Overall, there was a similar prevalence of female-to-male participants in hip labral repair research, with a 55% to 45% female-to-male ratio in all studies included in this review. Despite this, there is a lack of female-only studies, inclusion of menstrual status, high-level female athletes, and female participants evaluated for performance outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101069"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845094","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":"Declining Postoperative 90-Day Opioid Prescriptions From 2010 to 2021 Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome","authors":"Wesley Day B.S.,&nbsp;Scott Halperin B.S.,&nbsp;Serkan Surucu M.D.,&nbsp;Andrew E. Jimenez M.D.,&nbsp;Beatrice Katsnelson B.S.,&nbsp;Justin Zhu B.S.,&nbsp;Jonathan N. Grauer M.D.","doi":"10.1016/j.asmr.2025.101078","DOIUrl":"10.1016/j.asmr.2025.101078","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze postoperative opioid prescriptions after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in a large, opioid-naive population and to evaluate factors associated with receiving more opioids.</div></div><div><h3>Methods</h3><div>Opioid-naive adult patients who underwent hip arthroscopy for FAIS were queried in the 2010 to 2022 PearlDiver Mariner 161 national administrative database. Exclusion criteria included patients with a history of chronic pain and patients who received opioid prescriptions more than 30 days before surgery. Patient variables were extracted: age, sex, and Elixhauser Comorbidity Index. Ninety-day postoperative opioid prescriptions (by total morphine milligram equivalents [MMEs]) were assessed with multivariate linear regression. Ninety-day postoperative opioid prescriptions from 2011 to 2021 were assessed.</div></div><div><h3>Results</h3><div>Of 27,079 patients with postoperative opioid prescriptions identified, a mean ± standard deviation of 347.6 ± 729.2 MMEs (40 tablets of 5 mg oxycodone) were prescribed per patient, with a mean of 1.6 prescriptions filled per patient within 90 days following surgery. Seventy-five percent of patients filled fewer than 600 MMEs, but a small subset filled more than 2,000 MMEs. Multivariate analysis revealed that, compared to patients in the age 30- to 39-year group, those aged 20 to 29 years received fewer MMEs (Δ = –72.5, <em>P</em> &lt; .017). Compared to those with an Elixhauser Comorbidity Index of 2 or under, those &gt;2 were prescribed more MMEs (Δ = 52.5, <em>P</em> &lt; .017). Sex did not correlate with the postoperative MMEs prescribed. From 2011 to 2021, a 58.2% decrease in the 90-day mean MMEs prescribed was noted per patient (<em>P</em> &lt; .017).</div></div><div><h3>Conclusions</h3><div>Fewer postoperative MMEs were filled following FAIS hip arthroscopy for patients in their 20s relative to those in their 30s, as well as for those with lower comorbidity burden. Patient sex was not associated with differences in postoperative MMEs prescribed. The amount of mean MMEs prescribed per patient decreased from 2011 to 2021.</div></div><div><h3>Clinical Relevance</h3><div>This study provides information about the typical amount of narcotics required after surgery. This is increasingly useful information, as surgeons/clinicians continue to try to minimize the role of narcotics in postoperative recovery.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101078"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845136","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":"Low Income, Younger Age, Female Sex, and Poor Mental Health Are Risk Factors for Diminished Access to Care Among Patients With Meniscus Tears","authors":"Drew W. Barron B.S. ,&nbsp;Vikram S. Gill B.S. ,&nbsp;Sayi P. Boddu B.A. ,&nbsp;Nathan C. Beckett B.S. ,&nbsp;Sailesh V. Tummala M.D. ,&nbsp;Anikar Chhabra M.D.","doi":"10.1016/j.asmr.2024.101064","DOIUrl":"10.1016/j.asmr.2024.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>To use the All of Us database to investigate barriers to health care access for patients with meniscus tears and to examine how specific demographic, socioeconomic, and health-related factors independently influence their health care utilization.</div></div><div><h3>Methods</h3><div>The National Institutes of Health All of Us database was queried for patient data between March 2017 and March 2023 to form a cohort of patients with meniscal tears. Patients with meniscal tears were identified using Systematized Nomenclature of Medicine clinical terms. All patients with self-reported meniscus tears were included, with no exclusion criteria to ensure a diverse representation of underrepresented individuals. Patient responses to the “Healthcare Access and Utilization Survey” were analyzed across 4 domains: “delayed care,” “could not afford care,” “skipped medication,” and “have not seen a provider in over one year.”</div></div><div><h3>Results</h3><div>In total, 5,671 survey respondents with meniscal tears were included for analysis from a population of 436,000 eligible records. Among them, 27.7% reported delayed care, 23.9% were unable to afford care, 11.8% skipped medication, and 2.0% had not seen a provider in over a year. Patients with annual incomes under $50,000 were more likely to delay care (odds ratio [OR], 1.41; <em>P</em> &lt; .001), be unable to afford care (OR, 1.73; <em>P</em> &lt; .001), or skip medications (OR, 1.79; <em>P</em> &lt; .001). Younger age than the cohort mean of 65.4 years, female sex, and poor physical and mental health were associated with impaired access in at least 1 care domain.</div></div><div><h3>Conclusions</h3><div>Over one-fourth of patients with a diagnosis of meniscus tear who responded to the All of Us “Healthcare Access and Utilization Survey” reported difficulties with access to care across 4 domains, with those of low income, younger age, female sex, and poor mental or physical health experiencing significant barriers to care.</div></div><div><h3>Clinical Relevance</h3><div>This research can inform strategies for equitable treatment of meniscal injuries by highlighting disparities in orthopaedic care access and utilization.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101064"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845141","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":"Risk Factors and Injury Prevention in the Throwing Athlete","authors":"Daniel Kline P.T., D.P.T, S.C.S. ,&nbsp;Sarah Kate Fischer P.T., D.P.T., S.C.S. ,&nbsp;Garrett S. Bullock P.T., D.P.T., D.Phil. ,&nbsp;Michael J. Kissenberth M.D. ,&nbsp;Ellen Shanley P.T., Ph.D., O.C.S. ,&nbsp;Charles A. Thigpen P.T., A.T.C., Ph.D.","doi":"10.1016/j.asmr.2024.101037","DOIUrl":"10.1016/j.asmr.2024.101037","url":null,"abstract":"<div><h3>Abstract</h3><div>Arm injuries are the most common throwing injury, with growing concern as the most severe injuries, such as UCL reconstruction, continue to rise. Furthermore, throwing injuries are frequently recurrent, suggesting once injured, players are at increased risk for another arm injury. The increase in injury rates and severity has been attributed to increases in pitching volume and year-round participation, and specialized training. Thus, initial efforts to prevent arm injuries by USA Baseball and Little League have focused on the extrinsic factor of pitching exposure in the form of pitch counts, yet arm injury rates have stayed constant. Therefore, injury prevention strategies should include extrinsic factors and address modifiable, intrinsic factors that are associated with arm injury. Collectively addressing factors, such as shoulder range of motion and strength deficits, trunk and lower extremity function, and implantation of training programs yields a comprehensive approach to reduce arm injury rates. We will use a directed acyclic graph (DAG) to organize how the internal factors (i.e., fatigue, injury history, range of motion, and strength) interact with the external factors (i.e., training load and pitching exposure) and how together they are thought contribute to potential injury and inform arm injury reduction strategies. This will provide a roadmap to build adaptable arm injury reduction strategies to improve the modifiable physical factors in context of the external factors that change over time and between throwing athletes.</div></div><div><h3>Level of Evidence</h3><div>Level V, expert opinion.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101037"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845164","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":"Professional Baseball Players Return to the Same Level of Play With No Effects on Performance After Operative Treatment of Batter’s Shoulder","authors":"Roger V. Ostrander III M.D.,&nbsp;Skyler T. Hoelscher M.D.,&nbsp;Reece Vesperman M.D.,&nbsp;James R. Andrews M.D.","doi":"10.1016/j.asmr.2024.101039","DOIUrl":"10.1016/j.asmr.2024.101039","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate return to play and level of performance after posterior labral repair for the treatment of batter’s shoulder in professional baseball players.</div></div><div><h3>Methods</h3><div>Subjects were selected if they underwent posterior labral repair from 2007 to 2019 at a single institution and had evidence of a batter’s shoulder injury defined as posterior instability and pain while batting. Subjects were excluded if they reported other traumatic mechanisms of injury. Demographic and perioperative data were collected from the participants’ medical records. Historical professional baseball statistics were collected from historical baseball statistics databases.</div></div><div><h3>Results</h3><div>This study included 4 Major League Baseball and 2 Minor League Baseball players. All players in this study were able to return to play at a professional level. The mean difference in at bats from 2 years before to 2 years after surgery was +209.83, which was not statistically significant (95% confidence interval [CI], –329 to 897; <em>P</em> = .219). The mean difference in batting average from 2 years before to 2 years after surgery was –0.054, which was also not statistically significant (95% CI, –0.136 to 0.017; <em>P</em> = .063). The mean difference in relative batting average from 2 years before to 2 years after surgery was +0.192, with a 95% nonparametric CI of –0.048 to 0.458; this was also not statistically significant (<em>P</em> = .062).</div></div><div><h3>Conclusions</h3><div>Players who have a batter’s shoulder injury do not experience any statistically significant drop in performance after posterior labral repair (2 years before vs 2 years after).</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 2","pages":"Article 101039"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845170","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":"Lower Trapezius Tendon Transfer Restores Deltoid Function and Shoulder Stability More Effectively Than Superior Capsular Reconstruction in Massive Rotator Cuff Tears","authors":"Nirav Mungalpara M.D. ,&nbsp;Cody Lee M.D. ,&nbsp;Sunjung Kim Ph.D. ,&nbsp;Kevin Chen B.A. ,&nbsp;Hayden Baker M.D. ,&nbsp;Aravind Athiviraham M.D. ,&nbsp;Elhassan Bassem M.D. ,&nbsp;Jason Koh M.D. ,&nbsp;Nicholas Maassen M.D. ,&nbsp;Farid Amirouche Ph.D.","doi":"10.1016/j.asmr.2024.101045","DOIUrl":"10.1016/j.asmr.2024.101045","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the biomechanical effectiveness of superior capsular reconstruction (SCR) and lower trapezius tendon transfer (LTT) to restore the native shoulder kinematics in managing massive rotator cuff tears (MRCTs) using a dynamic shoulder testing system in a cadaver model.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric hemithoraces were tested using a custom-made dynamic shoulder testing system. The conditions tested are intact, supraspinatus tear, MRCT (supraspinatus and infraspinatus tear), LTT with Achilles allograft, SCR combined with LTT, and SCR alone. Measurements included cumulative deltoid force, humeral head translation (HHT), and subacromial peak pressure during humeral abduction at various angles.</div></div><div><h3>Results</h3><div>Significant reductions in cumulative deltoid force were observed from intact to MRCT conditions (<em>P</em> = .023). LTT alone significantly improved deltoid force compared to its combination with SCR (<em>P</em> = .017) and outperformed SCR alone (<em>P</em> = .023). The intact condition showed increasing subacromial peak pressure with higher abduction angles, peaking at 541 kPa at 90°. MRCT exhibited the highest HHT and peak pressure, indicating significant instability. LTT reduced HHT and peak pressure compared to MRCT, indicating partial restoration of stability. The combined LTT + SCR condition demonstrated HHT values close to the intact condition and lower peak pressures, indicating substantial restoration of glenohumeral stability.</div></div><div><h3>Conclusions</h3><div>Simulated active unconstrained humeral abduction in the scapular plane using an entire hemithorax model suggests that LTT can restore dynamic stability and deltoid function in MRCTs, while SCR offers static stability without restoring deltoid function. Combining LTT and SCR may result in lower subacromial peak pressures on the undersurface of the acromion than either procedure alone.</div></div><div><h3>Clinical Relevance</h3><div>This study will contribute to understanding shoulder kinetics concerning current surgical techniques and suggest a dynamic concept of shoulder biomechanics testing.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101045"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845171","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}