Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Biomechanical Effect of Dermal Allograft or Bone Block Augmentation on Standard Labral Repair in a Time-Zero Cadaveric Model of Glenoid Bone Loss","authors":"Sam Akhavan M.D. ,&nbsp;Brittany M. Glaeser M.S. ,&nbsp;Sarah J. Ingwer B.S. ,&nbsp;Sohail Qazi M.D. ,&nbsp;Jahan Aslami M.S. ,&nbsp;Oliver Hauck M.S.","doi":"10.1016/j.asmr.2025.101193","DOIUrl":"10.1016/j.asmr.2025.101193","url":null,"abstract":"<div><h3>Purpose</h3><div>To biomechanically evaluate the stability of a labral repair technique using dermal augmentation (DA) compared with standard labral repair (SLR) and bone block augmentation (BBA) in the context of subcritical glenoid bone loss in a cadaveric model.</div></div><div><h3>Methods</h3><div>Eight cadaveric shoulder specimens were disarticulated and dissected, leaving only labral tissue. The specimens were secured to custom fixtures with 60° of glenohumeral abduction, 30° of external rotation, 20° of scapular anterior tilt, and 40 N of glenohumeral compression. In a repeated-measures design, the specimens were tested in 5 states: native, defect (with 15% glenoid bone loss), SLR, DA, and BBA. Dislocation was performed at 1 N/s over the anterior-inferior rim. Maximum load and distance to dislocation were recorded and statistically analyzed.</div></div><div><h3>Results</h3><div>Maximum loads for the defect state and SLR were significantly less than those for the native state (<em>P</em> = .005 and <em>P</em> = .008, respectively) and BBA (<em>P</em> = .014 and <em>P</em> = .022, respectively). The distance to dislocation decreased significantly for the defect state (<em>P</em> &lt; .001) and SLR (<em>P</em> &lt; .001) compared with the native state. The distance to dislocation for the defect state, SLR, and DA was significantly reduced compared with BBA (<em>P</em> &lt; .001, <em>P</em> &lt; .001, and <em>P</em> &lt; .001, respectively). The distance to dislocation was significantly greater for DA than for the defect state (<em>P</em> &lt; .001) and SLR (<em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>Dermal allograft repair showed similar biomechanical characteristics to the native state and showed an increased distance to dislocation and higher forces at dislocation compared with SLR. BBA restored the distance to dislocation and resulted in non-significantly increased maximum loads when compared with the native state.</div></div><div><h3>Clinical Relevance</h3><div>DA of labral repair is an alternative procedure for subcritical glenoid bone loss that potentially mitigates adverse effects from bone grafting. Future clinical investigation is warranted.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101193"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934050","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":"Players in the National Hockey League Experience Position-Specific Variations in Recovery and Performance After Shoulder Surgery","authors":"Shaunak S. Digambar M.S. ,&nbsp;Hayden Hartman B.S. ,&nbsp;Daniel Walsh M.D. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Mia V. Rumps M.S. ,&nbsp;Rob Hand ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101153","DOIUrl":"10.1016/j.asmr.2025.101153","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the rate of return to play (RTP) and level of performance in National Hockey League (NHL) players after shoulder surgery from 2000 to 2020.</div></div><div><h3>Methods</h3><div>Data on NHL players undergoing shoulder surgery from 2000 to 2020 were collected from <span><span>prosportstransactions.com</span><svg><path></path></svg></span>. Performance metrics, including shots on goal, time on ice, saves, and goals against average, were analyzed for 1 season presurgery and 2 seasons postsurgery. Nonparametric analysis of variance and post-hoc tests assessed performance changes.</div></div><div><h3>Results</h3><div>Of 1,047 players, 120 met inclusion criteria. Centers had greater body mass index (mean = 26.7, <em>P</em> = .03), whereas goalies had lower body mass index(mean = 24.7, <em>P</em> = .008). Defenders sustained injuries later in their careers, whereas forwards had shorter careers after surgery. Average RTP was 235 days, with defenders returning sooner (203 days, <em>P</em> &lt; .001) and goalies taking longer (437 days, <em>P</em> = .008). Forwards’ shots on goal/games played declined after surgery, whereas defenders’ time on ice/games played remained stable. No significant difference in games played per season was observed across positions. Each additional year of age reduced RTP by 7.5 days (<em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>Recovery times and performance after shoulder surgery in NHL players vary by position, although differences were statistically insignificant. Defenders had shortest RTP with stable performance, suggesting minimal impact endurance and defensive contributions. Goalies required longer RTP likely as the result of the physical demands of their position, which heavily relies on attributes like upper-body mobility, among others—factors likely affected by shoulder surgery. Offensive players experienced initial declines in performance but returned to near baseline by the second season. Older players generally returned sooner as the result of greater familiarity with injury management and shorter competitive career windows.</div></div><div><h3>Clinical Relevance</h3><div>This study provides insight into the positional and age-related differences in recovery and performance among NHL players following shoulder surgery, highlighting the need for tailored rehabilitation protocols to optimize return-to-play outcomes.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101153"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934135","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":"No Difference in Pain Levels and Functional Outcomes After Primary Hip Arthroscopy With Labral Repair Versus Labral Augmentation at Minimum 1-Year Follow-Up","authors":"Ryan S. Marder M.D. ,&nbsp;Daniel J. Garcia B.S. ,&nbsp;Sydney M. Fasulo M.D. ,&nbsp;Sean M. Richards B.A. ,&nbsp;Nicolas J. Nadeau B.S. ,&nbsp;Matthew J. Kraeutler M.D. ,&nbsp;Anthony J. Scillia M.D.","doi":"10.1016/j.asmr.2025.101175","DOIUrl":"10.1016/j.asmr.2025.101175","url":null,"abstract":"<div><h3>Purpose</h3><div>To retrospectively compare the 1-year clinical outcomes of patients undergoing primary hip arthroscopy with labral repair (LR) versus labral augmentation (LA) for femoroacetabular impingement.</div></div><div><h3>Methods</h3><div>In this single-surgeon cohort study, we performed a retrospective review of prospectively collected data from patients who underwent primary hip arthroscopy with LR or LA between 2019 and 2022. LA was performed by the addition of an iliotibial band allograft to the repair construct. Indications for LA included a hypotrophic labrum, an everted labrum, or labral ossification. A survey of patient-reported outcome measures (PROMs) was completed at a minimum of 1 year postoperatively. PROMs included the visual analog scale pain score; University of California, Los Angeles Activity Scale score; modified Harris Hip Score; Hip Outcome Score–Sports-Specific Subscale; and Single Assessment Numeric Evaluation. The minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) for each PROM were compared between groups.</div></div><div><h3>Results</h3><div>A total of 99 patients (99 hips) were included in the final analysis (64 LR and 35 LA patients). No differences were found between the LR and LA groups in terms of demographic characteristics. There was a significantly longer time to follow-up in the LR group (26.1 ± 8.7 months in LR group vs 20.2 ± 7.9 months in LA group, <em>P</em> = .001). There were no significant differences between the LR and LA groups in terms of postoperative PROMs including the visual analog scale pain score (2.3 ± 2.4 vs 3.0 ± 2.7, <em>P</em> = .23); University of California, Los Angeles score (7.8 ± 2.3 vs 7.5 ± 2.6, <em>P</em> = .48); modified Harris Hip Score (77.3 ± 15.3 vs 73.8 ± 16.6, <em>P</em> = .30); Hip Outcome Score–Sports-Specific Subscale (79.0 ± 22.8 vs 69.2 ± 31.8, <em>P</em> = .08); or Single Assessment Numeric Evaluation score (84.8 ± 18.8 vs 77.0 ± 26.1, <em>P</em> = .10). No differences were identified between groups in terms of achieving the MCID, PASS, or SCB for the PROMs assessed. By the final follow-up, 2 patients (3.1%) in the LR group and 0 patients in the LA group underwent revision hip arthroscopy.</div></div><div><h3>Conclusions</h3><div>At 1-year follow-up, there were no differences in patient-reported outcomes in young active patients undergoing hip arthroscopy with LR versus LA. There were no significant differences in the sex-based subgroup analysis between LR and LA in terms of all postoperative PROMs and in achieving the MCID, PASS, or SCB for the PROMs assessed.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101175"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934054","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":"Informational Quality of YouTube Content on Partial Meniscectomy Remains Inadequate","authors":"Shankar S. Thiru B.S. ,&nbsp;Nicholas E. Aksu M.D. ,&nbsp;Gregorio Baek B.S. ,&nbsp;Theodore A. Joaquin B.S. ,&nbsp;Gregory T. Perraut M.D. ,&nbsp;William F. Postma M.D.","doi":"10.1016/j.asmr.2025.101192","DOIUrl":"10.1016/j.asmr.2025.101192","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the quality of YouTube videos regarding partial meniscectomy.</div></div><div><h3>Methods</h3><div>The first 50 videos returned by the keyword search “partial meniscectomy” after screening for inclusion and exclusion criteria were included in the study. Off-topic videos, non-English language videos, duplicated videos, YouTube Shorts, and videos with poor audio quality were excluded. The primary outcomes were the DISCERN instrument (range, 15-75), <em>Journal of American Medical Association</em> (JAMA) benchmark criteria (range, 0-4), and Global Quality Scale (GQS) (range, 0-5). In addition, date of publication, video duration, number of likes, number of comments, and number of views were recorded. Videos were also categorized by source type (physicians, companies, or patients), subject (surgical technique, patient experience, or overview), and content (educational or subjective patient experience).</div></div><div><h3>Results</h3><div>Of the 50 videos, 24 (46.0%) were published by physicians; 20 (40.0%), by companies; and 6 (14.0%), by patients. The most prevalent type of information was an overview (44.0%); 86% of the videos were educational in nature, whereas the remaining 14% described subjective patient experiences. The mean video length was 5.07 ± 0.21 minutes. The mean number of views was 1,624,827.44 ± 8,334.86; the mean number of comments, 191.62 ± 34.11; and the mean number of likes, 25,984.84 ± 1,051.76. The mean DISCERN, JAMA, and GQS scores were 45.005 ± 1.75 (95% confidence interval [CI], 44.74-45.49; range, 15-75), 1.83 ± 0.52 (95% CI, 1.68-1.97; range, 0-4), and 2.97 ± 0.52 (95% CI, 2.83-3.11; range, 1-5) respectively. For the JAMA score and GQS score, videos published by physicians had greater quality (both <em>P</em> = .01). Finally, overview videos were of the highest quality regarding all scores (<em>P</em> &lt; .01 to <em>P</em> = .03), whereas educational content had higher quality than patient experience content (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>The overall quality of YouTube videos concerning partial meniscectomy remains poor to suboptimal. Currently, YouTube is not an appropriate resource for orthopaedic patients seeking information about partial meniscectomy.</div></div><div><h3>Clinical Relevance</h3><div>YouTube is not an appropriate resource for orthopaedic patients seeking information about partial meniscectomy.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101192"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932476","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":"Google Trends Shows Increased Public Interest in Platelet-Rich Plasma Injections in All Joints: Shoulder and Knee Show Greatest Increase","authors":"James Kim B.S. ,&nbsp;Christopher Rennie B.S. ,&nbsp;Neil Pathak M.D. ,&nbsp;Andrew Jimenez M.D. ,&nbsp;Arianna L. Gianakos D.O.","doi":"10.1016/j.asmr.2025.101199","DOIUrl":"10.1016/j.asmr.2025.101199","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess search term frequency of platelet-rich plasma (PRP) in multiple joints, including the shoulder, elbow, hip, knee, ankle, and foot, using Google Trends.</div></div><div><h3>Methods</h3><div>The following joints included were (1) shoulder, (2) elbow, (3) hip, (4) knee, (5) ankle, and (6) foot. Google Trends was utilized to obtain search trends from 2010 to 2023 for each joint. The search combinations “PRP” + “shoulder,” “elbow,” “hip,” “knee,” “ankle,” and “foot” were used, and a linear regression model was applied. Analysis of variance and post hoc Tukey honest significant difference analyses were performed to determine specific comparisons between joints.</div></div><div><h3>Results</h3><div>There was an increasing trend in Google queries for PRP and shoulder (<em>R</em>² = 0.669, <em>P</em> &lt; .001), elbow (<em>R</em>² = 0.284, <em>P</em> &lt; .001), hip (<em>R</em>² = 0.648, <em>P</em> &lt; .001), knee (<em>R</em>² = 0.802, <em>P</em> &lt; .001), ankle (<em>R</em>² = 0.240, <em>P</em> &lt; .001), and foot (<em>R</em>² = 0.040, <em>P</em> = .009). The shoulder showed the greatest rate of growth, shown by the slope in the linear regression model, followed by the knee (0.422 and 0.421, respectively). Within the lens of percent increase, PRP in the ankle had the highest magnitude of growth, followed by the knee (1,251.27% and 163.95%, respectively). The knee joint held the highest average relative search volume of 66.38 as of 2023.</div></div><div><h3>Conclusions</h3><div>Each of the search terms for PRP in the shoulder, elbow, hip, knee, ankle, and foot had statistically significant trends of increasing search volume. PRP for the shoulder and knee exhibited the highest rate of growth, whereas PRP for the foot exhibited the slowest increase.</div></div><div><h3>Clinical Relevance</h3><div>There appears to be substantial patient interest in PRP injections. The information in this study can be used by clinicians to better understand which joint injections patients may generally be interested in discussing during clinic visits. They can provide evidence-based materials to educate patients about PRP joint injections.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101199"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933719","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":"Angiotensinogen II Receptor Blockers May Decrease Risk of Adhesive Capsulitis After Rotator Cuff Repair","authors":"Cody S. Lee M.D. ,&nbsp;Jordan Cook Serotte M.D. ,&nbsp;Sai Reddy B.S. ,&nbsp;Lewis Shi M.D. ,&nbsp;Nicholas H. Maassen M.D.","doi":"10.1016/j.asmr.2025.101165","DOIUrl":"10.1016/j.asmr.2025.101165","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the effect of commonly prescribed antifibrotic medications on the odds of developing adhesive capsulitis (AC) following arthroscopic rotator cuff repair.</div></div><div><h3>Methods</h3><div>The Mariner data set of the PearlDiver database from 2010 to 2022 was used to identify patients aged 40 to 65 years who underwent rotator cuff repair (identified by Current Procedural Terminology codes) with an ipsilateral rotator cuff tear (identified by International Classification of Diseases, 10th Revision codes). Patients were required to have filled a prescription for only one of the following medications before and within 3 months of surgery: angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors, cyclooxygenase 2 inhibitors, and statins. Patients who developed ipsilateral AC within 6 months after surgery were identified using International Classification of Diseases codes. Additionally, all patients who underwent a manipulation under anesthesia (MUA) and/or arthroscopic lysis of adhesions (LOA) within 6 months of diagnosis of AC were identified using Current Procedural Terminology codes.</div></div><div><h3>Results</h3><div>A total of 183,563 patients met study inclusion criteria and were stratified based on the development of postoperative AC. The baseline characteristics (age, sex, smoking status, and diabetes and obesity prevalence) between the 2 groups were statistically different, except for the Charlson Comorbidity Index. In total, 4.62% (8,485/183,563) developed postoperative AC, and 8.5% (717/8,485) and 5.2% (438/8,485) of patients who developed AC underwent subsequent MUA and LOA, respectively. Patients on an ARB had an odds ratio of 0.87 (<em>P</em> = .04) for the development of AC. No other medication usage had a significant change in odds for the development of AC, nor did any medication have a change in odds of undergoing MUA or LOA.</div></div><div><h3>Conclusions</h3><div>Patients on an ARB had lower odds of being diagnosed with AC within 6 months of surgery. Once diagnosed with AC, there was no difference in odds of undergoing MUA or LOA among any of the medication groups.</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 101165"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934049","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":"Risks of Intra-articular Hip Corticosteroid Injections Include Rapidly Progressive Osteoarthritis and Femoral Head Collapse in Patients With and Without Pre-existing Osteoarthritis: A Systematic Review","authors":"Dylan Parry B.S. ,&nbsp;Jaydeep Dhillon D.O. ,&nbsp;Matthew J. Kraeutler M.D.","doi":"10.1016/j.asmr.2025.101169","DOIUrl":"10.1016/j.asmr.2025.101169","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify studies reporting cartilage-related complications associated with hip intra-articular corticosteroid injections (IACSIs).</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines by searching PubMed, the Cochrane Library, and Embase to identify any study or case report reporting on cartilage-related complications after IACSIs. The search terms used were as follows: hip AND injection AND corticosteroid. Inclusion criteria included any study or case report reporting on cartilage-related complications after IACSIs. Studies were excluded if they were unrelated to the hip joint, performed injection into the soft tissue surrounding the hip joint, and/or did not report on any complications after corticosteroid injection into the hip joint. The outcomes assessed were rapidly progressive osteoarthritis (RPOA), osteonecrosis (ON), femoral head collapse (FHC), insufficiency fracture (IF), and worsening osteoarthritis (WOA) in patients with and without pre-existing osteoarthritis (OA).</div></div><div><h3>Results</h3><div>Twenty studies (1 Level II, 12 Level III, 3 Level IV, 4 Level V) met the inclusion criteria, with a total of 34,367 hips that underwent IACSIs. The mean patient age ranged from 50.0 to 78.0 years, the average body mass index ranged from 26.3 to 31.4, and the overall percentage of female patients ranged from 5.5% to 100%. Excluding case reports, the RPOA incidence ranged from 0.2% to 21.1%; ON incidence, from 0.6% to 27.1%; FHC incidence, from 3.2% to 20.4%; IF incidence, from 0.4% to 1.3%; and WOA incidence, from 1.1% to 44.3%.</div></div><div><h3>Conclusions</h3><div>Risks of IACSI include RPOA, ON, FHC, IF, and WOA, although the incidence rates of these outcomes vary notably. Adverse outcomes occur in patients without pre-existing OA, but most of the available literature reports these outcomes in patients with pre-existing OA.</div></div><div><h3>Level of Evidence</h3><div>Level V, systematic review of Level II to V studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101169"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934139","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":"Handheld Dynamometry Shows Moderate Reliability and Responsiveness in Assessing Shoulder Muscle Strength After Rotator Cuff Repair","authors":"Hirotomo Shibahashi O.T.R., Ph.D. ,&nbsp;Miyuki Murakawa O.T.R., Ph.D. ,&nbsp;Issei Yuki M.D. ,&nbsp;Tomohiro Uno M.D., Ph.D. ,&nbsp;Kanta Ohno O.T.R., Ph.D. ,&nbsp;Michiaki Takagi M.D., Ph.D. ,&nbsp;Yuya Takakubo M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101211","DOIUrl":"10.1016/j.asmr.2025.101211","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate both the reliability and responsiveness of handheld dynamometry (HHD) in assessing shoulder external rotation, flexion, and internal rotation strength during long-term follow-up in patients following rotator cuff repair and to provide evidence for the clinical utility of HHD in this context.</div></div><div><h3>Methods</h3><div>This retrospective study investigated patients who underwent arthroscopic rotator cuff repair between 2014 and 2019. Patients with repeat tears were excluded. Muscle strength was assessed preoperatively and at 6, 12, 18, and 24 months postoperatively using a handheld dynamometer. Test-retest reliability was evaluated using intraclass correlation coefficients (ICCs) from linear mixed-effects models, while responsiveness was assessed via minimal clinically important difference (MCID) calculations. Missing data were handled with multiple imputations, and statistical analyses were performed using R.</div></div><div><h3>Results</h3><div>A total of 124 patients (mean age: 64.4 ± 9.8 years) were included, with 69.4% of surgeries performed on the right shoulder. Moderate reliability of HHD was shown for muscle strength measurements, with intraclass correlation coefficients ranging from 0.59 to 0.69. Muscle strength and MCID achievement rates improved significantly over 24 months (<em>P</em> &lt; .001). For 90° of abduction, muscle strength increased from 47.4 ± 42.6 N preoperatively to 103.2 ± 45.9 N at 24 months postoperatively, while the rate of MCID achievement at 24 months postoperatively was 80.7%.</div></div><div><h3>Conclusions</h3><div>HHD showed moderate reliability and responsiveness in assessing shoulder muscle strength after arthroscopic rotator cuff repair. Significant improvements in muscle strength and MCID achievement rates were observed over 24 months, suggesting the potential utility of HHD for monitoring recovery in this patient population.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective diagnostic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101211"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934051","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 Relative Value Scale Methodology Underestimates Perioperative Workload in Hip Arthroscopy","authors":"Shelby C. Hodges B.S. ,&nbsp;Juan J. Gordillo B.S. ,&nbsp;Clay A. Rahaman B.A. ,&nbsp;Mathew Hargreaves B.S. ,&nbsp;Maxwell L. Harrell B.S. ,&nbsp;Dev Dayal B.S. ,&nbsp;Thomas B. Evely D.O. ,&nbsp;Eugene W. Brabston M.D. ,&nbsp;Amit M. Momaya M.D. ,&nbsp;Aaron J. Casp M.D.","doi":"10.1016/j.asmr.2025.101157","DOIUrl":"10.1016/j.asmr.2025.101157","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the accuracy of the current times and work relative value units (wRVUs) recommended by the Relative Value Scale (RVS) Update Committee (RUC) for the perioperative work associated with hip arthroscopy in a single surgeon’s practice.</div></div><div><h3>Methods</h3><div>The RUC was contacted to obtain a list of perioperative tasks and times allotted for these tasks for hip arthroscopy procedures (Current Procedural Terminology codes 29914, 29915, and 29916). A board-certified, sports medicine fellowship–trained orthopaedic surgeon recorded the time it took to perform each perioperative task. Recorded times were multiplied by their respective Centers for Medicare &amp; Medicaid Services–assigned intensity coefficients to calculate the wRVUs for preservice and postservice tasks. Calculated and allotted wRVUs were compared for accuracy.</div></div><div><h3>Results</h3><div>The tasks timed in this study were allotted 83 minutes by the RUC with a wRVU of 1.72. Our study found that these same tasks significantly differed, at 93.4 minutes and total wRVU of 1.95 (<em>P</em> &lt; .001). The overall time it took to perform perioperative tasks for hip arthroscopy was underestimated by 10.4 minutes, resulting in an undervaluation of wRVU by 0.23.</div></div><div><h3>Conclusions</h3><div>In a single surgeon’s practice, the RUC underestimates the time required to perform perioperative tasks for hip arthroscopy procedures.</div></div><div><h3>Clinical Relevance</h3><div>It is important to determine whether the amount surgeons are reimbursed for certain procedures, such as hip arthroscopy, is an accurate reflection of actual cost. Discrepancies between reimbursement and actual costs can influence the financial viability of offering such procedures, impacting access to care, procedural volume, and potentially long-term outcomes, particularly as health care systems move toward value-based reimbursement models.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101157"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934052","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":"Socioeconomic Disparities and Procedural Complexity Influence Charges in Primary Patellar Instability Treatment: A Nationwide Analysis","authors":"Timothy A. Reiad B.S. ,&nbsp;Peter V. Dinh B.S. ,&nbsp;David Bruni M.D. ,&nbsp;John Milner M.D. ,&nbsp;Brett D. Owens M.D. ,&nbsp;Stephen E. Marcaccio M.D.","doi":"10.1016/j.asmr.2025.101197","DOIUrl":"10.1016/j.asmr.2025.101197","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the factors associated with charges of primary treatment options for patellar instability, analyze the financial impact of performing specific concomitant procedures, and identify critical social determinants of health care charges associated with patellar instability treatment.</div></div><div><h3>Methods</h3><div>This retrospective study used the 2019 Nationwide Ambulatory Surgery Sample to analyze patients with primary patellar instability undergoing a single stabilization procedure, including relevant concomitant procedures. Cases with multiple primary stabilization procedures or cases with unrelated concomitant Current Procedural Terminology codes were excluded. Bivariate analyses identified significant covariates, which were included in a generalized linear model to compare charges across Current Procedural Terminology codes, adjusting for patient and hospital factors.</div></div><div><h3>Results</h3><div>In total, 3,035 procedures were analyzed, including 54.79% arthroscopic lateral retinacular releases, 7.45% open lateral releases, 31.73% medial patellofemoral ligament (MPFL) reconstructions, and 6.03% tibial tubercle osteotomies. On average, tibial tubercle osteotomy ($47,401) had greater charges than MPFL reconstruction ($41,333), arthroscopic lateral release ($23,930), and open lateral release ($34,520). Charges varied by patient demographics and hospital characteristics. Non-White patients faced greater charges compared with White patients ($36,051 vs $29,924, <em>P</em> &lt; .001). Similarly, Hispanic patients faced greater charges than non-Hispanic patients ($38,256 vs $30,861, <em>P</em> &lt; .001). Male patients were charged more than female patients (<em>P</em> &lt; .001). Private hospitals charged $10,422 more than public hospitals (<em>P</em> &lt; .001). Urban hospitals charged $3,929 more than hospitals in rural locations. Osteochondral grafting increased charges by $35,816 (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>This study highlights significant variability in charges for patellar instability treatments, influenced by procedural complexity, concomitant interventions, and demographic factors. Tibial tubercle osteotomy was the most expensive treatment option, followed by MPFL reconstruction. Concomitant osteochondral grafting significantly increased charges. Disparities in charges were evident on the basis of patient demographics and hospital characteristics, with greater charges associated with non-White race, Hispanic ethnicity, and procedures performed in private hospitals or urban hospitals.</div></div><div><h3>Clinical Relevance</h3><div>Understanding cost drivers in patellar instability treatment can inform clinical decision-making, resource allocation, and efforts to address health care disparities in orthopedic and sports medicine care.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101197"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934132","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}