Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Artificial Intelligence−Driven Analysis Identifies Anterior Cruciate Ligament Reconstruction, Hip Arthroscopy and Femoroacetabular Impingement Syndrome, and Shoulder Instability as the Most Commonly Published Topics in Arthroscopy","authors":"Henry B.G. Baird B.S. ,&nbsp;William Allen M.D. ,&nbsp;Mauricio Gallegos M.D. ,&nbsp;Cody C. Ashy M.D. ,&nbsp;Harris S. Slone M.D. ,&nbsp;W. Michael Pullen M.D.","doi":"10.1016/j.asmr.2025.101108","DOIUrl":"10.1016/j.asmr.2025.101108","url":null,"abstract":"<div><h3>Purpose</h3><div>To use advanced topic modeling, specifically the Bidirectional Encoder Representations from Transformers Topic (BERTopic) Model, to analyze research topics in <em>Arthroscopy: The Journal of Arthroscopic and Related Surgery (Arthroscopy)</em>.</div></div><div><h3>Methods</h3><div>Text data from the titles and abstracts of 7,304 original articles and reviews published in <em>Arthroscopy</em> between 1985 and 2023 were included to train the BERTopic artificial intelligence (AI) model for topic generation. BERTopic, an advanced natural language processing tool implemented in Python via Jupyter Notebook, uses contextual embeddings and clustering algorithms to efficiently group large datasets into topics based on semantic similarity. The AI-generated topics were then analyzed by frequency (i.e., the number of studies classified under each topic from 1985 to 2023) and popularity (i.e., “hot” and “cold” topic patterns based on linear regression models of topic frequency from 2020 to 2023).</div></div><div><h3>Results</h3><div>The BERTopic model categorized 6,901 articles into 35 topics. The most common topics from 1985 to 2023 were anterior cruciate ligament reconstruction, hip arthroscopy and femoroacetabular impingement (FAI), and shoulder instability. From 2020 to 2023, hip arthroscopy and femoroacetabular impingement, superior capsular reconstruction, and anterior cruciate ligament reconstruction were identified as “hot” or popular topics, whereas suture anchor biomechanics, platelet-rich plasma, and arthroscopic irrigation were identified as “cold” topics, indicating a decline in popularity.</div></div><div><h3>Conclusions</h3><div>Using BERTopic, the study showed an efficient way to analyze large amounts of data to establish patterns within orthopaedic sports medicine literature. This study shows the capacity of the BERTopic model to synthesize thousands of articles within <em>Arthroscopy: The Journal of Arthroscopic and Related Surgery</em> into 35 key topics. The ability to process large amounts of data with accuracy and efficiency provides a powerful tool for establishing and defining the current landscape and potential future directions of orthopaedic literature.</div></div><div><h3>Clinical Relevance</h3><div>Using AI to investigate topics a journal has published will allow us to recognize patterns, identifying common topics, emerging topics, and shifts in focus over time. It will also allow us to identify research gaps that may need to be addressed.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101108"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480758","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 Western Ontario Meniscal Evaluation Tool Translated Into Italian Is a Reliable, Precise, and Responsive Patient-Reported Outcome Measure for Arthroscopic Meniscal Surgery","authors":"Michelangelo Palco M.D. ,&nbsp;Gabriele Giuca M.D. ,&nbsp;Giorgio Gasparini M.D. ,&nbsp;Roberto Simonetta M.D. ,&nbsp;Danilo Leonetti M.D. ,&nbsp;Filippo Familiari M.D.","doi":"10.1016/j.asmr.2025.101115","DOIUrl":"10.1016/j.asmr.2025.101115","url":null,"abstract":"<div><h3>Purpose</h3><div>To translate and culturally adapt the Western Ontario Meniscal Evaluation Tool (WOMET) into Italian to examine its reliability, measurement precision, and responsiveness in patients undergoing arthroscopic meniscal surgery.</div></div><div><h3>Methods</h3><div>Patients with magnetic resonance imaging–confirmed meniscal injuries completed the Italian WOMET at baseline and again at 3 and 6 months postoperatively. The translation followed established guidelines for cross-cultural adaptation, including forward-backward translation and cognitive debriefing. Test-retest reliability was assessed using the intraclass correlation coefficient, and measurement precision was evaluated by calculating the standard error of measurement and the minimal detectable change. Responsiveness was measured via the standardized response mean. The Knee Injury and Osteoarthritis Outcome Score 4 questionnaire was administered for comparison.</div></div><div><h3>Results</h3><div>A total of 97 patients (mean age, 38 years; age range, 22-58 years) were included. The Italian WOMET showed excellent test-retest reliability (intraclass correlation coefficient, 0.87). The standard error of measurement was 109.68 points, and the minimal detectable change was 307 points, indicating a high level of precision for detecting true clinical changes. The standardized response means were 1.94 at 3 months and 2.44 at 6 months, indicating strong responsiveness. A high correlation (<em>r</em> = 0.85, <em>P</em> &lt; .001) with the Knee Injury and Osteoarthritis Outcome Score 4 supported concurrent validity.</div></div><div><h3>Conclusions</h3><div>The Italian WOMET is a reliable, precise, and highly responsive patient-reported outcome measure for assessing health-related quality of life in patients undergoing arthroscopic meniscal surgery.</div></div><div><h3>Clinical Relevance</h3><div>Given the increasing prevalence of meniscal injuries in Italy and the need for culturally relevant diagnostic tools, the validation of the WOMET in Italian is important for patients, health care providers, and scientists.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101115"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481242","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":"Medicaid Patients Have Similar Functional Patient Outcomes but Lower Mental Health Scores Than Patients With Private Insurance Following Rotator Cuff Repair","authors":"Melissa L. Carpenter B.S.,&nbsp;Michael J. Murray B.S.,&nbsp;Trevor A. Poulson M.S.,&nbsp;Monique Haynes M.D.,&nbsp;Alexander Mamonov,&nbsp;Juan Bernardo Villarreal-Espinosa M.D.,&nbsp;Jorge Chahla M.D., Ph.D.,&nbsp;Nikhil N. Verma M.D.","doi":"10.1016/j.asmr.2025.101148","DOIUrl":"10.1016/j.asmr.2025.101148","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether patients insured through Medicaid exhibit differences in patient-reported outcomes, functional measurements, reinjury, and reoperation metrics after primary rotator cuff repair compared with patients insured with private insurance.</div></div><div><h3>Methods</h3><div>All skeletally mature patients insured through Medicaid who had undergone a primary rotator cuff repair from January 2014 to July 2023 were identified and compared with a matched cohort of patients with private insurance. Patients were excluded if they were undergoing a revision procedure, had a history of shoulder infection, did not have completed medical records or baseline patient-reported outcome measures, or were lost to follow-up before 1 year postoperatively. Patients were provided questionnaires containing the American Shoulder and Elbow Surgeons (ASES) score, the Veterans RAND 12-Item Health Survey (VR-12), and reinjury and reoperation metrics. Physical therapy (PT) and clinic notes were also reviewed to determine the number of PT visits attended, number of PT visits missed, distance from patients’ home address to the PT facility, range of motion, and comorbidities.</div></div><div><h3>Results</h3><div>A total of 16 patients insured through Medicaid and 16 insured through private insurance were enrolled in this study. There was no difference in average follow-up time between the 2 groups (31.1 vs 38.4 months; <em>P</em> = .391). The 2 groups showed no differences in age, body mass index, sex, smoking status, or other comorbidities, including diabetes, hypertension, and depression. The Medicaid group had a significantly lower preoperative ASES (29.86 vs 46.28; <em>P</em> = .008). Patients insured through Medicaid also had a significantly lower postoperative VR-12 Mental Score (38.20 vs 53.40; <em>P</em> = .013). There was no significant difference in preoperative or postoperative forward flexion or external rotation between the 2 groups. The average distance from home to PT facility, the number of postoperative PT sessions attended and missed, and reinjury and reoperation rates were also similar between groups. Both groups attained the minimal clinically important difference for ASES and VR-12 Physical but not VR-12 Mental.</div></div><div><h3>Conclusions</h3><div>Despite Medicaid patients having a lower ASES preoperatively, they showed no difference in functional outcomes compared to patients with private insurance at final follow-up. However, patients with Medicaid had a significantly lower postoperative VR-12 Mental score, which requires further exploration.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480278","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 Perceptions of Social Media Use by Orthopaedic Surgeons: Comparing Responses Across the United States","authors":"Benjamin R. Wharton M.D. ,&nbsp;Daniel J. Stokes M.D. ,&nbsp;Alexander J. Johnson M.D. ,&nbsp;Nicholas G. Girardi B.S. ,&nbsp;Miranda G. Manfre B.S. ,&nbsp;Carson Keeter M.S. ,&nbsp;Kevin K. Shinsako P.A.-C. ,&nbsp;Eric C. McCarty M.D. ,&nbsp;Jonathan T. Bravman M.D. ,&nbsp;Rachel M. Frank M.D.","doi":"10.1016/j.asmr.2025.101097","DOIUrl":"10.1016/j.asmr.2025.101097","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze patient perceptions of social media (SM) content posted by orthopaedic surgeons across the United States.</div></div><div><h3>Methods</h3><div>The SM posts of 20 professional orthopaedic surgeons with at least 500 followers and 1 post in the month before this study were reviewed and categorized. A validated survey was written to assess respondents’ SM usage practices and perceptions of these categories. The survey was administered to patients in the clinics of 13 geographically diverse orthopaedic surgeons via QR code. Patient responses were analyzed for differences in SM use and perceptions of SM content types.</div></div><div><h3>Results</h3><div>There were 636 patient surveys completed in full. SM use was high across all age groups. In 31% of patients, SM was used to seek information related to their health care at least once per month, 45% of patients reported visiting the SM account of any physician at least a few times a year, and 29% of patients indicated that SM content is likely or very likely to influence their selection of which physician from whom to obtain care. Respondents held consistently positive views of posts providing patient education on common injuries, discussing sports team coverage, and detailing patient testimonials. Patients held consistently neutral views of posts educating colleagues, discussing physicians’ attendance and presentations at national research meetings, displaying aspects of surgeons’ personal lives, highlighting cases, such as radiographs, or magnetic resonance imaging, or other diagnostic imaging, and supporting marginalized groups. Finally, physicians vocalizing their political positions on SM was found to be perceived negatively.</div></div><div><h3>Conclusions</h3><div>In this study, 57% of patients used SM within the last year to access health care−related information. Respondents perceived SM content focused on patient education, patient testimonials, and physician coverage of athletic teams most favorably. The most widely used patient platforms include Facebook, followed by Instagram, Snapchat, TikTok, Twitter, and then LinkedIn.</div></div><div><h3>Clinical Relevance</h3><div>The information from this study clarifies how patients use SM and what types of SM posts are more likely to be viewed positively, negatively, and which illicit a polarized response. This information can help further guide physicians across the United States who use social media to interact effectively with patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101097"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480300","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-Reported Outcome Scores Are Comparable When Administered at Home or in Clinic Following Hip Preservation Surgery","authors":"Bill Garrett Bodine M.D.,&nbsp;Ashley L. Kapron Ph.D.,&nbsp;Benjamin T. Johnson B.S.,&nbsp;Travis G. Maak M.D.,&nbsp;Justin J. Ernat M.D.,&nbsp;Stephen K. Aoki M.D.","doi":"10.1016/j.asmr.2025.101103","DOIUrl":"10.1016/j.asmr.2025.101103","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if the setting of administration (home vs clinic) results in significant differences in patient scores from questionnaires assessing hip and general physical function in a hip preservation patient population.</div></div><div><h3>Methods</h3><div>Adult patients presenting to a hip preservation clinic completed the Modified Harris Hip Score (MHHS), the Physical Function Computed Automated Test (PFCAT), and the sports subscore of Hip Outcome Score (HOS) twice: on an electronic tablet during a clinic appointment and at home via website within 3 to 5 days of the clinic appointment. Patients were randomized into 2 groups to complete the home questionnaires before or after their clinic appointment. Mixed-effects multivariable linear regression analysis, including order of completion as a covariate (i.e., home or clinic first), was used to determine differences in home and clinic scores. Intraclass correlation coefficients were calculated to evaluate reliability. A Bland-Altman analysis evaluated the agreement between completions.</div></div><div><h3>Results</h3><div>A total of 52 patients were included, 26 in each group. Mean age was 39.3 ± 12.2 years, and 38 of 52 (73%) patients were female. There was no significant difference between home and clinic completions of all 3 questionnaires (all <em>P</em> &gt; .270). The covariate representing order of completion was not significant (all <em>P</em> &gt; .346). Reliability was almost perfect for all 3 questionnaires (all intraclass correlation coefficients &gt;0.93). The Bland-Altman analysis indicated a very small bias of higher home than clinic scores for all 3 questionnaires. The PFCAT had the tightest limits of agreement (–5.9 to 5.5), followed by the MHHS (–16.8 to 14.4) and HOS (–24.2 to 21.7).</div></div><div><h3>Conclusions</h3><div>The MHHS, PFCAT, and HOS have high repeatability and are, on average, not affected by settings of administration. When reviewing data on the level of the cohort, no distinction is required for patient-reported outcomes completed at home or clinic within 5 days of a clinical appointment.</div></div><div><h3>Level of Evidence</h3><div>Level II, lesser quality randomized controlled trial.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101103"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480282","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":"Division 1 Collegiate American Football Players Experience a Low Revision Rate After Undergoing Arthroscopic Shoulder Labral Repair","authors":"Camila Grandberg M.D. ,&nbsp;Ian D. Engler M.D. ,&nbsp;Neilen A. Benvegnu M.D. ,&nbsp;Janina Kaarre M.D., M.Sc. ,&nbsp;Adam J. Popchak D.P.T., Ph.D. ,&nbsp;Michael S. Rocca M.D. ,&nbsp;Brian M. Godshaw M.D. ,&nbsp;Jonathan D. Hughes M.D., Ph.D. ,&nbsp;Volker Musahl M.D.","doi":"10.1016/j.asmr.2024.101028","DOIUrl":"10.1016/j.asmr.2024.101028","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe rates of revision surgery and recurrence events, as well as to evaluate functional outcomes and return to play (RTP) of a cohort of Division 1 (D1) collegiate American football players who underwent arthroscopic labral repair for shoulder instability.</div></div><div><h3>Methods</h3><div>D1 collegiate American football players undergoing arthroscopic surgical management of shoulder instability between 2017 and 2021 at a single institution were included. Demographics, imaging, surgical details, and postoperative outcomes, including revision surgery and Western Ontario Shoulder Instability Index (WOSI), were collected. Hill-Sachs lesions and glenoid bone loss were evaluated on magnetic resonance imaging.</div></div><div><h3>Results</h3><div>Fifteen shoulders of 15 consecutive male athletes were included, with mean age of 19.7 ± 1.0 years and mean follow-up of 2.1 ± 1.0 years. Twelve injuries were shoulder subluxations and 3 were dislocations. Seven cases were posterior injuries, 4 were anterior, and 4 included both anterior and posterior injuries. All patients underwent arthroscopic labrum repair alone, without remplissage or any additional open procedures. A mean of 6 anchors were used in each shoulder, with anchors being placed in at least 2 quadrants. Hill-Sachs lesions were observed in 6 shoulders (40%). Thirteen shoulders had no glenoid bone loss, and 2 had &gt;15% glenoid bone loss. Two shoulders required revision surgery. Significant differences were found in postoperative WOSI scores between patients with and without recurrent instability (66.9 ± 11.5% vs 94.6 ± 5.0%), and between patients with and without Hill-Sachs lesions (84.6 ± 14.7% vs 95.0 ± 5.9%). Fourteen patients (93%) RTP at the same level.</div></div><div><h3>Conclusions</h3><div>Arthroscopic labral repairs as a treatment for shoulder instability in D1 American football players, without remplissage/bone block procedures, yielded low recurrence and revision rates, and a high RTP rate. Additionally, Hill-Sachs lesions and recurrent shoulder instability were associated with inferior postoperative subjective outcomes (WOSI score).</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 3","pages":"Article 101028"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480381","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":"Arthroscopic Knotless Double-Row Transosseous Equivalent Repair Is a Viable Option for Treatment of Large and Massive Rotator Cuff Tears","authors":"Patrick A. Massey M.D., M.B.A. ,&nbsp;Lincoln Andre M.D. ,&nbsp;Kevin Perry M.D., D.P.T. ,&nbsp;Lindy Robichaux-Edwards M.D. ,&nbsp;Rachel Kushner M.D. ,&nbsp;Christopher Caldwell M.D. ,&nbsp;Robert Rutz M.D. ,&nbsp;Alberto Simoncini M.D.","doi":"10.1016/j.asmr.2025.101099","DOIUrl":"10.1016/j.asmr.2025.101099","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the clinical outcomes of large and massive rotator cuff tears treated with a knotless double-row transosseus equivalent repair. It is hypothesized that there would be statistically significant improvement in pain, range of motion, and function over time.</div></div><div><h3>Methods</h3><div>Patients who had an arthroscopic rotator cuff repair (Current Procedural Terminology code 29827) performed by a single surgeon at a community-based hospital were reviewed over a 32-month period. Patients were included if their tear measured more than 3 cm in the coronal and sagittal planes based on preoperative magnetic resonance imaging and if they had a repair using a knotless transosseous equivalent technique with suture tape. Minimum follow-up was 2 years. Clinical evaluation was performed using shoulder functionality tests, Constant score, and University of California, Los Angeles score. Postoperative ultrasonography was performed and reviewed by a musculoskeletal radiologist. Data were compared preoperatively versus postoperatively using the Wilcoxon rank test.</div></div><div><h3>Results</h3><div>Thirty-two patients met inclusion criteria with an average age of 64.4 ± 8.7 years. The average tear size on coronal magnetic resonance imaging T2 imaging was 4.0 ± 0.7 cm and on sagittal imaging was 4.2 ± 1.8 cm. The average follow-up was 2.5 ± 1.1 years. At the 2-year follow-up the average pain had improved from 7.3 to 0.8 (<em>P</em> &lt; .001), the UCLA score improved from 11.6 to 31.2 (<em>P</em> &lt; .001) and the Constant score improved from 38.3 to 78.7 (<em>P</em> &lt; .001). At the final follow-up, the mean shoulder scaption strength was 16.1 lbs. on both the nonoperative shoulder and postoperative shoulder (<em>P</em> = .95). Of the 14 patients available for postoperative ultrasound, 12 showed sonographic healing (86%), 1 partial tear, and 1 full-thickness tear.</div></div><div><h3>Conclusions</h3><div>The arthroscopic double-row transosseus equivalent repair is a viable option for repairing large and massive rotator cuff tears with significant improvement in pain, active range of motion, functional outcomes and a high rate of radiographic healing.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101099"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480382","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":"Four-Strand Hamstring Autografts Less Than 8-mm Wide Provide Less Capability for Conversion to a 6- or 7-Strand Graft Than Larger-Diameter Hamstring Autografts","authors":"W.P. Yau M.B.B.S., F.R.C.S.Ed., F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)","doi":"10.1016/j.asmr.2025.101098","DOIUrl":"10.1016/j.asmr.2025.101098","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the proportion of patients who have long-enough hamstring (HS) tendons to prepare an anterior cruciate ligament reconstruction (ACLR) graft of 5 strands, 6 strands, 7 strands, or 8 strands in patients with a small 4-strand HS ACLR graft diameter &lt;8 mm (HS-ACLR-4S &lt;8 mm) compared with patients who had a 4-strand HS ACLR graft diameter ≥8 mm (HS-ACLR-4S ≥8 mm).</div></div><div><h3>Methods</h3><div>Patients who underwent medial HS harvest for single-bundle ACLR between 2008 and 2018 were included. Patients were included if the ACLR graft was a doubled semitendinosus and doubled gracilis autograft and they were skeletally mature. The primary outcome was the length of the HS. The likelihood of successful preparing an HS ACLR with 5 strands of tendons or more (HS-ACLR ≥5S) was compared between HS-ACLR-4S &lt;8 mm and HS-ACLR-4S ≥8 mm. Any anthropometric factors significantly associated with the feasibility of preparing a HS-ACLR≥5S were reported.</div></div><div><h3>Results</h3><div>A total of 296 patients, including 223 men and 73 women, were included. One hundred patients had HS-ACLR-4S &lt;8 mm, whereas 196 patients had HS-ACLR-4S ≥8 mm. The length of the HS was shorter in the HS-ACLR-4S &lt;8-mm group compared with the HS-ACLR-4S ≥8-mm group (<em>P</em> &lt; .001). There was no significant difference between the 2 groups in the chance of successfully preparing a 5-strand graft (97% and 98%, respectively; <em>P</em> = .327). However, there was a lower chance of preparing an ACLR graft using 6 or 7 strands of tendons in patients with HS-ACLR-4S &lt;8-mm (<em>P</em> = .031 and <em>P</em> &lt; .001, respectively). In addition, body height was the sole independent predictor of the likelihood of successfully preparing a HS-ACLR of more than 5 strands of tendon.</div></div><div><h3>Conclusions</h3><div>Preparation of a 5-strand ACLR graft is almost always possible, regardless of whether the HS-ACLR-4S graft diameter was less than 8 mm or 8 mm or greater. Shorter body height was associated with a lower chance of successfully preparing an HS-ACLR with 5 strands of tendons. However, the likelihood of successfully preparing a 6-strand and a 7-strand HS-ACLR graft were lower in the group of patients with an HS-ACLR-4S &lt;8 mm compared with HS-ACLR-4S ≥8 mm.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the factors related to ACL HS tendon autograft preparation can allow surgeons to ensure grafts of adequate length and diameter.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101098"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481235","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":"Obese Patients Demonstrate Higher Failure Rates, Infection Rates, and Inferior Patient-Reported Outcomes Compared With Nonobese Patients Following Multiligamentous Knee Surgery","authors":"Adam V. Daniel M.D.,&nbsp;Warren A. Williams M.D.,&nbsp;Brendan J. Kosko M.D.,&nbsp;Joshua A. Cohen,&nbsp;Andrew D. Carbone M.D.,&nbsp;Stanley J. Kupiszewski M.D.","doi":"10.1016/j.asmr.2025.101111","DOIUrl":"10.1016/j.asmr.2025.101111","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine outcomes following surgically treated multiligamentous knee injuries (MLKIs) in obese versus nonobese patients.</div></div><div><h3>Methods</h3><div>Patients who were surgically treated for MLKIs between 2008 and 2021 were included in this study. Patients were divided into 2 groups and classified as obese (body mass index ≥30) or nonobese. The following patient-reported outcome measures were collected: the visual analog scale for pain, the International Knee Documentation Committee subjective score, and the Lysholm knee scoring scale. Complications such as revision ligamentous reconstruction, conversion to total knee arthroplasty (TKA), infection, and arthrofibrosis were also documented.</div></div><div><h3>Results</h3><div>A total of 88 patients (88 knees; 43 obese, 45 nonobese) were included in the final analysis. The mean overall age was 34.3 ± 12.7 years (10-61 years), and there were 30 women and 58 men included in this study cohort. The mean follow-up for the patients who did not receive a revision or TKA was 9.2 years (range, 3.4-15.3 years). There were no differences seen between groups for age, sex, mechanism of injury, neurovascular status, concomitant injuries, frank knee dislocations, surgical staging, or external fixator application. However, the mean follow-up in the nonobese group was higher than in the obese group (9.7 vs 8.3 years, <em>P</em> = .003). The nonobese cohort had significantly more open injuries compared to the obese cohort (11.1% vs 2.3%, <em>P</em> = .05). Although there were no differences seen in conversion to TKA or arthrofibrosis, the obese cohort had a higher rate of ligament failure (30.2% vs 8.9%, <em>P</em> = .02) and infection (14% vs 2.2%, <em>P</em> = .05). Additionally, the obese cohort had worse visual analog scale for pain scores (4.4 vs 2.2, <em>P</em> = .002), lower International Knee Documentation Committee scores (50.3 vs 74.6, <em>P</em> &lt; .001), and lower Lysholm scores (59.9 vs 80.6, <em>P</em> = .004) at final follow-up compared to the nonobese cohort.</div></div><div><h3>Conclusions</h3><div>Obese patients had significantly higher rates of ligament failure and infection rates, higher pain scores, and worse patient-reported outcomes than nonobese patients following surgically treated MLKIs.</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 3","pages":"Article 101111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481240","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":"Guided Education and the Fundamentals of Arthroscopy Surgery Training (FAST) Workstation Improve Surgical Resident Knot-tying Skills","authors":"Hassan Farooq M.D. ,&nbsp;Andrew Gaetano B.S. ,&nbsp;Dane Salazar M.D., M.B.A. ,&nbsp;Nickolas Garbis M.D.","doi":"10.1016/j.asmr.2025.101110","DOIUrl":"10.1016/j.asmr.2025.101110","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the influence of guided education on the mechanical resilience of knots tied by surgical residents using the Fundamentals of Arthroscopy Surgery Training (FAST) workstation as a quantitative tool.</div></div><div><h3>Methods</h3><div>Surgical residents in postgraduate year (PGY) 1 through 5 were asked to tie knots first in a pre-education phase. Next, residents were provided an instructional video demonstrating high-level knot-tying instructed by a fellowship-trained shoulder and elbow surgeon. After the video demonstration, residents were asked to tie knots again in a posteducation phase. Using the FAST workstation, the mechanical resilience of each knot was quantified by suture loop elongation. The McNemar test was used for statistical analysis.</div></div><div><h3>Results</h3><div>Forty-one surgical residents were enrolled into this investigation. Among all participants, there was significantly greater knot-tying success in the posteducation phase after review of the instructional video as compared with the pre-education phase (<em>P</em> &lt; .001). Subgroup analysis was conducted for each PGY level (1-5), and significant findings of greater knot-tying success in the posteducation phase was notable for the PGY-1 and PGY-2 residents (<em>P</em> &lt; .001 and <em>P</em> = .002, respectively).</div></div><div><h3>Conclusions</h3><div>Guided education with the use of an instructional video and a FAST workstation significantly enhances the mechanical resilience of surgical resident knots, particularly for those in their early PGYs. However, the permanency of this improvement is unknown.</div></div><div><h3>Clinical Relevance</h3><div>It is important to evaluate tools that can improve surgical education. Information from this study can be used by residency programs to ensure the proficiency of their trainees.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481304","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}