{"title":"Between 2008 and 2022, Lower-Extremity Injuries Declined in Male Rugby Players, Whereas Noncontact Knee Injuries Showed No Decline in Female Rugby Players","authors":"","doi":"10.1016/j.asmr.2024.100967","DOIUrl":"10.1016/j.asmr.2024.100967","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the distribution and mechanisms of lower-extremity injuries among high school and college age rugby players presenting to U.S. emergency departments (EDs) from 2008 to 2022.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System was queried for lower-extremity rugby injuries (ages 14-23 years) from January 2008 to December 2022. Patient demographics, injury location, diagnosis, and disposition were extracted for each case. Linear regression analysis assessed differences over time. Injury distribution for male versus female players was evaluated using Pearson χ<sup>2</sup> analysis.</div></div><div><h3>Results</h3><div>An estimated 31,318 (845 National Electronic Injury Surveillance System cases) high school and college-age rugby players presented to U.S. EDs with a lower-extremity injury during the study period. Male players accounted for 66.9% of the injuries. Linear regression analysis revealed a significant decrease in the annual frequency of lower-extremity injuries presenting to U.S. EDs from 2008 to 2022 (<em>P</em> = .001). The most common injury mechanism was overwhelmingly a noncontact twisting motion (11,108, 35.5%) followed by a hit/collision (5,298, 16.9%). Strains/sprains were the most common diagnosis (17,243, 55.1%). Injuries most commonly occurred at the ankle (12,659, 40.4%) and knee (11,016, 35.2%). In a sex-specific linear regression analysis, there was a significant decrease in lower-extremity injuries sustained by male players (<em>P</em> = .001) but no significant decrease among female players (<em>P</em> = .112). Furthermore, χ<sup>2</sup> analysis revealed that female players sustained a significantly greater proportion of knee injuries secondary to twists (15.9% for female vs 9.0% for male players, <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Lower-extremity injuries are declining among high school and college-age male rugby players. However, there has not been a corresponding decrease among female rugby players. Furthermore, female players are disproportionately affected by noncontact twisting knee injuries.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medial Patellofemoral Ligament Augmented With a Reinforced Bioinductive Implant Is Biomechanically Similar to the Native Medial Patellofemoral Ligament at Time Zero in a Cadaveric Model","authors":"","doi":"10.1016/j.asmr.2024.100975","DOIUrl":"10.1016/j.asmr.2024.100975","url":null,"abstract":"<div><h3>Purpose</h3><div>To biomechanically compare primary medial patellofemoral ligament (MPFL) repair (MPFLr) augmented with a reinforced bioinductive implant (RBI) to the native MPFL ligament and a semitendinosus (semi-T) MPFL reconstruction (MPFLR) at time zero.</div></div><div><h3>Methods</h3><div>Four fresh-frozen matched pair cadavers (8 knees) were used to biomechanically compare the native MPFL to augmented MPFLr (n = 4) and semi-T MPFLR (n = 4). The native MPFL (n = 8) was isolated, preserving the femoral and patellar attachments, and pulled to failure. The semi-T was harvested from 1 of the matched pairs and whipstitched, as was a 250-mm × 5-mm RBI. A standard double-bundle docking technique was utilized. The patella was potted and mechanically pulled parallel to the transverse axis until failure in both cohorts. Cyclic creep, load and displacement at failure, failure mode, and stiffness were recorded.</div></div><div><h3>Results</h3><div>Failure load was highest in the RBI with repair group (287 ± 130 N) compared to the native MPFL (219 ± 64 N) and the semi-T group (84 ± 29 N). No statistically significant difference in failure load between the RBI augmentation with repair group and the native ligament (<em>P</em> = .19) were found. The semi-T reconstruction group failed at the least amount of displacement (7.93 ± 3.4 mm) compared to the native MPFL (20.9 ± 9 mm) (<em>P</em> < .01) and the RBI with repair group (33.2 ± 17.7 mm) (<em>P</em> < .02). At 10 mm of displacement, the RBI group (8.3 ± 1.2 N/mm) demonstrated stiffness in the midrange compared to the native MPFL (14.1 ± 7.1 N/mm). Early anchor/tendon pullout failure on the patella side was noted in the semi-T group compared to the RBI group. One reconstruction was excluded from analysis due to poor bone quality.</div></div><div><h3>Conclusions</h3><div>No statistically significant difference was seen between the augmented MPFL repair and the native MPFL in load-to-failure testing. The augmented MPFL repair was observed to have biomechanical properties similar to the native MPFL. MPFLr with RBI augmentation provided consistent stiffness at clinically relevant displacement.</div></div><div><h3>Clinical Relevance</h3><div>Primary MPFL repair and reconstruction using the semi-T graft, while effective, are nevertheless imperfect procedures. MPFL repair has been shown to have higher instability recurrence rates, while the stiffness profile of MPFLR with semi-T is higher than the native MFPL and may lead to knee stiffness, loss of motion, or cartilage damage. The results of this time-zero biomechanical study indicate that the use of an RBI for augmentation of a primary MPFL repair may be a viable alternative to traditional MPFL repair or reconstruction using a semi-T graft.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Graft Type and Diameter Are Predictors of Reinjury After Transphyseal Anterior Cruciate Ligament Reconstruction in Pediatric and Adolescent Patients","authors":"","doi":"10.1016/j.asmr.2024.100964","DOIUrl":"10.1016/j.asmr.2024.100964","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the rate of anterior cruciate ligament (ACL) graft failure by physis status (open, closing, closed) and to analyze which factors were associated with higher risk of ACL graft failure.</div></div><div><h3>Methods</h3><div>Patients younger than 18 years who underwent transphyseal ACL reconstruction (ACLR) between 2000 and 2018 at a single institution were reviewed at minimum 2 years after ACLR. Patient records were reviewed for anthropometrics, surgical techniques, and ACL graft failure. Patients were subsequently stratified based on physis status (open, closing, closed) and analyzed.</div></div><div><h3>Results</h3><div>A total of 272 patients (mean age of 15.4 ± 1.3 years) were assessed. The transtibial technique was used in 63.6% of cases. A hamstring autograft was used exclusively in the open physis group. A patellar tendon autograft was used in 65.9% of patients with a closing physis and 80.9% of patients with a closed physis. The overall graft failure rate was 13.2%, with a contralateral ACL injury rate of 11.0%. Kaplan-Maier analysis by physis status showed different injury free from ACL reinjury (<em>P</em> < .001). An open physis was associated with increased risk of ACL reinjury (hazard ratio, 5.2; <em>P</em> < .001) when compared to a closed physis. A closing physis presented a higher hazard ratio but was not statistically significant (hazard ratio, 2.6; <em>P</em> = .08). Hamstring graft type (<em>P</em> = .03) and lower graft diameter (<em>P</em> = .04) were significantly related to higher ACL reinjury after adjusting for physis status.</div></div><div><h3>Conclusions</h3><div>Transphyseal ACLR is a safe procedure in pediatric patients. The rate of reinjury was 13.2%. This rate decreases with skeletal maturity, use of patellar tendon autograft, and a larger graft diameter.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Most Systematic Reviews and Meta-analyses Reporting Clinical Outcomes of the Remplissage Procedure Have at Least 1 Form of Spin","authors":"","doi":"10.1016/j.asmr.2024.100969","DOIUrl":"10.1016/j.asmr.2024.100969","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence of spin in systematic reviews (SRs) and meta-analyses of clinical studies of the remplissage procedure.</div></div><div><h3>Methods</h3><div>Two reviewers independently performed a literature search of the PubMed, Scopus, and Embase databases using the search term “remplissage” in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The full article of each included SR was assessed for the presence of the 15 most common types of spin. Methodologic quality was assessed using the second version of A Measurement Tool to Assess Systematic Reviews (AMSTAR 2).</div></div><div><h3>Results</h3><div>A total of 15 SRs (8 accompanied by meta-analyses; 6 Level III and 9 Level IV) were included. Overall, 13 SRs (86.7%) contained at least 1 form of spin, with 33 unique instances of spin recorded; the mean frequency was 2.2 ± 1.3 (range, 0-4). The most prevalent form of spin, present in 11 studies (73%), was type 9 (“conclusion claims the beneficial effect of the experimental treatment despite reporting bias”). There were 14 uses of spin classified as misleading reporting, 16 classified as misleading interpretation, and 3 classified as inappropriate extrapolation. The mean 5-year impact factor of the publishing journals was 4.4 ± 0.9 (range, 0-6.1), the mean number of citations per SR was 33.3 ± 24.9 (range, 0-55), and the mean number of citations per month since publication was 0.68 ± 0.44 (range, 0-1.48). According to the AMSTAR 2 assessment, confidence in the results of the SRs was rated as critically low for 20% of reviews, low for 33.3%, and moderate for 46.7%.</div></div><div><h3>Conclusions</h3><div>Most SRs of the remplissage procedure are affected by the presence of spin. Favorable reporting was observed in the absence of definite findings, as was minimization of drawbacks for certain populations.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Concomitant Popliteomeniscal Fascicles Tears Are Found in 21% of Professional Soccer Players With Acute Anterior Cruciate Ligament Injuries","authors":"","doi":"10.1016/j.asmr.2024.100956","DOIUrl":"10.1016/j.asmr.2024.100956","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the incidence of popliteomeniscal fascicles (PMF) tears in anterior cruciate ligament (ACL) rupture in professional soccer players, to describe arthroscopic and magnetic resonance imaging (MRI) findings and treatment of these lesions with clinical outcomes, and to evaluate the incidence of subsequent lateral meniscus tears and ACL reinjury.</div></div><div><h3>Methods</h3><div>ACL reconstructions on soccer players were retrospectively analyzed, and among them, a cohort of patients with PMFs tears was reviewed. The cohort was assessed with MRI examination, arthrometric testing, Lysholm score, and International Knee Documentation Committee score. The occurrence of subsequent lateral meniscus tears and ACL reinjury were evaluated.</div></div><div><h3>Results</h3><div>A total of 208 ACL reconstructions were identified. From these, 43 male and 3 female subjects with a mean age of 24 ± 4.2 years were included. Median time from injury to surgery was 5 days. Preoperative MRI showed a tear of posterior PMFs in 24 of 47 knees (51.1%). The mean preoperative arthrometric measured laxity was 4.3 ± 1.65 mm, and postoperatively 0.1 ± 1.1 mm. Preoperative Lysholm score and International Knee Documentation Committee score were, respectively, 50.4 ± 25.4 and 39.6 ± 5, and postoperatively 98 ± 2.4 and 73.6 ± 1.2. Mean time to return to play, at the same preoperative level for all patients, was 184 ± 41.7 days. One patient underwent ACL revision due to a reinjury 9 months after surgery, whereas no lateral meniscus tears occurred in the follow-up period.</div></div><div><h3>Conclusions</h3><div>PMF tears are found in approximately 20% of professional soccer players with acute ACL injuries. After ACL reconstruction and PMFs repair, outcomes including return to play are good, ACL retear is low, and recurrent lateral meniscus tears were not observed.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Top-20 Studies About Anterior Shoulder Instability From an Altmetric Analysis Had Higher Levels of Evidence Than Those From a Traditional Bibliometric Analysis","authors":"","doi":"10.1016/j.asmr.2024.100974","DOIUrl":"10.1016/j.asmr.2024.100974","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the characteristics of the top-20 studies about anterior shoulder instability according to the Altmetric Attention Score (AAS) with total citation counts.</div></div><div><h3>Methods</h3><div>Two separate searches were performed for articles related to anterior shoulder instability. The Altmetric search identified the top-20 articles according to AAS. A bibliometric search using Web of Science identified the top-20 most-cited articles. Altmetric criteria were applied to the bibliometric list and vice versa.</div></div><div><h3>Results</h3><div>The AAS from the Altmetric list ranged from 44 to 432. The highest AAS from the bibliometric search was 70. One study appeared in both lists. Most online mentions were from X (formerly Twitter). The geographical breakdown of X mentions saw 71 countries appearing in the Altmetric search versus 21 in the bibliometric search. The total citations in the bibliometric list ranged from 91 to 358 versus 0 to 121 for the Altmetric list. The Altmetric top-20 list contained 8 studies that were Level II or higher versus 3 in the bibliometric list.</div></div><div><h3>Conclusions</h3><div>The top-20 studies according to AAS or citation count are not the same. The top-20 studies by AAS are composed of studies at higher levels of evidence versus the top-20 studies when listed by citation count.</div></div><div><h3>Clinical Relevance</h3><div>Electronic searches are an important way to access information in the modern world. Different search options generate results according to different parameters and may generate different results for the same query. It is important to understand these differences so that users have a better understanding of where the most clinically useful information can be found, especially regarding medical conditions.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Defensive Performance Declines in Ultimate Fighting Championship Fighters Following Anterior Cruciate Ligament Reconstruction","authors":"","doi":"10.1016/j.asmr.2024.100961","DOIUrl":"10.1016/j.asmr.2024.100961","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact anterior cruciate ligament reconstruction (ACLR) has on strike evasion rates, strike and landing rates, win percentage, and career longevity in Ultimate Fighting Championship (UFC) fighters.</div></div><div><h3>Methods</h3><div>UFC fighters who underwent ACLR from 1993 to 2022 were matched 2:1 with uninjured controls. The percentage of each injured fighter’s career that occurred before ACLR was deemed the “index percentage.” Injured fighter performance pre-/post-ACLR was compared with control metrics pre-/postindex percentage.</div></div><div><h3>Results</h3><div>Of the 82 patients with documented ACL injuries identified, 48 met the inclusion criteria. Of these, 27 returned for more than 2 fights and were paired with 54 controls. UFC fighters demonstrated return-to-sport rates of 81.25% and 56.25% for at least 1 and 2 fights, respectively. On average, it took 411.85 ± 174.73 (range, 165-879) days for fighters to return. All fighters had significantly lower evasion rates against total significant strikes, distance strikes, and head strikes, postindex (<em>P</em> < .05 for each). ACLR fighters had significantly lower submission attempts and evasion rates against clinch strikes, ground strikes, and total strikes, postindex (<em>P</em> < .05 for each). Controls had a significantly lower evasion rate against leg strikes, postindex. Both groups’ win percentages significantly declined (ACLR, <em>P</em> = .001; control, <em>P</em> = .012). No significant difference in total career fights was observed (<em>P</em> = .873).</div></div><div><h3>Conclusions</h3><div>In this study, we found that most UFC fighters who undergo ACLR return to sport for at least 1 fight; however, just over half return for at least 2 fights. There was not a significant difference in career length between fighters who returned to sport following ACLR for at least 2 fights and their controls. Defensive performance, but not offensive performance, declined significantly following ACLR. All fighters demonstrated significant declines in their win percentage as their career progressed, irrespective of ACLR.</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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ChatGPT and Google Provide Mostly Excellent or Satisfactory Responses to the Most Frequently Asked Patient Questions Related to Rotator Cuff Repair","authors":"","doi":"10.1016/j.asmr.2024.100963","DOIUrl":"10.1016/j.asmr.2024.100963","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the differences in frequently asked questions (FAQs) and responses related to rotator cuff surgery between Google and ChatGPT.</div></div><div><h3>Methods</h3><div>Both Google and ChatGPT (version 3.5) were queried for the top 10 FAQs using the search term “rotator cuff repair.” Questions were categorized according to Rothwell’s classification. In addition to questions and answers for each website, the source that the answer was pulled from was noted and assigned a category (academic, medical practice, etc). Responses were also graded as “excellent response not requiring clarification” (1), “satisfactory requiring minimal clarification” (2), “satisfactory requiring moderate clarification” (3), or “unsatisfactory requiring substantial clarification” (4).</div></div><div><h3>Results</h3><div>Overall, 30% of questions were similar between what Google and ChatGPT deemed to be the most FAQs. For questions from Google web search, most answers came from medical practices (40%). For ChatGPT, most answers were provided by academic sources (90%). For numerical questions, ChatGPT and Google provided similar responses for 30% of questions. For most of the questions, both Google and ChatGPT responses were either “excellent” or “satisfactory requiring minimal clarification.” Google had 1 response rated as satisfactory requiring moderate clarification, whereas ChatGPT had 2 responses rated as unsatisfactory.</div></div><div><h3>Conclusions</h3><div>Both Google and ChatGPT offer mostly excellent or satisfactory responses to the most FAQs regarding rotator cuff repair. However, ChatGPT may provide inaccurate or even fabricated answers and associated citations.</div></div><div><h3>Clinical Relevance</h3><div>In general, the quality of online medical content is low. As artificial intelligence develops and becomes more widely used, it is important to assess the quality of the information patients are receiving from this technology.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tibial Tubercle Osteotomies Performed in an Outpatient Setting Have a Low Rate of Early Complications","authors":"","doi":"10.1016/j.asmr.2024.100948","DOIUrl":"10.1016/j.asmr.2024.100948","url":null,"abstract":"<div><h3>Purpose</h3><p>To characterize the early postoperative complications following outpatient tibial tubercle osteotomy (TTO) to determine its safety in this setting.</p></div><div><h3>Methods</h3><p>Patients undergoing TTO by a single surgeon between July 2017 and August 2022 for patellar instability or patellofemoral chondromalacia and achieving a minimum of 3 months of clinical and radiographic follow-up were evaluated for inclusion. Although an inclusion criterion was a minimum follow-up of 3 months, if evidence of a healed osteotomy was observed sooner, final follow-up was accepted at 2 months. Patient demographics, perioperative risk factors, and incidence of complications were collected retrospectively. Categorical data were analyzed using χ<sup>2</sup> and Fisher exact tests. Continuous data were analyzed using 2-tailed <em>t</em> tests and Mann-Whitney <em>U</em> data for parametric and nonparametric data, respectively.</p></div><div><h3>Results</h3><p>A total of 195 knees in 167 patients met inclusion criteria, with a mean age of 24.7 ± 9.2 years and mean follow-up time of 10.9 months (range, 2-69 months). Fifty-one early postoperative complications occurred in 47 (24.1%) knees in 42 (25.1%) patients. Ten major and 41 minor complications occurred. Major complications were associated with older age (<em>P</em> = .015), smoking (<em>P</em> = .038), and smaller preoperative patellar tendon–lateral trochlear ridge distance (<em>P</em> = .012). Forty-four reoperations occurred in 42 (21.5%) knees in 37 (22.2%) patients. The most common reasons for reoperation included removal of symptomatic hardware (31 knees; 15.9%) and arthrofibrosis requiring lysis of adhesions and manipulation under anesthesia (8 knees; 4.1%). The mean time to reoperation was 13.0 months (range, 1-42 months). Smaller body mass index was associated with increased risk of reoperation (<em>P</em> = .002).</p></div><div><h3>Conclusions</h3><p>Outpatient TTO is safe when performed with the described technique, but the later development of minor complications is not infrequent following surgery. Patients should be counseled regarding a relatively high incidence of hardware irritation, arthrofibrosis, and eventual reoperation.</p></div><div><h3>Level of Evidence</h3><p>Level IV, case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X2400066X/pdfft?md5=47d3b4ee114f781dc65c7af9287752eb&pid=1-s2.0-S2666061X2400066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Use of Platelet-Rich Plasma Augmentation in Meniscus Repair Results in a Lower Failure Rate than in the Control Group: A Systematic Review From Meta-analysis","authors":"","doi":"10.1016/j.asmr.2024.100934","DOIUrl":"10.1016/j.asmr.2024.100934","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the efficacy of platelet-rich plasma (PRP) as an augmentation in meniscus repair.</p></div><div><h3>Methods</h3><p>A comprehensive search of PubMed, Medline (via EBSCO), ProQuest, and ScienceDirect from January to February 2023 was conducted using the terms “meniscus repair,” “PRP,” and “meniscus tear.” Meta-analyses that investigated the rate of failure after meniscus repair were included. Studies before 2003, not in English, associated procedures during surgery, and animal studies were excluded. The included studies underwent quality appraisal and risk of bias assessment. Data were extracted from each study‘s text, figures, tables, and associated supplementary files and then analyzed qualitatively.</p></div><div><h3>Results</h3><p>The failure rate is lower in the PRP augmentation group compared with the group without augmentation, with a mean difference of 0.42, 0.50, and 0.43. Visual analog scale score was also found to be significantly lower in the treatment group, with a mean difference of 0.40, 0.76, and 6.69. However, only mean differences in Lysholm score in one of the included studies were found significant regarding functional outcomes, which can be found in the Xie et al. study with a mean difference of 3.06.</p></div><div><h3>Conclusions</h3><p>In this study, we found that meniscal repairs augmented with PRP have a lower failure rate.</p></div><div><h3>Level of Evidence</h3><p>Level IV, systematic review of Level III-IV studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X2400052X/pdfft?md5=570f10ced767650c96fef75f8cb3d9e9&pid=1-s2.0-S2666061X2400052X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}