Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Arthroscopic Iliopsoas Lengthening Is a Safe and Effective Treatment for Anterior Iliopsoas Impingement After Total Hip Arthroplasty","authors":"James Pate M.D. ,&nbsp;Austin Hughes M.D. ,&nbsp;Dillon Morrow M.D. ,&nbsp;Tyler M. Goodwin M.D. ,&nbsp;Andrew Wilson ,&nbsp;Brandon Cincere M.D.","doi":"10.1016/j.asmr.2025.101262","DOIUrl":"10.1016/j.asmr.2025.101262","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the demographic characteristics, preoperative variables, and postoperative outcomes of patients who underwent arthroscopic iliopsoas lengthening for anterior iliopsoas impingement (AII) after total hip arthroplasty (THA).</div></div><div><h3>Methods</h3><div>A retrospective, single-surgeon case series was conducted to identify patients with AII after THA who underwent arthroscopic iliopsoas lengthening between 2017 and 2024. A minimum 1-year follow-up after arthroscopic procedures was required for patients to be included in this study. All arthroscopic procedures were completed by a single orthopaedic sports fellowship-trained surgeon. The primary outcomes were the incidence of THA revision, incidence of reoperations and secondary surgical procedures, and changes in pain scores.</div></div><div><h3>Results</h3><div>Of 15 hips, 12 (80%) were reported to be pain free at most recent follow-up (median follow-up, 3.8 years [range, 1.3-6.8 years]). There were no THA revisions performed after arthroscopy, no reoperations or secondary surgical procedures, and no infections requiring surgical intervention. The median pain score decreased from 8 preoperatively (interquartile range, 6.5-10; range, 3-10) to 0 postoperatively (interquartile range, 0-1; range, 0-5) (<em>P</em> &lt; .001). For the index THA, a posterior approach was used in 7 patients (47%) whereas an anterior approach was used in 8 (53%).</div></div><div><h3>Conclusions</h3><div>Arthroscopic iliopsoas lengthening is a safe and effective treatment for AII after THA. The procedure had minimal complications, provided considerable pain relief in 80% of patients, and helped avoid major revision arthroplasty surgery in 100% of cases.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101262"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808475","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":"Prophylactic Knee Bracing in College Football Players Is Associated With a Low Rate of Anterior Cruciate Ligament Tears","authors":"David Riopelle M.D. ,&nbsp;Christian Cruz M.D. ,&nbsp;Russ Romano M.A., A.T.C., F.A.F.S. ,&nbsp;Alexander Weber M.D. ,&nbsp;Seth Gamradt M.D.","doi":"10.1016/j.asmr.2025.101263","DOIUrl":"10.1016/j.asmr.2025.101263","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the annual incidence of anterior cruciate ligament (ACL) injuries in National Collegiate Athletic Association (NCAA) college football offensive linemen utilizing prophylactic knee bracing at a single institution from 2002 to 2023.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study on prospectively collected data from an institutional NCAA football injury database. We retrospectively analyzed data between 2002 and 2023 to assess the incidence of ACL injury in NCAA football players, comparing offensive linemen wearing bilateral prophylactic knee braces (PKBs) to the overall injury rates of all positions on the team. Injury rate per 1,000 athlete-exposures was calculated for each group with 95% confidence intervals (CIs), and the difference between groups was calculated with a significance level set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>There was an estimated total of 52,844 offensive linemen athlete-exposures and 298,320 all-position athlete-exposures in the cohort. There were 8 total ACL injuries in offensive linemen wearing bilateral PKBs over a period of 22 years, compared to 58 in all other positions, with an offensive linemen ACL injury rate of 0.151 per 1,000 athlete-exposures (95% CI, 0.030-0.273) versus an overall ACL injury rate of 0.194 per 1,000 athlete-exposures (95% CI, 0.145-0.243). There was a difference of 0.043 ACL tears per 1,000 athlete-exposures in favor of the offensive linemen, which did not reach significance (<em>P</em> = .501).</div></div><div><h3>Conclusions</h3><div>In this study over a 22-year span, we found a low overall incidence of ACL tears among NCAA football offensive linemen wearing bilateral PKBs, with a lower, although not statistically significant, rate of ACL injury compared to players at all positions.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective comparative study of prospectively collected data.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101263"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808497","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":"Percutaneous Subacromial Balloon Spacer Insertion Under Fluoroscopic Guidance in Patients Older Than 60 Years With Rotator Cuff Arthropathy Results in Significant Pain Relief but Does Not Improve Function","authors":"Sean Wei Loong Ho M.B.B.S., F.R.C.S.Ed. (Ortho) ,&nbsp;Marcus Josef Lee M.B.B.S., F.R.C.S.Ed. (Ortho) ,&nbsp;Jegathesan T. M.B.B.S., F.R.C.S.Ed. (Ortho) ,&nbsp;Wei Zhang M.B.B.S., M.Med. (Ortho) ,&nbsp;Keng Thiam Lee M.B.B.S., F.R.C.S.Ed. (Ortho) ,&nbsp;Lester Teong Jin Tan M.B.B.S., F.R.C.S.Ed. (Ortho)","doi":"10.1016/j.asmr.2025.101254","DOIUrl":"10.1016/j.asmr.2025.101254","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the mid-term clinical outcomes of percutaneous balloon spacer insertion in patients older than 60 years with rotator cuff arthropathy under regional anesthesia and fluoroscopic guidance.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted. Patients older than 60 years with rotator cuff arthropathy, an American Society of Anesthesiologists (ASA) score of 3 or 4, and undergoing balloon spacer insertion under fluoroscopic guidance were included. Patients with previous rotator cuff repair/arthroscopic surgery or who did not have a trial of physical therapy prior to surgery were excluded. Range of motion, visual analog scale (VAS), Single Assessment Numeric Evaluation, and American Shoulder &amp; Elbow Surgeons score were collected at baseline, 2 weeks, 6 months, and a minimum of 1 year postoperatively.</div></div><div><h3>Results</h3><div>Seven operated shoulders (6 patients) were included in this study. The mean age was 78.1 years (range, 68-90 years). There were 5 ASA 3 patients (83%) and 1 ASA 4 patient (17%). At 2 weeks postoperation, there was significant improvement in the VAS score, from a mean (SD) of 7.7 (1.6) to 4.8 (2.6) (<em>P</em> = .003). At 6 months postoperation, there was significant and sustained improvement in the VAS score, with a mean (SD) of 3 (3.2) (<em>P</em> = .020). At a minimum of 1 year postoperatively (range 12-48 months), there was significant improvement, with a mean (SD) of 2.9 (3.0) (<em>P</em> = .012) in the VAS score and 67 (21) (<em>P</em> = .025) in the Single Assessment Numeric Evaluation score. The American Shoulder &amp; Elbow Surgeons score improved from a mean (SD) of 44.7 (13) to 64.3 (26.5) at final follow-up but was not statistically significant. Range of motion did not significantly improve at all time points.</div></div><div><h3>Conclusions</h3><div>Percutaneous insertion of a subacromial balloon spacer results in a significant reduction of pain in patients aged 60 years and older with rotator cuff arthropathy but does not improve their function at a minimum 1-year follow-up.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101254"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808444","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":"Durable Mid-Term Outcomes and High Rates of Meaningful Improvement After Hip Arthroscopy With Concomitant Periacetabular Osteotomy","authors":"Ady H. Kahana-Rojkind M.D. ,&nbsp;Elizabeth G. Walsh B.S. ,&nbsp;Roger Quesada-Jimenez M.D. ,&nbsp;Benjamin D. Kuhns M.D. ,&nbsp;Justin M. LaReau M.D. ,&nbsp;Benjamin G. Domb M.D.","doi":"10.1016/j.asmr.2025.101290","DOIUrl":"10.1016/j.asmr.2025.101290","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate 5-year outcomes following combined hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia and intra-articular pathology, with a focus on the rates of achieving clinically meaningful outcome thresholds.</div></div><div><h3>Methods</h3><div>Minimum 5-year outcome data from a prospectively maintained database were queried to identify patients who underwent concomitant primary hip arthroscopy and PAO between October 2010 and July 2019. Patient-reported outcomes evaluated included the modified Harris Hip Score (mHHS), non-arthritic hip score (NAHS), hip outcome score sport-specific subscale (HOS-SSS), and international hip outcome tool 12 (iHOT12). Clinically meaningful thresholds were also assessed, including minimal clinically important difference (MCID), patient-acceptable symptom state (PASS), and substantial clinical benefit (SCB).</div></div><div><h3>Results</h3><div>A total of 32 hips were included in this study. All PROs demonstrated significant improvement from the preoperative baseline to the 5-year follow-up (<em>P</em> &lt; .001). Clinical outcomes remained durable, with no significant decline observed between 2-year and 5-year follow-ups (mHHS <em>P</em> = 0.612; NAHS <em>P</em> = 0.701; iHOT-12 <em>P</em> = 0.284; HOS-SSS <em>P</em> = 0.158). Similarly, achievement rates for MCID, PASS, and SCB thresholds were sustained over time (<em>P</em> = 0.105 to &gt;0.999). Two hips (5.7%) converted to total hip arthroplasty (THA).</div></div><div><h3>Conclusions</h3><div>Concomitant hip arthroscopy and PAO are an effective procedure with durable 5-year outcomes. Patients demonstrated sustained improvements and a high rate of clinically meaningful success, supporting the value of this combined approach in appropriately selected cases.</div></div><div><h3>Level of Evidence</h3><div>Level IV: Retrospective therapeutic case series</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101290"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808436","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":"Insurance Status and Income Proxies Are the Most Consistent Predictors of Disparities in Access to Care and Outcomes After Medial Patellofemoral Ligament Reconstruction in the United States: A Systematic Review","authors":"Erin L. Brown B.A. ,&nbsp;Kenneth T. Nguyen B.S. ,&nbsp;Daman P. Dhunna M.S. ,&nbsp;Laura A. Wright M.L.I.S. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Saijayanth Mosalakanti B.S. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2025.101268","DOIUrl":"10.1016/j.asmr.2025.101268","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the influence of health care access, insurance coverage, racial and ethnic identity, income-related proxies, employment status, preventive care use, and geographic location on the diagnosis, treatment, and outcomes after medial patellofemoral ligament reconstruction (MPFLR).</div></div><div><h3>Methods</h3><div>A systematic review of electronic databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify Level II-IV clinical studies related to patellar instability that were published between January 2010 and January 2025. Studies were included if they were peer-reviewed English-language studies detailing the socioeconomic and demographic factors of outcomes after MPFLR. Case reports, systematic reviews, animal and cadaver studies, and publication formats other than peer-reviewed journal studies were excluded.</div></div><div><h3>Results</h3><div>Seven studies met inclusion criteria, which resulted in a total 983,985 patients (983,658 female, 99.97%, and 327 male, 0.03%). Three studies (42.9%) found that insurance status affected the evaluation and treatment of patients with patellar instability, and subsequent outcomes after MPFLR, with those who were privately insured experiencing a better clinical course with regards to evaluation, treatment, and outcomes. Four (57.1%) studies identified race or ethnicity as a factor that influenced the prevalence of patellar instability, treatment, cost, and outcomes. One study (12.5%) found certain markers of high income such as home ownership, full-time employment, and having a recent health check-up positively affected the evaluation, treatment, and postoperative outcomes of patients with patellar instability.</div></div><div><h3>Conclusions</h3><div>This systematic review found that lower socioeconomic status, public insurance coverage (as opposed to private coverage), and minority racial or ethnic identity were associated with delayed evaluation, lower likelihood of surgical intervention, and reduced postoperative compliance or satisfaction among patients undergoing MPFLR. Patients with these characteristics experience longer wait times from injury to clinic evaluation and have reduced odds in selection as a candidate for surgery. Postoperative satisfaction was also markedly worse for surgical patients with these characteristics.</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":"7 6","pages":"Article 101268"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808465","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":"Lateral Meniscus Hypermobility Is Associated With Popliteomeniscal Fascicle Injuries in Patients With Varus Knee Osteoarthritis Undergoing Medial Opening-Wedge High Tibial Osteotomy","authors":"Tsuneari Takahashi M.D., Ph.D. ,&nbsp;Mitsuharu Nakashima M.D., Ph.D. ,&nbsp;Mikiko Handa M.D. ,&nbsp;Takashi Fukushima M.D., Ph.D. ,&nbsp;Yuya Kimura M.D. ,&nbsp;Katsushi Takeshita M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101287","DOIUrl":"10.1016/j.asmr.2025.101287","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between arthroscopically detected lateral meniscus (LM) hypermobility and popliteomeniscal fascicle (PMF) injuries in patients with varus knee osteoarthritis undergoing medial opening-wedge high tibial osteotomy (MOWHTO).</div></div><div><h3>Methods</h3><div>Patients with varus knee osteoarthritis who underwent MOWHTO were retrospectively reviewed. During arthroscopic observation before osteotomy, the presence of LM hypermobility and PMF tears was assessed. Tom's test was performed under standardized negative pressure using an arthroscopic suction system. LM hypermobility was defined as complete posterior translation of the LM beyond the midpoint of the lateral tibial plateau without major tear. The association between LM hypermobility and PMF tear was analyzed using logistic regression.</div></div><div><h3>Results</h3><div>LM hypermobility was detected in 72 of 136 knees. PMF tears were observed in 65 knees. LM hypermobility was significantly associated with PMF tears. Among the entire cohort, 33 knees had partial-type discoid lateral meniscus (DLM), and 3 knees had complete-type DLM. Among the hypermobile LM group, 21 knees presented with partial or complete DLM, whereas only 15 knees in the stable LM group had DLM. However, this difference was not statistically significant. Demographic characteristics including age, body mass index, preoperative mechanical axis, and Kellgren-Lawrence grade were comparable between the LM hypermobile and stable groups. No significant differences in clinical symptoms related to the lateral compartment were observed between groups.</div></div><div><h3>Conclusions</h3><div>LM hypermobility is a frequent arthroscopic finding in patients undergoing MOWHTO and is significantly associated with PMF tears. Despite the absence of preoperative lateral symptoms, LM instability may represent a relevant intraoperative consideration.</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 6","pages":"Article 101287"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808431","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":"Biointegrative Fixation for Tibial Tubercle Osteotomy Is Effective and May Lower Removal Rate","authors":"Scott M. Feeley M.D. ,&nbsp;Rehan Dawood D.O. ,&nbsp;Parth Sharma B.S. ,&nbsp;Jamie M. Mwendwa B.S. ,&nbsp;Christopher M. Kuenze Ph.D. ,&nbsp;Edward S. Chang M.D. ,&nbsp;Brandon J. Bryant M.D.","doi":"10.1016/j.asmr.2025.101267","DOIUrl":"10.1016/j.asmr.2025.101267","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the safety and efficacy of biointegrative fiber-reinforced implants for tibial tubercle osteotomy (TTO) and perform a cost-benefit analysis.</div></div><div><h3>Methods</h3><div>Patients treated with TTO for all indications by a single surgeon from May 2017 to July 2024 were retrospectively reviewed. There were no exclusion criteria. In 2023, the surgeon switched TTO fixation from two 4.5-mm metal compression screws to 2 biointegrative, partially threaded 4.0-mm headless compression screws, made of continuous mineral fibers comprised of elements found in natural bone (SiO₂, Na₂O, CaO, MgO, B₂O₃, and P₂O₅), and bound together by PLDLA [poly (L-lactide-co-D,L-lactide)] (70:30 L:DL) in 50% weight by weight ratio. Postoperative protocols were consistent across fixation types, with full weight-bearing as tolerated in full extension for 6 weeks and range of motion from 0 to 90° allowed immediately. Patients were followed longitudinally for osseous union, recurrent instability, and return to the operating room.</div></div><div><h3>Results</h3><div>Sixty-two TTOs were analyzed (44 metal, 18 biointegrative); 61.3% of patients were female, and the median age was 23.3 years (interquartile range 22.5). One patient with biointegrative implants underwent irrigation and debridement with implant retention at 9 days postoperatively. Mean follow-up for biointegrative fixation was 1.3 ± 0.4 years (range: 0.5-1.8) and for metal fixation was 3.5 ± 1.8 years (range: 0.4-6.7), <em>P</em> &lt; .001. All patients achieved clinical union by 6 months without differences in time to clinical union (<em>P</em> = .159). Hardware removal rates differed between metal versus biointegrative groups (29.5 vs 0%, <em>P</em> = .009) but otherwise did not differ for rates of superficial infection (2.3 vs 0%, <em>P</em> = .519) or deep infection (2.3 vs 5.6%, <em>P</em> = .507).</div></div><div><h3>Conclusions</h3><div>Biointegrative screws are a safe and effective alternative to metal screws for TTO in short-term follow-up. The use of biointegrative fixation may reduce the need for secondary hardware removal procedures commonly reported with 4.5-mm metal screws, albeit at a potentially increased cost to the health system.</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 6","pages":"Article 101267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808447","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":"Preserving Hip Stability Yields Better Cartilage Repair With Microfracture Treatment: A Rabbit Study","authors":"Elshan Hajiyev M.D. ,&nbsp;Ozgur Aydin M.D. ,&nbsp;Selahaddin Aydemir M.D. ,&nbsp;Pinar Akokay Yilmaz Ph.D. ,&nbsp;Guven Erbil M.D. ,&nbsp;Ahmet Kaan Arslan M.D. ,&nbsp;Burak Duymaz M.D. ,&nbsp;Onur Hapa M.D.","doi":"10.1016/j.asmr.2025.101284","DOIUrl":"10.1016/j.asmr.2025.101284","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the individual and combined effects of microfracture and hip stability achieved through preservation of the soft tissue on cartilage repair in rabbit femoral head osteochondral defect.</div></div><div><h3>Methods</h3><div>Twenty-four male New Zealand white rabbits were divided into 4 groups. In group 0, the untreated right femoral heads of 6 rabbits served as healthy controls. Osteochondral defects (5 × 3 mm) were created on the left femoral heads of all 24 animals. Group 1 (n = 6) received microfracture, with the labrum preserved and capsule repaired. Group 2 (n = 6) received microfracture, but the labrum was excised and the capsule left unrepaired; additionally, a 2 × 6-mm portion of the capsule was excised. Group 3 (n = 6) had no microfracture, but the labrum and capsule were preserved. Group 4 (n = 6) had no microfracture and additionally the labrum was excised and capsule left unrepaired; as in Group 2, a 2 × 6-mm portion of the capsule was also excised. After 4 weeks, cartilage healing was assessed using the International Cartilage Regeneration &amp; Joint Preservation Society (ICRS) and modified O’Driscoll scores and via immunohistochemically with collagen type I, II, and aggrecan staining.</div></div><div><h3>Results</h3><div>Group 1 demonstrated significantly better cartilage healing than the other groups (<em>P</em> &lt; .05), with better outcomes in at least one of the following parameters: ICRS score, defect filling ratio, or modified O’Driscoll score. Group 3 scored better than group 2 in ICRS assessment (<em>P</em> = .048). Type II collagen and aggrecan expression were significantly greater in Group 1 than in groups 2 and 4 (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Preservation of the hip stability enhances the effectiveness of microfracture treatment, promoting superior cartilage regeneration compared with microfracture alone in a rabbit model.</div></div><div><h3>Clinical Relevance</h3><div>Maintaining or restoring the hip stability leads to improved cartilage healing beyond the effect of isolated microfracture.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101284"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808433","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":"Seven-Tesla Magnetic Resonance Imaging Has Increased Sensitivity but Decreased Specificity in Diagnosing Cartilage Defects in the Knee Compared With 1.5- and 3-Tesla Magnetic Resonance Imaging","authors":"Andrew George M.D. ,&nbsp;Karen L. Hernandez B.S. ,&nbsp;Bradley Lambert Ph.D. ,&nbsp;Haley M. Goble M.H.A. ,&nbsp;Nakul Gupta M.D. ,&nbsp;Patrick C. McCulloch M.D.","doi":"10.1016/j.asmr.2025.101255","DOIUrl":"10.1016/j.asmr.2025.101255","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the accuracy of 7-Tesla (T) magnetic resonance imaging (MRI) compared with standard-of-care (SOC) 1.5- or 3-T MRI in detecting and grading cartilage defects in the knee.</div></div><div><h3>Methods</h3><div>Participants who already underwent SOC MRI at 1.5- or 3-T and provided consent were scheduled for 7-T MRI prior to arthroscopy for all indications except revision surgery. SOC and 7-T MRI scans were independently reviewed in randomized order by 2 blinded musculoskeletal radiologists using a modified Outerbridge classification system for defect grading. Image quality (sharpness, contrast, artifact, noise) was also rated. At the time of arthroscopy, each articular surface was then graded by the surgeon, who was blinded to the 7-T MRI scans. Using arthroscopy as the gold standard, we calculated the sensitivity and specificity of SOC MRI and 7-T MRI, as well as inter-rater reliability.</div></div><div><h3>Results</h3><div>A total of 81 patients—41 female patients (aged 45 ± 14 years) and 40 male patients (aged 40 ± 14 years)—were enrolled. The average time between SOC and 7-T MRI was 69 days, and the average time between 7-T MRI and surgery was 6 days. Sharpness, contrast, and noise ratings were all significantly improved with 7-T MRI compared with SOC MRI (<em>P</em> &lt; .05). Seven-Tesla MRI had higher sensitivity but lower specificity in detecting cartilage defects for all 6 articular surfaces (patella, trochlea, lateral femoral condyle, medial femoral condyle, lateral tibial plateau, and medial tibial plateau) when using arthroscopy as the gold standard. Intraoperative cartilage grading was significantly closer to 7-T grading compared with SOC grading for 2 of 6 surfaces (<em>P</em> &lt; .05). Seven-Tesla MRI had reduced coefficient-of-variation values for 1 articular surface (medial femoral condyle) compared with 3-T MRI (<em>P</em> = .036). There were no significant differences in other coefficient-of-variation measures or interobserver reliability with 7-T MRI compared with SOC MRI.</div></div><div><h3>Conclusions</h3><div>Seven-Tesla MRI showed improved imaging quality metrics and increased sensitivity but decreased specificity in diagnosing cartilage defects in the knee compared with SOC 1.5- and 3-T MRI using arthroscopy as the gold standard.</div></div><div><h3>Level of Evidence</h3><div>Level II, prospective comparative diagnostic accuracy study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808495","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":"Reported Rates of Labral Repair and Reconstruction in Primary Hip Arthroscopy Vary Widely Across Published Studies: A Systematic Review","authors":"Paul D. Gaschen M.D. ,&nbsp;Jaydeep Dhillon D.O. ,&nbsp;Andrew F. Ibrahim B.S. ,&nbsp;Carson Keeter M.S. ,&nbsp;Matthew J. Kraeutler M.D.","doi":"10.1016/j.asmr.2025.101259","DOIUrl":"10.1016/j.asmr.2025.101259","url":null,"abstract":"<div><h3>Purpose</h3><div>To perform a systematic review to evaluate the reported proportions of labral repair and reconstruction performed during primary hip arthroscopy.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by searching PubMed, the Cochrane Library, and Embase to identify studies, published from 2015 to October 2024, on primary hip arthroscopy reporting a number of hips undergoing labral repair versus reconstruction. When labral debridement was performed, these numbers were included as well. The search phrase used was: <em>hip AND arthroscopy AND labral AND repair AND reconstruction</em>. Outcomes reported were the numbers of labral repairs, reconstructions, and debridements in each study.</div></div><div><h3>Results</h3><div>Seven studies (all Level III) met the inclusion criteria with a total of 4,134 hips undergoing primary hip arthroscopy. Mean patient age ranged from 28.4 to 43.7 years, and the overall percentage of male patients ranged from 11.8% to 52.8% across studies. Procedures were carried out by a total of 13 surgeons. The proportion of cases in which labral repair was performed ranged from 25.7% to 86.9% across studies. Overall, 3,184 labral repairs, 902 labral reconstructions, and 48 selective labral debridements were performed. These procedures represented 25.6% to 86.9%, 13.1% to 21.8%, and 0.0% to 5.5% of procedures, respectively.</div></div><div><h3>Conclusions</h3><div>Among studies reporting labral repair and reconstruction during primary hip arthroscopy, the proportion of each procedure performed varies widely. These findings highlight the procedural heterogeneity across surgeons performing hip arthroscopy.</div></div><div><h3>Level of Evidence</h3><div>Level III, systematic review of level III studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 6","pages":"Article 101259"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145808464","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}