Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Semiautomated Three-Dimensional Landmark Placement on Knee Models Is a Reliable Method to Describe Bone Shape and Alignment","authors":"Nancy Park B.S. ,&nbsp;Johannes Sieberer M.Sc. ,&nbsp;Armita Manafzadeh Ph.D. ,&nbsp;Rieke-Marie Hackbarth ,&nbsp;Shelby Desroches B.S. ,&nbsp;Rithvik Ghankot B.S. ,&nbsp;John Lynch Ph.D. ,&nbsp;Neil A. Segal M.D. ,&nbsp;Joshua Stefanik Ph.D. ,&nbsp;David Felson M.D. ,&nbsp;John P. Fulkerson M.D.","doi":"10.1016/j.asmr.2024.101036","DOIUrl":"10.1016/j.asmr.2024.101036","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the inter- and intrarater reliability of 21 anatomical landmarks initially placed with an artificial intelligence algorithm and then manually verified with human input.</div></div><div><h3>Methods</h3><div>Thirty computed tomography scans of the knees of participants from the Multicenter Osteoarthritis Study (MOST) ages 45 to 55 years were included. Approximately one-half experienced progression of patellofemoral osteoarthritis, defined as an increased cartilage score in the patellofemoral compartment on magnetic resonance imaging over 2 years. The algorithm automatically placed 19 anatomic landmarks on the femur, tibia, and patella. An additional 2 landmarks were added manually. Two landmark reviewers separately reviewed all 30 scans and verified all landmarks. After 2 weeks, one reviewer repeated the process for the same dataset. The mean Euclidean distance of manual landmark displacement, mean absolute disagreement between and within raters, and intraclass correlation coefficients for inter- and intrarater reliability were calculated.</div></div><div><h3>Results</h3><div>All landmarks had excellent inter-rater reliability. The tibial and femoral shaft centers had intraclass correlation coefficients (ICCs) of 1, indicating their positions did not differ. Seventeen landmarks had ICCs between 0.90 and 0.99 and the tibial tuberosity had an ICC of 0.87. Intrarater reliability scores were 1 for 16 landmarks and between 0.90 and 0.99 for the remaining 5.</div></div><div><h3>Conclusions</h3><div>There was excellent agreement on the locations of all 21 landmarks evaluated in this study.</div></div><div><h3>Clinical Relevance</h3><div>The potential role of artificial intelligence in medical imaging and orthopaedic research is a growing area of interest. The excellent reliability demonstrated across multiple landmarks in our study reveals the potential for semiautomated 3-dimensional methods to enhance precision of anatomical measurements of the knee over 2-dimensional methods.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101036"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845138","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":"Procedure Type and Preoperative Patient-Reported Outcome Metrics Predict Variation in the Value of Hip Arthroscopy for Femoroacetabular Impingement","authors":"Michael C. Dean B.A. ,&nbsp;Nathan J. Cherian M.D. ,&nbsp;Ana Paula Beck da Silva Etges Ph.D. ,&nbsp;Zachary L. LaPorte B.A. ,&nbsp;Kieran S. Dowley B.A. ,&nbsp;Kaveh A. Torabian M.S. ,&nbsp;Ryan E. Dean M.D. ,&nbsp;Scott D. Martin M.D.","doi":"10.1016/j.asmr.2024.101073","DOIUrl":"10.1016/j.asmr.2024.101073","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize variation in the value of hip arthroscopy for femoroacetabular impingement and explore associations between value and patient-specific demographic characteristics, comorbidities, preoperative patient-reported outcome measures (PROMs), and intraoperative variables.</div></div><div><h3>Methods</h3><div>We included all patients aged 18 years or older who underwent primary arthroscopic acetabular labral repair or debridement between 2015 and 2020 with minimum 2-year follow-up. The exclusion criteria were hip dysplasia, advanced hip osteoarthritis (TÖnnis grade &gt;1), or unreconcilable documenting errors. Value was calculated by dividing 2-year postoperative International Hip Outcome Tool 33 scores by time-driven activity-based costs. To protect the confidentiality of internal hospital cost data, the study average for value was normalized to 100. Multivariable linear mixed-effects models were used to identify factors underlying variation in value.</div></div><div><h3>Results</h3><div>This study included 161 patients. There were 76 women (47.2%) and 85 men, with a mean age of 36.0 years (standard deviation [SD], 10.9 years) and mean body mass index (BMI) of 25.8 (SD, 4.3). Most patients were white (92.5%), were not Hispanic (93.8%), and were commercially insured (92.5%). Preoperatively, 57.1% of hips were classified as Tönnis grade 1 (57.1%) whereas the remainder were grade 0. The normalized value of hip arthroscopy ranged from 25.4 to 216.4 (mean ± SD, 100 ± 38.4), with a 3.0-fold variation between patients in the 10th and 90th percentiles. Higher value was significantly associated with Tönnis grade 0 (12.2-point increase, <em>P</em> = .025), no prior contralateral hip arthroscopy (17.3-point increase, <em>P</em> = .039), higher preoperative PROMs (0.52-point increase per 1-unit increase, <em>P</em> &lt; .001), and no bone marrow aspirate concentrate or microfracture (33.8-point increase, <em>P</em> &lt; .001). Value was also significantly associated with osteoplasty type and labral treatment technique (<em>P</em> &lt; .05 for both). In contrast, operative year, age, sex, BMI, race, ethnicity, Outerbridge grade, and American Society of Anesthesiologists score were not independently associated with value. A model incorporating these factors as fixed effects and the surgery center as a random effect explained 42.3% of the observed variation in value. Sensitivity analyses revealed that value drivers may vary slightly across PROMs.</div></div><div><h3>Conclusions</h3><div>This study revealed wide variation in the value of hip arthroscopy that was most strongly explained by osteoplasty type, labral management technique, and preoperative PROMs. In contrast, patient demographic characteristics such as age, sex, and BMI contributed minimal independent variability.</div></div><div><h3>Level of Evidence</h3><div>Level IV, economic and decision analysis.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101073"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845135","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":"Microsoft Copilot Provides More Accurate and Reliable Information About Anterior Cruciate Ligament Injury and Repair Than ChatGPT and Google Gemini; However, No Resource Was Overall the Best","authors":"Suhasini Gupta B.S. ,&nbsp;Rae Tarapore M.D. ,&nbsp;Brett Haislup M.D. ,&nbsp;Allison Fillar M.D.","doi":"10.1016/j.asmr.2024.101043","DOIUrl":"10.1016/j.asmr.2024.101043","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze and compare the quality, accuracy, and readability of information regarding anterior cruciate ligament (ACL) injury and reconstruction provided by various artificial intelligence AI interfaces (Google Gemini, Microsoft Copilot, and OpenAI ChatGPT).</div></div><div><h3>Methods</h3><div>Twenty questions regarding ACL reconstruction were inputted into ChatGPT 3.5, Gemini, and the more precise subinterface within Copilot and were categorized on the basis of the Rothwell criteria into Fact, Policy, and Value. The answers generated were analyzed using the DISCERN scale, JAMA benchmark criteria, and Flesch-Kincaid Reading Ease Score and Grade Level. The citations provided by Gemini and Copilot were further categorized by source of citation.</div></div><div><h3>Results</h3><div>All 3 AI interfaces generated DISCERN scores (≥50) demonstrating “good” quality of information except for Policy and Value by Copilot which were scored as “excellent” (≥70). The information provided by Copilot demonstrated greater reliability, with a JAMA benchmark criterion of 3 (of 4) as compared with Gemini (1) and ChatGPT (0). In terms of readability, the Flesch-Kincaid Reading Ease Score scores of all 3 sources were &lt;30, apart from Fact by Copilot (31.9) demonstrating very complex answers. Similarly, all Flesch-Kincaid Grade Level scores were &gt;13, indicating a minimum readability level of college level or college graduate. Finally, both Copilot and Gemini had a majority of references provided by journals (65.6% by Gemini and 75.4% by Copilot), followed by academic sources, whereas Copilot provided a greater number of overall citations (163) as compared with Gemini (64).</div></div><div><h3>Conclusions</h3><div>Microsoft Copilot was a better resource for patients to learn about ACL injuries and reconstruction compared with Google Gemini or OpenAI ChatGPT in terms of quality of information, reliability, and readability. The answers provided by LLMs are highly complex and no resource was overall the best.</div></div><div><h3>Clinical Relevance</h3><div>As artificial intelligence models continually evolve and demonstrate increased potential for answering complex surgical questions, it is important to investigate the quality and usefulness of the responses for patients. Although these resources may be helpful, they should not be used as a substitute for any discussions with health care providers.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101043"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845140","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":"Patients Have Similar Clinical Outcomes and Failure Rates After Anterior Cruciate Ligament Reconstruction With Tibialis Anterior Tendon, Bone–Patellar Tendon–Bone, Hamstring Tendon, or Achilles Tendon Allografts: A Systematic Review","authors":"Udit Dave B.S. ,&nbsp;Juan Bernardo Villarreal-Espinosa M.D. ,&nbsp;Harshal Shah B.S. ,&nbsp;Eric J. Cotter M.D. ,&nbsp;Fernando Gómez-Verdejo M.D. ,&nbsp;Melissa Carpenter B.S. ,&nbsp;Cameron Gerhold B.S. ,&nbsp;Alexander Mamonov ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Nikhil N. Verma M.D.","doi":"10.1016/j.asmr.2024.101035","DOIUrl":"10.1016/j.asmr.2024.101035","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare postoperative outcomes and functionality in patients who undergo primary allograft anterior cruciate ligament reconstruction (ACLR) with tibialis anterior (TA) tendon, bone–patellar tendon–bone (BPTB), hamstring tendon (HT), and Achilles tendon allografts.</div></div><div><h3>Methods</h3><div>In April 2024, a comprehensive search of the PubMed, Embase, and Cochrane Library databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies were included if they evaluated primary ACLR using allograft, were prospective randomized controlled trials or retrospective studies, compared outcomes in patients undergoing primary ACLR with different allograft types, and were published between 2000 and 2024. Data collection included patient demographic characteristics, graft type, activity level, drilling technique, concomitant and augmentation procedures, patient-reported outcome measures, complications, and graft rerupture rates. Pooling of data was avoided, and qualitative data comparison was conducted.</div></div><div><h3>Results</h3><div>The initial search identified 957 studies, 7 of which were included in this systematic review. Of these, 5 were randomized controlled trials and 2 were retrospective studies. A total of 735 patients were included, with 167 HT patients, 252 BPTB patients, 162 TA patients, and 153 Achilles patients. The mean ages within the cohorts ranged from 23.9 to 37.2 years. The mean follow-up times across studies ranged from 25.6 to 90.0 months. Demographic characteristics were similar among the graft cohorts, and each study had a low risk of bias. Failure rates ranged from 2% to 65% across studies. Similar International Knee Documentation Committee, Lysholm, and Tegner scores were reported among the graft types. Additionally, similar functional outcomes as measured by side-by-side differences in arthrometer readings and similar complication rates after primary ACLR with HT, BPTB, TA, and Achilles allografts were found.</div></div><div><h3>Conclusions</h3><div>Primary ACLR with allografts in patients older than 23 years is safe and effective with few differences in patient-reported outcomes, postoperative function, and graft failure rates among graft options.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101035"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Injury Epidemiology in Soccer Players in the 2019 Confederation of North, Central America and Caribbean Association Football Gold Cup as Reported by Team Physicians","authors":"Brian Forsythe M.D. ,&nbsp;Derrick M. Knapik M.D. ,&nbsp;Daanish Khazi-Syed B.S. ,&nbsp;Joshua Chang B.S. ,&nbsp;Camden Bohn B.A. ,&nbsp;Catherine Hand B.S. ,&nbsp;Avinaash Korrapati M.D. ,&nbsp;Ophelie Lavoie-Gagne M.D. ,&nbsp;George Chiampas M.D. ,&nbsp;Bert R. Mandelbaum M.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101074","DOIUrl":"10.1016/j.asmr.2024.101074","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe and characterize injuries reported in professional soccer athletes participating in the 2019 Confederation of North, Central America and Caribbean Association Football (CONCACAF) Gold Cup tournament.</div></div><div><h3>Methods</h3><div>Data were collected from electronic medical reports submitted after each match of the 2019 CONCACAF Gold Cup tournament. Reports were generated from a 20-question online survey completed by team physicians from all 16 participating teams. For every recorded injury, a separate survey was completed by team physicians documenting athlete demographic characteristics, context of injury, injury characteristics, and expected time lost from injury.</div></div><div><h3>Results</h3><div>A total of 62 surveys were distributed, of which 80% (50 of 62) were collected for analysis. A total of 27 injuries (7%) were recorded among the 368 participating athletes. Injuries most frequently occurred during matches (92%, 24 of 27), with a significantly higher number of injuries recorded between the 61st and 75th minutes of play (<em>P</em> &lt; .05). New injuries constituted 85% of all injuries (23 of 27), whereas 15% of injuries (4 of 27) were recorded as recurrences of prior injuries. Defenders had the highest number of injuries (41%, 11 of 27). Injuries to the lower extremities comprised 52% of all injuries (14 of 27), with thigh strains being the most common.</div></div><div><h3>Conclusions</h3><div>During the 2019 CONCACAF Gold Cup, injuries were recorded in 7% of athletes (27 of 368), with 89% of injuries recorded as occurring during match play, primarily consisting of injuries involving strains to the thigh.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the epidemiology of soccer (football) injuries can help physicians better educate athletes including their patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101074"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Cruciate Ligament Reconstruction Improves Sexual Health Postoperatively","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Federico Valli M.D. ,&nbsp;Pietro Marchetti M.D. ,&nbsp;Nicola Ursino M.D. ,&nbsp;Amit Meena M.B.B.S., M.S., D.N.B.","doi":"10.1016/j.asmr.2024.101041","DOIUrl":"10.1016/j.asmr.2024.101041","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate changes in sexual function and quality of life following arthroscopic posterior cruciate ligament (PCL) reconstruction.</div></div><div><h3>Methods</h3><div>Patients aged between 18 and 45 years who underwent PCL reconstruction were considered for inclusion. At the time of hospital admission, each patient was asked to complete the New Sexual Satisfaction Scale-Short Form, before injury (preinjury) and at the time of hospital admission (preoperative). In addition, patients were followed for a minimum of 24 months (final follow-up). Quality of life was measured using the Anterior Cruciate Ligament Quality of Life Questionnaire at hospital admission (preoperative) and at the 24-month follow-up visit (final follow-up).</div></div><div><h3>Results</h3><div>A total of 35 patients were included in the study; 24 (68.6%) were male, and 11 were female (31.4%). The mean age at the time of surgery was 29.23 <em>±</em> 7.52 years, and the mean follow-up duration was 52.97 <em>±</em> 22.69 months. In all patients, the hamstring tendon was used. Sexual activity at the last follow-up visit was significantly different from that preoperatively (<em>P</em> = .024), while no difference was observed between the preinjury and last follow-up values (<em>P</em> = . 243). Sexual activity was more frequent before injury than preoperatively (<em>P</em> = . 009). Quality of life at the last follow-up visit was significantly better than that preoperatively (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Reconstructive surgery after PCL injury improves the sexual health of patients regardless of age or sex.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101041"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Substantial Increase in Injuries and Hospitalizations Associated With Playing Pickleball From 2020 to 2022","authors":"Ryan Cheng B.A. ,&nbsp;Jay Moran M.D. ,&nbsp;Billy Kim M.D. ,&nbsp;Marshall S. Yuan Pharm.D. ,&nbsp;Connor J. O’Leary B.A. ,&nbsp;Calvin Wang B.S. ,&nbsp;Joshua S. Dines M.D. ,&nbsp;Brian M. Katt M.D. ,&nbsp;Andrew E. Jimenez M.D.","doi":"10.1016/j.asmr.2024.101067","DOIUrl":"10.1016/j.asmr.2024.101067","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the estimated number and the types of pickleball-related injuries stratified by sex and age presenting to U.S. emergency departments from 2020 to 2022, as estimated by the National Electronic Injury Surveillance System (NEISS) database.</div></div><div><h3>Methods</h3><div>Data from the NEISS database were queried to characterize pickleball-related injuries that presented to 96 NEISS-affiliated emergency departments across the United States between 2020 and 2022. The estimated numbers of injuries and hospital admissions were calculated using weights assigned by the NEISS based on geographical location. Narratives for each emergency department visit were manually reviewed to categorize injuries by type and site. Multivariable analyses were used to determine risk factors associated with pickleball-related hospital admissions.</div></div><div><h3>Results</h3><div>The estimated number of annual pickleball-related injuries presenting to U.S. emergency departments increased by 91% from 2020 to 2022 (8,894 injuries vs 16,997 injuries). Pickleball-related hospital admissions increased by 257% from 2020 in 2022 (992 hospital admissions vs 3,541 hospital admissions). Most injuries (73%, 9,932 estimated injuries per year) were sustained by patients aged between 60 and 79 years (mean ± standard deviation, 63.9 ± 14.7 years). The most common types of injuries were fractures (29%, 3,990 estimated injuries per year) and strains/sprains (21%, 2,808 estimated injuries per year). Multivariable analyses controlling for age, sex, injury type, and injury site showed that patients aged 65 years or older were at an increased risk of hospitalization (odds ratio, 2.48; 95% confidence interval, 1.54-4.11; <em>P</em> &lt; .001) compared with those younger than 65 years.</div></div><div><h3>Conclusions</h3><div>The estimated number of pickleball-related injuries presenting to U.S. emergency departments and subsequent hospital admissions has increased by 91% and 257%, respectively, from 2020 to 2022. Patients who were aged 65 years or older at the time of injury were at an increased risk of hospital admission.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the current trends and types of pickleball-related injuries presenting to U.S. emergency departments is critical toward the development of injury prevention measures and understanding the U.S. health care system, particularly as participation in pickleball continues to grow.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101067"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Patient Representation Is Acceptable in Studies Regarding Hip Arthroscopy With Labral Repair Yet Deficient in Key Study Design and Sport-Specific Features","authors":"Benjamin M. Ose M.P.H. ,&nbsp;Libby Frye B.S. ,&nbsp;Dylan Wentzel B.S. ,&nbsp;Richard McEntee M.D. ,&nbsp;Ashley A. Herda Ph.D. ,&nbsp;Scott M. Mullen M.D. ,&nbsp;John P. Schroeppel M.D. ,&nbsp;Bryan G. Vopat M.D. ,&nbsp;Lisa M. Vopat M.D.","doi":"10.1016/j.asmr.2024.101069","DOIUrl":"10.1016/j.asmr.2024.101069","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically review and examine the current literature regarding the representation of female athletes in studies examining arthroscopic hip labral repair procedures.</div></div><div><h3>Methods</h3><div>Studies regarding arthroscopic hip labral repair were identified in PubMed. We included human studies of all levels of evidence written in English that identified the biological sex of study participants and were conducted in the United States or non-US countries that offer the same treatment strategies available in the United States. Data regarding study population, athletic caliber, menstrual status, research theme, sample of males and females, journal impact factor, and paper Altmetric score were recorded and analyzed.</div></div><div><h3>Results</h3><div>We screened 1,152 studies and identified 62 to be included in this audit. Females made up 55% of the population of participants. Female-only and male-only studies represented 4.8% and 14.5% of studies investigated, respectively. No studies investigated outcomes of female participants at the highest athletic caliber. Menstrual status was not considered or included as a variable in any study. Participants within athletic performance, indirect association, and health research theme had 32.8%, 61.1%, and 58.6% female representation, respectively. Median impact factor was similar among study population classifications. Study Altmetric score was highest among male-only studies and studies of the highest levels of athletic caliber.</div></div><div><h3>Conclusions</h3><div>Overall, there was a similar prevalence of female-to-male participants in hip labral repair research, with a 55% to 45% female-to-male ratio in all studies included in this review. Despite this, there is a lack of female-only studies, inclusion of menstrual status, high-level female athletes, and female participants evaluated for performance outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101069"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Declining Postoperative 90-Day Opioid Prescriptions From 2010 to 2021 Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome","authors":"Wesley Day B.S.,&nbsp;Scott Halperin B.S.,&nbsp;Serkan Surucu M.D.,&nbsp;Andrew E. Jimenez M.D.,&nbsp;Beatrice Katsnelson B.S.,&nbsp;Justin Zhu B.S.,&nbsp;Jonathan N. Grauer M.D.","doi":"10.1016/j.asmr.2025.101078","DOIUrl":"10.1016/j.asmr.2025.101078","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze postoperative opioid prescriptions after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in a large, opioid-naive population and to evaluate factors associated with receiving more opioids.</div></div><div><h3>Methods</h3><div>Opioid-naive adult patients who underwent hip arthroscopy for FAIS were queried in the 2010 to 2022 PearlDiver Mariner 161 national administrative database. Exclusion criteria included patients with a history of chronic pain and patients who received opioid prescriptions more than 30 days before surgery. Patient variables were extracted: age, sex, and Elixhauser Comorbidity Index. Ninety-day postoperative opioid prescriptions (by total morphine milligram equivalents [MMEs]) were assessed with multivariate linear regression. Ninety-day postoperative opioid prescriptions from 2011 to 2021 were assessed.</div></div><div><h3>Results</h3><div>Of 27,079 patients with postoperative opioid prescriptions identified, a mean ± standard deviation of 347.6 ± 729.2 MMEs (40 tablets of 5 mg oxycodone) were prescribed per patient, with a mean of 1.6 prescriptions filled per patient within 90 days following surgery. Seventy-five percent of patients filled fewer than 600 MMEs, but a small subset filled more than 2,000 MMEs. Multivariate analysis revealed that, compared to patients in the age 30- to 39-year group, those aged 20 to 29 years received fewer MMEs (Δ = –72.5, <em>P</em> &lt; .017). Compared to those with an Elixhauser Comorbidity Index of 2 or under, those &gt;2 were prescribed more MMEs (Δ = 52.5, <em>P</em> &lt; .017). Sex did not correlate with the postoperative MMEs prescribed. From 2011 to 2021, a 58.2% decrease in the 90-day mean MMEs prescribed was noted per patient (<em>P</em> &lt; .017).</div></div><div><h3>Conclusions</h3><div>Fewer postoperative MMEs were filled following FAIS hip arthroscopy for patients in their 20s relative to those in their 30s, as well as for those with lower comorbidity burden. Patient sex was not associated with differences in postoperative MMEs prescribed. The amount of mean MMEs prescribed per patient decreased from 2011 to 2021.</div></div><div><h3>Clinical Relevance</h3><div>This study provides information about the typical amount of narcotics required after surgery. This is increasingly useful information, as surgeons/clinicians continue to try to minimize the role of narcotics in postoperative recovery.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101078"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Income, Younger Age, Female Sex, and Poor Mental Health Are Risk Factors for Diminished Access to Care Among Patients With Meniscus Tears","authors":"Drew W. Barron B.S. ,&nbsp;Vikram S. Gill B.S. ,&nbsp;Sayi P. Boddu B.A. ,&nbsp;Nathan C. Beckett B.S. ,&nbsp;Sailesh V. Tummala M.D. ,&nbsp;Anikar Chhabra M.D.","doi":"10.1016/j.asmr.2024.101064","DOIUrl":"10.1016/j.asmr.2024.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>To use the All of Us database to investigate barriers to health care access for patients with meniscus tears and to examine how specific demographic, socioeconomic, and health-related factors independently influence their health care utilization.</div></div><div><h3>Methods</h3><div>The National Institutes of Health All of Us database was queried for patient data between March 2017 and March 2023 to form a cohort of patients with meniscal tears. Patients with meniscal tears were identified using Systematized Nomenclature of Medicine clinical terms. All patients with self-reported meniscus tears were included, with no exclusion criteria to ensure a diverse representation of underrepresented individuals. Patient responses to the “Healthcare Access and Utilization Survey” were analyzed across 4 domains: “delayed care,” “could not afford care,” “skipped medication,” and “have not seen a provider in over one year.”</div></div><div><h3>Results</h3><div>In total, 5,671 survey respondents with meniscal tears were included for analysis from a population of 436,000 eligible records. Among them, 27.7% reported delayed care, 23.9% were unable to afford care, 11.8% skipped medication, and 2.0% had not seen a provider in over a year. Patients with annual incomes under $50,000 were more likely to delay care (odds ratio [OR], 1.41; <em>P</em> &lt; .001), be unable to afford care (OR, 1.73; <em>P</em> &lt; .001), or skip medications (OR, 1.79; <em>P</em> &lt; .001). Younger age than the cohort mean of 65.4 years, female sex, and poor physical and mental health were associated with impaired access in at least 1 care domain.</div></div><div><h3>Conclusions</h3><div>Over one-fourth of patients with a diagnosis of meniscus tear who responded to the All of Us “Healthcare Access and Utilization Survey” reported difficulties with access to care across 4 domains, with those of low income, younger age, female sex, and poor mental or physical health experiencing significant barriers to care.</div></div><div><h3>Clinical Relevance</h3><div>This research can inform strategies for equitable treatment of meniscal injuries by highlighting disparities in orthopaedic care access and utilization.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101064"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}