Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Risk Factors and Injury Prevention in the Throwing Athlete","authors":"Daniel Kline P.T., D.P.T, S.C.S. ,&nbsp;Sarah Kate Fischer P.T., D.P.T., S.C.S. ,&nbsp;Garrett S. Bullock P.T., D.P.T., D.Phil. ,&nbsp;Michael J. Kissenberth M.D. ,&nbsp;Ellen Shanley P.T., Ph.D., O.C.S. ,&nbsp;Charles A. Thigpen P.T., A.T.C., Ph.D.","doi":"10.1016/j.asmr.2024.101037","DOIUrl":"10.1016/j.asmr.2024.101037","url":null,"abstract":"<div><h3>Abstract</h3><div>Arm injuries are the most common throwing injury, with growing concern as the most severe injuries, such as UCL reconstruction, continue to rise. Furthermore, throwing injuries are frequently recurrent, suggesting once injured, players are at increased risk for another arm injury. The increase in injury rates and severity has been attributed to increases in pitching volume and year-round participation, and specialized training. Thus, initial efforts to prevent arm injuries by USA Baseball and Little League have focused on the extrinsic factor of pitching exposure in the form of pitch counts, yet arm injury rates have stayed constant. Therefore, injury prevention strategies should include extrinsic factors and address modifiable, intrinsic factors that are associated with arm injury. Collectively addressing factors, such as shoulder range of motion and strength deficits, trunk and lower extremity function, and implantation of training programs yields a comprehensive approach to reduce arm injury rates. We will use a directed acyclic graph (DAG) to organize how the internal factors (i.e., fatigue, injury history, range of motion, and strength) interact with the external factors (i.e., training load and pitching exposure) and how together they are thought contribute to potential injury and inform arm injury reduction strategies. This will provide a roadmap to build adaptable arm injury reduction strategies to improve the modifiable physical factors in context of the external factors that change over time and between throwing athletes.</div></div><div><h3>Level of Evidence</h3><div>Level V, expert opinion.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101037"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845164","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":"Professional Baseball Players Return to the Same Level of Play With No Effects on Performance After Operative Treatment of Batter’s Shoulder","authors":"Roger V. Ostrander III M.D.,&nbsp;Skyler T. Hoelscher M.D.,&nbsp;Reece Vesperman M.D.,&nbsp;James R. Andrews M.D.","doi":"10.1016/j.asmr.2024.101039","DOIUrl":"10.1016/j.asmr.2024.101039","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate return to play and level of performance after posterior labral repair for the treatment of batter’s shoulder in professional baseball players.</div></div><div><h3>Methods</h3><div>Subjects were selected if they underwent posterior labral repair from 2007 to 2019 at a single institution and had evidence of a batter’s shoulder injury defined as posterior instability and pain while batting. Subjects were excluded if they reported other traumatic mechanisms of injury. Demographic and perioperative data were collected from the participants’ medical records. Historical professional baseball statistics were collected from historical baseball statistics databases.</div></div><div><h3>Results</h3><div>This study included 4 Major League Baseball and 2 Minor League Baseball players. All players in this study were able to return to play at a professional level. The mean difference in at bats from 2 years before to 2 years after surgery was +209.83, which was not statistically significant (95% confidence interval [CI], –329 to 897; <em>P</em> = .219). The mean difference in batting average from 2 years before to 2 years after surgery was –0.054, which was also not statistically significant (95% CI, –0.136 to 0.017; <em>P</em> = .063). The mean difference in relative batting average from 2 years before to 2 years after surgery was +0.192, with a 95% nonparametric CI of –0.048 to 0.458; this was also not statistically significant (<em>P</em> = .062).</div></div><div><h3>Conclusions</h3><div>Players who have a batter’s shoulder injury do not experience any statistically significant drop in performance after posterior labral repair (2 years before vs 2 years after).</div></div><div><h3>Level of Evidence</h3><div>Level IV, Therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101039"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845170","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":"Lower Trapezius Tendon Transfer Restores Deltoid Function and Shoulder Stability More Effectively Than Superior Capsular Reconstruction in Massive Rotator Cuff Tears","authors":"Nirav Mungalpara M.D. ,&nbsp;Cody Lee M.D. ,&nbsp;Sunjung Kim Ph.D. ,&nbsp;Kevin Chen B.A. ,&nbsp;Hayden Baker M.D. ,&nbsp;Aravind Athiviraham M.D. ,&nbsp;Elhassan Bassem M.D. ,&nbsp;Jason Koh M.D. ,&nbsp;Nicholas Maassen M.D. ,&nbsp;Farid Amirouche Ph.D.","doi":"10.1016/j.asmr.2024.101045","DOIUrl":"10.1016/j.asmr.2024.101045","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the biomechanical effectiveness of superior capsular reconstruction (SCR) and lower trapezius tendon transfer (LTT) to restore the native shoulder kinematics in managing massive rotator cuff tears (MRCTs) using a dynamic shoulder testing system in a cadaver model.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric hemithoraces were tested using a custom-made dynamic shoulder testing system. The conditions tested are intact, supraspinatus tear, MRCT (supraspinatus and infraspinatus tear), LTT with Achilles allograft, SCR combined with LTT, and SCR alone. Measurements included cumulative deltoid force, humeral head translation (HHT), and subacromial peak pressure during humeral abduction at various angles.</div></div><div><h3>Results</h3><div>Significant reductions in cumulative deltoid force were observed from intact to MRCT conditions (<em>P</em> = .023). LTT alone significantly improved deltoid force compared to its combination with SCR (<em>P</em> = .017) and outperformed SCR alone (<em>P</em> = .023). The intact condition showed increasing subacromial peak pressure with higher abduction angles, peaking at 541 kPa at 90°. MRCT exhibited the highest HHT and peak pressure, indicating significant instability. LTT reduced HHT and peak pressure compared to MRCT, indicating partial restoration of stability. The combined LTT + SCR condition demonstrated HHT values close to the intact condition and lower peak pressures, indicating substantial restoration of glenohumeral stability.</div></div><div><h3>Conclusions</h3><div>Simulated active unconstrained humeral abduction in the scapular plane using an entire hemithorax model suggests that LTT can restore dynamic stability and deltoid function in MRCTs, while SCR offers static stability without restoring deltoid function. Combining LTT and SCR may result in lower subacromial peak pressures on the undersurface of the acromion than either procedure alone.</div></div><div><h3>Clinical Relevance</h3><div>This study will contribute to understanding shoulder kinetics concerning current surgical techniques and suggest a dynamic concept of shoulder biomechanics testing.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101045"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845171","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":"Postoperative Outcomes Are Comparable Between Arthroscopic Subscapularis Repairs Performed With Either All-Suture Anchors or Hard-Body Anchors","authors":"Diego Gonzalez-Morgado M.D. ,&nbsp;Javier Ardebol M.D. ,&nbsp;Ali Ihsan Kilic M.D., Ph.D. ,&nbsp;Matthew B. Noble D.O. ,&nbsp;Lisa A. Galasso M.D. ,&nbsp;Matthew Nugent M.D. ,&nbsp;Cameron Phillips M.D. ,&nbsp;Patrick J. Denard M.D.","doi":"10.1016/j.asmr.2024.101060","DOIUrl":"10.1016/j.asmr.2024.101060","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare clinical outcomes and tendon healing rates of patients undergoing arthroscopic rotator cuff repairs involving the subscapularis (SSC) tendon (isolated or combined) with all-suture anchors (ASAs) versus hard-body anchors (HBAs) and to compare SSC healing rates between these 2 anchors.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was performed on patients who underwent arthroscopic rotator cuff repair of the SSC with either ASAs or HBAs and had a minimum 2-year follow-up. Range of motion and patient-reported outcomes were collected pre- and postoperatively, including a visual analog scale for pain, American Shoulder and Elbow Surgeons score, and Subjective Shoulder Value. Postoperative strength was measured, including Constant strength and belly press test. SSC healing was evaluated on ultrasounds at the final follow-up.</div></div><div><h3>Results</h3><div>Eighty-four patients met the study criteria. Twenty-eight underwent SSC repair with ASAs and 56 with HBAs. The mean follow-up for the ASA group and HBA group was 44 ± 22.7 months and 48.4 ± 28.3, respectively (<em>P</em> = .743). Baseline characteristics were comparable between groups (<em>P</em> &gt; .05). Overall, patient-reported outcomes and range of motion showed significant improvements from baseline to the final follow-up in all groups (<em>P</em> &lt; .001). Postoperatively, patients in the ASA group had greater improvement in forward flexion compared to the HBA group: 31° (95% confidence interval, 20°-42°) versus 14° (95% confidence interval, 5°-8°), respectively (<em>P</em> = .002). Postoperative Constant strength was higher in the ASA group compared to the HBA group: 17.5 ± 7.5 versus 13.5 ± 5.6, respectively (<em>P</em> = .04). No statistically significant difference in SSC retear rates was observed between groups: none in the ASA group and 3 (10.7%) in the HBA group (<em>P</em> = .27).</div></div><div><h3>Conclusions</h3><div>Arthroscopic SSC repair leads to significant functional improvement, with both ASAs and HBAs demonstrating similar low failure rates.</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 101060"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845172","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":"Tourniquet Use During Anterior Cruciate Ligament Reconstruction Is Associated With Postoperative Quadriceps Atrophy and Pain but No Negative Effects in the Long Term: A Systematic Review","authors":"Caleb V. Hayes B.S. ,&nbsp;Saad M. Ibrahim B.S. ,&nbsp;Anna E. Crawford B.S. ,&nbsp;James R. Jones M.D. ,&nbsp;Mathew D. Hargreaves B.S. ,&nbsp;Clay A. Rahaman B.A. ,&nbsp;Eugene W. Brabston M.D. ,&nbsp;Thomas B. Evely M.D. ,&nbsp;Aaron J. Casp M.D. ,&nbsp;Kevin E. Wilk D.P.T. ,&nbsp;Amit M. Momaya M.D.","doi":"10.1016/j.asmr.2024.101040","DOIUrl":"10.1016/j.asmr.2024.101040","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effect of tourniquet use during ACL reconstruction on quadriceps strength, intraoperative and postoperative blood loss, operative time, thigh girth or calf girth, and postoperative pain.</div></div><div><h3>Methods</h3><div>A systematic review using PubMed, EMBASE, and Cochrane Database of Systematic Reviews was conducted following the PRISMA guidelines. Randomized controlled trials and nonrandomized studies that evaluated intraoperative and postoperative effects of tourniquet usage during arthroscopic ACL reconstruction published between November 1996 and January 2023 were included. Outcomes evaluated included intraoperative visualization, pain, quadricep strength thigh or calf girth, blood loss, and operative time.</div></div><div><h3>Results</h3><div>Eight studies with 502 total patients were included in this review. There were 253 total patients in the tourniquet (T) group and 249 in the non-tourniquet (NT) group. Postoperative blood loss was higher in the T group (<em>P</em> &lt; .05). Two studies reported significantly increased postoperative analgesic usage within the T group (<em>P</em> &lt; .05), while 2 studies listed no significant differences between groups. Postoperative pain was not significantly increased in either group 2 days postoperation; however, 2 studies reported an increase in pain in the T group within the 10-hour, postoperative window (<em>P</em> &lt;.05). Although 3 studies indicated an initial decrease in quadriceps strength within the T group following surgery (<em>P</em> &lt; .05), overall findings consistently demonstrated a recovery of quadriceps strength within a few weeks. Similarly, there were no long-term significant differences in thigh or calf girth reported. Decreased operative time was reported with tourniquet use across included studies with 1 study demonstrating a significant difference (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Tourniquet use during ACL reconstruction does not have negative long-term effects on quadriceps strength. Although tourniquet use was associated with increased quadriceps atrophy and pain in the immediate postoperative period, these effects did not persist.</div></div><div><h3>Level of Evidence</h3><div>Level II, systematic review of Level I and II studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101040"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845221","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":"Magnetic Resonance Imaging Is an Effective First-Line Noninvasive Tool for Meniscal Tear Detection: A Retrospective Comparative Analysis With Knee Arthroscopy","authors":"Ahmed Mohsen Abbas El-Hagrasy M.B., B.Ch., B.A.O. ,&nbsp;Aaron Jijimon Theckayil M.B., B.Ch., B.A.O. ,&nbsp;Mohammad Adeel Khan M.B.B.S., M.R.C.S. ,&nbsp;Hammad Naqi Khan M.B.B.S., F.C.P.S. ,&nbsp;Ahsan Javaid Butt M.B.B.S., F.R.C.S., Tr.&Orth.","doi":"10.1016/j.asmr.2024.101065","DOIUrl":"10.1016/j.asmr.2024.101065","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI) with intraoperative knee arthroscopic findings for identifying or diagnosing meniscal tears.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of patients who underwent MRI and knee arthroscopy showing either medial meniscus (MM) or lateral meniscus (LM) tears at a single university hospital. The preoperative MRI findings of patients were compared with intraoperative arthroscopic findings to determine the presence, location, and morphology of meniscal tears. The results of arthroscopy were considered the definitive diagnosis.</div></div><div><h3>Results</h3><div>A total of 543 patients were initially identified. Of these, 220 met the study eligibility criteria and were included. The sensitivity, specificity, and accuracy of MRI in relation to arthroscopy were 94.29% (95% confidence interval [CI], 89.05%-97.50%), 78.75% (95% CI, 68.17%-87.11%), and 88.64% (95% CI, 83.68%-92.51%), respectively, for MM tears and 76.74% (95% CI, 66.39%-85.18%), 94.03% (95% CI, 88.58%-97.39%), and 87.27% (95% CI, 82.13%-91.37%), respectively, for LM tears. Complex tears were the most common morphology of tears, and the posterior horn was the most common location.</div></div><div><h3>Conclusions</h3><div>MRI is an effective first-line noninvasive diagnostic tool for investigating meniscal tears, with overall diagnostic accuracies of 88.64% for MM tears and 87.27% for LM tears. MM tears had the highest incidence, particularly in the posterior horn. MRI showed high sensitivity for MM tears, high specificity for LM tears, and substantial agreement with arthroscopy in diagnosing both MM and LM tears. However, MRI’s specificity for MM tears and sensitivity for LM tears were lower, suggesting that it may not be as reliable in confirming MM tears or ruling out LM tears.</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 101065"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845142","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":"Isokinetic Testing After Anterior Cruciate Ligament Injury Showed a Greater Hamstrings/Quadriceps Ratio at 240°/S Over 6 Months From Injury but No Difference of Limb Symmetry Index","authors":"Guillaume Mesnard M.D. ,&nbsp;Gaspard Fournier M.D. ,&nbsp;Nicolas Cance ,&nbsp;Robert A. Magnussen M.D., M.P.H. ,&nbsp;Sébastien Lustig M.D., Ph.D. ,&nbsp;Elvire Servien M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101063","DOIUrl":"10.1016/j.asmr.2024.101063","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess preoperative quadriceps and hamstring strength at various time points after anterior cruciate ligament (ACL) injury but before ACL reconstruction.</div></div><div><h3>Methods</h3><div>Patients who underwent isokinetic muscle strength testing before planned ACL reconstruction were included. Patients were placed in 1 of the following 3 groups on the basis of time from injury to testing: &lt;3 months, 3 to 6 months, and 6 to 12 months. Among these 3 groups, hamstring and quadriceps limb symmetry index (LSI) and hamstring/quadriceps (H/Q) ratios were compared. A total of 100 patients were included (&lt;3 months [n = 55]; 3-6 months [n = 31]; and 6-12 months [n = 14]).</div></div><div><h3>Results</h3><div>There were no significant differences between patients in the 3 groups in regards to age, body mass index, or flexion range of motion, but there was a greater proportion of female patients in the 6 to 12 month group than the other groups. No significant differences in quadriceps or hamstring strength were noted among the 3 groups. H/Q ratio was significantly greater in the 6 to 12 month group than the less than 3 months and 3 to 6 months groups, with concentric testing at 240°/s. No correlation was found between patient sex and LSI or H/Q ratios.</div></div><div><h3>Conclusions</h3><div>Patients who underwent isokinetic muscle strength testing 6 to 12 months after ACL injury had a greater H/Q ratio at 240°/s than those who were testing within 6 months of injury. No differences in hamstring or quadriceps LSI were noted on the basis of time.</div></div><div><h3>Clinical Relevance</h3><div>An understanding of the factors that influence preoperative isokinetic muscle strength testing (including time from injury to surgery) is important, given associations noted between preoperative strength and postoperative strength recovery after ACL reconstruction.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101063"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845273","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":"Extracorporeal Shockwave Therapy Is Associated With Similar Functional Outcomes for Male and Female Runners With Patellar or Quadriceps Tendinopathy: A Pilot Investigation","authors":"Nicole B. Katz M.D. ,&nbsp;Jonathan P. Fee B.S. ,&nbsp;Andrew S. Nowak M.D., J.D. ,&nbsp;Adam S. Tenforde M.D., F.A.C.S.M.","doi":"10.1016/j.asmr.2024.101024","DOIUrl":"10.1016/j.asmr.2024.101024","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize functional outcomes in runners with patellar tendinopathy (PT) and quadriceps tendinopathy (QT) following extracorporeal shockwave therapy (ESWT) and explore differences in response by tendinopathy (PT or QT) and by sex (female or male).</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of runners with PT or QT treated with ESWT (radial or combined radial and focused) at a single sports medicine clinic during a 5-year period. Individuals were included if they had a primary diagnosis of PT or QT, self-identified as a runner, and had complete baseline and final functional outcome questionnaires for ESWT with treatment duration defined by response based on best practices. Functional outcome at baseline and following treatment were assessed using the Victorian Institute of Sport Assessment–Patellar Tendon questionnaires. Treatment success was defined as meeting the minimal clinically important difference (MCID) of ≥13 points.</div></div><div><h3>Results</h3><div>Of the 19 runners included, 26% identified as female and 74% as male; all runners identified as cisgendered. There were 12 runners with PT (17% female, 83% male) and 7 with QT (43% female, 57% male). Median follow-up was 3.0 months (range, 1.0-23.0; interquartile range, 3.0-6.0). Of all runners, 67% with PT and 71% with QT achieved MCID with no significant difference between tendinopathy groups (<em>P</em> = .90). There was also no difference in the percentage that achieved MCID between sexes, with 80% of women and 64% of men meeting MCID (<em>P</em> = .72).</div></div><div><h3>Conclusions</h3><div>Similar functional outcomes were observed in female and male runners with QT or PT following radial and combined ESWT, with most achieving MCID. This study suggests that ESWT, in combination with physical therapy, may be an effective treatment for runners with PT or QT and that ESWT could be considered for PT or QT refractory to physical therapy.</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 2","pages":"Article 101024"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Repair for Posterior Shoulder Instability Is Associated With Favorable Outcomes and High Return to Sport or Work: A Systematic Review and Meta-Analysis","authors":"Antonio Cusano M.D. ,&nbsp;Alexander J. Ment B.A. ,&nbsp;Kevin A. Hao M.D. ,&nbsp;Jayson Saleet B.A. ,&nbsp;Patrick Nian B.A. ,&nbsp;Emily Curry M.P.H. ,&nbsp;Michael Groot M.S. ,&nbsp;David Novikov M.D. ,&nbsp;Hussein Abdul-Rassoul M.D. ,&nbsp;Robert L. Parisien M.D. ,&nbsp;Brett D. Owens M.D. ,&nbsp;Xinning Li M.D.","doi":"10.1016/j.asmr.2024.101032","DOIUrl":"10.1016/j.asmr.2024.101032","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess clinical outcomes of primary arthroscopic repair for unilateral posterior shoulder instability (PSI) in all patients, to evaluate clinical outcomes in athletes, and to compare clinical outcomes between contact and overhead athletes.</div></div><div><h3>Methods</h3><div>A systematic review was performed using PRISMA Guidelines. Included studies reported on primary arthroscopic treatment of PSI with at least 1 year of follow-up. Studies were excluded if they were not in English, included revisions/open procedures or anterior/multidirectional instability, had fewer than 10 patients or no full text available, or were biomechanical analyses/descriptions of surgical technique. Primary outcomes were rates of return to sport (RTS), return to preinjury level (RTPL), recurrent instability, and revision surgery. Outcomes were evaluated in all patients and all athletes, with further subdivision for <em>contact</em> and <em>overhead</em>.</div></div><div><h3>Results</h3><div>Of the 1,504 screened studies, 30 met inclusion criteria (1,649 shoulders). Mean age at surgery was 23.3 years (range: 12.4–65 years), and mean follow-up was 35.5 months (range: 12–140.4 months). There were 1,051 males and 196 females. RTS rates were 91.7% among all patients and 90.9% in all athletes, with no statistical difference between contact and overhead athletes (92.8% vs 88.1%; <em>P</em> = .176). RTPL rates were 78.7% among all patients and 75.6% in all athletes, with no statistical difference between contact and overhead athletes (90.8% vs 62.3%; <em>P</em> = .072). Recurrent instability rates were 7.0% among all patients and 8.0% in all athletes, with no statistical difference between contact and overhead athletes (7.3% vs 7.4%; <em>P</em> = .981). Revision rates were 3.7% among all patients and 3.3% in all athletes, with no statistical difference between contact and overhead athletes (6.8% vs. 0%; <em>P</em> = 1).</div></div><div><h3>Conclusion</h3><div>Primary arthroscopic treatment of PSI is associated with favorable outcomes and high return to sport and work rates. Recurrent instability and pain were the most common reasons for revision.</div></div><div><h3>Level of Evidence</h3><div>Level IV, Systematic review and meta-analysis of Level II to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101032"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845093","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":"Blood Flow Restriction Training: A Tool to Enhance Rehabilitation and Build Athlete Resiliency","authors":"Mark Murphy P.T., D.P.T., S.C.S., C.S.C.S.","doi":"10.1016/j.asmr.2024.101022","DOIUrl":"10.1016/j.asmr.2024.101022","url":null,"abstract":"<div><div>Blood flow restriction training (BFRT) is a tool utilized in rehabilitation and injury prevention to improve muscle strength and size, particularly in load-compromised individuals. BFRT facilitates gains in muscular strength and hypertrophy at lower loads, allowing for accelerated recovery and less disuse atrophy. BFRT must be applied appropriately and with caution, particularly in individuals with cardiovascular concerns. There are applications for BFRT across a wide spectrum of human performance training and in rehabilitation of both lower and upper extremity conditions, providing a high-quality adjunct to improve muscle strength, power, and endurance.</div></div><div><h3>Level of Evidence</h3><div>Level V, expert opinion.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101022"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845165","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}