Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"There Is Increasing Osteopathic Representation Among Orthopaedic Sports Medicine Fellowship Applicants, in Addition to Increasing Match Rates, Whereas the Number of Female Applicants Remains Disproportionately Lower Than the Number of Women in Residency Programs","authors":"Kenneth B. Choy D.O. ,&nbsp;Shreya M. Saraf M.S. ,&nbsp;Olivia I. Campbell M.P.H. ,&nbsp;Adam Bitterman D.O. ,&nbsp;Scott P. Steinmann M.D. ,&nbsp;Lisa K. Cannada M.D. ,&nbsp;Mary K. Mulcahey M.D. ,&nbsp;Randy M. Cohn M.D.","doi":"10.1016/j.asmr.2025.101198","DOIUrl":"10.1016/j.asmr.2025.101198","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate trends in gender and degree type of applicants to sports medicine fellowships from 2012 to 2023 and the impact of these factors on match success.</div></div><div><h3>Methods</h3><div>San Francisco Matching Program (SF Match) data from 2012 to 2023 were extracted and analyzed. Data regarding number of applicants and match rates based on applicant degree and gender were evaluated. The Pearson correlation test was used to evaluate trends and proportions for the number of applicants and match rates. The Fisher exact test was used to compare the match rates of allopathic and osteopathic applicants, as well as male and female candidates.</div></div><div><h3>Results</h3><div>In total, there were 2,996 applicants for sports medicine fellowships from 2012 to 2023. There were 510 international medical graduates (17.1%) who were excluded from this analysis, leaving 2,486 applicants in the study cohort. There were 319 osteopathic applicants (12.8%) and 2,167 allopathic applicants (77.2%). Of the applicants, 265 (10.7%) were women and 2,221 (89.3%) were men. From 2012 to 2023, there was no significant difference in match rates between osteopathic and allopathic residents applying to sports medicine fellowships (<em>P</em> = .62). There was no statistically significant change in the match rate of male applicants over the study period (<em>r</em> = 0.45, <em>P</em> = .06). Female applicants matched at a slightly higher rate than male applicants (94.1% vs 91.4%), although this difference was not statistically significant (<em>P</em> = .13).</div></div><div><h3>Conclusions</h3><div>There was a significant increase in the number of osteopathic applicants and the match rate of osteopathic residents for orthopaedic sports medicine fellowships, whereas there was no statistically significant change in the number or match rate of allopathic residents. There was no difference in match rates between osteopathic and allopathic candidates nor was there a statistically significant difference in match rates between male and female applicants. However, the number of women applying to orthopaedic sports medicine fellowships remained slightly lower than the proportion of female residents over the study period.</div></div><div><h3>Clinical Relevance</h3><div>Understanding trends in gender and degree type among applicants to sports medicine fellowships, as well as their impact on match outcomes, may help identify potential disparities and inform strategies to promote equity and diversity in the sports medicine workforce.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101198"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934186","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":"ChatGPT-Generated Responses Across Orthopaedic Sports Medicine Surgery Vary in Accuracy, Quality, and Readability: A Systematic Review","authors":"Jacob D. Kodra B.S. ,&nbsp;Arthur Saroyan B.S. ,&nbsp;Fabrizio Darby B.S. ,&nbsp;Serkan Surucu M.D. ,&nbsp;Scott Fong B.A. ,&nbsp;Stephen Gillinov B.A. ,&nbsp;Kevin Girardi B.A. ,&nbsp;Rajiv Vasudevan M.D. ,&nbsp;Jeremy K. Ansah-Twum M.D. ,&nbsp;Louise Atadja M.D. ,&nbsp;Jay Moran M.D. ,&nbsp;Andrew E. Jimenez M.D.","doi":"10.1016/j.asmr.2025.101210","DOIUrl":"10.1016/j.asmr.2025.101210","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the current literature regarding the accuracy and efficacy of ChatGPT in delivering patient education on common orthopaedic sports medicine operations.</div></div><div><h3>Methods</h3><div>A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. After PROSPERO registration, a keyword search was conducted in the PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases in September 2024. Articles were included if they evaluated ChatGPT’s performance against established sources, examined ChatGPT’s ability to provide counseling related to orthopaedic sports medicine operations, and assessed ChatGPT’s quality of responses. Primary outcomes assessed were quality of written content (e.g., DISCERN score), readability (e.g., Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease Score), and reliability (<em>Journal of the American Medical Association</em> Benchmark Criteria).</div></div><div><h3>Results</h3><div>Seventeen articles satisfied the inclusion and exclusion criteria and formed the basis of this review. Four studies compared the effectiveness of ChatGPT and Google, and another study compared ChatGPT-3.5 with ChatGPT-4. ChatGPT provided moderate- to high-quality responses (mean DISCERN score, 41.0-62.1), with strong inter-rater reliability (0.72-0.91). Readability analyses showed that responses were written at a high school to college reading level (mean Flesch-Kincaid Grade Level, 10.3-16.0) and were generally difficult to read (mean Flesch-Kincaid Reading Ease Score, 28.1-48.0). ChatGPT frequently lacked source citations, resulting in a poor reliability score across all studies (mean <em>Journal of the American Medical Association</em> score, 0). Compared with Google, ChatGPT-4 generally provided higher-quality responses. ChatGPT also displayed limited source transparency unless specifically prompted for sources. ChatGPT-4 outperformed ChatGPT-3.5 in response quality (DISCERN score, 3.86 [95% confidence interval, 3.79-3.93] vs 3.46 [95% confidence interval, 3.40-3.54]; <em>P</em> = .01) and readability.</div></div><div><h3>Conclusions</h3><div>ChatGPT provides generally satisfactory responses to patient questions regarding orthopaedic sports medicine operations. However, its utility remains limited by challenges with source attribution, high reading complexity, and variability in accuracy.</div></div><div><h3>Level of Evidence</h3><div>Level V, systematic review of Level V studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101210"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934133","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 Magnetic Resonance Imaging–Based Clinical Prediction Model Accurately Identifies Patellar Instability Risk Using Common Patellofemoral Measurements","authors":"Varun Nukala B.S.,&nbsp;Alisha Sodhi B.A.,&nbsp;Isha Wadhavkar B.S.,&nbsp;Kartik Mangudi Varadarajan Ph.D.,&nbsp;Orhun Muratoglu Ph.D.,&nbsp;Alireza Borjali Ph.D.,&nbsp;Miho J. Tanaka M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101159","DOIUrl":"10.1016/j.asmr.2025.101159","url":null,"abstract":"<div><h3>Purpose</h3><div>To predict parameters associated with patellar instability from magnetic resonance imaging (MRI) measurements using a machine learning model and to quantify the relative importance of radiographic risk factors that are associated with the presence of instability.</div></div><div><h3>Methods</h3><div>Patients with a confirmed clinical diagnosis of patellar instability and age- and sex-matched controls without patellofemoral pathology were identified retrospectively. Multiple measurements to describe patella alta, malalignment, and trochlear dysplasia were performed on knee MRI scans. Univariate and multivariable logistic regressions were used to identify MRI measurements associated with patellar instability. Machine learning models were developed and evaluated for accuracy, discrimination, and calibration in predicting patellar instability. Shapley additive explanations (SHAP) were used to evaluate global and local variable importance.</div></div><div><h3>Results</h3><div>A total of 256 patients were included in this study (128 with patellar instability and 128 controls, 63% female sex). Multivariable logistic regression found significant associations between diagnosis of patellar instability and lower patellotrochlear index (OR, 1.39 [95% CI, 1.15-1.69]; <em>P</em> &lt; .001), greater Insall-Salvati ratio (OR, 1.65 [95% CI, 1.37-2.02]; <em>P</em> &lt; .001), greater tibial tubercle–trochlear groove (TT-TG) distance (OR, 1.12 [95% CI, 1.06-1.19]; <em>P</em> &lt; .001), and lower trochlear depth (OR, 1.42 [95% CI, 1.09-1.87]; <em>P</em> = .009). The random forest model had the highest performance among machine learning models, with an area under the receiver operating characteristic curve of 0.85. In this model, the variables with the greatest importance were Insall-Salvati ratio, TT-TG distance, and trochlear depth.</div></div><div><h3>Conclusions</h3><div>The final model was able to reliably predict MRI-based parameters associated with patellar instability. Insall-Salvati ratio, TT-TG distance, and trochlear depth were the most important risk factors both in the machine learning models and using conventional statistical analysis.</div></div><div><h3>Clinical Relevance</h3><div>This model has the potential to improve the diagnostic accuracy of patellar instability from MRI scans. The explanations provided by the model could enable clinicians to personalize care and understand the factors driving patellar instability in individual patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101159"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934134","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":"Current Techniques for Processing Osteochondral Allografts Are Variable: A Systematic Review","authors":"Michael J. Meade M.D. ,&nbsp;Kisan Patel B.S. ,&nbsp;Nicholas A. Sgaglione M.D.","doi":"10.1016/j.asmr.2025.101151","DOIUrl":"10.1016/j.asmr.2025.101151","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the current optimal processing and storage protocols for fresh cold-stored osteochondral allografts (OCAs) used for resurfacing osteochondral defects in the knee.</div></div><div><h3>Methods</h3><div>Using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, 3 databases (PubMed, Embase, and Scopus) were queried for peer-reviewed articles on OCA storage and processing techniques. Articles were excluded if performed on nonhuman subjects or were narrative or systematic reviews, meta-analyses, or other forms of secondary sources. In vivo data included study type, population size, follow-up time, type, site and location of injury, description of surgery, description of postoperative rehabilitation, and outcome criteria used. Ex vivo data collection included tissue source and type, storage procedure including temperature, media changes, gas environment, storage solution including type of solution and additive used, cell viability methodology, and outcomes methodology.</div></div><div><h3>Results</h3><div>In total, 386 studies were screened between the 3 databases, with 27 studies satisfying all criteria. Eight human studies were included, with mean Modified Coleman Methodology Score of 48.38 ± 5.73. In total, 397 total patients were included with a mean of 49.6 patients per study. Five of the 8 studies had follow-up greater than 24 months. Three articles were retrospective studies, 4 were case series, 1 was a prospective cohort. Four articles were Level III evidence, 4 articles were Level IV evidence. In addition, 19 ex vivo human studies were included. A total of 78.95% of studies included grafts stored at 4°C or 1 to 10°C, 31.58% investigated 37°C, and 21.05% investigated room temperature. In total, 19 different storage media were investigated, with 68.42% including various additives.</div></div><div><h3>Conclusions</h3><div>OCA storage at 4°C remains the most common temperature with the most evidence-based research. However, investigation of OCAs at 37°C and room temperature, particularly those stored with proprietary protocol such as the Missouri Osteochondral Preservation System, have shown promising results at improved maintenance of viable chondrocyte density. Variability in storage media remains without clear consensus.</div></div><div><h3>Clinical Relevance</h3><div>A variety of methodologies are used for OCAs, and the best strategies are not well understood. There is a need to compile the available evidence from in vivo and ex vivo studies of OCAs to resolve conflicts regarding various available methodologies and provide better understanding of current techniques.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101151"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934141","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":"No Differences in Graft Failure After Anterior Cruciate Ligament Reconstruction With Suture Tape Augmentation in Adolescents","authors":"Lisa Tamburini M.D. ,&nbsp;Adam P. Weaver P.T., D.P.T. ,&nbsp;Donna Pacicca M.D. ,&nbsp;Amirul Anuar M.S. ,&nbsp;J. Lee Pace M.D. ,&nbsp;Calista Sinclair Stevens B.S. ,&nbsp;Matthew Brown M.D. ,&nbsp;Allison Crepeau M.D.","doi":"10.1016/j.asmr.2025.101163","DOIUrl":"10.1016/j.asmr.2025.101163","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare outcomes of anterior cruciate ligament reconstruction (ACLR) with and without suture tape augmentation (STA) in adolescent patients.</div></div><div><h3>Methods</h3><div>Retrospective review of patients between 12 and 18 years of age who had ACLR with quadriceps tendon autograft between 2017 and 2022 with a minimum 2-year follow-up. Charts were reviewed for demographics and surgical data. Two groups were created: ACLR with STA (+STA) and ACLR without STA (–STA). Comparisons between continuous variables were performed using Student <em>t</em> tests or Mann-Whitney <em>U</em> tests. Comparisons between categorical variables were performed using χ² or Fisher exact test.</div></div><div><h3>Results</h3><div>In total, 110 patients were included in analysis. There was no significant difference in demographics between groups. There was a significant difference between the percentage of extra-articular procedures with 4% in the –STA group and 29% in the +STA group (<em>P</em> &lt; .001). No difference was seen in femoral tunnel size (<em>P</em> = .27), tibial tunnel size (<em>P</em> = .20), or concomitant meniscal repair or resection (<em>P</em> = .88) between groups. There was no significant difference in the number of anterior cruciate ligament graft failures (<em>P</em> = .61) or time to failure between groups (<em>P</em> = .62). There were 9 failures (13.2%) in the –STA group and 7 failures (16.6%) in the +STA group, with a median of time to failure of 698 days and 355 days in the –STA and +STA group, respectively. Of the patients, 19.1% in the –STA group and 31.0% in the +STA group underwent lysis of adhesions (<em>P</em> = .16).</div></div><div><h3>Conclusions</h3><div>In our study population of adolescents undergoing primary, unilateral ACLR with quadriceps tendon autograft, we found no difference in the number of graft failures or time to failure based on the use of suture tape augmentation. Additionally, we found no difference in arthrofibrosis rates between groups.</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 4","pages":"Article 101163"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933718","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":"YouTube Videos on Osteochondral Allograft Transplantation Lack Accuracy and Quality","authors":"Sebastian Schmidt M.D. ,&nbsp;Alexander Bumberger M.D. ,&nbsp;Luis Navas M.D. ,&nbsp;Chilan B.G. Leite M.D., Ph.D. ,&nbsp;Domenico Franco M.D. ,&nbsp;Ali Darwich M.D. ,&nbsp;Christian Lattermann M.D.","doi":"10.1016/j.asmr.2025.101156","DOIUrl":"10.1016/j.asmr.2025.101156","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the accuracy and informational quality of YouTube videos related to osteochondral allograft (OCA) transplantation as a potentially valuable educational resource for patients and health care professionals.</div></div><div><h3>Methods</h3><div>A systematic analysis of YouTube videos retrieved through a predefined search strategy using the key words “osteochondral allograft” was performed. Videos were categorized by content sources, such as health care professionals with and without commercial bias, individuals, or personal testimonials. The video’s duration, the publication date, and number of likes and views were recorded. To evaluate the accuracy, reliability and quality of video content, each video was assessed using the <em>Journal of the American Medical Association</em> (JAMA) benchmark criteria, Global Quality Score (GQS), DISCERN, and a newly developed Osteochondral Allograft Quality (OCA-QAL) score, designed specifically for this procedure.</div></div><div><h3>Results</h3><div>In total, 80 YouTube videos were included. Overall, the quality of OCA-related YouTube videos was low, with mean scores of 2.16 (JAMA), 2.28 (GQS), 32.58 (DISCERN), and 5.71 (OCA-QAL). Only one video was rated as “excellent” on OCA-QAL, and none achieved full points on JAMA or GQS. Video categories included educational content with (27.5%) or without (51.3%) commercial bias for health care professionals, content for nonhealth care individuals (13.8%), and testimonials (7.5%). Strong positive correlations emerged between OCA-QAL, GQS, and DISCERN scores, whereas views and likes did not predict quality.</div></div><div><h3>Conclusions</h3><div>YouTube videos on OCA transplantation generally do not meet the quality standards like peer-reviewed validation necessary for reliable patient education. Given the low quality of available content, health care providers should be cautious in recommending YouTube as a resource for OCA transplantation information and should guide patients to more rigorously reviewed resources.</div></div><div><h3>Clinical Relevance</h3><div>As cartilage procedures like OCA transplantation become more common, surgeons and patients lack reliable online resources. This study underscores the need for improved digital health content to ensure accurate and trustworthy patient education.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101156"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933918","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":"Preferences Including Graft Choice, Lateral Augmentation, and Rehabilitation After Anterior Cruciate Ligament Reconstruction Among National Football League Team Orthopaedic Surgeons","authors":"Sean Hazzard P.A., M.B.A. ,&nbsp;Blake Bacevich B.S. ,&nbsp;Mia Lustig B.S. ,&nbsp;Danielle Lonati B.A. ,&nbsp;Peter Asnis M.D.","doi":"10.1016/j.asmr.2025.101161","DOIUrl":"10.1016/j.asmr.2025.101161","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess current treatment preferences among National Football League (NFL) team orthopaedic knee surgeons for the management of anterior cruciate ligament (ACL) injuries.</div></div><div><h3>Methods</h3><div>NFL team physicians who are sports medicine knee surgeons were identified by using public databases and emailed a multiple-choice poll evaluating various preferences involving treating ACL injuries in various situations.</div></div><div><h3>Results</h3><div>Ninety-seven NFL team knee surgeons were identified, with 51 responding (53%). Respondent surgeons had 19.6 years of experience performing ACL surgery with 103.9 ACL reconstructions performed annually. Patella tendon was the favored graft in a 20-year-old running back, as well as the 25-year-old and 35-year-old recreational athlete. Quadriceps tendon became the second most favored graft in all situations. In total, 4% of surgeons said they would perform a primary repair of an ACL in the setting of a proximal tear in a 20-year-old running back, 96% said they would consider adding a lateral augmentation procedure in the primary ACLR setting but only if certain findings were obtained, 25% recommended outpatient physical therapy to supplement working with the team rehabilitation staff, whereas 76% did not recommend a brace for return to play.</div></div><div><h3>Conclusions</h3><div>Patella tendon autograft is the favored graft in ACL reconstruction among professional and recreational athletes by NFL team orthopaedic knee surgeons. Quadriceps tendon autograft is the second most preferred graft. Lateral augmentation procedures would be considered in a primary ACLR but only if certain findings are present. Most respondents do not recommend supplementing rehab with outpatient PT or using a brace for return to play.</div></div><div><h3>Clinical Relevance</h3><div>NFL team surgeons consider numerous factors when treating ACL injuries in professional athletes, including return to function, speed of recovery, and risk of reinjury, all of which directly impact the athlete’s ability to sustain a livelihood during a relatively short professional career. Insights gained from these surgical practices may inform and enhance treatment strategies across a broader patient population.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101161"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933919","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":"Postless Hip Arthroscopy in the Lateral Decubitus Position Is Safe and Associated With Low Rates of Traction-Related Complications","authors":"Jacob D. Kodra B.S. ,&nbsp;Robert Healey M.B.A. ,&nbsp;Kaleb Keener B.S. ,&nbsp;Christopher Papatheofanis D.O. ,&nbsp;Michael P. Muldoon M.D.","doi":"10.1016/j.asmr.2025.101205","DOIUrl":"10.1016/j.asmr.2025.101205","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the incidence of traction-related complications in the early postoperative period after postless hip arthroscopy with patients in the lateral decubitus position.</div></div><div><h3>Methods</h3><div>This retrospective study included patients undergoing hip arthroscopy by a single fellowship-trained orthopaedic surgeon from January 2019 to June 2022. Patients were included if they underwent unilateral labral repair, femoroplasty, and/or acetabuloplasty within the study period; attended all 3 postoperative visits over a period of 12 weeks; and were treated with the described surgical technique. Patients who underwent concomitant periacetabular or femoral osteotomy were excluded. Intraoperative traction force, duration, and adequacy were recorded. Postoperative complications and neuropathic symptoms were queried at postoperative visits up to 12 weeks after hip arthroscopy. Data were analyzed using <em>t</em> tests, with the level of significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>A total of 242 patients (151 females and 91 males) aged 17 to 70 years were included. The mean traction force was 66.74 ± 20.62 pounds-force (lbf), with a mean traction duration of 62.73 ± 19.35 minutes. Neuropathic symptoms occurred in only 7 patients (2.89%), with 42.86% resolving within 3 months. Compared to male patients, female patients required significantly less traction force (56.67 ± 12.17 lbf vs 83.63 ± 21.37 lbf, <em>P</em> &lt; .001) and traction time (59.54 ± 17.41 minutes vs 67.93 ± 21.25 minutes, <em>P</em> = .0015). The postoperative symptom incidence was higher in male patients (6.59%) than female patients (0.66%, <em>P</em> = .012).</div></div><div><h3>Conclusions</h3><div>Postless hip arthroscopy performed in the lateral decubitus position shows low rates of traction-related neuropathic complications.</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 4","pages":"Article 101205"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933984","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":"Proper Patient Selection and Choosing the Right Treatment: The Recipe for Good Clinical Outcomes","authors":"Paul D. Gaschen M.D.,&nbsp;Matthew J. Kraeutler M.D.","doi":"10.1016/j.asmr.2025.101196","DOIUrl":"10.1016/j.asmr.2025.101196","url":null,"abstract":"<div><div>Ensuring good clinical outcomes in orthopaedic surgery requires a structured, evidence-based approach to decision making. We suggest that the formula for ensuring these results involves 2 key components: proper patient selection and choosing the appropriate intervention. Proper patient selection involves identifying individuals with the greatest likelihood of success when considering known risk factors for poor outcomes. Choosing the appropriate intervention requires taking into account all patient factors and aligning patient-specific needs with established treatment indications. Surgeons are advised to avoid pitfalls such as choosing to operate on all-comers or expanding surgical indications beyond evidence-based thresholds. By integrating these 2 components, surgeons can enhance their decision-making process and maximize patient success.</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 4","pages":"Article 101196"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934128","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":"Soaking in Povidone-Iodine, Chlorhexidine, Teicoplanin, Vancomycin, and Saline Solution Differentially Alters Porcine Flexor Tendon Size and Biomechanical Properties","authors":"Kaan Gurbuz M.D. ,&nbsp;Yukun Zhang Ph.D. ,&nbsp;Logan Opperman Ph.D. ,&nbsp;Matthew B. Fisher Ph.D.","doi":"10.1016/j.asmr.2025.101168","DOIUrl":"10.1016/j.asmr.2025.101168","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the impact of povidone-iodine, chlorhexidine, vancomycin, and teicoplanin on the size and biomechanical properties of porcine flexor tendon grafts.</div></div><div><h3>Methods</h3><div>Porcine deep digital flexor tendons (N = 120) were collected in pairs and allocated into povidone-iodine, chlorhexidine, vancomycin, teicoplanin, and saline solution groups (12 pairs per solution). The tendons from one side underwent a 30-minute soaking in these solutions, whereas those from the other side were wrapped in saline solution–soaked gauze. Tendon cross-sectional area (CSA) was measured before and after soaking, along with unsoaked controls. Tensile testing to failure was performed. Stiffness, load at failure, modulus, and stress at failure were calculated.</div></div><div><h3>Results</h3><div>Soaking in povidone-iodine and chlorhexidine decreased the average CSA by 8% (–0.9 mm² [95% confidence interval (CI), –1.7 to –0.2 mm²], <em>P</em> = .02) and 13% (–1.1 mm² [95% CI, –1.5 to –0.7 mm²], <em>P</em> &lt; .001), respectively. Conversely, the average CSA increased by 12% after soaking in teicoplanin (1.0 mm² [95% CI, 0.7 to 1.3 mm²], <em>P</em> &lt; .001) and by 6% after soaking in vancomycin (0.7 mm² [95% CI, 0.2 to 1.2 mm²], <em>P</em> = .01), similar to saline solution (11% increase; 0.8 mm² [95% CI, 0.4 to 1.1 mm²], <em>P</em> &lt; .001). The stiffness of tendons soaked in chlorhexidine was 8% lower than that of unsoaked contralateral controls (–13.3 N/mm [95% CI, –31.0 to –6.9 N/mm], <em>P</em> = .01), but stress at failure increased by 15% (8.9 MPa [95% CI, 0.6 to 17.2 MPa], <em>P</em> = .04). We observed no significant difference in tensile properties due to soaking in other solutions.</div></div><div><h3>Conclusions</h3><div>Soaking porcine flexor tendons in povidone-iodine and chlorhexidine resulted in a decrease in CSA, whereas soaking in vancomycin and teicoplanin led to an increase, similar to saline solution. No significant side-to-side differences in average CSA were observed. Soaking in chlorhexidine decreased stiffness but increased stress at failure. None of the solutions affected load at failure.</div></div><div><h3>Clinical Relevance</h3><div>It is important to understand the impact of soaking porcine flexor tendon grafts in various antimicrobial solutions to ensure that there are no harmful biomechanical effects to the tissues used in the clinical setting.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 4","pages":"Article 101168"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932475","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}