Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"iPhone-Based Cartilage Topography Scanning Yields Similar Results to Computed Tomography Scanning","authors":"","doi":"10.1016/j.asmr.2024.100936","DOIUrl":"10.1016/j.asmr.2024.100936","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the feasibility and accuracy of 3-dimensional (3D) iPhone scans using commercially available applications compared with computed tomography (CT) for mapping chondral surface topography of the knee.</p></div><div><h3>Methods</h3><p>Ten cadaveric dysplastic trochleae, 16 patellae, and 24 distal femoral condyles (DFCs) underwent CT scans and 3D scans using 3 separate optical scanning applications on an iPhone X. The 3D surface models were compared by measuring surface-to-surface least distance distribution of overlapped models using a validated 3D-3D registration volume merge method. The absolute least mean square distances for the iPhone-generated models from each scanning application were calculated in comparison to CT models using a point-to-surface distance algorithm allowing regional “inside/outside” measurement of the absolute distance between models.</p></div><div><h3>Results</h3><p>Only 1 of the 3 scanning applications created models usable for quantitative analysis. Overall, there was a median absolute least mean square distance between the usable model and CT-generated models of 0.18 mm. The trochlea group had a significantly lower median absolute least mean square distance compared with the DFC group (0.14 mm [interquartile range, 0.13-0.17] vs 0.19 mm [0.17-0.25], <em>P</em> = .002). iPhone models were smaller compared with CT models (negative signed distances) for all trochleae, 83% of DFCs, and 69% of patellae.</p></div><div><h3>Conclusions</h3><p>In this study, we found minimal differences between a 3D iPhone scanning application and conventional CT scanning when analyzing surface topography.</p></div><div><h3>Clinical Relevance</h3><p>Emerging 3D iPhone scanning technology can create accurate, inexpensive, real-time 3D models of the intended target. Surface topography evaluation may be useful in graft selection during surgical procedures such as osteochondral allograft transplantation.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000543/pdfft?md5=c531a008b0acbdc81e33eae80475e259&pid=1-s2.0-S2666061X24000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bursal Tissue Harvested During Rotator Cuff Repair Contains Viable Mesenchymal Stem Cells","authors":"","doi":"10.1016/j.asmr.2024.100947","DOIUrl":"10.1016/j.asmr.2024.100947","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the effect of intraoperative ablation on the viability, distribution, phenotype, and potential for culture expansion of bursal cells harvested during arthroscopic rotator cuff surgery.</p></div><div><h3>Methods</h3><p>Tissue was collected during primary arthroscopic rotator cuff repair on 6 healthy, randomly selected patients from a fellowship-trained surgeon’s practice between September 2020 and January 2021. There were 3 women (aged 60 ± 8 years) and 3 men (aged 61 ± 10 years). At the time of surgery, subacromial bursal tissue was subjected to no ablation, 1 second of ablation, or 3 seconds of ablation. Tissues were collected by an autograft harvesting system connected to an arthroscopic shaver and a pituitary grasper. Tissue fragments from each condition were sampled for viability testing or cell isolation. A viability kit with confocal microscopy was used to assess live and dead cells. Cell isolation consisted of collagenase digestion or placing tissue fragments onto tissue culture–treated plates that induced migration of cells out of the tissue. Cell proliferation rates were monitored and surface markers for mesenchymal stem cells (MSC) and pericytes were analyzed via multicolor flow cytometry.</p></div><div><h3>Results</h3><p>Increased ablation time significantly reduced cell viability. The mean percentage of live cells was 55.2% ± 27.2% (range, 26%-90% live) in the control group, 46.8% ± 23.8% (range, 9.6%-69.6%, <em>P</em> = .045) in the short-ablation group, and 35.5% ± 19% (range, 11%-54%, <em>P</em> = .03) in the long-ablation group. No significant differences in population doubling level (1.6 ± 0.5 days) and population doubling time (6.7 ± 2.4 days) were observed in cells from any treatment. The surface marker profile indicated an MSC phenotype with absence of a pericyte population. Ablation or cell isolation procedure had no significant effect on the surface marker profile of isolated cells.</p></div><div><h3>Conclusions</h3><p>Radiofrequency ablation significantly reduced the overall tissue viability but had no significant effect on cell proliferation or expression of surface markers on isolated subacromial bursal cells harvested arthroscopically.</p></div><div><h3>Clinical Relevance</h3><p>Analysis of the viability and performance of cells harvested after the use of ablation devices using mechanical surgical collection during rotator cuff repair surgery could further our understanding of subacromial bursal tissue and its potential role in augmenting rotator cuff repair healing.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000658/pdfft?md5=9d38deec67884cde2974b732a2d29a15&pid=1-s2.0-S2666061X24000658-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Measurements Predict Knee Chondral Lesion Size More Accurately Than Magnetic Resonance Imaging, and Mechanism of Injury Influences Ability of Either Technique to Predict Graft Size","authors":"","doi":"10.1016/j.asmr.2024.100951","DOIUrl":"10.1016/j.asmr.2024.100951","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare osteochondral defect size measurements and characteristics across magnetic resonance imaging (MRI) and arthroscopy and at the time of osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI).</p></div><div><h3>Methods</h3><p>Patients who underwent ACI and OCA transplantation at a single institution between 2015 and 2019 were retrospectively identified. Patients were excluded if they had severe osteoarthritis, MRI scans were not available for review, surgical records did not include defect sizing necessary for analysis, or operative reports were not available. Osteochondral lesion characteristics including size were collected preoperatively by MRI and arthroscopy and at the time of definitive open surgical intervention. Subgroup analysis was performed comparing measurement techniques depending on the corrective surgical approach used, as well as depending on the mechanism of chondral injury, to determine whether these factors had any effect on the ability of arthroscopy or MRI to predict graft size.</p></div><div><h3>Results</h3><p>Overall, 136 chondral lesions were addressed, with restoration procedures in 117 patients (mean age, 32.5 years). The average difference between the final graft size and the lesion area measured with index arthroscopy was 116 mm², whereas the average difference between the final graft size and the lesion size measured with preoperative MRI was 182 mm² (<em>P</em> &lt; .001). Depending on surgical technique, measurements with MRI were more similar to the final graft size when a patient underwent OCA transplantation versus ACI (<em>P</em> = .007). Depending on the mechanism of injury, MRI measurements of lesions were closer to the graft area when lesions resulted from trauma (<em>P</em> = .047).</p></div><div><h3>Conclusions</h3><p>Chondral lesion size as determined by preoperative MRI is less accurate than arthroscopic measurement. The mechanism of injury leading to chondral damage and degree of damage may influence the ability of MRI and arthroscopy to accurately measure chondral lesions and predict the final graft size used in surgical correction.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000695/pdfft?md5=f09da9449e807ba0037c326b87c5bf28&pid=1-s2.0-S2666061X24000695-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Football League Quarterbacks With Ulnar Collateral Ligament Injuries Have High Return-to-Play Rates, but Older Players Have Inferior Postinjury Performance","authors":"","doi":"10.1016/j.asmr.2024.100954","DOIUrl":"10.1016/j.asmr.2024.100954","url":null,"abstract":"<div><h3>Purpose</h3><p>To characterize the epidemiology, mechanism (contact vs noncontact), management, and return-to-play (RTP) times for quarterbacks in the National Football League (NFL) who experienced ulnar collateral ligament (UCL) injuries.</p></div><div><h3>Methods</h3><p>Using the Pro Sports Transactions Archive, NFL quarterbacks who sustained UCL injuries between 1991 and 2023 were identified. Age at time of injury, mechanism of injury (contact vs noncontact), management strategy, and RTP time were recorded. In addition, player performance metrics including games played, quarterback rating, completion percentage, touchdowns, and interceptions were examined for the season before injury through the second season after injury. Player performance analysis was assessed using principal component analysis, which is a dimensionality reduction statistical method that compresses the several performance metrics into a single value, the first principal component.</p></div><div><h3>Results</h3><p>A total of 21 injuries in 20 players were identified. The mean age of quarterbacks at time of injury was 28.7 years (± 4.6 years standard deviation). Ten injuries occurred during contact with another player, and 11 injuries were noncontact. Most (n = 13) of UCL injuries were managed nonoperatively. Sixteen players achieved RTP, 4 of whom underwent repair or reconstruction (UCLR). Overall, the mean RTP time was 165.6 days (± 178.8 days standard deviation), but players who underwent UCLR had a longer average RTP time (359.0 days vs 98.25 days, <em>P</em> = .014). Injuries sustained after 2006 were associated with improved postinjury performance (<em>P</em> = .041), but older age at time of injury was associated with diminished postinjury performance (<em>P</em> = .048).</p></div><div><h3>Conclusions</h3><p>NFL quarterbacks sustain more noncontact UCL injuries and are undergoing UCLR at greater rates than previously reported. Although RTP rates are high and players demonstrate improved postinjury performance for injuries sustained after 2006, older age at the time of injury is associated with worse postinjury performance.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000725/pdfft?md5=afaa251df568556280eff3f159123f1d&pid=1-s2.0-S2666061X24000725-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Athletes With Partial Extensor Mechanism Tears of the Knee Achieve Variable Return-to-Sport Rates Following Operative Versus Nonoperative Management: A Systematic Review","authors":"","doi":"10.1016/j.asmr.2024.100944","DOIUrl":"10.1016/j.asmr.2024.100944","url":null,"abstract":"<div><h3>Purpose</h3><p>(1) To systematically review treatments for partial extensor mechanism tendon tears in professional and amateur athletes and (2) to report outcomes for patients undergoing operative versus nonoperative management.</p></div><div><h3>Methods</h3><p>PubMed, Cochrane, Scopus, Google Scholar, and Web of Science were queried in August 2023 using the following Boolean search: (quadriceps OR patella) AND (partial) AND (tear). Articles were included if they reported outcomes of operative or nonoperative management of partial extensor mechanism tears of the knee in athletes. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. Each study was queried for demographics, tendon injured, sport and level of athlete, prior treatments, final treatment modality, and return to sport (RTS) outcomes of that treatment. A qualitative subanalysis was performed for professional athletes.</p></div><div><h3>Results</h3><p>Ten studies met inclusion criteria and included 191 partial patellar or quadriceps tendon tears. Of the patients, 81.6% were male and 18.4% were female, with average age ranging from 21 to 28 years; 97% of patients underwent initial nonoperative management. Ultimately, 111 patients (58.1%) were maintained on nonoperative management, and 80 (41.9%) progressed to surgery. Of surgeries, 39 (48.8%) were tendon debridements, 36 (45.0%) were repairs, and 5 (6.3%) were not specified. RTS rates ranged from 33% to 93% after surgery and 70% to 89% following conservative management. Of professional athletes, 23 (33%) underwent surgery, and 46 (67%) underwent ultimate conservative management. RTS rates ranged from 33% to 67% after surgery and were 89% for the applicable study of conservative management.</p></div><div><h3>Conclusions</h3><p>Nearly all patients with partial extensor mechanism tears underwent initial nonoperative management. RTS rates were high but somewhat variable among both patients treated with final nonoperative versus surgical management. Even among professional athletes, most injuries were treated with initial nonoperative management and did not progress to surgery.</p></div><div><h3>Level of Evidence</h3><p>Level V, systematic review of Level IV and V studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000622/pdfft?md5=61a12bfb053a84aac203e15f9df0ff1b&pid=1-s2.0-S2666061X24000622-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Patients Who Underwent Elbow Arthroscopy Had an 86% Return-to-Sport Rate, a 12% Reoperation Rate, and a 3.7% Complication Rate","authors":"","doi":"10.1016/j.asmr.2024.100952","DOIUrl":"10.1016/j.asmr.2024.100952","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the applicability and safety of elbow arthroscopy in the pediatric population at our institution by analyzing the indications and complications in a large pediatric patient series.</p></div><div><h3>Methods</h3><p>We retrospectively identified all patients who underwent elbow arthroscopy at age 18 years or younger from 2006 to 2017 performed by a single fellowship-trained surgeon. The exclusion criteria were follow-up shorter than 8 weeks and open surgical procedures (not fully arthroscopic). Medical records were reviewed for baseline characteristics, indications for elbow arthroscopy, range of motion, complications, and reoperations.</p></div><div><h3>Results</h3><p>In total, 191 patients (64 boys and 127 girls) were included, with a median age of 15.5 years (interquartile range, 14.0-16.7 years). Indications for arthroscopic surgery were grouped into treatment of osteochondritis dissecans (60%), debridement for bony or soft-tissue pathology (35%), contracture release (3%), and diagnostic arthroscopy (3%). The complication rate was 3.7%, including 4 minor complications (3 superficial wound problems and 1 case of transient ulnar neuropathy) and 3 major complications (1 case of manipulation under anesthesia for stiffness, 1 deep infection, and 1 [unplanned] reoperation for persistent locking within 1 year of the index procedure). Subsequent surgery was required in 23 patients (12%) because of newly developed, persisting or recurring elbow problems. Of the patients, 86% were able to return to sports.</p></div><div><h3>Conclusions</h3><p>Pediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique for a wide variety of elbow conditions has an acceptable complication rate that is similar to rates in the previously published literature on elbow arthroscopy in the pediatric and adult populations; however, a significant proportion of patients needed subsequent surgery in the following years.</p></div><div><h3>Level of Evidence</h3><p>Level IV, therapeutic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000701/pdfft?md5=73c485b38dc0e429c29dbf0261414713&pid=1-s2.0-S2666061X24000701-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dynamic, Self-Tensioning Suture Contracts in Saline to Counteract Changes in Loop Length From Cyclic Loading","authors":"","doi":"10.1016/j.asmr.2023.100872","DOIUrl":"10.1016/j.asmr.2023.100872","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the biomechanical performance of a suture with proposed dynamic self-tensioning properties with that of commonly used high-tensile sutures by evaluating suture loop length changes, responses to cyclic loading, and failure testing with intermittent saline soaks.</p></div><div><h3>Methods</h3><p>Six knots each of 4 different sutures were studied: 3 high-tensile sutures (ORTHOCORD, FiberWire, and ETHIBOND), and a dynamically self-tensioning suture (DYNACORD). After we measured loop length, knots were soaked in 37°C saline for 24 hours. Loop lengths were remeasured and tensile testing was performed. Cyclic elongation, first-cycle excursion, and elongation amplitude were recorded. Knots were then resoaked and retested. Finally, knots were pulled to failure, and peak load and stiffness were measured. Values were compared using nonparametric statistical tests.</p></div><div><h3>Results</h3><p>DYNACORD loop length decreased by 27% after the first soak (<em>P</em> = .002), whereas the other sutures demonstrated no length change (<em>P</em> &gt; .05). Although DYNACORD loop length increased during cyclic load testing (<em>P</em> = .009), it was still significantly reduced after the second saline soak compared with its initial length (<em>P</em> = .002), whereas all other suture loops had elongated. ETHIBOND (<em>P</em> = .004) and ORTHOCORD (<em>P</em> = .002) had significantly less cyclic elongation from cycle I to cycle II testing compared with the other sutures. ETHIBOND had the lowest peak load at failure (<em>P</em> = .002). FiberWire had the greatest stiffness (<em>P</em> = .006).</p></div><div><h3>Conclusions</h3><p>Compared with other suture types, the self-tensioning suture showed dynamic properties, demonstrating a decrease in loop length when soaked in a saline bath. This length was maintained after a second soak despite increased loop length during interval cyclic loading.</p></div><div><h3>Clinical Relevance</h3><p>Knot and loop security are of paramount importance to arthroscopic soft-tissue procedures. The ability for a suture to self-tension has implications for how it may interact with tissues in vivo to increase construct stability after arthroscopic soft tissue repair procedures.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23002237/pdfft?md5=e4e2f2518808b2581a937127070c47e9&pid=1-s2.0-S2666061X23002237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commercially Available Guides Overestimate Socket Length During Anterior and Posterior Cruciate Ligament Socket Retrograde Drilling","authors":"","doi":"10.1016/j.asmr.2024.100913","DOIUrl":"10.1016/j.asmr.2024.100913","url":null,"abstract":"<div><h3>Purpose</h3><p>To objectively assess the accuracy of socket measurements taken during cruciate ligament reconstruction using a retrograde reaming technique.</p></div><div><h3>Methods</h3><p>Six complete knee sawbone specimens were used to ream anterior and posterior cruciate ligament sockets in the femur and tibia in a retrograde fashion using a standard retrograde reaming device. The longest and shortest sides of the sockets were measured using a ruler. One-sided Wilcoxon signed-rank sum tests were used to evaluate whether the actual measured socket length matched the estimated length set on the drill guide.</p></div><div><h3>Results</h3><p>One fellowship-trained surgeon reamed 24 total sockets in sawbone specimens using guides. Statistical analysis revealed a significant difference between the estimated measurement and the actual shortest tunnel length in each of the sockets. The median short side socket lengths were shorter than their respective intended depths by 4 mm for the femoral anterior cruciate ligament socket, 6 mm for the femoral posterior cruciate ligament socket, 6 mm for the tibial anterior cruciate ligament socket, and 4.5 mm for the tibial posterior cruciate ligament socket. All differences were significant at α = 0.05.</p></div><div><h3>Conclusions</h3><p>The estimated cruciate socket lengths reamed during ligament reconstruction using a retrograde reamer and standard intra-articular measuring instrumentation were greater than the actual measured socket lengths.</p></div><div><h3>Clinical Relevance</h3><p>Successful cruciate ligament reconstruction relies on accurate socket measurements. This study examined the accuracy of commercially available cruciate ligament socket drill guides and the implications for clinical practice, to include graft-tunnel mismatch and surface area available for healing. Surgeons may consider reaming slightly longer than estimated sockets when performing all-inside cruciate ligament reconstructions to ensure appropriate socket depth for graft fixation.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000312/pdfft?md5=5de08460b433d2510bc1a6a2ef16257e&pid=1-s2.0-S2666061X24000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meniscal Comma Sign Responds to Partial Meniscectomy Despite Increased Levels of Arthritis","authors":"","doi":"10.1016/j.asmr.2024.100935","DOIUrl":"10.1016/j.asmr.2024.100935","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the outcomes of patients undergoing partial meniscectomy preoperatively identified with the “meniscal comma sign” with those undergoing meniscectomy with other tear patterns.</p></div><div><h3>Methods</h3><p>Patients with meniscal “comma sign,” as indicated by a query of magnetic resonance imaging reports, were screened using the search terms “meniscotibial recess,” “meniscus perched over the medial tibial margin,” or other search terms by radiologists between January 2008 and November 2019. Patients were matched and chart review was done for demographics, revision surgery, and progression to total knee arthroplasty. Radiographs were used for osteoarthritis grading using the Kellgren-Lawrence (KL) scoring system. Preoperative and postoperative International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Lysholm, and Short Form 12-item Survey scores were collected.</p></div><div><h3>Results</h3><p>A total of 406 patients met inclusion (comma sign = 197; control group = 209). The control group had an increased duration of symptoms at the initial visit (<em>P</em> = .001). More patients with the meniscal comma sign received corticosteroid knee injections before surgery (<em>P</em> = .011), and they also had greater mean KL scores (<em>P</em> = .001) as well as greater KL categorical scores (<em>P</em> = .002), indicating more advanced levels or arthritis. There were no differences in those receiving physical therapy (PT) before surgery (<em>P</em> = .966) or those receiving injections or PT after surgery (<em>P</em> = .631, <em>P</em> = .37, respectively). International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Lysholm, and Short Form 12-Item Survey Physical scores improved preoperatively to postoperatively in both groups (<em>P</em> &lt; .05), and there was no difference between the case and control group (<em>P</em> &gt; .05). No significant difference was found in revisions or progression to total knee arthroplasty between cohorts. (<em>P</em> = .676 and <em>P</em> = .424).</p></div><div><h3>Conclusions</h3><p>Patients presenting with preoperative findings of meniscal comma sign fare similarly to those that do not. Patients with this meniscal injury tend to have more advanced grading of osteoarthritic changes in the knee at presentation and seek care earlier than those without. Arthroscopic meniscectomy is a good treatment option for patients with a meniscal fragment in the meniscotibial recess and shows outcomes comparable with those with other tear patterns.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000531/pdfft?md5=8c076bba94cbe076791c36cbfa51b64e&pid=1-s2.0-S2666061X24000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Body Mass Index Is Associated With Rotator Cuff Disease: A Systematic Review and Meta-analysis","authors":"","doi":"10.1016/j.asmr.2024.100953","DOIUrl":"10.1016/j.asmr.2024.100953","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the literature regarding obesity, body mass index (BMI), and rotator cuff disease (RCD).</p></div><div><h3>Methods</h3><p>In this Systematic Review and Meta-analysis, we queried PubMed, Embase, Cochrane, Cumulative Index to Nursing &amp; Allied Health, and Science Direct using key words (August 25, 2023). Analytic observational studies (cohort, case-control, and cross-sectional studies) with more than 30 participants per comparison group, evaluating the association between obesity and rotator cuff pathology, were eligible for inclusion. Meta-analysis was performed to quantitatively summarize associations between BMI and RCD to report odds ratios and corresponding 95% confidence intervals (CIs) for regression-based models and BMI mean differences between cases and controls. Risk Of Bias In Non-randomised Studies – of Interventions tool was used to evaluate risk of bias across all studies in the systematic review.</p></div><div><h3>Results</h3><p>After full-text review of 248 articles, 27 presented data on obesity and RCD, and 17 qualified for meta-analysis. Individuals with RCD were 1.21 times (95% CI 1.10-1.34) as likely to have overweight and 1.44 times (95% CI 1.32-1.59) as likely to have obesity compared with those without RCD. Each 5-unit increase in BMI was associated with 35% greater odds of having rotator cuff tear (95% CI 1.06-1.71). In-depth assessment for risk of bias shows quality of studies varies greatly and highlights outcome heterogeneity, lack of temporality, confounding and selection bias as major concerns for individual studies.</p></div><div><h3>Conclusions</h3><p>In this study, we found a positive association between elevated BMI and RCD.</p></div><div><h3>Level of Evidence</h3><p>Level III, systematic review and meta-analysis of Level II-III studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000713/pdfft?md5=50e77e4ae54ad09170b10f1c60ec4a8c&pid=1-s2.0-S2666061X24000713-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}