Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Sleep Quality and Cognitive Skills Impact Neurocognitive Function and Reduce Sports-Related Injury Risk","authors":"Brett Haskell Ph.D., C.M.P.C. ,&nbsp;Abigail Eiler L.M.S.W., M.S.W. ,&nbsp;Haven Essien L.L.M.S.W., M.S.W.","doi":"10.1016/j.asmr.2025.101077","DOIUrl":"10.1016/j.asmr.2025.101077","url":null,"abstract":"<div><div>Injury prevention in sports is critically influenced by cognitive factors, particularly sleep quality and cognitive skills. Research has underscored the role of cognitive processes in injury risk and recovery, highlighting that inadequate sleep and poor cognitive functioning can significantly elevate injury susceptibility. Despite the well-documented benefits of adequate sleep and cognitive training in mitigating injury risk, access to sports psychology expertise is limited among athletes and health care providers. This work reviews the literature on the effectiveness of cognitive skills and sleep training in reducing sports-related injuries. Sleep affects musculoskeletal recovery, cognitive function, and immune response, which may further exacerbate injury risk. Neurobiological processes during sleep are crucial for muscle repair, cognitive function, and immune efficiency, all of which are integral to reducing the injury risk in athletes. Environmental factors such as travel schedules, training intensity, and competitive pressures disrupt sleep and increase the risk of injury. Cognitive Behavioral Therapy for Insomnia has shown promise in addressing sleep disturbances by improving sleep habits and addressing cognitive distress related to sleep. In addition, cognitive skills training, including mental skills training and mindfulness, enhances perceptual awareness, decision making, and reaction times, potentially reducing injury incidence by improving cognitive and motor function. Evidence supports the pivotal role of sleep and cognitive skills in preventing sports injuries. Interventions like Cognitive Behavioral Therapy for Insomnia and mental skills training can effectively address these factors, suggesting that integrating these approaches into athlete training programs could significantly enhance injury prevention strategies.</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 101077"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845168","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":"Academic Productivity at Orthopaedic Surgery Sports Medicine Fellowship Programs in the United States Has a Weak Positive Correlation With Nonresearch Lifetime Industry Earnings","authors":"Benjamin Miltenberg M.D. ,&nbsp;William L. Johns M.D. ,&nbsp;Anthony N. Baumann D.P.T. ,&nbsp;Faheem Pottayil M.S. ,&nbsp;Bradley Richey M.D. ,&nbsp;Albert T. Anastasio M.D. ,&nbsp;Kempland C. Walley M.D. ,&nbsp;Christopher C. Dodson M.D. ,&nbsp;Sommer Hammoud M.D.","doi":"10.1016/j.asmr.2024.101042","DOIUrl":"10.1016/j.asmr.2024.101042","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize the relationship between academic productivity, as defined by the h-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships.</div></div><div><h3>Methods</h3><div>The American Orthopaedic Society for Sports Medicine fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total nonresearch lifetime earnings were obtained from the Centers for Medicare &amp; Medicaid Services website. Academic productivity of each fellowship faculty was assessed via the h-index. Frequency counts and other descriptive statistic measures were used to describe the data for this study. Correlation was performed for continuous data using Spearman’s ρ.</div></div><div><h3>Results</h3><div>Ninety orthopaedic surgery sports medicine fellowships were identified with a combined total of 574 orthopaedic surgery sports medicine fellowship faculty. There was a weak positive correlation between individual physician h-index and individual physician lifetime earnings at orthopaedic surgery sports medicine fellowships (<em>P</em> &lt; .001; Spearman’s ρ = 0.329). There was a statistically significant difference between individual faculty h-index by quartile and individual faculty lifetime earnings (test statistic: 47.3; <em>P</em> &lt; .001). There was no significant regional difference in payments, but there is remarkable heterogeneity in the distribution of payments to individual physicians, with the top 10% of physicians receiving over 80% of industry dollars.</div></div><div><h3>Conclusions</h3><div>There is a positive correlation between academic productivity and industry payments at both the individual and institutional levels in orthopaedic sports medicine departments, although this relationship was greater at the fellowship level. Furthermore, the majority of nonresearch industry funding goes to a minority of physicians.</div></div><div><h3>Clinical Relevance</h3><div>Evaluating the impact that nonresearch industry payments have on a sports medicine orthopaedic surgeon’s research productivity can offer valuable insights into the relationship between industry compensation and scholarly output in this field.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101042"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845092","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":"Thermal Modalities Including Hot Baths and Cold Plunges Play a Unique Role in Injury Prevention and Recovery","authors":"Kiera L. Vrindten M.B.S. ,&nbsp;Danielle P. Lonati B.A. ,&nbsp;Jillian L. Mazzocca B.A. ,&nbsp;Elizabeth G. Matzkin M.D.","doi":"10.1016/j.asmr.2025.101143","DOIUrl":"10.1016/j.asmr.2025.101143","url":null,"abstract":"<div><div>There are several different modalities for injury prevention to consider in order to help our patients’ reach their ultimate goals. The purpose of this review is to analyze the use of hot and cold therapies to prevent injury. Thermotherapy has been used in clinical rehabilitation settings to treat health conditions. The therapeutic use of cold, known as cryotherapy, is historically the most popular treatment for acute musculoskeletal injury or fatigue. Cold therapy was seen to decrease delayed-onset muscle soreness and help resolve global or generalized muscle injury or fatigue. In sum, both cold and hot therapy play similar but unique roles in injury prevention and recovery. The key to effective use of either depends on understanding the nature of the injury and mastering the appropriate timing of therapeutic application. By leveraging the unique mechanisms of each modality, athletes can optimize their recovery process and reduce the risk of future injury.</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 101143"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845167","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":"Early Surgical Intervention Results in Better Patient-Reported Outcomes Than Delayed Treatment in Patients Undergoing Anterior Cruciate Ligament Reconstruction in the Presence of Concomitant Medial Collateral Ligament Injury","authors":"Blake M. Bacevich B.S. ,&nbsp;Sean Hazzard P.A., M.B.A. ,&nbsp;Mia Lustig B.S. ,&nbsp;Saoirse Connelly B.S. ,&nbsp;Varun Nukala B.S. ,&nbsp;Peter Asnis M.D.","doi":"10.1016/j.asmr.2024.101038","DOIUrl":"10.1016/j.asmr.2024.101038","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the influence of the timing of anterior cruciate ligament (ACL) reconstruction (ACLR) on patient-reported outcomes, comparing patients with and without concomitant medial collateral ligament (MCL) injury.</div></div><div><h3>Methods</h3><div>This study included patients who underwent ACLR between September 2015 and October 2020. The inclusion criteria included patients for whom preoperative and postoperative patient-reported outcome measures were available and a follow-up period of at least 2 years. Patients who sustained grade 2 or 3 MCL injuries with ACL tears were compared with patients with no MCL injuries as a control. All patients underwent ACLR with either bone-tendon-bone autograft or bone-tendon-bone allograft. Patient-reported outcomes (International Knee Documentation Committee [IKDC] score, Lysholm score, and Knee Injury and Osteoarthritis Outcome Score [KOOS]) were recorded, and outcomes were analyzed by sex and time from index injury. A stratified linear mixed-effects regression analysis was conducted.</div></div><div><h3>Results</h3><div>A total of 253 eligible patients with 2-year outcomes were enrolled. Patients with combined ACL-MCL injuries had lower IKDC scores (β = –6.1 vs β = –8.3, <em>P</em> = .003), KOOS Quality of Life values (β = –9.3 vs β = –11, <em>P</em> = .004), and KOOS Sport values (β = –12 vs β = –13, <em>P</em> = .08) if surgery was performed more than 6 weeks after the index injury. Patients with isolated ACL injuries showed lower KOOS Activities of Daily Living values (β = –2.4, <em>P</em> = .045) if surgery was performed at between 3 and 6 months. Among patients with combined ACL-MCL injuries, autograft was found to have worse IKDC scores (β = –11 [95% confidence interval (CI), –18 to –4.2]; <em>P</em> = .002), Lysholm scores (β = –9.2 [95% CI, –15 to –3.1]; <em>P</em> = .004), KOOS Quality of Life values (β = –11 [95% CI, –20 to –1.6]; <em>P</em> = .023), KOOS Pain values (β = –5.1 [95% CI, –10 to –0.03]; <em>P</em> = .049), KOOS Symptoms values (β = –7.6 [95% CI, –10 to –0.03]; <em>P</em> = .02), and KOOS Sport values (β = –21 [95% CI, –32 to –10]; <em>P</em> &lt; .001) than allograft.</div></div><div><h3>Conclusions</h3><div>Patients undergoing ACLR with grade 2 or 3 MCL injuries have improved patient-reported outcomes if surgery is performed within 6 weeks from the time of injury. In this cohort, allografts resulted in better outcome scores compared with autografts.</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 101038"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845139","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":"Revision Surgery Is the Most Common Definition of Failure in Studies Evaluating Knee Cartilage Restoration Outcomes: A Systematic Review","authors":"Lexy Farrington B.S.,&nbsp;Marcus Trotter M.D.,&nbsp;Ezra Goodrich M.D.,&nbsp;Armin Tarakemeh B.A.,&nbsp;Erik Henkelman M.D.,&nbsp;Paul Schroeppel M.D.,&nbsp;Christopher D. Bernard M.D.,&nbsp;Rachel Long B.S.,&nbsp;Tucker Morey B.S.,&nbsp;Jacob White M.S.,&nbsp;Bryan G. Vopat M.D.","doi":"10.1016/j.asmr.2024.101044","DOIUrl":"10.1016/j.asmr.2024.101044","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the definitions of “failure” of knee chondral restoration surgery in the current literature and to provide a recommendation on what should define failure.</div></div><div><h3>Methods</h3><div>By use of Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria, a systematic search of the PubMed, Embase, Ovid, and Cochrane Library databases was conducted to identify studies published between January 1, 2017, and May 1, 2021. The inclusion criteria consisted of studies containing patients who underwent knee cartilage surgery that included a definition of failure. We excluded animal studies; articles comparing alternative medical treatments, such as rehabilitation, anti-inflammatory medications, and physical therapy; studies enrolling patients with diseases other than those of the knee, and non–English-language studies. Failure data were extracted and categorized as surgical, graft related, or based on patient-reported outcomes (PROs). This information was analyzed to develop a recommendation for a standardized definition of failure of knee cartilage restoration.</div></div><div><h3>Results</h3><div>A total of 61 studies met the inclusion criteria. The most common definition of knee chondral restoration failure was the need for any revision surgery (52 of 61 studies, 85.3%), with failure rates ranging from 3.22% to 75%. Graft failure, defined as delamination and/or graft inadequacy (39 of 61, 63.9%), with failure rates ranging from 2.10% to 47%, and conversion to knee arthroplasty (34 of 61, 55.7%) were also used as definitions. Failure to return to sport and/or regular activity (4 of 61, 6.6%), presence of symptoms (21 of 61, 34.4%), removal of graft or implant (14 of 61, 22.9%), and other unclassified follow-up revisions (8 of 61, 13.1%) were additional definitions of failure documented. Subjective PROs were used in 54.1% of the studies (33 of 61), with failure rates ranging from 3.45% to 59%.</div></div><div><h3>Conclusions</h3><div>A variety of definitions of failure are used to evaluate knee chondral restorative surgery outcomes in the orthopaedic literature. Any unplanned revision surgery and graft failure, defined as delamination and/or graft inadequacy, were the most common criteria defining knee chondral restoration failure. Patients’ functionality and quality of life, determined by PROs, were also used to define knee chondral restoration failure in multiple studies. Higher rates of failure were observed after knee chondral restorative procedures when using multiple definitions of failure that were more inclusive. To account for heterogeneity in definitions, procedures, and patient circumstances, we recommend using multiple outcomes, including unplanned surgical procedures, PROs, and the ability to return to the desired level of function, as factors to define failure.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level II to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101044"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845223","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":"Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review","authors":"Jeffrey Lee B.S. ,&nbsp;Johnathon R. McCormick M.D. ,&nbsp;Kevin Credille M.D. ,&nbsp;Navya Dandu M.D. ,&nbsp;Zachary Wang B.S. ,&nbsp;Nicholas A. Trasolini M.D. ,&nbsp;Reem Y. Darwish B.S. ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Adam B. Yanke M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101075","DOIUrl":"10.1016/j.asmr.2025.101075","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the consistency of risk factor reporting for anterior cruciate ligament reconstruction (ACLR) failure after primary reconstruction, identify risk factors more frequently associated with ACLR failure, and help clinicians prevent reinjury in patients with risk factors for ACLR failure.</div></div><div><h3>Methods</h3><div>Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct a systematic review. Initial title and abstract screening yielded 561 studies, from which 76 studies were assessed for eligibility. Thirty-two full-text studies met the following inclusion criteria: (1) clinical studies of anterior cruciate ligament injuries; (2) patients undergoing ACLR; (3) clinical outcome data, including failure rate; (4) studies assessing preoperative risk factors for failure; and (5) manuscripts published within the past 6 years. These studies were subdivided into those that defined ACLR failure as revision surgery or graft failure.</div></div><div><h3>Results</h3><div>Ten risk factors were included in the review for 22 studies defining ACLR failure as revision surgery. Eight risk factors were included in the review for 10 studies defining ACLR failure as graft failure. Posterior tibial slope (PTS) (80%, 4/5 studies), age (79%, 11/14 studies), and graft characteristics (71%, 5/7 studies) such as allograft versus bone–patellar tendon–bone autograft, high-dose radiation, and BioCleanse preparation technique were the most significant risk factors for revision ACLR. PTS (100%, 2/2 studies) and activity level (67%, 2/3 studies) were the most significant risk factors for graft failure.</div></div><div><h3>Conclusions</h3><div>Age, PTS, use of allograft, and activity level are significant preoperative risk factors that should be considered when attempting to prevent reinjury in ACLR candidates. Studies investigating risk factors for ACLR failure often fail to control for confounding variables that can influence outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level II to IV studies,</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101075"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845225","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":"Individuals Frequently Search Google With Questions About the Management of Meniscal Tears and the Indications for and Technical Details of Surgery but the Quality of the Information Is Suboptimal","authors":"Jonathan Spaan M.S. ,&nbsp;John Streepy M.S. ,&nbsp;Alexander Hodakowski M.D. ,&nbsp;Amelia Hummel M.D. ,&nbsp;Colton Mowers B.S. ,&nbsp;Sabrina Schundler B.S. ,&nbsp;Johnathon R. McCormick M.D. ,&nbsp;Jonathan Riboh M.D. ,&nbsp;Dana Piasecki M.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101061","DOIUrl":"10.1016/j.asmr.2024.101061","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the frequently asked questions that patients search online regarding meniscal tears and meniscal surgery and evaluate the quality of websites used to answer these common queries.</div></div><div><h3>Methods</h3><div>This study used Google’s People Also Ask function to extract the most common 300 questions and associated Web pages regarding meniscal tears and meniscal surgery. Questions on both meniscal tear and meniscal surgery were categorized using the Rothwell classification, and websites were evaluated with <em>The Journal of the American Medical Association</em> (JAMA) criteria.</div></div><div><h3>Results</h3><div>The Rothwell classification of questions on meniscal tear/surgery was 54.0%/55% fact, 37.7%/30.0% policy, and 8.3%/15.0% value. The meniscal tear cohort asked significantly more questions related to policy (<em>P</em> = .047), whereas the meniscal surgery cohort asked significantly more questions about value (<em>P</em> = .011). Academic (31.7% and 27.3%), medical practice (23.0% and 25.3%), and single-surgeon (12.3% and 13.3%) websites were the most common types of sites encountered. The mean total JAMA score was 1.3 of 4, with journals (mean, 3.4) having the highest score. Single-surgeon practice (mean, 0.5) and legal (mean, 0) sites had the lowest JAMA scores. The most frequently encountered query in the meniscal tear cohort was “What are three signs of a meniscus tear in the knee?” In contrast, in the meniscal surgery cohort, it was a tie between “What is the fastest way to recover from meniscus surgery?” and “Should meniscus surgery be done over 65?”</div></div><div><h3>Conclusions</h3><div>The quality of online information related to meniscal tears and surgery is often suboptimal based on objective measures of value. Individuals frequently search for insights into indications, management, and technical details.</div></div><div><h3>Clinical Relevance</h3><div>Understanding common themes in online searches can provide valuable insights that could improve patient education. Surgeons can use this information to anticipate potential questions, establish appropriate patient expectations, and enhance informed decisions.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101061"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845271","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":"High Return to Play and Variable Salary Impact After Hip Arthroscopy in National Hockey League Players","authors":"Michael A. Gaudiani M.D. ,&nbsp;Joshua P. Castle M.D. ,&nbsp;Muhammad J. Abbas M.D. ,&nbsp;Matthew J. Myhand B.S. ,&nbsp;Thomas J. Sprys-Tellner B.S. ,&nbsp;Jack T. McConnell B.S. ,&nbsp;Brittaney A. Pratt B.S. ,&nbsp;T. Sean Lynch M.D.","doi":"10.1016/j.asmr.2024.101006","DOIUrl":"10.1016/j.asmr.2024.101006","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the impact of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) on National Hockey League (NHL) player performance, career length, and salary.</div></div><div><h3>Methods</h3><div>Through a retrospective review, all NHL players who underwent hip arthroscopy for FAIS from 2003 to 2023 were identified from a public online database. A 2:1 matched control cohort was used for comparison. Game use and performance metrics were collected and compared at 1 season and 3 seasons before and after the index season. Game use, performance, and salary were compared between operatively managed players and healthy controls. Performance measures and financial data were recorded.</div></div><div><h3>Results</h3><div>Of the 75 NHL players who underwent hip arthroscopy, 66 (88%) returned to play and were matched to 132 healthy controls. At 1 season after the index season, the operative cohort of NHL players showed a significantly decreased Corsi percentage compared with the year prior (48.4% ± 5.2% vs 50.8% ± 4.2%, <em>P</em> = .024). The control cohort showed an increased Corsi percentage (51.6% ± 5.1% vs 48.9% ± 8.1%, <em>P</em> = .011) and increased Fenwick percentage (51.3% ± 4.6% vs 48.8% ± 8.0%, <em>P</em> = .013) at 1 season after the index season. On financial analysis, by season, injured players in the lower salary group showed lower earnings at season 2 ($1,360,000 ± $910,000 vs $3,950,000 ± $3,300,000; <em>P</em> = .012). However, by cumulative earnings, the total injured cohort showed higher earnings at season 4 ($17,300,000 ± $7,760,000 vs $12,960,000 ± $8,100,000; <em>P</em> = .041), driven by higher cumulative earnings in the highest salary group in seasons 3 and 4.</div></div><div><h3>Conclusions</h3><div>After hip arthroscopy for FAIS, 88% of NHL players successfully return to play. Career length was found to be similar between the injured and matched groups. One season after surgery, NHL players showed worse performance compared with their prior season, but this returned to baseline 3 seasons after surgery. Lower-salary players in the injured group showed decreased salaries at 2 seasons after the index season compared with controls, whereas no differences were found in cumulative salaries.</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 1","pages":"Article 101006"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386776","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":"ChatGPT-3.5 and -4.0 Do Not Reliably Create Readable Patient Education Materials for Common Orthopaedic Upper- and Lower-Extremity Conditions","authors":"Ryan S. Marder M.D. ,&nbsp;George Abdelmalek M.D. ,&nbsp;Sean M. Richards B.A. ,&nbsp;Nicolas J. Nadeau B.S. ,&nbsp;Daniel J. Garcia B.S. ,&nbsp;Peter J. Attia B.A. ,&nbsp;Gavin Rallis M.D. ,&nbsp;Anthony J. Scillia M.D.","doi":"10.1016/j.asmr.2024.101027","DOIUrl":"10.1016/j.asmr.2024.101027","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether ChatGPT-3.5 and -4.0 can serve as a viable tool to create readable patient education materials for patients with common orthopaedic upper- and lower-extremity conditions.</div></div><div><h3>Methods</h3><div>Using ChatGPT versions 3.5 and 4.0, we asked the artificial intelligence program a series of 2 questions pertaining to patient education for 50 common orthopaedic upper-extremity pathologies and 50 common orthopaedic lower-extremity pathologies. Two templated questions were created and used for all conditions. Readability scores were calculated using the Python library Textstat. Multiple readability test scores were generated, and a consensus reading level was created taking into account the results of 8 reading tests.</div></div><div><h3>Results</h3><div>ChatGPT-3.5 produced only 2% and 4% of responses at the appropriate reading level for upper- and lower-extremity conditions, respectively, compared with 54% produced by ChatGPT-4.0 for both upper- and lower-extremity conditions (both <em>P</em> &lt; .0001). After a priming phase, ChatGPT-3.5 did not produce any viable responses for either the upper- or lower-extremity conditions, compared with 64% for both upper- and lower-extremity conditions by ChatGPT-4.0 (both <em>P</em> &lt; .0001). Additionally, ChatGPT-4.0 was more successful than ChatGPT-3.5 in producing viable responses both before and after a priming phase based on all available metrics for reading level (all <em>P</em> &lt; .001), including the Automated Readability index, Coleman-Liau index, Dale-Chall formula, Flesch-Kincaid grade, Flesch Reading Ease score, Gunning Fog score, Linsear Write Formula score, and Simple Measure of Gobbledygook index.</div></div><div><h3>Conclusions</h3><div>Our results indicate that ChatGPT-3.5 and -4.0 unreliably created readable patient education materials for common orthopaedic upper- and lower-extremity conditions at the time of the study.</div></div><div><h3>Clinical Relevance</h3><div>The findings of this study suggest that ChatGPT, while constantly improving as evidenced by the advances from version 3.5 to version 4.0, should not be substituted for traditional methods of patient education at this time and, in its current state, may be used as a supplemental resource at the discretion of providers.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101027"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386628","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":"Similar Rates of Return to Play After Operative and Nonoperative Management of Physeal Nonunions and Stress Fractures of the Proximal Ulna in Athletes: A Systematic Review of 174 Patients","authors":"Jacob S. Borgida B.S. ,&nbsp;Rik J. Molenaars M.D. ,&nbsp;Huub H. de Klerk B.S. ,&nbsp;Bert Berenschot M.S. ,&nbsp;Job N. Doornberg M.D., Ph.D. ,&nbsp;Denise Eygendaal M.D., Ph.D. ,&nbsp;Thuan V. Ly M.D. ,&nbsp;Michel P.J. van den Bekerom M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101019","DOIUrl":"10.1016/j.asmr.2024.101019","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the clinical and demographic presentation, treatment strategies, and outcomes of athletes who sustained proximal ulna stress injuries and elucidate the available evidence on management and anatomic variation.</div></div><div><h3>Methods</h3><div>A literature search was performed on the basis of the medical databases MEDLINE/PubMed and Embase. Articles reporting on sports-related physeal injuries and stress fractures of the proximal ulna were eligible for inclusion. Outcome variables included clinical presentation, imaging assessments, management, and complications.</div></div><div><h3>Results</h3><div>A total of 40 studies were included with 174 athletes who sustained physeal injuries or stress fractures of the proximal ulna. The age ranges of the 74 patients with physeal injuries and 100 patients with stress fractures were 11-26 years and 14-30 years, respectively. Of the studies reporting on clinical symptoms, athletes most commonly presented with olecranon tenderness to palpation and swelling. All athletes with physeal injuries were diagnosed with plain radiographs, whereas 47 athletes who underwent radiography for olecranon stress fractures required additional advanced imaging. Studies on nonoperative management reported return to play rates from 67% to 100% (median, 100% [interquartile range, 100-100%]) and 2 complications were reported (chondromalacia of the trochlear notch and occasional symptomology). One hundred twenty-six patients were treated operatively, of which failure of conservative management was reported in 15 of 40 studies, including 61 athletes. The return to play rates ranged from 67% to 100% (median, 100% [interquartile range, 100-100%]) and 20 complications were reported, most commonly hardware irritation (n = 15).</div></div><div><h3>Conclusions</h3><div>Proximal ulna stress injuries in athletes can be managed either nonoperatively or operatively, with both showing satisfactory rates of return to play. Although operative management was more common, almost one half of these athletes failed an initial trial of nonoperative management.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101019"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386634","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}