Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Emphasizing the Importance of Naproxen Prophylaxis May Decrease the Rate of Heterotopic Ossification After Hip Arthroscopy","authors":"","doi":"10.1016/j.asmr.2024.100941","DOIUrl":"10.1016/j.asmr.2024.100941","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.</p></div><div><h3>Methods</h3><p>A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit. The control cohort was merely prescribed the postoperative prophylactic NSAIDs, whereas the intervention cohort also received dedicated in-person education, emphasizing the importance of NSAID adherence. The presence of HO was determined through review of follow-up radiographs. Standard descriptive statistics were used to describe the findings.</p></div><div><h3>Results</h3><p>Both the control and intervention groups consisted of 200 continuous hip arthroscopy patients, with the control group treated from 2015 to 2017 and the intervention group treated from 2020 to 2023. Within the control group, 10 cases of HO (5%) were detected. Within the intervention group, 2 cases of HO (1%) were found. The Pearson χ² test with Yates continuity correction produced a value of 4.21, with a <em>P</em> value of .04.</p></div><div><h3>Conclusions</h3><p>In this study, we found a significantly lower incidence rate of HO in patients who received standardized education on the importance of NSAID compliance versus those who did not. This finding suggests that patient education may play a contributory role in reducing the incidence of HO after hip arthroscopy.</p></div><div><h3>Level of Evidence</h3><p>Level III, comparative cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100941"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000592/pdfft?md5=127f2ff993f12eb5ca446d1b3dfd7cb9&pid=1-s2.0-S2666061X24000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786369","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":"Most Patients Older Than 40 Years of Age Who Underwent Meniscal Root Repair Presented With an Effusion, a Positive McMurray Test, and a Positive Hyperflexion Test","authors":"Andres R. Perez B.A. ,&nbsp;Carlo Coladonato B.S. ,&nbsp;Adeeb J. Hanna B.S. ,&nbsp;Matthew Sabitsky B.S. ,&nbsp;Alexa L. Cohen ,&nbsp;Kevin B. Freedman M.D. ,&nbsp;Steven B. Cohen M.D.","doi":"10.1016/j.asmr.2024.100949","DOIUrl":"10.1016/j.asmr.2024.100949","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the presenting symptoms and clinical examination findings of patients undergoing meniscal root repairs to aid physicians in diagnosing this injury.</p></div><div><h3>Methods</h3><p>All patients undergoing isolated arthroscopic meniscal root repair from January 1, 2016, to September 1, 2021, were identified. Patients younger than the age of 40 years were excluded. Clinical notes were reviewed for presenting symptoms and physical examination findings. Preoperative radiographs were graded using the Kellgren-Lawrence (KL) scale for osteoarthritis. Root tears were graded using the radiographic criteria of Chung et al. and articular cartilage injury was graded using a validated system, AMADEUS (mean total Area Measurement And Depth &amp; Underlying Structures).</p></div><div><h3>Results</h3><p>In total, 221 patients met inclusion criteria; 65.6% of patients reported that their pain began after an acute injury, with 39.4% of patients reporting a “pop.” On examination, an effusion was present in 71% of knees. McMurray test was reported positive in 85.5% and a positive hyperflexion test in 53.8% of knees. In total, 49.5% of knees were graded KL 1. 154 had medial root tears, 10 had lateral root tears, and 24 suffered both root tears. In total, 44.1% of tears occurred at the midsubstance of the root, with 28.0% occurring at the enthesis and 28.0% occurring at the root-posterior horn junction. The mean AMADEUS score was 94.4 ± 11.4.</p></div><div><h3>Conclusions</h3><p>Although most patients reported pain began after acute injury, less than one-half reported hearing a “pop.” When patients were evaluated, an effusion, positive McMurray test, and positive hyperflexion test were present in most meniscal root tears.</p></div><div><h3>Level of Evidence</h3><p>Level IV, diagnostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100949"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000671/pdfft?md5=e1ee72d31147cd1bb35d435800251021&pid=1-s2.0-S2666061X24000671-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164577","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":"Arthroscopy Patients in Medicare Population Became Sicker While Reimbursement Decreased From 2013 to 2020","authors":"","doi":"10.1016/j.asmr.2024.100950","DOIUrl":"10.1016/j.asmr.2024.100950","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess surgeon reimbursement for common arthroscopic procedures, including arthroscopic meniscal debridement and arthroscopic rotator cuff repair, in patients with differing risk profiles within the Medicare population.</p></div><div><h3>Methods</h3><p>A publicly available Medicare database was used to identify all cases of arthroscopic meniscal debridement and arthroscopic rotator cuff repair procedures billed to Medicare from 2013 to 2020. The surgeon reimbursement from Medicare was collected and adjusted for inflation. All procedure episodes were split into 2 cohorts; those with a hierarchical condition category (HCC) risk score ≥1.5, and those with patient HCC risk scores &lt;1.5. Reimbursement rates were compared between groups.</p></div><div><h3>Results</h3><p>From 2013 to 2020, a total of 624,077 meniscal debridement procedures and 567,794 arthroscopic rotator cuff repairs were billed to Medicare Part B. During this time, the mean adjusted surgeon reimbursement for arthroscopic rotator cuff repair decreased by 9.2% from 2013 to 2020. During the same time period, the adjusted mean surgeon reimbursement for arthroscopic both compartment meniscal debridement and single compartment meniscal debridement decreased by 7.9% and 9.9%, respectively. Throughout the study period, the mean HCC risk score increased from 1.19 in 2013 to 1.31 in 2020 (<em>P</em> &lt; .001). Across all years in the study, the sicker cohort had a significantly greater rate of all comorbidities and a greater mean body mass index (<em>P</em> &lt; .001 for all variables). The mean reimbursement across this cohort was lower for both rotator cuff repair (<em>P</em> = .037) and meniscal debridement procedures (<em>P</em> &lt; .001) compared with the healthier cohort.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that from 2013 to 2020, inflation-adjusted surgeon reimbursement for arthroscopic rotator cuff repair and meniscal debridement decreased while patient complexity increased. Further, mean surgeon reimbursement was lower among patients with more complexity in comparison with their healthier counterparts for such procedures.</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":"6 4","pages":"Article 100950"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000683/pdfft?md5=b6b9bc52932b326666ead26fe7f8ff31&pid=1-s2.0-S2666061X24000683-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032631","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":"Meniscus-Related Videos on TikTok Are Widely Viewed and Shared but the Educational Quality for Patients Is Poor","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Timothy E. Hewett M.D.","doi":"10.1016/j.asmr.2024.100927","DOIUrl":"10.1016/j.asmr.2024.100927","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the quality of meniscus-related TikTok videos to better understand their value for patient education.</p></div><div><h3>Methods</h3><p>The term “meniscus” was used as the key word for an extensive online search of video content on the TikTok on November 14, 2023. The first 100 videos were used for analysis. The duration of the videos and the number of likes, shares, and views were recorded for each video. Furthermore, videos were categorized based on the source (health workers, private user), the type of subject (patient experience, physical therapy, anatomy, clinical examination, surgical technique and injury mechanism), type of content (patient experience/testimony, education, rehabilitation), and the presence of music or voice. The quality and reliability assessments of video contents were conducted using the DISCERN instrument, the <em>Journal of the American Medical Association</em> benchmark criteria, and Global Quality Score.</p></div><div><h3>Results</h3><p>Of the 100 videos included in this study, 62 (62%) videos were published by health workers and 38 by private users (38%). Most of the information regarded patient experience (36, 36%), followed by physical therapy (32, 32%), anatomy (14, 14%), clinical examination (8, 8%), surgical technique (6, 6%), and injury mechanism (4, 4%). Video content reported patient experience in 39 (39%) videos, rehabilitation in 31 (31%) videos, and education in the remaining 30 (30%). The mean length of the videos was 39.12 ± 49.56 seconds. The mean number of views was 1,383,001.65 ± 5,291,822.28, whereas the mean numbers of comments, likes and shares were 408.53 ± 1976.90, 54,763.43 ± 211,823.44 and 873.70 ± 2,802.01, respectively. The mean DISCERN score, <em>Journal of the American Medical Association</em> benchmark criteria score, and Global Quality Score were 17.93 ± 5.07, 0.24 ± 0.47, and 1.15 ± 0.41, respectively.</p></div><div><h3>Conclusions</h3><p>Meniscus-related videos on TikTok are widely viewed and shared but the overall educational value to patients is poor.</p></div><div><h3>Clinical Relevance</h3><p>As patients increasingly use social media to learn about their conditions, it is important for orthopaedic health care professionals to understand the limitations of TikTok videos addressing the meniscus as potential sources of information for their patients.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100927"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000452/pdfft?md5=16cd1ee774eed10bba785b5eab80f7a5&pid=1-s2.0-S2666061X24000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268907","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":"Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome","authors":"Cory D. Smith M.D.,&nbsp;Evan Simpson B.S.,&nbsp;Bailey Johnson M.D.,&nbsp;Edward Quilligan B.S.,&nbsp;Robert Grumet M.D.,&nbsp;Kevin C. Parvaresh M.D.","doi":"10.1016/j.asmr.2024.100918","DOIUrl":"10.1016/j.asmr.2024.100918","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).</p></div><div><h3>Methods</h3><p>We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under “select criteria,” patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas “all criteria” added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs.</p></div><div><h3>Results</h3><p>A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ² Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria.</p></div><div><h3>Conclusions</h3><p>In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone.</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":"6 3","pages":"Article 100918"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000361/pdfft?md5=65c0a4059174742831e23c6c61dd70b2&pid=1-s2.0-S2666061X24000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466610","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":"Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes","authors":"Mark A. Glover B.S. ,&nbsp;Jeffery D. St. Jeor M.D. ,&nbsp;Nihir Parikh B.S. ,&nbsp;Danielle E. Rider M.D. ,&nbsp;Garrett S. Bullock D.P.T., D.Phil. ,&nbsp;Nicholas A. Trasolini M.D. ,&nbsp;Brian R. Waterman M.D.","doi":"10.1016/j.asmr.2024.100911","DOIUrl":"10.1016/j.asmr.2024.100911","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.</p></div><div><h3>Results</h3><p>In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, <em>P</em> &lt; .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; <em>P</em> &lt; .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, <em>P</em> &lt; .001; 1.04, 95% CI 1.01-1.07, <em>P</em> = .020; 1.11, 95% CI 1.03-1.19, <em>P</em> = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, <em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prognostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100911"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000294/pdfft?md5=e741866ffbc3e96342e1bba123f83a04&pid=1-s2.0-S2666061X24000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965952","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":"Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates","authors":"Sarah Whitaker B.A. ,&nbsp;Sarah Cole B.A. ,&nbsp;Maria Peri B.S. ,&nbsp;James Satalich M.D. ,&nbsp;Conor O’Neill M.D. ,&nbsp;Alexander Vap M.D.","doi":"10.1016/j.asmr.2024.100928","DOIUrl":"10.1016/j.asmr.2024.100928","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.</p></div><div><h3>Methods</h3><p>The American College of Surgeons National Surgical Quality Improvement Program was filtered using <em>Current Procedural Terminology</em> codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.</p></div><div><h3>Results</h3><p>Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.</p></div><div><h3>Conclusions</h3><p>In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100928"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000464/pdfft?md5=0b156ecaeb705f575831e7d62f978f80&pid=1-s2.0-S2666061X24000464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271704","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":"Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy","authors":"Onur Hapa M.D. ,&nbsp;Selahaddin Aydemir M.D ,&nbsp;Asli Irmak Akdogan M.D ,&nbsp;Mustafa Celtik M.D ,&nbsp;Ozgur Aydin M.D ,&nbsp;Batuhan Gocer M.D ,&nbsp;Onur Gursan M.D","doi":"10.1016/j.asmr.2024.100943","DOIUrl":"10.1016/j.asmr.2024.100943","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.</p></div><div><h3>Methods</h3><p>Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score–Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.</p></div><div><h3>Results</h3><p>Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (<em>P</em> = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (<em>P</em> &gt; .05).</p></div><div><h3>Conclusions</h3><p>In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.</p></div><div><h3>Clinical Relevance</h3><p>Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100943"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000610/pdfft?md5=3768006f6948a9a0d2b81bd149da89d9&pid=1-s2.0-S2666061X24000610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787306","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":"Blood Flow in the Meniscus Can Be Visualized Arthroscopically Using an Intravenous Indocyanine Green Solution Diluted 10× in a Pig Model","authors":"Tamiko Kamimura M.D., Ph.D.","doi":"10.1016/j.asmr.2024.100932","DOIUrl":"10.1016/j.asmr.2024.100932","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the optimal indocyanine green (ICG) dose required for assessing vascularity in the meniscus using ICG fluorescence-guided knee arthroscopy in a pig model.</p></div><div><h3>Methods</h3><p>A 3-month-old Japanese esculent female pig was used in this study. Intravenous injections of ICG (25 mg) were administered with 2.0 mL of 5×, 10×, 100×, and 1,000× diluted solutions. An additional experiment was conducted to assess the microvasculature within the meniscus considering the results of the optimal dilution setting. A radial tear was purposely induced in the middle-to-posterior section of the medial meniscus to observe vascularity in the cross-sectioned meniscus; the optimal ICG dilution was administered.</p></div><div><h3>Results</h3><p>No fluorescence was detected in the meniscus with solutions diluted by 1,000× and 100×. Fluorescence was visualized at the anterior portion of the synovium and the anterior cruciate ligament using ICG diluted by 10×. Diluting ICG by 5×, contrast enhancement was too intense for observation. Therefore, the 10× diluted solution was considered the optimal setting for knee arthroscopy and observation of the radial tear. No fluorescence was observed in the cross section of the medial meniscus. Arterial hemorrhage was observed by stimulating the fluorescence-dyed synovium adjacent to the tear site. Through the additional waiting time after stimulating the tear site, the hemorrhage inside the meniscus became more intense.</p></div><div><h3>Conclusions</h3><p>The optimal dilution and dose setting of ICG for knee arthroscopy was 10× in a 2.0-mL intravenous injection. The meniscus showed no active blood flow, even in the red-red zone. This finding might support the notion that blood flow cannot be initiated, without synovial stimulation, even in vascular areas.</p></div><div><h3>Clinical Relevance</h3><p>This study could determine an ICG solution suitable for ICG fluorescence-guided knee arthroscopy. This finding could be valuable in future research focusing on case-specific meniscal vascularization under arthroscopy, particularly applying these findings to human meniscal treatment.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100932"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000506/pdfft?md5=072200b5b9eccfb2f436f8594ef3cf97&pid=1-s2.0-S2666061X24000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405115","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":"Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Lateral Compartment Meniscectomy or Chondroplasty Does Not Lead to Decreased Return to Sport and Activity Compared With No Lateral Pathology","authors":"Sean Hazzard P.A., M.B.A.,&nbsp;Saoirse Connolly B.S.,&nbsp;Brendan Fitzgerald B.S.,&nbsp;Peter Asnis M.D.","doi":"10.1016/j.asmr.2024.100910","DOIUrl":"https://doi.org/10.1016/j.asmr.2024.100910","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the influence of lateral meniscal and cartilage pathology on the outcome after anterior cruciate ligament (ACL) reconstruction in patients who participate in pivoting sports.</p></div><div><h3>Methods</h3><p>Using a single-surgeon patient registry, patients undergoing an anterior cruciate ligament reconstruction (ACLR) using bone–patellar tendon–bone autograft were evaluated with minimum 2-year patient reported outcomes evaluated using Marx, Tegner, Lysholm, and International Knee Documentation Committee scales. Patients were divided into 3 groups: isolated ACL surgery, ACLR with a partial lateral meniscectomy, or a ACLR with partial lateral meniscectomy and lateral compartment chondroplasty.</p></div><div><h3>Results</h3><p>A total of 98 patients met inclusion criteria. Using the isolated ACL reconstruction group as a control, we found that Marx scores were greater in patients who additionally underwent a partial lateral meniscectomy at 1 year (<em>P</em> = .016). There were no significant differences between the ACL-only group and the ACL with partial lateral meniscectomy and chondroplasty group. Within the partial meniscectomy cohort comparing the patients with red-white zone tears with the patients with white-white zone tear, we found there were no significant differences when compared with the ACL-only control. There were no significant differences appreciated between groups using the International Knee Documentation Committee, Lysholm, and Tegner scales.</p></div><div><h3>Conclusions</h3><p>ACL reconstruction using bone–patellar tendon–bone autograft with anteromedial portal drilling technique does not have any significant short-term (2-year outcome) differences in return to activity and patient-reported outcomes compared with if patients additionally have a partial lateral meniscectomy and/or lateral compartment chondroplasty. Additional partial lateral meniscectomy showed significantly greater Marx scores at 1 and 2 years’ postoperatively.</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":"6 3","pages":"Article 100910"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000282/pdfft?md5=588ff7456a47f300daf11f39c50406b1&pid=1-s2.0-S2666061X24000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486542","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}