Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Medial Meniscal Posterior Root Tears Are Associated With Steeper Medial Posterior Tibial Slope and Varus Alignment","authors":"Felicitas Allende M.D. ,&nbsp;José Rafael García B.S. ,&nbsp;Salvador González Ayala B.S. ,&nbsp;Lika Dzidzishvili M.D., Ph.D. ,&nbsp;Gonzalo Quiroga M.D. ,&nbsp;Sachin Allahabadi M.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2024.100998","DOIUrl":"10.1016/j.asmr.2024.100998","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze a series of cases with and without medial meniscal posterior root tears (MMPRTs) to determine whether varus alignment and increased sagittal medial tibial slope (MTS) are risk factors for MMPRTs.</div></div><div><h3>Methods</h3><div>The study evaluated 2 groups of patients: The tear group included patients with arthroscopically confirmed MMPRTs, and the no-tear group consisted of control patients matched to the tear group who underwent similar imaging but did not have meniscal root tears. Age, sex, side of injury, and body mass index were recorded for all cases. Preoperative joint space height and Kellgren-Lawrence grade were measured on radiographs. Group matching was performed based on demographic factors (age, sex, and body mass index), joint space height, and Kellgren-Lawrence grade. Mechanical axis measurements were determined from full-limb-length radiographs. MTS was analyzed on preoperative magnetic resonance imaging. Two observers performed the measurements on 2 separate occasions, and intraobserver reliability and interobserver reliability were analyzed using the intraclass correlation coefficient (ICC). Multivariate regression analysis was performed to identify potential risk factors associated with MMPRTs.</div></div><div><h3>Results</h3><div>Of the 142 matched patients included, 76 had root tears (tear group) and 66 did not (no-tear group). Both mechanical axis (183.2° ± 3.2° vs 181.2° ± 2.3°) and MTS (4° ± 1.9° vs 2.4° ± 2.5°) measurements were significantly greater in the tear group (<em>P</em> &lt; .01 for each). However, despite the statistical significance, the small degrees of difference between the groups raises questions about the clinical significance. The intraobserver ICCs were 0.98 and 0.99 for mechanical axis and 0.87 and 0.98 for MTS. The interobserver ICCs showed excellent reliability for mechanical axis (0.95) and good reliability for MTS (0.77). The lower intraobserver and interobserver reliabilities for MTS measurements also suggest a higher likelihood of error. The multivariate logistic regression model indicated that the risk of sustaining an MMPRT increased with varus alignment (odds ratio, 1.268; 95% confidence interval, 1.104-1.478; <em>P</em> = .001) and increased MTS (odds ratio, 1.364; 95% confidence interval, 1.137-1.677; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>In this study, MMPRTs were associated with varus alignment and steeper MTS. However, the clinical significance of these associations may be limited owing to the small differences between the groups.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case-control study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100998"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386778","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":"Prevalence of Asymptomatic Hip Joint Abnormalities Among Adult Professional Soccer Players and Their Association With Age and Limb Dominance","authors":"Eduard Bezuglov Ph.D., M.D. ,&nbsp;Georgiy Malyakin M.D. ,&nbsp;Andrey Sereda D.Med.Sc., M.D. ,&nbsp;Sergey Izmailov M.D. ,&nbsp;Alesya Grinchenko M.D. ,&nbsp;Gleb Chernov M.D. ,&nbsp;Elizaveta Kapralova M.D. ,&nbsp;Anastasiya Lyubushkina M.D. ,&nbsp;Evgeny Goncharov Ph.D., M.D.","doi":"10.1016/j.asmr.2024.101004","DOIUrl":"10.1016/j.asmr.2024.101004","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prevalence of asymptomatic hip joint abnormalities among adult professional soccer players and to determine the relationship between the number of these abnormalities with age and limb dominance as well as the relationship between those abnormalities themselves.</div></div><div><h3>Methods</h3><div>Adult male professional soccer players from 1 top-division soccer club in a European country underwent magnetic resonance imaging using 1.5 Tesla scanners, the results of which were analyzed independently by 2 experienced radiologists. The incidence of hip osteoarthritis according to the Kellgren-Lawrence and Scoring Hip Osteoarthritis Using MRI classifications, femoroacetabular impingement, hip dysplasia, and presence of os acetabuli was analyzed.</div></div><div><h3>Results</h3><div>A total of 47 patients were included (age 24.5 ± 5.4 years, height 181.5 ± 5.7 cm, body mass index 22.8 ± 1.3). One to 5 magnetic resonance imaging abnormalities were detected in 63 (67%) hip joints. Osteoarthritis of the first and second degree was determined in 46.8% and 18.1% of all hip joints accordingly. The overall prevalence of femoroacetabular impingement was 32%, with pincer-type femoroacetabular impingement occurring in 27.7% of cases, cam type in 11.7%, and mixed type in 6.4% of images. These abnormalities were not related to the dominant leg. Significant correlations were found between cam-type femoroacetabular impingement and osteoarthritis (<em>P</em> = .007), as well as between pincer-type femoroacetabular impingement and osteoarthritis (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Femoroacetabular impingement was found among one-third of the soccer players with no hip complaints. Additionally, a correlation between the presence of femoroacetabular impingement and hip osteoarthritis was observed. However, these abnormalities do not appear to be associated with leg dominance.</div></div><div><h3>Level of Evidence</h3><div>Level IV, prognostic study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101004"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386631","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":"Medical Malpractice Lawsuits Against Team Physicians in the National Football League Increased Between 1971 and 2020 But Remain Low Overall","authors":"Kaitlynn Littleford B.S. ,&nbsp;Jantz J. Arbon M.D. ,&nbsp;Mikalyn T. DeFoor M.D. ,&nbsp;Daniel J. Cognetti M.D.","doi":"10.1016/j.asmr.2024.101013","DOIUrl":"10.1016/j.asmr.2024.101013","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine malpractice lawsuits filed by National Football League (NFL) players against team physicians to understand the factors involved with medical liability in the context of professional football.</div></div><div><h3>Methods</h3><div>A comprehensive review of publicly available legal databases, court records, and news archives was conducted in August 2023 to identify and analyze malpractice lawsuits involving NFL players, teams, and team physicians. Data on case demographics, physician subspecialty, allegations, and outcomes, including monetary amounts, were collected and analyzed. Linear regression was used to assess for a temporal relation with the number of lawsuits.</div></div><div><h3>Results</h3><div>There were 273 physicians identified, of whom 190 were orthopaedic surgeons. There were 28 lawsuits filed by NFL players against physicians, and a significant increase in lawsuits was identified from 1971 to 2020 (<em>P</em> = .0086, <em>R</em>² = 0.60). The most common anatomic locations of injury in the lawsuits were the knee (n = 11), spine (n = 4), and foot/ankle (n = 4). Other lawsuits included a lawsuit for wrongful death resulting from a heat-related injury, as well as a class action lawsuit regarding pain medication prescribing practices and other individual lawsuits over anti-inflammatory use. The highest amount for which a lawsuit was filed was $180 million, with at least 6 lawsuits filed for over $1 million, although many settlements and final verdicts were not available or were sealed.</div></div><div><h3>Conclusions</h3><div>There was an increase in the number of medical malpractice lawsuits filed by professional athletes against team physicians in the NFL between 1971 and 2020, but the overall number remains low.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the frequency and characteristics of medical malpractice lawsuits is essential for physicians, sports organizations, and policymakers to help guide appropriate health care delivery and risk management strategies for athletes in the NFL.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101013"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386632","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 Screw Length of 14 mm Is Sufficient to Avoid the Physis During Juvenile Osteochondritis Dissecans Lesion Repair but This Can Vary Based on Age and Region of the Distal Femur","authors":"Patrick A. Massey M.D., M.B.A. ,&nbsp;Gabriel Sampognaro M.D. ,&nbsp;Lincoln Andre M.D. ,&nbsp;Bradley Nelson M.D. ,&nbsp;Robert Rutz M.D. ,&nbsp;Henry Craighead B.S. ,&nbsp;Alberto Simoncini M.D.","doi":"10.1016/j.asmr.2024.101011","DOIUrl":"10.1016/j.asmr.2024.101011","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the safest screw length that will avoid penetrating the femoral physis for surgical fixation of juvenile osteochondritis dissecans lesions and to compare the safe screw lengths for different regions in the condyles.</div></div><div><h3>Methods</h3><div>After institutional review board approval, we retrospectively reviewed T1-weighted magnetic resonance images of pediatric patients. Longitudinal axis reference lines were made on the femur. Lines were then placed at 45° anterior and posterior to this axis to simulate screw start points. From these points, we measured the shortest distance from the articular surface to the physis, noting the shortest distances. These measurements simulated screw lengths in the anterior, posterior, and central regions on both the medial and lateral condyle. Statistical analysis was performed to determine the 95% confidence interval for all measurements. Analysis of variance was performed to compare different regions.</div></div><div><h3>Results</h3><div>A total of 97 knee magnetic resonance images from patients aged 6 to 17 years were reviewed. The safe screw lengths among all samples were 14.1 mm, 20.9 mm, 18.2 mm, 14.4 mm, 17.5 mm, and 14.1 mm for the anteromedial, central medial, posteromedial, anterolateral, central lateral, and posterolateral regions, respectively. There was a difference in simulated screw lengths among all 6 groups (<em>P</em> &lt; .001). There was a moderate correlation between increasing age of the patient and increasing screw length (<em>r</em> = .397, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>While a screw length of 14 mm appears to be safe in all ages and regions of the distal femur, safe screw length varies based on age and location of the lesion. The posteromedial region has a safe length of 18 mm.</div></div><div><h3>Clinical Relevance</h3><div>Surgeons must respect the physis when repairing knee osteochondritis dissecans lesions in pediatric patients. Fluoroscopic confirmation should be used to confirm safe screw lengths, and surgeons should use caution when using screws longer than 14 mm (or 18 mm posteromedially), particularly in younger patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101011"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386714","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":"The Perineal Post for Hip Arthroscopy Is Dead—Or at Least It Should Be","authors":"Matthew J. Kraeutler M.D.","doi":"10.1016/j.asmr.2024.101068","DOIUrl":"10.1016/j.asmr.2024.101068","url":null,"abstract":"<div><div>Traditionally, distraction of the hip joint during hip arthroscopy has been achieved with the use of a perineal post, which acts as a counterforce. However, our knowledge of the potential complications related to the use of a perineal post continues to grow. Although pudendal neurapraxia is the most common of these potential complications, the perineal post also may cause skin tears of the perineum, erectile dysfunction and, in rare cases, permanent pudendal nerve injury. In response, several techniques for performing postless hip arthroscopy have been developed in recent years. Although some of these techniques are commercially available and some are “do-it-yourself,” preliminary evidence has shown minimal risk of groin-related complications with these postless techniques. In addition to reducing complication rates, our research revealed significantly better patient-reported outcomes with postless compared with post-assisted hip arthroscopy at a minimum 1-year follow-up. Groin-related complications during hip arthroscopy are confusing and anxiety-producing to patients. Hip arthroscopy is an elective procedure, and patients do not expect to have any groin symptoms after a hip surgery. Because this is a sensitive issue, the potential for groin-related complications is rarely discussed with patients preoperatively. In addition, patients often are confused and reluctant to mention groin-related complications to their surgeon, especially if these symptoms are short-lived. Postless hip arthroscopy is a readily accessible, safe alternative to using a perineal post and should be adopted as the standard of care sooner rather than later.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101068"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386434","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":"Female Sex, Fibromyalgia Diagnosis, Obesity, Tobacco Use, Preoperative Opioid Use, and Postoperative Recurrent Instability Are Risk Factors for Return to the Emergency Department 1 Year After Arthroscopic Shoulder Stabilization","authors":"Jacqueline M. Brady M.D.,&nbsp;Isaac Lapite M.D.,&nbsp;Albert Yim B.S.,&nbsp;Jung U. Yoo M.D.","doi":"10.1016/j.asmr.2024.101016","DOIUrl":"10.1016/j.asmr.2024.101016","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify risk factors for return to the emergency department (ED) 1 year after arthroscopic shoulder stabilization and to evaluate secondary outcomes related to postoperative opioid use and recurrent shoulder instability.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients aged 18 to 30 years old undergoing first-time arthroscopic shoulder stabilization (Current Procedural Terminology code 29806). The PearlDiver database was queried for patients between 2017 and 2019 with minimum of 3 months preoperatively to 24 months postoperative assessment, to analyze returns to the emergency department (ED), 1-year postsurgery opioid use, and recurrent instability.</div></div><div><h3>Results</h3><div>Among 12,223 patients, 2,643 (21.6%) patients had at least 1 ED visit within 1-year postoperation. Factors significantly associated (<em>P</em> &lt; .01) included sex (odds ratio [OR] 0.65), obesity (OR 1.71), tobacco use (OR 3.57), perioperative interscalene nerve block (OR 1.23), and recurrent instability (OR 1.49). When the analysis was carried out in the 642 (5.3%) patients with 3 or more postoperative ED visits, significant predictors (<em>P</em> &lt; .01) were female sex (OR 0.49), fibromyalgia (OR 1.42), obesity (OR 1.96), tobacco use (OR 4.25), preoperative opioid use (OR 1.53), nerve block (OR, 1.36), and recurrent instability (OR 2.19). At 1 year postoperative, 2,160 (17.7%) patients were still taking opioids, with significant predictors (<em>P</em> &lt; .01) of age (OR 1.02), sex (OR 0.58), fibromyalgia (OR 1.46), obesity (OR 1.24), tobacco use (OR 1.60), and preoperative opioid use (OR, 1.86). Recurrent instability was found in 1,012 (8.3%) patients, and tobacco use (OR, 1.60) and preoperative opioid use (OR, 1.29) were significantly predictive (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Factors predictive of return to ED 1 year after arthroscopic shoulder stabilization included female sex, fibromyalgia diagnosis, obesity, tobacco use, preoperative opioid use, and postoperative recurrent instability. Factors predictive of opioid use 1 year postoperatively included female sex, obesity, tobacco use, and recurrent instability but not preoperative opioid use. Factors predictive of recurrent instability included female sex and tobacco use.</div></div><div><h3>Level of Evidence</h3><div>Level IV, prognostic study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101016"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386470","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":"Preoperative Magnetic Resonance Imaging Measurements of Hamstring Tendons’ Cross-Sectional Area May Be Used to Predict the 5-Stranded Graft Diameter in Anterior Cruciate Ligament Reconstruction","authors":"Jack M. Ayres M.D. ,&nbsp;Benjamin M. Ose M.P.H. ,&nbsp;Tucker Morey B.S. ,&nbsp;Elizabeth Brown M.D. ,&nbsp;Damon Mar Ph.D. ,&nbsp;Erik Henkelman M.D. ,&nbsp;Bryan G. Vopat M.D. ,&nbsp;Ian Goodman M.D. ,&nbsp;Jeffrey Randall M.D.","doi":"10.1016/j.asmr.2024.101001","DOIUrl":"10.1016/j.asmr.2024.101001","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if preoperative magnetic resonance imaging (MRI) measurements of semitendinosus and gracilis tendon cross-sectional area (CSA) could be used in predicting the intraoperative diameter of a 5-strand hamstring autograft.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of patients who underwent anterior cruciate ligament (ACL) reconstruction with a 5-strand hamstring autograft. All patients undergoing a 5-strand hamstring autograft ACL reconstruction from a single surgeon between 2018 and 2021 were included in this analysis. CSA of both the semitendinosus (CSAst) and gracilis (CSAgr) tendons were measured on preoperative MRI. Demographic and operative data were recorded via chart review. Analyses of within-rater and between-rater reliability were performed. Multiple linear regression was used to analyze the predictors of graft diameter.</div></div><div><h3>Results</h3><div>A total of 45 ACLs were included in this study. An initial multiple linear regression model included multiple patient-independent variables (<em>R</em>² = 0.62, <em>P</em> &lt; .001), but CSAst was the only significant predictor of graft diameter. Accordingly, a second multiple linear regression model was created using CSAst and CSAgr (<em>R</em>² = 0.61, <em>P</em> &lt; .001). Both CSAst and CSAgr were significant predictors of graft diameter. The resulting equation for determining the graft diameter based on CSAst and CSAgr is as follows: [Graft Diameter (mm)] = 5.324 + 0.124 ∗ [CSAst (mm²)] + 0.183 ∗ [CSAgr (mm²)].</div></div><div><h3>Conclusions</h3><div>CSA measurements of the semitendinosus and gracilis tendons on preoperative MRI axial imaging, measured at the level for which the femoral condyle was the widest, may be used to predict the intraoperative graft diameter for ACL reconstruction using the 5-strand autograft technique.</div></div><div><h3>Clinical Relevance</h3><div>Predicting ACL autograft size on preoperative MRI can aid in preoperative planning, including choice of graft.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101001"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386710","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":"Visualization of Trochlear Dysplasia Using 3-Dimensional Curvature Analysis in Patients With Patellar Instability Facilitates Understanding and Improves the Reliability of the Entry Point to Trochlea Groove Angle","authors":"Johannes M. Sieberer M.S. ,&nbsp;Nancy Park B.S. ,&nbsp;Armita R. Manafzadeh Ph.D. ,&nbsp;Shelby T. Desroches M.S. ,&nbsp;Kelsey Brennan ,&nbsp;Curtis McDonald M.A.Sc. ,&nbsp;Steven M. Tommasini Ph.D. ,&nbsp;Daniel H. Wiznia M.D. ,&nbsp;John P. Fulkerson M.D.","doi":"10.1016/j.asmr.2024.101010","DOIUrl":"10.1016/j.asmr.2024.101010","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine a method to visualize a 3-dimensional (3D) rendered distal femur using 3D curvature analysis and to compare models of patellofemoral instability (PFI) with controls to study the reliability of the entry point to trochlear groove angle (EPTG) metric.</div></div><div><h3>Methods</h3><div>The 3D models of patients with recurrent patellar instability, defined by at least 2 reported patellar dislocation events, and age- and sex-matched controls were created from computed tomography scans. Curvature was calculated to highlight the proximal trochlear ridges and the trochlear groove by overlaying them on the 3D models. Anteroposterior views with and without curvature visualization were created and used for qualitative comparison and to measure the EPTG. The EPTG was measured by 2 raters with and without the aid of the curvature maps. Significant differences between patients with PFI and controls were compared with a Mann-Whitney <em>U</em> test. Inter-rater reliability was calculated using interclass correlation coefficients, classified according to literature and compared using a permutation test. Significance was assumed at .05.</div></div><div><h3>Results</h3><div>Qualitive analysis between 30 PFI patient knees (age: 23.9 ± 8.4 years, female/male: 24/6) and 30 control knees (age: 21.8 ± 5.6 years, female/male: 22/8) showed that in general, patients with PFI have a lateralized medial ridge and trochlear groove, with the trochlear groove being shorter and shallower. Qualitatively, differences between patients with PFI and controls were significant for measurements both with and without the aid of the curvature maps. Inter-rater reliability was significantly (<em>P</em> = .0349) better when using the curvature visualization.</div></div><div><h3>Conclusions</h3><div>Curvature-based visualization aids overlain on a 3D model have the power to increase the information gained from 3D imaging and corresponding 3D models, amplifying their potential value in clinical decision-making. Such visualizations facilitate both the identification of qualitative differences between patient and control morphology and improve the reliability of the EPTG trochlear dysplasia metric.</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 101010"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386713","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":"Timing of Surgical Treatment for High-Grade Acromioclavicular Joint Injuries Does Not Affect Functional Outcomes","authors":"Ryan W. Paul B.S. ,&nbsp;Nathaniel Tchangou B.S. ,&nbsp;Krysten Floyd B.S. ,&nbsp;Matthew Sabitsky B.S. ,&nbsp;Gregory Connors B.S. ,&nbsp;Bryson Kemler M.D. ,&nbsp;John Hayden Sonnier M.D. ,&nbsp;Fotios P. Tjoumakaris M.D. ,&nbsp;Kevin B. Freedman M.D.","doi":"10.1016/j.asmr.2024.101017","DOIUrl":"10.1016/j.asmr.2024.101017","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine, using multivariate regression, whether patient-reported outcomes are associated with surgical timing to account for differences between groups.</div></div><div><h3>Methods</h3><div>Patients who underwent acromioclavicular (AC) joint surgery from 2010 to 2019 were included if they underwent primary AC joint surgery for a Rockwood grade III-V AC joint separation. Chart review was conducted to determine time from injury to surgery, Rockwood injury grade, and surgical technique. Postoperative complications, revisions, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) scores, and radiographic outcomes were collected. Radiographic outcomes were determined by measuring coracoclavicular (CC) distance on preoperative, immediate postoperative, and all follow-up anterior-posterior views of the operative shoulder. Multivariate regressions were conducted with postoperative ASES, SANE, and CC distance as the outcomes of interest.</div></div><div><h3>Results</h3><div>Overall, 221 patients (104 early, 117 delayed) with an average age of 40 ± 15 years were included in this study. Significant differences in patient age, body mass index, injury grade, surgical technique used, and preoperative CC distance were observed between groups (all <em>P</em> &lt; .05). After we controlled for confounding variables such as age, sex, body mass index, injury grade, and surgical technique, multivariate regression found that time from injury to surgery was not related to postoperative ASES score (R² = 0.137, <em>P</em> = .563) or postoperative SANE score (R² = 0.087, <em>P</em> = .441). Female patients had lower ASES scores than male patients (estimate: −8.25, 95% confidence interval −15.99 to −0.050, <em>P</em> = .039); however, no other significant relationships were identified from multivariate regression.</div></div><div><h3>Conclusions</h3><div>The timing of AC joint surgery did not affect functional outcomes in patients with AC joint separation.</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 101017"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386528","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 Bibliometric Review of the Top 100 Most Cited Articles in Hip Preservation, Not Counting Self-Citations","authors":"Tyler R. Dorobek B.S. ,&nbsp;Max V. Golden B.A. ,&nbsp;Andrew K. Kirchmeier B.A. ,&nbsp;Jeanne G. Moua B.A., M.P.H. ,&nbsp;Andrea M. Spiker M.D.","doi":"10.1016/j.asmr.2024.100958","DOIUrl":"10.1016/j.asmr.2024.100958","url":null,"abstract":"<div><h3>Purpose</h3><div>To summarize the characteristics of the top 100 most-cited publications related to hip preservation, not counting self-citation.</div></div><div><h3>Methods</h3><div>Databases accessible through ISI Web of Science were queried for articles related to hip preservation between 1965 and June 2022. Analysis included citation number, visual network mapping, publication year, geographic distribution, authorship, impact factor, citation density, and institution. Data analysis was performed excluding self-citations.</div></div><div><h3>Results</h3><div>The top 100 most cited articles in hip preservation had citations ranging between 151 and 2,001, with publication years between 1965 and 2018. An increase in citation density over time was observed. Fifty-seven percent of articles were from the United States, 23% from Switzerland, and 8% from Canada; 57% of the articles were published in the 2000s, and a majority were Level IV Evidence (n = 62). <em>Clinical Orthopaedics and Related Research</em> led in number of publications (n = 32) and mean citations (n = 353) followed by <em>Arthroscopy—The Journal of Arthroscopic and Related Surgery</em> (n =23) and <em>American Journal of Sports Medicine</em> (n = 11). “Femoroacetabular impingement” (occurrences = 19) and “arthroscopy” (15) have been focal keywords since the turn of the 21st century, whereas in the 20th century, “acetabulum” (occurrences = 2) was the predominant keyword.</div></div><div><h3>Conclusions</h3><div>The 100 most-cited articles in hip preservation, not counting self-citation, were published between 1965 and 2018. Citation density increased over time. The majority of articles were published in the United States and in <em>Clinical Orthopaedics and Related Research</em>. The focus in hip preservation has expanded from acetabulum pathology to extensive work across topics including femoroacetabular impingement, capsular biomechanics, and arthroscopy innovation.</div></div><div><h3>Level of Evidence</h3><div>Level IV, descriptive epidemiology study using large database.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100958"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386549","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}