Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"A Substantial Increase in Injuries and Hospitalizations Associated With Playing Pickleball From 2020 to 2022","authors":"Ryan Cheng B.A. ,&nbsp;Jay Moran M.D. ,&nbsp;Billy Kim M.D. ,&nbsp;Marshall S. Yuan Pharm.D. ,&nbsp;Connor J. O’Leary B.A. ,&nbsp;Calvin Wang B.S. ,&nbsp;Joshua S. Dines M.D. ,&nbsp;Brian M. Katt M.D. ,&nbsp;Andrew E. Jimenez M.D.","doi":"10.1016/j.asmr.2024.101067","DOIUrl":"10.1016/j.asmr.2024.101067","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the estimated number and the types of pickleball-related injuries stratified by sex and age presenting to U.S. emergency departments from 2020 to 2022, as estimated by the National Electronic Injury Surveillance System (NEISS) database.</div></div><div><h3>Methods</h3><div>Data from the NEISS database were queried to characterize pickleball-related injuries that presented to 96 NEISS-affiliated emergency departments across the United States between 2020 and 2022. The estimated numbers of injuries and hospital admissions were calculated using weights assigned by the NEISS based on geographical location. Narratives for each emergency department visit were manually reviewed to categorize injuries by type and site. Multivariable analyses were used to determine risk factors associated with pickleball-related hospital admissions.</div></div><div><h3>Results</h3><div>The estimated number of annual pickleball-related injuries presenting to U.S. emergency departments increased by 91% from 2020 to 2022 (8,894 injuries vs 16,997 injuries). Pickleball-related hospital admissions increased by 257% from 2020 in 2022 (992 hospital admissions vs 3,541 hospital admissions). Most injuries (73%, 9,932 estimated injuries per year) were sustained by patients aged between 60 and 79 years (mean ± standard deviation, 63.9 ± 14.7 years). The most common types of injuries were fractures (29%, 3,990 estimated injuries per year) and strains/sprains (21%, 2,808 estimated injuries per year). Multivariable analyses controlling for age, sex, injury type, and injury site showed that patients aged 65 years or older were at an increased risk of hospitalization (odds ratio, 2.48; 95% confidence interval, 1.54-4.11; <em>P</em> &lt; .001) compared with those younger than 65 years.</div></div><div><h3>Conclusions</h3><div>The estimated number of pickleball-related injuries presenting to U.S. emergency departments and subsequent hospital admissions has increased by 91% and 257%, respectively, from 2020 to 2022. Patients who were aged 65 years or older at the time of injury were at an increased risk of hospital admission.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the current trends and types of pickleball-related injuries presenting to U.S. emergency departments is critical toward the development of injury prevention measures and understanding the U.S. health care system, particularly as participation in pickleball continues to grow.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101067"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845276","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":"Female Patient Representation Is Acceptable in Studies Regarding Hip Arthroscopy With Labral Repair Yet Deficient in Key Study Design and Sport-Specific Features","authors":"Benjamin M. Ose M.P.H. ,&nbsp;Libby Frye B.S. ,&nbsp;Dylan Wentzel B.S. ,&nbsp;Richard McEntee M.D. ,&nbsp;Ashley A. Herda Ph.D. ,&nbsp;Scott M. Mullen M.D. ,&nbsp;John P. Schroeppel M.D. ,&nbsp;Bryan G. Vopat M.D. ,&nbsp;Lisa M. Vopat M.D.","doi":"10.1016/j.asmr.2024.101069","DOIUrl":"10.1016/j.asmr.2024.101069","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically review and examine the current literature regarding the representation of female athletes in studies examining arthroscopic hip labral repair procedures.</div></div><div><h3>Methods</h3><div>Studies regarding arthroscopic hip labral repair were identified in PubMed. We included human studies of all levels of evidence written in English that identified the biological sex of study participants and were conducted in the United States or non-US countries that offer the same treatment strategies available in the United States. Data regarding study population, athletic caliber, menstrual status, research theme, sample of males and females, journal impact factor, and paper Altmetric score were recorded and analyzed.</div></div><div><h3>Results</h3><div>We screened 1,152 studies and identified 62 to be included in this audit. Females made up 55% of the population of participants. Female-only and male-only studies represented 4.8% and 14.5% of studies investigated, respectively. No studies investigated outcomes of female participants at the highest athletic caliber. Menstrual status was not considered or included as a variable in any study. Participants within athletic performance, indirect association, and health research theme had 32.8%, 61.1%, and 58.6% female representation, respectively. Median impact factor was similar among study population classifications. Study Altmetric score was highest among male-only studies and studies of the highest levels of athletic caliber.</div></div><div><h3>Conclusions</h3><div>Overall, there was a similar prevalence of female-to-male participants in hip labral repair research, with a 55% to 45% female-to-male ratio in all studies included in this review. Despite this, there is a lack of female-only studies, inclusion of menstrual status, high-level female athletes, and female participants evaluated for performance outcomes.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101069"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845094","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":"Declining Postoperative 90-Day Opioid Prescriptions From 2010 to 2021 Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome","authors":"Wesley Day B.S.,&nbsp;Scott Halperin B.S.,&nbsp;Serkan Surucu M.D.,&nbsp;Andrew E. Jimenez M.D.,&nbsp;Beatrice Katsnelson B.S.,&nbsp;Justin Zhu B.S.,&nbsp;Jonathan N. Grauer M.D.","doi":"10.1016/j.asmr.2025.101078","DOIUrl":"10.1016/j.asmr.2025.101078","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze postoperative opioid prescriptions after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in a large, opioid-naive population and to evaluate factors associated with receiving more opioids.</div></div><div><h3>Methods</h3><div>Opioid-naive adult patients who underwent hip arthroscopy for FAIS were queried in the 2010 to 2022 PearlDiver Mariner 161 national administrative database. Exclusion criteria included patients with a history of chronic pain and patients who received opioid prescriptions more than 30 days before surgery. Patient variables were extracted: age, sex, and Elixhauser Comorbidity Index. Ninety-day postoperative opioid prescriptions (by total morphine milligram equivalents [MMEs]) were assessed with multivariate linear regression. Ninety-day postoperative opioid prescriptions from 2011 to 2021 were assessed.</div></div><div><h3>Results</h3><div>Of 27,079 patients with postoperative opioid prescriptions identified, a mean ± standard deviation of 347.6 ± 729.2 MMEs (40 tablets of 5 mg oxycodone) were prescribed per patient, with a mean of 1.6 prescriptions filled per patient within 90 days following surgery. Seventy-five percent of patients filled fewer than 600 MMEs, but a small subset filled more than 2,000 MMEs. Multivariate analysis revealed that, compared to patients in the age 30- to 39-year group, those aged 20 to 29 years received fewer MMEs (Δ = –72.5, <em>P</em> &lt; .017). Compared to those with an Elixhauser Comorbidity Index of 2 or under, those &gt;2 were prescribed more MMEs (Δ = 52.5, <em>P</em> &lt; .017). Sex did not correlate with the postoperative MMEs prescribed. From 2011 to 2021, a 58.2% decrease in the 90-day mean MMEs prescribed was noted per patient (<em>P</em> &lt; .017).</div></div><div><h3>Conclusions</h3><div>Fewer postoperative MMEs were filled following FAIS hip arthroscopy for patients in their 20s relative to those in their 30s, as well as for those with lower comorbidity burden. Patient sex was not associated with differences in postoperative MMEs prescribed. The amount of mean MMEs prescribed per patient decreased from 2011 to 2021.</div></div><div><h3>Clinical Relevance</h3><div>This study provides information about the typical amount of narcotics required after surgery. This is increasingly useful information, as surgeons/clinicians continue to try to minimize the role of narcotics in postoperative recovery.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101078"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845136","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":"Low Income, Younger Age, Female Sex, and Poor Mental Health Are Risk Factors for Diminished Access to Care Among Patients With Meniscus Tears","authors":"Drew W. Barron B.S. ,&nbsp;Vikram S. Gill B.S. ,&nbsp;Sayi P. Boddu B.A. ,&nbsp;Nathan C. Beckett B.S. ,&nbsp;Sailesh V. Tummala M.D. ,&nbsp;Anikar Chhabra M.D.","doi":"10.1016/j.asmr.2024.101064","DOIUrl":"10.1016/j.asmr.2024.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>To use the All of Us database to investigate barriers to health care access for patients with meniscus tears and to examine how specific demographic, socioeconomic, and health-related factors independently influence their health care utilization.</div></div><div><h3>Methods</h3><div>The National Institutes of Health All of Us database was queried for patient data between March 2017 and March 2023 to form a cohort of patients with meniscal tears. Patients with meniscal tears were identified using Systematized Nomenclature of Medicine clinical terms. All patients with self-reported meniscus tears were included, with no exclusion criteria to ensure a diverse representation of underrepresented individuals. Patient responses to the “Healthcare Access and Utilization Survey” were analyzed across 4 domains: “delayed care,” “could not afford care,” “skipped medication,” and “have not seen a provider in over one year.”</div></div><div><h3>Results</h3><div>In total, 5,671 survey respondents with meniscal tears were included for analysis from a population of 436,000 eligible records. Among them, 27.7% reported delayed care, 23.9% were unable to afford care, 11.8% skipped medication, and 2.0% had not seen a provider in over a year. Patients with annual incomes under $50,000 were more likely to delay care (odds ratio [OR], 1.41; <em>P</em> &lt; .001), be unable to afford care (OR, 1.73; <em>P</em> &lt; .001), or skip medications (OR, 1.79; <em>P</em> &lt; .001). Younger age than the cohort mean of 65.4 years, female sex, and poor physical and mental health were associated with impaired access in at least 1 care domain.</div></div><div><h3>Conclusions</h3><div>Over one-fourth of patients with a diagnosis of meniscus tear who responded to the All of Us “Healthcare Access and Utilization Survey” reported difficulties with access to care across 4 domains, with those of low income, younger age, female sex, and poor mental or physical health experiencing significant barriers to care.</div></div><div><h3>Clinical Relevance</h3><div>This research can inform strategies for equitable treatment of meniscal injuries by highlighting disparities in orthopaedic care access and utilization.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101064"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845141","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":"Risk Factors and Injury Prevention in the Throwing Athlete","authors":"Daniel Kline P.T., D.P.T, S.C.S. ,&nbsp;Sarah Kate Fischer P.T., D.P.T., S.C.S. ,&nbsp;Garrett S. Bullock P.T., D.P.T., D.Phil. ,&nbsp;Michael J. Kissenberth M.D. ,&nbsp;Ellen Shanley P.T., Ph.D., O.C.S. ,&nbsp;Charles A. Thigpen P.T., A.T.C., Ph.D.","doi":"10.1016/j.asmr.2024.101037","DOIUrl":"10.1016/j.asmr.2024.101037","url":null,"abstract":"<div><h3>Abstract</h3><div>Arm injuries are the most common throwing injury, with growing concern as the most severe injuries, such as UCL reconstruction, continue to rise. Furthermore, throwing injuries are frequently recurrent, suggesting once injured, players are at increased risk for another arm injury. The increase in injury rates and severity has been attributed to increases in pitching volume and year-round participation, and specialized training. Thus, initial efforts to prevent arm injuries by USA Baseball and Little League have focused on the extrinsic factor of pitching exposure in the form of pitch counts, yet arm injury rates have stayed constant. Therefore, injury prevention strategies should include extrinsic factors and address modifiable, intrinsic factors that are associated with arm injury. Collectively addressing factors, such as shoulder range of motion and strength deficits, trunk and lower extremity function, and implantation of training programs yields a comprehensive approach to reduce arm injury rates. We will use a directed acyclic graph (DAG) to organize how the internal factors (i.e., fatigue, injury history, range of motion, and strength) interact with the external factors (i.e., training load and pitching exposure) and how together they are thought contribute to potential injury and inform arm injury reduction strategies. This will provide a roadmap to build adaptable arm injury reduction strategies to improve the modifiable physical factors in context of the external factors that change over time and between throwing athletes.</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 101037"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845164","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":"Professional Baseball Players Return to the Same Level of Play With No Effects on Performance After Operative Treatment of Batter’s Shoulder","authors":"Roger V. Ostrander III M.D.,&nbsp;Skyler T. Hoelscher M.D.,&nbsp;Reece Vesperman M.D.,&nbsp;James R. Andrews M.D.","doi":"10.1016/j.asmr.2024.101039","DOIUrl":"10.1016/j.asmr.2024.101039","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate return to play and level of performance after posterior labral repair for the treatment of batter’s shoulder in professional baseball players.</div></div><div><h3>Methods</h3><div>Subjects were selected if they underwent posterior labral repair from 2007 to 2019 at a single institution and had evidence of a batter’s shoulder injury defined as posterior instability and pain while batting. Subjects were excluded if they reported other traumatic mechanisms of injury. Demographic and perioperative data were collected from the participants’ medical records. Historical professional baseball statistics were collected from historical baseball statistics databases.</div></div><div><h3>Results</h3><div>This study included 4 Major League Baseball and 2 Minor League Baseball players. All players in this study were able to return to play at a professional level. The mean difference in at bats from 2 years before to 2 years after surgery was +209.83, which was not statistically significant (95% confidence interval [CI], –329 to 897; <em>P</em> = .219). The mean difference in batting average from 2 years before to 2 years after surgery was –0.054, which was also not statistically significant (95% CI, –0.136 to 0.017; <em>P</em> = .063). The mean difference in relative batting average from 2 years before to 2 years after surgery was +0.192, with a 95% nonparametric CI of –0.048 to 0.458; this was also not statistically significant (<em>P</em> = .062).</div></div><div><h3>Conclusions</h3><div>Players who have a batter’s shoulder injury do not experience any statistically significant drop in performance after posterior labral repair (2 years before vs 2 years after).</div></div><div><h3>Level of Evidence</h3><div>Level IV, Therapeutic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101039"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845170","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":"Lower Trapezius Tendon Transfer Restores Deltoid Function and Shoulder Stability More Effectively Than Superior Capsular Reconstruction in Massive Rotator Cuff Tears","authors":"Nirav Mungalpara M.D. ,&nbsp;Cody Lee M.D. ,&nbsp;Sunjung Kim Ph.D. ,&nbsp;Kevin Chen B.A. ,&nbsp;Hayden Baker M.D. ,&nbsp;Aravind Athiviraham M.D. ,&nbsp;Elhassan Bassem M.D. ,&nbsp;Jason Koh M.D. ,&nbsp;Nicholas Maassen M.D. ,&nbsp;Farid Amirouche Ph.D.","doi":"10.1016/j.asmr.2024.101045","DOIUrl":"10.1016/j.asmr.2024.101045","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the biomechanical effectiveness of superior capsular reconstruction (SCR) and lower trapezius tendon transfer (LTT) to restore the native shoulder kinematics in managing massive rotator cuff tears (MRCTs) using a dynamic shoulder testing system in a cadaver model.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric hemithoraces were tested using a custom-made dynamic shoulder testing system. The conditions tested are intact, supraspinatus tear, MRCT (supraspinatus and infraspinatus tear), LTT with Achilles allograft, SCR combined with LTT, and SCR alone. Measurements included cumulative deltoid force, humeral head translation (HHT), and subacromial peak pressure during humeral abduction at various angles.</div></div><div><h3>Results</h3><div>Significant reductions in cumulative deltoid force were observed from intact to MRCT conditions (<em>P</em> = .023). LTT alone significantly improved deltoid force compared to its combination with SCR (<em>P</em> = .017) and outperformed SCR alone (<em>P</em> = .023). The intact condition showed increasing subacromial peak pressure with higher abduction angles, peaking at 541 kPa at 90°. MRCT exhibited the highest HHT and peak pressure, indicating significant instability. LTT reduced HHT and peak pressure compared to MRCT, indicating partial restoration of stability. The combined LTT + SCR condition demonstrated HHT values close to the intact condition and lower peak pressures, indicating substantial restoration of glenohumeral stability.</div></div><div><h3>Conclusions</h3><div>Simulated active unconstrained humeral abduction in the scapular plane using an entire hemithorax model suggests that LTT can restore dynamic stability and deltoid function in MRCTs, while SCR offers static stability without restoring deltoid function. Combining LTT and SCR may result in lower subacromial peak pressures on the undersurface of the acromion than either procedure alone.</div></div><div><h3>Clinical Relevance</h3><div>This study will contribute to understanding shoulder kinetics concerning current surgical techniques and suggest a dynamic concept of shoulder biomechanics testing.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101045"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845171","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":"Postoperative Outcomes Are Comparable Between Arthroscopic Subscapularis Repairs Performed With Either All-Suture Anchors or Hard-Body Anchors","authors":"Diego Gonzalez-Morgado M.D. ,&nbsp;Javier Ardebol M.D. ,&nbsp;Ali Ihsan Kilic M.D., Ph.D. ,&nbsp;Matthew B. Noble D.O. ,&nbsp;Lisa A. Galasso M.D. ,&nbsp;Matthew Nugent M.D. ,&nbsp;Cameron Phillips M.D. ,&nbsp;Patrick J. Denard M.D.","doi":"10.1016/j.asmr.2024.101060","DOIUrl":"10.1016/j.asmr.2024.101060","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare clinical outcomes and tendon healing rates of patients undergoing arthroscopic rotator cuff repairs involving the subscapularis (SSC) tendon (isolated or combined) with all-suture anchors (ASAs) versus hard-body anchors (HBAs) and to compare SSC healing rates between these 2 anchors.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was performed on patients who underwent arthroscopic rotator cuff repair of the SSC with either ASAs or HBAs and had a minimum 2-year follow-up. Range of motion and patient-reported outcomes were collected pre- and postoperatively, including a visual analog scale for pain, American Shoulder and Elbow Surgeons score, and Subjective Shoulder Value. Postoperative strength was measured, including Constant strength and belly press test. SSC healing was evaluated on ultrasounds at the final follow-up.</div></div><div><h3>Results</h3><div>Eighty-four patients met the study criteria. Twenty-eight underwent SSC repair with ASAs and 56 with HBAs. The mean follow-up for the ASA group and HBA group was 44 ± 22.7 months and 48.4 ± 28.3, respectively (<em>P</em> = .743). Baseline characteristics were comparable between groups (<em>P</em> &gt; .05). Overall, patient-reported outcomes and range of motion showed significant improvements from baseline to the final follow-up in all groups (<em>P</em> &lt; .001). Postoperatively, patients in the ASA group had greater improvement in forward flexion compared to the HBA group: 31° (95% confidence interval, 20°-42°) versus 14° (95% confidence interval, 5°-8°), respectively (<em>P</em> = .002). Postoperative Constant strength was higher in the ASA group compared to the HBA group: 17.5 ± 7.5 versus 13.5 ± 5.6, respectively (<em>P</em> = .04). No statistically significant difference in SSC retear rates was observed between groups: none in the ASA group and 3 (10.7%) in the HBA group (<em>P</em> = .27).</div></div><div><h3>Conclusions</h3><div>Arthroscopic SSC repair leads to significant functional improvement, with both ASAs and HBAs demonstrating similar low failure rates.</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 101060"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845172","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":"Tourniquet Use During Anterior Cruciate Ligament Reconstruction Is Associated With Postoperative Quadriceps Atrophy and Pain but No Negative Effects in the Long Term: A Systematic Review","authors":"Caleb V. Hayes B.S. ,&nbsp;Saad M. Ibrahim B.S. ,&nbsp;Anna E. Crawford B.S. ,&nbsp;James R. Jones M.D. ,&nbsp;Mathew D. Hargreaves B.S. ,&nbsp;Clay A. Rahaman B.A. ,&nbsp;Eugene W. Brabston M.D. ,&nbsp;Thomas B. Evely M.D. ,&nbsp;Aaron J. Casp M.D. ,&nbsp;Kevin E. Wilk D.P.T. ,&nbsp;Amit M. Momaya M.D.","doi":"10.1016/j.asmr.2024.101040","DOIUrl":"10.1016/j.asmr.2024.101040","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effect of tourniquet use during ACL reconstruction on quadriceps strength, intraoperative and postoperative blood loss, operative time, thigh girth or calf girth, and postoperative pain.</div></div><div><h3>Methods</h3><div>A systematic review using PubMed, EMBASE, and Cochrane Database of Systematic Reviews was conducted following the PRISMA guidelines. Randomized controlled trials and nonrandomized studies that evaluated intraoperative and postoperative effects of tourniquet usage during arthroscopic ACL reconstruction published between November 1996 and January 2023 were included. Outcomes evaluated included intraoperative visualization, pain, quadricep strength thigh or calf girth, blood loss, and operative time.</div></div><div><h3>Results</h3><div>Eight studies with 502 total patients were included in this review. There were 253 total patients in the tourniquet (T) group and 249 in the non-tourniquet (NT) group. Postoperative blood loss was higher in the T group (<em>P</em> &lt; .05). Two studies reported significantly increased postoperative analgesic usage within the T group (<em>P</em> &lt; .05), while 2 studies listed no significant differences between groups. Postoperative pain was not significantly increased in either group 2 days postoperation; however, 2 studies reported an increase in pain in the T group within the 10-hour, postoperative window (<em>P</em> &lt;.05). Although 3 studies indicated an initial decrease in quadriceps strength within the T group following surgery (<em>P</em> &lt; .05), overall findings consistently demonstrated a recovery of quadriceps strength within a few weeks. Similarly, there were no long-term significant differences in thigh or calf girth reported. Decreased operative time was reported with tourniquet use across included studies with 1 study demonstrating a significant difference (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Tourniquet use during ACL reconstruction does not have negative long-term effects on quadriceps strength. Although tourniquet use was associated with increased quadriceps atrophy and pain in the immediate postoperative period, these effects did not persist.</div></div><div><h3>Level of Evidence</h3><div>Level II, systematic review of Level I and II studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101040"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845221","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":"Magnetic Resonance Imaging Is an Effective First-Line Noninvasive Tool for Meniscal Tear Detection: A Retrospective Comparative Analysis With Knee Arthroscopy","authors":"Ahmed Mohsen Abbas El-Hagrasy M.B., B.Ch., B.A.O. ,&nbsp;Aaron Jijimon Theckayil M.B., B.Ch., B.A.O. ,&nbsp;Mohammad Adeel Khan M.B.B.S., M.R.C.S. ,&nbsp;Hammad Naqi Khan M.B.B.S., F.C.P.S. ,&nbsp;Ahsan Javaid Butt M.B.B.S., F.R.C.S., Tr.&Orth.","doi":"10.1016/j.asmr.2024.101065","DOIUrl":"10.1016/j.asmr.2024.101065","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI) with intraoperative knee arthroscopic findings for identifying or diagnosing meniscal tears.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of patients who underwent MRI and knee arthroscopy showing either medial meniscus (MM) or lateral meniscus (LM) tears at a single university hospital. The preoperative MRI findings of patients were compared with intraoperative arthroscopic findings to determine the presence, location, and morphology of meniscal tears. The results of arthroscopy were considered the definitive diagnosis.</div></div><div><h3>Results</h3><div>A total of 543 patients were initially identified. Of these, 220 met the study eligibility criteria and were included. The sensitivity, specificity, and accuracy of MRI in relation to arthroscopy were 94.29% (95% confidence interval [CI], 89.05%-97.50%), 78.75% (95% CI, 68.17%-87.11%), and 88.64% (95% CI, 83.68%-92.51%), respectively, for MM tears and 76.74% (95% CI, 66.39%-85.18%), 94.03% (95% CI, 88.58%-97.39%), and 87.27% (95% CI, 82.13%-91.37%), respectively, for LM tears. Complex tears were the most common morphology of tears, and the posterior horn was the most common location.</div></div><div><h3>Conclusions</h3><div>MRI is an effective first-line noninvasive diagnostic tool for investigating meniscal tears, with overall diagnostic accuracies of 88.64% for MM tears and 87.27% for LM tears. MM tears had the highest incidence, particularly in the posterior horn. MRI showed high sensitivity for MM tears, high specificity for LM tears, and substantial agreement with arthroscopy in diagnosing both MM and LM tears. However, MRI’s specificity for MM tears and sensitivity for LM tears were lower, suggesting that it may not be as reliable in confirming MM tears or ruling out LM tears.</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 101065"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845142","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}