Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Both Single- and Double-anchor Remplissage Techniques Restore Native Stability in a Cadaveric Model of Hill-Sachs Lesions in Anterior Shoulder Instability","authors":"Patrick J. Morrissey M.D.,&nbsp;Edward J. Testa M.D.,&nbsp;Matthew Quinn M.D.,&nbsp;Elaine He B.S.,&nbsp;Rohit Badida B.S.,&nbsp;Joseph Cusano M.D.,&nbsp;Brett D. Owens M.D.","doi":"10.1016/j.asmr.2024.101003","DOIUrl":"10.1016/j.asmr.2024.101003","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the most effective number and location of fixation points for remplissage of Hill-Sachs lesions (HSL) in a cadaveric model of anterior shoulder instability.</div></div><div><h3>Methods</h3><div>Eleven fresh-frozen cadaveric shoulder specimens were tested. A robot device tested resistance to anterior translation of the humeral head. Eleven shoulder conditions were tested: (1) intact, (2) 15% HSL, (3) 15% HSL with 1 central, (4) 15% HSL with 2 central, (5) 15% HSL with 1 medial, (6) 15% HSL with 2 medial, (7) 30% HSL, (8) 30% HSL with 1 central, (9) 30% HSL with 2 central, (10) 30% HSL with 1 medial, and (11) 30% HSL with 2 medial.</div></div><div><h3>Results</h3><div>All remplissage techniques tested restored peak resistance to at least equal that of the intact shoulder condition. In the small Hill-Sachs condition, the mean peak resistance for 1 central, 2 central, 1 medial, and 2 medial fixation was 41.5, 52.3, 45.1, and 54.8, respectively. In the large Hill-Sachs condition, the mean peak resistance was 41.7, 59.9, 42.6, and 64.43, respectively. Two fixation points provided more resistance than one in both the medial (<em>P</em> &lt; .01) and central (<em>P</em> &lt; .01) locations. When comparing fixation location, however, there was not a significant difference between 1 central and 1 medial (<em>P</em> &gt; .05) or 2 central to 2 medial (<em>P</em> &gt; .05) in either the large or small HSL.</div></div><div><h3>Conclusions</h3><div>All remplissage techniques were able to successfully restore mean peak resistance to anterior translation to the native condition in this cadaveric model. There was not a difference in resistance force between medial wall and central placement for either the single- or double-fixation configurations.</div></div><div><h3>Clinical Relevance</h3><div>This study suggests that one anchor placed either medially or centrally will restore native stability in remplissage for anterior shoulder instability.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101003"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386468","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":"Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications","authors":"Michael R. Cesarek M.S. ,&nbsp;Nicholas O. Gerard III M.S. ,&nbsp;Brianna N. Griswold B.S. ,&nbsp;Mia V. Rumps M.S. ,&nbsp;Michael J. O’Brien M.D. ,&nbsp;Felix H. Savoie III M.D. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.asmr.2024.101030","DOIUrl":"10.1016/j.asmr.2024.101030","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution and to identify the most common medications and classes of drugs being taken in this specific patient population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of patients treated by 3 fellowship-trained orthopaedic sports medicine and shoulder surgeons between 2019 and 2021. All patients who underwent shoulder arthroscopy during this period were included. The following data were collected: age, sex, laterality of surgery, prior surgical procedures on the operated shoulder, specific surgery performed, and use of psychotropic medications. Drug categories included anticonvulsants, antidepressants/anxiolytics, sedative hypnotics, stimulants, antipsychotics, and multiple psychotropic drugs. Psychotropic medications were included if they were listed as being taken at any time in the patient’s chart (“taking”) within a 6-month window prior to surgery.</div></div><div><h3>Results</h3><div>Of the 1,279 patients (828 male and 451 female patients) whose charts were reviewed, 534 (41.8%) were prescribed at least 1 psychotropic. Of the 453 patients treated in 2021, 201 (44.4%) were taking at least 1 psychotropic. Similarly, 152 of the 397 patients treated in 2020 (38.2%) and 181 of the 429 patients treated in 2019 (42.2%) were found to be taking at least 1 psychotropic. Among the 1,279 patients included, 282 of 828 male patients (34.1%) were prescribed psychotropic drugs compared with 252 of 451 female patients (55.9%, <em>P</em> = .001). From 2019 to 2021, 137 of the patients using psychotropic drugs (25%) were prescribed anticonvulsants/mood stabilizers; 105 (19%), antidepressants; 75 (14%), sedative hypnotics; 23 (4%), stimulants; 4 (1%), antipsychotics; and 190 (35%), multiple psychotropics. From 2019 to 2021, the rate of antidepressant/anxiolytic and/or sedative hypnotic prescription psychotropic drug use increased from 28% to 30.5% (<em>P</em> = .42).</div></div><div><h3>Conclusions</h3><div>This study showed that a large portion of patients undergoing shoulder arthroscopy were taking psychotropic medications. Furthermore, we found that female patients had significantly higher utilization of these medications compared with male patients.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the prevalence of these medications in orthopaedic patients is essential for surgeons to take into consideration to limit preoperative, intraoperative, and postoperative complications, as well as optimize patient outcomes.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101030"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386530","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":"Multidisciplinary Team Discussions and the Inclusion of Individualized Patient Factors May Improve Informed Consent in Sports Medicine","authors":"John Grossi B.S. ,&nbsp;Lexi Garber B.S. ,&nbsp;Brandon Klein D.O., M.B.A. ,&nbsp;Lucas Bartlett D.O. ,&nbsp;Adam D. Bitterman D.O. ,&nbsp;Randy M. Cohn M.D. ,&nbsp;Nicholas A. Sgaglione M.D.","doi":"10.1016/j.asmr.2024.101007","DOIUrl":"10.1016/j.asmr.2024.101007","url":null,"abstract":"<div><div>Informed consent allows for the maintenance of patient autonomy and is essential in establishing trusting relationships between physicians and their patients. This process involves thorough discussion of the risks and alternatives, as well as the short- and long-term outcomes, of proposed treatment options. Inadequacies with informed consent can lead to inferior patient outcomes and may be subject to severe legal consequences. Individualized discussions are warranted to address the questions of these patients, whether it be the high-level athlete or the weekend warrior. This review highlights factors, identifies barriers, and proposes potential solutions to improve informed consent within orthopaedic sports medicine.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101007"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386531","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":"Twenty-Year Analysis of Surfing Head and Neck Injuries Presenting to United States Emergency Departments Showed a Decrease in Overall Injuries Despite Steady Concussion Rates","authors":"Eli M. Snyder B.S. ,&nbsp;Elizabeth A. Rooks B.A. ,&nbsp;Kyle K. Obana M.D. ,&nbsp;Spencer K.Y. Chang M.D. ,&nbsp;Christopher S. Ahmad M.D. ,&nbsp;Charles A. Popkin M.D. ,&nbsp;David P. Trofa M.D.","doi":"10.1016/j.asmr.2024.101014","DOIUrl":"10.1016/j.asmr.2024.101014","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the etiology, diagnosis, and incidence of head and neck (HN) injuries among ocean surfers.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System database was queried for surfing HN injuries presenting to United States emergency departments (EDs) between January 2003 and December 2022. Date of presentation, age, sex, race, injured body part, injury diagnosis, and disposition, as well as a brief injury narrative, were included in the data. National estimates (NEs) were calculated using the associated statistical weight of the reporting hospital.</div></div><div><h3>Results</h3><div>A total of 1,359 surfing-related HN injuries (NE, 90,872) were included in this study. The average age at presentation was 29.2 ± 13.8 years (range, 3 to 81 years). The most commonly specified mechanisms of injury were impact with board (NE, 48,360 [53%]) and impact with ocean floor (NE, 8,690 [10%]). Concussions represented 5% of surfing HN injuries and occurred at a higher rate (8%) in the age group younger than 20 years. There were statistically significant decreases in overall HN injuries (<em>P</em> &lt; .01) (coefficient, –270; 95% confidence interval [CI], –355 to –206), lacerations (<em>P</em> &lt; .01) (coefficient, –208; 95% CI, –258 to –158), and impact-with-board injuries (<em>P</em> &lt; .01) (coefficient, –177; 95% CI, –327 to –117) presenting to United States EDs from 2003 to 2022.</div></div><div><h3>Conclusions</h3><div>Although surfing HN injury ED presentations decreased from 2003 to 2022, the rate of surfing-related concussions presenting to EDs remained steady. Concussions therefore remain a significant concern in surfing, especially among surfers under 20 years of age.</div></div><div><h3>Clinical Relevance</h3><div>As the sport of surfing has increased in popularity, it is important to understand the range of surfing injuries seen in EDs. HN injuries, especially concussions, should be thoroughly investigated to better understand the risks of ocean surfing, to advise athletes, and to develop effective injury prevention strategies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101014"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386548","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 Capsulectomy Through Humeral Fenestration in Arthroscopic Arthrolysis for Elbow Stiffness Is Safe and Effective","authors":"Clémence Lemaître ,&nbsp;Antoine Senioris M.D. ,&nbsp;Fabrice Duparc M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101029","DOIUrl":"10.1016/j.asmr.2024.101029","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate arc of motion and complications following transhumeral anterior capsulectomy through a purely posterior approach with the Outerbridge-Kashiwagi procedure in treating elbow stiffness.</div></div><div><h3>Methods</h3><div>Patients who were treated for elbow stiffness between April 2003 and February 2023 were retrospectively identified. The inclusion criteria were an extension/flexion arc deficit of at least 30° and treatment with arthroscopic arthrolysis through posterior and posterolateral portals with humeral fenestration. Elbow joint range of motion and the Mayo Elbow Performance Score were assessed preoperatively, intraoperatively, at 6 weeks, and at final follow-up. The follow-up ended when the elbow became asymptomatic again or when the recovery was considered stable. Postoperative complications were recorded.</div></div><div><h3>Results</h3><div>A total of 30 patients (23 men/7 women; 31 elbows; 1 bilateral/29 unilateral) were included. Mean follow-up was 11.1 months (1-64). Mean joint amplitudes intraoperatively increased in all areas of mobility, including extension/flexion from 86° to 132.6° (<em>P</em> = .001) and pronation/supination from 163.9° to 179.7° (<em>P</em> = .025). At the longest follow-up, mean joint amplitude was increased from 86° to 118.9° (<em>P</em> = .002) in extension/flexion and from 136.9° to 173.9° (<em>P</em> = .022) in pronation/supination. The mean deficit was reduced from 54° to 21.1° (<em>P</em> = .001) in extension/flexion and from 16.1° to 6.1° (<em>P</em> = .006) in pronation/supination. The mean gain in the extension/flexion arc was 31.5° and 10° for the pronation/supination arc. Loss in flexion/extension was limited (mean: 14.2°, extreme: 50°). The study showed no neurologic complications.</div></div><div><h3>Conclusions</h3><div>Arthroscopic arthrolysis of a stiff elbow using a purely posterior approach with anterior capsulectomy via the Outerbridge-Kashiwagi procedure was safe and effective. Clinical results showed improvement in joint range of motion in flexion/extension and pronation/supination, both intraoperatively and postoperatively, with no postoperative neurologic complications.</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 1","pages":"Article 101029"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386774","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":"Rotator Cuff Repairs Using Double-Row Modified Mason-Allen Stitches Resulted in Superior Clinical Outcomes at 2-Year Follow-Up Compared to the Double-Row Suture-Bridge Technique: A Case-Control Matching Study","authors":"W.P. Yau M.B.B.S., F.R.C.S.Ed., F.R.C.S.Ed. (Ortho), F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)","doi":"10.1016/j.asmr.2024.100997","DOIUrl":"10.1016/j.asmr.2024.100997","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical outcomes of rotator cuff repair using a double-row modified Mason-Allen stitch (DR-MA) with those repaired with a double-row suture bridge (DR-SB).</div></div><div><h3>Methods</h3><div>A retrospective case-control matching study was conducted to compare the results of patients who received complete supraspinatus tendon repair using a DR-MA configuration and a DR-SB pattern between 2009 and 2020. Exact matching was performed for patients with intact rotator cuff repair at postoperative magnetic resonance imaging. The matching criteria included sex, workers’ compensation, smoking status, hyperlipidemia, size and retraction of tear, and acromioplasty. Clinical outcomes, including visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score, and active shoulder forward flexion (FF), were documented at the 2-year follow-up. The percentage of patients who achieved minimum clinically important difference (MCID) was reported.</div></div><div><h3>Results</h3><div>A total of 64 patients, including 28 men and 36 women, were matched, and the 2-year follow-up rate was 100%. All patients received postoperative magnetic resonance imaging at 19 ± 11 months. Significant improvement in all clinical outcomes was observed, regardless of the repair pattern (<em>P</em> &lt; .001). The 2-year VAS was better in the DR-MA group compared to the DR-SB group (1.5 ± 2.0 and 2.9 ± 2.6, respectively; <em>P</em> = .009). At the 2-year follow-up, 91%, 90%, and 63% of patients in the DR-MA group achieved MCID in VAS, ASES, and FF, respectively. There was no difference in the proportion of patients achieving MCID between the 2 treatment arms. However, a more substantial improvement in VAS (<em>P</em> = .008), ASES (<em>P</em> = .014), and FF (<em>P</em> = .039) between preoperation and the 2-year follow-up was noted in the DR-MA group.</div></div><div><h3>Conclusions</h3><div>No clinical differences in pain or function were found between DR-MA and DR-SB despite small and statistically significant differences in favor of DR-MA.</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 100997"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386467","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":"Cadaveric Specimens Used in Studies Evaluating Bone Loss in Anterior Shoulder Instability Are Not Representative of the Affected Patient Population: A Systematic Review","authors":"Amin Karimi M.D.,&nbsp;Anya Singh-Varma B.S.,&nbsp;Rajiv P. Reddy M.D.,&nbsp;Matthew P. Kolevar M.D.,&nbsp;Albert Lin M.D.","doi":"10.1016/j.asmr.2024.100996","DOIUrl":"10.1016/j.asmr.2024.100996","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the age, sex, and site of evaluated bone loss in specimens used in cadaveric studies assessing the role of bone loss in anterior shoulder instability and to evaluate whether these studies evaluate glenoid and humeral bone loss separately or as a combined biomechanical problem.</div></div><div><h3>Methods</h3><div>Embase, MEDLINE, Scopus, Web of Sciences, Google Scholar, and Cochrane databases were queried electronically in April 2023 for cadaveric studies examining the relationship between anatomic structures and recurrent anterior shoulder instability. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Studies were excluded if they evaluated the role of soft tissue structures in anterior shoulder stability or assessed anterior bony reconstruction methods to create a stable shoulder and those with fewer than 5 specimens. The following search terms were used: cadaver(s), corpse(s), shoulder dislocation(s), glenohumeral dislocation(s), glenohumeral subluxation(s), glenoid (cavity), and humeral head. Data collected included the age, sex, and site of evaluated bone loss in cadaveric specimens. Studies were categorized based on the anatomic structure that was examined in connection with recurrent anterior shoulder instability: proximal humerus bone defects, glenoid bone defects, and combined bone defects.</div></div><div><h3>Results</h3><div>Eighteen articles were included in the review, which evaluated 244 cadavers. The sex of 74 cadavers (30.3%) was recorded as male, 50 (20.4%) as female, and 120 (49.1%) were not reported. The mean age of the cadavers was 61.1 ± 15.9 years. Most of the investigations (55.5%) were conducted in the United States. Ten studies looked at the relationship between anterior shoulder instability and glenoid bony structure, 3 assessed the effect of Hill-Sachs lesion size, and only 5 (27.7%) investigated the impact of bipolar bone defects.</div></div><div><h3>Conclusions</h3><div>The ages of cadavers utilized in biomechanical studies assessing the relationship of glenoid and humeral bone loss to anterior shoulder instability are different from the age range of patients who present with this clinical problem. Males were more frequently studied, and most of these biomechanical studies were conducted in the United States. In addition, few studies evaluate the relationship between anterior shoulder instability and bone loss as a bipolar structural defect.</div></div><div><h3>Clinical Relevance</h3><div>It is important to understand how closely study specimens match the patient population with the condition being investigated. This study will provide information about the cadaveric specimens used in studies evaluating bone loss in anterior shoulder instability.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100996"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386550","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":"In Patients With Bilateral Rotator Cuff Tear, Staged Surgery is Superior to Simultaneous Surgery: A Systematic Review","authors":"Gaston Davis B.S. ,&nbsp;Usman Zareef B.A. ,&nbsp;Andres Perez B.A. ,&nbsp;Ryan W. Paul B.S. ,&nbsp;Daniel Givner B.S. ,&nbsp;Brandon J. Erickson M.D. ,&nbsp;Kevin B. Freedman M.D. ,&nbsp;Steven B. Cohen M.D. ,&nbsp;Fotios P. Tjoumakaris M.D.","doi":"10.1016/j.asmr.2024.101033","DOIUrl":"10.1016/j.asmr.2024.101033","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare revision rates and functional outcomes between patients who underwent staged versus simultaneous bilateral rotator cuff repair (RCR).</div></div><div><h3>Methods</h3><div>This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with no institutional review board approval or funding required. The PubMed, SportDiscus, and Ovid Medline databases were queried to identify original research studies evaluating preoperative characteristics and postoperative outcomes of staged or simultaneous RCR. The following search algorithm was used: ((Bilateral) OR (simultaneous) OR (Staged)) AND (rotator cuff repair). Demographics including the number of male and female patients, age, type of surgical intervention, time between staged surgery, and surgical indication were collected. Variables of interest included pre- and postoperative shoulder pain and functional scores, as well as retear, reoperation, revision, complications, and their rates of occurrence.</div></div><div><h3>Results</h3><div>Overall, 594 studies were screened, and 8 studies were included in this systematic review. In total, 11,188 patients (97.5%) underwent staged repair and 286 (2.5%) underwent simultaneous repair. Delaying staged surgery by more than 2 years also had decreased surgical complications such as conversion to reverse total shoulder arthroplasty, postoperative infection, venous thromboembolism, and emergency department visits when compared with simultaneous RCR (<em>P</em> ≤ .031) and earlier staging (less than 3 months) (<em>P</em> ≤ .015). In addition, one study found staged RCR had better patient-reported outcome measures (University of California-Los Angeles, Constant, and American Shoulder and Elbow Surgeons scores; <em>P</em> &lt; .001) when staged greater than 9 months apart.</div></div><div><h3>Conclusions</h3><div>Staged RCR has superior functional outcomes, decreased surgical complications, as well as lower revision rates than simultaneous RCR.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level II-IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101033"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386633","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":"Lateral Meniscal Oblique Radial Tears Were Observed Concomitantly With Anterior Cruciate Ligament Tears in 6% of Pediatric Patients Undergoing Anterior Cruciate Ligament Reconstruction","authors":"John F. Burke M.D.,&nbsp;Emma L. Klosterman M.D.,&nbsp;Adam J. Tagliero M.D.,&nbsp;Neil P. Blanchard M.D.,&nbsp;Royce Le B.S.,&nbsp;Antonio Almario B.S.,&nbsp;David R. Diduch M.D.","doi":"10.1016/j.asmr.2024.101012","DOIUrl":"10.1016/j.asmr.2024.101012","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the incidence of lateral meniscal oblique radial tears (LMORTs) concomitant with anterior cruciate ligament (ACL) tears in pediatric patients undergoing ACL reconstruction.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort design was used to analyze all patients 18 years and younger undergoing ACL reconstruction between July 2017 and February 2023. Operative notes and intraoperative arthroscopic photos were analyzed to determine the incidence of LMORTs. Two independent observers reviewed the images and reached agreement on LMORT incidence and classification of each tear. Demographic, clinical, and outcomes data were collected and analyzed.</div></div><div><h3>Results</h3><div>Lateral meniscal oblique radial tears were identified in 19 of 310 (6.13%) adolescent and pediatric ACL reconstruction cases. Of these patients, 68.4% were male. All but one patient had signs of lateral meniscus injury on preoperative magnetic resonance imaging. Of the LMORT patients, 7 (37%) had a type 1 tear, 1 (5%) had a type 2 tear, 7 (37%) had a type 3 tear, and 4 (21%) had a type 4 tear.</div></div><div><h3>Conclusions</h3><div>Lateral meniscal oblique radial tears were observed concomitantly with ACL tears in 6% of pediatric patients undergoing ACL reconstruction.</div></div><div><h3>Clinical Relevance</h3><div>Awareness and recognition of LMORTs is important as the treatment paradigm for LMORT injuries continues to evolve.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 101012"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386715","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":"Patients with Frozen-Phase Frozen Shoulder Demonstrated Improvement of Pain and Mobility of Forward Elevation and Internal Rotation After a Single Glenohumeral Injection of Corticosteroids","authors":"Wei-Hsuan Wang ,&nbsp;Poyu Chen Ph.D. ,&nbsp;Louis Yi Lu M.D. ,&nbsp;Cheng-Pang Yang M.D. ,&nbsp;Joe Chih-Hao Chiu M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101025","DOIUrl":"10.1016/j.asmr.2024.101025","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the improvement in frozen-phase frozen shoulder (FS) patients’ pain and shoulder mobility, including passive forward elevation (FE), external rotation (ER), and internal rotation (IR), after 2 consecutive intra-articular corticosteroid (IACS) injections.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was performed from July 2020 to November 2023. All patients with frozen-phase FS received 2 ultrasound-guided IACS injections at 6-week intervals. FE, ER, IR, and visual analog scale scores were measured at each follow-up consultation with a 6-week interval.</div></div><div><h3>Results</h3><div>A total of 134 patients finished the study. There were varying degrees of change in pain relief and range-of-motion improvement between each IACS injection. FE and IR improved significantly between the first and second injections (<em>P</em> = 5.2 × 10⁻²⁴ and 1.1 × 10⁻²¹, respectively), whereas ER only improved significantly after the second injection (<em>P</em> &lt; .05). The pain level improved both after the first injection and after the second injection (both <em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Patients with frozen-phase FS show improved pain, FE mobility, and IR mobility after a single IACS injection. However, a second IACS injection provides similar therapeutic effects and significantly improves ER mobility.</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 101025"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386716","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}