Arthroscopy Sports Medicine and Rehabilitation最新文献

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Four-Strand Hamstring Autografts Less Than 8-mm Wide Provide Less Capability for Conversion to a 6- or 7-Strand Graft Than Larger-Diameter Hamstring Autografts 宽度小于8毫米的四股腿筋自体移植物比直径较大的腿筋自体移植物转化为6股或7股腿筋移植物的能力要小
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101098
W.P. Yau M.B.B.S., F.R.C.S.Ed., F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)
{"title":"Four-Strand Hamstring Autografts Less Than 8-mm Wide Provide Less Capability for Conversion to a 6- or 7-Strand Graft Than Larger-Diameter Hamstring Autografts","authors":"W.P. Yau M.B.B.S., F.R.C.S.Ed., F.H.K.C.O.S., F.H.K.A.M. (Orthopaedic Surgery)","doi":"10.1016/j.asmr.2025.101098","DOIUrl":"10.1016/j.asmr.2025.101098","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the proportion of patients who have long-enough hamstring (HS) tendons to prepare an anterior cruciate ligament reconstruction (ACLR) graft of 5 strands, 6 strands, 7 strands, or 8 strands in patients with a small 4-strand HS ACLR graft diameter &lt;8 mm (HS-ACLR-4S &lt;8 mm) compared with patients who had a 4-strand HS ACLR graft diameter ≥8 mm (HS-ACLR-4S ≥8 mm).</div></div><div><h3>Methods</h3><div>Patients who underwent medial HS harvest for single-bundle ACLR between 2008 and 2018 were included. Patients were included if the ACLR graft was a doubled semitendinosus and doubled gracilis autograft and they were skeletally mature. The primary outcome was the length of the HS. The likelihood of successful preparing an HS ACLR with 5 strands of tendons or more (HS-ACLR ≥5S) was compared between HS-ACLR-4S &lt;8 mm and HS-ACLR-4S ≥8 mm. Any anthropometric factors significantly associated with the feasibility of preparing a HS-ACLR≥5S were reported.</div></div><div><h3>Results</h3><div>A total of 296 patients, including 223 men and 73 women, were included. One hundred patients had HS-ACLR-4S &lt;8 mm, whereas 196 patients had HS-ACLR-4S ≥8 mm. The length of the HS was shorter in the HS-ACLR-4S &lt;8-mm group compared with the HS-ACLR-4S ≥8-mm group (<em>P</em> &lt; .001). There was no significant difference between the 2 groups in the chance of successfully preparing a 5-strand graft (97% and 98%, respectively; <em>P</em> = .327). However, there was a lower chance of preparing an ACLR graft using 6 or 7 strands of tendons in patients with HS-ACLR-4S &lt;8-mm (<em>P</em> = .031 and <em>P</em> &lt; .001, respectively). In addition, body height was the sole independent predictor of the likelihood of successfully preparing a HS-ACLR of more than 5 strands of tendon.</div></div><div><h3>Conclusions</h3><div>Preparation of a 5-strand ACLR graft is almost always possible, regardless of whether the HS-ACLR-4S graft diameter was less than 8 mm or 8 mm or greater. Shorter body height was associated with a lower chance of successfully preparing an HS-ACLR with 5 strands of tendons. However, the likelihood of successfully preparing a 6-strand and a 7-strand HS-ACLR graft were lower in the group of patients with an HS-ACLR-4S &lt;8 mm compared with HS-ACLR-4S ≥8 mm.</div></div><div><h3>Clinical Relevance</h3><div>Understanding the factors related to ACL HS tendon autograft preparation can allow surgeons to ensure grafts of adequate length and diameter.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101098"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481235","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}
引用次数: 0
Obese Patients Demonstrate Higher Failure Rates, Infection Rates, and Inferior Patient-Reported Outcomes Compared With Nonobese Patients Following Multiligamentous Knee Surgery 与非肥胖患者相比,肥胖患者在多韧带膝关节手术后表现出更高的失败率、感染率和较差的患者报告结果
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101111
Adam V. Daniel M.D., Warren A. Williams M.D., Brendan J. Kosko M.D., Joshua A. Cohen, Andrew D. Carbone M.D., Stanley J. Kupiszewski M.D.
{"title":"Obese Patients Demonstrate Higher Failure Rates, Infection Rates, and Inferior Patient-Reported Outcomes Compared With Nonobese Patients Following Multiligamentous Knee Surgery","authors":"Adam V. Daniel M.D.,&nbsp;Warren A. Williams M.D.,&nbsp;Brendan J. Kosko M.D.,&nbsp;Joshua A. Cohen,&nbsp;Andrew D. Carbone M.D.,&nbsp;Stanley J. Kupiszewski M.D.","doi":"10.1016/j.asmr.2025.101111","DOIUrl":"10.1016/j.asmr.2025.101111","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine outcomes following surgically treated multiligamentous knee injuries (MLKIs) in obese versus nonobese patients.</div></div><div><h3>Methods</h3><div>Patients who were surgically treated for MLKIs between 2008 and 2021 were included in this study. Patients were divided into 2 groups and classified as obese (body mass index ≥30) or nonobese. The following patient-reported outcome measures were collected: the visual analog scale for pain, the International Knee Documentation Committee subjective score, and the Lysholm knee scoring scale. Complications such as revision ligamentous reconstruction, conversion to total knee arthroplasty (TKA), infection, and arthrofibrosis were also documented.</div></div><div><h3>Results</h3><div>A total of 88 patients (88 knees; 43 obese, 45 nonobese) were included in the final analysis. The mean overall age was 34.3 ± 12.7 years (10-61 years), and there were 30 women and 58 men included in this study cohort. The mean follow-up for the patients who did not receive a revision or TKA was 9.2 years (range, 3.4-15.3 years). There were no differences seen between groups for age, sex, mechanism of injury, neurovascular status, concomitant injuries, frank knee dislocations, surgical staging, or external fixator application. However, the mean follow-up in the nonobese group was higher than in the obese group (9.7 vs 8.3 years, <em>P</em> = .003). The nonobese cohort had significantly more open injuries compared to the obese cohort (11.1% vs 2.3%, <em>P</em> = .05). Although there were no differences seen in conversion to TKA or arthrofibrosis, the obese cohort had a higher rate of ligament failure (30.2% vs 8.9%, <em>P</em> = .02) and infection (14% vs 2.2%, <em>P</em> = .05). Additionally, the obese cohort had worse visual analog scale for pain scores (4.4 vs 2.2, <em>P</em> = .002), lower International Knee Documentation Committee scores (50.3 vs 74.6, <em>P</em> &lt; .001), and lower Lysholm scores (59.9 vs 80.6, <em>P</em> = .004) at final follow-up compared to the nonobese cohort.</div></div><div><h3>Conclusions</h3><div>Obese patients had significantly higher rates of ligament failure and infection rates, higher pain scores, and worse patient-reported outcomes than nonobese patients following surgically treated MLKIs.</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 3","pages":"Article 101111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481240","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}
引用次数: 0
Guided Education and the Fundamentals of Arthroscopy Surgery Training (FAST) Workstation Improve Surgical Resident Knot-tying Skills 引导教育和关节镜手术基础训练(FAST)工作站提高外科住院医师打结技能
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101110
Hassan Farooq M.D. , Andrew Gaetano B.S. , Dane Salazar M.D., M.B.A. , Nickolas Garbis M.D.
{"title":"Guided Education and the Fundamentals of Arthroscopy Surgery Training (FAST) Workstation Improve Surgical Resident Knot-tying Skills","authors":"Hassan Farooq M.D. ,&nbsp;Andrew Gaetano B.S. ,&nbsp;Dane Salazar M.D., M.B.A. ,&nbsp;Nickolas Garbis M.D.","doi":"10.1016/j.asmr.2025.101110","DOIUrl":"10.1016/j.asmr.2025.101110","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the influence of guided education on the mechanical resilience of knots tied by surgical residents using the Fundamentals of Arthroscopy Surgery Training (FAST) workstation as a quantitative tool.</div></div><div><h3>Methods</h3><div>Surgical residents in postgraduate year (PGY) 1 through 5 were asked to tie knots first in a pre-education phase. Next, residents were provided an instructional video demonstrating high-level knot-tying instructed by a fellowship-trained shoulder and elbow surgeon. After the video demonstration, residents were asked to tie knots again in a posteducation phase. Using the FAST workstation, the mechanical resilience of each knot was quantified by suture loop elongation. The McNemar test was used for statistical analysis.</div></div><div><h3>Results</h3><div>Forty-one surgical residents were enrolled into this investigation. Among all participants, there was significantly greater knot-tying success in the posteducation phase after review of the instructional video as compared with the pre-education phase (<em>P</em> &lt; .001). Subgroup analysis was conducted for each PGY level (1-5), and significant findings of greater knot-tying success in the posteducation phase was notable for the PGY-1 and PGY-2 residents (<em>P</em> &lt; .001 and <em>P</em> = .002, respectively).</div></div><div><h3>Conclusions</h3><div>Guided education with the use of an instructional video and a FAST workstation significantly enhances the mechanical resilience of surgical resident knots, particularly for those in their early PGYs. However, the permanency of this improvement is unknown.</div></div><div><h3>Clinical Relevance</h3><div>It is important to evaluate tools that can improve surgical education. Information from this study can be used by residency programs to ensure the proficiency of their trainees.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481304","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}
引用次数: 0
Biointegrative Nail Raftering Improves Pain and Function in Patients With Subchondral Insufficiency of the Knee 生物综合钉固定术改善膝关节软骨下功能不全患者的疼痛和功能
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101105
Alexander C. Weissman M.S., Allen A. Yazdi B.S., Jared P. Sachs M.S., Sarah A. Muth B.A., Andrew S. Bi M.D., Ron Gilat M.D., Brian J. Cole M.D., M.B.A.
{"title":"Biointegrative Nail Raftering Improves Pain and Function in Patients With Subchondral Insufficiency of the Knee","authors":"Alexander C. Weissman M.S.,&nbsp;Allen A. Yazdi B.S.,&nbsp;Jared P. Sachs M.S.,&nbsp;Sarah A. Muth B.A.,&nbsp;Andrew S. Bi M.D.,&nbsp;Ron Gilat M.D.,&nbsp;Brian J. Cole M.D., M.B.A.","doi":"10.1016/j.asmr.2025.101105","DOIUrl":"10.1016/j.asmr.2025.101105","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the utility of implanting biointegrative cannulated nails in a rafter arrangement within the tibial plateau or femoral condyle for treatment of subchondral insufficiency of the knee.</div></div><div><h3>Methods</h3><div>Patients were followed for 12 months after surgical intervention for subchondral insufficiency using biointegrative, fiber-reinforced fixation nails. Patients (ages 18-75 years) had moderate knee pain for at least 6 months, unicompartmental Kellgren-Lawrence grade 2-3 and bone marrow lesions confirmed on magnetic resonance imaging (MRI). Comparison of baseline and postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome measure. Other patient-reported outcome measures included International Knee Documentation Committee (IKDC) and Patient-reported Outcomes Measurement Information System (PROMIS). Minimal clinically important difference was calculated for each PRO. Calculated bone marrow lesion volumes measured on MRI were compared from baseline to 12 months postoperative.</div></div><div><h3>Results</h3><div>Nine patients were included, with follow-up of 12 ± 1 months. Significant improvements were seen in KOOS, IKDC, PROMIS, and Veterans RAND 12-Item Health Survey (VR-12). The average change in patient-reported outcome measures at 12 months were KOOS (19.68, <em>P</em> = .008), IKDC (28.99, <em>P</em> = .004), PROMIS Pain Interference (10.35, <em>P</em> = .008), PROMIS Physical Function (11.06, <em>P</em> = .008), and VR-12 Physical (16.14, <em>P</em> = .008). Minimal clinically important difference was achieved in 89% of patients for KOOS, 100% for IKDC, 87.5% for PROMIS Pain Interference and Physical Function, and 62.5% for VR-12 Physical. The average decrease in subchondral lesion size measured on MRI did not reach statistical significance (<em>P</em> = .064). All patients reported successful return to sport, with no reoperations or implant failures.</div></div><div><h3>Conclusions</h3><div>Biointegrative fixation nail raftering for treatment of subchondral insufficiency of the knee resulted in improved patient-reported pain and functionality at 12-month follow-up in the setting of early-to-moderate osteoarthritis.</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 3","pages":"Article 101105"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481238","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}
引用次数: 0
TikTok Videos Related to the Posterior Cruciate Ligament Have Low Educational Value 与后十字韧带相关的抖音视频教育价值较低
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101102
Riccardo D’Ambrosi M.D. , Pietro Maria Marchetti M.D. , Domenico Albano M.D. , Chiara Ursino M.D. , Matteo Formica M.D. , Nicola Ursino M.D. , Timothy E. Hewett Ph.D.
{"title":"TikTok Videos Related to the Posterior Cruciate Ligament Have Low Educational Value","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Pietro Maria Marchetti M.D. ,&nbsp;Domenico Albano M.D. ,&nbsp;Chiara Ursino M.D. ,&nbsp;Matteo Formica M.D. ,&nbsp;Nicola Ursino M.D. ,&nbsp;Timothy E. Hewett Ph.D.","doi":"10.1016/j.asmr.2025.101102","DOIUrl":"10.1016/j.asmr.2025.101102","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the validity and informational value of the material about the posterior cruciate ligament (PCL) provided on TikTok.</div></div><div><h3>Methods</h3><div>The terms “posterior cruciate ligament” and “PCL” were used as keywords for an extensive search of the video content on the TikTok video platform. The video duration and the numbers of likes, shares, saves, and views were recorded for each video. The quality and reliability assessments of the video content were conducted via the DISCERN instrument, <em>Journal of the American Medical Association</em> benchmark criteria, and Global Quality Score.</div></div><div><h3>Results</h3><div>A total of 48 videos were included in the analysis, of which 18 (37.5%) were posted by physiotherapists; 14 (29.2%), by private users; and 16 (33.3%), by medical doctors/doctors of osteopathic medicine. Most of the information concerned clinical examination (12-25%) or patient experience (12-25%). Video content was focused on education in 26 videos (54.2%), patient experience in 11 (22.9%), and rehabilitation in 11 (22.9%). Most of the videos used music as the background audio (29-60.4%). The mean length of the videos was 29.29 ± 26.95 seconds. The mean number of views was 565,863.02 ± 2,686,462.45, whereas the mean numbers of likes, comments, shares, and saves were 15,533.58 ± 73,143.51, 127.85 ± 671.49, 661.38 ± 3,049.96, and 1,473.90 ± 7,523.37, respectively. The mean DISCERN score, <em>Journal of the American Medical Association</em> score, and Global Quality Score were 16.15 ± 2.53, 0.15 ± 0.36, and 1.08 ± 0.28, respectively, indicating the poorest quality for all 3 indices.</div></div><div><h3>Conclusions</h3><div>Videos about the PCL on the TikTok platform are not comprehensive and have low educational value.</div></div><div><h3>Clinical Relevance</h3><div>Given the growing number of patients using social media to seek information about their medical concerns, it is crucial for orthopaedic health care practitioners to recognize the constraints of TikTok videos that focus on the PCL as possible sources of information for their patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101102"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480285","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}
引用次数: 0
Disagreement Persists on Optimal Rehabilitation Goals and Timelines for Weight-Bearing Restriction, Knee Brace Use, and Return to Sports After Posterolateral Corner Reconstruction 对于负重限制、膝关节支架的使用和后外侧角重建后重返运动的最佳康复目标和时间表,仍存在分歧
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101142
Ilan Y. Mitchnik M.D. , Tomer Mimouni M.Sc. , Loren S. Haichin M.Sc. , Suzana Bayyouk B.P.T. , Gilbert Moatshe M.D. , Dror Lindner M.D. , Jorge Chahla M.D., Ph.D. , Yiftah Beer M.D. , Ron Gilat M.D.
{"title":"Disagreement Persists on Optimal Rehabilitation Goals and Timelines for Weight-Bearing Restriction, Knee Brace Use, and Return to Sports After Posterolateral Corner Reconstruction","authors":"Ilan Y. Mitchnik M.D. ,&nbsp;Tomer Mimouni M.Sc. ,&nbsp;Loren S. Haichin M.Sc. ,&nbsp;Suzana Bayyouk B.P.T. ,&nbsp;Gilbert Moatshe M.D. ,&nbsp;Dror Lindner M.D. ,&nbsp;Jorge Chahla M.D., Ph.D. ,&nbsp;Yiftah Beer M.D. ,&nbsp;Ron Gilat M.D.","doi":"10.1016/j.asmr.2025.101142","DOIUrl":"10.1016/j.asmr.2025.101142","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the variability of rehabilitation protocols for both isolated posterolateral corner (PLC) reconstructions and those with a concomitant anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) reconstruction, to construct uniform rehabilitative protocol recommendations, and to propose rehabilitative outcome measures for future PLC-related clinical studies.</div></div><div><h3>Methods</h3><div>A Google search was conducted for online PLC reconstruction rehabilitation protocols, categorizing them into isolated PLC reconstructions or PLC with concomitant ACL/PCL reconstructions. Rehabilitative goals and timelines were described and agreement rates among protocols were calculated. Comparisons were made between groups and before/after 2019, when a global consensus was published. Common rehabilitative goals with high agreement rates were used to form a recommended protocol.</div></div><div><h3>Results</h3><div>Thirty-seven protocols were analyzed (19 isolated PLC, 9 PLC + PCL, and 9 PLC + ACL). Overall, 31% of rehabilitative goals and timelines had good-to-excellent agreement rates. Post-2019 consensus, adherence to a stepwise rehabilitative approach significantly improved, especially for initiating strength exercises after muscular endurance exercises (<em>P</em> = .009) and initiating power exercises after strength exercises (<em>P</em> = . 031). However, there was no significant change in overall agreement rates (<em>P</em> = . 735). Most disagreements involved postoperative weight-bearing restrictions, with one half of protocols recommending non−weight-bearing and one half partial-weight-bearing; the period of time a knee brace is required after 6 weeks; and return to sports timing, which differed with concomitant ACL (later return) and PCL (earlier return) reconstructions.</div></div><div><h3>Conclusions</h3><div>There is disagreement about optimal rehabilitative goals and timelines for weight-bearing restriction, knee brace use, and return to sports after PLC reconstructions. Rehabilitative outcomes that warrant further research were identified, and a suggested rehabilitation protocol was constructed.</div></div><div><h3>Clinical Relevance</h3><div>Rehabilitation after PLC reconstruction lacks standardization, with significant variation in key milestones such as weight-bearing, knee bracing, and return-to-sport timelines. This study provides an analysis of current rehabilitation protocol inconsistencies and offers a structured recommendation that may assist clinicians and physiotherapists in patient counseling and protocol development.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101142"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480290","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}
引用次数: 0
Combined Latissimus Dorsi/Teres Major Transfer and Superior Capsular Reconstruction Using Autogenous Biceps Tendon Effectively Relieves Pain and Improves Shoulder Function for Posterosuperior Irreparable Rotator Cuff Tears 联合背阔肌/大圆肌转移和自体肱二头肌肌腱上囊重建有效缓解后上不可修复肩袖撕裂的疼痛和改善肩功能
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101147
Luis Alfredo Miranda M.D. , Bo Taek Kim M.D. , Paulo J. Llinás M.D. , Chang Hee Baek M.D. , Jean-David Werthel M.D. , Jean Kany M.D.
{"title":"Combined Latissimus Dorsi/Teres Major Transfer and Superior Capsular Reconstruction Using Autogenous Biceps Tendon Effectively Relieves Pain and Improves Shoulder Function for Posterosuperior Irreparable Rotator Cuff Tears","authors":"Luis Alfredo Miranda M.D. ,&nbsp;Bo Taek Kim M.D. ,&nbsp;Paulo J. Llinás M.D. ,&nbsp;Chang Hee Baek M.D. ,&nbsp;Jean-David Werthel M.D. ,&nbsp;Jean Kany M.D.","doi":"10.1016/j.asmr.2025.101147","DOIUrl":"10.1016/j.asmr.2025.101147","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical outcomes of fully arthroscopic latissimus dorsi (LD) and teres major (TM) transfer combined with superior capsular reconstruction (SCR) using long head of biceps (LHB) tendon in patients with posterior-superior irreparable cuff tears (PSIRCTs).</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients who underwent fully arthroscopic LDTM transfer with SCR using LHB tendon for PSIRCT between January 2021 and November 2023. The inclusion criteria were failure of conservative treatments, PSIRCTs with intact LHB, no or minimal glenohumeral arthritis, and minimum of one year follow-up. Patients were excluded if loss to follow-up, or follow-up of less than 1 year. Clinical assessments included the visual analog scale for pain, Simple Shoulder Test, Subjective Shoulder Value, and American Shoulder and Elbow Surgeons scores, and range of motion (ROM). Using 0.5 standard deviation distribution-based method, the percentage of the minimal clinically important difference was evaluated.</div></div><div><h3>Results</h3><div>A total of 17 patients were included (10 male and 7 female), with a mean follow-up period of 16.3 ± 5.9 months (range, 12-27 moths). Significant improvements were observed across all outcome measures, including the visual analog scale (6.3 ± 2.0 to 2.0 ± 2.2), Simple Shoulder Test (3.3 ± 2.6 to 7.6 ± 2.9), Subjective Shoulder Value (34.1 ± 16.7 to 71.7 ± 13.8), Activities of Daily Living requiring active External Rotation (18.3 ± 8.3 to 26.2 ± 5.2), and American Shoulder and Elbow Surgeons (37.7 ± 21.8 to 77.3 ± 16.8) scores (all <em>P</em> &lt; .001). The percentage of the minimal clinically important difference achieved for each score was 94.1%, 82.3%, 100%, 76.5%, and 82.3%, Shoulder ROM improvements were as follows: forward elevation increased from 123° ± 28° to 155° ± 30°, abduction improved from 87° ± 31° to 142° ± 31°, and external rotation increased from 21° ± 20° to 40° ± 10°. At the final follow-up, no patients experienced retears of transferred tendon, infection, progression of arthritis, or axillary nerve palsy.</div></div><div><h3>Conclusions</h3><div>Fully arthroscopic LDTM with SCR using LHB tendon effectively alleviated pain and improved shoulder function in patients with PSIRCTs at short term follow-up. Significant improvements were observed in pain, patient-reported outcome measures, and ROM, with no progression of glenohumeral arthritis and no significant complications reported.</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 3","pages":"Article 101147"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480384","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}
引用次数: 0
Most TikTok Videos Regarding the Anterolateral Ligament of the Knee Are Posted by Patients and Have Little Educational Value 大多数关于膝关节前外侧韧带的TikTok视频都是患者发布的,没有什么教育价值
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101101
Riccardo D’Ambrosi M.D. , Thais Dutra Vieira M.D. , Bertrand Sonnery-Cottet M.D., Ph.D.
{"title":"Most TikTok Videos Regarding the Anterolateral Ligament of the Knee Are Posted by Patients and Have Little Educational Value","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Thais Dutra Vieira M.D. ,&nbsp;Bertrand Sonnery-Cottet M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101101","DOIUrl":"10.1016/j.asmr.2025.101101","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the validity and informational value of TikTok content related to the anterolateral ligament (ALL) of the knee.</div></div><div><h3>Methods</h3><div>The terms “anterolateral ligament of the knee,” “ALL reconstruction,” “LET,” “lateral extra-articular tenodesis,” “Lemaire,” and “Segond fracture” were used as keywords for an extensive search of video content on the TikTok video platform in August 2024. The video duration and the numbers of likes, shares, saves, and views were recorded for each video. The quality and reliability assessments of the video content were conducted via the DISCERN instrument, <em>Journal of the American Medical Association</em> benchmark criteria, and Global Quality Score.</div></div><div><h3>Results</h3><div>A total of 55 videos were included in the analysis, of which 4 (7.3%) were posted by physiotherapists; 7 (12.7%), doctors of osteopathic medicine; 38 (69.1%), patients; and 6 (10.9%), medical doctors. Most of the information concerned patient experience (36%-65.5%). The mean length of the videos was 39.56 ± 49.31 seconds. The mean number of views was 16,444.44 ± 49,509.91, whereas the mean number of likes was 739.05 ± 2,558.24; comments, 9.40 ± 20.06; shares, 10.47 ± 33.59; and saves, 44.02 ± 113.35. The mean DISCERN score, <em>Journal of the American Medical Association</em> score, and Global Quality Score were 15.45 ± 1.56, 0.04 ± 0.19, and 1.07 ± 0.26, respectively, indicating the poorest quality for all 3 indices.</div></div><div><h3>Conclusions</h3><div>Most of the videos on TikTok about the ALL of the knee are posted by patients. Videos created by health professionals are significantly more valid and reliable than those created by patients, but all the videos have low educational value.</div></div><div><h3>Clinical Relevance</h3><div>In light of the increasing number of patients who use social media for medical information, it is imperative for orthopaedic health care professionals to acknowledge the limitations of TikTok videos concerning the ALL as potential informational resources for their patients.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101101"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481239","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}
引用次数: 0
Conservative Treatment for Frozen Shoulder Is Effective Regardless of the Severity of Symptoms 无论症状的严重程度如何,保守治疗对肩周炎都是有效的
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101149
Chanont Kanokvaleewong M.D. , Takashi Inoue M.D. , Morihito Tokai M.D. , Hiroyuki Sugaya M.D.
{"title":"Conservative Treatment for Frozen Shoulder Is Effective Regardless of the Severity of Symptoms","authors":"Chanont Kanokvaleewong M.D. ,&nbsp;Takashi Inoue M.D. ,&nbsp;Morihito Tokai M.D. ,&nbsp;Hiroyuki Sugaya M.D.","doi":"10.1016/j.asmr.2025.101149","DOIUrl":"10.1016/j.asmr.2025.101149","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the recovery duration of pain and functional activity after conservative treatment, including oral medication, injections, and rehabilitation, for frozen shoulder among patients based on the severity of their symptoms.</div></div><div><h3>Methods</h3><div>The study involved patients with new reports of shoulder night pain considered more severe than daytime pain and limited range of motion between January 2021 and December 2021 at the Tokyo Sports and Orthopaedic Clinic. Patients with recent shoulder treatment, a history of shoulder injury, rotator cuff tears, arthritic changes, or shoulder trauma were excluded. After dividing patients into 3 groups by severity of stiffness (group 1, severe; group 2, moderate; and group 3, mild), we recorded retrospective data on range of motion and details of conservative treatment, such as oral medication, injection frequency, and physical therapy, each time the patient visited.</div></div><div><h3>Results</h3><div>The study included 113 shoulders from 106 patients (39 men and 67 women), with a mean age of 54 years (range, 43-75 years). For night pain treatment, median recovery time was 1, 1, and 0.5 months for groups 1, 2, and 3, respectively, with no significant difference. Group 1 used oral medication and injections significantly more than groups 2 and 3 (<em>P</em> &lt; .004). No significant differences were found in the number of rehabilitation sessions among the 3 groups, which had averages of 17.5, 12, and 16 sessions in groups 1, 2, and 3, respectively. Median recovery times for range of motion were 10, 9, and 12 months in groups 1, 2, and 3, with no significant differences. Similar results were observed for oral medication duration, injection frequency, and rehabilitation sessions. Group 1 had median durations of 1 month for oral medication, 3 injections, and 17.5 rehabilitation sessions; group 2 had durations of 1 month, 2 injections, and 12 sessions; group 3 had durations of 1, 1.5, and 16 months for oral medication, injections, and rehabilitation sessions, respectively.</div></div><div><h3>Conclusions</h3><div>Conservative treatment is effective for the treatment of frozen shoulder. In this study, it improved night pain within a month and enhanced range of motion significantly within a year.</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 3","pages":"Article 101149"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480277","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}
引用次数: 0
Perioperative Arthroscopic Tourniquet Usage: Practices and Trends of the AANA Membership Are Varied 围手术期关节镜止血带的使用:AANA会员的实践和趋势各不相同
Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI: 10.1016/j.asmr.2025.101106
Brian Day M.B., M.Sc., F.R.C.P.(Lon), F.R.C.S.(Eng and C)
{"title":"Perioperative Arthroscopic Tourniquet Usage: Practices and Trends of the AANA Membership Are Varied","authors":"Brian Day M.B., M.Sc., F.R.C.P.(Lon), F.R.C.S.(Eng and C)","doi":"10.1016/j.asmr.2025.101106","DOIUrl":"10.1016/j.asmr.2025.101106","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate current practices for tourniquet use, including tourniquet times, indications, and other perioperative applications, among Arthroscopy Association of North America (AANA) members and to determine whether recommendations can be made for safer tourniquet use.</div></div><div><h3>Methods</h3><div>Participants in this study were AANA members who responded to our survey in the AANA DocMatter Community. The survey was developed based on discussion prompts in DocMatter. The survey consisted of 28 questions on 4 core themes, including demographic characteristics, general understanding of tourniquet safety, applied tourniquet use in arthroscopy, and tourniquet technology in perioperative applications. The survey was open for responses for 7 weeks from September to November 2023. Multiple-choice responses were counted, and short-form responses were reviewed and aggregated based on keywords. Qualitative analysis was used to understand the data.</div></div><div><h3>Results</h3><div>A total of 59 AANA DocMatter Community Members participated in the survey. Eighty percent of respondents had been in practice for more than 10 years, whereas 20% had been in practice for between 3 and 10 years. Tourniquet usage in arthroscopy was varied, although some patterns were detected. For example, 91% of responders applied tourniquets for all limb procedures, but many inflated them only as needed, and some preferred not to use a tourniquet. When tourniquet times were minimized by selectively inflating cuffs, tourniquet times averaged between 15 and 20 minutes compared with 20 to 60 minutes for continuous inflation. However, 76% of participants reported encountering venous congestion when a tourniquet was applied but not inflated. Perioperative tourniquet uses were also varied. Almost half of respondents used tourniquets for blood flow restriction therapy in their care protocols. In a separate possible trend, a majority of respondents were interested in using tourniquet-related technology to help resolve postsurgical lymphedema.</div></div><div><h3>Conclusions</h3><div>Despite large reported variation in the indications for tourniquet use and the control of key tourniquet parameters, use is evolving through a focus on optimizing tourniquet times through selective inflation for specific aspects of arthroscopic procedures.</div></div><div><h3>Clinical Relevance</h3><div>Standardized approaches to the safe use of tourniquets and their evolving applications are important areas of investigation.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101106"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480291","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}
引用次数: 0
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