Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"Double-Allograft Shoulder Stabilization for Multidirectional Instability Is Associated With Improved Function and Survivability After 2 Years","authors":"Felix H. Savoie III M.D. ,&nbsp;Matthew W. Cole M.D. ,&nbsp;Lacee K. Collins B.S. ,&nbsp;J. Heath Wilder M.D. ,&nbsp;Bailey J. Ross M.D. ,&nbsp;Michael J. O’Brien M.D. ,&nbsp;William F. Sherman M.D., M.B.A.","doi":"10.1016/j.asmr.2025.101120","DOIUrl":"10.1016/j.asmr.2025.101120","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe a double-allograft technique used for patients with severe, symptomatic multidirectional instability and hyperlaxity of the shoulder as well as to introduce a modification of the Beighton score that helps determine when this procedure should be utilized and report long-term outcomes of this procedure in the management of these patients.</div></div><div><h3>Methods</h3><div>A retrospective review of patients with multidirectional instability who were managed with the double-allograft technique after failure of extensive physical therapy was conducted. The final analysis included 43 patients (46 shoulders). Included patients had minimum 2 years of in-office follow-up with a Tulane modified Beighton score of 11 or greater and severe multidirectional instability/hyperlaxity of the shoulder. Preoperative and postoperative patient-reported outcome (PRO) measures were compared using 2-tailed paired <em>t</em> -tests. Subgroup analyses were performed using 2-tailed, independent <em>t</em><em>-</em>tests.</div></div><div><h3>Results</h3><div>Mean postoperative outcome scores were significantly improved compared with preoperative scores for all PRO measures evaluated from the 6-month postoperative visit on (all <em>P</em> &lt; .001). Subgroup analyses of gender, age, and patients with versus without genetically confirmed Ehlers-Danlos syndrome were equivalent with respect to postoperative improvements in PRO scores. The average Tulane modified Beighton score was 14, range 11 to 15. Among the 46 operative cases, there were a total of 7 (15.2%) complications and 5 recurrences requiring additional surgery. The 5 (10.9%) patients who underwent a subsequent revision procedure did so at a mean time of 5.36 ± 2.64 years.</div></div><div><h3>Conclusions</h3><div>The double allograft reconstruction technique appears to be a safe and effective method to restore shoulder stability in patients with severe ligamentous laxity.</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 101120"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480383","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":"Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery","authors":"Benjamin D. Kuhns M.D., M.S. ,&nbsp;Tyler R. McCarroll M.D. ,&nbsp;Roger Quesada-Jimenez M.D. ,&nbsp;Ady H. Kahana-Rojkind M.D. ,&nbsp;Drashti Sikligar M.Eng. ,&nbsp;Meredith F. Cohen B.A. ,&nbsp;Benjamin G. Domb M.D.","doi":"10.1016/j.asmr.2025.101146","DOIUrl":"10.1016/j.asmr.2025.101146","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the reliability of sagittal radiographic variables across multiple positions and radiographic views and to correlate measures obtained on anteroposterior (AP) radiographs to lateral pelvis imaging.</div></div><div><h3>Methods</h3><div>Subjects undergoing hip surgery with complete AP and lateral pelvic imaging were included. Images were evaluated by 4 independent reviewers. Sagittal radiographic variables included the sacral slope, spinopelvic tilt (SPT), anterior pelvic plane (APP), pelvic inclination, and pelvic incidence. AP pelvic measures of sagittal pelvic position included the sacrococcygeal to pubis distance (SC distance) and the trans-teardrop to pubis ratio. Interobserver reliability for each measure was evaluated through the intraclass correlation coefficient (ICC). Bivariate linear correlations between AP and lateral standing, supine, and sitting images were obtained.</div></div><div><h3>Results</h3><div>In total, 60 subjects who underwent hip surgery with complete AP and lateral pelvic imaging were included. The sacral slope and SC distance showed excellent reliability (ICC &gt;0.90) across all positions. Additional parameters showed good reliability (ICC &gt;0.85) in standing and supine positions, with moderate-to-good reliability (ICC 0.76-0.79) for the APP, SPT, and pelvic inclination in the sitting position. Measures of pelvic tilt on AP radiographs had variable correlations to sagittal parameters, with the strongest correlation occurring between the SC distance and sacral slope in the supine and standing positions (r = 0.72 and 0.70, respectively; <em>P</em> &lt; .001 for both positions).</div></div><div><h3>Conclusions</h3><div>Spinopelvic radiographic parameters are reliable in the supine and standing positions. The APP, SPT, and pelvic inclination had lower reliability when compared with the sacral slope in the sitting position. There were significant correlations between multiple spinopelvic parameters on the AP and lateral radiographs, the strongest of which were between the SC distance and sacral slope. These findings support the routine evaluation of positional spinopelvic parameters before both hip-preservation and reconstruction surgery.</div></div><div><h3>Clinical Relevance</h3><div>Evaluation of spinopelvic parameters across multiple functional positions will increase the understanding of dynamic hip motion as it relates to the lumbar spine and pelvis.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101146"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480284","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":"Anterior Peripheral Rim Instability Is Prevalent in Young, Skeletally Immature Patients With Discoid Lateral Meniscus and Has Favorable Postoperative Outcomes","authors":"Steven Maxwell Henick M.D.,&nbsp;Zachariah Samuel B.S.,&nbsp;Joseph Nicholas Charla B.S.,&nbsp;Emily Ferreri B.S.,&nbsp;Emmanuel Mbamalu B.S.,&nbsp;Edina Gjonbalaj B.S.,&nbsp;Leila Mehraban Alvandi Ph.D.,&nbsp;Jacob Foster Schulz M.D.,&nbsp;Eric Daniel Fornari F.A.O.A., M.D.,&nbsp;Mauricio Drummond Jr. M.D.","doi":"10.1016/j.asmr.2025.101119","DOIUrl":"10.1016/j.asmr.2025.101119","url":null,"abstract":"<div><h3>Purpose</h3><div>To report the prevalence and patient characteristics of anterior peripheral rim instability (PRI) in patients &lt;21 years of age with symptomatic discoid lateral meniscus (DLM) requiring operative intervention and to compare preoperative magnetic resonance imaging (MRI) with arthroscopic findings and patient-reported outcomes (PROs) after arthroscopic treatment of anterior compared with nonanterior PRI.</div></div><div><h3>Methods</h3><div>A retrospective review was performed at a single academic institution between 2012 and 2022. Patients were &lt;21 years old and underwent operative DLM management with a minimum follow-up period of 2 years. Patients were divided into 2 groups: anterior PRI (isolated anterior PRI and anterior combined with posterior PRI) and nonanterior PRI (nonanterior PRI designated as isolated posterior or no PRI). Data collection included demographics, clinical presentation, MRI results, arthroscopic findings, reoperation rates, complications, and PROs.</div></div><div><h3>Results</h3><div>Forty-four patients were included, 22 in the anterior PRI group and 22 in the nonanterior PRI group. Anterior PRI prevalence was 50% in this cohort. Patients in the anterior PRI group were younger (10.77 ± 3.07 vs 13.002 ± 3.39; <em>P</em> = .028) and more likely skeletally immature (16 vs 8; <em>P</em> = .034). Extension deficit (<em>P</em> = .486) did not differ significantly between the groups. MRI was less sensitive for detecting anterior PRI compared with posterior PRI (72.2% vs 95.0%; <em>P</em> = .140). Patients with anterior PRI showed significant improvements in postoperative PROs (Pedi- International Knee Documentation Committee 54.23 vs 89.65; <em>P</em> = .0006) after 6.1 years of average follow-up, achieving good-to-excellent scores that did not significantly differ between groups.</div></div><div><h3>Conclusions</h3><div>The prevalence of anterior PRI in symptomatic DLM is 50% in our cohort and is more likely to cause symptoms in skeletally immature and younger patients. It more commonly presents with posterior PRI (59%) than as an isolated entity (41%). Arthroscopic outside-in repair yields good-to-excellent PROs and low complication and reoperation rates after mean 6.1 years of follow-up.</div></div><div><h3>Level of Evidence</h3><div>Level III, therapeutic retrospective, cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101119"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480288","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":"Knee Fellowships Improve Clinical Practice and Scientific Activity","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Andy Williams M.B., B.S., F.R.C.S. (Orth.). ,&nbsp;Bertrand Sonnery-Cottet M.D., Ph.D. ,&nbsp;Christian Fink M.D.","doi":"10.1016/j.asmr.2025.101100","DOIUrl":"10.1016/j.asmr.2025.101100","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the benefits of completing a knee fellowship for orthopaedic surgeons specializing in the treatment of sports injuries.</div></div><div><h3>Methods</h3><div>An online survey was conducted to assess changes in clinical practice, and scientific activity in knee surgery, with special focus on the anterior cruciate ligament (ACL) before and after a knee fellowship.</div></div><div><h3>Results</h3><div>A total of 74 of 102 (72.54%) fellows completed the survey. The mean age of the respondents was 36.85 ± 5.0 years (range 28-47 years). Sixty-nine (93.24%) were male, and 5 were female (6.75%). Before the fellowship, only 6 (8.10%) surgeons had performed more than 50 ACL surgeries yearly as the first operator, whereas more than 60% (46) had performed fewer than 10 ACL surgeries; after the fellowship, more than 50% (41) of the surgeons performed more than 50 ACL surgeries yearly as the first operator (<em>P</em> &lt; .001). Before the fellowship, 57 (77.02%) surgeons did not perform anterolateral procedures or performed in less than 20% of their cases, whereas after the fellowship, almost 40% (31) performed anterolateral procedures in most of their cases (<em>P</em> &lt; .001). A significant increase was also noted in the number of publications developed during the fellowship and conference presentations given between the period before and after the fellowship (<em>P</em> &lt; .001). More than 90% (70%-94.59%) answered that they would do the fellowship again.</div></div><div><h3>Conclusions</h3><div>Knee fellowships in highly specialized centers improve surgical activity in terms of surgical procedures and scientific production; furthermore, almost all the fellows reported that they would pursue such a fellowship again.</div></div><div><h3>Clinical Relevance</h3><div>The results of this study may provide fellowship directors with important feedback about the strengths and weaknesses of the experience from participants.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101100"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481236","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":"Physical Performance and Patient-Reported Outcomes Remain Stable at 5 Years After Total Knee Arthroplasty","authors":"Pakpoom Ruangsomboon M.D., M.Sc. ,&nbsp;Onlak Ruangsomboon M.D., M.Sc. ,&nbsp;Chirathit Anusitviwat M.D. ,&nbsp;Bheeshma Ravi M.D., Ph.D., F.R.C.S.C. ,&nbsp;Aasis Unnanuntana M.D., M.Sc.","doi":"10.1016/j.asmr.2025.101104","DOIUrl":"10.1016/j.asmr.2025.101104","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate changes in physical performance tests (PPTs) and patient-reported outcome measures (PROMs) at baseline, 1 year after total knee arthroplasty (TKA), and a minimum of 5 years after TKA.</div></div><div><h3>Methods</h3><div>We enrolled patients who underwent TKA between 2013 and 2015 performed by a single arthroplasty surgeon at Siriraj Hospital, Mahidol University, Bangkok, Thailand. We evaluated PPTs and PROMs over a minimum 5-year follow-up period to assess changes over time, identified independent factors associated with PPT deterioration, and determined TKA survivorship.</div></div><div><h3>Results</h3><div>The study included 126 participants with a mean age of 77.8 years. The average follow-up time was 7.4 ± 2.3 years. PPTs and PROMs changed significantly over time from baseline. However, the 2-minute walk test and timed up-and-go test results slightly declined after 1 year but did not attain minimal clinically important differences, and PROMs were maintained and showed no clinically significant changes after 1 year. Hospitalizations owing to complex medical conditions or trauma were independently associated with PPT deterioration. There was a 98.8% survivorship rate at 7.6 years.</div></div><div><h3>Conclusions</h3><div>In an Asian population undergoing TKA, PPTs and PROMs are maintained within acceptable ranges for at least 5 years after primary TKA. Trauma or hospitalizations arising from complex medical conditions were found to be associated with functional decline. A combined evaluation of PPTs and PROMs is advocated for a comprehensive assessment of patients after TKA.</div></div><div><h3>Level of Evidence</h3><div>Level III, cohort study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101104"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481237","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":"Sitting Pain Is More Common Than Standing Hip Pain Regardless of Diagnosis of Femoroacetabular Impingement Syndrome Versus Hip Dysplasia: A Prospective Comparative Study","authors":"Matthew J. Kraeutler M.D. ,&nbsp;Brian Q. Nguyen B.A. ,&nbsp;Carson Keeter M.S. ,&nbsp;Kyle S.J. Jamar B.S. ,&nbsp;Kristian Samuelsson M.D., Ph.D. ,&nbsp;Jessica H. Lee M.D. ,&nbsp;Omer Mei-Dan M.D.","doi":"10.1016/j.asmr.2025.101116","DOIUrl":"10.1016/j.asmr.2025.101116","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore a possible correlation between sitting versus standing hip pain and a primary diagnosis of femoroacetabular impingement syndrome (FAIS) versus hip dysplasia.</div></div><div><h3>Methods</h3><div>All new patients presenting to a hip preservation clinic starting in September 2023 were prospectively asked, “Do you have more hip pain with sitting or standing for a long time?” Patients were divided into two groups based on primary diagnosis: FAIS or hip dysplasia. Primary diagnosis was based on a combination of history, physical examination, and imaging. Patients with concomitant FAIS and dysplasia were given a primary diagnosis of dysplasia if they were recommended to undergo a periacetabular osteotomy (PAO), although patients with concomitant dysplasia and a large cam lesion were excluded. Logistic regression analysis was performed to determine if any variables were significantly associated with sitting versus standing hip pain.</div></div><div><h3>Results</h3><div>A total of 115 patients (118 hips) were included (30 male, 88 female). FAIS and hip dysplasia were the diagnoses in 71 and 47 hips, respectively. Mean age at initial presentation was 34 years. Overall, regardless of diagnosis, sitting pain (n = 74; 62.7%, 95% CI 53.7-70.9) was found to be more likely than standing hip pain (n = 44; 37.3%, 95% CI 29.1-46.3). There was no evidence of a difference in the odds of experiencing sitting versus standing hip pain between the FAIS and hip dysplasia groups (<em>P</em> = .85). There was also no evidence that age, sex, lateral center edge angle, femoral torsion angle, or alpha angle contribute to the odds of experiencing sitting versus standing pain.</div></div><div><h3>Conclusions</h3><div>Sitting pain is more common than standing pain regardless of diagnosis of FAIS versus hip dysplasia, with no evidence of an association between FAI/sitting pain and dysplasia/standing pain.</div></div><div><h3>Level of Evidence</h3><div>Level II, consecutive series diagnostic study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101116"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480283","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":"Traumatic Onset of Medial Meniscus Posterior Root Tears Is Associated With Younger Age While Insidious Onset Is Associated With Chronic Overload and Bone Bruising","authors":"Rodrigo Saad Berreta B.A. ,&nbsp;Lucas Pallone M.D. ,&nbsp;Enzo S. Mameri M.D. ,&nbsp;Felipe Gonzalez M.D. ,&nbsp;Jared Rubin B.A. ,&nbsp;Ashwinee Manivannan B.Sc. ,&nbsp;Juan Bernardo Villarreal-Espinosa M.D. ,&nbsp;Salvador Ayala B.S. ,&nbsp;José Rafael Gracia B.S. ,&nbsp;Felicitas Allende M.D. ,&nbsp;Nikhil N. Verma M.D. ,&nbsp;Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2025.101118","DOIUrl":"10.1016/j.asmr.2025.101118","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate clinical and radiographic findings for medial meniscus posterior root tears (MMPRTs) and investigate their associations with traumatic and insidious etiologies.</div></div><div><h3>Methods</h3><div>Patients who underwent arthroscopic isolated MMPRT repair by one fellowship-trained surgeon from 2019 to 2023 were retrospectively identified. Clinical variables included history of present illness (HPI), medical history, and physical examination findings. Radiographic variables included Kellgren-Lawrence grade, bone bruise, ghost sign, truncation sign, linear hyperintensity perpendicular to the meniscus, meniscal extrusion, tibial slope, and mechanical axis. Patients were stratified by inciting event versus insidious onset for subgroup analysis.</div></div><div><h3>Results</h3><div>Of 72 patients (mean age 56.7 ± 8.9 years, mean BMI 32.3 ± 5.7 k/m²), recollection of an inciting event was reported in 45.8% of patients. The most prevalent findings in the HPI were knee swelling (72.2%) followed by mechanical symptoms (62.5%) and episodes of perceived instability (45.8%), whereas medial joint line tenderness (93.1%) and a positive McMurray’s test (69.4%) were commonly observed on physical examination. On MRI, ghost sign was identified in 91.7% of cases followed by truncation sign (83.3%) and a linear signal perpendicular to the meniscus (68.1%). The average measured meniscal extrusion was 4.18 ± 1.09 mm. Cases with an inciting event were more likely to be younger (<em>P</em> = .021), present acutely (<em>P</em> = .039), and have a positive McMurray test (<em>P</em> = .036). Cases with an insidious presentation were found to have higher rates of bone bruising at the medial femoral condyle (<em>P</em> = .016) and medial plateau (<em>P</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>Patients with MMPRT associated with an inciting event are typically younger and more likely to present acutely, with a positive McMurray’s test. Conversely, patients with insidious presentation are older, present chronically, and exhibit higher rates of bone bruising, particularly when there is varus malalignment.</div></div><div><h3>Level of Evidence</h3><div>Level IV, prognostic case series.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101118"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480287","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":"Patient-Reported Outcomes Differentially Worsen in Patients With Greater Obesity Classes After Hip Arthroscopy","authors":"Gregory Perraut M.D. ,&nbsp;Madison Thompson B.A. ,&nbsp;Emily Krisanda M.D. ,&nbsp;Seleem Elkadi M.D. ,&nbsp;Shankar Thiru B.A. ,&nbsp;Danny Chamaa B.A. ,&nbsp;Evan Michaelson M.D. ,&nbsp;William Postma M.D.","doi":"10.1016/j.asmr.2024.101072","DOIUrl":"10.1016/j.asmr.2024.101072","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the association between obesity classification and patient-reported outcomes (PROs) in hip arthroscopy.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients who underwent hip arthroscopy and completed at least 1 preoperative and corresponding postoperative PRO—the modified Harris Hip Score (mHHS), visual analog pain scale (VAS), or Veterans RAND 12 (VR-12)—between December 2018 and August 2023. Exclusion criteria included previous ipsilateral hip surgery, incomplete or missing PROs, missing body mass index (BMI) data, follow-up &lt;2 weeks, inflammatory arthritis, hip dysplasia, or avascular necrosis. Nonobesity was defined as BMI &lt;30 and obesity as BMI ≥30, further classified as class I/II (BMI 30-40) or class III (BMI ≥40). Significance was set at alpha = 0.05.</div></div><div><h3>Results</h3><div>In total, 349 cases were included in this study. Average BMI was 25.87 and age was 34.42 years. 65% of patients were female. In total, 288 patients (82.5%) did not have obesity and 61 patients (17.5%) had obesity. In the obesity group, 3 patients (4.9%) were defined as having class III obesity. Compared with baseline, patients without obesity demonstrated significant improvements across all 4 PROs at every time point. Similarly, patients classified with class I/II obesity showed significant improvement in the VAS, HHS, and VR-12 Physical but not in the VR-12 Mental score. Patients with class III obesity did not experience any improvement in PROs after 4 weeks and had significantly worse scores compared with both patients with class I/II obesity and patients without obesity at every time point.</div></div><div><h3>Conclusions</h3><div>Although patients without obesity consistently demonstrated significant improvements across all 4 PROs, outcomes for patients with obesity varied depending on the severity of obesity. Patients with class I/II obesity showed intermittent improvements, with significant gains in some PROs but not all. In contrast, patients with class III obesity did not experience any significant lasting improvements in outcomes after hip arthroscopy.</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 101072"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845173","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":"Greater Detail Is Needed When Reporting Schenck Knee Dislocation V Injuries in the Orthopaedic Literature: A Systematic Review","authors":"Aaron J. Marcel M.S. ,&nbsp;Sarah Levitt B.S. ,&nbsp;Joshua S. Green M.D. ,&nbsp;Jay Moran M.D. ,&nbsp;Peter Jokl M.D. ,&nbsp;Robert C. Schenck M.D. ,&nbsp;Daniel C. Wascher M.D. ,&nbsp;Michael J. Alaia M.D. ,&nbsp;Michael J. Medvecky M.D.","doi":"10.1016/j.asmr.2024.101046","DOIUrl":"10.1016/j.asmr.2024.101046","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine how knee dislocations (KDs) with associated periarticular fractures classified using the Schenck KD V subcategory are reported in the literature.</div></div><div><h3>Methods</h3><div>PubMed, Cumulative Index to Nursing and Allied Health Literature, and Scopus were queried in January 2024. Studies were included if full-text articles in English were available, the Schenck KD classification system was used, and Schenck KD class V was mentioned. The exclusion criteria were as follows: studies in which the Schenck KD classification system was used but only KD classes I to IV were mentioned; systematic reviews, meta-analyses, review articles, commentaries, surgical technique articles, or animal studies; or studies in which pediatric patients were included. Studies were systematically examined for details regarding the descriptions of KD V injuries, including fracture and ligament tear patterns.</div></div><div><h3>Results</h3><div>Seventy-four studies met the inclusion criteria. Of these 74 studies, 45 (60.8%) provided no description of either the ligament tear or fracture patterns that were present in KD V injuries. Fifty-two studies (70.3%) provided no description of the ligament tear patterns and 51 studies (68.9%) provided no description of the fracture patterns associated with KD V injuries. Only 16 of 74 studies (21.6%) included descriptions of ligament tear patterns and fractures present in KD V injuries.</div></div><div><h3>Conclusions</h3><div>Descriptions of Schenck KD class V are poorly represented in the orthopaedic literature.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level II to IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 2","pages":"Article 101046"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845224","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":"Elevated Instability Resolution Angle Predicts Inferior Patient-Reported Outcomes in Isolated Medial Patellofemoral Ligament Reconstruction","authors":"Zachary Wang B.S.,&nbsp;Daniel Kaplan M.D.,&nbsp;Navya Dandu M.D.,&nbsp;Erik Haneberg B.S.,&nbsp;Kevin Credille M.D., M.S.,&nbsp;Tristan Elias M.D.,&nbsp;Nikhil Verma M.D.,&nbsp;Brian J. Cole M.D., M.B.A.,&nbsp;Adam B. Yanke M.D., Ph.D.","doi":"10.1016/j.asmr.2024.101066","DOIUrl":"10.1016/j.asmr.2024.101066","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prognostic utility of an examination under anesthesia (EUA) by evaluating the patient-reported outcome scores (PROs) and failure rates of patients undergoing primary, isolated medial patellofemoral ligament reconstruction (MPFLR) relative to their EUA findings.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on patients who underwent primary, isolated MPFLR between August 2015 and August 2021. During the EUA the instability resolution angle (IRA) was identified by applying a lateral force on the patella through increasing knee flexion and defined by the degree of flexion the patella ceased lateral translation. PROs, including International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score Jr, and Kujala, were collected at 1-year and 2-year minimum after surgery. In addition, MPFLR failure was recorded and defined by patellar redislocation.</div></div><div><h3>Results</h3><div>In total, 94 patients met inclusion criteria, with 42 patients having an IRA &lt;60° and 52 patients with an IRA ≥60° of knee flexion. At 2-year minimum follow-up, IKDC and Kujala PROs were significantly lower in patients with IRA ≥60° compared with patients with IRA &lt;60° for both final and delta PROs. Mean tibial tubercle-trochlear groove distance examined on preoperative magnetic resonance imaging was 17.21 ± 5.00 mm for the IRA ≥60° cohort and 14.36 ± 4.89 mm for the IRA &lt;60° cohort (<em>P &lt;</em> .01). Four patients redislocated their patella, and all 4 had an IRA ≥60° (<em>P =</em> .07).</div></div><div><h3>Conclusions</h3><div>Patients who underwent isolated MPFLR with an IRA ≥60° had significantly lower IKDC and Kujala scores than similar patients with IRA &lt;60° of knee flexion at 2-year minimum follow-up. Four (7.7%) patients with IRA ≥60° redislocated their patella, whereas zero patients with IRA &lt;60° experienced redislocation.</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 101066"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845270","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}