Arthroscopy Sports Medicine and Rehabilitation最新文献

{"title":"A Dynamic, Self-Tensioning Suture Contracts in Saline to Counteract Changes in Loop Length From Cyclic Loading","authors":"Nabil Mehta M.D.,&nbsp;Elizabeth Shewman M.S.,&nbsp;Sachin Allahabadi M.D.,&nbsp;Stanley Liu M.A.,&nbsp;Niraj V. Lawande B.S.,&nbsp;Burton Dunlap M.D.,&nbsp;Jorge Chahla M.D.,&nbsp;Gregory P. Nicholson M.D.,&nbsp;Grant E. Garrigues M.D.","doi":"10.1016/j.asmr.2023.100872","DOIUrl":"10.1016/j.asmr.2023.100872","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the biomechanical performance of a suture with proposed dynamic self-tensioning properties with that of commonly used high-tensile sutures by evaluating suture loop length changes, responses to cyclic loading, and failure testing with intermittent saline soaks.</p></div><div><h3>Methods</h3><p>Six knots each of 4 different sutures were studied: 3 high-tensile sutures (ORTHOCORD, FiberWire, and ETHIBOND), and a dynamically self-tensioning suture (DYNACORD). After we measured loop length, knots were soaked in 37°C saline for 24 hours. Loop lengths were remeasured and tensile testing was performed. Cyclic elongation, first-cycle excursion, and elongation amplitude were recorded. Knots were then resoaked and retested. Finally, knots were pulled to failure, and peak load and stiffness were measured. Values were compared using nonparametric statistical tests.</p></div><div><h3>Results</h3><p>DYNACORD loop length decreased by 27% after the first soak (<em>P</em> = .002), whereas the other sutures demonstrated no length change (<em>P</em> &gt; .05). Although DYNACORD loop length increased during cyclic load testing (<em>P</em> = .009), it was still significantly reduced after the second saline soak compared with its initial length (<em>P</em> = .002), whereas all other suture loops had elongated. ETHIBOND (<em>P</em> = .004) and ORTHOCORD (<em>P</em> = .002) had significantly less cyclic elongation from cycle I to cycle II testing compared with the other sutures. ETHIBOND had the lowest peak load at failure (<em>P</em> = .002). FiberWire had the greatest stiffness (<em>P</em> = .006).</p></div><div><h3>Conclusions</h3><p>Compared with other suture types, the self-tensioning suture showed dynamic properties, demonstrating a decrease in loop length when soaked in a saline bath. This length was maintained after a second soak despite increased loop length during interval cyclic loading.</p></div><div><h3>Clinical Relevance</h3><p>Knot and loop security are of paramount importance to arthroscopic soft-tissue procedures. The ability for a suture to self-tension has implications for how it may interact with tissues in vivo to increase construct stability after arthroscopic soft tissue repair procedures.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100872"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23002237/pdfft?md5=e4e2f2518808b2581a937127070c47e9&pid=1-s2.0-S2666061X23002237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164516","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":"Commercially Available Guides Overestimate Socket Length During Anterior and Posterior Cruciate Ligament Socket Retrograde Drilling","authors":"Emily R. McDermott M.D. ,&nbsp;Michael Proffitt Ph.D. ,&nbsp;Clayton W. Nuelle M.D. ,&nbsp;Bjorn Christian Balldin M.D.","doi":"10.1016/j.asmr.2024.100913","DOIUrl":"10.1016/j.asmr.2024.100913","url":null,"abstract":"<div><h3>Purpose</h3><p>To objectively assess the accuracy of socket measurements taken during cruciate ligament reconstruction using a retrograde reaming technique.</p></div><div><h3>Methods</h3><p>Six complete knee sawbone specimens were used to ream anterior and posterior cruciate ligament sockets in the femur and tibia in a retrograde fashion using a standard retrograde reaming device. The longest and shortest sides of the sockets were measured using a ruler. One-sided Wilcoxon signed-rank sum tests were used to evaluate whether the actual measured socket length matched the estimated length set on the drill guide.</p></div><div><h3>Results</h3><p>One fellowship-trained surgeon reamed 24 total sockets in sawbone specimens using guides. Statistical analysis revealed a significant difference between the estimated measurement and the actual shortest tunnel length in each of the sockets. The median short side socket lengths were shorter than their respective intended depths by 4 mm for the femoral anterior cruciate ligament socket, 6 mm for the femoral posterior cruciate ligament socket, 6 mm for the tibial anterior cruciate ligament socket, and 4.5 mm for the tibial posterior cruciate ligament socket. All differences were significant at α = 0.05.</p></div><div><h3>Conclusions</h3><p>The estimated cruciate socket lengths reamed during ligament reconstruction using a retrograde reamer and standard intra-articular measuring instrumentation were greater than the actual measured socket lengths.</p></div><div><h3>Clinical Relevance</h3><p>Successful cruciate ligament reconstruction relies on accurate socket measurements. This study examined the accuracy of commercially available cruciate ligament socket drill guides and the implications for clinical practice, to include graft-tunnel mismatch and surface area available for healing. Surgeons may consider reaming slightly longer than estimated sockets when performing all-inside cruciate ligament reconstructions to ensure appropriate socket depth for graft fixation.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100913"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000312/pdfft?md5=5de08460b433d2510bc1a6a2ef16257e&pid=1-s2.0-S2666061X24000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842067","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":"Meniscal Comma Sign Responds to Partial Meniscectomy Despite Increased Levels of Arthritis","authors":"","doi":"10.1016/j.asmr.2024.100935","DOIUrl":"10.1016/j.asmr.2024.100935","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the outcomes of patients undergoing partial meniscectomy preoperatively identified with the “meniscal comma sign” with those undergoing meniscectomy with other tear patterns.</p></div><div><h3>Methods</h3><p>Patients with meniscal “comma sign,” as indicated by a query of magnetic resonance imaging reports, were screened using the search terms “meniscotibial recess,” “meniscus perched over the medial tibial margin,” or other search terms by radiologists between January 2008 and November 2019. Patients were matched and chart review was done for demographics, revision surgery, and progression to total knee arthroplasty. Radiographs were used for osteoarthritis grading using the Kellgren-Lawrence (KL) scoring system. Preoperative and postoperative International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Lysholm, and Short Form 12-item Survey scores were collected.</p></div><div><h3>Results</h3><p>A total of 406 patients met inclusion (comma sign = 197; control group = 209). The control group had an increased duration of symptoms at the initial visit (<em>P</em> = .001). More patients with the meniscal comma sign received corticosteroid knee injections before surgery (<em>P</em> = .011), and they also had greater mean KL scores (<em>P</em> = .001) as well as greater KL categorical scores (<em>P</em> = .002), indicating more advanced levels or arthritis. There were no differences in those receiving physical therapy (PT) before surgery (<em>P</em> = .966) or those receiving injections or PT after surgery (<em>P</em> = .631, <em>P</em> = .37, respectively). International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Lysholm, and Short Form 12-Item Survey Physical scores improved preoperatively to postoperatively in both groups (<em>P</em> &lt; .05), and there was no difference between the case and control group (<em>P</em> &gt; .05). No significant difference was found in revisions or progression to total knee arthroplasty between cohorts. (<em>P</em> = .676 and <em>P</em> = .424).</p></div><div><h3>Conclusions</h3><p>Patients presenting with preoperative findings of meniscal comma sign fare similarly to those that do not. Patients with this meniscal injury tend to have more advanced grading of osteoarthritic changes in the knee at presentation and seek care earlier than those without. Arthroscopic meniscectomy is a good treatment option for patients with a meniscal fragment in the meniscotibial recess and shows outcomes comparable with those with other tear patterns.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100935"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000531/pdfft?md5=8c076bba94cbe076791c36cbfa51b64e&pid=1-s2.0-S2666061X24000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795451","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":"Elevated Body Mass Index Is Associated With Rotator Cuff Disease: A Systematic Review and Meta-analysis","authors":"Simone D. Herzberg Ph.D. ,&nbsp;Gustavo A. Garriga M.S. ,&nbsp;Nitin B. Jain M.D., M.S.P.H. ,&nbsp;Ayush Giri Ph.D.","doi":"10.1016/j.asmr.2024.100953","DOIUrl":"10.1016/j.asmr.2024.100953","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the literature regarding obesity, body mass index (BMI), and rotator cuff disease (RCD).</p></div><div><h3>Methods</h3><p>In this Systematic Review and Meta-analysis, we queried PubMed, Embase, Cochrane, Cumulative Index to Nursing &amp; Allied Health, and Science Direct using key words (August 25, 2023). Analytic observational studies (cohort, case-control, and cross-sectional studies) with more than 30 participants per comparison group, evaluating the association between obesity and rotator cuff pathology, were eligible for inclusion. Meta-analysis was performed to quantitatively summarize associations between BMI and RCD to report odds ratios and corresponding 95% confidence intervals (CIs) for regression-based models and BMI mean differences between cases and controls. Risk Of Bias In Non-randomised Studies – of Interventions tool was used to evaluate risk of bias across all studies in the systematic review.</p></div><div><h3>Results</h3><p>After full-text review of 248 articles, 27 presented data on obesity and RCD, and 17 qualified for meta-analysis. Individuals with RCD were 1.21 times (95% CI 1.10-1.34) as likely to have overweight and 1.44 times (95% CI 1.32-1.59) as likely to have obesity compared with those without RCD. Each 5-unit increase in BMI was associated with 35% greater odds of having rotator cuff tear (95% CI 1.06-1.71). In-depth assessment for risk of bias shows quality of studies varies greatly and highlights outcome heterogeneity, lack of temporality, confounding and selection bias as major concerns for individual studies.</p></div><div><h3>Conclusions</h3><p>In this study, we found a positive association between elevated BMI and RCD.</p></div><div><h3>Level of Evidence</h3><p>Level III, systematic review and meta-analysis of Level II-III studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100953"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000713/pdfft?md5=50e77e4ae54ad09170b10f1c60ec4a8c&pid=1-s2.0-S2666061X24000713-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164517","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":"Emphasizing the Importance of Naproxen Prophylaxis May Decrease the Rate of Heterotopic Ossification After Hip Arthroscopy","authors":"","doi":"10.1016/j.asmr.2024.100941","DOIUrl":"10.1016/j.asmr.2024.100941","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.</p></div><div><h3>Methods</h3><p>A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit. The control cohort was merely prescribed the postoperative prophylactic NSAIDs, whereas the intervention cohort also received dedicated in-person education, emphasizing the importance of NSAID adherence. The presence of HO was determined through review of follow-up radiographs. Standard descriptive statistics were used to describe the findings.</p></div><div><h3>Results</h3><p>Both the control and intervention groups consisted of 200 continuous hip arthroscopy patients, with the control group treated from 2015 to 2017 and the intervention group treated from 2020 to 2023. Within the control group, 10 cases of HO (5%) were detected. Within the intervention group, 2 cases of HO (1%) were found. The Pearson χ² test with Yates continuity correction produced a value of 4.21, with a <em>P</em> value of .04.</p></div><div><h3>Conclusions</h3><p>In this study, we found a significantly lower incidence rate of HO in patients who received standardized education on the importance of NSAID compliance versus those who did not. This finding suggests that patient education may play a contributory role in reducing the incidence of HO after hip arthroscopy.</p></div><div><h3>Level of Evidence</h3><p>Level III, comparative cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100941"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000592/pdfft?md5=127f2ff993f12eb5ca446d1b3dfd7cb9&pid=1-s2.0-S2666061X24000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786369","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":"Most Patients Older Than 40 Years of Age Who Underwent Meniscal Root Repair Presented With an Effusion, a Positive McMurray Test, and a Positive Hyperflexion Test","authors":"Andres R. Perez B.A. ,&nbsp;Carlo Coladonato B.S. ,&nbsp;Adeeb J. Hanna B.S. ,&nbsp;Matthew Sabitsky B.S. ,&nbsp;Alexa L. Cohen ,&nbsp;Kevin B. Freedman M.D. ,&nbsp;Steven B. Cohen M.D.","doi":"10.1016/j.asmr.2024.100949","DOIUrl":"10.1016/j.asmr.2024.100949","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the presenting symptoms and clinical examination findings of patients undergoing meniscal root repairs to aid physicians in diagnosing this injury.</p></div><div><h3>Methods</h3><p>All patients undergoing isolated arthroscopic meniscal root repair from January 1, 2016, to September 1, 2021, were identified. Patients younger than the age of 40 years were excluded. Clinical notes were reviewed for presenting symptoms and physical examination findings. Preoperative radiographs were graded using the Kellgren-Lawrence (KL) scale for osteoarthritis. Root tears were graded using the radiographic criteria of Chung et al. and articular cartilage injury was graded using a validated system, AMADEUS (mean total Area Measurement And Depth &amp; Underlying Structures).</p></div><div><h3>Results</h3><p>In total, 221 patients met inclusion criteria; 65.6% of patients reported that their pain began after an acute injury, with 39.4% of patients reporting a “pop.” On examination, an effusion was present in 71% of knees. McMurray test was reported positive in 85.5% and a positive hyperflexion test in 53.8% of knees. In total, 49.5% of knees were graded KL 1. 154 had medial root tears, 10 had lateral root tears, and 24 suffered both root tears. In total, 44.1% of tears occurred at the midsubstance of the root, with 28.0% occurring at the enthesis and 28.0% occurring at the root-posterior horn junction. The mean AMADEUS score was 94.4 ± 11.4.</p></div><div><h3>Conclusions</h3><p>Although most patients reported pain began after acute injury, less than one-half reported hearing a “pop.” When patients were evaluated, an effusion, positive McMurray test, and positive hyperflexion test were present in most meniscal root tears.</p></div><div><h3>Level of Evidence</h3><p>Level IV, diagnostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100949"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000671/pdfft?md5=e1ee72d31147cd1bb35d435800251021&pid=1-s2.0-S2666061X24000671-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164577","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":"Arthroscopy Patients in Medicare Population Became Sicker While Reimbursement Decreased From 2013 to 2020","authors":"","doi":"10.1016/j.asmr.2024.100950","DOIUrl":"10.1016/j.asmr.2024.100950","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess surgeon reimbursement for common arthroscopic procedures, including arthroscopic meniscal debridement and arthroscopic rotator cuff repair, in patients with differing risk profiles within the Medicare population.</p></div><div><h3>Methods</h3><p>A publicly available Medicare database was used to identify all cases of arthroscopic meniscal debridement and arthroscopic rotator cuff repair procedures billed to Medicare from 2013 to 2020. The surgeon reimbursement from Medicare was collected and adjusted for inflation. All procedure episodes were split into 2 cohorts; those with a hierarchical condition category (HCC) risk score ≥1.5, and those with patient HCC risk scores &lt;1.5. Reimbursement rates were compared between groups.</p></div><div><h3>Results</h3><p>From 2013 to 2020, a total of 624,077 meniscal debridement procedures and 567,794 arthroscopic rotator cuff repairs were billed to Medicare Part B. During this time, the mean adjusted surgeon reimbursement for arthroscopic rotator cuff repair decreased by 9.2% from 2013 to 2020. During the same time period, the adjusted mean surgeon reimbursement for arthroscopic both compartment meniscal debridement and single compartment meniscal debridement decreased by 7.9% and 9.9%, respectively. Throughout the study period, the mean HCC risk score increased from 1.19 in 2013 to 1.31 in 2020 (<em>P</em> &lt; .001). Across all years in the study, the sicker cohort had a significantly greater rate of all comorbidities and a greater mean body mass index (<em>P</em> &lt; .001 for all variables). The mean reimbursement across this cohort was lower for both rotator cuff repair (<em>P</em> = .037) and meniscal debridement procedures (<em>P</em> &lt; .001) compared with the healthier cohort.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that from 2013 to 2020, inflation-adjusted surgeon reimbursement for arthroscopic rotator cuff repair and meniscal debridement decreased while patient complexity increased. Further, mean surgeon reimbursement was lower among patients with more complexity in comparison with their healthier counterparts for such procedures.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 4","pages":"Article 100950"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000683/pdfft?md5=b6b9bc52932b326666ead26fe7f8ff31&pid=1-s2.0-S2666061X24000683-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032631","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":"Meniscus-Related Videos on TikTok Are Widely Viewed and Shared but the Educational Quality for Patients Is Poor","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Timothy E. Hewett M.D.","doi":"10.1016/j.asmr.2024.100927","DOIUrl":"10.1016/j.asmr.2024.100927","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the quality of meniscus-related TikTok videos to better understand their value for patient education.</p></div><div><h3>Methods</h3><p>The term “meniscus” was used as the key word for an extensive online search of video content on the TikTok on November 14, 2023. The first 100 videos were used for analysis. The duration of the videos and the number of likes, shares, and views were recorded for each video. Furthermore, videos were categorized based on the source (health workers, private user), the type of subject (patient experience, physical therapy, anatomy, clinical examination, surgical technique and injury mechanism), type of content (patient experience/testimony, education, rehabilitation), and the presence of music or voice. The quality and reliability assessments of video contents were conducted using the DISCERN instrument, the <em>Journal of the American Medical Association</em> benchmark criteria, and Global Quality Score.</p></div><div><h3>Results</h3><p>Of the 100 videos included in this study, 62 (62%) videos were published by health workers and 38 by private users (38%). Most of the information regarded patient experience (36, 36%), followed by physical therapy (32, 32%), anatomy (14, 14%), clinical examination (8, 8%), surgical technique (6, 6%), and injury mechanism (4, 4%). Video content reported patient experience in 39 (39%) videos, rehabilitation in 31 (31%) videos, and education in the remaining 30 (30%). The mean length of the videos was 39.12 ± 49.56 seconds. The mean number of views was 1,383,001.65 ± 5,291,822.28, whereas the mean numbers of comments, likes and shares were 408.53 ± 1976.90, 54,763.43 ± 211,823.44 and 873.70 ± 2,802.01, respectively. The mean DISCERN score, <em>Journal of the American Medical Association</em> benchmark criteria score, and Global Quality Score were 17.93 ± 5.07, 0.24 ± 0.47, and 1.15 ± 0.41, respectively.</p></div><div><h3>Conclusions</h3><p>Meniscus-related videos on TikTok are widely viewed and shared but the overall educational value to patients is poor.</p></div><div><h3>Clinical Relevance</h3><p>As patients increasingly use social media to learn about their conditions, it is important for orthopaedic health care professionals to understand the limitations of TikTok videos addressing the meniscus as potential sources of information for their patients.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100927"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000452/pdfft?md5=16cd1ee774eed10bba785b5eab80f7a5&pid=1-s2.0-S2666061X24000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268907","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":"Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome","authors":"Cory D. Smith M.D.,&nbsp;Evan Simpson B.S.,&nbsp;Bailey Johnson M.D.,&nbsp;Edward Quilligan B.S.,&nbsp;Robert Grumet M.D.,&nbsp;Kevin C. Parvaresh M.D.","doi":"10.1016/j.asmr.2024.100918","DOIUrl":"10.1016/j.asmr.2024.100918","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).</p></div><div><h3>Methods</h3><p>We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under “select criteria,” patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas “all criteria” added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs.</p></div><div><h3>Results</h3><p>A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ² Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ² Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria.</p></div><div><h3>Conclusions</h3><p>In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100918"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000361/pdfft?md5=65c0a4059174742831e23c6c61dd70b2&pid=1-s2.0-S2666061X24000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466610","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":"Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes","authors":"Mark A. Glover B.S. ,&nbsp;Jeffery D. St. Jeor M.D. ,&nbsp;Nihir Parikh B.S. ,&nbsp;Danielle E. Rider M.D. ,&nbsp;Garrett S. Bullock D.P.T., D.Phil. ,&nbsp;Nicholas A. Trasolini M.D. ,&nbsp;Brian R. Waterman M.D.","doi":"10.1016/j.asmr.2024.100911","DOIUrl":"10.1016/j.asmr.2024.100911","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.</p></div><div><h3>Results</h3><p>In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, <em>P</em> &lt; .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; <em>P</em> &lt; .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, <em>P</em> &lt; .001; 1.04, 95% CI 1.01-1.07, <em>P</em> = .020; 1.11, 95% CI 1.03-1.19, <em>P</em> = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, <em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prognostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 3","pages":"Article 100911"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000294/pdfft?md5=e741866ffbc3e96342e1bba123f83a04&pid=1-s2.0-S2666061X24000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965952","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}