Hss Journal最新文献

{"title":"The Challenge of the Pitch.","authors":"Charles N Cornell","doi":"10.1177/15563316261484573","DOIUrl":"10.1177/15563316261484573","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261484573"},"PeriodicalIF":1.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-Detected Intravertebral Cleft Predicts Radiographic Collapse Progression After Body-Cast Treatment of Acute Osteoporotic Vertebral Fractures.","authors":"Yugo Morita, Kazushi Otsuka, Shigeo Yoshida, Kohei Nishitani","doi":"10.1177/15563316261480114","DOIUrl":"10.1177/15563316261480114","url":null,"abstract":"<p><strong>Background: </strong>Progressive radiographic collapse after osteoporotic vertebral fractures (OVFs) may lead to kyphotic deformity. Predictors remain inconsistent, partly because prior studies used heterogeneous conservative treatment protocols that may alter collapse risk.</p><p><strong>Questions/purposes: </strong>We asked (1) how much vertebral compression progressed after a standardized body-cast protocol, (2) which factors were associated with progression, and (3) whether computed tomography (CT)-detected intravertebral cleft (IVC) independently predicted progression.</p><p><strong>Methods: </strong>We retrospectively reviewed 162 patients with 202 acute OVFs from a single institution who were treated with early body-cast immobilization followed by rigid bracing between April 2013 and March 2016. Follow-up radiographs obtained 6 to 13 months after injury were used to assess collapse progression, defined as the change in anterior vertebral body compression percentage between baseline and follow-up. Baseline CT and magnetic resonance imaging (MRI) obtained within 2 weeks of injury were used to assess cortical wall fractures, MRI signal patterns, and IVCs. Variables with <i>P</i> <i><</i> .10 on univariate analysis entered multivariable linear regression models.</p><p><strong>Results: </strong>Mean anterior vertebral body compression percentage increased from 22.2% to 29.0% (mean progression, 6.9%). Vertebrae with IVCs progressed more than those without IVCs (≥3 mm, 13.8%; 1-<3 mm, 14.0%; none, 4.9%). In multivariable analysis, IVC was the only independent predictor of greater radiographic collapse progression.</p><p><strong>Conclusions: </strong>This retrospective observational study found that baseline CT-detected IVC of at least 1 mm identified vertebrae at risk for radiographic collapse progression despite standardized body-cast treatment. This finding should be interpreted as a radiographic risk marker, not direct evidence of treatment failure.</p><p><strong>Level of evidence: </strong>Level III, retrospective prognostic study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261480114"},"PeriodicalIF":1.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthrofibrosis After Total Knee Arthroplasty: Biological Mechanisms, Diagnosis, and Treatment: An International Consensus Symposium.","authors":"Peter K Sculco, Ronald E Delanois, Gwo-Chin Lee, William A Jiranek, Matthew P Abdel, Laura Moore, Harold I Salmons","doi":"10.1177/15563316261474517","DOIUrl":"10.1177/15563316261474517","url":null,"abstract":"<p><p>Arthrofibrosis following total knee arthroplasty (TKA) is a challenging complication that contributes to failure to achieve functional range of motion and results in physical impairment, pain, and revision surgery. Despite increasing recognition of arthrofibrosis as a biological disease process rather than a purely mechanical complication, there is no single document that integrates current evidence on diagnosis, surgical management, and preventive strategies. In June 2025, the Stavros Niarchos Foundation Complex Joint Reconstruction Center at Hospital for Special Surgery convened an international symposium to address arthrofibrosis following TKA. Invited experts in orthopedic surgery, basic science, biomechanics, and outcomes research were organized into 3 panels focused on (1) basic science, diagnosis, and risk stratification; (2) surgical management and postoperative rehabilitation; and (3) prevention strategies and adjunctive therapies. Each panel reviewed the literature, addressed predefined clinical questions, and developed consensus through structured discussion. This summary describes the recommendations from each panel, emphasizing early, multispecialty evaluation, stage-specific intervention, and procedure-specific rehabilitation strategies. Gaps in the evidence and priorities for future research are highlighted. These recommendations aim to standardize care, guide clinical decision-making, and shift the focus from late salvage toward early identification and prevention of arthrofibrosis following TKA. <b>Level of Evidence:</b> Level V: expert opinion.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261474517"},"PeriodicalIF":1.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Versus Conservative Management of Ulnar Collateral Ligament Injuries in the Overhead Athlete: A Narrative Review.","authors":"Nathan H Varady, Jude Alawa, Andrew J Sama, Joshua R Eskew, Victoria Mack, Christopher L Camp, Joshua S Dines","doi":"10.1177/15563316261470432","DOIUrl":"10.1177/15563316261470432","url":null,"abstract":"<p><p>Ulnar collateral ligament (UCL) injuries are common in overhead athletes, and optimal selection of nonoperative versus operative treatment remains variable. This narrative review summarizes contemporary evaluation and management of UCL injuries in overhead athletes, emphasizing how symptoms, athlete goals, chronicity, and tear morphology guide decision-making. Nonoperative care is generally initially utilized for low-grade, proximal partial-thickness tears, and centers on kinetic-chain-based rehabilitation with staged return-to-throwing, with reported return-to-play (RTP) rates near 80%. Adjunctive platelet-rich plasma has gained interest, but available evidence reflects heterogeneous protocols and mixed clinical benefit. Surgery is typically indicated for high-grade, distal, or chronic pathology in high-demand athletes. UCL reconstruction provides reliable RTP rates often exceeding 90% but requires a longer rehabilitation timeline (approximately 12-18 months). Contemporary UCL repair with internal brace augmentation can achieve comparable outcomes with accelerated RTP (approximately 4-7 months) in appropriately selected acute proximal or distal tears with adequate tissue quality. Key gaps include predicting nonoperative failure, standardizing biologic and rehabilitation protocols, defining objective RTP criteria, and strengthening evidence in nonthrowing overhead athletes.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261470432"},"PeriodicalIF":1.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Imaging for the Overhead Athlete: A Narrative Review.","authors":"Christian S Geannette, Mitchell A Johnson, Harry G Greditzer, Philip G Colucci","doi":"10.1177/15563316261478631","DOIUrl":"10.1177/15563316261478631","url":null,"abstract":"<p><p>Overhead throwing athletes place unique stresses on the soft tissues of the core and upper extremities, predisposing them to both acute and chronic overuse injuries. In addition to clinical factors and examination, imaging techniques aid in the diagnosis and management of these conditions. Advances in ultrasound and 3D imaging modalities continue to improve detection of these injuries. This narrative review provides an overview of advanced imaging techniques, including recent developments, focusing on the diagnosis of injuries in the overhead athlete.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261478631"},"PeriodicalIF":1.4,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Patients Demonstrate Improved Patient-Reported Outcome Measures Following Revision Shoulder Arthroplasty Relative to Their Pre-Primary Condition? A Retrospective Case Series.","authors":"Justin Leal, Eoghan T Hurley, Lulla Kiwinda, Mikhail Bethell, Samuel G Lorentz, Sean P Ryan, Christopher S Klifto","doi":"10.1177/15563316261474883","DOIUrl":"10.1177/15563316261474883","url":null,"abstract":"<p><strong>Background: </strong>No study has evaluated patient-reported outcome measures (PROMs) from before primary total shoulder arthroplasty (TSA) to after revision TSA to determine if patients felt that they were better off than prior to undergoing primary TSA. Understanding this longitudinal trajectory could help guide clinical decision-making and set realistic patient expectations regarding the potential benefits of revision TSA.</p><p><strong>Purposes: </strong>The purpose of this study was to compare PROMs of patients prior to initial TSA to after revision TSA to determine if they were better off relative to their pre-primary TSA condition.</p><p><strong>Methods: </strong>A single center was retrospectively reviewed to identify patients who underwent revision TSA from May 1, 2013, to February 1, 2024. All patients' charts were reviewed to collect their primary procedure date and indication. Only patients who underwent anatomic or reverse TSA were included. Pre-primary and post-revision generic PROMs were subsequently collected. Patients who did not have pre-primary and post-revision PROMs collected were excluded. Median pre-primary and post-revision PROMs were then compared.</p><p><strong>Results: </strong>A total of 62 patients were included. After revision TSA, patients had lower median Patient-Reported Outcome Measure Information System (PROMIS) pain interference scores than before their primary TSA (62.0 [55.2-66.8] vs 66.5 [63.0-72.0]) and 66.1% achieved minimum clinically important difference (MCID). Median PROMIS physical function post-revision was higher than pre-primary TSA scores (38.0 [32.0-44.0] vs 30.5 [27.0-36.0]) and 61.3% achieved MCID.</p><p><strong>Conclusion: </strong>The findings of this retrospective case series suggest that patients who have been revised for complications after TSA showed improved PROMs relative to their pre-primary TSA condition.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261474883"},"PeriodicalIF":1.4,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Shoulder and Elbow Injuries in Overhead Athletes: A Clinical Commentary.","authors":"David Iodice, Robert Andrews, Alex Gough, Nicholas Perry","doi":"10.1177/15563316261478575","DOIUrl":"10.1177/15563316261478575","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261478575"},"PeriodicalIF":1.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Clinical Comparison of Mulligan's Mobilization With Movement and Kaltenborn Mobilization in Elbow Recovery: A Pilot Study.","authors":"Mehlaqa Waseem, Nehal Fatima, Arslan Iftikhar","doi":"10.1177/15563316261475265","DOIUrl":"https://doi.org/10.1177/15563316261475265","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic stiffness is a pathological condition that results from injury and the soft tissue response, leading to reduced or lost joint motion and functional impairments.</p><p><strong>Purpose: </strong>This pilot study aimed to compare the efficacy of Kaltenborn mobilization and Mulligan Mobilization with movement (MWM) in managing post-traumatic elbow stiffness.</p><p><strong>Methods: </strong>A 6-month prospective non-randomized comparative interventional pilot study was conducted at Independent University Hospital, Faisalabad, Pakistan. Forty-five participants were equally divided into 3 groups: Group A (Active range of motion [A-RoM] + actinotherapy), Group B (Kaltenborn Grade III glides + actinotherapy), and Group C (MWM with sustained end-range glides + actinotherapy). Baseline assessments included demographics, elbow RoM (flexion, extension, pronation, supination), manual muscle testing, Mayo Elbow Performance Score, and Numeric Pain Rating Scale. This study was registered in the Clinical Trials Registry of Australia and New Zealand (ACTRN12625000820404). Post-intervention analysis using paired <i>t</i>-tests and 2-way analysis of variance was conducted.</p><p><strong>Results: </strong>The interventions in Group C were associated with the greatest improvements in RoM, strength, and pain relief compared to A-RoM exercises and Kaltenborn mobilization. Kaltenborn mobilization resulted in significant clinical improvement, whereas A-RoM exercises did not show any difference.</p><p><strong>Conclusion: </strong>The findings of this pilot study suggest that MWM may address biomechanical dysfunctions more effectively than Kaltenborn mobilization in patients with post-traumatic elbow stiffness. Further study is needed to confirm that MWM should be integrated into standard post-traumatic elbow rehabilitation protocols.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic Study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261475265"},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trending Pediatric Injuries in the Overhead Athlete: A Narrative Review.","authors":"Joseph Molony, Donna Merkel, Kathryn McElheny, Yukiko Matsuzaki, Michelle Yang","doi":"10.1177/15563316261474789","DOIUrl":"https://doi.org/10.1177/15563316261474789","url":null,"abstract":"<p><p>Pediatric overhead athlete injuries are increasing in frequency, many of them unique to the youth musculoskeletal system. Conditions relate not only to growth centers but also to subchondral bone and joint instability linked to immature connective tissue. Diagnosis depends on a thorough patient history, correct examination techniques, and use of imaging. Management of these patients requires a greater focus on neuromuscular rehabilitation principles than is needed for adults. There is a lack of consensus on the role of functional testing in rehabilitation decisions, and further investigation is necessary. In addition, practitioners need to be mindful of the psychosocial dynamics among players, parents, and coaches, who may not understand appropriate workloads for young athletes and feel pressured to accelerate the pace of recovery. This narrative review covers the most current principles of diagnosis, treatment, and return-to-play strategies for pediatric overhead athlete injuries including preventing of recurrent injuries and avoiding long-term sequelae.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261474789"},"PeriodicalIF":1.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"With Interval Throwing Programs, No One Approach Fits All: A Commentary.","authors":"Daniel Kline, Kendall Henry, Avery Epstein, Jacquelyn Robbins, Niall O'Brien, Natalie L Myers","doi":"10.1177/15563316261473607","DOIUrl":"10.1177/15563316261473607","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261473607"},"PeriodicalIF":1.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}