Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Increased rate of surgery for loss of motion following anterior cruciate ligament reconstruction during COVID-19","authors":"Joseph D. Giusto ,&nbsp;Gillian M. Ahrendt ,&nbsp;Ariana Lott ,&nbsp;Kathleen M. Poploski ,&nbsp;Janina Kaarre ,&nbsp;Camila Grandberg ,&nbsp;Jonathan D. Hughes ,&nbsp;James J. Irrgang ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2024.100314","DOIUrl":"10.1016/j.jisako.2024.100314","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the incidence and risk factors associated with loss of motion after anterior cruciate ligament reconstruction (ACLR) during the coronavirus disease 2019 pandemic (COVID-19).</div></div><div><h3>Methods</h3><div>A retrospective review of patients undergoing primary ACLR between March 2017 and November 2022 by a senior high-volume orthopaedic surgeon was performed. Exclusion criteria included revision ACLR, multiligamentous knee surgery, and age &lt;14 years. The COVID-19 group was categorized according to the United States Centers for Disease Control Public Health Emergency declaration dates (January 31, 2020–May 11, 2023). To minimize confounding variables associated with the early stages of COVID-19, patients who underwent ACLR between December 1, 2019 and February 29, 2020 were excluded. Loss of motion was defined using the International Knee Documentation Committee criteria for loss of motion of the knee (i.e. an extension deficit &gt;5° or flexion deficit &gt;15° compared to the contralateral knee) 3–12 months after ACLR or as requiring surgery to restore motion within 12 months of ACLR.</div></div><div><h3>Results</h3><div>A total of 336 individuals who underwent 352 primary ACLRs (164 pre-COVID-19, 188 during COVID-19) were included (mean age: 25.2 ​± ​10.6 years, 44% female). The overall rate of postoperative loss of motion was 15% (n = 53), and 9% (n = 31) required surgery to restore motion within 12 months of ACLR. More patients underwent surgery for loss of motion during COVID-19 compared to pre-COVID-19, which was statistically significant (12% (n = 23) vs 5% (n = 8), respectively, P = 0.02). However, a statistically significant difference in the rate of loss of motion was not detected (18% (n = 33) vs 12% (n = 20), respectively, P = 0.16). A statistically significant increased median time from injury to ACLR was observed during COVID-19 compared to pre-COVID-19 (55 vs 37 days, P &lt;0.01). More patients were unable to achieve terminal extension (0°) at minimum 9 months postoperatively during COVID-19 compared to pre-COVID-19 (10% vs 3%, P = 0.04) and motion was worse at this interval (0°–136° vs −2°–138°, P &lt;0.01).</div></div><div><h3>Conclusion</h3><div>Surgery for loss of motion following ACLR was more common during COVID-19. Decreased access to elective medical care, changed activity level, psychological effects, or COVID-19 itself may explain the increased rate of surgery for loss of motion during COVID-19.</div></div><div><h3>Level of evidence</h3><div>Case series; level IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074076","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":"Development and validation of a novel method for assessing physical activity profiles after anterior cruciate ligament reconstruction: The Sports and Physical Activity scale","authors":"Haydn J. Klemm ,&nbsp;Kate E. Webster ,&nbsp;Brian M. Devitt ,&nbsp;Cameron J. Norsworthy ,&nbsp;Timothy S. Whitehead ,&nbsp;Julian A. Feller","doi":"10.1016/j.jisako.2024.100312","DOIUrl":"10.1016/j.jisako.2024.100312","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe and evaluate the preliminary validity of a novel scoring system for assessing the physical activity of patients after anterior cruciate ligament (ACL) reconstruction.</div></div><div><h3>Methods</h3><div>The Sports and Physical Activity (SPA) scale consists of thirty options of sports and physical activities, followed by four frequency options for each option selected. Factors used to develop the scoring system were frequency of participation and intensity of the sports or physical activities. Possible scores ranged from a low of 0 to a high of 24. The scale was assessed for validity and responsiveness.</div></div><div><h3>Results</h3><div>The study cohort included 418 primary ACL reconstructed patients 2 years after surgery, and a subgroup of 183 patient 5 years after surgery. The mean and median SPA scores for the cohort were 12.35 ( ​± ​6.95) and 12, respectively. There was no statistically significant difference between the scores of men and women (U ​= ​21,541.0, p ​= ​0.921). The SPA scale had a small but statistically significant inverse correlation with age (r_s ​= ​−0.2, p = &lt;0.001), indicating divergent validity. Patients who had returned to sport had a statistically significantly higher score (U ​= ​21593.5, p = &lt;0.001), and there was a statistically significant difference between scores of the three current sports status groups (H ​= ​19.99, p value = &lt;0.001) indicating convergent validity. Construct validity was indicated with a statistically significant correlation with the Marx scale (r_s ​= ​0.422, p value= &lt;0.001). In a subgroup (n ​= ​183) of the patient sample, comparison between scores at 2-years (13.27 ​± ​7.02) and 5-years (12.11 ​± ​7.88) found a statistically significant decline (p= &lt;0.001). However, this decline was smaller than the decline seen in the Marx score between 2 and 5 years (11.11 ​± ​4.07 and 9.30 ​± ​4.52 p= &lt;0.001).</div></div><div><h3>Conclusion</h3><div>Preliminary validity was found for the SPA scale. Women and men were found to be participating in a similar amount of activity 2 years post ACL reconstruction, despite return to sport differences between men and women being well documented. The scores of the SPA scale showed a statistically significant decrease over time with a negligible effect size.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056786","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":"Transcultural adaptation and validation of the 4-Domain Sports PROM into Italian","authors":"S.R. Piedade ,&nbsp;G.L. Canata ,&nbsp;N. Maffulli","doi":"10.1016/j.jisako.2024.100305","DOIUrl":"10.1016/j.jisako.2024.100305","url":null,"abstract":"<div><h3>Objectives</h3><div>This work aims to evaluate and validate the process of cross-cultural adaptation and validation of the 4-Domain Sports PROM (4-DSP) into Italian, assessing its understandability and reproducibility in all questionnaire domains for Italian-speaking patients.</div></div><div><h3>Methods</h3><div>Cross-sectional study, level of evidence II. The questionnaire was self-administered by 100 patients (80 males and 20 females) who had undergone anterior cruciate ligament (ACL) reconstruction and had a one-year minimum follow-up. The mean age and standard deviation (SD) was 31.20 ​± ​12.65 years. According to their level of sports participation, 51% were recreational, 31% were regional, 12% were national, and 6% were international athletes. All patients filled in the 4-DSP questionnaire without direct supervision of their trainer/coach or researcher. All data were collected and processed anonymously. The translation and cultural adaptation of the 4-DSP involved six phases: (1) translation, (2) synthesis, (3) back-translation, (4) pre-test, (5) expert committee review and (6) final version approval by the author of the original version for publication.</div></div><div><h3>Results</h3><div>The cross-cultural validation of the questionnaire 4-DSP into Italian presented a global Cronbach's alpha of 0.65, Conceptual equivalence to translation and relevance were 99.09% and 99.81%, respectively, and the percentage of agreement was 99.09%.</div></div><div><h3>Conclusion</h3><div>The cross-culturally validated version of the 4-DSP into Italian proved to be adequately understandable and reproducible in all questionnaire domains and can be safely and reliably used in Italian-speaking patients.</div></div><div><h3>Level of evidence</h3><div>Study level II.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056749","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":"Vascular complications after a multiligament knee reconstruction: A case report highlighting the role of preoperative imaging","authors":"Simon Martel ,&nbsp;KC Herne ,&nbsp;Saud M. Alfayez ,&nbsp;Mark Burman ,&nbsp;Paul A. Martineau","doi":"10.1016/j.jisako.2024.100313","DOIUrl":"10.1016/j.jisako.2024.100313","url":null,"abstract":"<div><div>Vascular injuries are serious complications of multiligament knee injuries and can result in catastrophic outcomes. These injuries can range from intimal flaps with no compromise of the distal perfusion to a complete occlusion or transection requiring emergent vascular intervention. Several diagnostic tests, including the measurement of the ankle-brachial index (ABI), conventional angiography, and computed tomography angiography (CTA), are commonly used as diagnostic tools to identify vascular injuries in the context of a multiligament knee injury. In this report, the authors discuss the case of a patient with a normal ABI and palpable distal pulses on physical examination who developed limb ischemia after a multiligament knee reconstruction under tourniquet. The patient underwent emergent embolectomy and had a favorable postoperative outcome. During vascular exploration, there was no evidence of injury to the popliteal artery. The two working diagnoses were that either the patient had an intimal flap complicated by the development of a thrombus during surgery or that the initial vascular injury was not detected by ABI and clinical examination. Therefore, intimal flaps in multiligament knee injuries can lead to limb threatening ischemia in the context of reconstructive knee surgery and are likely underdiagnosed with ABI assessment. The utilization of preoperative CTA may help identify these injuries in patients indicated for reconstructive surgeries.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056750","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":"Osteochondroplasty with or without labral repair is more cost-effective than arthroscopic lavage with or without labral repair for treatment of young adults with femoroacetabular impingement: A cost-utility analysis based on data from a randomized controlled trial","authors":"Jiajun Yan ,&nbsp;Brittany Humphries ,&nbsp;Zhenyan Bo ,&nbsp;Ling Dai ,&nbsp;Nicole Simunovic ,&nbsp;Feng Xie ,&nbsp;Olufemi R. Ayeni","doi":"10.1016/j.jisako.2024.100307","DOIUrl":"10.1016/j.jisako.2024.100307","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to conduct a cost–utility analysis of osteochondroplasty with or without labral repair compared to arthroscopic lavage with or without labral repair for femoroacetabular impingement (FAI) from a Canadian public payer perspective.</div></div><div><h3>Methods</h3><div>A Markov model was constructed to compare the lifetime quality-adjusted life years (QALYs) and costs of the two treatment strategies. The target population was surgical FAI patients aged 36 years. The primary data source was patient-level data from the Femoroacetabular Impingement Randomised Controlled Trial, which evaluated the efficacy of the surgical correction of FAI via arthroscopic osteochondroplasty with or without labral repair compared to arthroscopic lavage with or without labral repair in Canada. Long-term data were extrapolated using a generalized gamma model. The primary outcome was the incremental cost-effectiveness ratio, calculated by dividing the difference in costs by the difference in QALYs between osteochondroplasty and lavage, with or without labral repair. Probabilistic sensitivity analyses and one-way sensitivity analyses were used to characterize uncertainty of model parameters and assumptions.</div></div><div><h3>Results</h3><div>Over a lifetime horizon, osteochondroplasty, with or without labral repair, had a greater expected benefit (0.63 QALYs gained per patient) and lower costs ($955.89 saved per patient), as compared with lavage with or without labral repair. Probabilistic sensitivity analyses demonstrated that the probability of osteochondroplasty, with or without labral repair, being cost-effective was 90.5% at a commonly used willingness-to-pay threshold of $50,000/QALY in Canada. Across all one-way sensitivity analyses, osteochondroplasty with or without labral repair remained a cost-effective option.</div></div><div><h3>Conclusion</h3><div>Over a lifetime time horizon, osteochondroplasty, with or without labral repair, is a cost-effective treatment strategy for young adults with FAI. Future research involving real-word data is needed to further validate these findings.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056748","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":"Management of patellar and trochlear cartilage lesions with matrix-induced autologous chondrocyte implantation in conjunction with patellofemoral realignment procedures improves patient-reported outcomes and magnetic resonance image appearance","authors":"Julia S. Retzky ,&nbsp;E. Grant Carey ,&nbsp;Ryan S. Selley ,&nbsp;Connor Fletcher ,&nbsp;Matthew J. Hartwell ,&nbsp;Alissa J. Burge ,&nbsp;Andreas Gomoll ,&nbsp;Sabrina Strickland","doi":"10.1016/j.jisako.2024.100311","DOIUrl":"10.1016/j.jisako.2024.100311","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study is to evaluate the relationship between the achievement of clinically significant improvement in patient-reported outcome measures (PROMs) and the postoperative magnetic resonance image (MRI) appearance of matrix-associated chondrocyte implantation (MACI), in conjunction with patellofemoral realignment procedures, for the treatment of grade-IV chondral defects about the patellofemoral joint.</p></div><div><h3>Methods</h3><p>A retrospective review of patients undergoing MACI for grade-IV chondral defects of the patella or trochlea by a single sports-medicine-fellowship-trained surgeon from 2017 to 2020 was performed. Concomitant realignment procedures, including tibial tubercle osteotomy and medial patellofemoral ligament reconstruction, were also performed as needed. Patients with preoperative and minimum 1-year postoperative PROMs and postoperative knee MRI were included. MRI scans were obtained at 6.3 (interquartile range: 5.8, 7.5) months postoperatively. A fellowship-trained musculoskeletal radiologist assigned a Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score (range: 0–100, with 100 equating to complete graft healing) to each MRI. Achievement of the minimal clinically important difference (MCID) for International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score—Quality of Life, and Kujala scores were determined for each patient. Paired t-tests or Wilcoxon rank-sum tests were used to evaluate for an association between achievement of the MCID for each PROM and MOCART score. The average follow-up time and time from surgery to PROMs were 2.7 ​± ​1.5 years and 1.7 ​± ​0.66 years, respectively.</p></div><div><h3>Results</h3><p>Thirty patients were included. There was a significant improvement in all PROMs from preoperative to postoperative (p ​&lt; ​0.001). More than two-thirds of patients achieved the MCID for each PROM. Patients who achieved the MCID for IKDC had significantly higher MOCART scores (66.5 ​± ​16.2) than those who did not meet the MCID for IKDC (50.6 ​± ​23.6, p ​= ​0.043).</p></div><div><h3>Conclusion</h3><p>MACI for the treatment of patellofemoral chondral injuries is associated with clinically significant improvement in PROMs at short-term follow-up. Clinically significant improvements in IKDC scores are associated with a more mature MRI appearance of the autologous chondrocyte implantation graft on postoperative MRI, as indicated by higher MOCART scores.</p></div><div><h3>Level of evidence</h3><p>IV—Case Series.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001585/pdfft?md5=c16361d1ebfa9a54936ed58b4ea590bd&pid=1-s2.0-S2059775424001585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000823","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":"Quadriceps tendon size does not affect postoperative strength recovery following quadriceps tendon anterior cruciate ligament reconstruction","authors":"Jumpei Inoue ,&nbsp;M Enes Kayaalp ,&nbsp;Joseph D. Giusto ,&nbsp;Koji Nukuto ,&nbsp;Bryson P. Lesniak ,&nbsp;Andrew L. Sprague ,&nbsp;James J. Irrgang ,&nbsp;Volker Musahl","doi":"10.1016/j.jisako.2024.100308","DOIUrl":"10.1016/j.jisako.2024.100308","url":null,"abstract":"<div><h3>Objective</h3><p>The influence of quadriceps tendon (QT) size on postoperative quadriceps strength following QT anterior cruciate ligament reconstruction (ACLR) is unclear. Therefore, this study aimed to determine the relationship between QT morphology and postoperative quadriceps strength recovery following primary ACLR using a QT autograft.</p></div><div><h3>Methods</h3><p>Patients who underwent primary ACLR using QT autograft from 2014 to 2022 followed by a postoperative isometric strength measurement between 5 and 8 months were retrospectively reviewed. Using preoperative magnetic resonance imaging findings, the anterior–posterior (A-P) thickness, medial–lateral (M-L) width, and cross-sectional area (CSA) of the QT were measured. Postoperative residual CSA of QT was estimated based on the graft-harvest diameter. The quadriceps index (QI) was also calculated, which was determined by dividing the maximum isometric quadriceps torque on the involved side by the maximum quadriceps torque on the uninvolved side. Associations between the QI and QT morphology were assessed. Furthermore, multivariable logistic regression analysis with the addition of sex as a covariate was performed with the addition of each individual measure of QT morphology to determine the association with a QI ​≥80%.</p></div><div><h3>Results</h3><p>A total of 84 patients (mean age: 21.9 ​± ​7.3 years; 46 female) were included. Residual CSA showed a statistically significant positive correlation with the QI (r ​= ​0.221, <em>p</em> ​= ​0.043). There were no statistically significant correlations between QI and CSA, A-P thickness, or M-L width. Multivariable logistic analysis adjusting for sex demonstrated that each individual measure of QT morphology was not statistically significantly associated with a QI ​≥80%.</p></div><div><h3>Conclusion</h3><p>A statistically significant correlation between measures of preoperative QT size and postoperative quadriceps strength were not detected in patients undergoing primary QT autograft ACLR. A smaller residual QT CSA based on QT harvest diameter was weakly associated with decreased quadriceps strength 5–8 months postoperatively, but this association was not independent of sex. Future studies examining the impact of QT morphology on quadriceps strength at longer follow-up intervals are needed.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S205977542400155X/pdfft?md5=915e38d8d339a90bd4c385e7dc499eeb&pid=1-s2.0-S205977542400155X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000824","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":"Sagittal computed tomography evaluation of osteochondritis dissecans of the capitellum correlates with clinical outcomes of arthroscopic debridement in adolescent baseball players","authors":"Kenji Yokoyama ,&nbsp;Tetsuya Matsuura ,&nbsp;Joji Iwase ,&nbsp;Toshiyuki Iwame ,&nbsp;Koichi Sairyo","doi":"10.1016/j.jisako.2024.07.009","DOIUrl":"10.1016/j.jisako.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the relationship between the size and location of osteochondral defects in capitellar osteochondritis dissecans (OCD) measured on coronal and sagittal reconstructed computed tomography (CT) images and the clinical outcomes of arthroscopic debridement in adolescent baseball players.</div></div><div><h3>Methods</h3><div>This retrospective study investigated the clinical outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players with ≥24 months of follow-up after surgery between 2008 and 2020. On preoperative coronal CT images, medial and lateral distance (%) were used to evaluate the location of the defect. Defect size (%) was also evaluated. On preoperative sagittal CT images, superior and inferior angles (deg) were used to evaluate the location of the defect. The size of the defect was evaluated using the defect angle (deg). Outcome measures were determined using the Timmerman–Andrews score at the latest follow-up. Spearman’s rank correlation coefficient was used to examine relationships between these parameters and the Timmerman–Andrews score. Statistical significance was set at <em>p</em> ​&lt; ​0.05.</div></div><div><h3>Results</h3><div>Thirty players [mean age, 14 (range, 11–16) years] underwent arthroscopic debridement: 5 were pitchers, 7 were catchers, 13 were infielders, and 5 were outfielders. Mean follow-up duration was 26 (range, 24–66) months. The median Timmerman–Andrews score at the latest follow-up was 193 [interquartile range (IQR), 181–200] points. Inferior angle showed statistically significant positive correlations with Timmerman–Andrews score (r_s ​= ​0.520, <em>p</em> ​&lt; ​0.01), pain (r_s ​= ​0.478, <em>p</em> ​&lt; ​0.01), and sagittal arc of motion (r_s ​= ​0.409, <em>p</em> ​= ​0.025). Defect angle showed statistically significant negative correlations with Timmerman–Andrews score (r_s ​= ​−0.462, <em>p</em> ​= ​0.010) and flexion contracture (r_s ​= ​-0.424, <em>p</em> ​= ​0.020). Medial distance, lateral distance, defect size, and superior angle were not correlated with the Timmerman–Andrews score or any of its subscores.</div></div><div><h3>Conclusion</h3><div>Posterior or large osteochondral defects of the humeral capitellum on preoperative sagittal CT images affected the outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players.</div></div><div><h3>Level of evidence</h3><div>Level V, case series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the medium term, more than half of males report kinesiophobia after anterior cruciate ligament reconstruction","authors":"Leho Rips ,&nbsp;Tauno Koovit ,&nbsp;Mihkel Luik ,&nbsp;Helena Saar ,&nbsp;Rein Kuik ,&nbsp;Jüri-Toomas Kartus ,&nbsp;Madis Rahu","doi":"10.1016/j.jisako.2024.100309","DOIUrl":"10.1016/j.jisako.2024.100309","url":null,"abstract":"<div><h3>Objectives</h3><p>Anterior cruciate ligament rupture is a serious trauma with long-term consequences for the patient. Psychological and physiological factors may negatively affect patient recovery after anterior cruciate ligament reconstruction (ACLR), and development of kinesiophobia is possible. The aim of this study was to examine the presence of kinesiophobia and lower-leg muscle strength recovery in both sexes after ACLR.</p></div><div><h3>Methods</h3><p>140 ACLR patients agreed to participate in the study. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK). The Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS) and Tegner Activity Scale (TAS) were used for patient-related outcome measurements. In both legs quadriceps and hamstring muscle strength at 60°/s and 180°/s were measured with an isokinetic dynamometer. For dynamic balance and leg function, the Y-balance test and single-leg hop test were used.</p></div><div><h3>Results</h3><p>100 (71%) males and 40 (29%) females—mean age 32.5 (±8.3)—were examined 5.5 (±1.25) years after ACLR. 68/140 patients (48.6%) reported a TSK kinesiophobia score equal to or higher than 37 points: 54/100 (54%) males and 14/40 (35%) females (p ​= ​0.04). Patients with kinesiophobia had significantly lower KOOS values (p ​&lt; ​0.001). In terms of the TAS no significant differences were found between those with or without kinesiophobia. Knee strength deficiency at 180°/sec and 60°/sec was significantly higher in the kinesiophobia group in knee extension in males (p ​= ​0.009) and knee flexion in females (p ​= ​0.001). Normalized body weight isokinetic average peak torque strength tests were significantly better in males compared to females in both groups (p ​&lt; ​0.001).</p></div><div><h3>Conclusion</h3><p>Both sexes reported high rates of kinesiophobia, but males are at higher risk of developing kinesiophobia than females in the medium term after ACLR. Furthermore, patients with kinesiophobia have significantly lower total KOOS scores, and females were significantly weaker than males in knee flexion and extension according to normalized body weight muscle strength tests. Also, a longer time from injury to surgery increases the risk of kinesiophobia in females.</p></div><div><h3>Level of evidence</h3><p>Level IV.</p></div><div><h3>Type of study</h3><p>Retrospective case series study.</p></div><div><h3>Clinical trial registration</h3><p>Trial registration in ClinicalTrials.gov. Identifier: NCT05762809.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001561/pdfft?md5=565b082441ee48ba20c4163df9eff267&pid=1-s2.0-S2059775424001561-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005497","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":"Shoulder girdle muscle abscess: Potential routes of spread and surgical management by a dual anterior approach","authors":"Narendran Pushpasekaran ,&nbsp;Sivaranjinie Selvakkalanjiyam ,&nbsp;Monish Kumar Rajesh ,&nbsp;Muthukannan Hari Sivanandan ,&nbsp;Kandasamy Meenakshi Sundaram","doi":"10.1016/j.jisako.2024.100310","DOIUrl":"10.1016/j.jisako.2024.100310","url":null,"abstract":"<div><h3>Background</h3><p>Spontaneous infections involving muscles in the shoulder girdle are uncommon conditions rarely reported in the literature. The large musculature of shoulder girdle, complex communicating spaces into the periscapular region, and late glenohumeral joint involvement can cause delay in diagnosis of infections involving muscular portion of rotator cuff. The method of surgical drainage with involvement of scapulothoracic and subscapular spaces and prognosis can be challenging.</p></div><div><h3>Methodology</h3><p>In this descriptive study, we included patients with shoulder girdle muscle abscess and analyzed the spread in the shoulder girdle and arm through various pathways radiologically. Debridement of the abscess in the subscapular muscle and adnexa was done through the dual approach, one with deltopectoral approach for the shoulder girdle and another incision anterior to the latissimus dorsi muscle for inferior subscapular spaces and gravity-dependent drainage of collection.</p></div><div><h3>Results</h3><p>The causative organism <em>Staphylococcus aureus</em> was isolated only in two patients out of four cases. In repeated collections, axillary and suprascapular nerve palsies were commonly encountered. Adequate debridement, antibiotic cover with vancomycin and clindamycin for six weeks, and rehabilitation restored normal functions of the shoulder in three patients.</p></div><div><h3>Conclusion</h3><p>Unsuspecting nature of the subscapular abscess and similarities with common shoulder conditions at initial presentation often led to extensive shoulder girdle involvement via subscapular space, subcoracoid recess, and scapulothoracic space to adjacent areas. The dual approach provides adequate access to drain the collections in subscapularis muscle, subscapular spaces, and shoulder girdle.</p></div><div><h3>Level of study</h3><p>V.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001573/pdfft?md5=99d5adcfeb1e102126de87c5560e4926&pid=1-s2.0-S2059775424001573-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005498","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}