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

{"title":"Diagnosis and treatment approach of delayed presentation of anterior branch axillary nerve injury following shoulder dislocation: case report","authors":"","doi":"10.1016/j.jisako.2024.05.006","DOIUrl":"10.1016/j.jisako.2024.05.006","url":null,"abstract":"<div><p>In this case report, a unique instance of delayed isolated anterior branch axillary nerve injury following shoulder dislocation is highlighted. The patient, a 55-year-old manual laborer, presented with severe deltoid wasting and reduced power 18 months postdislocation, necessitating a specialized treatment approach. The use of axillary nerve neurolysis and an innovative upper trapezius to anterior deltoid transfer via a subacromial path posterior to the clavicle, facilitated by an autologous semitendinosus graft, resulted in significant improvement with 160 degrees of abduction and Grade 4+ power Medical Research Council grading (MRC) at the 5-year follow-up.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000932/pdfft?md5=365355cef52ecaaf236c124fb796bbf4&pid=1-s2.0-S2059775424000932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916815","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":"Machine learning/artificial intelligence in sports medicine: state of the art and future directions","authors":"","doi":"10.1016/j.jisako.2024.01.013","DOIUrl":"10.1016/j.jisako.2024.01.013","url":null,"abstract":"<div><p>Machine learning (ML) is changing the way health care is practiced and recent applications of these novel statistical techniques have started to impact orthopaedic sports medicine. Machine learning enables the analysis of large volumes of data to establish complex relationships between “input” and “output” variables. These relationships may be more complex than could be established through traditional statistical analysis and can lead to the ability to predict the “output” with high levels of accuracy. Supervised learning is the most common ML approach for healthcare data and recent studies have developed algorithms to predict patient-specific outcome after surgical procedures such as hip arthroscopy and anterior cruciate ligament reconstruction. Deep learning is a higher-level ML approach that facilitates the processing and interpretation of complex datasets through artificial neural networks that are inspired by the way the human brain processes information. In orthopaedic sports medicine, deep learning has primarily been used for automatic image (computer vision) and text (natural language processing) interpretation. While applications in orthopaedic sports medicine have been increasing exponentially, one significant barrier to widespread adoption of ML remains clinician unfamiliarity with the associated methods and concepts. The goal of this review is to introduce these concepts, review current machine learning models in orthopaedic sport medicine, and discuss future opportunities for innovation within the specialty.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000130/pdfft?md5=84642d9805e1a58138aa82232d5d9c6c&pid=1-s2.0-S2059775424000130-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713114","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":"Physiopathology of patello-femoral osteoarthritis: current concepts","authors":"","doi":"10.1016/j.jisako.2024.06.004","DOIUrl":"10.1016/j.jisako.2024.06.004","url":null,"abstract":"<div><p>Patellofemoral osteoarthritis (PFOA) is the result of degeneration and loss of articular cartilage of the patella and trochlea, and is a common cause of anterior knee pain. PFOA is triggered by insufficient adaptation to overload of the articular cartilage of the PF joint created by abnormal biomechanics. It is important to understand the pathophysiology and natural history to make the diagnosis and to plan treatment. Innate factors including malalignment, patellar instability, kinematic disorders, and acquired factors like trauma, obesity, and endocrine diseases have been found to be causes of PFOA. Genetic predisposition is also described as a contributing cause but without much scientific evidence. The diagnosis will be based on clinical manifestations, such as anterior knee pain aggravated by overloading activities, identification of risk factors, and exclusion of referred pain from other pathologies, followed by a systematic and structured physical examination. Imaging will be useful for assessing the presence of early osteoarthritis in the other compartments, for classification of the PFOA, and to identify features to establish an adequate treatment. This paper discusses varying management options for different causes of patellofemoral disease and explains the complexity of the PF joint and its often poorly understood biomechanics.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001214/pdfft?md5=53ef5f4a0dcc252ba781bddd8c636a0c&pid=1-s2.0-S2059775424001214-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427822","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":"Biomechanical and biological factors of sexual dimorphism in anterior knee pain: Current concepts","authors":"","doi":"10.1016/j.jisako.2024.05.014","DOIUrl":"10.1016/j.jisako.2024.05.014","url":null,"abstract":"<div><p>Female gender is one of the commonly mentioned risk factors for anterior knee pain (AKP), among a spectrum of other factors including anatomical, biomechanical, hormonal, behavioral and psychological elements contributing to its development. Despite the focus on individual risk factors, there's a notable gap in comprehending how gender influences and interacts with other risk factors. The objective of this review was to identify and emphasize the connections between these interactions, gender-related risk factors for AKP, and the potential mechanisms that explain their associations with other risk factors, aiming to aid in the creation of precise prevention and treatment approaches. Gender influences the majority of risk factors for AKP, including anatomical, biomechanical, hormonal, behavioral and psychological factors. Women have on average smaller patellae, higher patellofemoral cartilage stress and for AKP, disadvantageous trochlear morphology, ligament and muscle composition and unfavorable neuromuscular control pattern. In contrast, men show on average an increased ability to strengthen their hip external rotators, which are both protective against AKP. Particularly in kinetic and kinematic analysis, men have been shown to have a distinctly different risk factor profile than women. Sex hormones may also play a role in the risk of AKP, with estrogen potentially influencing ligamentous laxity, increasing midfoot loading and affecting neuromuscular control of the lower extremities and testosterone positively affecting muscle mass and strength. The higher incidence of AKP in women is likely due to a combination of slightly increased risk factors. Although all risk factors can be present in both men and women and the holistic evaluation of each individual's risk factor composition is imperative regardless of gender, knowing distinctive risk factors may help with focused evaluation, treatment and implementing preventive measures of AKP.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001019/pdfft?md5=e9401581f4ec085b27f8d86a68a32adb&pid=1-s2.0-S2059775424001019-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440936","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":"Playing surface and sport contact status modulate time to lower extremity musculoskeletal injury at a greater level than concussion history among collegiate student-athletes","authors":"","doi":"10.1016/j.jisako.2024.06.008","DOIUrl":"10.1016/j.jisako.2024.06.008","url":null,"abstract":"<div><h3>Objectives</h3><p>While previous investigations have demonstrated a positive correlation between previous concussion and risk of subsequent lower extremity musculoskeletal injury (LEMSKI), the effect of sport- and patient-specific factors on time to injury has not been thoroughly described. This study's main objective was to evaluate the relationship between prior concussion and time to LEMSKI among a population of collegiate student-athletes. Secondary objectives were to evaluate the relationship between playing surface, sport contact status, and biologic sex on time to LEMSKI. We hypothesized that those with previous concussions, those competing on synthetic surfaces, and those competing in collision sports would experience decreased latency to LEMSKI overall.</p></div><div><h3>Methods</h3><p>A retrospective observational analysis of National Collegiate Athletic Association (NCAA) Division I student-athletes was conducted utilizing a mixed linear model analysis with contrasts. Inclusion criteria included participation in the Pac-12 Health Analytics Program with a documented LEMSKI between 2017 and 2020. Exclusion criteria included concurrent concussion and LEMSKI, injury resulting in serious morbidity or mortality, and incomplete medical record. Participants were classified by whether they sustained a concussion prior to LEMSKI in each athletic season.</p></div><div><h3>Results</h3><p>Of 1179 athletes included, 1140 had no previous concussion and 37 had a previous concussion. There was no observed effect of previous concussion (F ​= ​0.038; p ​= ​0.846) on time to LEMSKI overall. Student-athletes competing on constructed surfaces sustained a subsequent LEMSKI 14.5 days sooner (SE ​= ​5.255; p ​= ​0.045), and those competing on organic surfaces sustained a subsequent LEMSKI 23.5 days sooner (SE ​= ​4.018; p ​&lt; ​0.001) in the season than those competing on synthetic surfaces. Contact sport student-athletes sustained a subsequent LEMSKI 52.1 days sooner than collision sport student-athletes (SE ​= ​5.248; p ​&lt; ​0.001), and limited contact sport student-athletes sustained a subsequent LEMSKI 42.29 days sooner than collision sport student-athletes (SE ​= ​4.463; p ​&lt; ​0.001). There was no observed effect of biologic sex (F ​= ​0.602; p ​= ​0.438) on time to LEMSKI overall.</p></div><div><h3>Conclusion</h3><p>There was no observed impact of concussion on time on LEMSKI overall in this collegiate athletic population. Contact sports were associated with decreased time to LEMSK, while synthetic surfaces were associated with increased time to LEMSKI in this population. There was no observed impact of biologic sex on time to LEMSKI.</p></div><div><h3>Level of evidence</h3><p>Case-control, level of evidence III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001251/pdfft?md5=ab47423afb8fc0cfa0b39e5b14f05e89&pid=1-s2.0-S2059775424001251-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459769","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":"Biological internal bracing with remnant repair allows the “best of both worlds” for subacute ACL femoral avulsions","authors":"","doi":"10.1016/j.jisako.2023.09.001","DOIUrl":"10.1016/j.jisako.2023.09.001","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775423005564/pdfft?md5=cc83bd5abe11d2d4e46274bcc0acd51b&pid=1-s2.0-S2059775423005564-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213369","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":"A rare presentation of a large suprascapular fossa lipoma causing suprascapular nerve traction injury leading to massive rotator cuff tear, treated arthroscopically – case report","authors":"","doi":"10.1016/j.jisako.2024.05.005","DOIUrl":"10.1016/j.jisako.2024.05.005","url":null,"abstract":"<div><p>Suprascapular fossa lipoma extending to the suprascapular notch causing traction injury to the suprascapular nerve is a rare presentation. We report a 47-year-old male with progressive weakness of the right shoulder joint of 8 months duration, with a palpable mass over the spine of the scapula was noticed 2 months earlier and developed a sudden drop in arm following a moderate strain. A magnetic resonance imaging (MRI) scan revealed a rotator cuff tear involving the supraspinatus and infraspinatus muscles with a tumor like lesion in the suprascapular fossa, displacing the suprascapular muscle mass and extending into the suprascapular notch. Electromyography and nerve conduction velocity studies revealed suprascapular neuropathy. After histopathologic confirmation, an arthroscopic excision of the mass with decompression of the suprascapular notch was performed along with repair of the rotator cuff. Six months after the procedure, the patient had improved considerably in terms of function and postoperative MRI revealed a complete excision of the mass, and further follow-up of 2 years showed no recurrence.</p><p>Suprascapular nerve entrapment can be caused by a lipoma in the shoulder, leading to weakness, atrophy, and consequent tear of the rotator cuff tendons. Arthroscopic management, after histopathological confirmation, gives good results in this situation.</p></div><div><h3>Level of evidence</h3><p>Level IV.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000920/pdfft?md5=31dd096e209bd8bf9594a58afa89edd1&pid=1-s2.0-S2059775424000920-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916768","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":"Ramp-like lateral meniscus tear. Description of an infrequent lesion","authors":"","doi":"10.1016/j.jisako.2024.04.005","DOIUrl":"10.1016/j.jisako.2024.04.005","url":null,"abstract":"<div><p>Numerous studies on meniscal tears have been published, a pathology that continues to evolve in terms of treatment and patient outcomes. As our understanding of anatomy and biomechanics improves, new entities have emerged. The lateral meniscus, especially its posterior attachment, tends to be overlooked due to its greater mobility compared to the medial meniscus. Evaluating the instability of the posterior horn poses a challenge, even during arthroscopy, therefore, it is crucial to understand the posterior menisco-synovial detachment lesions, which are indeed real and, to date, haven't received enough attention in the existing literature.</p><p>The aim is to describe a new entity affecting the posterior synovial attachment of the lateral meniscus, without injury to the posterior horn of the lateral meniscus (PHLM). We also aim to present a case report detailing the intraoperative diagnosis and management of a 20-year-old patient with a sports trauma that led to a combined anterior cruciate ligament (ACL) and lateral meniscus tear managed with arthroscopic ACL reconstruction and all-inside meniscal suture.</p><p>Through conventional arthroscopic evaluation of the posterior capsule anatomy and dissections, we have identified a distinct lesion of the PHLM at the menisco-synovial junction. Further research is necessary in this field to understand the biomechanical repercussions and determine the ideal surgical management.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000762/pdfft?md5=11585d9b5108ce916c26de7334cc1b9c&pid=1-s2.0-S2059775424000762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140797652","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":"Relationship between cement penetration and incidence of a radiolucent line around the tibia 2 years after total knee arthroplasty: A retrospective study","authors":"","doi":"10.1016/j.jisako.2024.05.015","DOIUrl":"10.1016/j.jisako.2024.05.015","url":null,"abstract":"<div><h3>Objectives</h3><p>Cement penetration (CP) plays a key role in implant stability for cemented total knee arthroplasty (TKA), and the radiolucent line (RLL) &gt;2 ​mm is a preliminary sign for loosening of components. However, the direct relationship between CP and the frequency of RLL &gt;2 ​mm is unclear, and the best cut-off value for CP to prevent RLL &gt;2 ​mm also remains unclear. This study aimed to investigate this relationship between CP and RLL and to determine the clinical cut-off value for tibial CP in patients 2 years after TKA.</p></div><div><h3>Methods</h3><p>This retrospective study investigated 157 knees from 123 patients with osteoarthritis who underwent cemented TKA. The CP and RLL immediately after TKA and the RLL 2 years after TKA were measured for the medial, lateral, anterior, and posterior tibial baseplate zones. Receiver operating characteristic (ROC) curves were constructed to determine the best cut-off values for CP.</p></div><div><h3>Results</h3><p>RLL &gt;2 ​mm was not observed just after TKA. An RLL &gt;2 ​mm was observed in any tibial baseplate zone in 22 knees from 20 patients (RLL+ group) and was not observed in the remaining (RLL− group) 2 years after TKA. The mean CP for all zones was significantly higher in the RLL− group (2.5 ​± ​1.1 ​mm) than in the RLL+ group (1.7 ​± ​0.6 ​mm; <em>P</em> ​&lt; ​0.001). An RLL &gt;2 ​mm was seen in 21 knees in the medial zone, 9 knees in the lateral zone, 8 knees in the anterior zone, and 3 knees in the posterior zone. CP values with RLL &gt;2 ​mm were significantly lower than those without the RLL at the medial, anterior, and posterior tibial baseplate zones. The best cut-off values from the ROC curve of CP in each zone were between 1.1 ​mm and 2.1 ​mm.</p></div><div><h3>Conclusions</h3><p>The depth of the CP directly affects the incidence of an RLL &gt;2 ​mm. The best cut-off value for tibial CP to prevent an RLL &gt;2 ​mm is 2.1 ​mm.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001020/pdfft?md5=671cba7defe8bd429226639c663662dd&pid=1-s2.0-S2059775424001020-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200500","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":"Secondary restraints in ACL reconstruction: State-of-the-art","authors":"","doi":"10.1016/j.jisako.2024.05.001","DOIUrl":"10.1016/j.jisako.2024.05.001","url":null,"abstract":"<div><p>At-risk patients continue to experience a high likelihood of graft rupture after anterior cruciate ligament (ACL) reconstruction (ACLR). This narrative review seeks to provide the reader with an evidence-based synopsis of state-of-the-art concepts related to secondary restraint lesions, and how addressing them surgically might result in improved outcomes of ACLR.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000889/pdfft?md5=763120b6d16a08edb996057a81ea4d2e&pid=1-s2.0-S2059775424000889-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909379","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}