Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology最新文献

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Early intervention of extracorporeal shockwave therapy sustained positive long-term effect on rotator cuff healing: A randomized controlled trial with 3-year follow-up 体外冲击波疗法的早期干预对肩袖愈合具有长期的积极影响:为期三年的随机对照试验
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-10-01 DOI: 10.1016/j.asmart.2024.09.004
{"title":"Early intervention of extracorporeal shockwave therapy sustained positive long-term effect on rotator cuff healing: A randomized controlled trial with 3-year follow-up","authors":"","doi":"10.1016/j.asmart.2024.09.004","DOIUrl":"10.1016/j.asmart.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The long-term effects of extracorporeal shockwave therapy (ESWT) on rotator cuff repair are unknown.</div></div><div><h3>Objectives</h3><div>To investigate the functional outcomes and structural changes of ESWT at 3-year follow-up after rotator cuff repair.</div></div><div><h3>Methods</h3><div>A randomized clinical trial was conducted, including patients who underwent rotator cuff repair. The patients were assigned to two groups based on whether they underwent radial ESWT 3 months postoperatively. The ESWT Group received 5 weeks of rehabilitation and ESWT weekly, whereas the CONTROL Group received only rehabilitation. Visual analog scale (VAS) pain score and functional scores were analyzed at 3 months (baseline), 6 months, and 3 years follow-up. In addition, MRI and ultrasonography were used to assess tendon maturation, integrity, tendon quality, acromiohumeral distance (AHD), and muscle fatty infiltration.</div></div><div><h3>Results</h3><div>Finally, 32 participants completed all the assessments. At the final follow-up, 2 patients in the ESWT Group (16.5 %) versus one patient in the CONTROL Group (6.25 %) had rotator cuff failure (P = 0.176). The ESWT treatment showed similar clinical outcomes in VAS-pain score, functional scores, tendon quality, AHD, and muscle fatty infiltration versus the CONTROL Group (Ps &gt; 0.05). MRI analysis indicated improved tendon healing after ESWT treatment at both 6-month (P = 0.036) and 3-year follow-up (P = 0.028).</div></div><div><h3>Conclusion</h3><div>Early intervention with radial ESWT sustained long-term effects on the healing of the repaired rotator cuff and similar functional outcomes at long-term follow-up compared with standard rehabilitation.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444878","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}
引用次数: 0
Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis 影响多次关节内注射富血小板血浆治疗膝关节骨关节炎疗效的因素
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-10-01 DOI: 10.1016/j.asmart.2024.09.006
{"title":"Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis","authors":"","doi":"10.1016/j.asmart.2024.09.006","DOIUrl":"10.1016/j.asmart.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Platelet-rich-plasma (PRP) is rapidly spreading as a conservative treatment option for knee osteoarthritis (KOA), however, its therapeutic efficacy is controversial. This study aimed to investigate the factors affecting the therapeutic effect of intra-articular PRP therapy for KOA in patients who received multiple PRP injections (PRP-I).</div></div><div><h3>Methods</h3><div>This is a historical cohort study included 1057 knees of 701 patients who received PRP-I during KOA treatment from 2018 to 2020. The difference in visual analog scale (VAS) scores before and after PRP-I was defined as the amount of change in VAS (ΔVAS). A linear mixed-effects model was employed with ΔVAS as a random effect and age, sex, BMI, KL classification, pre-treatment VAS, treatment duration, and the number of PRP injections as fixed effects. Evaluations using the Kellgren-Lawrence (KL) classification were added.</div></div><div><h3>Results</h3><div>Age, KL grade, and VAS score before treatment and after three, four, and five PRP-I were significantly associated with ΔVAS score. According to KL grade, age was significantly associated with ΔVAS score in the KL grade 4 group. VAS score before treatment was significantly associated with ΔVAS score, regardless of KL grade. Three-time PRP-I were significantly associated with ΔVAS in the KL-grade 1 and 2 groups. For KL grade 4, two or more PRP-I were significantly associated with the high efficacy.</div></div><div><h3>Conclusions</h3><div>Age, pain before treatment, KL grade and number of injections were associated with pain reduction after intra-articular PRP-I for KOA treatment. Pain reduction can be expected after PRP-I when patients are younger or experience severe pain before treatment. Three-time PRP-I are recommended to reduce pain in early-stage KOA and more than three times in advanced-stage KOA.</div></div><div><h3>Trial registration</h3><div>Retrospectively registration.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357073","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}
引用次数: 0
The residual laxity of medial collateral ligament after magic point pie crusting MCL released in arthroscopic management of medial meniscus 关节镜治疗内侧半月板时,魔点派结痂 MCL 释放后内侧副韧带的残余松弛度
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-09-25 DOI: 10.1016/j.asmart.2024.09.001
{"title":"The residual laxity of medial collateral ligament after magic point pie crusting MCL released in arthroscopic management of medial meniscus","authors":"","doi":"10.1016/j.asmart.2024.09.001","DOIUrl":"10.1016/j.asmart.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>In order to do arthroscopic surgery on medial meniscus injuries, there must be enough joint space and good visibility for instrumentation. There is a possibility of iatrogenic cartilage damage if the medial joint space is reduced. Therefore, a medial collateral ligament (MCL) releasing procedure may be necessary for the majority of individuals with medial knee tightness. The MCL residual laxity after pie-crusting release during arthroscopic medial meniscus repair in medial knee tightness were studied in this study.</div></div><div><h3>Methods</h3><div>Between July 2022 and June 2023, fourteen patients (4 male, 10 female) underwent medial meniscus surgery with pie-crusting release of the superficial MCL. Mean age was 50 ± 10 years (range, 35–63 years). Medial meniscal lesions were meniscus root tear in 10 cases (71.5 %), longitudinal tear in 2 (14.5 %), horizontal tear in 1 (7 %) and radial tear in 1 (7 %). Preoperatively, valgus stress radiographs were obtained. During surgery if arthroscopic exploration revealed medial joint space narrowing after applying valgus force with the knee in 20 degrees of flexion, pie-crusting MCL release was performed. At the 3-month follow-up, valgus stress radiographs were obtained. Residual MCL laxity was assessed by comparing preoperative and 3-month follow-up medial joint space width measurements.</div></div><div><h3>Result</h3><div>At the 3-month follow-up, no significant increase in the medial joint space width on valgus stress radiograph was observed in comparison to the preoperative. The medial joint space width on valgus stress radiograph was 7.42 ± 1.16 mm preoperatively and 7.47 ± 1.15 mm at 3-month postoperatively (<em>p</em> value = 0.914). All patients had no intraoperative iatrogenic cartilage injury and no saphenous nerve injury after operation.</div></div><div><h3>Conclusions</h3><div>The magic point pie-crusting MCL release is a reliable and useful procedure to arthroscopic surgery in patients with medial meniscal injury and medial knee tightness. Furthermore, percutaneous pie-crusting MCL release had no effect on residual valgus laxity at the last follow-up.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318609","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}
引用次数: 0
Fast rehabilitation does not worsen clinical, radiological, and arthroscopic outcomes after medial meniscus posterior root repair: A retrospective comparative study 快速康复不会恶化内侧半月板后根修补术后的临床、放射学和关节镜结果:回顾性比较研究
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-09-23 DOI: 10.1016/j.asmart.2024.09.003
{"title":"Fast rehabilitation does not worsen clinical, radiological, and arthroscopic outcomes after medial meniscus posterior root repair: A retrospective comparative study","authors":"","doi":"10.1016/j.asmart.2024.09.003","DOIUrl":"10.1016/j.asmart.2024.09.003","url":null,"abstract":"<div><h3>Background/Objective</h3><div>The main surgical treatment for medial meniscus posterior root tear (MMPRT) has shifted from meniscectomy to meniscus repair; however, there is no clear consensus regarding the optimal postoperative management strategy after MMPRT repair. This study aimed to perform a comparative analysis of patients who received conventional rehabilitation or fast rehabilitation following MMPRT repair.</div></div><div><h3>Methods</h3><div>The current retrospective cohort study compared clinical, radiological, and arthroscopic outcomes after conventional rehabilitation (group A, January 2020 to April 2020, 24 patients) with those after fast rehabilitation (group B, May 2020 to August 2020, 24 patients) in patients who underwent pullout repair for MMPRT. Partial weight-bearing and range of motion exercises were allowed 2 weeks postoperatively in group A and 1 week postoperatively in group B. In patients with an average weight of approximately 60 kg, full weight bearing was allowed 4 weeks postoperatively in group A and 3 weeks postoperatively in group B.</div></div><div><h3>Results</h3><div>At 12 months postoperatively, the clinical scores, including International Knee Documentation Committee and Japanese Knee Injury and Osteoarthritis Outcome Score, significantly improved in both groups (p &lt; 0.01). Although meniscus healing was achieved in both groups, medial meniscus extrusion significantly progressed by 0.9 mm in group A and 0.8 mm in group B (p &lt; 0.01, compared with preoperative extrusion). There were no significant differences in clinical scores, arthroscopic meniscal healing status, or medial meniscus extrusion progression on magnetic resonance images between the groups.</div></div><div><h3>Conclusion</h3><div>A fast rehabilitation protocol can be safely implemented without compromising patient outcomes after pullout repair for MMPRT.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000220/pdfft?md5=0d1d3caf8f4a1cd6c37f226b9a53e49b&pid=1-s2.0-S2214687324000220-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312422","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}
引用次数: 0
ACL injury characteristics in badminton : A registry study with prospectively collected data on sports related epidemiology and injury mechanism of 539 badminton players 羽毛球前交叉韧带损伤特征:一项登记研究,前瞻性地收集了 539 名羽毛球运动员的运动相关流行病学和损伤机制数据
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-09-21 DOI: 10.1016/j.asmart.2024.09.005
{"title":"ACL injury characteristics in badminton : A registry study with prospectively collected data on sports related epidemiology and injury mechanism of 539 badminton players","authors":"","doi":"10.1016/j.asmart.2024.09.005","DOIUrl":"10.1016/j.asmart.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><p>Over recent years, more anterior cruciate ligament (ACL) ruptures in badminton players have occurred. Little is known about the injury mechanism in badminton. The hypothesis is that most ACL injuries occur with single leg landings on the non-dominant leg in the backhand side or with lunge movements in the forehand side on the dominant leg. To inform prevention strategies the aim of this study was to investigate the mechanism of ACL injuries in badminton, specifically if ACL injuries occur in certain positions on the badminton court and/or with certain movements. Secondary aims were to investigate differences among gender, age groups and between recreational and tournament players.</p></div><div><h3>Methods</h3><p>The study, ACL Denmark, investigate ACL ruptures in a cohort of 90.610 participants diagnosed between 2000 and 2018. Of those, 539 participants reported ACL rupture during badminton and filled in an online questionnaire in December 2021–January 2022 on the injury mechanism and other injury characteristics. Data is presented as numbers, percentage, means (SD) and median (IQR) with chi square test or Fischers exact test for dichotomous outcomes.</p></div><div><h3>Results</h3><p>Most participants played badminton (n = 435, 81 %) as primary sport and 155 (29 %) reported to play on a competitive level (Tegner score 8). The rear court (n = 285, 40 %) was the most frequent location of injury but with a high percentage on the front and midcourt (n = 154, 22 %). The rear court was more prevalent among players aged 18–29 (p &lt; 0.001). The most prevalent movement preceding the ACL injury was the scissor kick jump on the rear court (100, 19 %) followed by lunge at the net (70, 13 %) and lunge at the rear court (69, 13 %). One hundred and six players (15 %) were injured preceded by a deceptive shot from the opponent. The dominant leg was mainly injured in the forehand side and the non-dominant leg mainly in the backhand side.</p></div><div><h3>Conclusion</h3><p>The most prevalent movement preceding the ACL injury was the lunge followed by the scissor kick jump. The rear court was the primary location of ACL injury in badminton and the dominant knee has a higher risk of injury in the forehand side and the non-dominant knee in the backhand side. More focus on the technical performance of lunge and scissor kick jumps and development of a badminton specific ACL injury prevention program is needed in badminton.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000256/pdfft?md5=8242fc3d3c88de034375afd8a901680d&pid=1-s2.0-S2214687324000256-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271352","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}
引用次数: 0
In vivo kinematic comparison of bi-cruciate retaining total knee arthroplasty between mechanical alignment and functional alignment methods 双韧带固定全膝关节置换术机械对位法和功能对位法的体内运动学比较
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-09-14 DOI: 10.1016/j.asmart.2024.09.002
{"title":"In vivo kinematic comparison of bi-cruciate retaining total knee arthroplasty between mechanical alignment and functional alignment methods","authors":"","doi":"10.1016/j.asmart.2024.09.002","DOIUrl":"10.1016/j.asmart.2024.09.002","url":null,"abstract":"<div><h3>Background/objective</h3><p>This study aimed to clarify the kinematics of bi-cruciate-retaining (BCR) total knee arthroplasty (TKA) by comparing the mechanical alignment (MA) and functional alignment (FA) methods and to evaluate differences between the two alignment methods.</p></div><div><h3>Methods</h3><p>The <em>in vivo</em> kinematics of 20 MA TKA and 20 FA TKA knees were investigated under fluoroscopy during squatting using a two-to three-dimensional registration technique. Accordingly, knee flexion angle, axial rotational angle, varus–valgus angle, anteroposterior translation of the medial and lateral low contact points of the femoral component relative to the tibial component and kinematic pathway were evaluated.</p></div><div><h3>Results</h3><p>No difference in the knee flexion angle was observed between the MA and FA TKA groups. Femoral external rotation was observed in both groups and no significant difference was observed. Significant varus alignment from extension to early flexion range was observed in the FA TKA group. The posterior translation of the medial side was smaller in the FA TKA group than in the MA TKA group. Conversely, no significant difference in the anteroposterior translation of the lateral side was observed. In the kinematic pathway, a medial pivot motion from 0° to 20° of flexion and a lateral pivot motion beyond 20° of flexion were observed in both groups.</p></div><div><h3>Conclusion</h3><p>During squatting in BCR TKA, the FA TKA group significantly showed varus alignment and smaller posterior translation of the medial side than the MA TKA group from extension to early flexion range.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000219/pdfft?md5=8a9ccfb252d8684905b4fd045c3d0a69&pid=1-s2.0-S2214687324000219-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228724","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}
引用次数: 0
Retrospective cohort study comparing postoperative joint stability between all-inside PCL reconstruction technique and conventional PCL reconstruction technique in patients with multiligament knee injury 比较膝关节多韧带损伤患者全内侧 PCL 重建技术与传统 PCL 重建技术术后关节稳定性的回顾性队列研究
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-08-08 DOI: 10.1016/j.asmart.2024.07.001
{"title":"Retrospective cohort study comparing postoperative joint stability between all-inside PCL reconstruction technique and conventional PCL reconstruction technique in patients with multiligament knee injury","authors":"","doi":"10.1016/j.asmart.2024.07.001","DOIUrl":"10.1016/j.asmart.2024.07.001","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of our study was to compare (1) posterior cruciate ligament (PCL) laxity, (2) patient-reported outcome, and (3) complications after the all-inside PCL reconstruction (Al-PCLR) technique and conventional PCLR (CON-PCLR) technique at minimum 2-year follow-up. We hypothesized that AI-PCLR and CONV-PCLR would yield similar results in PCL laxity, patient-reported outcomes, and complications.</p></div><div><h3>Method</h3><p>A retrospective cohort study was conducted on patients who underwent PCLR with the Al-PCLR technique and CON-PCLR technique from 2012 to 2023 in a single hospital. Medical records were reviewed for patients’ demographic data, the technique of PCL reconstruction and complications. Patient-reported outcome scores, including International Knee Documentation Committee (IKDC), Tegner activity scale, and Lysholm score, as well as bilateral kneeling radiographs and physical examinations, were collected at least 2 years postoperatively.</p></div><div><h3>Results</h3><p>Included in the study were 24 patients: 11 who underwent the CON-PCLR technique (mean age 40.7 +years) and 13 who underwent Al-PCLR (mean age 34.3 + 12.9 years). Three patients in AI-PCLR group were lost to follow-up and one patient is the CON-PCLR group, a revision case, was excluded from the study.</p><p>Bilateral stress kneeling radiographs showed a similar side-to-side difference between two groups (CON-PCLR vs AL-PCLR: mean 7.5 ± 5.2 vs 5.8 ± 4.8 mm; P = 0.38) There were no statically significant differences between the two groups in postoperative IKDC (CON-PCLR vs AL-PCLR: 68.9 vs 73.9; P = 0.37), Lysholm (89.1 vs 94.1; P = 0.42), or Tegner activity (6 vs 6.4; P = 0.68) scores.</p></div><div><h3>Conclusion</h3><p>All-inside PCLR demonstrates comparable stability to Conventional PCLR, with satisfactory patient-report outcome at minimum 2 years follow up and low rate of complications in patients with multiligament knee injury.</p><p>Level of evidence: III Retrospective comparative study.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000190/pdfft?md5=cf6f642f0cc7fd62dad507a71e0dd49f&pid=1-s2.0-S2214687324000190-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953180","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}
引用次数: 0
The application of proximal tibial anterior closing wedge osteotomy in anterior cruciate ligament reconstruction 胫骨近端前方闭合楔形截骨术在前交叉韧带重建中的应用
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-07-17 DOI: 10.1016/j.asmart.2024.06.001
{"title":"The application of proximal tibial anterior closing wedge osteotomy in anterior cruciate ligament reconstruction","authors":"","doi":"10.1016/j.asmart.2024.06.001","DOIUrl":"10.1016/j.asmart.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Posterior tibial slope (PTS) plays a vital role in knee stability. PTS of more than 12° may be considered with increased strain on the native anterior cruciate ligament (ACL) fibers. To handle the instability caused by changes in PTS degree, Proximal Tibial Anterior Closing Wedge Osteotomy (PT-ACWO) is adopted by surgeons.</p></div><div><h3>Methods</h3><p>Between October 2015 and October 2019, our department conducted a retrospective analysis of patients who experienced anterior cruciate ligament reconstruction (ACLR) graft failures, with a particular focus on pathological PTS. The time from initial ACLR to revision ranged from 1 to 10 years, with a mean of 2.5 years. Radiological assessments of PTS were conducted, and outcomes were quantified using the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity scale. The surgical technique and the use of 3D Patient-Specific Instrumentation (PSI) were outlined. Preoperative imaging included the use of Kirschner wires to establish tibial plateau reference points, and 3D-PSI was employed to guide the location and depth of the tibial osteotomy, which was performed obliquely. In a notable instance, a novel tibial tunnel was mapped out, and ortho-bridge system (OBS) fixation was utilized to ensure adequate space for the new tunnel.</p></div><div><h3>Results</h3><p>In a cohort of seven patients with a mean follow-up of 28.1 months, a significant reduction in PTS was noted postoperatively (median [interquartile range, IQR], from 15.27° [13.46°, 16.60°] to 6.25° [5.89°, 6.78°]; <em>P</em> = 0.002). IKDC score improved to 85.10 (80.25, 88.10), <em>P</em> &lt; 0.001; the Lysholm score to 88.00 (73.00, 90.50), <em>P</em> &lt; 0.001; and the Tegner score to 8.00 (7.20, 8.05), <em>P</em> = 0.025 at final follow-up. Skin incision healing delays occurred in two instances, yet achieved closure by six weeks. Radiographs at three months demonstrated faster bone healing in oblique osteotomies than transverse ones. Knee joint stability was maintained, with no additional complications or evidence of instability noted. Magnetic resonance imaging (MRI) confirmed graft integrity in all patients, without signs of enlargement or mispositioning at last observation.</p></div><div><h3>Conclusion</h3><p>An augmented PTS angle exceeding 12 may constitute a potential etiology for the failure of ACLR grafts. In such patients, the implementation of ACLR combined with PT-ACWO could mitigate the risk of surgical failure during initial ACLR or subsequent revision procedures.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000153/pdfft?md5=e61c6b45a6ee3c1c6524ca5da92bc736&pid=1-s2.0-S2214687324000153-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637643","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}
引用次数: 0
Longitudinal measurement of serum cartilage oligomeric matrix protein can detect the progression of cartilage degeneration in anterior cruciate ligament reconstruction patients 纵向测量血清软骨寡聚基质蛋白可检测前十字韧带重建患者软骨退化的进展情况
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-07-01 DOI: 10.1016/j.asmart.2024.06.003
Yohei Nishida , Yusuke Hashimoto , Kumi Orita , Kazuya Nishino , Takuya Kinoshita , Ken Iida , Hiroaki Nakamura
{"title":"Longitudinal measurement of serum cartilage oligomeric matrix protein can detect the progression of cartilage degeneration in anterior cruciate ligament reconstruction patients","authors":"Yohei Nishida ,&nbsp;Yusuke Hashimoto ,&nbsp;Kumi Orita ,&nbsp;Kazuya Nishino ,&nbsp;Takuya Kinoshita ,&nbsp;Ken Iida ,&nbsp;Hiroaki Nakamura","doi":"10.1016/j.asmart.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.06.003","url":null,"abstract":"<div><h3>Background/objective</h3><p>Cartilage oligomeric matrix protein (COMP) has utility as a diagnostic marker for osteoarthritis (OA). Our previous study revealed that the serum COMP level can be used to detect early cartilage change in non-OA patients with anterior cruciate ligament (ACL)-deficiency. However, there are still no studies on detecting the progression of cartilage degeneration in early OA. The aim of present study was to investigate whether serum COMP can detect the progression of cartilage degeneration after ACL reconstruction in non-OA patients.</p></div><div><h3>Methods</h3><p>Patients without cartilage degeneration of early OA at ACL reconstruction and whose serum COMP levels could be measured were included in the study. Cartilage degeneration of early OA were defined as International Cartilage Repair Society (ICRS) grade 1 to 4 in more than 2 compartments or ICRS grade 2 to 4 in 1 compartment. The patients were divided into two groups: those who had cartilage degeneration of early OA at second-look arthroscopy (cartilage degeneration progression group) and those who did not (non-progression group), and the serum COMP values between the two groups were compared.</p></div><div><h3>Results</h3><p>Thirty-one patients were included. There were 8 cases (25.8 %) in progression group and 23 cases (74.2 %) in non-progression group. There were significant differences between the two groups regarding age and change in serum COMP level. In terms of the rate of change in COMP, an increase of more than 1.24-fold was the cut-off value for detecting the progression of cartilage degeneration.</p></div><div><h3>Conclusions</h3><p>In this study, the increase in serum COMP levels was significantly greater in progressed cartilage degeneration group than non-progression group after ACL reconstruction. Longitudinal serum COMP measurement could detect the progression of cartilage degeneration.</p></div><div><h3>Level of evidence</h3><p>Level Ⅲ, retrospective comparative study.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000177/pdfft?md5=ff2dbf6169e37466be5d426743248f93&pid=1-s2.0-S2214687324000177-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596459","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}
引用次数: 0
Postoperative onset lateral hinge fracture is a risk factor for delayed union of the tibial tuberosity in medial opening wedge distal tibial tuberosity osteotomy 内侧开口楔形胫骨远端结节截骨术后外侧铰链骨折是胫骨结节延迟结合的风险因素
IF 1.5
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology Pub Date : 2024-07-01 DOI: 10.1016/j.asmart.2024.01.005
Hiroyasu Ogawa , Yutaka Nakamura , Masaya Sengoku , Tetsuya Shimokawa , Kazuichiro Ohnishi , Haruhiko Akiyama
{"title":"Postoperative onset lateral hinge fracture is a risk factor for delayed union of the tibial tuberosity in medial opening wedge distal tibial tuberosity osteotomy","authors":"Hiroyasu Ogawa ,&nbsp;Yutaka Nakamura ,&nbsp;Masaya Sengoku ,&nbsp;Tetsuya Shimokawa ,&nbsp;Kazuichiro Ohnishi ,&nbsp;Haruhiko Akiyama","doi":"10.1016/j.asmart.2024.01.005","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate bone union of the tibial tuberosity in patients undergoing medial opening wedge distal tibial tuberosity osteotomy (OWDTO). It was hypothesized that bone union of the tibial tuberosity could be associated with lateral hinge fractures (LHFs), but not thickness of the tibial tuberosity osteotomy.</p></div><div><h3>Methods</h3><p>Data of 61 consecutive patients who underwent OWDTO were retrospectively reviewed. Radiographic parameters of the lower limb and LHFs were evaluated. Thickness of the tibial tuberosity osteotomy and bone union of the tibial tuberosity were assessed at 1, 2, 3, 4, and 5 cm distal to the most proximal part of the tibial tuberosity on computed tomography. Bone union was assessed. Factors related to bone union of the tibial tuberosity were analyzed.</p></div><div><h3>Results</h3><p>There were 13 postoperative onset LHFs: all healed with conservative treatments within 6 months after surgery. The total score of bone union of the tibial tuberosity was 8.4 ± 2.1 points, which correlated with age, postoperative medial proximal tibial angle (MPTA), correction angle, and postoperative onset LHF (r = 0.307, 0.388, 0.275, and −0.624, respectively; <em>p</em> = 0.016, 0.002, 0.033, and &lt;0.001, respectively). Regression coefficient for postoperative onset LHF, postoperative MPTA, and body mass index were −0.619 (<em>p</em> &lt; 0.001), 0.285 (<em>p</em> = 0.003), and −0.227 (<em>p</em> = 0.021), respectively.</p></div><div><h3>Conclusion</h3><p>Postoperative onset LHFs, but not thickness of the tibial tuberosity osteotomy, were a risk factor for delayed union of the tibial tuberosity following OWDTO. Furthermore, to prevent delayed union of the tibial tuberosity, postoperative onset LHFs should be prevented.</p></div><div><h3>Level of evidence</h3><p>LEVEL III, Case-control study.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000050/pdfft?md5=cabe0b2245d5593cc4e49c352f39bacd&pid=1-s2.0-S2214687324000050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141543792","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}
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