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

{"title":"Using deep learning for ultrasound images to diagnose chronic lateral ankle instability with high accuracy","authors":"Masamune Kamachi,&nbsp;Kohei Kamada,&nbsp;Noriyuki Kanzaki,&nbsp;Tetsuya Yamamoto,&nbsp;Yuichi Hoshino,&nbsp;Atsuyuki Inui,&nbsp;Yuta Nakanishi,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.asmart.2025.01.001","DOIUrl":"10.1016/j.asmart.2025.01.001","url":null,"abstract":"<div><div>The purpose of this study is to calculate diagnostic accuracy of chronic lateral ankle instability (CLAI) from a confusion matrix using deep learning (DL) on ultrasound images of anterior talofibular ligament (ATFL). The study included 30 ankles with no history of ankle sprains (control group), and 30 ankles diagnosed with CLAI (injury group). A total of 2000 images were prepared for each group by capturing ultrasound videos visualizing the fibers of ATFL under the anterior drawer stress. The images of 20 feet in each group were randomly selected and used for training data and the images of remaining 10 feet in each group were used as test data. Transfer learning was performed using 3 pretraining DL models, and the accuracy, precision, recall (sensitivity), specificity, F-measure, and the area under the receiver operating characteristic curve (AUC) were calculated based on the confusion matrix. The important features were visualized using occlusion sensitivity, a method for visualizing areas that are important for model prediction. DL was able to diagnose CLAI using ultrasound imaging with very high accuracy and AUC in three different learning models. In visualization of the region of interest, AI focused on the substance of the ATFL and its attachment on the fibula for the diagnosis of CLAI.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155484","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":"Changes in the position of the medial meniscus owing to degenerative meniscus tears","authors":"Tomoyuki Kanayama,&nbsp;Yasushi Takata,&nbsp;Yoshihiro Ishida,&nbsp;Naoki Takemoto,&nbsp;Manase Nishimura,&nbsp;Satoru Demura,&nbsp;Junsuke Nakase","doi":"10.1016/j.asmart.2025.01.002","DOIUrl":"10.1016/j.asmart.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>While meniscal extrusion has been recognized as a key factor in meniscal dysfunction and osteoarthritis (OA) development, the specific movement of the posterior horn of the medial meniscus (MM) during extrusion, particularly in early-stage OA, remains unexplored. Therefore, in this study, we investigated the position of the MM in patients with medial knee pain and a Kellgren–Lawrence grade ≤1, investigating the relationship between meniscal extrusion and degenerative tears. We hypothesized that the MM extrusion (MME) would be larger when degenerative tears are present; the anterior horn would move posteriorly, and the posterior horn would move anteriorly, accordingly.</div></div><div><h3>Methods</h3><div>A total of 181 knees (mean age 61.7 ± 12.1 years; 97 men and 84 women) were included. Simple radiographs were used to measure the weight-bearing line ratio and medial proximal tibia angle. Magnetic resonance imaging was used to measure the medial proximal tibia slope, medial meniscus extrusion, anterior and posterior horn position, and degenerative tears on the posterior segment of the medial meniscus. Those with degenerative tears were designated as group T and those without were designated as group C. Student's t-test and Pearson's χ² test were performed to compare groups T and C. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Group T had a significantly larger medial posterior tibial slope (group T: 7.4 ± 2.3°; group C: 6.6 ± 2.2°, p = 0.010) and medial meniscus extrusion (group T: 2.7 ± 1.4 mm; group C: 1.9 ± 1.2 mm, p &lt; 0.001) scores compared with group C. Furthermore, the posterior point of the anterior horn (group T: 16.3 ± 5.0 %; group C: 14.3 ± 3.8 %, p = 0.004) and anterior point of the posterior horn (group T: 36.4 ± 7.1 %; group C:26.9 ± 5.9 %, p &lt; 0.001) were significantly larger in group T than in group C.</div></div><div><h3>Conclusion</h3><div>Degenerative MM tears cause not only MME but also an anteroposterior shift.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"40 ","pages":"Pages 7-11"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155483","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":"Reviewer Acknowledgement 2024","authors":"","doi":"10.1016/j.asmart.2025.01.005","DOIUrl":"10.1016/j.asmart.2025.01.005","url":null,"abstract":"","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Page I"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153541","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":"Neural structural alterations correlates of quadriceps muscle strength deficits in patients after anterior cruciate ligament reconstruction","authors":"Le Yu ,&nbsp;Shanshan Zheng ,&nbsp;Yushi Chen ,&nbsp;Xiao'ao Xue ,&nbsp;Zikun Wang ,&nbsp;JiaYan Cheng ,&nbsp;Yang Sun ,&nbsp;He Wang ,&nbsp;Yinghui Hua","doi":"10.1016/j.asmart.2024.11.001","DOIUrl":"10.1016/j.asmart.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Persistent maladaptive changes of corticospinal tract (CST) and quadriceps strength deficits exist in patients with anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the relationships between the structural alterations of CST and quadriceps muscle strength deficits in patients with ACLR.</div></div><div><h3>Methods</h3><div>Twenty-nine participants who had undergone unilateral ACLR (29 males; age = 32.61 ± 6.72 years) were enrolled in a cross-sectional investigation. We chose CST as a region of interest and performed diffusion tensor imaging (DTI) that measured the microstructure of white matter tracts. Maximal voluntary isometric quadriceps muscle strength was assessed using a hand-held dynamometer. Simple and partial correlation analyses were performed between the DTI outcomes and quadriceps muscle strength deficits in patients with ACLR before and after controlling for age, sex, BMI, Tegner activity score, and graft type. Sub-group analyses were also performed to investigate the relationships between the DTI outcomes of CST structure and quadriceps muscle strength deficits according to the graft type before and after controlling for age, sex, BMI, and Tegner activity score.</div></div><div><h3>Results</h3><div>Lower limb symmetry index (LSI) of quadriceps muscle strength was associated with a higher ratio of radial diffusivity (RD, r = −0.379, p = 0.042) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score and graft type. In subgroup analyses of ACLR patients with hamstring autografts, we found that higher injured quadriceps muscle strength was associated with higher axial diffusivity (AD, r = 0.616, p = 0.033) of CST structure and lower LSI of quadriceps muscle strength was associated with higher ratio of mean diffusivity (MD, r = −0.682, p = 0.014) and RD (r = −0.759, p = 0.004) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score.</div></div><div><h3>Conclusion</h3><div>Decreased integrity (higher ratio of RD) of CST microstructure in ACLR patients was significantly associated with lower quadriceps limb symmetry index, which hinted that quadriceps muscle strength deficits of injured side may be a demyelinating process of CST microstructure in ACLR.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 30-36"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956579","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":"Novel application of an imageless robotic system in simultaneous unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction","authors":"Joshua Yeuk Shun Tran ,&nbsp;Rex Wang-Fung Mak ,&nbsp;Kevin Ki-Wai Ho ,&nbsp;Jonathan Patrick Ng ,&nbsp;Cham Kit Wong ,&nbsp;Gloria Yan-Ting Lam ,&nbsp;Tsz Lung Choi ,&nbsp;Michael Tim-Yun Ong ,&nbsp;Patrick Shu-Hang Yung","doi":"10.1016/j.asmart.2024.12.001","DOIUrl":"10.1016/j.asmart.2024.12.001","url":null,"abstract":"<div><div>This technical note explores the novel use of an imageless robotic surgical system for simultaneous unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament reconstruction (ACLR). Knee osteoarthritis (OA) and anterior cruciate ligament (ACL) insufficiency are common conditions that traditionally require separate management. The integration of robotic assistance offers enhanced precision in surgical procedures, addressing both medial compartment OA and ACL insufficiency in a single operation.</div><div>We present a case involving a 47-year-old patient with medial compartment osteoarthritis and complete ACL rupture. The patient underwent a simultaneous robotic-assisted UKA and ACLR using the CORI Surgical System (Smith&amp;Nephew, London, UK). This approach enables accurate tibial tunnel placement and precise soft tissue balancing. The robotic system facilitates real-time gap assessment and balancing, reducing the risk of over- or under-constraint during ACL graft tensioning.</div><div>The procedure was performed with a standard medial parapatellar approach. Key steps included hamstring autograft harvesting, femoral and tibial tunnel creation, and robotic-assisted implant positioning. Post-operative rehabilitation allowed full weight-bearing by the third week.</div><div>This case represents the first reported instance of using an imageless robotic system for simultaneous UKA and ACLR, highlighting its potential to standardize and improve results in complex knee surgeries.</div><div>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 37-40"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972686","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":"Optimal suturing techniques in patch-bridging reconstruction for massive rotator cuff tears: A finite element analysis","authors":"Yuting Zhong ,&nbsp;Chengxuan Yu ,&nbsp;Sijia Feng ,&nbsp;Han Gao ,&nbsp;Luyi Sun ,&nbsp;Yunxia Li ,&nbsp;Shiyi Chen ,&nbsp;Jun Chen","doi":"10.1016/j.asmart.2024.10.002","DOIUrl":"10.1016/j.asmart.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.</div></div><div><h3>Methods</h3><div>A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs. Patch, suture, and anchor models were constructed, and the Marlow method was used to assign the material properties. Three suturing models were established: 1-knot simple, 1-knot mattress, and 2-knot mattress. The ultimate failure load, failure mode, stress distribution of each structure, and other biomechanical results of the different models were calculated and compared.</div></div><div><h3>Results</h3><div>The ultimate failure load of the 1-knot mattress suture (71.3 N) was 5.6 % greater than that of the 1-knot simple suture (67.5 N), while that (81.5 N) of the 2-knot mattress was 14.3 % greater than that of the 1-knot mattress. The stress distribution on the patch and supraspinatus tendon was concentrated on suture perforation. Failure of the bridging reconstruction mainly occurred at the suture perforation of the patch, and the damage forms included cutting-through and isthmus pull-out.</div></div><div><h3>Conclusion</h3><div>A finite element model for the patch-bridging reconstruction of MRCTs was established, and patch-bridging restored the mechanical integrity of the rotator cuff. The 2-knot mattress suture was optimal for patch-bridging reconstruction of MRCTs.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 22-29"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721149","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":"Predicting bursal-side supraspinatus tendon tears with the acromioclavicular angle","authors":"Nadhaporn Saengpetch ,&nbsp;Jaturong Bamrungchaowkasem ,&nbsp;Niyata Chitrapazt ,&nbsp;Pinkawas Kongmalai","doi":"10.1016/j.asmart.2024.11.003","DOIUrl":"10.1016/j.asmart.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Bursal-side supraspinatus tendon tears are a common form of rotator cuff injury, often associated with acromial impingement and other extrinsic factors. Existing anatomical parameters, such as the lateral acromion angle, acromial index, and critical shoulder angle, have been studied in relation to rotator cuff tears; however, reliable indicators specific to the risk of bursal-side supraspinatus tears remain lacking. The acromioclavicular (AC) angle, which reflects the angular relationship between the acromion and clavicle, may offer a new predictive marker for this specific pathology.</div></div><div><h3>Methods</h3><div>In this retrospective case-control study, patients presenting with shoulder pain between January 2016 and February 2020 were reviewed. Group 1 included patients with isolated bursal-side supraspinatus tendon tears confirmed by arthroscopy, while Group 2 consisted of age- and gender-matched controls without rotator cuff pathology. The AC angle was measured using both X-ray and MRI. Diagnostic performance was assessed through Receiver Operating Characteristic (ROC) curve analysis, identifying the optimal cut-point with Youden's index. Reliability was measured using the Intraclass Correlation Coefficient (ICC) for both intra- and inter-rater reliability.</div></div><div><h3>Results</h3><div>The ROC analysis determined an optimal AC angle cut-point of ≤160°. X-ray measurements showed moderate diagnostic value (AUC 0.60, sensitivity 67.2 %, specificity 51.7 %), while MRI measurements demonstrated good diagnostic performance (AUC 0.79, sensitivity 84.5 %, specificity 70.7 %). X-ray yielded high sensitivity but low specificity, suggesting its utility as an initial screening tool, whereas MRI provided improved diagnostic accuracy. Reliability assessments indicated high intra- and inter-rater reliability for AC angle measurements across both imaging modalities (ICC &gt;0.80).</div></div><div><h3>Conclusion</h3><div>The AC angle, particularly when measured on MRI, may serve as a valuable diagnostic marker for identifying isolated bursal-side supraspinatus tendon tears. While X-ray can be utilized as an accessible screening tool, combining it with clinical assessments and MRI is recommended for greater diagnostic precision. Further multi-center, prospective studies are warranted to confirm the clinical utility of the AC angle in predicting rotator cuff pathology.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 15-21"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721148","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":"Clinical outcomes over 2 years following arthroscopic ankle lateral ligament repair with os subfibulare","authors":"Shohei Sano,&nbsp;Noriyuki Kanzaki,&nbsp;Kiminari Kataoka,&nbsp;Koji Nukuto,&nbsp;Tetsuya Yamamoto,&nbsp;Yuta Nakanishi,&nbsp;Kyohei Nishida,&nbsp;Kanto Nagai,&nbsp;Yuichi Hoshino,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.asmart.2024.11.002","DOIUrl":"10.1016/j.asmart.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>There are reports indicating that between 10 and 38.5 % of patients with chronic lateral ankle instability (CLAI) have an os subfibulare. In cases where CLAI accompanied by os subfibulare is resistant to conservative treatment, surgery may be necessary; however, there is no consensus on the most appropriate surgical method. We report outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare at our hospital, followed for over 2 years post-operatively.</div></div><div><h3>Methods</h3><div>We reviewed 33 patients (39 ankles) whom underwent arthroscopic lateral ankle ligament repair (ALLR) for CLAI and followed for at least 2 years post-operatively between November 2015 and May 2020. Patients were classified into two groups: a group with os subfibulare (ossicle group) and a group without os subfibulare (non-ossicle group), based on the presence of an os subfibulare on pre-operative plain radiographs. ALLR surgeries were performed without resection of the os subfibulare in ossicle group. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-administered Foot Evaluation Questionnaire (SAFE-Q). In addition, the bone-union rate was evaluated by using plain computer tomography in the ossicle group.</div></div><div><h3>Results</h3><div>There were significant improvements in the mean total JSSF scale scores from pre-operative to post-operative measurements in both the ossicle and non-ossicle groups. The mean scores for pain and related symptoms, foot function and activities of daily living, social functioning, shoe-related, and general health and well-being subscales of the SAFE-Q also showed significant improvements in both groups. There were no significant differences between the post-operative ossicle and non-ossicle groups regarding the JSSF scale scores or the SAFE-Q subscale scores. In the ossicle group, the bone-union rate was 14.3 % (2 of 14 ankles), but no symptom recurrence was observed.</div></div><div><h3>Conclusion</h3><div>The 2 years outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare revealed good results and no symptom recurrence.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 9-14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706648","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":"Is there a difference in bony stability at three months postoperatively between opening-wedge high tibial osteotomy and opening-wedge distal tuberosity osteotomy?","authors":"Suguru Koyama ,&nbsp;Keiji Tensho ,&nbsp;Kazushige Yoshida ,&nbsp;Hiroki Shimodaira ,&nbsp;Daiki Kumaki ,&nbsp;Yusuke Maezumi ,&nbsp;Hiroshi Horiuchi ,&nbsp;Jun Takahashi","doi":"10.1016/j.asmart.2024.10.001","DOIUrl":"10.1016/j.asmart.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the initial postoperative stability of opening-wedge high tibial osteotomy (HTO) and opening-wedge distal tuberosity osteotomy (DTO) and investigate the factors that influence initial stability.</div></div><div><h3>Methods</h3><div>Patients with the same operative indications who underwent HTO (n = 51) and DTO (n = 55) were included. Demographic and preoperative radiographic data (weight-bearing line percentage [%WBL], femoral-tibial angle [FTA], medial proximal tibial angle [MPTA], posterior tibial slope and correction angle), and postoperative computed tomography (CT) scan data (initial postoperative stability [12 weeks postoperative], and hinge fracture [1 and 12 weeks postoperatively], and hinge length, flange thickness, flange length, axial flange osteotomy angle, sagittal flange osteotomy angle [1 week postoperatively]) were statistically analyzed. As a subgroup analysis, HTO and DTO patients were divided into Stable and Unstable groups respectively based on postoperative CT at 12 weeks; demographic and radiological data were compared.</div></div><div><h3>Results</h3><div>Patients with DTO was significantly younger (median [range]; 59 [22, 73] vs 64 [45, 75], P = 0.02) and had a smaller preoperative deformity (%WBL: median [range]; 28.9 [12.8, 46.0] vs 24.3 [4.9, 44.3], P &lt; 0.01, FTA: median [range]; 179.0 [173.0, 183.0] vs 180.0 [172.5, 186.2], P &lt; 0.01, MPTA: median [range]; 84.0 [79.0, 87.1] vs 83.0 [78.2, 86.5], P = 0.04) and smaller correction angles (median [range]; 9 [6, 12] vs 10 [7, 15], P &lt; 0.01). Postoperative CT data showed that DTO was associated with significantly more unstable cases (stable/unstable: 31/24 vs. 39/12, P = 0.02) and hinge fractures (none/1/2/3: 24/25/3/3 vs. 36/12/1/2, P &lt; 0.01) and shorter hinge (median [range]; 27.8 [14.7, 43.4] vs 32.6 [22.5, 44.0], P &lt; 0.01) than HTO. The Unstable DTO group had significantly shorter hinges (median [range]; 23.2 [14.7, 33.9] vs 31.1 [15.2, 43.4], P &lt; 0.01) and thicker flanges (median [range]: 15.2 [9.0, 24.8] vs. 11.0 [6.8, 13.8], P &lt; 0.01) than the stable group. The other data were not significantly different between the two groups.</div></div><div><h3>Conclusion</h3><div>DTO resulted in less initial postoperative stability than HTO. The risk factors for initial instability in DTO were a short hinge and thick flange.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"39 ","pages":"Pages 1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706647","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":"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":"Yang Wu ,&nbsp;Hong Shao ,&nbsp;Mingru Huang ,&nbsp;Junru Lu ,&nbsp;Li Cao ,&nbsp;Yunxia Li ,&nbsp;Shurong Zhang ,&nbsp;Yunshen Ge","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":"38 ","pages":"Pages 49-55"},"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}