Arthroscopy: The Journal of Arthroscopic & Related Surgery最新文献

{"title":"Combined Single Anchor Fixation of Subscapularis and Biceps Pathology Leads to Improved Clinical Outcomes.","authors":"William Ciccone","doi":"10.1016/j.arthro.2024.09.009","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.09.009","url":null,"abstract":"Upper-edge subscapularis tendon tears associated with biceps instability are a cause of anterior shoulder pain and disability. At shoulder arthroscopy, the incidence of subscapularis pathology was noted to be 27%, with 47% of these being combined lesions involving the medial reflection pulley. The anatomic location of the upper subscapularis and biceps allows for combined fixation techniques. Arthroscopic subscapularis tendon repair with biceps tenodesis with single-anchor fixation is a cheap and efficient way to address this pathology if biceps tissue quality is sufficient. Careful consideration of surgical technique should lead to improved patient outcomes.","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Posterolateral Corner Reconstruction Shows Low Failure and Complication Rates.","authors":"Warren W Nielsen,Andrew G Geeslin","doi":"10.1016/j.arthro.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.09.010","url":null,"abstract":"High-grade knee posterolateral corner (PLC) injuries are potentially devastating, and often associated with high energy mechanisms. Failure of PLC injury diagnosis or treatment can lead to residual instability after combined cruciate ligament reconstruction due to increased risk of graft failure, and varus malalignment may lead to early osteoarthritis and meniscal injuries. PLC reconstruction has consistently shown superiority over PLC repair. Biomechanical studies have compared reconstruction techniques, specifically evaluating rotational and varus laxity. Some studies have demonstrated no difference between techniques whereas other studies have reported improved stability with techniques that include a separate tibial tunnel for reconstruction of the popliteus tendon and PFL. Yet many have suggested that there is less technical difficulty with techniques that do not use a tibial tunnel, and this may be an important consideration in certain settings. Recent reviews showing no differences in clinical outcomes when comparing techniques for PLC reconstruction are based on heterogeneous, low level of evidence, high-risk-of-bias literature. It is well-recognized that PLC injuries are heterogeneous, with approximately three quarters occurring in combination with anterior and/or posterior cruciate ligament tears. Further, laxity patterns vary for these injuries including high-grade posterior laxity and knee hyperextension as well as proximal tibial-fibular joint laxity, and these findings may necessitate use of an anatomic (separate tibial tunnel) PLC reconstruction technique. Reassuringly, both techniques show low complication and failure rates.comparison.","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term, clinical outcome of arthroscopic rotator cuff repair may be improved with concomitant acromioplasty in patients with a Type III acromion.","authors":"Andrew Arjun Sayampanathan,Andrew Tan Hwee Chye","doi":"10.1016/j.arthro.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.09.007","url":null,"abstract":"In theory, extrinsic anterolateral acromial impingement of the rotator cuff can contribute to cuff tearing. Thus, acromioplasty may be performed concomitantly with arthroscopic rotator cuff repair (ARCR). A review of recent randomized controlled trials confirms that patient long-term outcomes after ARCR is superior when acromioplasty is performed, when compared to no concomitant acromioplasty, while complication and retear rates are similar. This is in contrast to previous reviews identifying no significant clinical differences in post-operative functional outcomes, patient reported outcomes, or reoperation rates in the short- to medium-term. In sum, emerging evidence suggests that we start to observe differences in outcomes in the longer-term in favor of acromioplasty. From our point of view, both patient and surgical factors determine outcome. There is growing evidence that ARCRs with acromioplasties may contribute to superior functional outcomes and reduced reoperation rates in the long-term post-operation. However, post-operative outcomes of such procedures remain dependent on both patient and surgical factors. Patient factors include acromial morphology, comorbidities, and tear pattern, size, and repairability. Type III acromial morphology is a risk factor for poor outcome absent acromioplasty. Surgical factors include repair technique and surgeon experience.","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injectable therapeutic peptides-an adjunct to regenerative medicine and sports performance?","authors":"Mikalyn T DeFoor,Travis J Dekker","doi":"10.1016/j.arthro.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.09.005","url":null,"abstract":"High level athletes and bodybuilders are constantly seeking novel therapies to enhance recovery and expedite return from injury-injectable peptides are a new and trending therapy that may be the wave of the future of in the realm of regenerative medicine research in treating joint injuries and osteoarthritis. Very early in vivo research of the pharmacokinetics suggests the possibility of Body Protection Compound 157 (BPC-157) appears to be at the forefront of therapeutic peptides with early demonstration of these experimental peptides optimizing endurance training, metabolism, recovery and tissue repair. While uUnregulated, yetand readily available for purchase over the internet, there is scarce orthopaedic literature investigating the clinical use and outcomes of these therapeutic peptides in tendon, muscle and cartilage injury. However, this has not slowed the recent exponential growth of the multi-billion-dollar industry in development of therapeutic peptides. As orthopaedic surgeons and team physicians, we should stay up-to-date with the latest pharmacokinetic, safety, ethical, and legal profilesregulations regarding synthetic peptide supplementation for injury recovery and sports performance optimization from our elite athletes to our fitness fanatics as these patients will continue to seek the latest and greatest in treatment options and will be approaching us with questions on their results, risks and benefits..","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suture tape augmentation improves posterior stability after isolated posterior cruciate ligament reconstruction using hamstring tendon autograft with single-bundle transtibial technique","authors":"Hangzhou Zhang, Jian Wang, Yuzhong Gao, Peng Zheng, Lianhai Gong","doi":"10.1016/j.arthro.2023.12.007","DOIUrl":"https://doi.org/10.1016/j.arthro.2023.12.007","url":null,"abstract":"<h3>Purpose</h3><p>The purpose of this study was to assess whether posterior cruciate ligament reconstruction (PCLR) suture tape augmentation can yield more stability after isolated PCLR.</p><h3>Methods</h3><p>A prospective database was retrospectively reviewed to identified patients that underwent primary isolated PCLR (control study) or isolated PCLR with suture tape augmentation (study group) from January 2016 to September 2020. the subjective International Knee Documentation Committee Subjective (IKDC) Knee, Lysholm and Tegner scores, posterior draw tests, as well as posterior stress radiographs and return to sports activity rates. The minimal clinically important difference (MCID) was used to evaluate the clinically relevance (subjective IKDC, Lysholm and Tegner scores).</p><h3>Results</h3><p>59 were included in this analysis (28 patients in control group, 31 patients in study group). The average length of follow-up was similar between the study and control groups (48.6 vs 47.9months; p=0.800). Knee function, in terms of subjective IKDC (study vs. control: 85.1±6.4 vs. 79.8±6.4; P=0.002), Lysholm (study vs. control: 86.3±7.4 vs. 80.8±7.4; P=0.005) and Tegner (study vs. control: 7.0±1.4 vs. 5.6±1. 7; P=0.006) scores, was significantly improved in the study group. However, the differences between control group and study group were less than the MCID in the subjective IKDC score and Lysholm score. 21.4% (6/28) and 48.4% of patients (15/31) in the control and study groups, respectively, returned to the preinjury sports activity levels (P=0.031). At last follow-up, the mean side-to-side differences in posterior laxity was significantly improved in the study group compared with the control patients (study vs. control: 1.52±0.70 mm vs. 3.17±2.01 mm; p&lt;0.01).</p><h3>Conclusions</h3><p>Primary isolated PCLR with suture tape augmentation provides better posterior stability than PCLR without suture tape augmentation at a minimum 2 years follow-up. No differences observed between the groups in the percentage of patients who met or exceeded the MCID in subjective IKDC and Lysholm score.</p>","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139030198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior Diagnosis of Opioid Related Disorder is Associated with Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study","authors":"Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor","doi":"10.1016/j.arthro.2023.12.008","DOIUrl":"https://doi.org/10.1016/j.arthro.2023.12.008","url":null,"abstract":"<h3>Purpose</h3><p>To compare adverse events, medical resource utilization, prescribing patterns and revision surgery rates of patients with opioid related disorders (ORD) undergoing primary hip arthroscopy against a propensity matched group with no opioid related disorders (NORD).</p><h3>Methods</h3><p>The TriNetX database was queried between January 2015 and December 2020 using ICD-10 and CPT codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and anti-depressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.</p><h3>Results</h3><p>A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P &lt; .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P &lt; .0001) compared to NORD patients within 1 year of surgery.</p><h3>Conclusion</h3><p>ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of ED visits, hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.</p><h3>Level of Evidence</h3><p>Level III, Cohort Study</p>","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":"310 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139030158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}