The American Journal of Sports Medicine最新文献

{"title":"Does the Timing of Lysis of Adhesions After Anterior Cruciate Ligament Reconstruction Affect Final Range of Motion?","authors":"Christopher A. Schneble, Benjamin Miltenberg, Kevin Jurgensmeier, Gaston Davis, Adam J. Tagliero, Kevin B. Freedman, Aaron J. Krych, Steven B. Cohen","doi":"10.1177/03635465251383162","DOIUrl":"https://doi.org/10.1177/03635465251383162","url":null,"abstract":"Background: Arthrofibrosis is seen in 1.7% to 38% of patients after anterior cruciate ligament reconstruction (ACLR) and has been associated with worse postoperative patient-reported outcomes. There are limited data regarding the optimal time to intervene in cases of arthrofibrosis after ACLR. Purpose: To assess if timing of arthrofibrosis treatment after ACLR affects final knee range of motion (ROM) and to help establish guidelines with regard to timing of intervention for arthrofibrosis after ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Databases were retrospectively screened at 2 high-volume practices for patients who underwent lysis of adhesions (LOA; Current Procedural Terminology [CPT] 29884 and 29875) with or without manipulation under anesthesia (CPT 27570) after ACLR (CPT 29888). Clinical ROM assessments were collected at multiple time points. Patients were grouped into cohorts based on timing of LOA. Comparative analysis was performed to assess for relationships between ROM and timing of intervention. Results: Seventy-nine patients underwent LOA after ACLR: 25 patients who had a time from ACLR to LOA &lt;3 months, 23 patients between 3 and 6 months, and 31 patients &gt;6 months. Earlier LOA was associated with greater total loss of motion before LOA. The final total arc of motion was 132.7°, 133.7°, and 131.8° for patients who had a time from ACLR to LOA &lt;3 months, between 3 and 6 months, and &gt;6 months, respectively. There were no significant differences among groups in final flexion ( <jats:italic toggle=\"yes\">P</jats:italic> = .8), extension ( <jats:italic toggle=\"yes\">P</jats:italic> = .746), or total arc of motion ( <jats:italic toggle=\"yes\">P</jats:italic> = .781). Linear regression modeling did not identify time from ACLR to LOA as a predictive variable ( <jats:italic toggle=\"yes\">P</jats:italic> = .982) in final ROM. Conclusion: This study failed to demonstrate a linear relationship between the timing of LOA and final ROM. Regardless of the time to intervention, ROM improved significantly; however, patients with more severe arthrofibrosis underwent LOA at earlier time points.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282662","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":"Incidence of Knee Cartilage Pathology on Magnetic Resonance Imaging and Correlation to Clinical Symptoms and Orthopaedic History Among Players at the National Basketball Association Draft Combine","authors":"Sachin Allahabadi, Zeeshan A. Khan, Jorge Chahla, Peter Meisel, John P. DiFiori, Asheesh Bedi, Imran M. Omar, Joshua M. Polster, Hollis G. Potter, Brian J. Cole","doi":"10.1177/03635465251381362","DOIUrl":"https://doi.org/10.1177/03635465251381362","url":null,"abstract":"Background: High-level basketball athletes at the collegiate level and in the National Basketball Association (NBA) have a greater proportion of knee cartilage pathology than the nonathlete population. However, little is known as to whether identified pathology on knee magnetic resonance imaging (MRI) correlates with clinical symptoms or orthopaedic history in these players. Purposes: (1) To evaluate knee MRI scans in a cross-sectional population of NBA Draft Combine players to establish prevalence of knee pathology, including that of articular cartilage and meniscus in professional basketball players. (2) To identify independent variables including demographic characteristics, playing history, previous knee injury, and symptoms that correlate to these MRI findings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Players from the NBA Draft Combine over a 2-year period voluntarily participated by undergoing bilateral knee MRI scanning and completing clinical questionnaires. MRI scans were independently and blindly evaluated by 2 radiologists for cartilage assessment (using modified Noyes score) and meniscal pathology. Associations between imaging findings and pain/function scores and orthopaedic history were evaluated. Results: A total of 43 players (80 knees) were included. Intraclass correlation coefficients were a mean of 0.827 for agreement and 0.831 for consistency for the modified Noyes score. Cartilage pathology was identified in 48.3% of knees, with the most common locations being the patella and trochlea. Previous knee surgery was associated with lateral tibial plateau chondral pathology (odds ratio [OR], 6.58; <jats:italic>P</jats:italic> = .04). Reduced function scores were predictive of cartilage pathology on the lateral femoral condyle (OR, 0.55; <jats:italic>P</jats:italic> = .03). Increased pain scores were associated with a nonzero modified Noyes score (OR, 6.11; <jats:italic>P</jats:italic> &lt; .01). Conclusion: The incidence of pathology identified on knee MRI scans in players at the NBA Draft Combine without clinical symptoms was high, in line with the hypothesis. Little correlation was found between the objective imaging findings and subjective pain, function, and orthopaedic injury history. Clinicians treating high-level athletes should focus on treating clinically significant findings and be cautious about treating pathology found on imaging that may not explain or correlate with symptoms. It remains critical to study the natural history of imaging findings in these athletes to better ascertain the ultimate effect of sport and physiologic load on disease progression.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246719","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":"Predictors of Tunnel Widening After Anterior Cruciate Ligament Reconstruction","authors":"Romir Patel, Maher Ghandour, Fabio Sammartino, Julien Druel, Drew Slater, Wiemi Douoguih, Matthieu Ollivier","doi":"10.1177/03635465251382911","DOIUrl":"https://doi.org/10.1177/03635465251382911","url":null,"abstract":"Background: Posterior tibial slope (PTS) has been implicated in tunnel widening after anterior cruciate ligament reconstruction (ACLR), yet its precise effect remains unclear. Additionally, the influence of lateral extra-articular tenodesis (LET) and meniscus root injuries on tunnel widening has not been well established. Purpose: To evaluate the effect of medial and lateral PTS, LET, and meniscus root injuries on tibial and femoral tunnel widening after ACL reconstruction using a hamstring tendon graft. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 307 patients who underwent primary ACLR with a hamstring tendon graft were included. Tibial and femoral tunnel diameters were measured immediately postoperatively and at 2-year follow-up. PTS was assessed by long lateral radiographs. Univariate and multivariate regression models were used to identify predictors of tunnel widening. Results: At 2 years, the mean ± Standard Deviation (SD) tibial tunnel diameter increased from 9.46 ± 1.00 mm postoperatively to 11.35 ± 1.55 mm ( <jats:italic>P</jats:italic> &lt; .001), and the mean femoral tunnel diameter increased from 9.27 ± 0.83 mm to 11.52 ± 1.63 mm ( <jats:italic>P</jats:italic> &lt; .001). Univariate analysis demonstrated that steeper medial and lateral PTS were significantly associated with tibial ( <jats:italic>P</jats:italic> &lt; .0001) and femoral ( <jats:italic>P</jats:italic> &lt; .0001) tunnel widening. Meniscus root injuries ( <jats:italic>P</jats:italic> = .0024) and higher body mass index ( <jats:italic>P</jats:italic> = .0127) were also associated with increased tunnel widening. In multivariate regression, medial PTS (β = −0.321; <jats:italic>P</jats:italic> &lt; .0001), lateral PTS (β = −0.137; <jats:italic>P</jats:italic> = .0356), LET (β = 0.2207; <jats:italic>P</jats:italic> = .0257), and meniscus root injuries ( <jats:italic>P</jats:italic> = .0024) remained independent predictors of tunnel widening. Conclusion: Steeper medial and lateral PTSs, the addition of LET, and the presence of meniscus root injuries are significant independent predictors of tibial and femoral tunnel widening after ACLR with a hamstring graft. These findings highlight key anatomic and surgical factors influencing postoperative tunnel remodeling and emphasize the importance of considering these variables in ACLR planning.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"1 1","pages":"3635465251382911"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246720","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":"Return to Sport After Hip Arthroscopy With Full-Thickness Acetabular Chondral Defect Treated With Microfracture.","authors":"Javier Sanz-Reig,Jesus Mas-Martinez,Marc Tey-Pons,Ana Castel-Oñate,Oliver Marin-Peña","doi":"10.1177/03635465251381784","DOIUrl":"https://doi.org/10.1177/03635465251381784","url":null,"abstract":"BACKGROUNDOnly a few studies have explored return to recreational sport activity after arthroscopic microfracture for full-thickness acetabular lesions.HYPOTHESISRecreational athletes undergoing acetabular microfracture, in addition to general hip arthroscopy procedures, would not achieve similar sport activity to recreational athletes undergoing hip arthroscopy without microfracture at the 5-year follow-up.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA retrospective review was conducted of a prospectively collected multicenter hip arthroscopy database of patients undergoing acetabular microfracture for full-thickness chondral lesions. Inclusion criteria were patients between 18 and 50 years of age who had participated in recreational sports before surgery, a diagnosis of femoroacetabular impingement, arthroscopic microfracture for full-thickness chondral lesion, labral repair, complete clinical patient-reported outcomes (PROs), radiographic measurements, and at least 5 years of postoperative follow-up. For each patient included in the study, 1 patient without chondral damage was paired at a 1:1 ratio based on age and sex. The following were assessed: radiographic evaluation, primary preoperative sport, Tegner activity scale score, self-administered Hip Outcome Score (HOS) questionnaire with Activities of Daily Living Subscale (ADL) and Sports-Specific Subscale (SSS) scores, and self-administered short version of the 12-item International Hip Outcome Tool (iHOT-12) score. Clinical relevance was measured using the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB).RESULTSA total of 33 patients met the inclusion criteria and were matched with 33 patients without chondral damage. There were no patients lost to follow-up. Both groups showed significant improvement from preoperative PROs to 5-year follow-up. There was no difference in the frequency of patients achieving the MCID, PASS, and SCB for PROs. Return to sport at the 5-year follow-up was similar between groups. Sixteen patients (66.7%) in the microfracture group changed the type of sport they participated in, compared with 9 patients (34.6%) in control group; this difference was statistically significant. The Tegner activity scale score decreased significantly in both groups, but there was no difference between them.CONCLUSIONRecreational athletes with full-thickness chondral lesions treated with arthroscopy acetabular microfracture experienced similar return to play to recreational athletes without chondral lesions at the 5-year follow-up. However, a statistically significantly higher rate of athletes in the microfracture group changed the type of sport they participated in.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"112 1","pages":"3635465251381784"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246721","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":"Trends in Racial, Ethnic, and Gender Diversity in Orthopaedic Surgery Sports Medicine Fellowships From 2007 to 2024.","authors":"Aziz Shittu,Kiera Lunn,Delano R Trenchfield,Henson Destine,Christopher J Murdock,Nichelle M Enata,Joshua J Wright-Chisem,Eric W Carson,Aaron M Brandt,Justin J Hicks","doi":"10.1177/03635465251380290","DOIUrl":"https://doi.org/10.1177/03635465251380290","url":null,"abstract":"BACKGROUNDDespite increases in gender, racial, and ethnic representation in medical school, orthopaedics continues to be recognized as one of the least diverse fields in medicine, as progress in achieving a more diverse orthopaedic community has not occurred nearly as rapidly.PURPOSETo ascertain and discuss the current state of racial, ethnic, and gender demographic trends in orthopaedic surgery sports medicine fellowships from 2007 to 2024.STUDY DESIGNDescriptive epidemiology study.METHODSFellowship demographic data were collected through the Accreditation Council for Graduate Medical Education. Data include gender, race and ethnicity, and total number of orthopaedic sports medicine fellows. Percentage equivalents were calculated for each group from 2007 to 2024. A χ2 test for trend was conducted to determine if there was a significant change in the percentages of each race, ethnicity, and gender during the study period. Results were considered statistically significant at P < .05. The 114 fellows (3.2%) who did not report gender and 468 fellows (16.8%) who reported other or unknown were excluded from their respective analyses.RESULTSFrom 2007 to 2024, White non-Hispanic males composed the majority of sports medicine fellowship positions. White non-Hispanic representation ranged from 74.9% to 88.2%, Asian from 6.6% to 16.3%, Hispanic from 0.0% to 8.4%, and Black non-Hispanic from 1.5% to 6.9%. There was a significant increase in the proportion of Hispanic orthopaedic sports medicine fellows (P = .001) but no other significant changes among the racial and ethnic makeup of fellows. There was a significant increase in the representation of female fellows (P = .041), with a range of 5.4% to 13.2%.CONCLUSIONOur study reveals a significant increase in female and Hispanic representation among orthopaedic sports medicine fellows from 2007 to 2024, but no other racial or ethnic groups showed significant change. The disparities identified in our study suggest that systemic interventions throughout the orthopaedic education pipeline may be necessary to improve sports medicine fellowship diversity.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"106 1","pages":"3635465251380290"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235574","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":"Tibiofemoral Joint Contact Force Profiles of Pediatric Patients After Anterior Cruciate Ligament Reconstruction.","authors":"Elizabeth Bjornsen,J Troy Blackburn,Jason R Franz,W Zachary Horton,Darin A Padua,Sandra J Shultz,Samantha Tayne,Brian G Pietrosimone","doi":"10.1177/03635465251372465","DOIUrl":"https://doi.org/10.1177/03635465251372465","url":null,"abstract":"BACKGROUNDIncidence rates of pediatric anterior cruciate ligament (ACL) injuries and ACL reconstruction (ACLR) are increasing. In adult patients with ACLR, limb-level loading profiles are less dynamic compared with uninjured controls (ie, lesser peaks and minimal offloading during midstance) early post-ACLR, and less dynamic profiles are associated with deleterious knee tissue changes. However, joint-level loading magnitudes during gait in the pediatric ACLR population are unknown.PURPOSE/HYPOTHESISThe purpose of this study was to compare medial and lateral tibiofemoral joint contact force profiles between pediatric patients with ACLR and pediatric matched controls. It was hypothesized that pediatric patients with ACLR would demonstrate less dynamic medial and lateral joint contact force profiles compared with matched uninjured pediatric controls.STUDY DESIGNCross-sectional study; Level of evidence, 2.METHODSPediatric patients 6 to 24 months post-ACLR (n = 25) and matched pediatric controls (n = 25; Tanner stage category, sex, Tegner activity score ±3) underwent a gait biomechanical assessment at a single time point, where ground-reaction forces and marker trajectories were collected. The concurrent optimization of muscle activation and kinematics algorithm was utilized to estimate medial and lateral compartment tibiofemoral joint contact forces in the ACLR limb and pediatric matched control limb. A functional linear model was utilized to determine differences in joint contact force profiles throughout stance phase (0%-100%).RESULTSPediatric patients with ACLR demonstrated a high occurrence of concomitant injuries (80% meniscal pathology; 13% chondral injuries) and walked with greater medial tibiofemoral joint contact forces in midstance (42%-63% of the stance phase; 339-N maximal difference) and greater lateral joint contact forces in the late stance compared with pediatric controls (69%-80%; 288 N).CONCLUSIONPediatric patients with ACLR may demonstrate a less dynamic tibiofemoral joint contact force loading profile in the medial compartment, as evidenced by greater loading during midstance, compared with matched pediatric controls.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"106 1","pages":"3635465251372465"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235621","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":"Anterior Cruciate Ligament, Meniscal, and Cartilage Injuries Are Associated With Distinct Synovial Fluid Biomarker Profiles at the Time of Knee Arthroscopy","authors":"Vishal Sundaram, Emily Berzolla, Bradley A. Lezak, Daniel J. Kaplan, Thorsten Kirsch, Eric J. Strauss","doi":"10.1177/03635465251381371","DOIUrl":"https://doi.org/10.1177/03635465251381371","url":null,"abstract":"Background: The knee’s inflammatory response to ligamentous, meniscal, and cartilage injuries is complex and incompletely understood, particularly in the setting of concomitant injuries. Recent research has highlighted the potential utility of synovial fluid biomarker analysis in identifying factors involved in the progression of posttraumatic osteoarthritis. Purpose: To investigate if unique patterns of knee injury are associated with distinct synovial fluid biomarker profiles at the time of surgical intervention. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients undergoing arthroscopic knee surgery were prospectively enrolled and asked to complete the Lysholm Knee Scoring Scale and visual analog scale for pain preoperatively. Synovial fluid was aspirated from the operative knee before surgical incision, and the concentrations of 10 biomarkers of interest were quantified. Patients with intraoperative evidence of articular cartilage, meniscal, and/or anterior cruciate ligament (ACL) injury were identified and included for subsequent analysis. Biomarker concentrations were log-normalized and standardized. Principal component analysis (PCA) was performed using biomarker variables to reduce dimensionality and extract key patterns. Multivariable linear regression for each retained principal component (PC) was performed with the predictors of age, sex, body mass index, symptom duration, ACL injury, meniscal injury, and Outerbridge grade. A separate regression analysis was performed to assess relationships between PCs and patient-reported outcomes controlling for the same variables. Results: A total of 387 patients were included in the analysis, of whom 176 (45.5%) had ACL rupture, 327 (84.5%) had meniscal injury, and 225 (58.1%) had cartilage injury. PCA yielded 3 PCs (PC1, PC2, and PC3) that explained 66.9% of variance in biomarker data. PC1 was found with significant loadings of VEGF, IL-6, MMP-3, MIP-1β, and MCP-1; PC2 with TIMP-1 and TIMP-2; and PC3 with RANTES, bFGF, and IL-1RA. Multivariable linear regression found ACL injury ( &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .014; β = .164) and meniscal injury ( &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .029; β = .118) to be positively associated with PC1, Outerbridge grade to be negatively associated with PC2 ( &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .041; β = –.132), and ACL injury to be positively associated with PC3 ( &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .035; β = .141). PC1 was associated with a worse preoperative Lysholm score ( &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .001; β = –.199). Conclusion: Cartilage lesions exhibited a synovial fluid inflammatory profile distinct from ACL and meniscal injury at the time of knee arthroscopy. While ACL and meniscal injuries displayed a pro-inflammatory phenotype, more severe cartilage lesions were associated with a reduced presence of anti-inflammatory markers. The pro-inflammatory phenotype also independently correlated with worse baseline knee function. These findings cont","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235365","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":"Exploring Various Labral Reconstruction Techniques in an Ovine Hip Model: A Biomechanical Perspective","authors":"Selahaddin Aydemir, Cagri Havitcioglu, Eren Akin, Mustafa Celtik, Firat Aydin, R. Bugra Husemoglu, Onur Hapa","doi":"10.1177/03635465251376619","DOIUrl":"https://doi.org/10.1177/03635465251376619","url":null,"abstract":"Background: Labral reconstruction using various graft materials, including autografts and allografts, is gaining popularity to address labral deficiencies. However, the biomechanical effects of graft size, type, and fixation techniques remain underexplored. Purpose/Hypothesis: The purpose was to evaluate the effects of graft size, graft type, tubularization, and anchor number on suction seal force and distractive stability in an ovine hip model. It was hypothesized that larger graft sizes and the use of allografts would improve the suction seal force and distractive stability compared with smaller grafts and fewer anchor numbers, while tubularization would have no significant effect. Study Design: Controlled laboratory study. Methods: A total of 40 sheep hip joints were randomly assigned to 5 groups. Labral excision was performed, followed by reconstruction using autografts or allografts. Ovine extensor tendons were chosen as autografts, whereas labrums from a different ovine hip were used for allografts. For group 1, autografts matching the original labral width were used. For group 2, autografts twice the original labral width were used. For group 3, allografts matching the original labral width were harvested from a different ovine hip. For group 4, autografts matching the original width were fixed with only 2 anchors. For group 5, autografts matching the original width were tubularized before use. Suction seal force was measured before and after reconstruction using an electromechanical testing system. Statistical analyses included Mann-Whitney <jats:italic>U</jats:italic> and Wilcoxon signed-rank tests ( <jats:italic>P</jats:italic> &lt; .05). Results: Group 2 showed the highest improvement in suction seal force, outperforming all other groups ( <jats:italic>P</jats:italic> &lt; .01). Group 4 exhibited the lowest distractive stability among all groups. Tubularization (group 5) did not enhance biomechanical performance ( <jats:italic>P</jats:italic> = .752). Group 3, reconstructed with an allograft, exhibited suction seal performance most closely approximating that of group 2, with no significant difference between them. Conclusion: The data from the ovine cadaveric model indicate that increasing the graft size enhances the suction sealing force; however, it remains below the measurements observed in an intact labrum. Furthermore, increasing the number of anchors and optimal graft selection improve postoperative biomechanical stability. Clinical Relevance: Optimizing graft size and fixation techniques in labral reconstruction may improve joint stability and suction seal function and may support surgical strategies aimed at improving outcomes and delaying the progression of osteoarthritis in patients with labral defects.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235366","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":"Systemic Biomarkers of Chondral Metabolism and Matrix Remodeling After Anterior Cruciate Ligament Reconstruction: A Prospective Study","authors":"Lachlan M. Batty, Minh Huynh, Kate E. Webster, Natasha Vassileff, Jereme Spiers, Haydn J. Klemm, Brian M. Devitt, Timothy S. Whitehead, Andrew F. Hill, Julian A. Feller","doi":"10.1177/03635465251376616","DOIUrl":"https://doi.org/10.1177/03635465251376616","url":null,"abstract":"Background: Anterior cruciate ligament (ACL) injuries and reconstruction are associated with alterations in chondral homeostasis and posttraumatic osteoarthritis. Biomarkers of chondral metabolism may have a role in quantitatively evaluating this phenomenon. Purposes: To describe changes in 3 systemic biomarkers of chondral metabolism and extracellular matrix remodeling during the first year after ACL reconstruction and to identify factors associated with biomarker concentrations at the baseline and 12-month postoperative timepoints. Study Design: Controlled laboratory study. Methods: From a longitudinal study, urine and serum samples were taken immediately before primary ACL reconstruction and at 6 and 12 months postoperatively. A total of 666 patients provided samples (mean ± SD age, 24.9 ± 7.2 years; 60.5% male). Immunoassays were used to measure concentrations of urinary C-terminal cross-linked telopeptide of type 2 collagen (CTX-II), a marker of type 2 collagen degradation; serum N-propeptide of collagen IIA (PIIANP), a marker of type 2 collagen synthesis; and serum matrix metalloproteinase 3 (MMP-3), a mediator of extracellular matrix remodeling. Linear mixed modeling and linear regression were used for data analysis. Results: Urinary CTX-II concentrations decreased by 25% (95% CI, 19%-31%) from baseline to 6 months and by 37% (95% CI, 22%-42%) from baseline to 12 months, respectively ( <jats:italic>P</jats:italic> &lt; .001). Serum PIIANP increased by 40% (95% CI, 34%-47%) from baseline to 6 months ( <jats:italic>P</jats:italic> &lt; .001) with no significant change between 6 and 12 months. Serum MMP-3 increased by 35% (95% CI, 29%-42%) and 44% (95% CI, 37%-52%) from baseline to 6 months and from baseline to 12 months respectively ( <jats:italic>P</jats:italic> &lt; .001). At the baseline timepoint, age, body mass index (BMI), sex, and time from injury to surgery were factors associated with biomarker concentrations. At the 12-month timepoint, age, sex, BMI, and time from injury to surgery were associated with biomarker concentrations. Conclusion: Decreasing urinary CTX-II concentrations coupled with increasing serum PIIANP concentrations may suggest a reparative chondral response within the first 12 months after ACL reconstruction. Increasing serum MMP-3 concentrations suggested persistent and progressive extracellular matrix remodeling during this same period. Predominantly nonmodifiable demographic factors were associated with baseline and 12-month concentrations of the 3 biomarkers. Clinical Relevance: Biomarkers of chondral metabolism may have future prognostic or decision-making roles in the management of patients with ACL injury. This could include predicting posttraumatic arthritis.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235324","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":"Associations Between Tissue Donor Variables and Clinically Significant Outcomes, Reoperations, and Failure After Primary Meniscal Allograft Transplantation","authors":"Sarah A. Muth, Chloe H. Franzia, Yusuf N. Mufti, Jared P. Sachs, Kyle R. Wagner, Katie J. McMorrow, Nicholas J. Lemme, Brian J. Cole","doi":"10.1177/03635465251376580","DOIUrl":"https://doi.org/10.1177/03635465251376580","url":null,"abstract":"Background: Donor-recipient sex mismatch for tissue and organ transplantation has been shown to negatively affect outcomes. Purpose: To analyze the effect of sex mismatching on outcomes after meniscal allograft transplantation (MAT) and to determine if there is an association between the sex of the recipient and the sex of the donor and how this affects clinically significant outcome (CSO), reoperation, and failure rates after primary MAT. Study Design: Case series; Level of evidence, 4. Methods: Between 2003 and 2022, patients who underwent MAT were prospectively followed, with the inclusion criteria of having undergone primary MAT and having a minimum of 2 years’ follow-up. Patient characteristics and clinical data, as well as donor age, donor sex, and graft expiration date, were collected. Reoperation and failure data were also collected, and patients were evaluated for achieving CSOs for the International Knee Documentation Committee (IKDC) score. A reoperation was any surgical intervention involving the transplanted allograft, including second-look arthroscopic surgery in the setting of recurrent symptoms or functional deficits, meniscectomy, and meniscal repair. Failure was defined as revision MAT and unicompartmental or total knee arthroplasty. Survivorship was assessed with a Kaplan-Meier curve. Log-rank testing evaluated survivorship between groups. Results: A total of 245 patients met the inclusion criteria and were followed for a mean of 8.4 ± 4.2 years (range, 2.0-19.1 years). Isolated MAT was performed in 73 of 247 knees (30%). There was a significantly greater prevalence of female knees (89/129 [69%]) than male knees (10/118 [9%]) that received a graft from the opposite sex ( <jats:italic>P</jats:italic> &lt; .001). On average, graft recipients were younger in the mismatch group than in the nonmismatch group (25.4 ± 8.5 vs 28.6 ± 8.8 years, respectively; <jats:italic>P</jats:italic> = .004). No donor variables were predictive of achieving CSOs for the IKDC score at 5 years. No difference in rates of survivorship from reoperations or failure was observed. Conclusion: Donor variables, including sex, age, and donor-recipient sex mismatch, did not negatively affect clinical outcomes. These findings suggest that sex matching is not necessary for graft selection, potentially increasing the availability of allografts and facilitating MAT in the setting of limited donor availability.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235511","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}