The American Journal of Sports Medicine最新文献

{"title":"Will Regenerative Medicine Live Up to Its Name?","authors":"Scott A. Rodeo","doi":"10.1177/03635465251357626","DOIUrl":"https://doi.org/10.1177/03635465251357626","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755829","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":"Clinical Outcomes and Sports Participation After the Modified Broström Procedure in Children and Adolescents With Chronic Lateral Ankle Instability: A 5- to 10-Year Follow-up of 111 Cases.","authors":"Shikai Xiong,Jing Pan,Xingming Xu,Yanbin Pi,Linxin Chen,Dong Jiang,Yuelin Hu,Chen Jiao,Xing Xie,Qinwei Guo","doi":"10.1177/03635465251354961","DOIUrl":"https://doi.org/10.1177/03635465251354961","url":null,"abstract":"BACKGROUNDChronic lateral ankle instability (CLAI) can severely impair sports performance and functional mobility in children and adolescents, necessitating surgical interventions such as the modified Broström procedure. However, midterm to long-term clinical outcomes and sports participation after this procedure remain inconclusive.PURPOSETo investigate the midterm to long-term clinical outcomes and analyze the reasons and risk factors for failure to participate at preinjury sports levels after the modified Broström procedure in children and adolescents with CLAI.STUDY DESIGNCase series study; Level of evidence, 4.METHODSA total of 144 consecutive patients younger than 18 years with CLAI underwent the modified Broström procedure from August 2014 to July 2019, of whom 126 meeting the inclusion criteria were contacted via telephone to complete a survey. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, Karlsson-Peterson score, Tegner score, and Foot and Ankle Outcome Score (FAOS). A structured questionnaire evaluated the outcomes of sports participation, ankle recurrent sprains, subjective satisfaction, and surgical complications. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing return to preinjury sports levels at final follow-up.RESULTSThere were 107 patients (111 ankles; 84.9% follow-up rate) included for analysis, with a mean age at the time of surgery of 15.2 ± 2.0 years and a follow-up period of 5 to 10 years (mean, 86.4 ± 17.7 months). Postoperative clinical scores showed significant improvements compared with preoperative scores, with VAS pain scores decreasing from 4.0 ± 2.1 to 0.8 ± 1.1, the Karlsson-Peterson score increasing from 55.8 ± 20.8 to 91.4 ± 7.9, the Tegner score increasing from 3.6 ± 2.0 to 5.5 ± 1.5, and the total FAOS score increasing from 64.4 ± 18.7 to 93.0 ± 6.2 (P < .001 for all). All cases returned to daily activities and recreational sports levels at a mean time of 5.1 ± 3.6 months after surgery. Among them, 55.0% were able to participate at their preinjury level of sports at final follow-up, while the other 45.0% were not, citing reasons such as ankle-related events (46.0%), health problems (10.0%), life-related events (18.0%), and personal preferences (24.0%). Recurrent sprains occurred in 27.0% of cases, with an overall complication rate of 5.4% (all cases with skin numbness; no infections) and a high patient satisfaction rate of 97.3%. Multivariate analysis identified that being an athlete (P = .035) or having a calcaneofibular ligament injury (P = .040) was negatively related to the success of returning to preinjury sports levels at 5- to 10-year follow-up.CONCLUSIONOver a 5- to 10-year follow-up period, the modified Broström procedure provided satisfactory clinical outcomes in children and adolescents with CLAI, enabling them to resume daily activities and recreational sports. However, approximately one-quarter experienced recurre","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"10 1","pages":"3635465251354961"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684092","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":"Spinopelvic Characteristics as Predictors of Cam Morphology: A 2-Year Follow-up of Elite Adolescent Soccer Players.","authors":"Dalia Al Otti,Filip Staes,Stijn Ghijselings,Senne Hermans,Lennart Scheys","doi":"10.1177/03635465251353155","DOIUrl":"https://doi.org/10.1177/03635465251353155","url":null,"abstract":"BACKGROUNDCam morphology develops gradually during the end stages of skeletal maturity before hip physis closure. It has been shown to be a risk factor for early-onset hip pain and joint degeneration.PURPOSETo (1) evaluate the differences in spinopelvic parameters between elite adolescent soccer players at baseline and follow-up and (2) discern whether certain parameters can predict the development of cam morphology over time.STUDY DESIGNCohort study (prognosis); Level of evidence, 2.METHODSThis prospective 2-year follow-up study involved elite soccer players aged 12 to 16 years (baseline: n = 29; follow-up: n = 20). At both baseline and follow-up, anteroposterior and 45° Dunn views were used to assess skeletal maturity and the presence of cam morphology to classify participants into the cam group or no cam group. Low-dose biplanar scans obtained in the standing, sitting, and squatting positions were used to determine pelvic incidence, sacral slope, sagittal pelvic tilt, lumbar lordosis, and pelvic-femoral angle. Differences in these parameters between the 3 weightbearing positions were used to calculate relative pelvic movement and relative hip flexion percentages.RESULTSAt baseline and follow-up, 55.2% of participants had cam morphology (right hip: n = 16; left hip: n = 15). Significant differences were observed between the cam and no cam groups at both time points in pelvic incidence (baseline: 50.5°± 5.1° vs 42.7°± 6.8°, respectively; P = .01) (follow-up: 52.8°± 7.9° vs 43.8°± 8.0°, respectively; P = .01), sacral slope while squatting (baseline: 29.0°± 8.6° vs 17.9°± 12.3°, respectively; P = .024) (follow-up: 27.5°± 10.0° vs 21.0°± 8.9°, respectively; P = .031), and relative pelvic movement while squatting (baseline: 32.4% ± 11.2% vs 47.4% ± 20.1%, respectively; P = .032) (follow-up: 38.4% ± 6.7% vs 45.3% ± 11.1%, respectively; P = .046). No significant changes were shown within groups longitudinally. On mixed-model logistic regression, pelvic incidence significantly predicted the development of cam morphology (estimate, 0.167; odds ratio, 1.182 [95% CI, 0.029-0.306]; P = .019).CONCLUSIONAdolescent soccer players with cam morphology exhibited different spinopelvic characteristics compared with those without cam morphology, especially on imaging while squatting. The stability of the spinopelvic parameters longitudinally and the suggested causal relationship between increased pelvic incidence and the development of cam morphology could inform early screening protocols.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"115 1","pages":"3635465251353155"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684091","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":"Introducing “Delta Angle” of Posterior Tibial Slope and Its Impact on ACL Reconstruction Failures: A Regression Analysis of 1174 Patients","authors":"Atif Ayuob, Siddarth Raj, Jonathan Jessup, Henry K.C. Searle, Imran Ahmed, Peter Thompson, Feisal Shah, Andrew Metcalfe, Nicholas Smith","doi":"10.1177/03635465251355213","DOIUrl":"https://doi.org/10.1177/03635465251355213","url":null,"abstract":"Background: Anterior cruciate ligament reconstruction (ACLR) failures are linked to various risk factors, including an increased posterior tibial slope (PTS). Recent studies have indicated that both the medial PTS (MPTS) and lateral PTS (LPTS) contribute to ACLR outcomes, but the clinical importance of their difference—delta angle—has not been previously explored. Hypothesis: The delta angle, or the difference between the lateral and medial PTSs, is a more significant predictor of ACLR rerupture than either slope considered individually. Study Design: Case series; Level of evidence, 4. Methods: The authors conducted a retrospective analysis of the medical records of 1174 patients who underwent primary, contralateral, or revision ACLR from 2007 to 2018 at a single institution. Medial and lateral PTSs were measured on lateral knee radiographs, and the delta angle was calculated as LPTS minus MPTS. Logistic regression analysis was used to assess the association between these variables and ACLR outcomes, adjusting for potential confounders, such as age and sex. Results: The mean delta angle was significantly lower in the primary ACLR group compared with the revision ACLR group (3.1°± 2.3° vs 6.2°± 2.2°; <jats:italic>P</jats:italic> &lt; .001). Isolated high LPTS was a better predictor of ACLR reruptures than isolated high MPTS. The delta angle was significantly associated with an increased risk of revision surgery (OR, 1.675; 95% CI, 1.618-1.968; <jats:italic>P</jats:italic> &lt; .001). Conclusion: The delta angle is a crucial risk factor for ACLR failure, with a higher delta angle significantly associated with higher odds of ACLR revision. These findings suggest that consideration of both medial and lateral PTSs, and particularly their difference, should be integral in assessing ACLR risk and planning surgical interventions.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677432","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":"Tibiocalcaneal Augmentation of Deltoid Ligament Repair Improves Ankle Stability: A Robotic Investigation of Ankle Biomechanics","authors":"Alex W. Brady, Justin R. Brown, Alexander R. Garcia, Amelia H. Drumm, Christopher D. Kreulen, Craig T. Haytmanek, Thomas O. Clanton","doi":"10.1177/03635465251352739","DOIUrl":"https://doi.org/10.1177/03635465251352739","url":null,"abstract":"Background: The deltoid ligament can tear in association with an ankle fracture or a syndesmotic injury or independently. Previous biomechanical research has shown that the optimal surgical treatment method for an anterior deltoid tear is repair with tibiocalcaneal augmentation. However, tibiocalcaneal augmentation is technically challenging to perform, as there is a risk of damage to neurovascular structures in the medial ankle. Purpose: To determine if tibiotalar augmentation is sufficient to stabilize the ankle in the setting of a deltoid tear. Study Design: Controlled laboratory study. Methods: A total of 10 cadaveric ankles were mounted to a 6 degrees of freedom robotic arm. Each specimen underwent biomechanical testing in 9 states: (1) intact, (2) anterior deltoid cut, (3) anterior deltoid repair, (4) anterior deltoid repair + tibiotalar augmentation, (5) anterior deltoid repair + tibiotalar augmentation + tibiocalcaneal augmentation, (6) posterior deltoid cut, (7) removal of tibiocalcaneal augmentation, (8) removal of tibiotalar augmentation, and (9) removal of anterior deltoid repair. Additionally, 6 tests were run under a 5-N·m load: (1) eversion at neutral, (2) eversion at 25° of plantarflexion, (3) external rotation at neutral, (4) external rotation at 25° of plantarflexion, (5) plantarflexion, and (6) dorsiflexion. Results: Anterior and complete tears significantly increased ankle laxity compared with the intact state on all tests (+5.6° and +12.0° in eversion at 25° of plantarflexion, respectively; <jats:italic>P</jats:italic> &lt; .0001). Anterior repair restored external rotation to the intact state for both anterior and complete tears, but it remained significantly more lax in eversion at 25° of plantarflexion (+2.9° [ <jats:italic>P</jats:italic> = .0007] and +5.0° [ <jats:italic>P</jats:italic> &lt; .001], respectively). Tibiotalar augmentation showed no significant improvement, while tibiocalcaneal augmentation restored eversion stability to the intact state. No significant reductions in range of motion were found for any surgical state compared with the intact state. Conclusion: Tibiotalar augmentation did not restore eversion stability to the intact state, but tibiocalcaneal augmentation restored eversion stability to the intact state for both anterior and complete tears. While this surgical technique may be technically challenging, it has a strong stabilizing effect on the ankle joint. Future research is necessary to further improve the safety and simplicity of this technique. Clinical Relevance: Clinicians may consider adding tibiocalcaneal suture tape augmentation to deltoid ligament repair to improve eversion stability.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677364","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 Follow-up After Arthroscopically Assisted 2-Bundle Anatomic Reduction of Acute Acromioclavicular Joint Separations.","authors":"Benjamin D Kleim,Sebastian Lappen,Maximilian Weyer,Maximilian Hinz,Arne J Venjakob,Klaus Wörtler,Sebastian Siebenlist,Andreas B Imhoff","doi":"10.1177/03635465251355958","DOIUrl":"https://doi.org/10.1177/03635465251355958","url":null,"abstract":"BACKGROUNDArthroscopically assisted techniques for acromioclavicular joint reconstruction have increasingly been used over the past 15 years. Long-term results are lacking.HYPOTHESISPatients will continue to show good clinical function and sustained anatomic reduction at long-term follow-up.STUDY DESIGNCohort study; Level of evidence, 3.METHODSTwenty patients (67%) with a known endpoint were followed up at a mean of 15 years (range, 14-16 years) postoperatively. Twelve patients (60%) had Rockwood type 5, 6 (30%) type 4, and 2 (10%) type 3 injuries. Clinical evaluation included the Simple Shoulder Test, Constant score, pain score of 0 to 10, and satisfaction graded 0 (not satisfied) to 4 (very satisfied). Fourteen patients had complete outcome scores at the final follow-up. Nine patients underwent radiographic examination and were assessed for coracoclavicular distance, posterior acromioclavicular subluxation, arthritis, ossification, and hardware displacement by 3 observers.RESULTSThe respective mean preoperative, 2-year, 5-year, and 15-year outcome scores were as follows: 34.5 ± 6.9, 94.3 ± 3.2 (P < .05), 91.5 ± 4.7, and 91.2 ± 4.8 (P > .05) for the Constant score; 2.8 ± 2.1, 12.0 ± 0 (P < .05), 11.8 ± 0.5, and 11.7 ± 0.4 (P > .05) for Simple Shoulder Test; and 4.5 ± 1.9, 0.3 ± 0.5 (P < .05), 0.3 ± 0.6, and 0.4 ± 0.8 (P > .05) for pain. The 2-year satisfaction was 4.0 ± 0; the 5-year score, 3.8 ± 0.5; and the 15-year score, 3.7 ± 0.4 (P > .05). Coracoclavicular distance (mm) decreased from 20.5 ± 4.6 preoperatively to 10.5 ± 3.6 at 2 years (P < .05), 11 ± 3.2 at 5 years, and 11.3 ± 4.3 at 15 years of follow-up (P > .05). Acromioclavicular posterior subluxation remained unchanged (P > .05). Six patients (67%) had asymptomatic ossification of the coracoclavicular ligaments; their Constant score was 93.3. One patient developed acromioclavicular arthritis radiologically with clinical correlation but did not require further surgery. Three patients (10%) underwent revision stabilization within 3 months, 1 for infection and 2 for mechanical failure.CONCLUSIONFifteen years postoperatively, good clinical results persisted and anatomic reduction was overall maintained, often with asymptomatic ossification of the coracoclavicular ligaments.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"109 1","pages":"3635465251355958"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669325","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":"Cost-Effectiveness of Medial Patellofemoral Ligament Reconstruction for First-Time Patellar Dislocations: A Markov Analysis.","authors":"Eoghan T Hurley,Jack Twomey-Kozak,Jacob F Oeding,Mark A Glover,Alex M Meyer,Samuel G Lorentz,Jonathan F Dickens,Jocelyn R Wittstein,Annunziato Amendola,Alison P Toth,Kendall E Bradley","doi":"10.1177/03635465251350394","DOIUrl":"https://doi.org/10.1177/03635465251350394","url":null,"abstract":"BACKGROUNDNonoperative management versus medial patellofemoral ligament reconstruction (MPFLR) for first-time patellar dislocations remains controversial, and it is unclear whether the increased up-front costs from MPFLR are justified.PURPOSETo compare the cost-effectiveness of an initial trial of physical therapy alone to that of early MPFLR to determine the preferred cost-effective treatment strategy for first-time patellar dislocations.STUDY DESIGNEconomic and decision analysis; Level of evidence, 3.METHODSA Markov chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs (in US$) of 1000 simulated patients undergoing nonoperative management versus MPFLR for first-time patellar dislocations. Health utility values, transition probabilities, and costs were derived from published level 1/2 evidence in the literature. Outcome measures included costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The 10-year cost for each patient in the microsimulation model was averaged by the initial treatment strategy to capture the costs of any subsequent treatment methods that the patient underwent as a result of recurrent dislocations. Cycle length was defined as 1 year, with all costs and utilities discounted at 3% annually.RESULTSOver the 10-year time horizon, mean total costs resulting from nonoperative management and MPFLR were $46,223 ± $9562 and $37,298 ± $14,130, respectively. On average, MPFLR was associated with 8.5 ± 0.6 QALYs, while nonoperative management was associated with 7.1 ± 0.5 QALYs. Overall, MPFLR was determined to be the preferred cost-effective strategy in 95.3% of patients included in the microsimulation, with nonoperative management predicted to be the preferred strategy in 4.7% of patients.CONCLUSIONMPFLR was shown to be the dominant cost-effective treatment strategy for first-time patellar dislocations based on the Monte Carlo microsimulation and probabilistic sensitivity analysis, and despite increased up-front costs, MPFLR was found to save costs in the long term. Patients who underwent an initial trial of nonoperative management experienced an increased risk of recurrent dislocations that ultimately resulted in an average cost for the nonoperative group that exceeded that of the MPFLR group because of the increased downstream costs incurred for recurrent dislocations. While this study supports the long-term cost-saving potential of MPFLR, these findings should be interpreted within the context of individual patient characteristics and clinical judgment.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"13 1","pages":"3635465251350394"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669372","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":"Glyburide Accelerates the Process of Tendon Healing by Inhibiting NLRP3 Inflammasome in Calcific Tendinopathy.","authors":"WeiYi Chen,WanQing Qi,MengYang Jia,QianRu Yao,Ying Yang,YunQing Su,XianXiang Xiang","doi":"10.1177/03635465251356463","DOIUrl":"https://doi.org/10.1177/03635465251356463","url":null,"abstract":"BACKGROUNDThe NOD-like receptor protein 3 (NLRP3) inflammasome activated by calcific crystals is particularly relevant to the initiation and progression of calcific tendinopathy. Moreover, NLRP3 inflammasome-driven inflammation controlled at low-grade levels could promote collagen regeneration of the tendon. Recently, it has been reported that glyburide, a hypoglycemic drug, inhibits the NLRP3 inflammasome, a possible diagnostic biomarker and therapeutic target for calcific tendinopathy.STUDY DESIGNControlled laboratory study.PURPOSETo investigate whether glyburide has therapeutic effects on calcific tendinopathy and to determine the role of the NLRP3 inflammasome in such an effect.METHODSA total of 60 Sprague-Dawley rats underwent collagenase injection into the Achilles tendon to induce calcific tendinopathy. Sixteen weeks later, the rats were randomly assigned to 3 groups: (1) 10% dimethyl sulfoxide (DMSO) group, (2) celecoxib group, and (3) glyburide group. Gross morphological and histological analyses were conducted to evaluate tendon healing. Additionally, real-time quantitative polymerase chain reaction and Western blotting were performed to assess whether glyburide degeneration influences the expression of components of the NLRP3 inflammasome, including NLRP3, apoptosis-associated speckle-like protein (ASC), caspase-1, IL-1β, and IL-18, within Achilles tendon enthesis at 2 weeks after treatment.RESULTSThe Achilles tendon tissues in the glyburide group exhibited significantly less degeneration and fewer calcium deposits compared with the celecoxib and DMSO groups. The mRNA and protein expression levels of NLRP3, ASC, caspase-1, IL-1β, and IL-18 were reduced in the glyburide group compared with both the celecoxib and DMSO groups.CONCLUSIONGlyburide targets the upstream NLRP3 signaling pathway, potentially accelerating tendon healing, which may contribute to advancements in the treatment of calcific tendinopathy.CLINICAL RELEVANCEGlyburide acts as an NLRP3 inflammasome inhibitor and may be a new option for tendon healing in calcific tendinopathy.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"13 1","pages":"3635465251356463"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669329","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":"Radial Extracorporeal Shockwave Therapy Reduces Subchondral Osteoblast Senescence in Knee Osteoarthritis.","authors":"Lin Chen,Zhan Zhang,Xun Ma,Di Zhang,Qi Xu,Qian Wang,Shinong Pan,Yu He,Xueyong Liu","doi":"10.1177/03635465251355245","DOIUrl":"https://doi.org/10.1177/03635465251355245","url":null,"abstract":"BACKGROUNDExcess subchondral bone (SCB) turnover due to osteoblast senescence has been confirmed as the histological manifestation of early-stage osteoarthritis (OA). The therapeutic efficacy of radial extracorporeal shockwave therapy (rESWT) on osteoblast senescence in early-stage OA has not been fully elucidated.PURPOSETo evaluate the therapeutic potential of rESWT in enhancing SCB osteogenesis and mitigating osteoblast senescence in a rat model of knee OA.STUDY DESIGNControlled laboratory study.METHODSThe expression of senescence biomarkers was evaluated by immunohistochemistry on tibial plateau samples from patients with knee OA (n = 3). Monosodium iodoacetate (MIA)-induced OA was established in 8-week-old male Sprague-Dawley rats, which were treated with 3 different doses of rESWT (0.096, 0.128, or 0.16 mJ/mm2; n = 6 per group) for 4 weeks. Articular cartilage and SCB samples were collected and analyzed using histological, radiological, immunohistochemical, and immunofluorescence techniques to assess the tissue repair, osteogenic, and antisenescence effects of rESWT as well as to identify the optimal therapeutic dose. Then, a new set of rats with MIA-induced OA that received rESWT, treadmill exercise, or combined therapy (n = 6 per group) was used to compare the therapeutic effects of the 3 methods on knee OA. For in vitro analysis, the impact of rESWT on senescence biomarkers was further evaluated using TNF-α-stimulated rat-derived osteoblasts (n = 3).RESULTSSignificant increases in osteoblast senescence biomarkers were observed in both human and rat SCB with knee OA. These abnormalities, along with damaged cartilage integrity and SCB microarchitecture, were evident in rats with MIA-induced OA but were alleviated by rESWT, with the optimal dose being 0.096 mJ/mm2. Significant mitigations in senescence and cell cycle disturbances were noted in rESWT-treated TNF-α-stimulated osteoblasts in vitro. No significant differences were found between rESWT and treadmill exercise, nor was there any further improvement after combining these 2 treatment methods.CONCLUSIONIn early-stage knee OA, rESWT alleviated SCB abnormalities, reducing osteoblast senescence and stabilizing the cell cycle. rESWT may serve as a supplementary or alternative treatment option, particularly when physical exercise is contraindicated.CLINICAL RELEVANCErESWT alleviated SCB abnormalities and mitigated osteoblast senescence in early-stage OA, making it a potential supplementary treatment approach for some patients with OA.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"11 1","pages":"3635465251355245"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645820","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":"Direct-to-Consumer Marketing: The Ethics of Snake Oil Sales? Letter to the Editor","authors":"Walter I. Sussman, Shane Shapiro, Ariana Demers, Ken Mautner, Don Buford, Kenneth Zaslav","doi":"10.1177/03635465241277447","DOIUrl":"https://doi.org/10.1177/03635465241277447","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"281 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640057","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}