The American Journal of Sports Medicine最新文献

{"title":"Compressive Graft Fit Promotes Tendon-to-Bone Integration After Anterior Cruciate Ligament Reconstruction","authors":"Keitaro Fujino, Sinaia Keith, Timur B. Kamalitdinov, Rashad Madi, Xi Jiang, Miltiadis H. Zgonis, Liane M. Miller, Andrew F. Kuntz, Nathaniel A. Dyment","doi":"10.1177/03635465251343011","DOIUrl":"https://doi.org/10.1177/03635465251343011","url":null,"abstract":"Background: Tendon graft integration with adjacent bone in the tunnels after anterior cruciate ligament reconstruction (ACLR) is critical to reach presurgical functional levels and achieve long-term surgical success. Unfortunately, tunnel integration does not always occur, resulting in complications attributed to cyst formation and tunnel widening, necessitating revision surgery. Previous studies have indicated that mechanical factors, including fit of the graft in the tunnel, can influence healing, but the extent to which graft fit facilitates tendon-to-bone integration is unclear. Purpose/Hypothesis: The purpose of this study was to investigate the effect of graft fit in the tunnel on zonal tendon-to-bone integration in a murine ACLR model. It was hypothesized that a tight-fitting graft would promote integration and reduce cyst formation. Study Design: Controlled laboratory study. Methods: ACLR surgery was performed in a compressive-fit group of mice using 27G needles (0.413-mm outer diameter) and 1 mm–diameter tendon autografts. The fit of the graft in the tunnels was modified to a loose fit in additional groups by either increasing the size of the tunnel (25G needle, 0.515-mm outer diameter) or decreasing the size of the graft (0.5 mm). The initial fit of the graft in the tunnel was assessed during surgery using a dynamometer. The extent of tunnel integration via mineralized fibrocartilage formation and cyst formation was measured at 28 days after surgery using multiplexed mineralized cryohistology. Results: As expected, the compressive-fit group resulted in a higher friction force required to pull the graft through the tunnel during surgery, and tunnels drilled with a 25G needle were wider than 27G tunnels at 28 days after surgery. The compressive fit in the tunnels improved tunnel integration, as assessed by mineralized fibrocartilage formation normalized to tunnel dimensions. Conversely, loose-fit tunnels resulted in higher overall cyst formation when normalized to tunnel dimensions. In particular, wider tunnels correlated with higher cyst formation. Conclusion: Tendon-to-bone integration was improved by creating a compressive fit of the soft tissue tendon graft in the tunnel while minimizing cyst formation as compared with loose-fit grafts. Therefore, the fit of the graft in the bone tunnel is an important consideration for enhancing zonal tendon-to-bone integration. Clinical Relevance: This study demonstrates that a compressive fit of a soft tissue tendon graft to the bone tunnel during ACLR resulted in improved zonal tendon-to-bone integration, providing evidence that sizing grafts toward a compressive fit could improve clinical outcomes.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341052","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":"Influence of Neighborhood Disparities on Traumatic Shoulder Instability Severity and Timing of Care in Adolescents.","authors":"Dang-Huy Do,John E Arvesen,James J McGinley,Amareesa K Robinson,Eliza E Lovrich,Henry B Ellis,Philip L Wilson","doi":"10.1177/03635465251346901","DOIUrl":"https://doi.org/10.1177/03635465251346901","url":null,"abstract":"BACKGROUNDIdentifying and understanding socioeconomic disparities among adolescents with traumatic shoulder instability can help to optimize care for patients by improving differences in the disease burden, disease severity, and awareness of resource limitations. Current studies evaluating disparities among patients with shoulder instability are limited to the adult population or surgical patients.PURPOSETo evaluate how educational, health/environmental, and social/economic disparities influence the timing of shoulder instability treatment and shoulder instability severity among adolescents.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA retrospective review of patients aged 10 to 19 years diagnosed with shoulder instability from January 2022 to April 2024 at a single institution was conducted. The Child Opportunity Index (COI) was used to evaluate inequalities in educational, health/environmental, and social/economic opportunities. Disease severity was determined using magnetic resonance imaging (MRI), including glenoid bone loss, Hill-Sachs interval size, distance to dislocation, and presence of an off-track lesion. Continuous variables were analyzed with the Mann-Whitney U test or the Spearman correlation coefficient, while categorical variables were analyzed using the chi-square test. Significance was set at P < .05.RESULTSThere were 181 patients who met the inclusion criteria. Patients with a lower overall COI had a longer time from injury to initial presentation (r = -0.15; P = .048), injury to orthopaedic evaluation (r = -0.17; P = .027), and injury to MRI (r = -0.16; P = .033) but not from injury to surgery. A history of recurrent dislocations was associated with a lower overall COI (B = -3.27; P = .041), lower educational COI (B = -3.01; P = .009), and lower social/economic COI (B = -3.65; P = .049). Patients with a distance to dislocation <10 mm were associated with a lower overall COI (B = -7.59; P = .003), lower educational COI (B = -8.38; P = .045), lower health/environmental COI (B = -7.88; P = .006), and lower social/economic COI (B = -8.22; P = .001).CONCLUSIONChildren living in neighborhoods with fewer educational and social/economic opportunities were associated with longer times from injury to orthopaedic evaluation and from injury to MRI for shoulder instability and were at a higher risk for recurrent shoulder dislocations.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"51 1","pages":"3635465251346901"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370132","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":"Corrigendum to \"Osteochondritis Dissecans of the Knee Associated With Mechanical Overload\".","authors":"","doi":"10.1177/03635465251352757","DOIUrl":"https://doi.org/10.1177/03635465251352757","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"3 1","pages":"3635465251352757"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295743","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":"Clinically Relevant Thresholds in Patient-Reported Outcomes: Do Patients’ Expectations Evolve Over Long-term Follow-up?","authors":"Elizabeth G. Walsh, Tyler R. McCarroll, Benjamin D. Kuhns, Ady H. Kahana-Rojkind, Roger Quesada-Jimenez, Benjamin G. Domb","doi":"10.1177/03635465251345823","DOIUrl":"https://doi.org/10.1177/03635465251345823","url":null,"abstract":"Background: Clinically relevant thresholds have been utilized to provide insight into postoperative functional status and patient satisfaction. Purpose: To define and evaluate the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) thresholds over the 2-, 5-, and 10-year timepoints for the modified Harris Hip Score (mHHS), Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and International Hip Outcome Tool (iHOT12). Study Design: Case series; Level of evidence, 4. Methods: Data were retrospectively reviewed for patients who underwent primary hip arthroscopy from 2008 to 2021. The inclusion criteria comprised complete patient-reported outcome scores with anchor questions at the 2-, 5-, or 10-year timepoints. Groups were propensity score–matched 1 to 1 to 1 for these 3 timepoints to limit confounding variables. The PASS, SCB, and MCID thresholds were defined using the anchor-based method for the mHHS, HOS-SSS, and iHOT12. Results: A total of 414 hips were included in the study. Area under the curve for all defined thresholds indicated acceptable to excellent discrimination. The thresholds for achieving the PASS, defined at the 2-, 5-, and 10-year respectively, were as follows: mHHS: 77.5, 85.5, and 78.5; HOS-SSS: 82.7, 76.4, and 67.7; and iHOT12: 67.4, 76.9, and 62.9. The percentage of patients achieving the PASS increased from 2 to 10 years, with the highest percentage at 10 years. The threshold for achieving the SCB was defined as follows: mHHS: 95, 99, and 88; HOS-SSS: 97, 80.9, and 90.5; and iHOT12: 89.4, 94.1, and 82.5. The percentage of patients achieving the SCB increased from 2 to 10 years. The mean changes required to achieve the MCID were defined as follows: mHHS: 7, 7.1, and 7.4; HOS-SSS: 10.6, 10.7, and 11.2; and iHOT12: (9.6, 9.7, -). The MCID and the percentage of patients achieving the MCID remained constant over 2 to 10 years. Conclusion: Patients met the MCID, PASS, and SCB thresholds at high rates over 10 years. Based on the PASS and SCB thresholds, patient expectations for function evolved. Lower expectations at long-term follow-ups may result in a higher percentage of patients meeting certain thresholds, as evidenced in the mHHS, HOS-SSS, and iHOT12 in this cohort. Understanding the evolution of patient expectations may help interpret clinically relevant thresholds in future studies.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290047","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":"Defining Clinically Important Outcomes for the Modified Harris Hip Score and Nonarthritic Hip Scope for Hip Arthroscopy to Treat Femoroacetabular Impingement at a Minimum 10-Year Follow-up","authors":"Emily Berzolla, Larry Chen, Griffith G. Gosnell, Nathaniel Mercer, Julian Seidenberg, Daniel J. Kaplan, Thomas Youm","doi":"10.1177/03635465251344594","DOIUrl":"https://doi.org/10.1177/03635465251344594","url":null,"abstract":"Background: The minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) are valuable clinical thresholds used to provide clinical relevance to patient outcome scores. In hip arthroscopy (HA) for femoroacetabular impingement (FAI) syndrome, these values have been defined for the short- and midterm postoperative period, but meaningful long-term thresholds have not been established. Purpose: To define the MCID, PASS, and SCB for the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) at a minimum follow-up of 10 years for patients who underwent HA for FAI syndrome. Study Design: Case series; Level of evidence, 4. Methods: A retrospective cohort study including all patients who underwent primary HA for FAI with a single surgeon from February 2010 to December 2013 was performed. Patient outcomes were assessed with an anchor question, mHHS, and NAHS at baseline and at 1, 5, and 10 years of follow-up. MCID was calculated using the distribution-based method at all time points, using 0.5 standard deviations as the threshold. The anchor-based MCID, PASS, and SCB were calculated at 10 years using thresholds representing the optimal cutoff on a receiver operating characteristic curve. Correlations between baseline characteristics and achievement of the MCID, PASS, and SCB were assessed with binomial logistic regressions. Results: The 154 patients included in the study had a mean age of 38.8 ± 13.0 years, a mean body mass index of 24.6 ± 3.9 kg/m <jats:sup>2</jats:sup> , and 63.6% were female. The distribution-based MCID values for 1-year, 5-year, and 10-year scores were 7.8, 8.3, and 9.5 for mHHS and 9.5, 10.4, and 10.2 for NAHS, respectively. The anchor-based MCID was 20.3 for mHHS and 24.4 for NAHS. The PASS was 81.9 for mHHS and 83.1 for NAHS. The SCB values were 34.0 and 41.9 for mHHS and NAHS, respectively. Increased body mass index was associated with decreased achievement of SCB for mHHS ( <jats:italic>P</jats:italic> = .03) and NAHS ( <jats:italic>P</jats:italic> = .04), as well as NAHS PASS ( <jats:italic>P</jats:italic> = .01) and anchor-based MCID ( <jats:italic>P</jats:italic> = .01). Conclusion: The establishment of the MCID, SCB, and PASS for the NAHS and mHHS provides a valuable clinical context for improvements in outcome scores after HA. Anchor-based calculations were consistently higher than distribution-based calculations.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290046","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":"Contribution of Labrum and Cartilage to Joint Surface in Different Hip Deformities: An Automatic Deep Learning–Based 3-Dimensional Magnetic Resonance Imaging Analysis","authors":"Malin K. Meier, Jose A. Roshardt, Adrian C. Ruckli, Nicolas Gerber, Till D. Lerch, Bernd Jung, Moritz Tannast, Florian Schmaranzer, Simon D. Steppacher","doi":"10.1177/03635465251339758","DOIUrl":"https://doi.org/10.1177/03635465251339758","url":null,"abstract":"Background: Multiple 2-dimensional magnetic resonance imaging (MRI) studies have indicated that the size of the labrum adjusts in response to altered joint loading. In patients with hip dysplasia, it tends to increase as a compensatory mechanism for inadequate acetabular coverage. Purpose: To determine the differences in labral contribution to the joint surface among different hip deformities as well as which radiographic parameters influence labral contribution to the joint surface using a deep learning–based approach for automatic 3-dimensional (3D) segmentation of MRI. Study Design: Cross-sectional study; Level of evidence, 4. Methods: This retrospective study was approved by the local ethics committee with waiver for informed consent. A total of 98 patients (100 hips) with symptomatic hip deformities undergoing direct hip magnetic resonance arthrography (3 T) between January 2020 and October 2021 were consecutively selected (mean age, 30 ± 9 years; 64% female). The standard imaging protocol included proton density–weighted turbo spin echo images and an axial-oblique 3D T1-weighted MP2RAGE sequence. According to acetabular morphology, hips were divided into subgroups: dysplasia (lateral center-edge [LCE] angle, &lt;23°), normal coverage (LCE, 23°-33°), overcoverage (LCE, 33°-39°), severe overcoverage (LCE, &gt;39°), and retroversion (retroversion index &gt;10% and all 3 retroversion signs positive). A previously validated deep learning approach for automatic segmentation and software for calculation of the joint surface were used. The labral contribution to the joint surface was defined as follows: labrum surface area/(labrum surface area + cartilage surface area). One-way analysis of variance with Tukey correction for multiple comparison and linear regression analysis was performed. Results: The mean labral contribution of the joint surface of dysplastic hips was 26% ± 5% (95% CI, 24%-28%) and higher compared with all other hip deformities ( <jats:italic>P</jats:italic> value range, .001-.036). Linear regression analysis identified LCE angle (β = −.002; <jats:italic>P</jats:italic> &lt; .001) and femoral torsion (β = .001; <jats:italic>P</jats:italic> = .008) as independent predictors for labral contribution to the joint surface with a goodness-of-fit <jats:italic>R</jats:italic> <jats:sup>2</jats:sup> value of 0.35. Conclusion: The labral contribution to the joint surface differs among hip deformities and is influenced by lateral acetabular coverage and femoral torsion. This study paves the way for a more in-depth understanding of the underlying pathomechanism and a reliable 3D analysis of the hip joint that can be indicative for surgical decision-making in patients with hip deformities.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237336","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":"Short-term Outcomes of Hip Arthroscopy for the Treatment of Femoroacetabular Impingement and Labral Tears in Underweight Patients","authors":"Roger Quesada-Jimenez, Jessica C. Keane, Ady H. Kahana-Rojkind, Yasemin E. Kingham, Matthew J. Strok, Benjamin G. Domb","doi":"10.1177/03635465251343299","DOIUrl":"https://doi.org/10.1177/03635465251343299","url":null,"abstract":"Background: Being underweight or malnourished has been recognized as an adverse prognostic factor in various surgical orthopaedic interventions. Purpose: (1) To report minimum 2-year outcomes of underweight patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and labral tears and (2) to compare these results with a propensity-matched control group of patients with normal weight. Study Design: Case series; Level of evidence, 4. Methods: Data were retrospectively analyzed for patients with a body mass index (BMI) ≤18.5 kg/m <jats:sup>2</jats:sup> who underwent primary hip arthroscopy by the senior surgeon at a single institution as treatment for FAI and labral tears between August 2008 and January 2022. Included patients had complete pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) score for pain at minimum 2-year follow-up. Clinically important thresholds for hip arthroscopy, revision surgery, and conversion to total hip arthroplasty were included in the analysis. Patients were propensity matched to a control group of normal weight patients (BMI, 18.6-24.99 kg/m <jats:sup>2</jats:sup> ) in a 1:2 ratio based on sex, age at surgery, acetabular Outerbridge grade, labral treatment, and capsular treatment. Results: A total of 234 patients were included in the study. Underweight patients displayed significant improvements across all PROs and high patient satisfaction. When underweight patients were compared with a benchmark control group, similar magnitudes of improvement were observed at a minimum 2-year follow-up for modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool-12, and VAS. Furthermore, the study cohort had a lower magnitude of improvement for the Hip Outcome Score–Sports-Specific Subscale (HOS-SSS) ( <jats:italic>P</jats:italic> &lt; .05). The study group reached Patient Acceptable Symptom State for HOS-SSS at lower rates. Underweight patients had a higher frequency of revision hip arthroscopy with a relative risk of 2.16 ( <jats:italic>P</jats:italic> &lt; .05). Conclusion: Hip arthroscopy for the treatment of FAI and labral tear in underweight patients yielded significant short-term improvements in PROs, which, except for postoperative VAS pain score and change in HOS-SSS, were comparable with a benchmark matched control group of normal weight patients. However, underweight patients had a 2.16-fold increased relative risk for revision hip arthroscopy. Underweight patients may benefit from preoperative nutritional evaluation.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237337","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":"Neurocognitive Challenges During Drop Vertical Jumps Increase Sensitivity to Differentiate Atypical Landing Mechanics and Jump Height in Individuals With Anterior Cruciate Ligament Reconstruction","authors":"Andrew Strong, Jonas L. Markström","doi":"10.1177/03635465251346145","DOIUrl":"https://doi.org/10.1177/03635465251346145","url":null,"abstract":"Background: Athletes with anterior cruciate ligament reconstruction (ACLR) have high rates of secondary injury. Insufficient return-to-sport screening may be due to standard functional tests not resembling chaotic sporting environments where injuries occur. Neurocognitive deficits among individuals with ACLR indicate that cognitive challenges during screening tests may better reveal atypical movement mechanics. Hypothesis: Adding secondary cognitive tasks to drop vertical jumps (DVJs) would increase between-group differences in landing mechanics and jump height compared with the standard DVJ. Study Design: Controlled laboratory study. Methods: Forty sports-active individuals 24.9 ± 16.1 months after unilateral ACLR and 40 uninjured controls (both groups 50% female) performed DVJs; downward- or upward-pointing arrows indicated whether to drop only or complete the vertical jump. Conditions were (1) black arrow presented before drop and (2) black or red arrow presented during drop (red arrow pointing in opposite direction of requested motor action) together with a memory task involving letter recalling. Jump height and biomechanical time-series data from an 8-camera motion capture system and 2 force plates during the first 100 ms of landing were compared between groups using conventional and functional <jats:italic>t</jats:italic> tests, respectively. Results: For the standard DVJ, the ACLR group had significantly less hip power and more hip abduction moment for the injured leg and uninjured leg, respectively, compared with controls. For the DVJ with secondary cognitive tasks, the ACLR group again showed significantly less hip power and more hip abduction moment but also less knee power, knee flexion moment, ankle power, and ankle dorsiflexion moment and lower jump height than controls. Conclusion: The addition of secondary cognitive tasks during DVJs elicited further significant differences in landing mechanics and jump performance among athletes with ACLR compared with uninjured athletes than were found for the standard DVJ. The aberrant biomechanical outcomes for the ACLR group indicate an incomplete rehabilitation. Clinical Relevance: The greater between-group differences in landing mechanics and jump height when adding secondary cognitive tasks to a DVJ indicate a need to provide neurocognitive challenges in rehabilitation and return-to-sport screening as a first step toward improved rehabilitation outcomes and more ecologically valid testing.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236932","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":"The Utilization of Patient-Reported Outcome Measures in Assessing the Treatment of Osteochondral Lesions of the Ankle Versus the Knee","authors":"Darius Luke Lameire, Caroline Cristofaro, Jong Min Lee, Kathrine Bhargava, Shgufta Docter, David Wasserstein, Sam Si-Hyeong Park","doi":"10.1177/03635465251333088","DOIUrl":"https://doi.org/10.1177/03635465251333088","url":null,"abstract":"Background: When assessing the outcomes of ankle and knee osteochondral lesions (OCLs), there are numerous patient-reported outcome measures (PROMs) that are used; however, not all are validated. Purpose: To compare the utilization of PROMs in assessing the treatment of ankle OCLs versus knee OCLs. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of Embase, MEDLINE, and CINAHL was conducted to identify all observational or experimental studies from January 1, 2014 to December 31, 2023 that used PROMs to assess the treatment of ankle or knee OCLs. The frequency of the use of specific validated PROMs between the ankle OCL and knee OCL literature was compared using an independent <jats:italic>t</jats:italic> -test. Correlation coefficients were calculated to assess differences based on journal impact factor (divided into quartiles), publication year, or level of evidence. Results: A total of 233 eligible ankle OCL studies and 211 knee OCL studies were identified. Validated clinical outcome measures were used in 41.2% of ankle OCL studies compared with 87.7% of knee OCL studies ( <jats:italic>P</jats:italic> &lt; .001). There were a total of 44 outcome measures used in ankle OCL studies, with the majority of studies (67.8%) utilizing the AOFAS (American Orthopaedic Foot and Ankle Society) score. There were no correlations between the use of validated outcome measures in the ankle OCL studies and journal impact factor ( <jats:italic>P</jats:italic> = .78), publication year ( <jats:italic>P</jats:italic> = .16), or level of evidence ( <jats:italic>P</jats:italic> = .45). Similarly, there were no correlations for the knee OCL studies based on journal impact factor ( <jats:italic>P</jats:italic> = .60), publication year ( <jats:italic>P</jats:italic> = .25), or level of evidence ( <jats:italic>P</jats:italic> = .55). Conclusion: Validated clinical outcome measures were more frequently utilized in knee OCL studies compared with ankle OCL studies. The low frequency of validated outcome measures used within the ankle literature may limit how well treatment effectiveness in the management of ankle OCLs is evaluated.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236933","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":"Biomechanical Analysis of Posterior Segmental Medial Meniscal Transplantation in a Human Cadaveric Model","authors":"Mark E. Cinque, Wyatt H. Buchalter, Justin F.M. Hollenbeck, Jonathan D. Haskel, Bradley M. Kruckeberg, Matthew T. Provencher, Jonathan A. Godin","doi":"10.1177/03635465251339068","DOIUrl":"https://doi.org/10.1177/03635465251339068","url":null,"abstract":"Background: Partial meniscectomy provides short-term symptom relief but may accelerate the development of knee arthritis due to meniscal deficiency and altered joint biomechanics. While meniscal allograft transplantation (MAT) addresses complete meniscal loss, segmental meniscal transplantation may be an option for segmental loss. Purpose: To evaluate the biomechanical effect of segmental posterior medial meniscal transplantation on knee joint loading characteristics and compare it with the states of both intact meniscus and full MAT. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen human cadaveric knees (mean age, 54.3 years) were tested under 4 conditions: intact meniscus, segmental medial meniscal loss, segmental posterior horn MAT, and full MAT. The knees were subjected to a 500-N compressive load at 0°, 30°, 60°, and 90° of knee flexion. Medial meniscal extrusion, contact area, mean contact pressure, and peak contact pressure were measured. Statistical analyses included 2-way repeated measures analysis of variance to assess the effects of meniscal state and knee flexion on biomechanical outcomes. Results: Segmental medial meniscal deficiency significantly increased extrusion (+1.32 mm at 0°; +1.45 mm at 30°; +1.42 mm at 60°; and +1.67 mm at 90°) and mean pressure compared with the intact meniscus across all flexion angles. Both segmental transplantation and full transplantation restored extrusion to intact levels, with full transplantation demonstrating superior improvement in peak pressure at flexion angles &gt;60° compared with segmental transplantation. Both segmental and full transplantation restored peak pressure to levels comparable with the intact meniscus at flexion angles ≥30°. Conclusion: Both segmental and full meniscal transplantation tested at the time of surgery restored meniscal extrusion and contact pressure to the intact state. Clinical Relevance: Segmental transplantation may offer a promising approach for managing posterior medial meniscal deficiencies by restoring knee joint function and reducing meniscal extrusion.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228484","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}