The American Journal of Sports Medicine最新文献

{"title":"Biomechanical Evaluation of Whipstitch Reinforcement in Cadaveric Semitendinosus Grafts","authors":"Neil S. Kumar, Pablo Sanchez-Urgelles, Josué G. Layuno-Matos, Rachel Carlson, Miguel A. Diaz","doi":"10.1177/03635465251370163","DOIUrl":"https://doi.org/10.1177/03635465251370163","url":null,"abstract":"Background: One challenge surgeons face when using certain suture knot techniques is where the forces concentrate along the central axis of the tissue, making the suture knot prone to failure due to suture pull-through and tissue shredding. New reinforcement techniques have been developed (suture tape augmentation) and are becoming popular to minimize tissue damage. Purpose: To assess biomechanical performance of whipstitch reinforcement techniques (locking stitch method or additional suture material) in human cadaveric semitendinosus tendons (STs). Study Design: Controlled laboratory study. Methods: A total of 42 STs were harvested and divided into 6 groups consisting of a standard whipstitch and varying reinforcement techniques based on stitch pattern (whipstitch [WS], whipstitch through tag [WT], locking whipstitch [WL], or locking whipstitch through tag [WLT]), and products from varying manufacturer samples were preconditioned and then loaded from 50 to 200 N at 1 Hz for 500 cycles, followed by load to failure. Elongation, stiffness, ultimate load, and failure mode were compared across groups. Results: No significant differences were observed between whipstitch groups WS <jats:sub>1</jats:sub> and WS <jats:sub>2</jats:sub> . Addition of suture material for reinforcement (WT <jats:sub>2</jats:sub> ) significantly improved biomechanical performance across all metrics compared with WS <jats:sub>2</jats:sub> . Reinforcement using a new locking whipstitch method (WL) resulted in significant increase in ultimate load compared with WS <jats:sub>1</jats:sub> . All reinforcement groups (WL, WT <jats:sub>1</jats:sub> , WT <jats:sub>2</jats:sub> , and WLT) achieved a similar level of biomechanical performance, with no significant differences across any metric. Addition of a second reinforcement (WLT) did not significantly enhance biomechanics beyond those achieved with a single reinforcement (WL). The failure mode for no-reinforcement groups was tissue pull-through, while reinforcement groups utilizing either material or locking method failed from suture breakage. Conclusion: Whipstitch alone offers limited biomechanical security, but reinforcement with either a locking method or additional suture material significantly enhances biomechanical performance. Clinical Relevance: Reinforcement may help limit tissue damage. The locking whipstitch method offers a promising alternative to reinforce a stitch with relatively less suture material.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035158","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 Elbow Ulnar Collateral Ligament Injury Prognosis Score","authors":"Elizabeth R. Dennis, Michael A. Mastroianni, John D. Mueller, Urvi Awasthi, Frank J. Alexander, Hasani W. Swindell, Nicole Skursky, Danica D. Vance, George Popa, Christopher S. Ahmad","doi":"10.1177/03635465251366318","DOIUrl":"https://doi.org/10.1177/03635465251366318","url":null,"abstract":"Background: No model exists to predict which patients with elbow ulnar collateral ligament (UCL) injuries will successfully return to play (RTP) after nonoperative treatment. The reported rates for successful RTP after the nonoperative management of UCL injuries are limited and vary widely. Furthermore, patient and injury characteristics that influence the failure of nonoperative treatment have not been established. Purpose: To identify patient- and injury-specific factors predictive of successful RTP after the nonoperative management of UCL injuries in baseball players. Study Design: Retrospective cohort study; Level of evidence, 3. Methods: A total of 205 patients with a UCL injury were enrolled from 2010 to 2020. Of these patients, 130 underwent nonoperative treatment and were either cleared for RTP (n = 46) or eventually underwent a surgical intervention (n = 84) after a minimum 1-month trial of nonoperative management. The Elbow UCL Injury Prognosis Score is a close approximation of a logistic regression model that was developed by recursively selecting features using a combination of the backward stepwise and best subset methods. The criteria considered for feature selection included <jats:italic>P</jats:italic> values using the Fisher exact test, variable importance from intermediary logistic models, and accuracy and sensitivity of the final model. The final logistic model was tested and validated using 5-fold cross-validation, and the score was validated against the logistic model. Results: The Elbow UCL Injury Prognosis Score provided an individualized prediction of each patient's need for surgery based on age, magnetic resonance imaging findings, and paresthesia of the fifth digit. The final model achieved an average accuracy of 78.7% and a consistently perfect sensitivity and negative predictive value on the test dataset. The area under the curve was 0.86. A simplified score to allow for calculation at the bedside was created by standardizing the weights from the logistic equation of the final model. The lower the score, the more likely that patients would successfully RTP without surgery. Conclusion: The Elbow UCL Injury Prognosis Score was created to predict which patients would succeed with nonoperative management and avoid unnecessary surgery while simultaneously identifying patients for whom nonoperative management would delay the inevitable need for a surgical intervention. Patients with a score ≥8 had a &gt;80% chance of requiring surgery. Overall, the Elbow UCL Injury Prognosis Score is a statistically rigorous and practical tool that can be used at the bedside to help counsel patients on their chances of needing surgery.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002864","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 Meniscal Allograft Transplantation in Collegiate and Professional Athletes.","authors":"Jared P Sachs,Yusuf N Mufti,Jared Rubin,Chloe H Franzia,Sarah A Muth,Katie J McMorrow,Thomes E Moran,Brian J Cole","doi":"10.1177/03635465251366445","DOIUrl":"https://doi.org/10.1177/03635465251366445","url":null,"abstract":"BACKGROUNDThere is limited literature evaluating return to sport (RTS) and clinical outcomes after meniscal allograft transplantation (MAT) in high-level athletes, particularly those at collegiate and professional levels.HYPOTHESISCollegiate and professional athletes undergoing MAT would demonstrate a >50% RTS rate at the preinjury level and report high satisfaction at a minimum 2-year follow-up.STUDY DESIGNRetrospective case series; Level of evidence, 4.METHODSA retrospective review was conducted to evaluate RTS after MAT in collegiate and professional athletes. Athletes who underwent MAT between 2010 and 2023 with a preoperative intent to return to sport were identified and contacted to complete a standardized RTS survey. Patient-reported outcome scores, including those for the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS), were collected at a minimum of 2 years postoperatively. RTS at the preinjury level, patient-reported outcome scores, reoperations, and failure rates were compared between athletes who returned and those who did not. Statistical analysis included the Mann-Whitney U, chi-square, and Fisher exact tests.RESULTSA total of 17 patients (mean age, 23.8 years; 10 male [58.8%]) were included: 13 collegiate athletes and 4 professional athletes. There were 8 athletes (47.1%) who returned to their preinjury level of competition at a mean of 12.4 months. Athletes who returned had significantly higher KOOS Sport (78.8 ± 6.3 vs 52.5 ± 19.3, respectively; P = .027) and KOOS Quality of Life (86.0 ± 9.5 vs 47.7 ± 31.5, respectively; P = .042) subscores than those who did not. While reoperations were common (10/17 [58.8%]), reoperation (50.0% RTS vs 66.7% no RTS; P > .99) and failure (11.8%) rates did not differ between groups. Overall, 75.0% of athletes indicated that they would undergo MAT again. Concomitant bone marrow aspirate concentrate, harvested from the proximal tibia and injected intraoperatively, was more frequently applied in athletes who returned (62.5% vs 11.1%, respectively; P = .0498). The primary reason for not returning was surgeon advice against further participation.CONCLUSIONAmong collegiate and professional athletes with a preoperative intent to return to sport, 47.1% successfully returned to their preinjury level of competition after MAT. The principal reason that an athlete did not return to sport was surgeon advice to discontinue participation. A reoperation in this cohort was common, although the rates of reoperations and clinical failure did not significantly differ between athletes who returned to sport and those who did not. Satisfaction rates after MAT remained high across both groups.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"15 1","pages":"3635465251366445"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960231","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":"Arthroscopic Ligamentum Teres Reconstruction in the Hip: Clinical Outcomes With Minimum 2-Year Follow-up.","authors":"Benjamin G Domb,Elizabeth G Walsh,Matthew J Strok,Ady H Kahana-Rojkind,Roger Quesada-Jimenez","doi":"10.1177/03635465251352826","DOIUrl":"https://doi.org/10.1177/03635465251352826","url":null,"abstract":"BACKGROUNDThe ligamentum teres (LT) plays an important role in the general stability of the hip joint. A high prevalence of concomitant LT pathology has been noted in patients undergoing hip arthroscopy. This increased prevalence has led to the development of multiple treatment options, including reconstruction techniques using different types of grafts. The current literature on outcomes of LT reconstruction is limited.PURPOSETo evaluate the outcomes of LT reconstruction with tibialis anterior allograft treatment for LT tears with a minimum 2-year follow-up.STUDY DESIGNCase series; Level of evidence, 4.METHODSData were retrospectively analyzed for all patients who underwent arthroscopic LT reconstruction with a tibialis anterior allograft between 2014 and 2021. Preoperatively and a minimum of 2 years postoperatively, included patients had completed questionnaires for the following patient-reported outcome (PRO) measures: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), 12-item International Hip Outcome Tool (iHOT-12) score, visual analog scale (VAS) for pain score, and patient satisfaction score; or they had a documented endpoint within the study's time frame. The minimal clinically important difference (MCID) was calculated for the mentioned PROs and included in the analysis. Survivorship was also evaluated and included in the analysis.RESULTSA total of 22 patients were included in the study. Significant improvement was shown in mHHS, NAHS, HOS-SSS, iHOT-12 score, and VAS pain score. A high patient satisfaction score was also observed at the latest follow-up. Furthermore, a high percentage of patients reached the calculated MCID for the mHHS, NAHS, HOS-SSS, and VAS score. Patients demonstrated 95.5% survivorship.CONCLUSIONArthroscopic LT reconstruction with a tibialis anterior allograft, concomitant with labral repairs and osteoplasties for femoroacetabular impingement, has shown favorable outcomes, high patient satisfaction rates, and a high percentage of patients reaching clinically important thresholds, with a low rate of complications and total hip arthroplasty conversion at a minimum 2-year follow-up. Furthermore, the choice of a graft rests in the hands of the surgeon based on training, familiarity, circumstances, and resources, as the optimal graft option has yet to be elucidated.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"36 1","pages":"3635465251352826"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960237","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":"Comparison of Postoperative Complications by Surgical Technique After Acute Midsubstance Achilles Tendon Repair.","authors":"Benjamin J Averkamp,Andrew B Rees,Tyler Kalbac,Christopher D Murawski,James Lendrum,Justin Rennard,Kayla Heitpas,Todd A Irwin,Carroll P Jones,John K Ellington,Scott Shawen,Samuel E Ford","doi":"10.1177/03635465251365520","DOIUrl":"https://doi.org/10.1177/03635465251365520","url":null,"abstract":"BACKGROUNDMidsubtance Achilles tendon ruptures remain the most common tendon injury within the lower extremity. While the incidence continues to rise, changing immobilization protocols, surgical techniques, and surgeon preferences have evolved over the past few decades.PURPOSETo compare the overall complication rate among 3 major surgical techniques (open, percutaneous, and suture anchor) across a large, heterogeneous orthopaedic group in a major metropolitan area.STUDY DESIGNCase series; Level of evidence, 4.METHODSAchilles tendon repairs (Current Procedural Terminology code 27650) performed from January 2018 through December 2022 with a minimum 2-month follow-up were identified and retrospectively reviewed. Patients were excluded if they had chronic tears that required reconstruction, underwent a revision repair/reconstruction, or were initially treated nonoperatively. A total of 1035 acute midsubstance Achilles tendon ruptures met inclusion criteria. The primary outcome measure was total complication rate, which consisted of major complications (reoperation, deep infection, tendon rerupture, and loss of Achilles tension requiring reoperation) and minor complications (sural neuritis, superficial infection, delayed wound healing, heel pain, painful repair site, and loss of Achilles tension not requiring reoperation). Total, major, and minor complication rates by surgical technique were recorded. Standard demographic data were noted. Descriptive statistics and multivariate regression were utilized.RESULTSThe overall complication rate was 15.7%, with 3% (n = 31) having major complications. Patients were significantly more likely to encounter any complication (26.3% complication rate with suture anchor, 14.3% with percutaneous, and 14.4% with open) (P = .004) or minor complication (P = .0304) with suture anchor fixation (20.2% rate) compared with the percutaneous (10.8%) or open (12.3%) technique. Patients with suture anchor fixation were more likely to experience clinically significant heel pain (10.5%; P < .001). There was no difference between incidence of sural neuritis with open (1.4%), percutaneous (3.2%), and suture anchor fixation (0.9%) (P = .104).CONCLUSIONAcute Achilles tendon repair is associated with a major complication rate of 3% requiring reoperation. Patients undergoing suture anchor fixation of Achilles tendon injuries experience all complications and minor complications at a significantly higher rate than those undergoing percutaneous or open procedures.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"14 1","pages":"3635465251365520"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960232","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":"Medial Meniscal Extrusion Increased on 6-Month Magnetic Resonance Imaging, Despite Successful Posterior Root Repair With or Without a Centralization Suture: A Randomized Controlled Clinical Trial.","authors":"Luke V Tollefson,Abdul Wahed Kajabi,Eisa Hedayati,Karsten Knutsen,Takashi Takahashi,Jutta Ellermann,Robert F LaPrade","doi":"10.1177/03635465251366443","DOIUrl":"https://doi.org/10.1177/03635465251366443","url":null,"abstract":"BACKGROUNDMeniscal extrusion has been reported to be present in >50% of knees after medial meniscus root repair. Meniscal extrusion has also been reported to be a risk factor for the progression of osteoarthritis and poorer patient-reported outcomes by impairing the ability of the meniscus to absorb hoop stress.PURPOSETo determine whether the addition of a centralization suture to 2-tunnel transtibial root repair reduces postoperative medial meniscal extrusion in patients with type 2 posterior medial meniscus root (PMMR) tears.STUDY DESIGNRandomized controlled trial; Level of evidence, 2.METHODSThis randomized controlled trial was performed between April 2021 and November 2024 for patients with an isolated type 2 PMMR tear. Patients undergoing PMMR repair were randomly selected to undergo transtibial repair with (treatment group) or without (control group) a centralization suture. A power analysis determined that 24 patients were necessary for the study. Magnetic resonance imaging (MRI) was performed preoperatively and at 6 months postoperatively using a high-resolution 7-T scanner. Medial meniscal extrusion was measured on coronal T2-weighted images using 2 vertical lines at the peripheral margins of the medial tibial plateau and the outermost edge of the meniscal body. Statistical analysis was performed using t tests, and significance was set at P < .05.RESULTSA total of 26 patients (21 female, 5 male) were examined; 14 patients were in the centralization group (treatment group, mean age, 50.3 years), and 12 patients were in the control group (no centralization, mean age, 56.1 years). All PMMR repair constructs were found to be intact on MRI postoperatively. Preoperatively, meniscal extrusion averaged 3.81 ± 1.16 mm for the centralization group and 3.31 ± 0.93 mm for the control group (P = .244). Postoperatively, meniscal extrusion averaged 4.61 ± 1.52 mm for the centralization group and 5.02 ± 1.33 mm for the control group (P = .483). In the centralization group, extrusion increased by a mean of 0.81 ± 0.72 mm (21.4% ± 17.7% increase) compared to preoperatively, while the control group experienced a mean increase of 1.71 ± 1.33 mm (59.8% ± 52.6% increase). The increase in extrusion of the centralization group was significantly smaller compared to that of the control group for both the absolute change (in mm; P = .026) and percentage change (P = .016). Postoperative extrusion increased in 25 of 26 (96.2%) patients.CONCLUSIONDespite surgically successful PMMR repair in all patients, medial meniscal extrusion was increased in 96.2% of patients at 6 months postoperatively compared to preoperatively. The addition of a centralization suture in transtibial root repair compared to isolated transtibial root repair resulted in a significantly less increase in postoperative extrusion at 6 months on MRI.REGISTRATIONNCT05088525 (ClinicalTrials.gov).","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"19 1","pages":"3635465251366443"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960238","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":"Osteochondral Allograft Transplant for Capitellar Osteochondritis Dissecans: Excellent Patient-Reported Outcome Scores and High Return to Sport at Minimum 2-Year Follow-up.","authors":"Crystal A Perkins,Michael T Busch,Anthony C Egger,Katie Liu,Erin Yuder,Jason Kim,Shivangi Choudhary,S Clifton Willimon","doi":"10.1177/03635465251366903","DOIUrl":"https://doi.org/10.1177/03635465251366903","url":null,"abstract":"BACKGROUNDUnstable osteochondritis dissecans of the capitellum (OCD-C) is most commonly treated with debridement and marrow stimulation. This treatment has historically been associated with suboptimal return to high-demand upper extremity sports and persistent elbow pain. Fresh osteochondral allograft transplant (OCAlloT) is an alternative treatment that restores subchondral bone and articular cartilage without the donor site morbidity that is associated with autograft harvest.PURPOSETo evaluate the outcomes of OCAlloT in pediatric patients with unstable OCD-C ≥10 mm in diameter.STUDY DESIGNCase series; Level of evidence, 4.METHODSA single-center prospective study was performed of pediatric patients younger than 19 years who had unstable OCD-C ≥10 mm in diameter treated with primary fresh OCAlloT using precut osteochondral allograft cores. Postoperative magnetic resonance imaging (MRI) was obtained to assess graft incorporation. Patient-reported outcome (PRO) scores were obtained preoperatively and then annually after surgery. Minimum follow-up duration was 2 years.RESULTSThe study included 28 elbows in 26 patients, mean age 13.5 years (range, 11.3-17.1 years). The most common primary sports were gymnastics and baseball. OCD location was far-lateral in 6 elbows (21%). Mean OCD size was 11 mm in width, 12 mm in length, and 7 mm in depth. Twenty-four elbows (86%) were treated with a single allograft plug. Median OCAlloT size was 11.8 mm in diameter. Mean follow-up duration was 40 months. No infections or graft failures occurred. Two elbows (7%) had a secondary surgery for arthrofibrosis and posterolateral synovial impingement. Postoperative MRI scans were obtained in 19 elbows (68%) and demonstrated a high degree of graft incorporation. All patients had preoperative, 1-year, and 2-year PRO scores, and the 1- and 2-year PRO scores showed significant improvements compared with preoperative PRO scores. A total of 23 elbows (82%) had returned to sports at 1 year, and 27 (96%) had returned to sports at 2 years.CONCLUSIONOCAlloT for treatment of OCD-C was associated with low rates of complications, excellent graft incorporation, high elbow function, patient satisfaction, and overall high rates of return to sports at 2 years.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"133 1","pages":"3635465251366903"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960212","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":"Correcting Excessive Glenoid Retroversion in Combination With Posterior Glenoid Bone Grafting Leads to Improved Glenohumeral Contact Pressures in a Cadaveric Posterior Instability Model.","authors":"Lukas Ernstbrunner,Alexander Paszicsnyek,Maximilian Vetter,Manuel Waltenspül,Paul Borbas,Fraser W Francis-Pester,Gregory A Hoy,David C Ackland,Samy Bouaicha,Karl Wieser","doi":"10.1177/03635465251365497","DOIUrl":"https://doi.org/10.1177/03635465251365497","url":null,"abstract":"BACKGROUNDThe extent to which excessive glenoid retroversion leads to increased glenohumeral contact pressures and whether these increases can be mitigated surgically is unknown.PURPOSETo evaluate the effect of excessive glenoid retroversion and posterior iliac crest bone grafting (ICBG) with or without glenoid osteotomy on glenohumeral contact patterns.STUDY DESIGNControlled laboratory study.METHODSSix fresh-frozen shoulders had a posterior open-wedge glenoid osteotomy allowing glenoid retroversion to be set at 0°, 10°, and 20°. Four conditions were simulated consecutively on the same specimen at each retroversion angle: intact glenohumeral joint, posterior Bankart lesion, 20% posterior glenoid deficiency, and posterior ICBG (at 20° of retroversion; corrected to 10° and 0° of retroversion). The contact pattern for each specimen was evaluated in the jerk position (60° of glenohumeral anteflexion, 60° of internal rotation) by measuring mean and peak contact pressures (megapascals), peak contact pressure distance (millimeters), and mean contact area (square millimeters).RESULTSIn the intact condition, retroversion of 20° resulted in a significant decrease in contact area but did not significantly affect contact pressure. Creating a posterior Bankart lesion and/or posterior glenoid deficiency showed a significant increase in mean and peak contact pressure at all 3 retroversion angles (P < .05). Correcting glenoid retroversion to 0° in combination with ICBG resulted in comparable contact area and mean and peak contact pressure of the intact condition (P > .05). At 10° and 20° of glenoid retroversion, ICBG resulted in significantly higher peak and mean contact pressure (mean not significantly different at 10°) and significantly lower contact area as compared with the intact condition (P < .05).CONCLUSIONGlenohumeral contact patterns highly depend on the amount of glenoid retroversion and posterior labral and/or bony glenoid integrity. Only the combination of ICBG and glenoid osteotomy to correct glenoid retroversion to 0° resulted in glenohumeral contact patterns comparable to the native condition with 0° of retroversion.CLINICAL RELEVANCEThe combined effect of posterior glenoid bone grafting and correcting excessive glenoid retroversion (20°) may correct abnormal glenohumeral contact patterns.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"19 1","pages":"3635465251365497"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960233","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":"Deeper Dive Into Methodology: Power Analysis","authors":"James L. Carey","doi":"10.1177/03635465251366312","DOIUrl":"https://doi.org/10.1177/03635465251366312","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923917","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":"Change-of-Direction Assessment in Healthy Adolescent Athletes: Task-Specific Biomechanical Responses Reveal the Optimal Cognitive Dual Task Condition","authors":"Sophia Ulman, Alex M. Loewen, Ashley L. Erdman, Ava N. Davis, Philip L. Wilson, Henry B. Ellis","doi":"10.1177/03635465251360242","DOIUrl":"https://doi.org/10.1177/03635465251360242","url":null,"abstract":"Background: Injury risk assessments for evaluating competition readiness could be improved by incorporating dual task testing, including decision-making and/or divided attention components, to more closely mirror a competition-like environment. Purpose/Hypothesis: The purpose was to identify the most disruptive (or biomechanically demanding) cognitive load to add to a series of change-of-direction tasks. It was hypothesized that a visual motor response component (unanticipated change in direction) would elicit the greatest biomechanical risk factors across tasks and that changes would be consistent between limbs. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 42 healthy adolescents (aged 14-18 years) were tested in a motion capture laboratory, performing the lateral shuffle, run plant, and run cut tasks with and without dual task conditions including verbal memory (Verbal), visual memory (Visual), and visual motor response (Motor) components. Then, 2-way repeated-measures analysis of variance was performed for each movement task to examine the effects of condition and dominance, as well as a potential interaction effect between condition and dominance, on kinematic and kinetic measures. Results: The Motor condition was found to alter mechanics during the shuffle task, specifically eliciting greater dynamic knee valgus, while the Visual condition had the greatest influence on the run cut task, resulting in a stiffer loading strategy. The run plant task was the least influenced by adding a cognitive load, but a slightly stiffer loading strategy was observed under the Verbal condition. Conclusion: It was concluded that the cognitive load employed for dual task testing was dependent on the movement task being evaluated. The cognitive load type chosen for dual task testing is important and should ideally involve rapid visual processing.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923922","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}