The American Journal of Sports Medicine最新文献

{"title":"Elbow Flexion Excursion: Intra- and Inter-Throwing Arm Kinetic Evaluations in High School and Professional Baseball Pitchers.","authors":"Joseph E Manzi,Brittany Dowling,Jennifer Estrada,Suleiman Y Sudah,Jay Moran,Kathryn D McElheny,Brandon J Erickson,Joseph Ruzbarsky,Michael C Ciccotti,Michael G Ciccotti,Joshua S Dines","doi":"10.1177/03635465251338080","DOIUrl":"https://doi.org/10.1177/03635465251338080","url":null,"abstract":"BACKGROUNDElbow flexion at stagnant time points of the pitch has been associated with increased elbow varus torque (EVT) and elbow injury history.PURPOSETo determine how elbow flexion angle throughout the pitch (excursion) between individual pitchers and a cohort of pitchers influences throwing arm kinetics in high school (HS) and professional (PRO) pitchers.STUDY DESIGNDescriptive laboratory study.METHODSHS (n = 59) and PRO (n = 288) pitchers were instructed to throw 8 to 12 fastball pitches evaluated with 3-dimensional motion capture system (480 Hz). Linear regression models were developed to examine the association between elbow flexion excursion with ball velocity and throwing arm kinetics. An intrapitcher analysis utilizing a linear mixed model was also used, introducing pitchers as a random effect.RESULTSThe mean elbow flexion excursion was significantly greater for HS (70° ± 22°) compared with PRO (63° ± 21°) pitchers (P < .001), while the mean normalized EVT was significantly less for HS pitchers (3.9% ± 0.7% vs 4.8% ± 0.8% body weight [BW] × body height; P < .001). For every 1 SD increase in elbow excursion, ball velocity increased by 0.8 to 1.0 m/s (approximately 2 mph) for intra- and interanalyses (P max = 0.006; β = 0.31-0.39) for HS pitchers, while it increased by only 0.2 to 0.4 m/s (<1 mph) for PRO pitchers (P max = 0.016; β = 0.10-0.17). EVT increased by 0.34 to 0.40 SD for every 1 SD increase in elbow excursion for intra- and interanalyses for HS pitchers and by 0.13 to 0.22 SD for PRO pitchers. Elbow medial force increased by 1.9% to 2.3% BW for every 1 SD increase in elbow excursion for intra- and interanalyses of HS pitchers (β = 0.35-0.44) and by 1.4% to 1.7% BW increase for PRO pitchers (β = 0.23-0.27).CONCLUSIONPRO pitchers have decreased elbow flexion excursion compared with HS pitchers. This may be an advantageous mechanism by which to minimize throwing arm kinetics, including EVT and elbow medial force, supported by both intra- and interpitcher analyses. Ball velocity benefits with increased elbow excursion were marginal for both cohorts.CLINICAL RELEVANCEIn support of previous literature suggesting that increased elbow flexion at later portions of the pitch is associated with increased EVT and injury history, this study further substantiates that this may be deleterious kinematics to baseball pitchers.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"18 1","pages":"3635465251338080"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945096","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 Prognosis of Athletes With Patellar Tendinopathy Receiving Physical Therapy: Patient-Reported Outcomes at 5-Year Follow-up.","authors":"Jie Deng,Jelle J Oosterhof,Denise Eygendaal,Stephan J Breda,Edwin H G Oei,Robert-Jan de Vos","doi":"10.1177/03635465251336466","DOIUrl":"https://doi.org/10.1177/03635465251336466","url":null,"abstract":"BACKGROUNDPatellar tendinopathy (PT) is a highly prevalent injury among jumping athletes. The long-term prognosis of athletes with PT following physical therapy is unknown.PURPOSETo assess self-perceived recovery rate and the 5-year change in pain levels, disability, and sports participation, and to explore the prognostic factors associated with self-perceived recovery.STUDY DESIGNCohort study; Level of evidence, 3.METHODSAthletes with PT who were previously enrolled in a randomized trial and received education, load management advice, and exercise therapy instructions at baseline were eligible. An online questionnaire was sent 5 years after inclusion. Self-perceived recovery was assessed by a dichotomized 7-point global rating of change (recovery was defined as \"significantly improved\" to \"completely recovered\"). Pain levels during sports (0-10 points) and disability assessed by the Victorian Institute of Sport Assessment-Patellar (VISA-P) score were recorded at baseline and 5 years. Sports participation was categorized into return to performance, return to sport, return to participation, and quitting sports. Nonparametric tests were performed to compare scores at baseline and 5 years. Logistic regression models were used to identify prognostic factors.RESULTSOf 76 eligible participants, 58 (76%) responded (mean age, 30 years [SD, 4 years]; 28% female). At a mean follow-up of 5 years, 76% of participants felt recovered. Pain levels during sports (median, 7 points [IQR, 7-8 points] to 2 points [IQR, 1-4 points]) and VISA-P score (median, 57 [IQR, 45-66] to 82 [IQR, 74-97] points) significantly improved from baseline to 5 years (all P < .001). In total, 41 participants (71%) returned to their desired sports (68% to performance and 32% below preinjury level), 12 participants (21%) returned to participation in other sports, and 5 (9%) completely ceased sports participation. Participants who felt unrecovered had higher levels of pain and disability and lower return to performance (all P < .05). No prognostic factors were identified that were associated with self-perceived recovery.CONCLUSIONAthletes with PT after physical therapy can expect a generally acceptable long-term prognosis. However, almost one-quarter did not feel recovered and perceived worse patient-reported outcomes. Clinicians treating athletes with PT may use these findings to estimate the average prognosis.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"57 1","pages":"3635465251336466"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945097","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 THA-10 Score for Predicting Conversion to Total Hip Arthroplasty After Contemporary Hip Arthroscopy for Femoroacetabular Impingement Syndrome at a Minimum 10-Year Follow-up","authors":"Ron Gilat, Michael J. Vogel, Alexander B. Alvero, Kyleen Jan, Omair Kazi, Richard M. Danilkowicz, Shane J. Nho","doi":"10.1177/03635465251336380","DOIUrl":"https://doi.org/10.1177/03635465251336380","url":null,"abstract":"Background: Previous studies have identified predictors of total hip arthroplasty (THA) conversion after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) at short- to midterm follow-up, yet no studies to the authors’ knowledge have established a scoring system for predicting THA conversion at a minimum 10-year follow-up. Purpose: To create a scoring system to predict 10-year THA conversion after contemporary HA for FAIS. Study Design: Case-control study; Level of evidence, 3. Methods: Data were prospectively collected from patients undergoing primary contemporary HA for FAIS, including labral repair, osteoplasty of FAIS deformity, and capsular repair, between January 2012 and October 2013, with a minimum 10-year follow-up. Patients who underwent THA conversion were compared with patients who achieved 10-year THA-free survivorship. Significant predictors of THA conversion were identified, and predictor weights were assigned to create the THA-10 score. The score was applied to the cohort, and its clinical utility was evaluated. The threshold score with the greatest sensitivity and specificity for predicting 10-year THA conversion was identified. Results: In total, 280 patients were included; 21 (7.5%) underwent THA conversion by the 10-year follow-up. Patients who underwent THA conversion were of older age (45.4 ± 11.3 vs 33.2 ± 12.1 years; <jats:italic>P</jats:italic> &lt; .001), had a greater body mass index (28.0 ± 5.2 vs 24.8 ± 4.7 kg/m <jats:sup>2</jats:sup> ; <jats:italic>P</jats:italic> = .011), and had a greater prevalence of Tönnis grade 1 osteoarthritis (42.9% vs 14.3%; <jats:italic>P</jats:italic> = .003) and high-grade acetabular (61.9% vs 12.7%; <jats:italic>P</jats:italic> &lt; .001) and femoral head (33.3% vs 7.3%; <jats:italic>P</jats:italic> &lt; .001) chondral defects compared with THA-free survivors. After variable weighting, the THA-10 score was established as 1 point for body mass index ≥25 kg/m <jats:sup>2</jats:sup> , 1 point for Tönnis grade 1, 2 points for age ≥47 years, and 3 points for high-grade defects of the acetabulum or femoral head. The THA-10 score was found to have clinically significant diagnostic value with an area under the receiver operating characteristic curve of 0.823. Patients scoring ≥4 points were 13.2 times more likely to undergo THA conversion (95% CI, 5.0-35.1; <jats:italic>P</jats:italic> &lt; .001). Conclusion: This study created the THA-10 score and showed it to have clinically significant diagnostic utility in predicting 10-year THA conversion after HA for FAIS. Patients scoring ≥4 points were 13.2 times more likely to undergo THA conversion.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939709","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":"Sex-Based Differences in Clinically Significant Outcome Achievement Following Primary Osteochondral Allograft Transplantation of the Knee at a Minimum 5-Year Follow-up.","authors":"Allen A Yazdi,Alexander C Weissman,Kyle R Wagner,Sarah A Muth,Jared M Rubin,Ron Gilat,Stephanie A Boden,Adam B Yanke,Brian J Cole","doi":"10.1177/03635465251338219","DOIUrl":"https://doi.org/10.1177/03635465251338219","url":null,"abstract":"BACKGROUNDPrimary osteochondral allograft transplantation (OCA) of the knee has been shown to improve patient-reported outcome measure (PROM) scores at various follow-up time points. However, studies analyzing the effects of patient sex on primary OCA outcomes remain limited and show conflicting results.PURPOSETo compare PROM scores and clinically significant outcome (CSO) achievement rates at a minimum 5-year follow-up between male and female patients who underwent primary OCA of the knee.STUDY DESIGNCohort study; Level of evidence, 3.METHODSA prospectively collected database was queried for patients who underwent primary OCA, regardless of the presence of concomitant procedures, between January 2003 and January 2018. Inclusion criteria consisted of (1) primary OCA, (2) a minimum 5-year follow-up, and (3) age &gt;18 years at the time of OCA. Patient characteristics, intraoperative variables, PROM scores, reoperations, and failures were compared. Rates of achieving the CSOs of the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) were compared at 5-year follow-up for the International Knee Documentation Committee (IKDC) score, Lysholm score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Regression analyses were performed to determine the factors associated with achieving the MCID, PASS, or SCB.RESULTSA total of 235 patients (119 female, 116 male) with a mean age of 31.0 ± 9.5 years, a mean follow-up of 6.5 years, and a mean body mass index of 26.7 ± 4.2 kg/m2 were included in this study. Male patients had a higher body mass index (28.0 ± 4.3 vs 25.5 ± 3.8 kg/m2, respectively; P &lt; .001), larger medial femoral condyle defects (20.2 ± 4.5 vs 17.7 ± 3.5 mm, respectively; P &lt; .001), and larger lateral femoral condyle defects (20.3 ± 4.0 vs 18.1 ± 3.1 mm, respectively; P = .002) and were more likely to undergo concomitant osteotomy (24.1% vs 13.4%, respectively; P = .036), particularly concomitant high tibial osteotomy (14.7% vs 3.4%, respectively; P = .002), compared with female patients. At baseline, male patients had higher IKDC (41.8 ± 15.1 vs 33.3 ± 15.2, respectively; P = .003) and KOOS Sport (35.2 ± 24.1 vs 25.1 ± 22.0, respectively; P = .032) scores compared with female patients. At a minimum 5-year follow-up, female patients demonstrated higher Lysholm (79.6 ± 15.9 vs 73.8 ± 15.6, respectively; P = .026) and KOOS Pain (82.6 ± 16.9 vs 79.1 ± 13.7, respectively; P = .049) scores and achieved the MCID for the KOOS Sport (75.7% vs 46.7%, respectively; P = .015), the PASS for the KOOS Quality of Life (89.6% vs 67.3%, respectively; P = .003), and the SCB for the KOOS Sport (64.9% vs 23.3%, respectively; P &lt; .001) at higher proportions than male patients. On multivariate regression analysis, male sex was associated with decreased odds of achieving the MCID (odds ratio, 0.234 [95% CI, 0.086-0.636]; P = .004) and SCB (odds ratio, 0.433 [95% CI, 0.205-0.917]; P = .","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"32 1","pages":"3635465251338219"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945091","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 Chondrocyte Viability Is Affected During Harvest by Irrigation Temperature and Reamer Speed.","authors":"Andrew R Phillips,Erik C Haneberg,Thomas E Moran,Ron Gilat,Kofi K Acheampong,Vince Morgan,Adam B Yanke","doi":"10.1177/03635465251336363","DOIUrl":"https://doi.org/10.1177/03635465251336363","url":null,"abstract":"BACKGROUNDPrevious literature shows that current osteochondral allograft (OCA) harvesting techniques lead to donor plug chondrocyte death during OCA transplant for treating focal knee cartilage defects.PURPOSETo evaluate the effects of drilling/reaming speed and irrigation temperature on chondrocyte viability during OCA harvest.STUDY DESIGNControlled laboratory study.METHODSFrom each human femoral condyle (n = 9) used in the study, cartilage plugs were harvested using a powered reamer with 15 mm-diameter coring bit and continuous saline irrigation. Four experimental groups were formed according to the following parameters that were used to randomly harvest the plugs: (1) drill speed setting with room temperature (RT) saline; (2) ream speed setting with RT saline; (3) drill speed setting with cold saline; (4) ream speed setting with cold saline. A control cartilage sample was harvested with a scalpel from a macroscopically healthy region near the intercondylar notch in each specimen. Chondrocyte viability, determined by calcein and ethidium live/dead stain, was compared between groups and controls across the whole, central third, and peripheral thirds of cartilage samples.RESULTSWhole drill RT (P = .001) and whole ream RT (P = .004) viabilities were significantly decreased in experimental samples compared with controls. Viability at the center and periphery of drill RT plugs (P = .001 and P < .001, respectively) and ream RT plugs (P = .001 and P = .002, respectively) were also decreased. Conversely, viability was not significantly different between controls and either whole drill cold (P = .17), center drill cold (P = .24), periphery drill cold (P = .20), whole ream cold (P = .15), center ream cold (P = .24), or periphery ream cold (P = .07) samples. Viability was decreased in whole drill RT compared with whole ream RT (P = .015), but there was no difference between whole drill cold and whole ream cold (P = .26).CONCLUSIONContinuous irrigation with 5°C saline rather than RT saline during OCA harvest maintained donor graft chondrocyte viability in vitro. With RT irrigation, faster reamer speed induced more chondrocyte death than slower reamer speed, although this difference was mitigated with 5°C saline irrigation.CLINICAL RELEVANCEIrrigation with 5°C saline during donor plug OCA harvest may mitigate thermally induced chondrocyte damage and improve graft incorporation, healing, and outcomes of OCA transplant.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"111 1","pages":"3635465251336363"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932907","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":"Days 7 to 14 May Represent an Optimal Window for Stem Cell–Based Treatment in a Rat Model of Anterior Cruciate Ligament Transection–Induced Posttraumatic Osteoarthritis","authors":"Zhidong Zhao, Peng Geng, Mingyang An, Yanpeng Zhao, Zheng Guo, Huayi Gao, Heng Zhu, Zhongli Li, Min Wei, Chunbao Li","doi":"10.1177/03635465251326499","DOIUrl":"https://doi.org/10.1177/03635465251326499","url":null,"abstract":"Background: The concept of early intervention at the appropriate time has been recognized for treating posttraumatic osteoarthritis (PTOA). However, the optimal intervention timing to achieve superior therapeutic efficacy remains unclear. In addition, there is a lack of direct evidence regarding therapeutic efficacies achieved at different time points. Hypothesis: The administration schedule of stem/stromal cells can significantly influence their ability to improve function and slow progression of PTOA. There may exist an appropriate time window for achieving superior therapeutic efficacy. Study Design: Controlled laboratory study. Methods: A total of 72 Sprague Dawley rats were included in this study. Anterior cruciate ligament transection (ACLT) was performed to induce PTOA. Animals in the control group underwent ACLT alone, whereas those in the sham group underwent knee articular capsulotomy alone. Bone marrow mesenchymal stem/stromal cells or phosphate-buffered saline (PBS) was intra-articularly administered on days 3, 7, 14, and 28 after ACLT (n = 6). Bioluminescence imaging was used to detect the retention of stem cells administered at different time points (n = 3). At the end of the experiment (8 weeks), gait analysis was conducted using CatWalk to compare the recovery of knee function between the 2 groups. Micro–computed tomography (CT) was performed to assess general appearance and quantify the microstructure of subchondral bone. Histological staining was used to evaluate the whole-joint pathology. Semiquantitative evaluations were conducted using Osteoarthritis Research Society International and Mankin scores. Results: PBS administration at different time points had no therapeutic effects on lower limb function or PTOA progression. Gait analysis suggested that stem cell administration significantly improved the general function of knee joints compared with the control group at all time points. However, the duty cycle was significantly higher on days 7 and 14 after ACLT. Micro-CT and histopathological staining of the knee samples suggested that although stem cell administration significantly ameliorated the progression of PTOA, the therapeutic efficacy was significantly better on days 7 and 14. After stem cell administration, the articular surface was considerably smoother with few scattered osteophytes, the deposition of cartilage extracellular matrix was more abundant, subchondral bone remodeling was significantly alleviated, and the synovium was less hyperplastic with reduced inflammatory cell infiltration. The general retention time of stem cells did not differ significantly at different administration time points. Conclusion: This study suggests that the intervention schedule is significantly correlated with the therapeutic efficacy of stem cells for PTOA, with the best effects observed on days 7 and 14 after ACLT. Clinical Relevance: Days 7 to 14 after trauma may be the appropriate intervention timing for clinical prevention and tr","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920122","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":"Postoperative Pain and Opioid Usage With Combined Adductor Canal and IPACK Block Versus Isolated Adductor Canal Block After Anterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Autograft: A Single-Center Randomized Controlled Trial.","authors":"Naina Rao,Jairo Triana,Amanda Avila,Kirk A Campbell,Michael J Alaia,Laith M Jazrawi,David Furiguele,Jovan Popovic,Eric J Strauss","doi":"10.1177/03635465251328609","DOIUrl":"https://doi.org/10.1177/03635465251328609","url":null,"abstract":"BACKGROUNDEfforts to decrease pain, improve early rehabilitation, and reduce opioid consumption have prompted a focus on peripheral nerve blocks for pain management after anterior cruciate ligament reconstruction (ACLR). The commonly used adductor canal block (ACB) might not provide sufficient postoperative pain control because of its lack of coverage of the posterior aspect of the knee. The addition of the IPACK (interspace between the popliteal artery and the capsule of the posterior knee) block, which targets this area, to the standard ACB could potentially provide better pain control after ACLR over the current standard of care.PURPOSE/HYPOTHESISThe purpose of this study was to compare and analyze postoperative pain, satisfaction, and opioid demand between the standard ACB and a combination of an ACB and IPACK block in patients undergoing ACLR with a bone-patellar tendon-bone (BTB) autograft. It was hypothesized was that the addition of the IPACK block would substantially improve early postoperative pain control and minimize opioid use.STUDY DESIGNRandomized controlled trial; Level of evidence, 2.METHODSA total of 102 patients undergoing ACLR with a BTB autograft at a single institution were recruited. Patients were randomly assigned to receive either the ACB alone or the ACB plus IPACK block. Patients were contacted at 24 hours (postoperative day [POD] 1), 48 hours (POD 2), 72 hours (POD 3), and 1 week to assess postoperative pain scores, opioid consumption, and satisfaction with their postoperative pain control. Intergroup comparative analysis was performed using a t test or nonparametric test for continuous variables and the chi-square test for categorical variables. Opioid usage was reported as morphine milligram equivalents (MME).RESULTSThe final analysis included 96 patients, with 47 in the control group (ACB) who received only the ACB and 49 in the experimental group (IPACK) who received the ACB and an additional IPACK block. The cohort was composed of 60.4% male patients with a mean age of 28.40 ± 7.51 years (range, 18-55 years) and a mean body mass index of 25.67 ± 4.84 kg/m2. There were no statistically significant differences between the groups with respect to age, body mass index, or sex (P &gt; .05). Patients in the IPACK group reported significantly lower opioid usage than those in the ACB group on POD 1 (mean, 6.1 [interquartile range (IQR), 4.5-7.7] vs 10.7 [IQR, 8.6-13.0] MME, respectively; P &lt; .001), POD 2 (mean, 7.3 [IQR, 5.2-9.5] vs 12.5 [IQR, 10.0-15.0] MME, respectively; P = .001), and POD 3 (mean, 4.2 [IQR, 2.8-5.5] vs 9.4 [IQR, 7.1-12.0] MME, respectively; P &lt; .001). The visual analog scale for pain score on POD 1 (mean, 67.7 [IQR, 62.0-73.0] vs 55.2 [IQR, 48.0-63.0], respectively; P = .024) and POD 3 (mean, 54.9 [IQR, 48.0-63.0] vs 44.4 [IQR, 37.0-51.0], respectively; P = .037) was statistically higher in the ACB group compared with the IPACK group. On POD 1, patient satisfaction was higher in the IPACK group than in the","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"13 1","pages":"1359-1367"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897445","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":"Orthopaedic Travel","authors":"Daniel C. Wascher","doi":"10.1177/03635465251332900","DOIUrl":"https://doi.org/10.1177/03635465251332900","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898245","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":"Identifying Independent Predictors of Achieving Clinically Significant Outcomes After Contemporary Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome at a Minimum 10-Year Follow-up.","authors":"Ron Gilat,Michael J Vogel,Omair Kazi,Richard M Danilkowicz,Shane J Nho","doi":"10.1177/03635465251336181","DOIUrl":"https://doi.org/10.1177/03635465251336181","url":null,"abstract":"BACKGROUNDPatients undergoing hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) have been shown to achieve clinically significant outcomes (CSOs) at high rates. However, limited studies, to date, have identified independent predictors of achieving CSOs at a minimum 10-year follow-up, and even fewer studies have reported on patients treated with contemporary hip arthroscopic techniques, including chondrolabral preservation, surgical correction of FAIS morphology, and capsular repair.PURPOSETo identify independent predictors of achieving minimum 10-year CSOs after contemporary hip arthroscopic surgery for FAIS with chondrolabral preservation, surgical correction of FAIS morphology, and capsular repair.STUDY DESIGNCase series; Level of evidence, 4.METHODSPatients undergoing primary contemporary hip arthroscopic surgery for FAIS between January 2012 and November 2013 with a minimum 10-year follow-up were identified. Patient-reported outcomes (PROs) collected included scores for the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, International Hip Outcome Tool-12, modified Harris Hip Score, and visual analog scale for pain. Cohort-specific thresholds for the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) were determined, and achievement rates were recorded. Patients achieving and not achieving each CSO for any PRO measure were compared. Stepwise multivariate logistic regression was used to identify independent predictors of achieving the MCID, PASS, and SCB for any PRO measure, with the odds ratio (OR) recorded.RESULTSA total of 294 patients with a minimum 10-year follow-up were included in this study. The mean age was 33.8 ± 12.3 years, and the mean body mass index was 25.0 ± 4.8 kg/m2. Most patients were female (60.2%). The reoperation-free survivorship rate was 85.0%. Achievement rates for the MCID, PASS, and SCB were 91.4%, 77.6%, and 71.6%, respectively. Independent predictors of achieving CSOs were age (OR, 0.97-0.98; P ≤ .039), sport participation (OR, 1.84-2.18; P ≤ .042), psychiatric history (OR, 0.46-0.47; P ≤ .041), and high-grade chondral defects (OR, 0.25-0.39; P ≤ .019).CONCLUSIONIndependent predictors of achieving 10-year CSOs after contemporary hip arthroscopic surgery with chondrolabral preservation, surgical correction of FAIS morphology, and capsular repair were younger age, the presence of sport participation, the absence of a psychiatric history, and the absence of chondral defects.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"20 1","pages":"3635465251336181"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893288","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":"Fresh Meniscal Allograft Transplantation Is Associated With Superior Functional Outcomes for Acetabular Labral Reconstruction in a Preclinical Canine Model.","authors":"Brent A Prenger,John R Baumann,James L Cook,Chantelle C Bozynski,Cristi R Cook,Aaron M Stoker,Keiichi Kuroki,Brett D Crist,Steven F DeFroda","doi":"10.1177/03635465251334132","DOIUrl":"https://doi.org/10.1177/03635465251334132","url":null,"abstract":"BACKGROUNDIrreparable acetabular labral defects often require acetabular labral reconstruction (ALR) to restore hip joint health and function. Optimal graft choices for ALR have not been fully delineated.HYPOTHESISFresh meniscal allograft transplantation (MAT) will be associated with cellular, extracellular matrix, geometric, and integration characteristics that mimic native acetabular labrum, which results in superior functional, diagnostic imaging, gross, and histologic outcomes as compared with fresh-frozen tendon allograft transplantation (TAT) for ALR.STUDY DESIGNControlled laboratory study.METHODSWith Institutional Animal Care and Use Committee approvals, canine fresh-frozen tendon allografts and fresh meniscal allografts were recovered. Acetabular labral resection was performed in 1 hip of research hounds (n = 12). Based on random assignment, TAT (n = 4) or MAT (n = 4) ALR was performed or the resected labrums were left untreated (resected, n = 4). Contralateral hips served as healthy controls (n = 12). Preoperatively and at 1, 3, and 6 months postoperatively, dogs were assessed for pain, function, and hip range of motion. Six-month endpoint magnetic resonance imaging (MRI), gross, and histologic assessments were performed. Cohorts were compared for statistically significant differences (P < .05).RESULTSThe resected cohort was associated with significantly worse hip pain (P = .028) and function (P = .036) when compared with controls and the MAT cohort at 3 and 6 months. Only the MAT cohort was superior to the resected cohort and not significantly different from controls for pain (P = .044) and function (P = .031) at all time points. MAT was judged to have superior MRI (P = .039) and histologic characteristics of joint health and labral graft integrity, integration, and healing (P < .0005) as compared with the TAT and resected cohorts, whereas TAT was superior to the resected cohort. No treatment was judged to fully restore MRI or histologic characteristics of controls.CONCLUSIONThis preclinical study suggests that ALR using allografts should be considered over labral resection for treatment of irreparable acetabular labral deficiency. When allograft-based ALR was performed, fresh MAT was associated with functional measures that were superior to fresh-frozen TAT and were attributed to cellular, extracellular matrix, geometric, and material property differences between the tissues.CLINICAL RELEVANCEThese preclinical data suggest that this canine model can help delineate mechanisms underlying acetabular labral pathology and related treatment options for clinically relevant translational application to patients.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"1 1","pages":"3635465251334132"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893205","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}