The American Journal of Sports Medicine最新文献

{"title":"Morphological Improvement of the Epiphyseal Plate and Trochlea After Surgical Correction in Skeletally Immature Patients With Patellar Dislocation and Trochlear Dysplasia","authors":"Kuo Hao, Zhongwei Li, Juncai Wang, Zhenhui Huo, Yingzhen Niu, Fei Wang","doi":"10.1177/03635465241301775","DOIUrl":"https://doi.org/10.1177/03635465241301775","url":null,"abstract":"Background:Studies have revealed abnormalities of the epiphyseal plate of the distal femur in patients with trochlear dysplasia, but it is unclear whether the epiphyseal plate could be remodeled after surgical correction of patellar dislocation.Purpose:To investigate whether the morphology of the epiphyseal plate and trochlea could be improved after medial patellar retinaculum plasty in skeletally immature patients and to investigate the correlations between the morphology of the epiphyseal plate and trochlear dysplasia as well as clinical outcomes.Study Design:Cohort study; Level of evidence, 3.Methods:Eligible skeletally immature patients were retrospectively enrolled: 48 with patellar dislocation who received medial patellar retinaculum plasty in the surgical group, 41 with patellar dislocation who received nonoperative treatment in the nonsurgical group, and 96 without patellofemoral joint disorders in the control group. Three-dimensional modeling techniques using computed tomography scans of the distal femur were utilized to display the epiphyseal plate and trochlea. The epiphyseal plate was evaluated using surface area, volume, and trochlea-epiphysis distance. The trochlea was evaluated using surface area, volume, Dejour classification, trochlear groove depth, lateral condylar height, medial condylar height, sulcus angle, and lateral trochlear inclination. Radiological and clinical evaluations were performed.Results:When compared with the control group at baseline, the surgical group had a smaller surface area and volume of the medial epiphyseal plate ( P < .001; P < .001, respectively), a shorter medial and lateral trochlea-epiphysis distance ( P < .001; P < .001), and a larger surface area and volume of the lateral epiphyseal plate ( P = .001; P = .007). At final follow-up, the surgical group demonstrated numerous significant increases—in surface area and volume of the medial epiphyseal plate ( P < .001; P < .001), medial and lateral trochlea-epiphysis distance ( P < .001; P < .001), surface area and volume of the proximal trochlear groove ( P < .001; P < .001), trochlear groove depth ( P < .001), lateral condylar height ( P < .001), medial condylar height ( P < .001), lateral trochlear inclination ( P < .001), and proportion of normal + type A trochlea—whereas its sulcus angle ( P < .001) was significantly decreased. The morphological parameters of the epiphyseal plate and trochlea in the nonsurgical group were not significantly improved, except for lateral condylar height ( P < .001) and medial condylar height ( P < .001). The surgical group had better radiological outcomes than the nonsurgical group, including tibial tuberosity–trochlear groove distance, patellar tilt angle, patellar congruence angle, lateral patellar angle, and lateral patellar translation, as well as better clinical outcomes. The surface area and volume of the medial epiphyseal plate and medial and the lateral trochl","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912063","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 Clinical and Structural Outcomes of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears: 10-Year Follow-up","authors":"Teruhisa Mihata, Thay Q. Lee, Akihiko Hasegawa, Kunimoto Fukunishi, Yukitaka Fujisawa, Mutsumi Ohue","doi":"10.1177/03635465241298898","DOIUrl":"https://doi.org/10.1177/03635465241298898","url":null,"abstract":"Background:Short-term follow-up studies have reported favorable clinical outcomes after arthroscopic superior capsule reconstruction (SCR) for irreparable rotator cuff tears.Purpose:To assess whether these positive outcomes are maintained long-term and whether cuff tear arthropathy worsens over time after fascia lata autograft SCR.Study Design:Case series; Level of evidence, 4.Methods:This study analyzed data collected prospectively from 34 consecutive patients (36 affected shoulders) with irreparable rotator cuff tears who underwent arthroscopic SCR using fascia lata autograft between 2007 and 2011. Active shoulder range of motion and American Shoulder and Elbow Surgeons, Japanese Orthopaedic Association, and visual analog scale for pain scores were evaluated before SCR and at 1, 5, and 10 years after surgery; rates of return to participation in sports and physically demanding work were determined as well. In addition, radiography and magnetic resonance imaging data were collected before surgery and at 3 and 6 months and 1, 2, 3, 4, 5, and 10 years afterward. Acromiohumeral distance and Hamada grade were evaluated using radiography. We defined Hamada grades 3 and 4b as acetabularization and grades 4a and 4b as glenohumeral osteoarthritis. Graft survival rate and thickness were assessed using T2-weighted magnetic resonance imaging.Results:When compared with preoperative values, American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores and active range of motion (elevation and external rotation) were increased significantly at 1 year after SCR ( P < .001) and maintained throughout follow-up. At 10 years after SCR, 88% (15 of 17) of workers with physically demanding jobs and 90% (9 of 10) of sports players still participated in these activities. Graft survival rate was 94% (34 of 36 shoulders) at 1 year after SCR, 92% (33 of 36) at 2 to 4 years, and 89% (32 of 36) at 5 to 10 years. In healed grafts, graft thickness was maintained for at least 10 years after SCR (mean ± SD, 7.8 ± 2.0 mm at 3 months after SCR and 7.8 ± 1.6 mm at 10 years). The incidence of acetabularization (affected shoulder, 9%; unaffected shoulder, 6%) and glenohumeral osteoarthritis (affected shoulder, 28%; unaffected shoulder, 16%) during the 10 years after SCR did not significantly differ between affected and unaffected shoulders. The complication rate was 2.8% (1 of 36 patients, anchor pullout).Conclusion:For irreparable rotator cuff tears, arthroscopic SCR using fascia lata autograft restored shoulder function and relieved shoulder pain, with high rates of return to recreational sports and physically demanding work, and it maintained significant improvements in clinical and structural outcomes for at least 10 years after surgery. In addition, graft healing completely prevented any progression of cuff tear arthropathy. Arthroscopic SCR using fascia lata autograft is an effective surgical option for irreparable rotator cuff tears and retains positive o","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912113","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":"Posterolateral Knee Ligament Reconstruction Using the Arciero Technique Provides Greater Rotational Stability Than the Modified Larson Technique: A Biomechanical Study","authors":"Christian Coppola, Maximilian Sigloch, Romed Hoermann, Michael Schlumberger, Philipp Schuster, Werner Schmoelz, Raul Mayr","doi":"10.1177/03635465241294072","DOIUrl":"https://doi.org/10.1177/03635465241294072","url":null,"abstract":"Background:It is still unknown if the double–femoral tunnel technique (Arciero [ARC]) provides better stability as compared with the single–femoral tunnel technique (modified Larson [LAR]) in posterolateral corner reconstruction. The ideal angle of fixation of the popliteofibular strand in ARC is also unknown.Hypotheses:The ARC provides greater external rotation (ER) stability than the LAR (hypothesis 1); there is no difference in varus rotation (VR) stability between LAR and ARC (hypothesis 2); and femoral fixation of the popliteofibular strand at 60° during the ARC leads to greater ER stability than fixation at 30° or 90° of knee flexion (hypothesis 3).Study Design:Controlled laboratory study.Methods:Eight fresh-frozen human knees were tested in a knee test bench in 4 states: native, posterolateral deficiency, LAR, and ARC. With the ARC, the popliteofibular strand was fixed at 30°, 60°, and 90° (ARC30, ARC60, ARC90). The order of testing (LAR/ARC) was randomized. A tibial ER and VR torque of 5 N·m was applied at 0°, 30°, 60°, and 90°. Rotation degrees were captured using an ultrasound-based analysis system. Wilcoxon signed rank tests were used to assess statistical significance between paired groups in different states.Results:The ARC and LAR significantly improved VR and ER stability at all flexion angles in comparison with posterolateral deficiency ( P < .05). At 60° and 90°, ARC30 showed significantly greater ER stability in comparison with the LAR (mean ± SD; ARC30 vs LAR at 60°, 21.2°± 5.1° vs 15.4°± 5.6° [ P < .05]; ARC30 vs LAR at 90°, 23.7°± 5.6° vs 16.8°± 6.3° [ P < .05]). At 90°, the LAR showed significantly greater VR instability in comparison with the native state (3.5°± 1.5° vs 2.5°± 1.0°; P = .012), and ARC30 was not significantly different from the native state with respect to VR (2.9°± 1.5° vs 2.5°± 1.0°; P = .327). No significant differences in ER and VR were found among ARC30, ARC60, and ARC90 at any flexion angle ( P≥ .05).Conclusion:The ARC technique provided greater tibial ER stability in comparison with the LAR at higher flexion angles (hypothesis 1 accepted). There were no differences between LAR and ARC in restoring VR stability, except at 90° (hypothesis 2 partly accepted). Different femoral flexion angles for fixation of the popliteofibular strand during the ARC did not show any significant differences in relation to knee stability (hypothesis 3 rejected).Clinical Relevance:Posterolateral corner reconstruction using the ARC technique provides greater ER stability at higher flexion angles than the modified LAR technique.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912104","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":"Knee Biomechanics During Cutting Maneuvers and Secondary ACL Injury Risk: Letter to the Editor","authors":"Timothy Hewett, Chad D. Lavender","doi":"10.1177/03635465241294197","DOIUrl":"https://doi.org/10.1177/03635465241294197","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912068","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":"Patient-Reported Outcomes of Bicruciate Multiligament Versus Single Cruciate Multiligament Knee Injuries","authors":"Ingrid Trøan, Tone Bere, Inger Holm, Robert F. LaPrade, Lars Engebretsen, Gilbert Moatshe","doi":"10.1177/03635465241293743","DOIUrl":"https://doi.org/10.1177/03635465241293743","url":null,"abstract":"Background:Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes.Purpose:To investigate patient-reported outcomes after surgical treatment of MLKI comparing single cruciate MLKI with bicruciate MLKI. The secondary aim was to investigate the influence of different factors on patient-reported outcomes after surgery.Study Design:Cohort study; Level of evidence, 3.Methods:This study was designed as a cross-sectional cohort study. Patients who underwent surgical treatment for MLKI at a single level 1 trauma center between January 2013 and December 2020 were included in this study. Patient-reported outcomes included the Tegner score, Lysholm score, International Knee Documentation Committee (IKDC) subjective knee form, Knee injury and Osteoarthritis Outcome Survey (KOOS), and a visual analog scale for pain.Results:Of the 191 patients meeting the inclusion criteria, 124 (65%) agreed to participate and had a complete data set with a follow-up time at a mean 74 ± 27 months. Patients with single cruciate MLKI (type I) had significantly higher scores for IKDC ( P = .007), Lysholm ( P = .012), KOOS Pain ( P = .04), KOOS Activities of Daily Living ( P = .01), KOOS Sport and Recreation ( P = .005), KOOS Quality of Life ( P = .04), KOOS<jats:sub>4</jats:sub> (which considers the subscales of Pain, Symptoms, Sport and Recreation, and Quality of Life) ( P = .01), Tegner ( P = .04), and visual analog scale for pain during activity ( P = .004) when compared with patients with bicruciate MLKI (type II-type IV). Furthermore, age was significantly associated with a lower IKDC ( P = .001), and an increased severity of injury was significantly associated with IKDC ( P = .015), KOOS<jats:sub>4</jats:sub> ( P = .022), and Lysholm ( P = .029) scores.Conclusion:MLKIs involving a single cruciate ligament had significantly higher patient-reported postoperative outcome measures compared with bicruciate MLKIs. Age and type of injury were important predictors for outcomes. Patients presenting with dislocated knees had lower patient-reported outcomes; however, there was no significant difference in outcomes between bicruciate MLKIs and patients presenting with dislocated knees.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912105","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":"Ezetimibe/Atorvastatin, a Treatment for Hyperlipidemia, Inhibits Supraspinatus Fatty Infiltration and Improves Bone-Tendon Interface Healing in a Rotator Cuff Tear Rat Model","authors":"Jong Pil Yoon, Sung-Jin Park, Dong-Hyun Kim, Yoon Seong Choi, Hyun Joo Lee, Eugene Jae Jin Park, Chul-Hyun Cho, Seok Won Chung","doi":"10.1177/03635465241299408","DOIUrl":"https://doi.org/10.1177/03635465241299408","url":null,"abstract":"Background:Multiple factors, such as muscle fatty infiltration (FI), tendon collagen content, and collagen arrangement, determine bone-tendon interface (BTI) healing after rotator cuff (RC) repair.Purpose:To evaluate the effects of systemic administration of ezetimibe-atorvastatin (EZE/ATZ) combination on muscle FI and tendon collagen density and arrangement in an RC repair rat model.Study design:Controlled laboratory study.Methods:A total of 26 male Sprague-Dawley rats were randomly divided equally into control and EZE/ATZ groups and subjected to RC tendon repair surgery. Postoperatively, the EZE/ATZ group rats received a combination of EZE (10 mg/kg/d) and ATZ (20 mg/kg/d) for 4 weeks, after which they were sacrificed. Oil Red O staining was used to assess FI in the supraspinatus muscle. The expression of biomarkers related to muscle atrophy and FI was measured using quantitative real-time polymerase chain reaction. For the qualitative and quantitative analysis of FI-related biomarkers, immunohistochemical staining was performed. Biomechanical and histological analyses were performed to evaluate the quality of BTI healing after RC repair.Results:The EZE/ATZ group showed significantly lower FI compared with the control group ( P &lt; .001) and significantly downregulated expression of gene markers related to muscle atrophy and FI. On histological analysis, the EZE/ATZ group exhibited increased collagen type I contents, consistent collagen arrangement ( P = .005), and significantly higher collagen density ( P = .003) compared with the control group. Biomechanical analysis of the BTI healing revealed that the EZE/ATZ group had significantly increased ultimate strength ( P = .006) compared with the control group.Conclusion:Systemic EZE/ATZ administration suppressed supraspinatus FI by downregulating muscle atrophy–related and FI-related genes after RC repair. Additionally, EZE/ATZ use improved collagen biosynthesis, density, and arrangement at the BTI and significantly increased tensile strength.Clinical Relevance:The results of the current study strongly advocate the use of EZE/ATZ to improve shoulder function and tendon healing after RC repair.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912106","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":"Recovery of the Medial Elbow Joint in the 24-Hour Period After Repetitive Pitching in High School Players","authors":"Hiroshi Hattori, Shun Okamura, Toby Hall, Katsunobu Sakaguchi, Kiyokazu Akasaka","doi":"10.1177/03635465241293074","DOIUrl":"https://doi.org/10.1177/03635465241293074","url":null,"abstract":"Background:Repetitive pitching causes immediate changes in the medial elbow joint. However, the recovery process from these changes is not clear.Purpose/Hypothesis:The purpose of this study was to investigate the recovery of the medial elbow joint in the 24-hour period after pitching. The hypothesis was that while some recovery will occur at 24 hours after repetitive pitching, this would not be a complete return to baseline.Study Design:Controlled laboratory study.Methods:A total of 26 high school baseball pitchers participated (mean age, 16.0 ± 0.5 years). Participants threw 100 pitches (5 sets of 20 pitches). Medial elbow joint width as well as strain ratios of the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) were measured and followed for 24 hours after pitching. The data before pitching and at each time point after pitching were compared. The standard error of measurement (SEM) and minimal detectable change with 95% confidence interval (MDC<jats:sub>95</jats:sub>) were calculated using measurements before pitching.Results:The medial elbow joint width significantly increased by 0.84 mm immediately after pitching ( P &lt; .05), but this was not maintained at 24 hours. The UCL strain ratio significantly decreased by 1.64 immediately after pitching ( P &lt; .05), but this was not maintained at 18 hours after pitching. The strain ratio of the FPMs significantly decreased by 0.09 immediately after pitching ( P &lt; .05) but significantly increased by 0.13 at 24 hours ( P &lt; .05). The SEM for medial elbow joint width was 0.06 mm, and the MDC<jats:sub>95</jats:sub> was 0.18 mm (maximum change: 0.84 mm immediately after pitching). The SEM for UCL strain ratio was 0.85, and the MDC<jats:sub>95</jats:sub> was 2.35 (maximum change: 1.64 immediately after pitching). The SEM for strain ratio of the FPMs was 0.08, and the MDC<jats:sub>95</jats:sub> was 0.22 (maximum change: 0.13 at 24 hours).Conclusion:After 100 pitches, stability against elbow valgus laxity recovered within 24 hours. UCL and FPMs showed statistical characteristic changes, but those changes were within the minimal detectable change.Clinical Relevance:Pitchers’ medial elbow joint tissue recovered to baseline at 24 hours after pitching. This suggests that it may be acceptable to resume low-intensity throwing after a 24-hour rest period after 100 repetitive pitches while also considering the condition of the rest of the body.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908221","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":"Thursdays With Bruce","authors":"Brett D. Owens","doi":"10.1177/03635465241302093","DOIUrl":"https://doi.org/10.1177/03635465241302093","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"352 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908224","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":"Knee Biomechanics During Cutting Maneuvers and Secondary ACL Injury Risk: Response","authors":"Lasse Mausehund, Tron Krosshaug","doi":"10.1177/03635465241294193","DOIUrl":"https://doi.org/10.1177/03635465241294193","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142912061","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":"Injectable Fibrocartilage-Forming Cores Enhance Bone-Tendon Healing in a Rat Rotator Cuff Model","authors":"Yuhao Yuan, Yiyang Mao, Buhua Sun, Can Chen","doi":"10.1177/03635465241300138","DOIUrl":"https://doi.org/10.1177/03635465241300138","url":null,"abstract":"Background:After surgical repair of rotator cuff (RC) tears, the torn tendon heals unsatisfactorily to the greater tuberosity owing to limited regeneration of the bone-tendon (BT) insertion. This situation motivates the need for new interventions to enhance BT healing in the RC repair site.Purpose:To develop injectable fibrocartilage-forming cores by tethering fibroblast growth factor 18 (FGF18) on acellular fibrocartilage matrix microparticles (AFM-MPs) and evaluate their efficacy on BT healing.Study Design:Controlled laboratory study.Methods:We harvested normal fibrocartilage tissue from the porcine RC insertion, after which it was decellularized and then micronized for fabricating AFM-MPs. The collagen-binding domain was fused into the N-terminus of FGF18 to synthesize recombinant FGF18 (CBD-FGF18), which was tethered to the collagen fibers of AFM-MPs to prepare the injectable fibrocartilage-forming cores (CBD-FGF18@AFM-MPs). After examining the influence of the CBD-FGF18@AFM-MPs on the viability and chondrogenic differentiation of bone marrow mesenchymal stem cells in vitro, we determined the function of the CBD-FGF18@AFM-MPs on BT healing in a rat RC tear model. A total of 80 Sprague-Dawley rats with RC injuries were randomly assigned to 4 supplemental treatments during RC repair: saline injection (control group), AFM-MPs injection, natural FGF18@AFM-MPs injection, and CBD-FGF18@AFM-MPs injection. At 4 and 8 weeks postoperatively, the harvested RC specimens were evaluated via micro–computed tomography, histologic staining, and mechanical testing.Results:In vitro, the CBD-FGF18@AFM-MPs were highly biomimetic, suitable for cell growth and proliferation, and superior in stimulating chondrogenesis. In vivo micro–computed tomography results showed that the CBD-FGF18@AFM-MPs group had significantly more new bone formation and better bone remodeling than the other 3 groups. Histologically, at 4 and 8 weeks postoperatively, the CBD-FGF18@AFM-MPs group had the best continuity of the BT insertion with regular collagen alignment and extensive fibrocartilage regeneration. Importantly, at 8 weeks postoperatively, the RC specimens from the CBD-FGF18@AFM-MPs group presented the highest failure load and stiffness.Conclusion:The injectable fibrocartilage-forming cores provide a new biological intervention to promote RC healing.Clinical Relevance:The injectable fibrocartilage-forming cores may be a new complementary treatment for surgical repair of RC tears.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908220","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}