Arthroscopy-The Journal of Arthroscopic and Related Surgery最新文献

{"title":"Athletes at Highest Risk of ACL Reconstruction Failure are Skeletally Immature Adolescents Treated With Complete Transphyseal All-Soft-Tissue Graft.","authors":"Frank A Cordasco, Daniel W Green, Lasun O Oladeji","doi":"10.1016/j.arthro.2024.11.062","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.062","url":null,"abstract":"<p><p>Given the increasing incidence of ACL injuries in skeletally immature patients, improving surgical outcome for ACLR has been at the forefront of orthopaedic pediatric and adolescent sports medicine research. This research has focused upon graft choice, modifiable risk factors, and non-modifiable risk factors. Allograft is contraindicated in these patients, and bone-tendon-bone grafts should be avoided (as bone plugs should be avoided near the growing epiphysis). Due to higher failure rates of hamstring tendon autograft in this cohort, especially in the older cohort of skeletally immature athletes treated with a complete transphyseal ACLR, our preferred technique is quadriceps tendon autograft. Rehabilitation is a modifiable risk factor, and we emphasize a need for return to sport assessment prior to release for sports. Non-modifiable risk factors in this skeletally immature cohort include recurvatum, increased anterior translation (>7mm), high-grade pivot shift, increased lateral posterior tibial slope, high velocity marrow edema patterns involving the lateral femoral condyle and lateral tibial plateau, Beighton score > 4, and the 8th and 9th grade athlete. When these findings are present in an athlete who plans to return to pivoting and contact/collision sports, we indicate a lateral extra-articular tenodesis in the form of a modified Lemaire procedure.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pectoralis minor transfer represents a joint preserving alternative to reverse total shoulder arthroplasty for younger, high-demand patients with irreparable anterosuperior rotator cuff tears.","authors":"Eric J Cotter","doi":"10.1016/j.arthro.2024.11.059","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.059","url":null,"abstract":"<p><p>The subscapularis is a dynamic structure serving as part of a shoulder force couple in the transverse plane, conferring stability, strength and optimizing motion. Full thickness, retracted anterosuperior rotator cuff tears with fatty infiltration pose a significant challenge to surgeons particularly in younger patients with high functional demands where primary repair may not be feasible. This clinical scenario is rare, and most investigations on this topic are limited to small, retrospective case-series with short-term follow-up. For patients in whom joint preservation is desired, pectoralis major transfer or latissimus dorsi transfers are the most reported surgical options with heterogeneity in techniques and clinical outcomes. Recent research describes an alternative of pectoralis minor transfer for this same purpose with promising short-term outcomes. However, as with pectoralis major transfers for management of anterosuperior irreparable, the outcome is highly dependent on the integrity of the posterosuperior rotator cuff. Thus, when faced with a patient with a massive anterosuperior rotator cuff tear with atrophy, retraction, and other demographic or medical conditions that may predispose that patient to a lower likelihood of healing and doing the extensive rehabilitation from a tendon transfer, consider the alternative of a reverse total shoulder arthroplasty. The reverse is a reliable operation that affords patients excellent pain relief, reasonable function typically lifting up to 25-30 pounds, with good patient reported outcomes even in patients as young as 60 years of age. Tendon transfers, including pectoralis minor transfers, have a role, but we need to be thoughtful about indications and counsel patients on expected outcomes and the durability of those outcomes over time.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Tibial Slope and Decreased Medial Proximal Tibial Angle Negatively Affect ACL Graft Maturation: Objective Evidence on When to Add a Lateral Extra-Articular Augmentation Procedure to a Soft Tissue Anterior Cruciate Ligament Reconstruction.","authors":"Luke V Tollefson, Christopher M LaPrade, Robert F LaPrade","doi":"10.1016/j.arthro.2024.11.061","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.061","url":null,"abstract":"<p><p>Recent anterior cruciate ligament (ACL) research focuses on risk factors for ACL graft failure and techniques and augmentations to limit failure. One of the most recognized risk factors is sagittal malalignment in the form of high posterior tibial slope (PTS), especially PTS ≥ 12°, which leads to increased force through the ACL and ACL graft. To reduce the risk associated with increased PTS, lateral augmentation techniques, typically either a lateral extra-articular tenodesis (LET) or an anterolateral ligament reconstruction (ALLR), improve clinical outcomes, and the authors preferred graft choice, particularly in such cases, is bone-patellar tendon-bone autograft (BTB). Furthermore, in revision cases, there exists a strong argument to perform a slope reducing osteotomy to correct bony malalignment which could lead to ACL graft failure. Slope reducing osteotomies are reported to significantly decrease anterior tibial translation and forces on the ACL graft Coronal malalignment is also a risk factor for ACL failure, (although not as extensively studied as sagittal alignment). Both varus and valgus alignment of the knee can lead to increased forces through the ACL or ACL graft compared to knees in neutral alignment, and workup requires proper lateral and long leg anteroposterior radiographs to determine sagittal and coronal alignment and guide treatment algorithms. Recent research shows that decreased medial proximal tibial angle of the knee (increasing varus alignment of the tibia) may delay graft maturation. However, there is yet to be a consensus about what exactly contributes to ACL graft failure in the coronal plane and what is the best treatment option, especially in the primary setting when an osteotomy is not indicated. Again, we recommend BTB autograft as our preferred graft choice unless contraindicated by skeletal immaturity.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Age is Not a Contraindication to Meniscus Repair.","authors":"Seth L Sherman, Melissa Albersheim","doi":"10.1016/j.arthro.2024.11.058","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.058","url":null,"abstract":"<p><p>Meniscus tears effect patients of all ages, with varying presentations, influence on function, and treatment requirements. Classic dogma suggests older patients should be treated non-operatively or offered meniscectomy when conservative treatment fails. However, recent data suggests improved subjective outcomes and reduced rate of degenerative change following meniscus repair, even in patients >40 years. Controversy exists regarding the comparative reoperation rates of meniscectomy and meniscus repair in the older cohort. While higher levels of evidence are lacking, it is unlikely that chronological age should be the major driver of surgical decision making for meniscus repair. Patient, joint, limb, and meniscus specific factors, including physiologic age, better guide the surgeon towards successful treatment.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding \"Adding Dexmedetomidine to Intra-Articular Local Anesthetics Results in Prolonged Analgesia After Knee Arthroscopy: A Systematic Review and Meta-analysis\" - Authors' Reply.","authors":"Marcela Tatsch Terres, Maria Luisa Machado, Rafael Arsky Lombardi, Carlos Balthazar da Silveira, Sara Amaral","doi":"10.1016/j.arthro.2024.11.057","DOIUrl":"10.1016/j.arthro.2024.11.057","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary: Anatomic Tibiofibular and Partially Anatomic-Based Fibular Posterolateral Corner Reconstruction Techniques Are Biomechanically Superior to Non-Anatomic Reconstruction Techniques: A Tibial Tunnel is the Gold Standard for An Anatomic Reconstruction.","authors":"Jay Moran, Luke V Tollefson, Christopher M LaPrade, Robert F LaPrade","doi":"10.1016/j.arthro.2024.11.053","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.053","url":null,"abstract":"<p><p>Nearly two decades ago, the posterolateral corner (PLC) was commonly referred to as the \"dark side\" of the knee due to our limited anatomical understanding, no anatomic-based reconstruction techniques, and high rates of clinical failures. During this time, non-anatomic PLC reconstruction techniques, or \"fibular slings\", gained popularity early on due to ease of the procedure; however, clinical studies demonstrated residual varus gapping and external rotation laxity associated with these non-anatomic techniques that only reconstructed the fibular (lateral) collateral ligament (FCL). The term \"anatomic\" PLC reconstruction generally refers to a procedure that aims to restore the entirety of the 3 main PLC static stabilizers. Currently, the most commonly utilized PLC reconstruction techniques have evolved to be either a complete anatomic reconstruction with a tibiofibular-based (LaPrade and Engebretsen) approach or a partial anatomic reconstruction through a fibular-based (Levy/Marx, Arciero) technique. Both reconstruction approaches incorporate the use of a second femoral tunnel for improved restoration of the femoral attachments of the FCL and popliteus tendon (PLT) and are biomechanically superior compared to the historic non-anatomic techniques. As such, these improved PLC reconstruction techniques, whether tibiofibular-based or fibular-based, are strongly recommended over non-anatomic reconstruction techniques. Compared to the fibular-based approach, an anatomic tibiofibular-based PLC reconstruction more closely recreates the native architecture of the PLC with recreation of the PFL and use of a tibial tunnel to restore the static function of the PLT. In addition, certain conditions, such as concurrent proximal tibiofibular joint instability and asymmetric knee hyperextension are contraindications to using fibular-based reconstructions and should always utilize a tibial tunnel.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Most Athletes who fail to Return to Sport After Latarjet Procedure Cite Psychological Factors: a Systematic Review.","authors":"James Ryan, Cory K Mayfield, Christian A Cruz, Jacob L Kotlier, Maya Abu-Zahra, Cailan L Feingold, Ioanna K Bolia, Joseph N Liu, Frank A Petrigliano","doi":"10.1016/j.arthro.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.003","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to identify the return-to-sport (RTS) rate in athletes undergoing a Latarjet procedure, while outlining the specific reasons for failure to RTS.</p><p><strong>Methods: </strong>An electronic literature search was conducted (PubMed/MEDLINE, Scopus, Web of Science). Studies in peer-reviewed journals with Latarjet procedures performed on athletes that reported rates and reasons for failure to RTS were included. Excluded studies were those that reported solely on non-athletes, non-Latarjet surgery, and missing rates of and reasons for failure to RTS. Study heterogeneity was assessed using the I² statistic and quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.</p><p><strong>Results: </strong>After review of 3617 articles, a total of 18 studies with 1,066 patients met the inclusion criteria. The level of evidence for included studies ranged from LOE II to LOE IV. Rates of not returning to sports (NRTS) ranged from 3.4-35.3%. More studies cited shoulder-unrelated reasons than shoulder-related reasons for why athletes failed to RTS. Ten (55.5%) studies, making up 656 (61.5%) patients reported that shoulder-unrelated reasons were accountable for more than 50% of NRTS. Only 3 (16.7%) studies reported 100% NRTS due to shoulder-related reasons, which include fear of reinjury and psychological factors. Study heterogeneity was found to be moderate (I² = 73.4%; 95% CI: 57.5-83.3; p < 0.001) and study quality was found to be satisfactory (Mean MINORS score 12.1 for non-comparative and 20.5 for comparative studies).</p><p><strong>Conclusion: </strong>According to this systematic review, the rate of NRTS after Latarjet ranged from 3.4-35.3% across 18 studies, with the majority of studies citing non-shoulder related reasons such as fear or reinjury or psychological factors as the major deterrent for returning to sports.</p><p><strong>Level of evidence: </strong>IV Systematic Review of Case Series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Reply to Letter to the Editor \"Comments on the Article 'Anterior Opening-Wedge High Tibial Osteotomy in the Setting of Genu Recurvatum'\".","authors":"Benjamin Kerzner, Zeeshan A Khan, Sachin Allahabadi, Jorge Chahla","doi":"10.1016/j.arthro.2024.11.055","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.055","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the article \"Technical Note: Anterior opening-wedge high tibial osteotomy in the setting of genu recurvatum\" published in Arthroscopy Techniques 2023, 12(11): e1559 - e1566.","authors":"Christophe Trojani","doi":"10.1016/j.arthro.2024.11.054","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.054","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding 'Adding Dexmedetomidine to Intra-articular Local Anesthetics Results in Prolonged Analgesia After Knee Arthroscopy: A Systematic Review and Meta-analysis '.","authors":"Musab Elhadi, Paul Stewart, Claire C Nestor","doi":"10.1016/j.arthro.2024.11.056","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.11.056","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}