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

{"title":"Emerging Biomechanical and Clinical Data Support Combined Superior Capsule Reconstruction and Lower Trapezius Transfer For The Management of Massive Irreparable Posterosuperior Rotator Cuff Tear.","authors":"Adnan Saithna","doi":"10.1016/j.arthro.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.019","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484696","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":"A Nationwide Analysis Demonstrates Anxiety Disorders are Associated with Higher Rates of Pneumonia, Pulmonary Embolism, Deep Vein Thrombosis and Acute Renal Failure Following Hip Arthroscopy for Femoral Acetabular Impingement Syndrome: A Matched-Control Analysis.","authors":"Ajit M Vakharia, Andrew Paliobeis, Luc M Fortier, Alexander Hallwachs, Marsalis Brown, Michael Salata","doi":"10.1016/j.arthro.2025.01.068","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.01.068","url":null,"abstract":"<p><strong>Purpose: </strong>To utilize a nationwide administrative database (PearlDiver) to investigate if patients with general anxiety disorder (GAD) undergoing primary hip arthroscopy for femoral acetabular impingement syndrome (FAIS) have higher rates of: 1) medical complications; 2) readmission rates; and 3) costs of care, as compared to patients without GAD.</p><p><strong>Methods: </strong>Using the PearlDiver database, a retrospective query from January 1<sup>st</sup>, 2010 to March 31<sup>st</sup>, 2020 was performed to include all patients who underwent hip arthroscopy for FAIS. From this base population, patients with a diagnosis of GAD were identified and represented as the study group. The study group was matched at a 1:5 ratio to a control group of patients without GAD who underwent hip arthroscopy for FAIS by age, sex, and multiple comorbidities (depression, hypertension, diabetes mellitus, and tobacco use). Primary outcomes analyzed included: 90-day medical complications, 90-day readmission rates, and 90-day costs of care. Chi-square analyses were used to compare patient demographics. Logistics regression analyses were used to calculate odds-ratios (OR) of medical complications and readmissions. Welch's t-test were used to compare costs. Bonferroni-correction was performed to reduce the probability of a type I error. This was done by taking the standard p-value of 0.05 and dividing it by the total number of dependent variables analyzed in the study. As such, a p-value less than 0.005 was considered statistically significant.</p><p><strong>Results: </strong>The query yielded 7,631 patients with GAD undergoing hip arthroscopy for FAIS. These patients were compared to 38,145 matched controls without GAD. Patients with anxiety were at significantly higher risk for post-surgical complications, with the highest risks observed for pneumonia (1.0% vs 0.4%; OR 2.57, 95% CI: 1.97 - 3.35, p = 0.004) and deep vein thrombosis (DVT) (0.36% vs 0.15%; OR 2.42, 95% CI: 1.52 - 3.76, p = 0.002). Other significant risks included acute renal failure (0.46% vs 0.21%; OR 2.13 95%CI: 1.42 - 3.15, p = 0.002) and pulmonary embolism (0.21% vs 0.13%; OR 1.66, 95%CI: 0.92 - 2.87, p = 0.001). There was no statistical difference in readmission within 90-days (1.46% vs 1.24%; OR 2.38, 95% CI: 2.13 - 2.67, p = 0.02) or 90 day total cost of care between the two groups ($4,812 +/- 1,292 vs $ 4,076 +/- 1,179, p = 0.73).</p><p><strong>Conclusion: </strong>After adjusting for age, sex, and medical comorbidities; this study found GAD was associated with a significantly higher rate of pneumonia, DVT, acute renal failure, and PE following hip arthroscopy for FAIS. There were no significant differences in 90-day readmissions rates or 90-day total cost of care. Considering the relatively high prevalence of anxiety and the increasing rate of hip arthroscopy, preoperative screening for anxiety may help surgeons identify and protect patients at increased risk of complications","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473188","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":"Arthroscope-Assisted Lower Trapezius Tendon Transfer Using Achilles Tendon Allograft for Irreparable Rotator Cuff Tears Demonstrates Excellent Short-Term Outcomes in the Setting of Concomitant Subscapularis Repair.","authors":"Berkcan Akpinar, Sarah M Koljaka, Matthew N Galati, Ryan Lohre, Bassem ElHassan, Jon J P Warner","doi":"10.1016/j.arthro.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.008","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to quantify the improvement patients undergoing scope-assisted lower trapezius tendon transfer (SALTT) for irreparable rotator cuff tears (IRCT) have and whether intra-operative subscapularis management affected these outcomes.</p><p><strong>Methods: </strong>From 2015 to 2023, patients undergoing primary SALTT for IRCT without osteoarthritis or brachial plexopathy with serial follow-up at 6- and minimum 12-months post-operatively were identified. Subjective Shoulder Value (SSV) scores, active forward elevation (aFE), external rotation (ER) lag, and cuff strength was recorded. Continuous variables were analyzed with one-way or repeated measures analysis of variance, and a multivariate linear regression was performed evaluating demographic, radiographic, and intra-operative variable effects on SSV and ER lag.</p><p><strong>Results: </strong>Seventy-six (mean age: 56.5±8.1 years; BMI: 29.0±4.3; 73% male) patients operated on by 4 surgeons (A: 66%; B: 15%; C: 13%; D: 4%) demonstrated significant improvement in baseline SSV scores (mean: 23.9±SD:13.1) to 6-month (mean: 73.5±10.6, 91% MCID achievement P<0.001) and final (mean: 43.5±29.5 months) follow up scores (mean: 79.9±16.5, 92% MCID achievement P<0.001; n=45/122:37% 2-year inclusion rate). Regression analysis for final SSV demonstrated age (beta: 0.8, P=0.017) to have a positive effect and subscapularis fatty infiltration (beta: -10.6, P<0.001) to have a negative effect. Active FE improved from 6-month (139±SD:23.8°) to final (146±23.0°, P=0.013) follow-up while ER lag (17±SD:17°) improved as well (6-month mean: 3±7.8°, P<0.001; final: 3±5.6°, P<0.001). Regression analysis demonstrated subscapularis fatty infiltration (beta:-11.6, P=0.003) had a negative effect on final aFE while infraspinatus fatty infiltration (beta:-1.2, P=0.048) and concomitant subscapularis repair (beta:-5.0, P=0.023) had a negative effect in final ER lag. Presence of subscapularis tears alone (beta:4.5, P=0.030) had a positive effect on ER lag. Overall, five (7%) patients underwent re-operations.</p><p><strong>Conclusion: </strong>Patients with IRCT undergoing SALTT with or without subscapularis tears requiring repair achieve excellent short-term clinical outcomes while improving from an exam standpoint.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473194","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":"Operative Treatment has Greater Expected Value than Nonoperative Treatment for First-Time Patellar Dislocations: A Meta-Analysis and Expected Value Decision Analysis.","authors":"Andrew J Recker, Thomas W Mason, Jelle P van der List, Garrett Bullock, Nicholas A Trasolini, Brian R Waterman","doi":"10.1016/j.arthro.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.013","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to use expected value decision analysis to determine the optimal treatment for first time patellar dislocations.</p><p><strong>Methods: </strong>A meta-analysis according to PRISMA guidelines and expected-value decision analysis were performed. A decision tree addressing the clinical question (operative vs. non-operative) was created, and a meta-analysis was performed to assess the probability of outcomes after operative versus non operative treatment. 70 patients were assessed regarding potential outcome preferences to a hypothetical injury. An expected-value decision analysis was performed to systematically quantify the clinical decision. Statistical fold back analysis calculated optimal treatment, and a sensitivity analysis was performed to determine the effect of changing redislocation rates on the expected value.</p><p><strong>Results: </strong>Forty-five participants (mean age 20 years [range 12-33], 58% male, 71% athletes) met inclusion criteria. Meta-analysis of 10 randomized controlled trials with 624 patients revealed the probability of a \"well\" outcome was significantly greater for operative treatment (59.3%, 95% CI 53.7% - 64.7%) than nonoperative treatment (44.7%, 95% CI 39.0% - 50.5%). Subsequent redislocation rates with operative treatment were significantly lower (29.8%, 95% CI 24.5% - 35.17%) compared to nonoperative treatment (44.7%, 95% CI 39.0% - 50.5%). MPFL reconstruction showed an 88% probability of a \"well\" outcome, and a 3% redislocation rate. Operative management had a higher chance of a well outcome (RR: 1.43 (95% CI: 1.12, 1.83), p = 0.005). The overall expected value for operative treatment was 6.09 versus 4.96 for nonoperative treatment. Secondary analysis of 27 articles for solely MPFL reconstruction demonstrated an expected value of 7.80 for operative treatment.</p><p><strong>Conclusions: </strong>Meta-analysis demonstrated more frequent favorable outcomes and lower subsequent dislocation rates with operative treatment. Decision analysis based on healthy patient responses to hypothetical scenarios demonstrates that operative treatment has a higher expected value for first time patellar dislocations than non-operative treatment.</p><p><strong>Level of evidence: </strong>Level IV, economic study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473218","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":"Early Intra-Articular Hyaluronic Acid injection following Anterior Cruciate ligament reconstruction provides short term pain relief and improves early postoperative function with no clinical benefits at 6 and 12 Months: A Randomized Controlled Trial.","authors":"Raghavendra Balagod, Sujit Kumar Tripathy, Siddharth Satyakam Pradhan, Paulson Varghese, Mathan Kumar Ramasubbu, Anand Srinivasan, Gunjar Jain, Mantu Jain","doi":"10.1016/j.arthro.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.010","url":null,"abstract":"<p><strong>Purpose: </strong>This randomized-controlled trial assessed the safety and effectiveness of intra-articular hyaluronic acid (IAHA) when administered at various time points following arthroscopic anterior cruciate ligament reconstruction (ACLR) surgery.</p><p><strong>Methods: </strong>Ninety ACL tear patients undergoing arthroscopic ACLR were divided into three groups: Early HA group received HA on day 2 and saline at 2 months; Late HA group received saline on day 2 and HA at 2 months; Placebo group received saline at both times. Clinical (range of motion-ROM, knee circumference, Lysholm score, IKDC, VAS, EQ5D5L, Tegner scores) and blood parameters (blood ESR, and CRP) were assessed at baseline, monthly up to 6 months, and at 12 months. The synovial TNF-alpha level was measured at baseline, day 2, and 3 months.</p><p><strong>Results: </strong>Early HA group showed significantly better ROM than Placebo (P=0.041) and Late HA groups (P=0.029) at one and two months' post-surgery. Pain was significantly lower in Early HA group at one month compared to Placebo (P=0.033). Early HA group achieved a faster median recovery to a Lysholm score of 83 (P=0.01) and had superior Lysholm scores at two months. EQ5D5L and IKDC scores were also significantly better at one and two months in Early HA group. There were no differences in blood ESR and CRP levels between the groups at any follow up. However, both HA groups had a significant decrease in TNF-alpha from baseline (P<0.05). No adverse events were reported. The Minimal Clinically Important Difference (MCID) for the VAS at one month was achieved by 93.3%, 60.7% and 65.5% participants respectively (p-value<0.01). However, no significant differences were observed between the groups in the percentages of patients achieving MCID for VAS at one year or for IKDC and Lysholm scores at one month, two months, and one year.</p><p><strong>Conclusion: </strong>Early IAHA injection following ACLR effectively reduces pain and improves ROM during the early postoperative period, leading to enhanced functional outcomes and quality of life. However, these benefits were not sustained beyond 2 months and no clinical benefits were noted at 6- and 12-month follow-ups. The treatment was found to be safe and well-tolerated for postoperative use. Notably, there was no significant difference in the number of patients achieving MCID for functional scores, except for pain at one month.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473215","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":"Patients with Seizure Disorders Undergoing Surgery for Recurrent Anterior Shoulder Instability Demonstrate Variable Rates of Recurrence with Seizures as the Most Common Cause of Failure: A Systematic Review.","authors":"Scott Fong, Fabrizio Darby, Seema Patel, James D Fox, Michael S Lee, Jay Moran, Stephen M Gillinov, Mackenzie Norman, Justin Zhu, Ronak J Mahatme, John M Apostolakos, Andrew E Jimenez","doi":"10.1016/j.arthro.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate postoperative outcomes of patients with seizure disorder undergoing stabilization surgery for the treatment of recurrent anterior shoulder instability.</p><p><strong>Methods: </strong>Pubmed, Cochrane Center for Register of Controlled Trials (CENTRAL) and Scopus were searched in January 2024 for articles using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Articles were included if they evaluated postoperative functional, clinical, or recurrence/reoperation outcomes following surgical stabilization in patients with a history of seizures and recurrent anterior shoulder instability. For postoperative outcomes reported in three or more studies with mean and standard deviation, forest plots were generated, and I² was calculated.</p><p><strong>Results: </strong>A total of eight studies were included: seven studies focused on the Latarjet or other bone block augmentation procedures and one study focused on a soft tissue-only stabilization procedure. There were a total of 157 Latarjet or bone block augmentation surgeries (143 patients: 124 M (86.7%), 19 F (13.3%)) and 29 soft tissue only stabilization surgeries (27 patients: 23 M (85.2%), 4F (14.8%)). Recurrent dislocation or subluxation rates ranged from 0% to 43%. Of the five studies that reported the cause of postoperative dislocation or instability, four identified seizures as the cause of all cases. In studies comparing Latarjet outcomes between patients with versus without seizure disorders, instability recurrence ranged from 1.8% to 9.5% in the non-seizure group and from 9% to 40% in the seizure group.</p><p><strong>Conclusion: </strong>The recurrence of anterior shoulder instability after surgical stabilization in patients with seizure disorders was variable across studies ranging from 0% to 43%. Seizure was the most common reported cause for recurrent instability after surgery.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473235","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":"Use of Hormonal Contraceptives is Associated with Decreased Incidence of ACL Injuries Requiring Reconstruction in Females.","authors":"Sydney A Fry, Ankit Hirpara, Kaitlyn E Whitney, Carson L Keeter, Evangelia P Constantine, Kyle G Williams, Jason L Dragoo","doi":"10.1016/j.arthro.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.012","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate associations between hormonal contraceptive use and females who had sustained an ACL injury requiring reconstruction.</p><p><strong>Methods: </strong>De-identified data were obtained from female patients 15 to 35 years of age between 2011 to 2024 from the Colorado Health Data Compass database for this study. The study was separated by females who sustained an ACL injury, treated by arthroscopic ACL reconstruction, and females without a history of ACL injury. Among these groups, non-contraceptive users, total hormonal systemic contraceptive (including oral contraceptive pills (OCPs), implant, ring, injection, and patch) users, OCP users (including formulations norethindrone (NE) only, drospirenone (DS) + ethinyl estradiol (EE), (NE + EE), norgestimate (NG + EE)) users were included in the analysis.</p><p><strong>Results: </strong>The 2,120,628 females in the systemic hormonal contraceptive use group had a lower ACL injury incidence (0.079%; CI: 0.075 to 0.083) compared to the incidence of the 12,766,138 females in the no contraceptive use group (0.12%; CI: 0.118 to 0.121). The 745,062 females in the OCP use group also had a lower ACL injury incidence (0.088%; CI: 0.081 to 0.095), suggesting an association between contraceptive use and ACL injuries. When stratified by five-year age intervals, the 15 to 19-year-old age group saw no difference between ACL injury incidence in the OCP use group (0.101%, CI: 0.081, 0.125) and no contraceptive group (0.118%, CI: 0.114, 0.122) while all other age groups had a lower ACL injury incidence in the OCP use group. All age groups in the systemic hormonal contraceptive use group had a lower ACL injury incidence compared to the no contraceptive use. Additionally, different contraceptive formulations showed similar injury incidence, with a lower proportion of ACL injuries in NE only (0.03%) users compared to NG+EE (0.093%), NE+EE (0.099%), and DS+EE users (0.096%).</p><p><strong>Conclusion: </strong>Systemic hormonal contraceptive use is associated with a lower incidence of ACL injury requiring ACL reconstruction compared to no contraceptive use in females ages 15 to 35, with a stronger association with progestin-only OCPs. Females ages 15 to 19 showed no difference in the association with ACL injury incidence between OCP use and no contraceptive use.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473248","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":"Patients with Mood Disorders Have Higher Rates of Healthcare Utilization, Medical Complications, Opioid Prescriptions, and Subsequent Knee Surgery after Arthroscopic Partial Meniscectomy.","authors":"Ankit Hirpara, Christopher Bine, Kyle G Williams, Sydney A Fry, Kaitlyn Whitney, Jason L Dragoo","doi":"10.1016/j.arthro.2025.01.067","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.01.067","url":null,"abstract":"<p><strong>Purpose: </strong>To compare rates of post-operative complications, healthcare utilization, opioid prescribing patterns, and secondary knee surgery in patients with versus without a preexisting anxiety or depressive disorder (ADD) undergoing isolated primary arthroscopic partial meniscectomy (APM).</p><p><strong>Methods: </strong>The TriNetX database was queried from inception to compare patients over 18-years-old who underwent isolated primary APM with versus without a pre-existing ADD. Patients were matched in a 1:1 ratio based on demographic factors and comorbidities, including diabetes and hypertension. The following outcomes were collected: 1) post-operative complications and healthcare utilization within ninety days, 2) proportion of patients prescribed an opioid within one year, and 3) subsequent knee surgery within two years, specifically ipsilateral or contralateral meniscus surgery or total knee arthroplasty. Two subgroup analyses were conducted. Opioid naive patients with and without an ADD were compared based on the proportion of patients prescribed an opioid within one year of APM. Rates of revision meniscus surgery on the ipsilateral knee were also compared within two years of APM.</p><p><strong>Results: </strong>Within 90 days, patients with a pre-existing ADD (n=26,507), compared to those without (n=26,507), had higher rates of healthcare utilization, including readmission (p<0.001), and medical complications, like cerebrovascular accident (p=0.002). A greater proportion of patients with an ADD were prescribed opioids at all chosen time points within one year of APM. Similarly, a greater proportion of opioid naive patients with an ADD were prescribed opioids within six months (p<0.001) and one year (p<0.001). Patients with an ADD also had higher rates of total knee arthroplasty (p=0.001) and ipsilateral revision meniscus surgery (left knee: p=0.020; right knee: p=0.019) within two years.</p><p><strong>Conclusion: </strong>Patients with an anxiety or depressive disorder have higher rates of healthcare utilization, medical complications, opioid prescriptions, and subsequent knee surgery after isolated primary arthroscopic partial meniscectomy.</p><p><strong>Level of evidence: </strong>III, retrospective cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473230","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":"Delayed anterior cruciate ligament reconstruction is associated with lower odds of returning to preinjury physical activity level at 12 months follow-up.","authors":"Johan Högberg, Emily Fridh, Ramana Piussi, Rebecca Simonsson, Riccardo Cristiani, Kristian Samuelsson, Roland Thomeé, Eric Hamrin Senorski","doi":"10.1016/j.arthro.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.02.011","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effects of timing of anterior cruciate ligament (ACL) reconstruction on the odds to recover muscle (quadriceps and hamstring) strength, return to preinjury physical activity level, and achieve rehabilitation goals at 12 months follow-up.</p><p><strong>Methods: </strong>Data were extracted from a local rehabilitation registry in Sweden in November 2023. Patients ≥16 years old who underwent primary ACL reconstruction with hamstring tendon autografts, who underwent isokinetic muscle strength assessment, and responded to patient-reported outcomes 12-months after surgery were included. A multivariable logistic regression analysis was used to analyze the association between timing of ACL reconstruction and the recovery of muscle strength, return to preinjury physical activity level, and achievement of rehabilitation goals. The results of the logistic regression analysis were expressed as odds ratios (OR) for every 1-unit increase in the predictor variable (months between ACL injury and reconstruction).</p><p><strong>Results: </strong>In total, 715 patients were included, of which 53.4% (n=383) were women. The mean age at ACL reconstruction was 28.3±10.5 years, and the median time between ACL injury to reconstruction was 4.9 months (IQR 2.9;9.4). Delayed ACL reconstruction significantly decreased the odds of returning to preinjury physical activity level at 12-months in patients with a Tegner score of 6-10 (OR 0.97 [95% CI 0.94;0.99], p=0.009) and regardless of age. Shorter median time in months from ACL injury to reconstruction was observed for patients who returned to preinjury physical activity level, especially in younger patients (16-30 years old) (3.9 [IQR 2.5;6.5] versus 4.7 [IQR 2.9;9.1], p=0.007) and in patients who participated in pivoting activities (Tegner scale 6-10) preinjury (3.4 [IQR 2.3-6.2] versus 5.0 [IQR 2.9-9.7], p<0.001).</p><p><strong>Conclusion: </strong>Delayed ACL reconstruction reduces the odds of returning to preinjury physical activity level in patients active in pivoting activities preinjury (Tegner 6-10), and in patients regardless of age 12 months after surgery.</p><p><strong>Level of evidence: </strong>III. Retrospective study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473213","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":"Patients Requiring Revision Surgery Following Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome Demonstrate a Small Reduction of Postoperative Labral Size: A Propensity-Matched Controlled Study.","authors":"Yichuan Zhu, Rui Sun, Tong Zuo, Xinzhi He, Guanying Gao, Yan Xu","doi":"10.1016/j.arthro.2025.01.065","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.01.065","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the changes in labral size following primary hip arthroscopy between patients requiring revision surgery and those did not.</p><p><strong>Methods: </strong>Data collected between August 2016 and September 2021 was retrospectively reviewed. Patients diagnosed with FAIS and undergoing primary and revision hip arthroscopy at our institute were included in the revision group. Exclusion criteria were Tönnis grade > 1, concomitant hip conditions, and incomplete MRI data. Patients who did not undergo revision surgery or conversion to total hip arthroplasty (THA) at minimum 2-year follow-up were matched in a 1:2 ratio and included in the control group. The labral size (width and height at 11:30, 1:30, and 3:00) on MRI (non-contrast, 3.0 T) before and after 12 months of primary surgery were compared.</p><p><strong>Results: </strong>Twenty-one patients were included in the revision group, and 42 patients were matched in the control group. In the revision group, significant reduction in labral width and height at 11:30 and 1:30, and labral width at 3:00 was observed at 12 months after primary hip arthroscopy (all with P < .05), while the control group did not demonstrate significant difference of changes in labral size (all with P > .05). Smaller postoperative labral width at 1:30 and 3:00 was observed in the revision group compared to the control group (all with P < .05). The revision group presented with greater reduction of labral width at all three positions and labral height at 1:30 compared to the control group (all with P < .05).</p><p><strong>Conclusion: </strong>Patients requiring revision surgery following primary hip arthroscopy for FAIS presented with smaller postoperative labral size (less than 1mm difference) and greater reduction of labral size (at or less than 1mm difference) on MRI 12 months after primary surgery compared to those patients that did not require later revision surgery.</p><p><strong>Level of evidence: </strong>Level III. Retrospective case control.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473222","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}