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

{"title":"Combined Transosseous and Capsular Repair Improves Grip Strength in Triangular Fibrocartilage Complex Tears: A Randomized Controlled Trial.","authors":"Lutian Liao, Fei Xiong, Fengming Gu, Xiaodong Fang, Qiuwen Ying, Xiaoyun Pan, Jingyi Mi","doi":"10.1016/j.arthro.2025.05.005","DOIUrl":"10.1016/j.arthro.2025.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes of arthroscopically assisted transosseous repair versus combined transosseous and capsular repair for triangular fibrocartilage complex tears in patients with distal radioulnar joint (DRUJ) instability.</p><p><strong>Methods: </strong>Patients treated for triangular fibrocartilage complex injuries (Atzei class 2) causing DRUJ instability between September 2020 and September 2022 were prospectively randomized into 2 treatment groups based on the surgical approach: Group A underwent transosseous repair (n = 20), whereas group B underwent combined transosseous and capsular repair (n = 20). Preoperative and postoperative follow-up data of patients were recorded, including DRUJ stability; visual analog scale score; Disabilities of the Arm, Shoulder and Hand score; Modified Mayo Wrist Score (MMWS); wrist range of motion (ROM; flexion and extension, ulnar-radial deviation, and forearm rotation); and grip strength ratio (compared with the contralateral side). Complications were recorded.</p><p><strong>Results: </strong>Forty participants were enrolled in this prospective randomized controlled trial. All patients completed the mandated minimum 24-month follow-up (median, 36 months; range, 24-48 months). Concerning grip strength recovery, group B (94.2% ± 4.2%) had significantly better outcomes than group A (84.2% ± 4.3%, P < .001). Clinically meaningful improvements were observed in the grip strength ratio (100%). Group B showed superior grip strength recovery (P < .001). Regarding DRUJ stability grades, group B included 15 patients with grade 0 and 5 with grade 1 whereas group A included 10 patients with grade 0 and 10 with grade 1 (P = .102). No statistically significant differences in wrist flexion-extension, forearm rotation, and ulnar-radial deviation were observed between groups A and B (P > .05 for all comparisons). The differences in visual analog scale score, Disabilities of the Arm, Shoulder and Hand score, and MMWS were not statistically significant (all P > .05).</p><p><strong>Conclusions: </strong>Arthroscopy-assisted transosseous repair with capsular augmentation showed significantly superior grip strength recovery compared with transosseous repair alone; both techniques achieved significant improvements in postoperative functional outcomes, pain reduction, MMWS, and wrist ROM.</p><p><strong>Level of evidence: </strong>Level Ⅰ, randomized controlled trial.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082268","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: Adductor Canal Peripheral Nerve Blocks Have Minimal Effect on Pain Control in the Immediate Postoperative Period Among Patients Undergoing Anterior Cruciate Ligament Reconstruction.","authors":"Andrew J Sheean","doi":"10.1016/j.arthro.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.03.028","url":null,"abstract":"<p><p>Minimizing opioid dosing in the perioperative period is important to providing safe and effective analgesia for patients undergoing anterior cruciate ligament reconstruction. The use of peripheral nerve blocks is common, as in multimodal regimens, focused on managing patients' postoperative pain. Recent research suggests that the addition of adductor canal peripheral nerve blocks to local infiltration analgesia injection at the surgical sites in bone-patellar tendon-bone and quadriceps tendon autograft anterior cruciate ligament reconstruction does not affect the dosage of opioid medication administered in the immediate postoperative period.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055625","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: Deteriorated Quality and Medial Retraction of Tendon Following Acute Traumatic Rotator Cuff Tear Are Predictors of Retear After Arthroscopic Repair.","authors":"Tyler J Uppstrom, Ayham Jaber, Peter J Millett","doi":"10.1016/j.arthro.2025.04.057","DOIUrl":"10.1016/j.arthro.2025.04.057","url":null,"abstract":"<p><p>Rotator cuff tears are a common cause of shoulder pain and dysfunction, affecting up to 33% of the population, and approximately 250,000 arthroscopic rotator cuff repairs are performed each year in the United States. Arthroscopic rotator cuff repair is the gold standard for surgical management of full-thickness rotator cuff tears and is associated with postoperative improvements in pain and function. However, reported retear rates based on postoperative magnetic resonance imaging vary from 7% to 90% following arthroscopic rotator cuff repair. Despite variations in repair techniques, implant technology, biologic and patch augmentation, and postoperative rehabilitation algorithms, retear rates following rotator cuff repair have remained high over the past several decades. As a result, there remains significant interest in identifying predictive factors of retear after rotator cuff repair. That said, numerous well-designed studies have demonstrated a poor correlation between postoperative magnetic resonance imaging findings and functional outcomes. Regardless, intraoperative evaluation of tendon quality, tear pattern, and tissue mobility is essential to predicting the likelihood of successful rotator cuff repair, although at the current time, this evaluation is largely subjective, and few validated assessment tools exist. As such, future objective research is required to improve our assessment and documentation of these intraoperative factors, with artificial intelligence and machine learning models possibly serving as useful tools for identifying meaningful intraoperative patterns predictive of postoperative outcomes in the future.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027874","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: Measurement of Sagittal Tibial Tubercle-Trochlear Groove Distance Using Computed Tomography Versus Magnetic Resonance Imaging Yields Different Results.","authors":"Anthony Zacharias","doi":"10.1016/j.arthro.2025.04.056","DOIUrl":"10.1016/j.arthro.2025.04.056","url":null,"abstract":"<p><p>The concept of anterior-to-posterior alterations of the tibial tubercle in reference to the trochlear groove (sagittal tibial tubercle-trochlear groove distance) has become a recent point of interest. These alterations have been noted in patellar instability and have been found to have implications for patellofemoral contact pressures. In characterizing pathology, it is critical to understand the limitations and differences between imaging modalities. Both computed tomography and magnetic resonance imaging are options to evaluate 3-dimensional pathology regarding patellar instability. However, it is evident these measurements are not interchangeable, and a firm understanding of both imaging modality and knee flexion angle is important as we continue to understand this measurement and how we can use this for surgical planning in the treatment of patellar instability.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058852","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: Various High Tibial Osteotomy Techniques Show High Survivorship, Medial Opening-Wedge Technique Has Risks, and Patient-Specific Instrumentation Shows Promise.","authors":"Adam V Daniel, Matthew J Wagner, Bruce A Levy","doi":"10.1016/j.arthro.2025.05.004","DOIUrl":"10.1016/j.arthro.2025.05.004","url":null,"abstract":"<p><p>Valgus-producing high tibial osteotomy (HTO) is a treatment for medial compartment knee osteoarthritis. There has been much debate about which type of osteotomy is the \"best.\" Many techniques, including medial opening-wedge, lateral closing-wedge, dome, and chevron-type osteotomies, have proven track records, with survival rates free of conversion to total knee replacement ranging from 85% to 93% at 8 years or more in some series. One of the main drawbacks to medial opening-wedge HTO is the effect on tibial slope and patellar height. These osteotomies tend to open more in the anterior aspect of the osteotomy, resulting in an increased posterior tibial slope. This can lead to strain on the anterior cruciate ligament, so there is interest in avoiding this in the setting of anterior cruciate ligament reconstruction. If there is a significant increase in posterior tibial slope, a \"bony\" flexion deformity might even occur. Another potential issue with medial opening-wedge HTO is a change in patellar height leading to patella infera, which may negatively impact the extensor mechanism and quadriceps function, lead to altered patellofemoral contact pressures, and theoretically, even cause accelerated rates of patellofemoral osteoarthritis. Patient-specific cutting guides developed with precise preoperative planning, using computed tomography, can guide everything from desired correction in 1 or multiple planes to positioning of the hinge pin. The data are so precise that the cutting jigs can determine the exact depth of the saw cut in each region of the bone, patient-specific plates can be precontoured to match the patient's bony anatomy after the osteotomy, and even the screw lengths for the plate can be determined. Initial data are quite encouraging; for example, a laboratory study has shown superior accuracy and decreased radiation exposure compared with the traditional freehand technique.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042947","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: Excitement Regarding Commercially Available Exosome Products Is High but Concerns Include Misinformation and Limited Evidence of Efficacy.","authors":"Adnan Saithna","doi":"10.1016/j.arthro.2025.05.003","DOIUrl":"10.1016/j.arthro.2025.05.003","url":null,"abstract":"<p><p>Exosomes are a subtype of extracellular vesicles. They act as carriers for intercellular communication, transferring molecules between cells and influencing their behavior. They play roles in various physiological processes, including tissue repair. Several basic science studies have evaluated the role of extracellular vesicles in animal models of rotator cuff pathology and have shown potential benefits, including improved structural and biomechanical properties (including greater load to failure, better tendon-to-bone healing, and prevention of muscle atrophy and fatty infiltration). However, clinical studies are lacking, and there are currently no US Food and Drug Administration-approved exosome products. Despite that, exosome products are available to patients, but the information available to them, especially through direct marketing and social media, can lack transparency and be misleading. As the exosome market continues to grow rapidly, it is likely that patients will be seeking information regarding them with increasing frequency. It is therefore important for sports medicine surgeons to understand the evolving landscape for biological augmentation of rotator cuff injuries and provide accurate and evidence-based recommendations to their patients.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063324","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":"Lower Trapezius Tendon Transfer Improves Range of Motion, Functional Outcomes, and Pain for Irreparable Rotator Cuff Tears: A Systematic Review.","authors":"Bradley J Lauck, Alan W Reynolds, Jelle P van der List, Nicholas A Trasolini, Brian R Waterman","doi":"10.1016/j.arthro.2025.04.026","DOIUrl":"10.1016/j.arthro.2025.04.026","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the available literature on lower trapezius tendon transfer (LTT) for functionally irreparable rotator cuff tears (FIRCTs) and summarize the outcomes of this procedure.</p><p><strong>Methods: </strong>A systematic review was conducted on April 4, 2024, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines in the MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and SPORTDiscus databases to identify clinical outcome studies on LTT for FIRCTs. Peer-reviewed publications with a level of evidence of Level IV or higher were included. Data related to clinical outcomes and complications were recorded. Risk of bias was assessed using the Methodological Index for Non-randomized Studies.</p><p><strong>Results: </strong>The initial search yielded 1,066 studies, resulting in 15 studies for inclusion, including 393 total patients. Mean follow-up ranged from 3 to 58.2 months. All studies reported significant improvements in patient-reported outcomes and range of motion after LTT for FIRCTs. Postoperative American Shoulder and Elbow Surgeons scores ranged from 54.8 to 84.8, with absolute improvements of 21.7 to 48.6, whereas visual analog scale pain scores improved by 1.7 to 5.4. Postoperative external rotation ranged from 35° to 101.7°, with mean improvements of 11° to 32.5°, and forward flexion improved by 7.9° to 66° to a range of 120° to 165.7°. Complications were reported in 12 studies, with LTT retear (range, 0%-19%) and infection (0%-13%) being the most common. Reoperations occurred in 10 studies, most frequently consisting of conversion to shoulder arthroplasty (0%-20%).</p><p><strong>Conclusions: </strong>LTT is a reliable option for FIRCTs, offering significant improvements in clinical and functional outcomes. It is particularly effective in restoring external rotation, with complication and reoperation rates comparable to alternative surgical procedures.</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":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044412","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: Digital Internet Information on Orthobiologic Treatments Is Low Quality, Misleading, and Unreliable.","authors":"Reena J Olsen, Ishan T Modi, Prem N Ramkumar","doi":"10.1016/j.arthro.2025.05.001","DOIUrl":"10.1016/j.arthro.2025.05.001","url":null,"abstract":"<p><p>In today's digital era, media platforms such as YouTube have become dominant sources of health information, yet much of the content on orthobiologic treatments-such as platelet-rich plasma, bone marrow aspirate concentrate, and mesenchymal stem cells-is of low quality, misleading, and unreliable. Commercial incentives and algorithm-driven content promotion allow misinformation to outpace evidence-based guidance. Despite this field's promising therapeutic potential, the unchecked spread of digital misinformation threatens patient understanding, informed consent, and trust in medical care. Given digital media's profound influence on patient perceptions, it is an ethical and clinical imperative for academic and medical communities to intentionally produce accessible, high-quality, evidence-based content and safeguard medical truth.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041422","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 to the Editor Regarding \"YouTube Is an Inconsistent Source of Information on Orthobiologics: Implications for Content Quality, Reliability, Comprehensiveness, and Patient Decision-Making\".","authors":"Venkata Dileep Kumar Veldi, Rachana Mehta, Ranjana Sah","doi":"10.1016/j.arthro.2025.04.047","DOIUrl":"10.1016/j.arthro.2025.04.047","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042620","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 Report Improved Functional Outcomes After Puncture Capsulotomy Technique for Hip Arthroscopy at 5 Years.","authors":"Rachel L Poutre, Jeffrey S Mun, Brandon J Allen, Srish S Chenna, Stephen M Gillinov, Bilal S Siddiq, Nathan J Cherian, Christopher T Eberlin, Scott D Martin","doi":"10.1016/j.arthro.2025.04.051","DOIUrl":"10.1016/j.arthro.2025.04.051","url":null,"abstract":"<p><strong>Purpose: </strong>To (1) evaluate minimum 5-year functional outcomes, (2) assess secondary surgery rates, and (3) analyze postoperative complications after hip arthroscopy for labral tears due to femoroacetabular impingement using the puncture capsulotomy technique.</p><p><strong>Methods: </strong>This was a retrospective review of prospectively collected data from May 2014 to May 2019 that included patients aged 18 years or older who underwent hip arthroscopy via puncture capsulotomy for labral tears and concomitant femoroacetabular impingement and completed patient-reported outcome measure surveys for 5 years postoperatively.</p><p><strong>Results: </strong>A total of 109 hips were included in this study (49.5% female sex; mean age ± standard deviation, 37.7 ± 14.1 years), with a mean follow-up time of 61.0 ± 1.58 months (range, 60-67 months) and mean body mass index of 25.5 ± 3.93. When compared with mean enrollment values, the mean modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports-Specific Subscale, and International Hip Outcome Tool-33 score were all significantly improved (P < .001) at 5-year follow-up (mHHS, 63.1 ± 14.6 preoperatively vs 88.9 ± 14.6 postoperatively; Hip Outcome Score-Activities of Daily Living, 71.1 ± 19.5 vs 92.8 ± 11.1; Hip Outcome Score-Sports-Specific Subscale, 41.8 ± 25.3 vs 81.7 ± 23.8; International Hip Outcome Tool-33 score, 41.9 ± 19.1 vs 84.4 ± 19.6). Furthermore, for the mHHS, 83.8%, 71.4%, and 52.1% of patients achieved the minimal clinically important difference, patient acceptable symptom state, and substantial clinical benefit, respectively. The rate of revision hip arthroscopy was 0%, and the rate of conversion to total hip arthroplasty was 7.83%.</p><p><strong>Conclusions: </strong>At minimum 5-year follow-up, puncture capsulotomy results in significantly improved functional outcomes, as well as clinically meaningful outcomes. Overall, patients reported minimal rates of complications and conversion to total hip arthroplasty.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059256","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}