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

{"title":"Rotator Cuff Repairs Augmented with Exosomes in a Rabbit Model Are Stronger and Histologically Superior to Repairs Performed in Isolation.","authors":"Andrew Sheean","doi":"10.1016/j.arthro.2025.04.045","DOIUrl":"https://doi.org/10.1016/j.arthro.2025.04.045","url":null,"abstract":"<p><p>Ongoing research should focus on improving healing of rotator cuff repairs at the tendon-to-bone interface. \"Cells, scaffolds, and signals\" is useful in categorizing orthobiologic-related approaches to augmenting RCR. Cell-based therapies such as platelet rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) exert positive effects through production of signaling molecules that modulate the inflammatory process, promote angiogenesis, and facilitate new tendon tissue growth. \"Scaffolds\" refer to structural and non-structural augments that may facilitate concentration of biologically active constituents at the healing site and provide time zero tissue strength of repaired tissues. Owing to challenges associated with the use of cell-based products, isolation and targeted delivery of the signaling molecules represent a promising avenue for optimizing tendon repair healing. \"Exosomes\" are small extracellular vesicles (30-150 nanometers) secreted by cells that serve as natural carriers of bioactive molecules. The role of exosomes in influencing intercellular communication-modulating inflammation, promoting angiogenesis, and regulating extracellular matrix (ECM) remodeling-makes them uniquely suited for tissue repair applications and a natural target for RCR-related basic science research. The use of exosomes represents a promising adjunct that appears to improve the biomechanical and histological properties of rotator cuff repairs. Rotator cuff repairs augmented with exosomes in a rabbit model may be stronger and histologically superior to repairs performed in isolation.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007549","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":"Fear of Reinjury, Psychological Factors, and Sport Played Have Negative Impact on Return to Sport Following Medial Patellofemoral Ligament Reconstruction for Patellar Instability","authors":"Patrick C. Ryan M.S. ,&nbsp;Idaleen C. Ching B.S. ,&nbsp;Victoria K. Ierulli M.S. ,&nbsp;Keith Pickett M.L.I.S. ,&nbsp;Mary K. Mulcahey M.D.","doi":"10.1016/j.arthro.2024.05.022","DOIUrl":"10.1016/j.arthro.2024.05.022","url":null,"abstract":"<div><h3>Purpose</h3><div><span>To analyze factors that affect return to sport after medial patellofemoral </span>ligament reconstruction (MPFLR), such as psychological factors, sport played, and a positive apprehension test following surgery, and to determine the average return to sport rates and time to return to sport.</div></div><div><h3>Methods</h3><div>A literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies met the following criteria: patients underwent MPFLR for patellar instability, return to sport was recorded, and a factor that affected return to sport was mentioned. Search terms included medial patellofemoral ligament, tibial tubercle osteotomy, tibial tubercle transfer, return to play, and return to sport.</div></div><div><h3>Results</h3><div>Eighteen of 632 identified studies met inclusion criteria, and 1,072 patients who underwent MFPLR were recorded. Return-to-sport rates and mean/median time ranged from 60.0% to 100% and 3 to 10.4 months, respectively. Of the patients, 55.6% to 84.0% returned to sport without decreasing the level of competition. Six of 12 studies (50.0%) reported fear of reinjury as the top reason for patients not returning or returning at a lower level of sport. Volleyball/handball had the lowest return to the same level following surgery (18.2%-50.0%).</div></div><div><h3>Conclusions</h3><div>Athletes who underwent MPFLR following recurrent patellar instability returned to sport at a range of 60.0% to 100%. Return to sport at the same level or higher was found to have a lower maximum rate at 55.6% to 84.0%. Fear of reinjury and sport played were found to have a substantial impact on ability to return to sport. Surgeons can use this information to advise patients on expectations following surgery.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1605-1617"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288992","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 Reoperation Rate and Superior Patient-Reported Outcome Following Arthroscopic Rotator Cuff Repair With Concomitant Acromioplasty: An Updated Systematic Review of Randomized Controlled Trials","authors":"Songyun Yang M.D. ,&nbsp;Long Pang M.D. ,&nbsp;Chunsen Zhang M.D. ,&nbsp;Jiapeng Wang M.D. ,&nbsp;Lei Yao M.D. ,&nbsp;Yinghao Li M.D. ,&nbsp;Yizhou Huang Ph.D. ,&nbsp;Xin Tang M.D., Ph.D.","doi":"10.1016/j.arthro.2024.05.026","DOIUrl":"10.1016/j.arthro.2024.05.026","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically assess the postoperative outcomes in patients undergoing arthroscopic rotator cuff repairs with or without concomitant acromioplasty through a rigorous systematic review of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>This systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to identify RCTs comparing clinical outcomes of patients with full-thickness rotator cuff tears undergoing arthroscopic rotator cuff repair with acromioplasty versus those without at a minimum 12-month follow-up. Databases searched included PubMed, Web of Science, Embase, and the Cochrane Library. The risk of bias in the included studies was assessed using the revised Cochrane Risk of Bias 2. Meta-analysis was conducted for outcomes with at least 3 studies reporting, with pooled effect estimates calculated using either fixed-effect or random-effects models based on heterogeneity levels. Results were presented as the weighted mean difference or odds ratio with 95% confidence intervals (CIs). Primary outcomes included rates of retear and reoperation, whereas secondary outcomes included improvement in American Shoulder and Elbow Surgeons (ASES) score, range of motion (ROM), and complication rate.</div></div><div><h3>Results</h3><div>Five high-quality RCTs, with low bias risk, involving 409 patients, revealed demographics of 58.4% males, mean age of 58.4 years, and the following acromion types: 12.2% type I, 70.7% type II, and 17.1% type III. Mean follow-up was 52.2 months. All involved studies reported comparable retear and complication rates between the 2 groups. However, the involved studies indicated a lower reoperation rate, and the pooled data demonstrated a statistically superior improvement in ASES score (weighted mean difference, 3.99; 95% CI, 1.00-6.99; <em>P</em> = .009) in the acromioplasty group. Both groups showed significant improvements in ROM, but insufficient data prevented a comparison.</div></div><div><h3>Conclusions</h3><div>Compared with arthroscopic rotator cuff repair alone, arthroscopic rotator cuff repair with acromioplasty demonstrated similar rates of retear and complications but had a significantly lower reoperation rate and superior improvement in ASES score. The available data were insufficient to draw a definitive conclusion regarding ROM. This conclusion is fragile due to a limited sample size.</div></div><div><h3>Level of Evidence</h3><div>Level II, systematic review of Level I and II studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1618-1634"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322095","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":"Fatty Infiltration, Tear Size, and Retraction Size Are Significant Risk Factors for Retear After Arthroscopic Rotator Cuff Repair: A Systematic Review","authors":"Azad Darbandi M.D. ,&nbsp;Kevin Credille M.D. ,&nbsp;Aria Darbandi M.D. ,&nbsp;Mario Hevesi M.D., Ph.D. ,&nbsp;Navya Dandu M.D. ,&nbsp;Blake M. Bodendorfer M.D. ,&nbsp;Zachary Wang B.S. ,&nbsp;Grant Garrigues M.D. ,&nbsp;Nikhil Verma M.D. ,&nbsp;Adam Yanke M.D., Ph.D.","doi":"10.1016/j.arthro.2024.06.040","DOIUrl":"10.1016/j.arthro.2024.06.040","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the consistency and quality of risk factor reporting for rotator cuff repair (RCR) retear and identify risk factors most frequently associated with retear.</div></div><div><h3>Methods</h3><div>A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Of the initial 3,158 studies, a total of 31 met the following inclusion criteria: (1) clinical studies regarding RCR failure, (2) arthroscopic procedures involving RCR, (3) reporting of clinical outcomes, (4) publication within the past 5 years, and (5) studies investigating preoperative risk factors for retear. After full-text review, 18 risk factors were analyzed.</div></div><div><h3>Results</h3><div>The most consistently significant risk factors were acromiohumeral distance (80%), critical shoulder angle (67%), tear size (63%), anterior-posterior dimension (60%), fatty infiltration (FI) (58%), and retraction size (56%). FI was analyzed using different methods among studies, with 63% finding significant results and 50% of all studies performing ordinal analysis. Tear size was inconsistently analyzed quantitatively or qualitatively, with 58% of studies finding significant results and 63% of all studies performing quantitative analysis. Risk factors consistently found to be nonsignificant included age, sex, diabetes mellitus, symptom duration, hand dominance, repair technique, smoking, and body mass index.</div></div><div><h3>Conclusions</h3><div>Tear size, FI, and retraction size were found to be significant risk factors in most of the included studies evaluating rotator cuff retear. Risk factors less likely reported as predictive included repair technique, age, sex, diabetes mellitus, symptom duration, hand dominance, repair technique, smoking, and body mass index. Risk factors that require further investigation include critical shoulder angle, acromiohumeral distance, and anterior-posterior tear dimension.</div></div><div><h3>Level of Evidence</h3><div>Level III, systematic review of Level III-IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1649-1666.e3"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581577","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: Combined Anterior Cruciate Ligament/Medial Collateral Ligament Injuries: Surgeons Should Have a Low Threshold to Operate on the Medial Collateral Ligament","authors":"Thomas R. Hays M.D.,&nbsp;Michael S. Barnum M.D.,&nbsp;Bruce A. Levy M.D.","doi":"10.1016/j.arthro.2024.07.004","DOIUrl":"10.1016/j.arthro.2024.07.004","url":null,"abstract":"<div><div>Combined anterior cruciate ligament/medial collateral ligament (ACL/MCL) injuries are relatively common, and multiple factors are involved in surgical decision-making, particularly when it comes to the MCL. Historically, most surgeons treated the MCL conservatively and performed staged MCL reconstruction after MCL reconstruction only if there was persistent medial instability. This was followed by a nonoperative approach for the MCL (when reconstructing the ACL) unless there was evidence of extreme (grade III or &gt;1 cm) valgus instability, valgus malalignment, or mid-substance or tibial-sided injury, avulsion, or Stener lesion. However, the most recent research demonstrates that combined ACL/MCL injuries present a higher risk of ACL reconstruction failure and subsequent revision compared to ACL injuries alone. With growing biomechanical and clinical evidence, more surgeons are repairing or reconstructing the MCL in these combined injuries. Although there is no clear consensus, we recommend surgeons consider surgically treating the MCL to avoid not only excessive force on the ACL graft but also persistent valgus laxity, which can lead to ACL failure. For distal MCL avulsions, repairs have shown excellent midterm outcomes, especially if the tissue quality is pristine. If the tissue quality is not repairable, then we would advocate for repairing whatever tissue is repairable and augmenting with an MCL reconstruction. For mid-substance MCL injuries, if surgical intervention is required, we advocate for MCL reconstruction. For proximal tears, the same criteria used for distal tears apply with management based on tissue quality and joint stability after repair. The ACL is a secondary stabilizer to valgus loads, and MCL deficiency results in tremendous strain on ACL graft reconstructions. If the MCL is even mildly incompetent, we strongly advocate for treating the MCL surgically in this setting.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1434-1437"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735773","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":"Regarding “Adding Dexmedetomidine to Intra-articular Local Anesthetics Results in Prolonged Analgesia After Knee Arthroscopy: A Systematic Review and Meta-analysis”","authors":"Musab Elhadi M.B.B.S., F.C.A.I.,&nbsp;Paul Stewart M.B. B.Ch. B.A.O., F.C.A.I., E.D.R.A.,&nbsp;Claire C. Nestor M.B. B.Ch. B.A.O., F.C.A.I., E.D.I.C., E.D.R.A.","doi":"10.1016/j.arthro.2024.11.056","DOIUrl":"10.1016/j.arthro.2024.11.056","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1245-1246"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","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}

{"title":"ASMAR Special Issue: Injury Prevention Is Optimized Using Cutting-Edge Rehabilitation Strategies","authors":"Stephanie C. Petterson M.P.T., Ph.D.,&nbsp;Elizabeth Matzkin M.D.,&nbsp;Michael J. Rossi M.D., M.S.","doi":"10.1016/j.arthro.2025.01.063","DOIUrl":"10.1016/j.arthro.2025.01.063","url":null,"abstract":"<div><div>Sports-related injuries are costly to treat and have many associated intangible effects. Musculoskeletal health care professionals in rehabilitation strive to keep athletes at their peak performance with a principal focus on injury prevention. “Prevention is better than a cure” remains relevant to all athletes and nonathletes alike. In this special issue of <em>Arthroscopy, Sports Medicine, and Rehabilitation,</em> “Injury Prevention and Rehabilitation,” which can be found at <span><span>https://www.arthroscopysportsmedicineandrehabilitation.org/injury-prevention-and-rehabilitation</span><svg><path></path></svg></span>, we bring a multifaceted approach and diverse perspectives in helping athletes and active individuals remain injury free with prevention and training strategies while optimizing performance and providing key rehabilitation strategies for common sports-related injuries.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1241-1242"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442710","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":"Arthroscopic Autologous Iliac Crest Grafting With an Adjustable-Loop Suspensory Device Yields Favorable Outcomes for Anterior Shoulder Instability With Glenoid Defects","authors":"Weilin Yu M.D., Ph.D. ,&nbsp;Di Wu M.D. ,&nbsp;Chenrui Yuan M.B.B.S. ,&nbsp;Xiping Jiang M.B.B.S. ,&nbsp;Yaohua He M.D., Ph.D.","doi":"10.1016/j.arthro.2024.07.035","DOIUrl":"10.1016/j.arthro.2024.07.035","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical and radiologic outcomes of the arthroscopic autologous iliac crest grafting (AICG) procedure with an adjustable-loop suspensory fixation device in the treatment of anterior shoulder instability with glenoid bone defects.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on the patients who underwent arthroscopic AICG with an adjustable-loop suspensory fixation device from January 2017 to December 2020. Patients with traumatic anterior shoulder instability, significant glenoid bone defects, and a minimum follow-up of 24 months were included. Patient-reported outcomes, including the Oxford Shoulder Instability Score (OSIS), the Rowe score, the Walch-Duplay score, the Constant score, and the visual analog scale score, were compared preoperatively and postoperatively. Radiologic assessments using computed tomography were performed before and after the procedure. Additional data on active range of motion, recurrence events, and complications were recorded.</div></div><div><h3>Results</h3><div>A total of 42 patients were included in the study, with a mean follow-up time of 35.2 months, ranging from 25.1 to 55.9 months. Mean preoperative OSIS, Rowe score, Walch-Duplay score, and Constant score significantly improved from 24.4 ± 7.2, 25.0 ± 9.0, 25.2 ± 9.8, 87.5 ± 7.1 to 42.4 ± 4.9, 92.4 ± 8.1, 87.9 ± 8.3, and 93.6 ± 4.5 at the last follow-up, respectively. All patients exceeded the minimal clinically important difference for OSIS, Rowe, and Walch-Duplay scores. The graft union rate was 100%, and the glenoid area increased significantly from 82.5% preoperatively to 100.1% at the final follow-up. No patient experienced a recurrence of instability. Two recorded complications included one case of dysesthesia around the donor site and one case of postoperative shoulder stiffness.</div></div><div><h3>Conclusions</h3><div>The outcomes of the arthroscopic AICG procedure, which uses an adjustable-loop suspensory fixation device, demonstrated stable bone graft fixation, high rates of graft integration, favorable clinical results, and a low incidence of complications. Moreover, the remodeling of the graft during the follow-up period significantly restored the width and concavity of the inferior glenoid, contributing to the overall recovery.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1326-1334"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019680","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":"Social Determinants of Health Disparities Increase 5-Year Revision Rates but Not Postoperative Complications After Primary Hip Arthroscopy","authors":"Stephen M. Gillinov A.B. ,&nbsp;Zachary L. LaPorte B.A. ,&nbsp;Jonathan S. Lee B.A. ,&nbsp;Bilal S. Siddiq B.S. ,&nbsp;Kieran S. Dowley B.A. ,&nbsp;Nathan J. Cherian M.D. ,&nbsp;Christopher T. Eberlin M.D. ,&nbsp;Michael P. Kucharik M.D. ,&nbsp;Scott D. Martin M.D.","doi":"10.1016/j.arthro.2024.07.038","DOIUrl":"10.1016/j.arthro.2024.07.038","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the impact of social determinants of health (SDOH) disparities on 30-day emergency department (ED) visits, 90-day postoperative complications, and 5-year secondary surgery rates after primary hip arthroscopy using a large national database.</div></div><div><h3>Methods</h3><div>A national administrative claims database was used to identify patients who underwent primary hip arthroscopy with femoroplasty, acetabuloplasty, and/or labral repair between 2015 and 2022. Queries were performed to identify patients who experienced any SDOH disparities, including economic, educational, environmental, or social disparities; those experiencing SDOH disparities within 1 year prior to primary hip arthroscopy were matched 1:1 by age, sex, Elixhauser Comorbidity Index score, diabetes, obesity, and tobacco use to patients not experiencing any lifetime SDOH disparities. The odds of 90-day complications and 30-day ED visits were compared using multivariable logistic regression. Rates of 5-year revision hip arthroscopy and of any secondary surgery (revision hip arthroscopy or total hip arthroplasty) were compared by Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>A total of 3,383 primary hip arthroscopy patients who experienced SDOH disparities were matched 1:1 to a control cohort of 3,383 patients who did not experience SDOH disparities (age of 41.0 years and 79.6% female sex in both cohorts). The odds of adverse events after arthroscopy were low and did not differ between the SDOH cohort (1.51%) and no-SDOH cohort (1.57%, <em>P</em> = .09). Additionally, there was no difference in the odds of 30-day ED visits between the SDOH cohort (5.65%) and no-SDOH cohort (4.79%, <em>P</em> = .10). The rate of 5-year revision hip arthroscopy was significantly greater among patients experiencing SDOH disparities (5.4% vs 4.1%, <em>P</em> = .02); however, there was no difference in the rate of any secondary surgery between cohorts (11.8% vs 10.4%, <em>P</em> = .10).</div></div><div><h3>Conclusions</h3><div>Patients experiencing SDOH disparities had similar odds of postoperative complications and ED visits after primary hip arthroscopy but greater rates of 5-year revision hip arthroscopy compared with a matched-control cohort of patients not experiencing SDOH disparities.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case-control study.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1402-1409.e3"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019681","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":"Greater Postoperative Biceps Tendon Migration After Arthroscopic Suprapectoral or Open Subpectoral Biceps Tenodesis Correlates With Lower Patient-Reported Outcome Scores","authors":"Brian Forsythe M.D. ,&nbsp;Elyse J. Berlinberg M.D. ,&nbsp;Daanish Khazi-Syed B.S. ,&nbsp;Harsh H. Patel M.D. ,&nbsp;Enrico M. Forlenza M.D. ,&nbsp;Kelechi R. Okoroha M.D. ,&nbsp;Brady T. Williams M.D. ,&nbsp;Adam B. Yanke M.D., Ph.D. ,&nbsp;Brian J. Cole M.D., M.B.A. ,&nbsp;Nikhil N. Verma M.D.","doi":"10.1016/j.arthro.2024.07.037","DOIUrl":"10.1016/j.arthro.2024.07.037","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the relation between tendon migration, as measured by radiostereometric analysis, and patient-reported outcome measures (PROMs) after biceps tenodesis (BT); to determine the likelihood of achieving clinically significant outcomes (CSOs) after BT; and to identify factors that impact CSO achievement.</div></div><div><h3>Methods</h3><div>Patients undergoing arthroscopic suprapectoral or open subpectoral BT at a single, high-volume academic medical center were prospectively enrolled. A tantalum bead sutured to the tenodesis construct was used as a radiopaque marker. Biceps tendon migration was measured on calibrated radiographs at 12 weeks postoperatively. PROMs (Constant-Murley, Single Assessment Numeric Evaluation [SANE], and Patient-Reported Outcomes Measurement Information System–Upper Extremity [PROMIS-UE] scores) were collected preoperatively and at minimum 2-year follow-up.</div></div><div><h3>Results</h3><div>Of 115 patients enrolled, 94 (82%) were included (median age, 52 years; median body mass index, 31.4). At a mean follow-up of 2.9 years, the median Constant-Murley, SANE, and PROMIS-UE scores were 33 (interquartile range [IQR], 26-35), 90 (IQR, 80-99), and 47 (IQR, 42-58), respectively. Median tantalum bead migration was 6.5 mm (IQR, 1.8-13.8 mm). There were significant correlations between migration and Constant-Murley score (<em>r</em>² = 0.222; β = –0.554 [95% confidence interval (CI), –1.027 to –0.081]; <em>P</em> = .022), SANE score (<em>r</em>² = 0.238; β = –0.198 [95% CI, –0.337 to –0.058]; <em>P</em> = .006), and PROMIS-UE score (<em>r</em>² = 0.233; β = –0.406 [95% CI, –0.707 to –0.104]; <em>P</em> = .009). On univariable analysis, higher body mass index was associated with achievement of substantial clinical benefit (unadjusted odds ratio [OR], 1.078 [95% CI, 1.007 to 1.161]; <em>P</em> = .038). Greater bead migration was negatively associated with achievement of the minimal clinically important difference (unadjusted OR, 0.969 [95% CI, 0.943 to 0.993]; <em>P</em> = .014) and patient acceptable symptomatic state (unadjusted OR, 0.965 [95% CI, 0.937 to 0.989]; <em>P</em> = .008) on all 3 instruments.</div></div><div><h3>Conclusions</h3><div>A 1-cm increase in post-tenodesis biceps tendon migration was associated with a decrease in the Constant-Murley, SANE, and PROMIS-UE scores of 6, 2, and 4 points, respectively, at a mean of 2.9 years after surgery. Most patients achieved CSOs for these PROMs by latest follow-up, and greater biceps tendon construct migration was negatively associated with the likelihood of CSO achievement.</div></div><div><h3>Level of Evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1302-1313.e2"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037791","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}