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

{"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}

{"title":"Editorial Commentary: In Cases of Cam Over-resection and Irreparable Hip Labral Tear Requiring Revision, Acetabular Circumferential Labral Reconstruction With Larger Graft Width Is Indicated","authors":"David R. Maldonado M.D. (Associate Editor)","doi":"10.1016/j.arthro.2024.08.039","DOIUrl":"10.1016/j.arthro.2024.08.039","url":null,"abstract":"<div><div>Hip arthroscopy technique and innovation has revolutionized the surgical approach to femoroacetabular impingement syndrome (FAIS). Arthroscopic labral reconstruction is the gold-standard treatment for irreparable acetabular labral tears in FAIS surgery and backed by robust long-term clinical data. However, cam over-resection has become a prevalent complication, often co-occurring with irreparable labral tears in revision FAIS surgery. Revision circumferential labral reconstruction is a promising solution, particularly from a biomechanical perspective, in restoring the suction seal. Larger graft width is indicated in these cases.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1400-1401"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156716","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: Multiple Factors, Including Multimodal Anesthesia, Can Reduce Opioid Requirements After Rotator Cuff Repair","authors":"Justin J. Greiner M.D. (Editorial Board)","doi":"10.1016/j.arthro.2024.09.017","DOIUrl":"10.1016/j.arthro.2024.09.017","url":null,"abstract":"<div><div>Rotator cuff repair often results in significant pain and discomfort early after surgery, whereas longer-term outcomes generally result in substantial improvement. Efforts to decrease pain levels and opioid use after arthroscopic rotator cuff repair have led to the expansion of multimodal analgesia techniques. An interscalene brachial plexus block (ISBPB)–“plus” technique adds a subacromial space injection and “blind” (i.e., without imaging) suprascapular and axillary nerve blocks. Recent research has shown that the ISBPB-plus technique results in less opioid consumption at 48 hours compared with an isolated ISBPB and that both techniques show similar patient satisfaction and postoperative pain scores. Although the optimal multimodal strategy has yet to be determined for specific surgical treatments, decreased opioid consumption is a high priority. Multiple patient factors also require consideration, including severity of pathology, management of depression, preoperative patient education, and cognitive-behavioral therapy. Moreover, surgical technique modifications, cryotherapy, and transcutaneous electrical nerve stimulation may provide pain-reduction benefits.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1299-1301"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301731","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":"No Clear Difference in Clinical Outcomes Between Knotted and Knotless Arthroscopic Bankart Repair: A Systematic Review","authors":"Gunjar Jain M.S.Ortho. ,&nbsp;Rameshwar Datt M.S.Ortho. ,&nbsp;Anant Krishna M.S.Ortho. ,&nbsp;Bishnu Prasad Patro M.S.Ortho. ,&nbsp;Rahul Morankar M.D.S.","doi":"10.1016/j.arthro.2024.05.036","DOIUrl":"10.1016/j.arthro.2024.05.036","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze whether the arthroscopic Bankart repair using a knotless suture anchor has a better functional outcome than the conventional knot-tying Bankart repair.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was done in the PubMed, Scopus, Embase, and Cochrane databases in May 2023. Studies comparing the clinical outcome of Bankart repair using knotless and knot-tying techniques were included in the study. In vitro, animal, and Level IV and V studies were excluded. The risk of bias in randomized controlled trials was calculated according to the RoB 2 tool, and for nonrandomized studies, Methodological Index for Non-Randomized Studies criteria were used. Statistical analysis was done using RevMan software.</div></div><div><h3>Results</h3><div>A total of 9 studies, including 2 randomized controlled trials and 7 nonrandomized comparative studies involving 720 patients, were included in the systematic review. The ROWE score ranged from 81.7 to 94.3 in the knot-tying group and 86 to 96.3 in the knotless group. Visual Analog Scale scores at the final follow-up ranged from 0.1 to 1.7 in the knot-tying group and 0.7 to 2.5 in the knotless group. The rate of redislocation, subluxation, and revision surgery in the knot-tying group ranged from 0% to 14.7%, 16.7% to 29.7%, and 1.6% to 17.6%, respectively, whereas that in the knotless group ranged from 2.4% to 23.8%, 7.4% to 22.2%, and 2.4% to 19%, respectively. The mean external rotation was 54° to 65° in the knot-tying group and 61° to 99° in the knotless group. The mean forward-flexion was 164 to 172 in the knot-tying group and 165 to 174 in the knotless group. Our subjective synthesis does not reveal any difference in the outcome between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The available literature does not demonstrate a clear difference in functional outcomes, residual pain, and rate of complications as redislocation, subluxation, and revision surgery between Bankart repairs performed with knotted and knotless anchors.</div></div><div><h3>Level of Evidence</h3><div>Level III, systematic review of Level I to III studies</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1637-1648.e1"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472921","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":"Anterior Cruciate Ligament Reconstruction Augmentation With Bone Marrow Aspirate Concentrate, Demineralized Bone Matrix, and Suture Tape Shows No Difference in Outcomes—But Faster Functional Recovery—Versus Non-augmented Anterior Cruciate Ligament Reconstruction","authors":"Chad D. Lavender M.D.,&nbsp;Andrew L. Schaver M.D.,&nbsp;Shane Taylor M.D.,&nbsp;Richard Peluso M.D.,&nbsp;Galen Berdis M.D.,&nbsp;Vishapreet Singh M.D.,&nbsp;Kara Cipriani N.P.,&nbsp;Dana Lycans M.D.,&nbsp;John Jasko M.D.,&nbsp;Timothy E. Hewett Ph.D.","doi":"10.1016/j.arthro.2024.06.042","DOIUrl":"10.1016/j.arthro.2024.06.042","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare outcomes after anterior cruciate ligament reconstruction (ACLR) with bone marrow aspirate concentrate (BMAC), demineralized bone matrix (DBM), and suture tape augmentation (STA) versus ACLR without biological augmentation or STA.</div></div><div><h3>Methods</h3><div>We performed a prospective randomized controlled trial at a single institution to compare ACLR with BMAC, DBM, and STA (group A) versus ACLR without biological augmentation or STA (group NA). The study sought to include 100 patients. Skeletally mature patients younger than 25 years received quadriceps tendon autograft, whereas patients aged 25 years or older underwent allograft ACLR with an all-inside technique. Patients with concomitant meniscal pathologies were included. The primary outcomes compared were range of motion (ROM), limb symmetry, and patient-reported outcomes. Secondary outcomes included radiographic outcomes and surgical complications. Univariate and mixed-model regression analyses were used to compare outcomes.</div></div><div><h3>Results</h3><div>Fifty-nine patients were included (29 patients in group A [11 female patients, 38%] and 30 patients in group NA [15 female patients, 50%]). Early ROM at 6 weeks (125° of flexion vs 109° of flexion, <em>P</em> &lt; .0001) and limb symmetry at 12 weeks (80.6% vs 36.7% [delta, 43.9%], <em>P</em> &lt; .001) were significantly improved in group A. At 2 years, International Knee Documentation Committee scores were similar (91.1 ± 12.7 vs 85.3 ± 10.8, <em>P</em> = .109). Quality-of-life subscores of the Knee Injury and Osteoarthritis Outcome Score were significantly enhanced in group A (85.2 ± 20.9 vs 72.1 ± 20.4, <em>P</em> = .042). In 22 patients (12 in group A and 10 in group NA), computed tomography scans were obtained at 6 months to compare bone tunnel healing. Overall, the mean increase in bone tunnel diameter was significantly smaller in group A than in group NA. No difference in graft rerupture or reoperation rate was observed. Reoperations were performed for stiffness in 7 of 59 patients (11.9%) (3 [10%] in group A vs 4 [13%] in group NA; <em>P</em> &gt; .999).</div></div><div><h3>Conclusions</h3><div>There were no differences in International Knee Documentation Committee scores between groups at 2-year follow-up. Functional outcomes including early ROM and limb symmetry were significantly improved in patients who received ACLR with BMAC, DBM, and STA.</div></div><div><h3>Level of Evidence</h3><div>Level II, randomized controlled trial.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 5","pages":"Pages 1496-1508"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762922","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}