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

{"title":"Anatomic Risk Factors for Lateral Patellar Instability","authors":"Arthur J. Only M.D. ,&nbsp;Elizabeth A. Arendt M.D. ,&nbsp;Betina B. Hinckel M.D., Ph.D.","doi":"10.1016/j.arthro.2024.08.009","DOIUrl":"10.1016/j.arthro.2024.08.009","url":null,"abstract":"<div><div>With an incidence of approximately 42 per 100,000 persons annually, patellar instability is a debilitating condition that can result in dysfunction of the normal patellar tracking and potential cartilage damage. The stability of the patellofemoral (PF) joint involves an intricate relationship between muscular forces, soft tissues, trochlear and patellar geometry, and limb alignment. Several anatomic patellar risk factors (APRFs) have been identified including patella alta (Caton Deschamps &gt;1.2; Insall-Salvati &gt;1.2), rotational malalignment (femoral anteversion &gt;30°, knee rotation &gt;10°, and tibial rotation &gt;35°), genu valgum (Valgus: zone 2 or greater), a lateralized tibial tubercle (tibial tubercle-trochlear grove distance &gt;17 mm; tibial tubercle-posterior cruciate ligament distance &gt;21 mm), and trochlear dysplasia. The importance of APRFs is highlighted by their overwhelming association with patellar instability; &gt;80% of patients with patellar instability have at least 1 risk factor. Biomechanically, these risk factors increase lateralizing forces on the patella, increase maltracking (patellar tilt and subluxation), decrease contact area, and increase pressure in the PF joint. In addition, there is greater anisometry of the medial PF ligament reconstruction. Clinically, the presence of APRFs increases the chances of recurrence after a first episode as well as failure rates of medial PF ligament reconstruction. Initially described by Dejour on lateral radiographs, current APRF evaluation includes standard radiographs along with axial slice imaging, with magnetic resonance imaging being more commonly used currently. In some instances, mechanical axis radiographic views and axial computed tomography rotational alignment studies may be indicated. Each risk factor can be assessed independently, as there are good-quality studies defining abnormal thresholds for individual APRF. However, there is a lack of robust clinical data defining use of these thresholds for guiding decisions regarding nonsurgical/surgical treatment, specifically, which factors need to be surgically managed and at what threshold for optimal outcomes. It is important to understand that there is an intricate and complex interaction between risk factors that need to be considered during PF evaluation. Overall, evaluation of APRF is one of the core elements of PF instability management.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"40 11","pages":"Pages 2642-2644"},"PeriodicalIF":4.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534354","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":"Low Volume and Early Career Surgeons have Higher Risk for Reoperation and Complications following Anterior Cruciate Ligament Reconstruction.","authors":"Aidan J Foley, Ryan T Halvorson, Cameron Nosrat, Brandon R Ho, Ashraf N Nawari, Kirk Terada-Herzer, Brian T Feeley, Drew A Lansdown, C Benjamin Ma, Alan L Zhang","doi":"10.1016/j.arthro.2024.10.017","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.017","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to characterize the population of surgeons performing ACLRs in the United States and investigate the relationships between surgeon volume, career duration, and practice setting on surgical outcomes.</p><p><strong>Methods: </strong>A large nationwide insurance database was queried for patients undergoing primary ACLR. Provider gender, degree type (allopathic vs. osteopathic), practice setting (academic versus private as defined by ACGME affiliation), surgeon volume per year, and career duration were obtained. Reoperations, hospitalizations, and emergency department visits were recorded. The relationships between surgeon-specific factors and postoperative outcomes were investigated through univariable and multivariable analyses controlling for patient factors such as age, gender and comorbidities.</p><p><strong>Results: </strong>54,498 patients underwent ACLR by 3,782 surgeons between 2015 and 2019 with a minimum 2-year follow up. 97.2% of the surgeons were male and 90.9% had an allopathic degree. Multivariate analysis controlling for patient variables including age, gender and comorbidities revealed surgeons with low yearly ACLR case volume demonstrated higher risk for revision ACLR while surgeons with high yearly case volume had lower revision ACLR rates (p = 0.02, p =0.003). Additionally, low case volume per year had higher rates of emergency department visits (p = 0.01). Early career surgeons had higher rates of both ACLR and non-ACLR arthroscopic reoperations (p < 0.001, p = 0.006) as well as increased emergency department visits (p <0.001). Academic affiliation was independently associated with greater non-ACLR reoperations (p < 0.001), emergency department visits (p = 0.007) and hospital readmissions (0.006).</p><p><strong>Conclusion: </strong>Patients undergoing ACLR by early career surgeons and surgeons with low yearly ACLR case volume were at increased risk for revision ACLR and post-operative ED visits.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549053","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":"Risk Factors for Failure of Hip Arthroscopy in Patients With Borderline Dysplasia Include a Tönnis Angle ≥15°, Age ≥40 to 42 Years, Female Sex, Anterior Wall Index <0.35, Labral Debridement, and Preexisting Hip Osteoarthritis: A Systematic Review.","authors":"Matthew J Kraeutler, Preston M Terle, Mahant Malempati, Jaydeep Dhillon, Kristian Samuelsson, Omer Mei-Dan","doi":"10.1016/j.arthro.2024.10.021","DOIUrl":"10.1016/j.arthro.2024.10.021","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature to determine potential risk factors for failure of hip arthroscopy (HA) in patients with borderline hip dysplasia (BHD).</p><p><strong>Methods: </strong>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching PubMed, the Cochrane Library, and Embase to identify English-language clinical studies reporting on patients with BHD undergoing HA from 2003 to 2023. The search terms used were (borderline OR mild) AND hip AND (arthroscopy OR dysplasia) AND failure. The primary outcomes assessed were risk factors reported by each study for failure of a HA-only approach in patients with BHD.</p><p><strong>Results: </strong>Fourteen studies (8 Level III, 6 Level IV) met inclusion criteria, totaling 749 hips. Patient age ranged from 29.8 to 39.2 years, with a mean follow-up ranging from 24.0 to 144.0 months. The overall percentage of female patients ranged from 11.8% to 100.0%. Overall, the clinical failure rate ranged from 0 to 53.3%, and the reoperation rate ranged from 0 to 44.0%. The predominant predictors of poor outcomes after HA alone included Tönnis angle ≥15°, age ≥40 to 42 years at surgery, and female sex. Other risk factors for failure were preoperative clinical arthritis, grade 3 or 4 articular cartilage changes to the femoral head or acetabulum, an anterior wall index <0.35, and labral debridement. Revision procedures performed included revision HA (n = 88, 0-28.0%), total hip arthroplasty (n = 55, 0%-23.7%), and endoscopic shelf acetabuloplasty (n = 5, 0%-11.0%). One study included an additional 9 patients converting to either periacetabular osteotomy or total hip arthroplasty without distinguishing between the two.</p><p><strong>Conclusions: </strong>For patients with BHD, Tönnis angle ≥15°, age ≥40 to 42 years at surgery, female sex, anterior wall index <0.35, labral debridement, and pre-existing hip osteoarthritis are common risk factors for treatment failure following isolated HA.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III-IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570378","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 Risk of Postoperative Complications and Rotator Cuff Retear Associated With Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair.","authors":"Anthony E Seddio, Jay Moran, Michael J Gouzoulis, Nickolas G Garbis, Dane H Salazar, Jonathan N Grauer, Andrew E Jimenez","doi":"10.1016/j.arthro.2024.09.057","DOIUrl":"10.1016/j.arthro.2024.09.057","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the potential impact of preoperative semaglutide use (the active agent in Ozempic and Wegovy) on 90-day postoperative outcomes and 2-year rotator cuff retear after arthroscopic rotator cuff repair (ARCR) in patients with type II diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Patients with T2DM undergoing primary ARCR were identified from the PearlDiver database using administrative billing codes. Exclusion criteria included patients <18 years old; previous RCR; concurrent nonrotator cuff-related arthroscopic shoulder procedures; any traumatic, neoplastic, or infectious diagnoses within 90 days before surgery; and <90-days follow-up. Patients with T2DM using semaglutide within 1 year of ARCR ([+]semaglutide) were matched 1:4 with patients with T2DM who did not ([-]semaglutide) by age, sex, Elixhauser Comorbidity Index, diabetes complications, obesity, tobacco, insulin, and metformin use. Occurrence of any adverse events (AAE), severe adverse events (SAE), and minor adverse events (MAE) within 90 days were compared by multivariable logistic regression. The 2-year retear was assessed by Kaplan-Meier survival analysis and compared by log-rank test.</p><p><strong>Results: </strong>There were 1,094 ARCR (+)semaglutide and 4,110 ARCR (-)semaglutide patients meeting inclusion criteria after matching. The incidence of AAE for the ARCR (-)semaglutide versus ARCR (+)semaglutide patients was 27.4% versus 11.0%, SAE was 10.5% versus 3.5%, and MAE was 22.0% versus 8.5%, respectively (P < .001 for all). ARCR (-)semaglutide patients had a greater odds ratio of AAE (3.65, P < .001) and SAE (3.62, P < .001), including surgical-site infection (2.22, P = .049), venous thromboembolism (3.10, P < .001), sepsis (3.87, P < .001), and cardiac events (3.96, P < .001), as well as greater odds of MAE (3.59, P < .001), including urinary tract infection (3.27), pneumonia (3.88), acute kidney injury (3.91), and emergency department visits (2.51) (P < .001 for all). In addition, (-)semaglutide patients revealed greater 2-year retear vs (+)semaglutide patients (18.3% vs 12.5%, respectively) (P < .001).</p><p><strong>Conclusions: </strong>Preoperative semaglutide use for patients with T2DM undergoing ARCR was associated with decreased odds of minor and serious 90-day adverse events and lower 2-year rotator cuff retear.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570330","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: Anterior Cruciate Ligament Reconstruction or Repair With Suture Augmentation Allows Early Rehabilitation: Collagen Co-braid Sutures May Improve Biological Integration.","authors":"Maximilian Michael Mueller, Sebastian Rilk, Fidelius von Rehlingen-Prinz, Gregory S DiFelice","doi":"10.1016/j.arthro.2024.10.022","DOIUrl":"10.1016/j.arthro.2024.10.022","url":null,"abstract":"<p><p>Suture augmentation in anterior cruciate ligament (ACL) reconstruction has the potential to combine improved long-term stability and high functional outcomes with accelerated rehabilitation, enhancing the biomechanical properties of the graft and reducing the risk of graft failure, particularly during the critical early phases of rehabilitation. Suture augmentation, applied to either ACL reconstruction (ACLR) or primary repair, introduces a \"safety belt\" synergistically sharing loads acting on the graft or repair. Several biomechanical studies using different autologous grafts for ACLR, as well as studies on ACL repair, have shown that suture augmentation enhances strength and prevents elongation of the graft or ligament. Suture augmentation can protect the graft-brace integrity under loads of 350 N, and reduces cyclic displacement by up to 31% compared with conventional ACLR using bone-patellar tendon-bone allograft. Perhaps, as above, the greatest advantage of suture augmentation is allowing early rehabilitation. Assuming successful ligamentization of the graft, the graft itself should stabilize the knee joint, thereby diminishing the long-term benefit of suture augmentation. In practice, we use suture augmentation to support immediate postoperative mobilization and weight bearing, enabling safe and early rehabilitation while minimizing the risk of failure. Regarding the oft-mentioned risk of overconstraint, this is not supported by biomechanical studies or clinical experience. The recent introduction of collagen co-braid sutures for suture augmentation offers 2 distinct advantages: first, potentially improved biocompatibility, and second, gradual biological integration allowing suture degradation over time.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570324","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: Studies Evaluating Artificial Intelligence Large Language Models' Ability to Respond to Questions Are Repetitive and Out-of-Date: Artificial Intelligence Must Now Be Applied to Improve Clinical Practice and Patient Care.","authors":"Jacob F Oeding","doi":"10.1016/j.arthro.2024.10.020","DOIUrl":"10.1016/j.arthro.2024.10.020","url":null,"abstract":"<p><p>While artificial intelligence (AI) technologies such as ChatGPT have shown very real and powerful capabilities to date, this does not mean that research studying these technologies is immune from \"shiny object syndrome,\" a psychological phenomenon in which individuals tend to focus on new and fashionable ideas only to be distracted from those that truly matter. In parallel with the increased publicity that AI has received since the release of large language models (LLMs) like ChatGPT, there has been an explosion in the number of studies evaluating LLMs' ability to answer hypothetical questions from patients on a variety of conditions. Nevertheless, these studies tend to leave us with the same conclusion: LLMs are generally capable of providing reliable and relevant responses to patient questions but are not without limitations. Given the abundance of studies demonstrating similar outcomes regardless of whether the LLMs are asked to respond to a patient's questions about their diabetes or about their shoulder dislocation, I'm afraid we are at risk of making AI more of a \"shiny object\" than a tool that can be used to change clinical practice and improve patient care. Specifically, we may be approaching a point at which a \"publish or perish\" mindset has promoted studies with repetitive methodologies that only confirm well-established theories around the capabilities and limitations of AI and has created a distraction from new use cases and more meaningful applications for patient care. We are now at a crossroads at which we can either remain stuck in the past, repeating old studies' methodologies on a different procedure or injury, or progress by expanding the number and impact of applications that these tools have in orthopaedic surgery. The capabilities of AI will continue to increase at a rapid pace, but it will be up to those with intricate knowledge of orthopaedics and patient care to keep up.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513445","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":"Females have Higher Return to Sport Rate than Males Among Collegiate Athletes Following Hip Arthroscopy for Femoroacetabular Impingement Due to the Difference in the Type of Sports, Type of Impingement, Prevalence of Severe Cartilage Damage.","authors":"Haruki Nishimura, Spencer Comfort, Jarrod Brown, Alexander R Garcia, Eddie Afetse, Olivia Jochl, Kohei Yamaura, Nicholas A Felan, Alyson Speshock, Grant J Dornan, Marc J Philippon","doi":"10.1016/j.arthro.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.016","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the return to sport (RTS) rate and the sex-based difference of collegiate athletes following arthroscopic treatment for FAI.</p><p><strong>Method: </strong>Patients who were collegiate athletes at the time of surgery and underwent hip arthroscopy for treatment of FAI between January 2009 and June 2020 were included. Patients were excluded if they were in their final year of eligibility, graduated, retired, or had plans to retire from collegiate play prior to surgery. Publicly available data was collected regarding each patient's collegiate team and division, and RTS status after surgery. Comparisons were made based on the RTS status and gender.</p><p><strong>Results: </strong>Of the 181 hips (144 athletes) who met the inclusion criteria, 114 were male (63%) and 67 female (37%) hips with a median age of 20.4 (Range: 18.0-24.5). Eighty-six percent (155 hips) returned to sport at the collegiate level following hip arthroscopy. Males were significantly less likely to return to sport compared to females (82% vs 93%, OR = 2.8, 95% CI [1.003, 7.819], p=0.042). Males participated in more contact sports (26% vs 1.5%, p < 0.001) and had more mixed-type FAI (95.6% vs 80.6%, P=0.003) compared to females. In addition, males had more grade 3/4 chondral defects (28% vs 13%, p=0.023) and underwent microfracture more frequently (11% vs 3%, p=0.047). Further, males had significantly larger postoperative alpha angles (46.2 vs 43.6, p< .001).</p><p><strong>Conclusion: </strong>Collegiate athletes were found to have a high return to sport rate of 86% following arthroscopy for the treatment of FAI, however, males were less likely to return to sport compared to females. Sex-based differences were identified in the type of sports, type of FAI, prevalence of severe cartilage damage, and postoperative alpha angle.</p><p><strong>Level of evidence: </strong>Retrospective case series, Level IV.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513443","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":"Lafi Saba Khalil, M.D., Associate Editor.","authors":"James H Lubowitz","doi":"10.1016/j.arthro.2024.10.018","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.10.018","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513444","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 Chondral Nail Fixation for Treating Acetabular Cartilage Delamination Results in Improved Pain Relief at Minimum 2-Year Follow-Up in Patients With Femoroacetabular Impingement Syndrome: A Propensity-Matched Study.","authors":"Yichuan Zhu, Hanmei Dong, Guanying Gao, Jiayang Liu, Cancan Du, Siqi Zhang, Kang Tian, Zhenlong Liu, Yan Xu","doi":"10.1016/j.arthro.2024.10.008","DOIUrl":"10.1016/j.arthro.2024.10.008","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical outcomes after arthroscopic chondral nail fixation for acetabular cartilage delamination (ACD) in patients with femoroacetabular impingement syndrome (FAIS), as well as the presentation of ACD on magnetic resonance imaging (MRI), at follow-up.</p><p><strong>Methods: </strong>A retrospective review was performed between March 2021 and March 2022 at our institute. Patients undergoing primary hip arthroscopy for FAIS in whom ACD was diagnosed intraoperatively were included. The exclusion criteria were incomplete data or loss to minimum 2-year follow-up and concomitant hip conditions including hip osteoarthritis with a Tönnis grade greater than 1, avascular necrosis, Legg-Calvé-Perthes disease, osteoid osteoma, synovial chondromatosis, pigmented villonodular synovitis, and developmental dysplasia of the hip. Patients who underwent chondral nail fixation were matched 1:1 to a control cohort of patients who only underwent simple debridement. Preoperative and minimum 2-year postoperative patient-reported outcome scores, including the visual analog scale (VAS) pain score and modified Harris Hip Score (mHHS), as well as percentage achieving the minimal clinically important difference and patient acceptable symptom state (PASS), were collected and compared. MRI was performed preoperatively and at final follow-up to assess ACD.</p><p><strong>Results: </strong>Fifty-eight patients were included in the study (29 patients in each group). Both groups showed improved VAS pain scores and mHHS values after surgery (all P < .05). The chondral nail group showed better postoperative VAS pain scores (P = .022) than the control group, whereas the postoperative mHHS values were comparable between the 2 groups (P = .852). No significant differences in achievement of the minimal clinically important difference were found between the 2 groups (all P > .05). More patients in the chondral nail group achieved the PASS for the VAS pain score compared with the control group (75.9% vs 48.3%, P = .030). No patient underwent revision surgery or conversion to total hip arthroplasty. The chondral nail group showed a significantly higher rate of ACD healing on MRI compared with the control group (P < .001).</p><p><strong>Conclusions: </strong>Patients undergoing arthroscopic chondral nail fixation for the treatment of ACD showed significant pain relief, greater achievement of the PASS for the VAS pain score, and a higher rate of ACD healing on MRI compared with those undergoing simple debridement.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481627","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: Both Rotator Cuff Repair and Superior Capsular Reconstruction in Patients With Diabetes Show Good Outcomes When Glucose Is Well Managed.","authors":"Stephen C Weber","doi":"10.1016/j.arthro.2024.10.015","DOIUrl":"10.1016/j.arthro.2024.10.015","url":null,"abstract":"<p><p>Diabetes has been reported to be a significant risk factor for rotator cuff repair, both for increased complication rates and poor cuff integrity at final follow-up. Similar results might be expected for superior capsular reconstruction; however, strict glucose management, as with rotator cuff repair, is shown to allow these rotator cuff procedures to proceed with success rates similar to patients without diabetes.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481630","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}