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

{"title":"Regarding “MRI Accurately Predicts Quadrupled Semitendinosus Autograft Size Using Posterior Hamstring Harvest for ACL Reconstruction”","authors":"","doi":"10.1016/j.arthro.2024.07.010","DOIUrl":"10.1016/j.arthro.2024.07.010","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762924","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":"Labral Augmentation With Either Iliotibial Band Allograft or Dermis Allograft Perform Similarly Regarding Peak Force, Displacement, and Work to Labral Repair in Suction Seal Restoration: A Biomechanical Study","authors":"","doi":"10.1016/j.arthro.2024.01.029","DOIUrl":"10.1016/j.arthro.2024.01.029","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether allograft<span><span> substitutes may be used to restore suctional seal properties with labral augmentation, the purpose of the current study was to evaluate the biomechanical properties<span> of the labral suction seal under several scenarios, including: (1) intact labrum, (2) rim preparation, (3) labral repair, (4) labral augmentation with iliotibial band (ITB), and (5) labral augmentation with a dermis </span></span>allograft.</span></div></div><div><h3>Methods</h3><div>Eleven hemi-pelvises were dissected to the level of the labrum and placed in a material testing system for biomechanical axial distraction. Each specimen was compressed to 250 newtons (N) and distracted at 10 mm/s while load, crosshead displacement, and time were continuously recorded. For each of the 5 labral states, 3 testing repetitions were performed. Peak force (N, newtons), displacement at peak force (mm, millimeter), and work (N-mm, newton, millimeter) were calculated and normalized to the intact state of each specimen.</div></div><div><h3>Results</h3><div><span>Eleven specimens were tested and 8 specimens (age: 58.6 ± 5.4 years, body mass index: 28.6 ± 6.8 kg/m</span><sup>2</sup><span>; 4 female patients; 5 right hips) were included in final analyses. Expressed as a percentage relative to the intact state, the average normalized peak force, displacement at peak force, and work for each labral state were as follows: intact (100.0% ± 0% for all), rim preparation (89.0% ± 9.2%, 93.3% ± 20.6%, 85.1% ± 9.0%), repair (61.3% ± 17.9%, 88.4% ± 36.9%, 58.1% ± 16.7%), ITB allograft (62.7% ± 24.9%, 83.9% ± 21.6%, 59.4% ± 22.4%), and dermis allograft (57.8% ± 27.2%, 88.2% ± 29.5%, 50.0% ± 20.1%). Regarding peak force, intact state was significantly greater compared with the labral repair, augmentation with ITB, and augmentation with the dermis allograft states (</span><em>P</em> < .001). No significant differences were demonstrated between displacement at peak force (<em>P</em> = .561). Regarding work, both intact state and rim preparation states were significantly greater than the repair, ITB augmentation, and dermis allograft augmentation states (<em>P</em> < .001). In all outcome measures, the dermis allograft augmentation performed with no statistical difference to the ITB augmentation state.</div></div><div><h3>Conclusions</h3><div>Labral repair and labral augmentation with either ITB allograft or the dermis allograft resulted in significantly lower peak force and work to equilibrium compared with the intact and rim prep states. There was no statistical difference between repair and augmentation states as well as no statistical difference between ITB allograft and dermal allograft at time zero.</div></div><div><h3>Clinical Relevance</h3><div>This study compares biomechanical properties of the suction seal of the hip comparing labral states including intact, rim preparation, repair, and augmentation, which can be used for su","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139687647","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":"Lateral Extra-articular Tenodesis Augmentation of Anterior Cruciate Ligament Reconstruction Is Most Commonly Indicated for Pivot Shift of Grade 2 or Greater and for Revision Anterior Cruciate Ligament Reconstruction","authors":"","doi":"10.1016/j.arthro.2024.01.031","DOIUrl":"10.1016/j.arthro.2024.01.031","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the most common indications for lateral extra-articular tenodesis<span> (LET) augmentation of anterior cruciate ligament reconstruction (ACLR).</span></div></div><div><h3>Methods</h3><div>A systematic review of the literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, Embase, Web of Science, and Cochrane Database of Systematic Reviews from 2000 to the present (June 2022). Studies that met the following criteria were included: patients of any age who underwent LET in addition to ACLR, studies reporting at least 1 indication for LET, and observational/randomized controlled trial study designs including prevalence of indications. Publications had to be reported in English and peer reviewed and to have originated in the United States or countries offering identical protocols and procedures.</div></div><div><h3>Results</h3><div>A total of 463 studies were identified from the initial search, 23 of which met inclusion criteria and were included in the review. Eight of the 23 studies (34.8%) used a modified Lemaire technique, seven (30.4%) used a MacIntosh modified by Arnold-Coker, and eight (34.8%) used other techniques to perform LET. A total of 2,125 patients (53% female, 47% male [3 studies did not report sex]) underwent ACLR augmented with LET. The indications along with prevalence were as follows: positive pivot shift test (grade ≥2) (19 of 23, 82.6%), revision ACLR (12 of 23, 52.2%), ligamentous laxity (11 of 23, 47.8%), general sports participation (11 of 23, 47.8%), age less than 25 years (8 of 23, 34.8%), high risk of graft failure (5 of 23, 21.7%), and positive Lachman test (4 of 23, 17.4%).</div></div><div><h3>Conclusions</h3><div>Pivot shift grade ≥2 was the most common reason orthopaedic surgeons chose to add LET to ACLR, with revision ACLR, patient age &lt;25, and general sports participation following closely behind.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level I-IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708659","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":"Classification Applicability to Special Injuries Such as Oblique Radial Tears, Ramp Lesions, and Posterior-Medial Tibial Rim Fractures","authors":"","doi":"10.1016/j.arthro.2024.06.033","DOIUrl":"10.1016/j.arthro.2024.06.033","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494388","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: Trends in Hip Arthroscopy Require Rapid Dissemination From Higher-Volume and Academic Surgeons to the Greater Orthopaedic Community","authors":"","doi":"10.1016/j.arthro.2024.02.029","DOIUrl":"10.1016/j.arthro.2024.02.029","url":null,"abstract":"<div><div>Trends in hip arthroscopy show that labral repair and preservation, capsular repair and preservation, and treatment of femoroacetabular impingement during hip arthroscopy are associated with superior short-term and mid- to longer-term outcomes. Hip arthroscopy, and in particular arthroscopic femoroacetabular impingement correction, is in its infancy compared with many other orthopaedic procedures. As we assimilate knowledge, data, and evidence-based research, it is critical to evaluate surgical trends and how they affect our management of these patients and pathologies. However, it is important to recognize that there is great variability with regards to surgical volume and awareness of impending evidence-based research for relatively newer procedures such as hip arthroscopy. This can lead to delays for incorporating newer evidence-based techniques. The gap is closing, but the time required to close this disparity in management trends between higher-volume/academic surgeons and the orthopaedic community as a whole could be shorter. Whether this delay for adapting evidence-based trends is consistent across the spectrum of orthopaedic surgery or specific to smaller subspecialty areas such as hip arthroscopy is unclear. Regardless, it is essential that those who are performing the larger volume of cases and research must raise our voices, turn up our loudspeakers, and publish, present, and use social media platforms to spread the word of the latest evidence-based trends quickly! It is equally critical for the greater orthopaedic community to listen for the benefit of patients. If all parties collaborate, we can get up to speed in a timelier manner and achieve the best-possible outcomes together.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051139","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: Multimodal Analgesia for Rotator Cuff Repair Should Be Individualized Based on Surgical Location and Complexity and Patient Comorbidity","authors":"","doi":"10.1016/j.arthro.2024.06.010","DOIUrl":"10.1016/j.arthro.2024.06.010","url":null,"abstract":"<div><div>Multimodal analgesia in arthroscopic rotator cuff surgery is commonly used for pain control and to reduce opioid consumption in the early postoperative time and the days following. Indeed, the combination of local anesthetic peripheral nerve blocks and systemic or oral analgesics ensures a better outcome than the isolated use of nonsteroidal anti-inflammatory drugs. In particular, intrascalene block has significant advantages in more complex procedures involving the anterior aspect of the shoulder. However, intrascalene block should be discouraged under conditions of respiratory comorbidity such as severe chronic obstructive pulmonary disease, obstructive sleep apnea, and morbid obesity. In such cases, a multimodal approach based on periarticular infiltration analgesia combined with pharmacologic therapies can ensure excellent pain control with limited use of opioids in the immediate postoperative period. When selecting the best therapeutic combination, it is essential to consider factors that can determine the best balance between safety and effectiveness, such as the complexity of the surgical procedure, preoperative pain, and any comorbidities that could contraindicate the use of certain medications or that could be negatively affected by potential complications or side effects of the analgesic therapy.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428327","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":"Author Reply to “Classification Applicability to Special Injuries Such as Oblique Radial Tears, Ramp Lesions, and Posterior-Medial Tibial Rim Fractures”","authors":"","doi":"10.1016/j.arthro.2024.06.034","DOIUrl":"10.1016/j.arthro.2024.06.034","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478007","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: Shoulder Minimal Clinically Important Difference and Patient Acceptable Symptomatic State Metrics Provide a Foundation for Interpreting Patient-Reported Outcomes.","authors":"Robert Z Tashjian","doi":"10.1016/j.arthro.2024.09.045","DOIUrl":"10.1016/j.arthro.2024.09.045","url":null,"abstract":"<p><p>Limited data have been previously published on the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) after the treatment of shoulder instability. The MCID and PASS are useful in understanding how well one treatment performs against another and whether the differences in outcomes between treatments are clinically important to patients, supporting either treatment, performing power calculations for clinical studies and trials, and making an assessment as to whether a patient's final clinical state after treatment is reasonable. Anchor-based and distribution methods of MCID calculation have been performed for a variety of patient-reported outcome measures after the treatment of shoulder instability. In general, there is a high degree of variability in the MCID and PASS metrics reported in a relatively limited number of studies. Because of the importance of these metrics in interpreting clinical data, an emphasis should be placed on improved research to further define these metrics, along with others including substantial clinical benefit and maximal outcome improvement, for a variety of different shoulder instability pathologies as well as treatments. Nevertheless, the initial set of MCID and PASS metrics published provides a solid foundation for interpreting patient-reported outcome measures in the treatment of shoulder instability.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333009","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":"How to Contribute to Our Field as an Orthopaedic Sports Medicine Surgeon.","authors":"Paul Gaschen, Matthew J Kraeutler","doi":"10.1016/j.arthro.2024.09.043","DOIUrl":"10.1016/j.arthro.2024.09.043","url":null,"abstract":"","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332999","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: The Ideal Treatment Option for Hip Cartilage Repair Remains Elusive and Requires Consideration of Individual Patient Factors.","authors":"Alexander Zimmerer","doi":"10.1016/j.arthro.2024.09.044","DOIUrl":"10.1016/j.arthro.2024.09.044","url":null,"abstract":"<p><p>Arthroscopic treatment of hip chondral lesions is a challenge. Recent research shows arthroscopic debridement with preservation of the subchondral bone plate shows superior results compared with microfracture. The results of microfracture can be unpredictable, largely because of the formation of fibrocartilage, which lacks the durability of hyaline cartilage. Autologous matrix-induced chondrogenesis has emerged as a promising alternative. This technique combines microfracture or abrasion with the application of a collagen membrane and aims to enhance the quality of the repair tissue. Autologous matrix-induced chondrogenesis not only improves patient-reported outcomes but also decreases the rate of conversion to total hip arthroplasty when compared with microfracture. Yet, the results remain only fair and variable. Autologous chondrocyte implantation, which involves the cultivation and reimplantation of chondrocytes, although more labor-intensive, may lead to a more robust and durable repair. In addition, newer methods like minced cartilage implantation show encouraging early results. We are in the early stages of understanding cartilage repair, and individual patient factors, such as size of the lesion, patient age, activity level, and coexisting conditions all require consideration.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332997","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}