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

{"title":"Editorial Commentary: Pain Relief Following a Preoperative Diagnostic Hip Injection Does Not Predict 2-Year Outcomes After Hip Arthroscopy for Femoral Acetabular Impingement Syndrome.","authors":"Robert Kollmorgen","doi":"10.1016/j.arthro.2024.09.037","DOIUrl":"10.1016/j.arthro.2024.09.037","url":null,"abstract":"<p><p>For decades, hip preservationists have utilized intra-articular preoperative injections for diagnostic and therapeutic reasons. In the presence of typical or atypical hip pain, impingement, instability, and torsional abnormalities, hip preservationists are challenged with consistently educating ourselves and patients on interventions that can predict long-term relief. Current evidence on the predictive postoperative value of a positive injection response is mixed. Injection results can show whether the patient's symptoms are coming from the hip and to what extent, but they may not predict future outcomes. The patient is more complicated than a positive or negative injection response, and the decision for surgery should be taken in context to all clinical factors, imaging findings, and patient expectations. Proper rehabilitation is also vital. Finally, a negative injection response in a patient diagnosed with femoral acetabular impingement syndrome should not deter the decision for surgery. With the correct diagnosis and procedure, patients can do well.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332996","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 Shoulder Simulation May Improve Short-Term Speed, Accuracy, and Efficiency of Surgical Movements in Orthopaedic Residents and Fellows: A Systematic Review.","authors":"Emma M Eng, Justin T Childers, Benjamin T Lack, Christopher W Haff, Edwin Mouhawasse, Garrett R Jackson, Vani J Sabesan","doi":"10.1016/j.arthro.2024.09.027","DOIUrl":"10.1016/j.arthro.2024.09.027","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the effectiveness and validity of orthopaedic surgery training using simulation technologies including augmented reality, virtual reality, and/or mixed reality within arthroscopic shoulder surgery.</p><p><strong>Methods: </strong>A literature search was conducted of the EMBASE and PubMed databases from inception to January 2024 per the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Included studies described arthroscopic shoulder surgery simulation training among orthopaedic surgery trainees. Exclusion criteria included studies assessing nonarthroscopic and nonshoulder simulations, non-English-language studies, case reports, animal studies, studies with overlapping cohorts, and review articles. Simulation characteristics, performance measurements, and validity assessed were extracted. The Cochrane risk-of-bias tool and Newcastle-Ottawa Scale assessed study quality. Simulation type, validation type, and simulation outcomes were assessed.</p><p><strong>Results: </strong>A total of 15 included articles, published from 2011 to 2021, evaluated 421 residents or fellows and 17 medical students. Virtual reality was used in 40% of studies and mixed reality in 60%. The most common outcomes assessed were time to completion (80%), visualizing and probing task performance (60%), and the Arthroscopic Surgery Skill Evaluation Tool (33.3%). Construct validity was assessed in 46.7% of studies, transfer validity in 26.7%, face validity in 20%, and content validity in 6.7%. Three studies demonstrated improved performance in those undergoing simulation training compared with nonsimulation groups. Two studies (13.3%) demonstrated improved time-to-task completion and decreased camera distance traveled when using simulation training. One study demonstrated that postgraduate year 1 and postgraduate year 5 residents derived the greatest benefit from simulation training.</p><p><strong>Conclusions: </strong>Arthroscopic shoulder simulation training may benefit the surgical skills of orthopaedic residents of all levels of experience as measured by time-to-completion, accuracy, and efficiency of surgical movements. Simulation training exhibits differences in operative time between more- and less-experienced orthopaedic surgeons and trainees. Virtual reality simulation training may result in more-efficient orthopaedic surgical techniques.</p><p><strong>Level of evidence: </strong>Level III, systematic review of level I-III studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332991","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: Machine Learning and Artificial Intelligence Are Valuable Tools yet Dependent on the Data Input.","authors":"Laurie A Hiemstra","doi":"10.1016/j.arthro.2024.09.030","DOIUrl":"10.1016/j.arthro.2024.09.030","url":null,"abstract":"<p><p>Machine learning is likely to become one of the most valuable tools for predicting outcomes in patients with patellofemoral instability. Traditional statistical analysis is challenging in this diagnosis as the result of the multitude of risk factors. However, 3 important cautions must be considered. (1) Machine learning is limited by the quality of the data entered. Many of the risk factors for patellofemoral instability rely on classification systems with significant interexaminer variability and patient-reported outcomes used to track changes contain inherent biases, especially with regard to race and gender. Poor data quality will lead to unreliable predictions, or \"garbage in equals garbage out.\" (2) The optimal machine-learning algorithms for addressing specific clinical questions remain uncertain. (3) The question of how much data we really need for accurate analysis is unresolved, which again, is completely dependent on the quality of the data. Machine learning is the future; just beware of what goes into the chicken salad.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333003","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: Meniscal Posterior Root to Bone Postoperative Healing Appears Incomplete at 24 Weeks in a Goat Model.","authors":"Jessica R Stambaugh, Reinaldo Colon-Morillo, L Alejandro Culebras Almeida, Farah Selman, Nicholas P J Perry","doi":"10.1016/j.arthro.2024.09.036","DOIUrl":"10.1016/j.arthro.2024.09.036","url":null,"abstract":"<p><p>The goal of many orthopaedic surgeries is to mechanically stabilize the tissue long enough for biological healing to occur. The healed tissue should be able to bear the load before the mechanical device (screw, suture, anchor, etc.) eventually fails. Recent research shows that in a goat model, meniscus posterior root repair to bone is not fully healed at 24 weeks postoperatively (after the suture is removed and under biomechanical and histologic testing). In addition, magnetic resonance imaging at 24 months postoperatively showed persistent meniscal extrusion but only under mechanical loading. Of course, in clinical practice, repair sutures are not removed and continue to provide mechanical stability until they either fail, the tissue-suture interface fails, or the meniscus root is healed enough to resist the load. Nevertheless, we need to be mindful of time to healing, weightbearing, and return to activity in human patients.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333004","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":"The Fibular Collateral Ligament Is a More Important Restraint to Varus Laxity Compared to the Anterolateral Complex in the Anterior Cruciate Ligament-Deficient Knee in a Cadaveric Biomechanical Study.","authors":"Andrew G Geeslin, Luke V Tollefson, Erik L Slette, Evan P Shoemaker, Mitchell Carlson, Robert F LaPrade, Lars Engebretsen, Gilbert Moatshe","doi":"10.1016/j.arthro.2024.09.025","DOIUrl":"10.1016/j.arthro.2024.09.025","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the influence of the fibular collateral ligament (FCL) and the anterolateral complex (ALC) on varus knee laxity in paired anterior cruciate ligament (ACL)-deficient cadaveric knees using varus stress radiographs.</p><p><strong>Methods: </strong>Varus laxity in 9 paired (N = 18, mean age 73.8 years) human cadaveric knees was assessed using varus stress radiographs with a 12-Nm varus stress applied at 20° of knee flexion. All knees underwent testing in the intact state and following ACL sectioning. One knee of each pair was randomly assigned to undergo FCL sectioning, and the contralateral knee was assigned to undergo ALC sectioning (anterolateral ligament [ALL] followed by the Kaplan fibers).</p><p><strong>Results: </strong>Both FCL sectioning and ALC (ALL and the Kaplan fibers) sectioning resulted in increased lateral compartment gapping compared to the intact state, 2.44 mm and 1.13 mm, respectively. ALL sectioning with intact Kaplan fibers did not result in increased lateral compartment gapping. Paired knee comparison revealed a significantly greater influence of the FCL than the ALC in restraining lateral compartment gapping under an applied varus stress (P = .0003).</p><p><strong>Conclusions: </strong>Sectioning the FCL resulted in significantly greater lateral compartment gapping under a varus stress than combined sectioning of the ALL and Kaplan fibers in an ACL-deficient knee, although both scenarios resulted in significantly increased gapping compared to the intact state. Sectioning of the ALL with intact Kaplan fibers did not result in increased lateral compartment gapping.</p><p><strong>Clinical relevance: </strong>The FCL is the most important structure in restraining varus laxity in the ACL-deficient knee, and the ALC is of secondary importance in restraining varus laxity. In ACL-deficient patients with a high-grade pivot shift, mild varus laxity on clinical examination, and an intact FCL on magnetic resonance imaging, injury to the anterolateral complex should be considered and may be evaluated with varus stress radiographs. This study validates prior biomechanical studies of FCL deficiency and demonstrates that an approximately 1-mm increase in lateral compartment gapping on varus stress radiographs may occur secondary to ALC injury, and clinicians should be aware of this when considering treatment for ACL-deficient patients with high-grade anterolateral laxity.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333012","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":"Reoperation Rates of Meniscal Repair Are Associated With a Higher Reoperation Rate Than Meniscectomy in Patients Aged 40 and Older.","authors":"Arjun N Choudhary, Richard Puzzitiello, Matthew Salzler, David Freccero","doi":"10.1016/j.arthro.2024.09.022","DOIUrl":"10.1016/j.arthro.2024.09.022","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the long-term reoperation rates of meniscectomy and meniscal repair and to determine patient and surgical factors associated with earlier reoperation among patients ≥40 years.</p><p><strong>Methods: </strong>A retrospective study was conducted using the IBM MarketScan Commercial Claims and Encounters Database from January 1, 2006, through December 31, 2020. Patients 40 and older who received a meniscectomy or a meniscal repair with a minimum 1-year follow-up were included. The primary outcome was ipsilateral knee reoperation during the study period. Kaplan-Meier survival curves were used to determine differences in reoperation rates for meniscal repair and meniscectomy over time. Multivariable Cox regression analysis was performed to identify factors associated with earlier time to reoperation.</p><p><strong>Results: </strong>A total of 3,026 patients (2,367 meniscectomy, 659 meniscal repair) were included. Mean follow-up was 14.5 ± 0.29 years (range, 1.0-14.91 years). There were no significant differences in baseline demographic characteristics of follow-up between the 2 groups. The survival curves of the 2 procedures significantly differed (P = .02), and the overall reoperation rate was higher after meniscal repair than meniscectomy (13.5% vs 10.1%, P = .01). However, the incidence of subsequent ipsilateral meniscectomy, meniscal repair, and knee arthroplasty procedures did not significantly differ. Multivariable Cox regression analysis identified meniscal repair, obesity, concomitant anterior cruciate ligament reconstruction, and increasing age as being significant risks for earlier reoperation, and male sex was protective.</p><p><strong>Conclusions: </strong>In a population of patients aged ≥40 with surgically treated meniscal tears and 14.5-year average follow-up, meniscal repair was associated with higher overall reoperation with shorter survival times compared to meniscectomy. However, the indications for the 2 procedures likely differed. Additionally, obesity, older age, female sex, and concomitant anterior cruciate ligament reconstruction were risk factors for earlier reoperation.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333008","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":"Editor's Reply: Meta-analysis of Nonrandomized Controlled Trials is Rarely Justified: Systematic Reviews Must Avoid Improper Pooling.","authors":"James H Lubowitz","doi":"10.1016/j.arthro.2024.09.039","DOIUrl":"https://doi.org/10.1016/j.arthro.2024.09.039","url":null,"abstract":"<p><p>Systematic reviews of the literature, as compared with original scientific articles, are the easiest types of studies to perform, and using contemporary meta-analysis software, a press of a button yields a \"pooled, weighted mean\" (averaging the outcomes of the included articles and adjusting for sample size). The results seem conclusive. However, if included studies are not homogeneous and/or of lower quality (high risk of bias), which is typical of nonrandomized trials, combination in a meta-analysis is not recommended, and quantitative pooling of nonrandomized studies is improper. In addition, by exploring heterogeneity (clinical and methodological differences) between studies included in a systematic review, we discover and reveal reasons for the differences in outcomes among studies. This allows us to more accurately inform individual patient care and future research.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332998","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: Quadrupled Semitendinosus Autograft Is a Suitable Graft Choice for Anterior Cruciate Reconstruction, Regardless of Diameter, in Patients With Lower Risk for Rerupture.","authors":"Timothy J Lin","doi":"10.1016/j.arthro.2024.09.031","DOIUrl":"10.1016/j.arthro.2024.09.031","url":null,"abstract":"<p><p>Multiple options exist for anterior cruciate ligament reconstruction autografts, including bone-patellar tendon-bone, quadriceps tendon, and hamstring tendon (HT). A variant among HT options is quadrupled semitendinosus autograft. In addition, smaller graft diameter (<8 mm) has been associated with failure of HT anterior cruciate ligament reconstruction. However, recent research shows that quadrupled semitendinosus autograft diameters <8 mm are not correlated with a higher rerupture rate in older patients. While among individuals with a lower risk of rerupture, graft diameter does not significantly alter graft rupture rates, and a smaller-diameter soft tissue graft is safe to use in the low-risk population, caution is required when applying this dogma to patients who are younger than 21 years or play higher-risk sports. In such patients, a reliable option is bone-patellar tendon-bone autograft and/or adding a secondary stabilizing procedure such as anterolateral ligament reconstruction or lateral extra-articular tenodesis. Finally, recent research shows there is little utility in trying to predict graft size prior to surgery.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333007","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":"Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears Yields Good Clinical Outcomes for Patients With and Without Diabetes Mellitus.","authors":"Akihiro Uchida, Teruhisa Mihata, Akihiko Hasegawa, Yusuke Noguchi, Masashi Neo","doi":"10.1016/j.arthro.2024.09.024","DOIUrl":"10.1016/j.arthro.2024.09.024","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes after superior capsule reconstruction (SCR) for irreparable rotator cuff tears (RCTs) in patients with and without diabetes mellitus (DM).</p><p><strong>Methods: </strong>Patients who underwent SCR using fascia lata autograft for irreparable RCTs between 2012 and 2020 with a minimum 2-year follow-up were divided into non-DM and DM groups. Propensity score matching was used to select controls matched for patients' characteristics. Only patients with glycosylated hemoglobin <8% were eligible. The visual analog scale for shoulder pain, American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores, and acromiohumeral distance were evaluated preoperatively and at 2 years postoperatively. Shoulder active range of motion (ROM) was evaluated preoperatively and at 6 months, 1 year, and 2 years postoperatively. Graft integrity and postoperative complications that required additional surgery were evaluated. The Wilcoxon signed-rank test and Mann-Whitney U test were used to compare continuous variables. Pearson χ² test and Fisher exact test were used for categorical variables. The interaction between the postoperative period and ROM was analyzed by the Friedman test and Wilcoxon rank-sum test with the Holm-Sidak post hoc test.</p><p><strong>Results: </strong>We studied 154 patients (non-DM, 130; DM, 24) who underwent SCR. After matching, 21 patients were selected in each group. All clinical outcomes significantly improved at 2 years (all P < .05) in both groups. We found no significant differences in clinical outcomes and rates of patients who achieved minimal clinically important differences in visual analog scale and American Shoulder and Elbow Surgeons scores between the groups (P = .10 to ≥.999). The rates of graft tear (both 9.5%) and complications (non-DM, 4.8%; DM, 0%) were not significantly different (both P ≥ .999).</p><p><strong>Conclusions: </strong>SCR using fascia lata autograft for irreparable RCTs yields good clinical outcomes, including ROM, in patients with and without DM. No significant differences in postoperative outcomes were observed between the 2 groups.</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":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333010","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":"M2 Macrophage-Derived Exosomes Promote Tendon-to-Bone Healing by Alleviating Cellular Senescence in Aged Rats.","authors":"Zhuochang Cai, Longqiang Shu, Chongyang Wang, Xuetao Xie, Xudong Liu","doi":"10.1016/j.arthro.2024.09.021","DOIUrl":"10.1016/j.arthro.2024.09.021","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the potential of M2 macrophage-derived exosomes (M2-Exos) in enhancing tendon-to-bone healing in aged rats by mitigating cellular senescence of bone marrow-derived stem cells (BMSCs).</p><p><strong>Methods: </strong>In vitro, the effects of M2-Exos on alleviating cellular senescence and improving chondrogenic potential of senescent BMSCs were evaluated. Rats (24 young and 48 aged) with chronic rotator cuff tear (RCT) were repaired and assigned into 3 groups: young group (young rats injected with fibrin at the enthesis), aged group (aged rats injected with fibrin at the enthesis), and aged + M2-Exos group (aged rats injected with fibrin containing M2-Exos at the enthesis). At 6 and 12 weeks after repair, enthesis regeneration was evaluated. Proteomic analysis was conducted to explore the mechanism through which M2-Exos mitigated cellular senescence.</p><p><strong>Results: </strong>In senescent BMSCs treated with M2-Exos, there was a reduction in senescence biomarkers including senescence-associated β-galactosidase, p53, p21, and senescence-associated secretory phenotype (P < .001). M2-Exos also enhanced chondrogenic potential of senescent BMSCs, reflected in greater Bern score (P < .001) and increased expression of Sox9 (P = .013), Col2a1 (P < .001), and Acan (P < .001). Histologically, aged rats treated with M2-Exos demonstrated significantly greater histologic scores (P < .001 at both 6 and 12 weeks) and increased fibrocartilage regeneration at the enthesis. Biomechanically, these rats exhibited greater failure load, stiffness, and stress (all P < .001) at 12 weeks. Mechanistically, proteomic analysis suggested that M2-Exos might alleviate cellular senescence by potentially regulating DNA replication and repair.</p><p><strong>Conclusions: </strong>M2-Exos can significantly alleviate BMSC senescence and thereby enhance tendon-to-bone healing in an aged rat RCT model.</p><p><strong>Clinical relevance: </strong>This study suggests the potential utility of M2-Exos as a therapy for RCT in the older population.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333002","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}